Poorer Children More Likely To Get Antipsychotics

krou writes "A new study by a team from Rutgers and Columbia has discovered that poorer children are more likely to be given powerful antipsychotic drugs. According to the NY Times (login required), 'children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance. And the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts.' It raises the question: 'Do too many children from poor families receive powerful psychiatric drugs not because they actually need them — but because it is deemed the most efficient and cost-effective way to control problems that may be handled much differently for middle-class children?' Two possible explanations are offered: 'insurance reimbursements, as Medicaid often pays much less for counseling and therapy than private insurers do,' and because of 'the challenges that families in poverty may have in consistently attending counseling or therapy sessions, even when such help is available.' The study is due to be published next year in the journal Health Affairs." The full article is available behind a paywall from the first link. The lead author of the study said he "did not have clear evidence to form an opinion on whether or not children on Medicaid were being overtreated."

Brave New World

[Torodung]

Take your soma and like it, kids.

Deeply troubling, but not unexpected.

--
Toro

Parent pushback

[andy1307]

Could it be because middle class parents are more likely to push back against drug recommendations?

Re:The short answer...

[MindlessAutomata]

From each according to his ability, to each according to how valuable he is to others.

Confounding Variables

[TheMeuge]

I deeply despise these kinds of articles for the joke they make of statistical correlation.

I think they could all come with a giant "Correlation!=Causation" red box warning.

On one hand, maybe the poor kids are getting over-medicated by a government/drug company/new world order rich person conspiracy.
On the other, maybe it just so happens that more of the poor tend to have psychological problems, which would explain their (and their children's) difficulties in progressing up within the society.
Or the environment endured by the children of the poor would tend to be more damaging than the safe and comfortable environment that the children of the wealthy enjoy.

Without much more data, and without very careful prospective analysis, these "correlation" articles are little more than curiously interesting FUD.

However, since they tend to be part of the outrage machine, I think we ought to hold the writers personally responsible for the reactions that ensue.

Re:Brave New World

[pwizard2]

Physical discipline is assault

Is it? Physical discipline can be a problem if you take it too far of course, but I was raised with a bit of corporal punishment and looking back I believe that it did me good. It definitely let me know when I was in the wrong and it did no real sort of damage. My parents never took pleasure in doing it and I can honestly say that each time it happened I really had it coming. In my day kids would never act like they do now. Parents have to do their damn job and set boundaries until their kids are old enough to think for themselves.

You can't reason with children like you would with an adult simply because children are NOT adults and do not have mature thought processes yet. Left to their own devices, they will do whatever they want in the immediate moment with no thought of consequences. I've lost track of the times I've seen parents who cannot control their own children AT ALL in public. The kids know that any threat their parent hands down is empty and will eventually be rescinded or go completely unenforced, so the kid has figured out that he is free to act however he wants.

Re:Brave New World

[bertoelcon]

Physical discipline is assault,

I don't know why people think that. I guess physical discipline could be assault at an extreme but forcing someone to take a bunch of pills that have worse side effects than the original problems. I have been on the receiving end of a belt and taking prescribed pills, but the belt felt like a real consequence for doing something because the pills were just "change the dosage/med" because whatever I had before didn't work.

Re:Perhaps

[MindlessAutomata]

Usually, it's a "small government conspiracy!" angle, because a lack of government involvement is usually seen as the problem.

Re:None of the Above

[wizardforce]

Part of the problem may be the parents themselves seeking a quick fix for behavioral problems rather than proper treatment. Combine that with the stress encountered by those who are poor and it shouldn't be surprising that the rates of treatment with antipsychotics is as high as it is in poor families on Medicare. The various side effects from the class of drugs themselves depends largely on the dose. Higher doses tend to cause more harm than good; some of them being rather nasty... The only reason I know about the class of drugs has to do with the fact taht my ex-girlfriend was on Risperidone which is an atypical antipsychotic drug. She was started on the drug when she was si and only very recently actually got treatment for her issues that went beyond the drug its self. FRom knowing her as long as I did, it became very apparent that the reason she was on the drug had much more to do with her parents than sound mental health treatment. Her issues went way beyond what the drug was designed to treat and it was largely ignored for years. Sadly, I don't think she's alone.

