Poorer Children More Likely To Get Antipsychotics 334
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."
The short answer... (Score:5, Interesting)
...yes.
But how do I back up such a horrifying claim? By analyzing the current state of affairs in our world today, and I can only draw conclusions from our countrys actions lately. A while ago, we had the news investigators claim that poor & unemployed people get showed back in the queue when it comes to medical attention, medicines and treatment. Incredibly enough - our government admitted that it was a problem, and further investigations showed that the doctors "general" reasons for doing so - wasn't motivated by the government - but by the fact that these people held a job, a position in the society - and thus were a better "investment" for the future.
Also - the doctors pointed out that "people with a position in society" were less likely to complain about mistreatments and other complaints, as the poor were more prone to lawsuits and false claims for monetary reasons, rather than real facts. This were all the rage on Danish TV a while ago.
Re:The short answer... (Score:4, Insightful)
From each according to his ability, to each according to how valuable he is to others.
Acts of the Apostles (Score:4, Interesting)
Re:Acts of the Apostles (Score:4, Interesting)
Just look at the last and only true communists on this planet - the Amish in US.
Re:Dumbass (Score:5, Informative)
No duh GGP was based more on Karl Marx than the Acts of the Apostles. But I need to know: Did you actually go and check Acts 2:44-45 before you told GP to check his sources?
New American Bible, Saint Joseph Edition, from around 2003 or so, Acts 2:44-45 -
All who believed were together and had all things in common, they would sell their property and possessions and divide them among all according to each one's need.
Marx was a philosopher, as we all know, so why shouldn't he have read up on his early Christianity? Acts 2:44-45 came before Marx, and Marx should have known his Christian stuff as a philosopher, and all this I would call evidence, though not proof, that Marx could have has his line inspired by the Acts verses.
Re:Dumbass (Score:4, Informative)
Re:Acts of the Apostles (Score:5, Interesting)
Whereas, the so much beloved capitalism, is essentially anti Christian.
Re: (Score:3, Funny)
That shows a very naive understanding of Christianity. Haven't you read the Gospel of Reagan?
Confounding Variables (Score:5, Insightful)
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: (Score:3, Interesting)
Without the "writers" reactions - we'd have a society that quietly accepts anything - but alas - we have a democracy, technically - this means we can think, investigate and opinionate on anything we want.
If you REALLY want the true stories, you'll have to dig into each writers "claims" - and google them, believe it or not - they're fairly easy to find - that is...if they're true. I see no reason why people would lie about it, maybe they're mis-informed, but lie? no.
Herein lies the answer (Score:4, Interesting)
Without the "writers" reactions - we'd have a society that quietly accepts anything
But that's the problem. We DO have a society that quietly accepts everything... everything that appeals to their basest drives, or reinforces past prejudices, with little to no application of logic or reason.
In this case, as well as when considering Anthropogenic Global Warming, Evolution, or vaccinations, the most paranoid conclusions are the most satisfying, in that they reinforce a foregone conclusion, as well as relieve the bearer of further responsibility.
Glaciers melt = not my fault, it's the sun.
Child has autism = not my fault, it's the vaccines
Child has problems = not my fault, it's the drug conspiracy
Too stupid = fluoride in the water
School shooting = gun manufacturers and video games
Poor = Conspiracy of the rich
These are just a few of a myriad of memes that have been further reinforced by the advent of the Internet and the ensuing ability to find supporters of the most wildly wrong ideas.
And that's scary.
Re:Herein lies the answer (Score:4, Insightful)
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:Herein lies the answer (Score:5, Interesting)
Re:Herein lies the answer (Score:4, Insightful)
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 (Score:5, Insightful)
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: (Score:3, Insightful)
Dear peasant,
You're welcome to check the facts for yourself, nobody here is stopping you, least of all me.
And then again... (Score:2)
everything that appeals to their basest drives, or reinforces past prejudices, with little to no application of logic or reason.
Sure, the internet is a "fast food / take-away" smorgasboard of "what would you like to believe today?".
