Poor Children Likelier to Get Antipsychotics

From the New York Times
Friday, December 11, 2009
By Duff Wilson

Image care of the New York TimesNew federally financed drug research reveals a stark disparity: 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, the data shows.

Those findings, by a team from Rutgers and Columbia, are almost certain to add fuel to a long-running debate. 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?

The questions go beyond the psychological impact on Medicaid children, serious as that may be. Antipsychotic drugs can also have severe physical side effects, causing drastic weight gain and metabolic changes resulting in lifelong physical problems.

On Tuesday, a pediatric advisory committee to the Food and Drug Administration met to discuss the health risks for all children who take antipsychotics. The panel will consider recommending new label warnings for the drugs, which are now used by an estimated 300,000 people under age 18 in this country, counting both Medicaid patients and those with private insurance.

Agnes’s Jacket reading & book signing.

Agnes’s JacketOn Thursday March 26 at 7pm Gail Hornstein will read from her new work Agnes’s Jacket at the Odyssey Bookstore in South Hadley.

In a Victorian-era German asylum, seamstress Agnes Richter painstakingly stitched a mysterious autobiographical text into every inch of the jacket she created from her institutional uniform. Despite every attempt to silence them, hundreds of other patients have managed to get their stories out, at least in disguised form. Today, in a vibrant underground network of “psychiatric survivor groups” all over the world, patients work together to unravel the mysteries of madness and help one another recover. Optimistic, courageous, and surprising, Agnes’s Jacket (on sale starting March 17; $25.95; Hardcover) takes us from a code-cracking bunker during World War II to the church basements and treatment centers where a whole new way of understanding the mind has begun to take form.

A vast gulf exists between the way medicine explains psychiatric illness and the experiences of those who suffer. Hornstein’s luminous work helps us bridge that gulf, guiding us through the inner lives of those diagnosed with schizophrenia, bipolar illness, depression and paranoia, and emerging with nothing less than a new model for understanding one another and ourselves.

Northampton Decree

DMH Memorial Panel
DMH Memorial Panel

I had the pleasure of attending a Memorial put on by the Department of Mental Health (DMH) last week to celebrate the 30th anniversary of the 1978 Brewster Consent Decree which began the process of closing Northampton State Hospital by stipulating that people with mental illness had the right to live and be treated in the least restrictive environment possible. I felt the speech given by Rebecca Macauley was especially apt and moving, and I have a recording made by WFCR (the local National Public Radio station) of the first half of the event. I will post the audio as soon as I get a chance to clean it up and cut it into sections.

Brewster Consent Decree at Washington University School of Law

Updated

  1. Full program and all speakers. Audio Player
  2. Dedication by Rev. Peter Ives, First Churches of Northampton.
    Audio Player
  3. Barbara Leadholm, DMH Commissioner.
    Audio Player
  4. Rebecca Macauley, Ex-patient, Security Guard and Advocate.
    Audio Player
  5. Elizabeth Cardona, Director, Western MA Office of the Governor.
    Audio Player
  6. Robert Fleischner, Center for Public Representation.
    Audio Player
Northampton State Hospital