Re:The short answer...

[ZeroExistenZ]

If they are so poor, why are they having children? Real question. A condom is a hell of a lot cheaper than a child, so you'd think it would be more popular among those who are in poverty.

If they have to choose to buy a family-pack of condoms now or get a few drinks and get laid now, they'd pick the latter ;)

I believe this might be a problem in certain demographies, where it's hard to make an extrapolation and weigh off short-term profit and long-term profit. The "instant gratification" seems much more appealing in a hopless situation, where you feel there is no tomorrow to live for.

rich v's poor

[naeone]

if you are rich and mad you are classed as an excentric, and if your poor and mad well you just plain mad

Re:Bi-Polar at Three?

[Lord Kano]

Okay, I understand that it's possible for three-year-olds to be bipolar, but how on Earth do you reliably test for that?

If they diagnosed a three year old child as bipolar, I can just about guarantee you that it was patently obvious to anyone that the kid had some kind of problem. I don't work in that field, but I have friends and loved ones who have had to deal with mental illness. I suppose that it's possible that this kid just happened to run into a quack, but it's more likely that he was violent with others and possibly even himself. Lawsuit potential is so high if they misdiagnose a child that young, that I'd be willing to bet that the doctor that prescribed this medication consulted many other doctors first.

LK

Re:Confounding Variables

[timmarhy]

you just gave me a new catch phrase for a phenomenon that I previously didn't have a name for - "The outrage machine" the modern media's obsession with everything being either a crisis, save the children or save the planet.

Drug Lobbies?

[Bob9113]

Two possible explanations are offered: 'insurance reimbursements, as Medicaid often pays much less for counseling and therapy than private insurers do', and because of 'the challenges that families in poverty may have in consistently attending counseling or therapy sessions, even when such help is available'.

Interesting explanations, but they ignore the economics and politics of the issue. Medicaid is heavily influenced by politicians. Politicians are heavily influenced by lobbies. Lobbying money flows very heavily from drug companies.

Run it backwards: Lobbying money flows heavily from drug companies. Politicians are heavily influenced by drug companies. Medicaid is heavily influenced by drug companies.

There are almost certainly other significant factors at play, but to ignore the influence of drug pushers on our government is stunningly short-sighted.

Also consider the health care bill: They've removed the public option and kept the new law requiring people to buy health insurance. Who are they working for? I want everyone to have access to health care. This story, however, is a stark example of the risks of channeling public funds to corporations, and of channeling corporate profits to policy-makers. That is a self-reinforcing system that will destroy us.

Re:Brave New World

[TubeSteak]

Parents have to do their damn job and set boundaries until their kids are old enough to think for themselves.

I'd like to second this.
Generally speaking, children are not puppies that can be trained solely by relying on rewards for good behavior.
You don't necessarily have to use corporal punishment, but you absolutely have to provide meaningful consequences.

Re:Parent pushback

[TubeSteak]

There are many explanations, none of them happy-making:

5. Families in poverty may have problems with consistently attending counseling or therapy sessions

If you know a doctor that accepts Medicaid patients, ask them about trying to schedule those patients.
It's a pain in the ass to schedule a kid whose parent(s) work two jobs and have to take a taxi to reach the Dr.

Re:Herein lies the answer

[Surt]

I fail to see how the rise in autism rates can justly be attributed to parenting skills. It may not be the vaccines, but it's almost certainly not the parents either.

Re:Perhaps

[fuzzyfuzzyfungus]

Compared to classic Mendelian stuff like Huntington's disease, the heritability of most psychological disorders is fairly modest, and the exact genetic basis rather obscure; but there is a substantial body of evidence that it isn't zero(for a fair number of conditions).