But we can't expect the layman to understand everything it takes several years of medicin and a degree to even comprehend, but the human nature alone - sometimes provide all the starting points you need for further investigation.
Just the case from Denmark alone, proved that there really were something to it, not just FUD.
As it turns out, it wasn't the government that was to blame, but simple human judgmen
Re:Herein lies the answer (Score:5, Informative)
"Poor = Conspiracy of the rich"
Except this one has abundant evidence. Government's are paid off by business to sit on their hands and not do anything their people request (disability, raise the minimum wage, etc).
Then there was the Bailout. Socialism for the rich, market discipline for everyone else. I could cite numerous other instances, oh like workers being killed by coca cola? Not to mention workers WERE being killed here in north america all the way up into the 1930's, your middle-class life came from a concerted effort of the working class against the rich. Ever wonder why we call it the 8 hour day?
http://en.wikipedia.org/wiki/8_hour_day [wikipedia.org]
What's even scarier is most peoples total lack of knowledge about business history.
Re: (Score:3, Insightful)
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
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Wait a minute. Autism is not the result of parenting.
I never claimed it was. But it's always easier to blame someone than to realize that a random recombination of your genetics may have resulted in an autistic child.
Why do you frame this in the need to blame someone, anyway?
That's the way most people see the world. It avoids having to take responsibility.
Re: (Score:3, Interesting)
I never claimed it was.
I see what you're saying -- you didn't explicitly say that it was. But the format of the argument you're making is one where the message is "people are refusing to take responsibility for their actions, and instead blame someone/thing else". If you're wondering why you got two responses "correcting" you, that's why.
That's the way most people see the world. It avoids having to take responsibility.
Okay, now you just blew it up.
In order to take responsibility for something, don't you generality have to have done something that would warrant taking of responsibility? They would rather blam
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Re:Confounding Variables (Score:5, Informative)
The article is actually normalized for one of your claimed possible confounds, the variance of psychological problems by socioeconomic position. The finding isn't just that the poor get more antipsychotics full stop, but that the poor with the same diagnosis as a wealthy person are more likely to be treated with antipsychotics for that condition.
Re:Confounding Variables (Score:4, Interesting)
Re: (Score:3, Interesting)
Re:Confounding Variables (Score:4, Insightful)
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: (Score:3, Insightful)
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 sam
Re: (Score:3, Informative)
Spoken like a true tobacco exec. Do you believe cigarettes cause cancer? Yes or no? Because they have never been shown to cause cancer mathematically. And to state that like it's an important thing about such studies is to imply the opposite.
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 correla
Re:Confounding Variables (Score:5, Insightful)
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 (Score:5, Insightful)
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 (Score:5, Interesting)
Nay, on the grandparents being more involved
My own parents have taken two of their grandkids away from their folks, ostensibly because the real parents didn't have time, and came close to getting three more. One of them was my own. They did this, ostensibly, because the real parents were "bad" parents who didn't spend enough time with their kids, or who were too strict when they did.
I don't recognize them anymore. In fact, I've gone so far as to fire both of them.
I remember them as drunken/angry vigilant defenders of the castle. Mom had her rum, and the occasional office job -- Dad had a real, swing-shift job that ate his soul but made good money and the occasional beer. I remember being up late while Mom sang Barbara Straisand tunes and played the piano (which she was never very good at), and I remember growing up in fear of waking up Dad when he'd been working nights.
Mom would bring home weird guys from the bar while Dad was at work. And there was a special belt that Dad had, mostly for when we'd pissed off Mom somehow and that made her tell him to "do something." The belt eventually broke in the middle. (For Mom, kitchen utensils were the favorite implement.)
But they've been going to church for the past few years, so they know better for what's good for their grandkids than the kids' own parents do. Court action ensues. Lies are told. Honesty defeated, kids disappear from the home they've always known.
