This past Sunday’s Washington Post featured an article by Elizabeth J. Roberts, a child and adolescent psychiatrist in California, who voiced concern about the increasing tendency of psychiatric and pediatric providers to unnecessarily pathologize and medicate children with emotional and behavioral difficulties. She states that “much of the increase in prescribing such [psychotropic] medications to kids is due to the widespread use of psychiatric diagnoses to explain away the results of poor parenting practices.� While Roberts is right to challenge these alarming trends and to highlight the underestimation of familial/environmental factors as a contributing factor, she neglects to give due consideration to the impact of broader social and economic forces—in particular, the increasing influence of pharmaceutical companies aggressively marketing their products and the increasing demands and stresses placed on overwhelmed family systems in an environment of decreasing supports and services—and so comes across as somewhat blaming of parents. Nonetheless, her essay offers many salient points and is worth reading, if for no other reason than it is rather unusual (and refreshing) for a psychiatrist to present such views. An excerpt follows:
A Rush to Medicate Young Minds
I have been treating, educating and caring for children for more than 30 years, half of that time as a child psychiatrist, and the changes I have seen in the practice of child psychiatry are shocking. Psychiatrists are now misdiagnosing and overmedicating children for ordinary defiance and misbehavior. The temper tantrums of belligerent children are increasingly being characterized as psychiatric illnesses.
Using such diagnoses as bipolar disorder, attention-deficit hyperactivity disorder (ADHD) and Asperger’s, doctors are justifying the sedation of difficult kids with powerful psychiatric drugs that may have serious, permanent or even lethal side effects.
There has been a staggering jump in the percentage of children diagnosed with a mental illness and treated with psychiatric medications. The Centers for Disease Control and Prevention reported that in 2002 almost 20 percent of office visits to pediatricians were for psychosocial problems — eclipsing both asthma and heart disease. That same year the Food and Drug Administration reported that some 10.8 million prescriptions were dispensed for children — they are beginning to outpace the elderly in the consumption of pharmaceuticals. And this year the FDA reported that between 1999 and 2003, 19 children died after taking prescription amphetamines — the medications used to treat ADHD. These are the same drugs for which the number of prescriptions written rose 500 percent from 1991 to 2000.
Some psychiatrists speculate that this stunning increase in childhood psychiatric disease is entirely due to improved diagnostic techniques. But setting aside the children with legitimate mental illnesses who must have psychiatric medications to function normally, much of the increase in prescribing such medications to kids is due to the widespread use of psychiatric diagnoses to explain away the results of poor parenting practices. According to psychiatrist Jennifer Harris, quoted in the January/February issue of Psychotherapy Networker, “Many clinicians find it easier to tell parents their child has a brain-based disorder than to suggest parenting changes.” [full text]
Kmareka.com 
Poor parenting is and always has been a big part of why many children have problems. I don’t think parenting has gotten all that much worse in the past 10 years. What has gotten worse is the amount of marketing of “magic pills” to parents to fix their kids. What has also changed is the general acceptance that everyone and everything can be improved through chemicals, side effects and long-term effects be damned. But more on this at another time.
While I agree with the “magic pill” hypothesis Kiersten postulates, I believe there is another layer to the problem. David alluded to it, but I believe it bears mentioning.
Most families now have two working parents. As such, the amount of time available to parents to, well, “parent” has dropped significantly over a generation. In this same period, we have seen the growth of the medication industry. I would suggest that the pressures on the family due to ever-expanding work schedules is what made the “magic pill” solution so attractive.
I say this realizing that Americans tend to look for instant gratification, and instant solutions; hence the diet industry (lose a lot of weight real fast by following this simple plan….)
It gets back to what I said on a previous thread about the number of hours (24/7, anyone?) parents are expected to work. The age of laptops, Blackberries, and cell phones has all-but eliminated the distinction between home and office. There was a BusinessWeek article a while back suggesting that parents work from home on the weekends instead of going to the office. As if one’s mere presence in the home constitutes “family time.” And how often do you see a family in a car, or at a restaurant, where one (or both) the parents are on a cell phone while junior runs wild?