Further, there is a fair amount of evidence that early life stresses(and even prenatal exposure to maternal stress) can have a number of permanent effects, most of them not good, on individuals.

And, of course, your risk of eating lead-paint chips, or living next to some sort of exciting toxin smelter as a child is pretty strongly correlated with class.

You could see this as ammunition for a second round of the eugenics movement(as well as something for would-be parents with these conditions to think very seriously about). However, I'd say that the new data probably represent more of a boon to progressive than to reactionary views of poverty.

If poverty looks like a more or less intractable problem, caused by the psychological defects of the poor, progressive programs are difficult to justify on other than grounds of moral duty. If, however, one can identify specific things "research shows that high serum lead levels correlate with high rates of criminality, even after correcting for demographic variables", it becomes rather easier to propose progressive programs that both satisfy the moralists and promise some results "If we conduct lead remediation of a given housing stock, along with population sampling and treatment of highly contaminated cases, we should see a reduction in criminality in a decade or so".

Ultimately, though, the use to which this idea will be put is almost irrelevant to the idea itself. There are a variety of techniques for assessing the heritability of a condition. If those techniques indicate that the condition is heritable, there you are. Full Stop. There is no step that involves checking whether or not it would be morally desirable for this to be true.

Re:Perhaps

[Ironsides]

I'm pretty sure a "sub class of humans" isn't what the OP meant. However, several mental diseases such as bi-polar and alzheimer's do have genetic causes and run in families. Sad, but true. Similarly, these diseases make it more difficult to succeed, not impossible, just something that raises the bar. This would be more along this lines of those who have mental diseases are more likely to be poor, which would be interesting to study.

Re:Bi-Polar at Three?

[Anonymous Coward]

The same way you diagnose a first grade boy with ADD or ADHD. Generally through complete ignorance on the part of the person who suggests it. In first grade, my teacher thought I had ADD. The only problem was I was bored in class. This country is over medicated. I say that as someone who has been properly (suicidal) and improperly (ADD/ADHD) diagnosed with mental problems before. We need to get people to understand there is no magic pill. From the article, I'll quote the following:

Too often, Dr. Suite said, he sees young Medicaid patients to whom other doctors have given antipsychotics that the patients do not seem to need. Recently, for example, he met with a 15-year-old girl. She had stopped taking the antipsychotic medication that had been prescribed for her after a single examination, paid for by Medicaid, at a clinic where she received a diagnosis of bipolar disorder.
Why did she stop? Dr. Suite asked. “I can control my moods,” the girl said softly.
After evaluating her, Dr. Suite decided she was right. The girl had arguments with her mother and stepfather and some insomnia. But she was a good student and certainly not bipolar, in Dr. Suite’s opinion.
“Normal teenager,” Dr. Suite said, nodding. “No scrips for you.”

This is probably most of what is going on.

Re:The short answer...

[Anonymous Coward]

"If they are so poor, why are they having children? Real question. A condom is a hell of a lot cheaper than a child, so you'd think it would be more popular among those who are in poverty".

...

"If they have to choose to buy a family-pack of condoms now or get a few drinks and get laid now, they'd pick the latter".

It's not just the instant gratification aspect that leads the poor to have sex without condoms and become pregnant. The poor are also more likely to be uneducated, so they won't understand how to prevent pregnancy, or that bringing a child into the world while being surrounded by poverty isn't exactly ideal. They are unaware of the long term impact that being a parent will have on their lives so having a kid isn't that big of a deal to them initially. Some poor and uneducated look at children as one of the few things in society that they can accomplish on their own. So they actively have children even though they cannot sufficiently raise them to become adequate or productive members of society.

They, the poor and young, also might be without any supervision. If you have a young child, say a teenager, that is sexually active with zero parental supervision and zero guidance from her school, the odds of her getting pregnant are significant. So you'll have a young girl lacking in parental supervision getting pregnant. And her child will probably have little supervision as well. It's a cycle of poverty.