Nay, on the grandparents. When I was a kid, Grandpa would take me to feed the ducks and get ice cream. If he had a problem with how I was being treated, he'd talk to my folks about it until he was satisfied. Nowadays (and this is in more than one family that I know) the grandparents think they've got it all figured out, and are willing to abandon their own children in order to do what's "right" for their grandkids.
Nay, again. Parents need to step up and be parents, and grandparents need to be grandparents. Any other way and the kids end up even more screwed up than they were going to be otherwise, while the courts seem to think it's OK.
Re: (Score:3, Insightful)
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 res
Re: (Score:3, Insightful)
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
Re: (Score:3, Insightful)
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: (Score:3, Insightful)
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 appea
Re: (Score:3, Insightful)
"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 t
Re: (Score:3, Funny)
So, that implies: one for dad, one for mom, one for daughter and one for son?
Or maybe, those should be called "anti-family-pack" of condoms?
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Re: (Score:3, Funny)
Laws will not repress crimes of poverty. The real answer is for the society afflicted to make certain that no person suffers poverty.
Uh, so we put them out of their suffering?
that's insightful (Score:5, Insightful)
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.
Brave New World (Score:3, Insightful)
Take your soma and like it, kids.
Deeply troubling, but not unexpected.
--
Toro
Re: (Score:2, Interesting)
Antipsychotics are actually pretty lame. They kill higher-level cognition, reduce you to a slow-witted and brainless dullard, put you to sleep and make working out damn near impossible depending on the dosage. They cause reversible decrease in penis size, lack of libido, weak erections, weak orgasms -- in other words, permanent whiskeydick as long as you take the drugs. They are the perfect drugs for creating a zombie society suited to 1984 rather than Brave N
Re:Brave New World (Score:4, Informative)
Lets not forget the irreversible damage to the brain and pancreas and the only somewhat reversible damage to the liver and the nearly inevitable weight gain (and the problems that presents).
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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 u
Re:Brave New World (Score:5, Insightful)
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:Brave New World (Score:4, Interesting)
I agree that physical discipline in moderation is a good thing, and my years of working with men and women that received it in their youth before joining the USAF (where I met them) supports reinforces my belief.
The reason I wrote "is assault" is because that is the popular image, and because a young person can easily use the threat of calling DSS or the police to punish a parent who disciplines them.
Re:Brave New World (Score:4, Insightful)
Re: (Score:3, Interesting)
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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 i
Re: (Score:3, Insightful)
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 --
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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.
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People don't think that, it's a legal fact, which I'm pretty sure is what the OP meant. (IE he was in FAVOR of returning CP to the set of tools available to disciplinarians).
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People don't think that, it's a legal fact,
Legal fact == glorified opinion. It means enough people thought that way for it to become a legal fact.
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Ultimately it depends on where you live. I feel the government has no right to tell you how to discipline your kids (that's tyranny and facism) as long as you do not genuinely abuse them. Believe me, there is a huge difference between discipline and child abuse. I've experienced both and the abuse did not come from my parents. A paddl
Re: (Score:3, Insightful)
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.
Parent pushback (Score:3, Insightful)
Re:Parent pushback (Score:5, Interesting)
There are many explanations, none of them happy-making:
1. families with dysfunctional dynamics that lead to serious behavior problems among children are more likely to be poor
2. families with histories of psychotic behavior are more likely to be poor
3. the same behavior is interpreted differently when it occurs among middle class and/or white children than when it occurs among poorer or non-white children
4. non-pharma interventions are more expensive.
Which of these explanations one jumps on first is a good litmus test of one's political ideology.
Re:Parent pushback (Score:5, Informative)
The study found an effect even among poor v. wealthy children with the same diagnosis, though, which none of 1/2/3 could explain. 1/2/3 could plausibly lead to more psychotic diagnoses among poor children, but not to more prescription of drugs within the same diagnosis.
Re:Parent pushback (Score:4, Insightful)
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: (Score:2)
Could it be because middle class parents are more likely to push back against drug recommendations?
Or could it be that lower class parents are more likely to blame anything but their poor parenting skills for their children's behavior and seek the "cure" in a pill?
is this restricted to medicare? (Score:3, Interesting)
Does this also happen with other public health care systems or is this mostly limited to Medicare in the US?