So we have poor, uneducated, unsupervised, sexually active individuals, with no practical access or training to use birth control. Guess what the results are?

What we need is community outreach programs to prevent pregnancy. Distribute condoms at schools, churches, or even door to door, and post pamphlets near any places that children congregate. Have teachers educate kids at an early age. Have teachers also educate the parents.

Re:Brave New World

[FlyMysticalDJ]

I disagree. I think you'll find that if you sit down with a child and talk to them, you'll find that they do understand a lot more than you give them credit for. And yes, they want what they want, they're scheming and will find whatever ways to break whatever rules and escape punishments. The point is don't let them escape. The only reason people find corporal punishment to be more effective is because they don't have the patience to sit down with a child, or make the sit and think it out without going off and not making sure the punishment is being executed in full. The only reason corporal punishment is so effective is because lazy parents can hit their kid, and that kid will feel the sting of it long after the parent has stopped talking to them about it.

Re:The short answer...

[Foobar of Borg]

What we need is community outreach programs to prevent pregnancy. Distribute condoms at schools, churches, or even door to door, and post pamphlets near any places that children congregate. Have teachers educate kids at an early age. Have teachers also educate the parents.

If you try that, the fundies will be up in arms (in some cases, literally). "You're trying to turn my daughter into a slut!" "She already is a slut, we just don't want her to be a knocked-up slut!" [blam!] "That's how you answer a heathen condom distributor! Hells yeahs!"

Re:Brave New World

[sjames]

Not really. Excessive physical discipline or "discipline" given in anger is assault, but a quick smack on the butt is not.

Pumping the kid full of drugs that damage the brain, shut down higher reasoning, and make them feel too doped up to move, much less misbehave is an assault.

Re:Confounding Variables

[AK Marc]

I've never seen someone use "correlation isn't causation" who understood what that means. They use it as "I don't like the implications" as opposed to "I understand what they said, I agree that they have valid methodology and the conclusion (that poorer children get different care) is correct, but I believe that there is some other cause." Poor children appear to get worse care. Is it that they got the appropriate care, but that diseases are sufficiently different across income lines (in which case it should be "being poor causes mental illness"), is it that the poor parents are more likely mentally ill with some genetic disease, or is it that the care given by public insurance differs from private insurance? Or is there something else out there you think it could be? There are only a very short list, if you concede the study is valid.

Without much more data, and without very careful prospective analysis, these "correlation" articles are little more than curiously interesting FUD.

In general, these are repeated by others. When found valid, they are then examined for confounds. If you have a correlation and all confounds corrected, you do have a case where correlation = causation. In nearly all cases I've seen with a valid study, correlation = causation (but is usually not just one factor, such as there being a real difference in the rate of genetic mental illness between those on private and public insurance, and the differences in insurance causing a real difference in treatments as well).

However, since they tend to be part of the outrage machine, I think we ought to hold the writers personally responsible for the reactions that ensue.

So you don't even care if they are right, you want to hold them "responsible" for the reactions? Where did the truth go? You aren't looking for it. You are assuming a study is wrong because you don't like its results, then already looking for the lynch mob for those that point out problems with our system. That's just nuts. Why not have firing squads for people that submit articles to scientific publications. We'll appoint you head, and if you know that the article has to be wrong, then you just shoot the submitters and be done with it. It's easier that having all that science hit the streets with people who can't understand it like you do.

There has never been a study that shows smoking causes cancer. In fact, there have been pretty much no studies done that show anything causes cancer in humans. We don't know if asbestos causes Mesothelioma. We just have some correlations, and we know those are always wrong and done by those trying to pervert science. I guess you were with the tobacco CEOs when they got up in front of Congress relatively recently (long after the warnings went on the packs) and stated that they do not believe that smoking is harmful? After all, it's never been proven. Just a couple correlational studies, and we know that if you find a correlation, it means there can't be a causational link. Right?