Re: (Score:3, Informative)
Don't most public healthcare systems take care of everyone regardless of socioeconomic status?
With poor patients on Medicare in the US, the physician has an economic incentive to get the patient out the door as quickly as possible. Under an all-encompassing public health care system, there'd be no difference between the poor and middle/upper-class patient.
Note about the link (Score:2)
Unless things have changed, the NYTimes links are not actually behind a "paywall", just behind a login (which is free as far as I remember).
In other words, feel "free" to RTFA.
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None of the Above (Score:4, Interesting)
Non of the above.
These people are beta-testing the atypical antipsychotics.
Poor people can't litigate. It makes the drug companies look good by 'helping the poor', and gives them lots of people to test their new drugs on. /I've taken these medications //as a class, after 6 months only 30% of people prescribed atypical antipsychotics can remain on them, because the side-effects are so unbearable.
Re:None of the Above (Score:4, Insightful)
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.
Information outside of your expertise is dangerous (Score:5, Interesting)
Before y'all get on your high horses, note that antipsychotics aren't exclusively used for psychosis. Abilify, one of the most popular, is used for mood swings, psychosis, bipolar in general, and as an adjunct to antidepressants. Abilify is an amazingly effective method of relieving intense psychological suffering quickly. The middle class alternative is a year or two on therapy and a couple other antidepressants, which is probably a nicer way of doing things for the patient, but is much slower and less cost effective. Once a patient is on a drug like Abilify, it is much easier to deal with their psychological trauma quickly. It might not be the best solution, but it is a very good one. And, truth be told, poor people aren't going to get the same care as middle-class people.
Re:Information outside of your expertise is danger (Score:5, Interesting)
I agree. Several years ago I saw a child who had some emotional problems come around relatively quickly with psychotropic drugs. Pumping an 11 year old full of these medications isn't the best solution but this kid was going to end up hurting someone or himself and his mother didn't have the money for the best therapists. It took about a year to get the combination of medicines and counseling right but it caused an amazing turn around in this little boy.
If they weren't so quick to medicate poor children, we'd be asking why so many poor kids are going without adequate treatment for mental illness.
LK
Re: (Score:3, Interesting)
Was that 11 year old ever able to stop taking the drugs?
Re: (Score:3, Informative)
He's 15 now. He's still medicated. It'll probably be for life, bi-polar disorder runs in his family.
LK
Re: (Score:3, Informative)
I'm sorry, but medication does nothing for mental illness.
Either you're drinking the Tom Cruise Kool-Aid or you've never known anyone who has taken psych meds. I have witnessed, first hand, how someone can be helped with medication.
LK
Re:Information outside of your expertise is danger (Score:4, Insightful)
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.
Perhaps (Score:5, Interesting)
Mental illness runs in the family and affects economic status. So poor parents pass on their mentally ill genes to their kids thus their kids are more likely to be mentally ill and on some kind of treatment. My own personal experience registers this is as true. I see a lot of emotional problems, especially mood instability, with poorer people. I wouldnt be surprised if this was a chicken and egg problem explained without the "OMG BIG GOVERNMENT/CAPITALIST CONSPIRACY" angle slashdot tends to sell.
Re: (Score:2)
Re: (Score:3, Insightful)
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-p
Re: (Score:3, Insightful)
Re: (Score:3, Insightful)
Usually, it's a "small government conspiracy!" angle, because a lack of government involvement is usually seen as the problem.
Re:Perhaps (Score:5, Informative)
Just because mental illnesses may be more common amongst poorer people doesn't explain why they are more likely to be given drugs. Please also note the line that says "Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts". If they're less severe in nature, then why the drugs?
Re: (Score:2)
Mental illness runs in the family and affects economic status.
True enough.