Now excuse me, I have to go smoke because a cigarette a day keeps the doctor away. Or so the tobacco industry tells us, and no study has ever proven them wrong.

Re:Brave New World

[sznupi]

Apply some of the things you write to concept you're defending.

Yes, you can't reason with children in the same way, there's no mature thinking about action-consequences, they live in the moment, especially in a case of "intense" circumstances

So...in the moment of corporal punishment it is all that matters. Not what "caused" it, but the fact that they are being harmed by the most important people in their world.

It's better to exploit that last bit, refusing the comfort the presence of parent gives (just so it clear you're upset, but more in a sad then angry way; and be distanced for some time)

Re:Information outside of your expertise is danger

[Trepidity]

I wouldn't get too strong into claims about what it's "amazingly effective" for. As you point out, Abilify is prescribed for a lot of things, and the vast majority of them are "off-label" uses for which there has been no real demonstration of effectiveness.

Getting a drug approved in the first place requires a fairly rigorous process of double-blind, peer-reviewed studies. But once it's approved for a particular use, there is no similar level of rigorous screening before it can be prescribed off-label for other, unapproved uses.

Re:Brave New World

[williamhb]

Is it? Physical discipline can be a problem if you take it too far of course, but I was raised with a bit of corporal punishment and looking back I believe that it did me good. It definitely let me know when I was in the wrong and it did no real sort of damage. My parents never took pleasure in doing it and I can honestly say that each time it happened I really had it coming. In my day kids would never act like they do now. Parents have to do their damn job and set boundaries until their kids are old enough to think for themselves.

This is a furphy. "Set boundaries" != "corporal punishment".

Ok -- a disclaimer. I don't want to specifically criticise your parents (I do not know them and do know what extent of physical punishment they used, and in any case they are your parents not mine). However, reading your post as "general advice", I think it is potentially bad advice.

"Did no real sort of damage" is a very vague claim, often used by parents to excuse violence. In reality, it is not the physical harm that is of primary concern -- from personal experience of undergoing physical punishment as a child, yes the bruises really do heal. What is harder to heal is the relationship between the parent and the child. Like it or not, children are fed a rich diet of "violence is not the way to solve your problems" messages from every role model outside the family -- school, government, police, etc. If your child, meanwhile, sees you trying to solve every behavioral problem with violence, you've got a problem. If your child really doesn't "think for himself" you might get away with it, but most smart children will connect the dots and think less of you as a parent for using violence to solve your problems. Suddenly you have a genuine reason for the child not to respect you; they are not merely disobeying you, they believe your actions are morally wrong. You are still their parent, so the child will go to great lengths to forgive you, but nonetheless you've got a recipe for a problematic relationship. In the extreme, they may even feel compelled to disobey you on the moral principle of not giving in to violence.

You can't reason with children like you would with an adult simply because children are NOT adults and do not have mature thought processes yet. Left to their own devices, they will do whatever they want in the immediate moment with no thought of consequences.

Children's thought processes are actually very sophisticated from a very young age. They do not push the boundaries mindlessly -- they do it with deliberate intent. Firstly of establishing what they can and cannot get away with (can I change Daddy's mind by persisting?) and secondly because it captures your attention (if you are disciplining your child, you are paying attention to them). Under-attended children will muck up just to get your attention; and if discipline is the only kind of attention they get, they'll ensure they need plenty of discipline. Far from "no thought of the consequences", those behaviours are very mindful of the consequences -- it's just not the same consequence that you were thinking of. This is where positive parenting programmes [triplep.net] have had a great deal of success -- by rewarding positive behaviours with attention rather than rewarding negative behaviours with attention.