So poor parents pass on their mentally ill genes to their kids thus their kids are more likely to be mentally ill and on some kind of treatment. My own personal experience registers this is as true. I see a lot of emotional problems, especially mood instability, with poorer people
An alternative explanation is that if you have poor emotional skills - unable to control your own emotions or understand those of others - you are less likely to succeed. And lacking emotional skills yourself, you are unable to teach your kids those skills.
While it could be genetic, it could equally be a function of poor parenting. There are probably plenty of cases in both categories, so I'd urge caution before assuming it's a genetic problem.
Re: (Score:2)
Or the other way around. Extra stress growing up/raising kids in poverty causes/exacerbates mental issues.
Life is complicated, but one thing's for sure: it sucks to be poor.
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"OMG BIG GOVERNMENT/CAPITALIST CONSPIRACY"
What does it say about a society when mental illness makes you a permanent member of the underclass?
However, my own observations are quite the opposite of yours. During a time when my personal economic status was poor, I became more volatile and had to make a much bigger effort to not beat the crap out of people who ticked me off. It's easy to be a stable happy person when you have a stable happy economic status.
Bi-Polar at Three? (Score:4, Interesting)
"They say it's impossible to stop now," Evelyn Torres, 48, of the Bronx, said of her son's use of antipsychotics since he received a diagnosis of bipolar disorder at age 3.
Okay, I understand that it's possible for three-year-olds to be bipolar, but how on Earth do you reliably test for that?
Re:Bi-Polar at Three? (Score:4, Insightful)
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
How this works... (Score:5, Interesting)
Doctor, Timmy is getting in trouble in school.
How does he get in trouble?
The teacher says he is too active and might have ADHD.
Have you seen a counselor about this?
No, we can't afford one!
Well, let's try a round of Adderall...
This might seem oversimplistic, but I teach a high school 'behavior intervention' classroom and deal with parents all the time who have the same concerns/issues. More often than anyone will admit, many of the issues related to behavior have to do with cost/consequences...and parents who will not/can not engage the reality of their children's behavior (It's not their fault! They are just picking on Timmy!).
Often, the teachers are just as guilty making these recommendations as the doctors--it is illegal for a teacher to recommend/suggest that a child has to be medicated to attend school, but it happens. And many 'poor' parents do not have the background/education to question the recommendation. So, they go to the doctor and tell them that Timmy has to have medicine to attend school.
The fun part in all this is watching the merry-go-round of meds that a child will/will not take to modify their behavior. For some kids, it is necessary to function. For most, it is not.
By the time they get to high school, many are dependent on the meds to function.
Nope! (Score:4, Funny)
Re: (Score:2)
If you are correct, we should see a case where the antipsychotic drug use is highest among the very rich (who can easily afford the drugs) and those on Medicare. Feel free to chime in with statistics to confirm or deny this prediction.
rich v's poor (Score:4, Insightful)
Healtscare system.. (Score:5, Interesting)
Isn't this just an indicator of how broken the US health care system is.
I have a hard time imagining this to be a problem in this way in the countries which have good public health systems. I've never had to think about the cost of healthcare, that's what I pay taxes for. My neighbour doesn't have to worry about the cost of healthcare, that's what I pay taxes for.
We pay damn high taxes. The benefits are pretty big, though and completely worth it.
I decided to go to University after having worked for over ten years.
Fees for school?
Free (for a good university, well, any university).
That's what I've been paying taxes for.
The youngsters studying with me. I paid for their tuition too (or took part in that).
And it pleases me.
Re:Healtscare system.. (Score:4, Informative)
This data would seem to support the removal of the government run insurance plan and its replacement with a private plan.
Oh look the sheep has given up on competent government, and is serving himself up to the wolves for lunch in the hope that they'll protect him.
All private health care is in business for is to take profit. They have have no more interest in providing a service than the government does. Privatization advocates are at best dishonest.
Drug Lobbies? (Score:5, Insightful)
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.