Re:Herein lies the answer

[TapeCutter]

I think your missing the point because you are putting words into the GP's mouth that are simply not there. - "not my fault" may be true but the urge to blame comes up with "it's the vaccines" rather than random bad luck/genes/whatever. You demonstrated this nicely by projecting your own urge to blame onto the GP and came up with "he is blaming the parents".

My own urge to blame says the "rise in autisim" is more likely a statistical artifact atributable to better diagnosis of the people that doctors diagnosed as "retards" in the not to distant past.

Re:Confounding Variables

[TheMeuge]

I've never seen someone use "correlation isn't causation" who understood what that means.

And what makes you so qualified?

In general, these are repeated by others. When found valid, they are then examined for confounds. If you have a correlation and all confounds corrected, you do have a case where correlation = causation. ...In nearly all cases I've seen with a valid study, correlation = causation...

That's so deeply wrong, it's not even funny.

Firstly, AFAIK correlation can NEVER show causation mathematically.

Even in a perfect 2-variable system, with a correlation of 1.0, one cannot assume causality from correlation because the direction of causality cannot be deduced from the correlation.

Secondly, there are countless instances where correlation has no causative relationship at all. For a simple explanation, consider the correlation of a chair and a table being in the same room. Now consider their causative relationship.

It's easy to prove a lack of causation. Proving a causative relationship statistically beyond a reasonable doubt is extremely difficult.

There has never been a study that shows smoking causes cancer. In fact, there have been pretty much no studies done that show anything causes cancer in humans.

It's hard to even consider responding to this nonsense. Of course there hasn't been a study that shows that smoking causes cancer. Except there's been ten million studies that examine individual components of the mechanism of how smoking causes cancer which complement the PROSPECTIVE statistical studies regarding the correlation between smoking and cancer.

We don't know if asbestos causes Mesothelioma. We just have some correlations, and we know those are always wrong and done by those trying to pervert science.

    I guess you were with the tobacco CEOs when they got up in front of Congress relatively recently (long after the warnings went on the packs) and stated that they do not believe that smoking is harmful? After all, it's never been proven. Just a couple correlational studies, and we know that if you find a correlation, it means there can't be a causational link. Right?

Now excuse me, I have to go smoke because a cigarette a day keeps the doctor away. Or so the tobacco industry tells us, and no study has ever proven them wrong.

You want to come up with more ad hominems, or are you done? Cause they don't impress me.

Re:Confounding Variables

[Runaway1956]

Hmmm. I've observed for decades that parenting skills seem to be people's lowest priority in life. I'm guilty, my parents were guilty, and many, many of my co-workers and associates are guilty. No one wants to take the TIME to work with their kids. And, parenting is a full time job - you can't spend 1/3 or more of your time on a job, a couple hours commuting each day, attend a couple meetings/ball games, spend an hour or two at the bar, and still find time to spend with your kids. Especially since the kids have their own routines that just never seem to mesh with yours. You find an hour or three to spend with the kid, and he has somewhere to go, something to do, a girl to see, or whatever.

Upper class or lower class, I see the same thing. Everyone has to go, go, go - they are busy with SOMETHING all day, every day - even if it's trying to score the next fix for their habit.

Is it any wonder that kids have problems? Couple that with our own unwillingness to spend time working problems out, and yes, drugs are over prescribed for the kids.

We've forgotten what it's like to be kids, don't know how to teach kids, and we're just annoyed that the kids are around to bother us - so we offer them some drugs that will change their conduct, and make them quieter, therefore more tolerable.

To really fix the problem, we need to slow society down a few notches. I've mentioned in another thread that grandparents serve a vital function in a healthy society. Today's grandparents are self centered, retiring to Florida or California at the earliest opportunity, rather than being part of the family. A retired person has little more than time - time that can be spent with the kids, helping them to understand the world, and teaching them to deal with adversity. Or, helping them with more mundane things, like algebra, or archery, or learning to drive.

Our culture is crazy - why shouldn't the kids be just as crazy?

IMHO, there are few conditions that can't be dealt with through patience, discipline, and love. Drugs aren't going to "fix" any problem a kid has. At best, he'll be turned into a zombie for as long as the drugs last, then he comes back to reality, with all the same problems.

But, don't try to sell those ideas to the big pharmaceutical companies. You'll be branded a heretic.

Re:Confounding Variables

[Technician]

Often overlooked is the amount of FAS/FAE children of lower income households. FAE often goes with drinking teens and unexpecte pregnancy. This drops these unwed mothers into the system in lower economic classes with chldren with ADD Bipolar ODD and other behaviour problems.

In general the survey failed to look at upstream to where these children and parents came from and any factors such as substance abuse, unwed, or other factors put more children with high needs into low income households.

The indicator is not that low income gets more treatment, but more that need treatment are in low income families.

Re:Confounding Variables

[retchdog]

It doesn't show ignorance in statistics as such. I think that most of them would agree, more or less, with the statement "if you control for all confounding variables then, except for a few managable technical problems, the analysis will be causally valid."

Now from my observations, what the "c!=c" people generally believe is that scientists who've spent months or years on a subject, have not even tried accounting for even the most obvious confounders. It's a symptom of hubris and closedmindedness, not ignorance or stupidity.

Of course, often there is a valid criticism, but it's the burden of the critic to RTFA and give an insightful critique in terms of the experimental methodology at hand, instead of a sound bite. In that sense, I agree, it is very unfortunate that "c!=c" sounds so erudite; it helps one overlook the fact, that one is not contributing any information or insight.

Re:Confounding Variables

[Runaway1956]

Ehh. I feel for you. I had an abusive father, and I can sympathize with what you are saying. Or, empathize. Even so - not all grandparents are assholes. And, some asshole parents mellow with age. I don't know if mine did or not - when I left his house at age 15, I never went back, he never saw his grandchildren, and I never even talked to him again.

But, there are literally MILLIONS of old bastards in this country who really do have a lot to offer today's kids. As a nation, we should tap into that resource. My wife's parents were great people, and Granny did her grandchildren a lot of good before we lost her. Grandpaw was just as great, but we lost him soon after our first son was born. I would have traded MY father's last thirty years for another ten years with HER father, in a heartbeat. To bad we can't make deals like that.....

All I'm saying is, look past the trees, and try to see the forest, alright?

that's insightful

[r00t]

There's no more "factory jobs" out there that will feed a family like even 15 years ago. All kids are pushed to perform in ways I'm not asked to, and I'm attending college both on campus and/or online and work full time. Frankly I think that's overkill but "education" seems to think that everybody should be trying to go to Harvard rather than state school.

We currently have little use for the people who are unfit for advanced education. We eliminated their jobs via protective measures that made them uncompetitive on the world market: environmental protection, worker safety, short work weeks, disability protection, minimum wage, etc. Other parts of the world have been happy to take the jobs, and they even ship us back much of the pollution via global winds and ocean currents!

Idle poor people tend to end up in jail. One can argue if that's worse than a dangerous job or not.

We're also ignoring biological reality. People naturally start families as they complete puberty, but we fail to prepare them for supporting families at that time. School drags on for years, offering neither vocational training nor more advanced studies. Tracking is schools is very inflexible, with a student who falls behind becoming permanently stuck in a slower (not merely later) track. For this reason, and because we are hesitant to face the anger and political power of parents with dumb/violent/lazy kids, we don't track kids early. Accepting biological reality would mean adjusting our educational system to ensure that most people would be fully capable of supporting a family around age 16, give or take a couple years. The dumber ones would have useful vocational skills, the brighter ones would have the equivalent of a non-joke 4-year college degree, and very few would be left needing either additional education or prison. We made everything all generic and watered-down though, resulting in near-worthless high school diplomas that merely mean you mostly showed up for class. Neither the bright nor the dim are well-served by this waste of time.