Middle Classes Under-Medicated? (Score:5, Interesting)
The subtext of this story is that medication is bad, that treatment of a disease state with chemicals is sub-optimal. What if the real story here is that middle-class children have a higher probability of being under-medicated and under-treated? They are already under-vaccinated because of bizarre anti-preservative delusions that tend to be associated with higher economic status parents. I've actually met middle-class parents who tried to treat their diabetic children homeopathically. That's a stupidity reserved for those with sufficient income, inappropriate self-esteem and just enough self-regard and personal "knowledge" to be dangerous.
It's not limited to children. (Score:2, Interesting)
I know this from firsthand experience, being an adult in that same system. It's even worse now, because beginning months ago psychological services are no longer covered by my state's Medicaid program, only psychiatric services. The authors of the study weren't keeping up with the ongoing consequences of the recession (no doubt because they're personally insulated from them).
In other words, pills are still covered by Medicaid, but seeing a shrink isn't. That affects children and adults alike, the the eff
Re:It's not limited to children. (Score:4, Interesting)
That's not actually in line with most of the studies that have come out over the past 10-15 years. Sure, there are a lot of quack methodologies, but following an accepted, mainstream program of counseling for a disorder for which the program is recommended by a mainstream body like the APA, carried out by properly accredited specialists, is generally associated with better-than-control outcomes (and better than informal counseling by a primary-care physician). Here [cambridge.org] and here [elsevier.com] are two recent systematic meta-analyses of the results for depression (the best-studied disorder).
Whether counseling is better or worse than drugs is more up in the air, and seems to depend pretty heavily on the demographics, the specific disorder, the type of counseling, the type of drugs, and the time period of which you're looking (and even within all those, there are huge variances among studies). This survey [nih.gov] is typical of the generally mixed/inconclusive results such comparisons come up with. (In addition, most disorders are much less well studied than depression, and sample sizes, especially within demographically comparable groups, are much smaller.)
In any case, I'm not aware of much in the way of peer-reviewed research that supports a hardline "pills are effective, and counseling is not" claim.
Re: (Score:3, Informative)
Are you a Scientologist? That sounded a bit like a CoS screed. I'm not a believer in TALK therapy, either, but I guess you've never heard of cognitive behavioral therapy (CBT)? That is classed as "therapy" too, but it appears to be effective for the people who need it.
In the UK this would be very Skewed (Score:4, Interesting)
Is there any allowance for children with mental problems eg.ADHD in the US?
In the UK it is not unknown for jobless families to seek to get their children diagnosed with ADHD in order to get a Disability Living Allowance. A bonus benifit designed to help pay for the extra care a disabled child would need.
Of course there is nothing wrong with little Timmy and the parents know this too so they don't give them the pills.
They do still pick up the prescriptions (to keep the diagnosis going) and drugs but end up dumping them. Occasionally get a bagfull of around a years supply of the stuff left in to the Pharmacy to be disposed of anonymously or worse dumped in the street.
Sounds cynical of me I know but people aren't beyond pushing their kids to do this when they themselves are very keen to be classed as sick because allowances are higher than those for the well jobless.
I hadn't realized... (Score:4, Funny)
I hadn't realized there were so many advantages to having money. Next they'll be telling us that rich people get all the best houses too.
emupaul (Score:5, Informative)
Re: (Score:2)
Antipsychotics like Risperidone act to block the D2 Dopamine receptors in the brain. As far as I am aware they are not addictive substances nor have much of a street value. It looks like it's just another cost cutting measure Medicare uses. Over-proscribing powerful antipsychotic drugs rather than pay for more expensive mental health treatment...
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*Can't get behind the paywall to determine if benzos were considered to be antipsychotics
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I hate to admit it, but I know way too many people who buy and sell prescription drugs. That said, here is what I have seen as typical prices for various drugs. 30mg Adderal - $7-$8 each. 10mg Hydrocodone - $5-6 each. 1mg Xanax/10mg Valium/other Benzodiazepine equivalent - $1 each. Of course, your 80mg Oxycontin can probably score you $20-$60 each but those are a little harder to get a hold of. Basically, on a per tablet basis ADHD drugs have a pretty high street price. Benzos are relatively cheap.