BTW, providing **social** rewards for academic success would go a long way toward motivating students. (money, the right to wander out for fresh air, more in-game time, parking rights, etc.)

For those that do go to college, we mislead and abuse them. We give loans for degrees that offer little hope of providing an income to pay off the loan, then we don't provide a reasonable way to escape the responsibility for repayment. Sure, you can get that interpretive dance degree! It's little wonder that so many people can point to an unemployed college graduate they personally know as an example of why education is worthless. Even the people who make wise choices get stuck spending too much time listening to non-technical professors pushing personal political agendas.

Ever wonder why so many people get communications degrees now? It's because they need to prove that they have the writing skills that used to be expected of those graduating from 5th grade or 6th grade. Ouch. Without some sort of college degree, nobody will believe that you have the basic literacy required for simple office work.

Re:Herein lies the answer

[moeinvt]

I'll take the bait on that one.

"...the bailouts were "socialisim" for the middle class."

WRONG! The savings of the middle class are insured by the FDIC. The big banks should have gone bankrupt, and the government should have then been forced to keep its word by making depositors whole. Not to mention the fact that the Federal Reserve is doing far more bailing out than the TARP bill. The Fed is the biggest scheme in the history of the U.S. for redistribution of wealth from the poor and middle class to the government and the wealthy elite. I wouldn't go so far as to call it a "conspiracy" when the behavior is so overt and obvious.

Re:The short answer...

[mcgrew]

Well, there's that correlation vs causation thing again. There may be many reasons.

One is, mental illness is likely to be more prevalent among the poor, with one causing the other. Poverty contributes to depression and other mental problems, and mental illnesses (many of which run in families) make it hard to obtain and retain a job, especially one that pays well.

Many (most?) private insurance plans won't pay for treatment for mental illness, so some with mental illnesses (e.g. the non-working spouse or children) won't get needed medications. Thank you, US Government, for keeping the sociopathic insurance industry alive.

OTOH, specialists usually don't take Medicaid patients (many GPs won't as well), so overmedication may be a product of the GP not having quite enough training in those particular illnesses. A patient with insurance may be sent to a specialist, whereas the GP may have to treat the Medicaid patient him or her self.

IMO, everyone should have access to mental health care. There is a correlation between mental illness and substance abuse. The health professionals almost always blame the illnesses on the abuse, and often that's actually the case. But there are exceptions (and maybe those exceptions are actually the norm). An example is a woman I know who had a terrible childhood, born to teenaged parents and shuffled from foster home to foster home and suffered from acute clinical depression since her teen years, who started drinking at about age thirty. In that case the correlation may not have anything to do with causation, but a thing cannot cause an earlier thing to happen. I suspect that had she had treatment in her twenties she may not have become an alcoholic.

I'd say it's better to spend government money treating the mentally ill and making them productive members of society, rather than having them be a drain on society.

Re:Confounding Variables

[JoeMerchant]

maybe the poor kids are getting over-medicated by a government/drug company/new world order rich person conspiracy.

It's not usually a conspiracy, it's usually an emergent property of a system of mostly self-serving, uncaring actors. That's why these things are studied and the lawmakers occasionally decide to change the rules to re-orient the self-serving actors to another course of action that will ultimately be better for society as a whole...

Yeah, that happens sometimes.

Re:Herein lies the answer

[JoeMerchant]

I agree. You know the main reason there is over-medication of the poor is probably the rate that poor clinics see people. 5-10 minutes with a doctor results in the easiest solution.

Pills are wickedly efficient, other forms of treatment take time and effort on the part of a caregiver. If you have no money, they'll take what little you have to give you pills, but you can't even hope to get access to significant amounts of other people's time and effort - plus you're probably spending all of your own just trying to get enough money to keep a roof over your head.

Re:Herein lies the answer

[TapeCutter]

"All we should need is your royal opinion, without checking the facts for ourselves"

Dear peasant,
You're welcome to check the facts for yourself, nobody here is stopping you, least of all me.