Yes, parenting skills may have atrophied. Yes, Big Pharma is relentlessly, even ruthlessly, seeking to expand its customer base. But there is a third aspect to the problem: the Corporations who steal our time.
Then the Corporate bosses have the nerve to point out how much stuff we have, as if that is an indicator of standard of living. Sure, we get more stuff, but our quality of life deteriorates, along with our health while the infant mortality rate increases.
No, despite the stuff, our standard of living is dropping. And that puts a lot of pressure on the ability to be an effective parent. As if the kids don’t catch the anxiety that mom & dad are feeling.
This is going to sound harsh, but issues like this really set me off.
I get sick of hearing parents say that they have “no choice” but to put their babies in daycare while both parents work. A working mom in the U.S. is expected to put her 8-week-old infant into daycare. That is flat-out OBSCENE. Think about it. A parent who works 8-9 hours a day has roughly 2-3 hours with his/her kid. There simply is no way to pack a day of quality parenting into 2-3 hours, esp with meals to prepare, laundry to fold, etc.
Child-rearing has become dangerously institutionalized. Kids are raised in large groups with strangers, rather than in family settings. And we wonder why our brats are desensitized and difficult to manage, why we are told that they need medication to “behave…”
No choice? There is ALWAYS a choice. Choose the kid. At least until s/he is school age. Babies need and deserve a solid foundation, which is more likely to be built thru consistent one-on-one parent-child interaction. Parents deserve to experience the joys and the burdens of caring for their own babies.
Give up something else. Sell the house and live in a teepee by the river if that’s what it takes. Heck, go on welfare for a couple years. But don’t sacrifice those crucial early years in favor of more money and more stuff.
There aren’t any do-overs where early childhood development is concerned. Get it right in the first couple years, and save decades of trying to make up for misspent time.
This is going to sound harsh, but issues like this really set me off.
I get sick of hearing parents say that they have “no choice” but to put their babies in daycare while both parents work. A working mom in the U.S. is expected to put her 8-week-old infant into daycare. That is flat-out OBSCENE. Think about it. A parent who works 8-9 hours a day has roughly 2-3 hours with his/her kid. There simply is no way to pack a day of quality parenting into 2-3 hours, esp with meals to prepare, laundry to fold, etc.
Child-rearing has become dangerously institutionalized. Kids are raised in large groups with strangers, rather than in family settings. And we wonder why our brats are desensitized and difficult to manage, why we are told that they need medication to “behave…”
No choice? There is ALWAYS a choice. Choose the kid. At least until s/he is school age. Babies need and deserve a solid foundation, which is more likely to be built thru consistent one-on-one parent-child interaction. Parents deserve to experience the joys and the burdens of caring for their own babies.
Give up something else. Sell the house and live in a teepee by the river if that’s what it takes. Heck, go on welfare for a couple years. But don’t sacrifice those crucial early years in favor of more money and more stuff.
There aren’t any do-overs where early childhood development is concerned. Get it right in the first couple years, and save decades of trying to make up for misspent time.
Thanks for your comments, Henry’s Mom. I wanted to respond yesterday but lots of stuff going on with…my kids! Now I just finished putting my baby down for her nap and was thinking again how much I value these times and am thankful to have them.
I often meet women who have accepted the dominant paradigm that tells them these simple times with their babies are not valuable, or not as valuable as driving a newer car or having a bigger house. This is a shame for the children who will not have the opportunity to appreciate who their parents are in a way that can only happen in the earliest years of life. It is also a shame for the adults who are missing something that can’t be replaced.
I am a parent who has two successful parenting subjects , R and J. They are well mannered successful young women. The one in college has scholarships and is a dedicated hard working student. We adopted many years ago another child. I have a degree in Early childhood and I knew that my third daughter was way off the bell curve for normal behavior. We tried EVERYTHING not to put her on meds. She did have a biological history of bipolar in her birth family. WE have tried taking meds down and off them entirely. She can’t function in society without them. I just want to let you know that she wasn’t in 40-50 hours of childcare a week. She was adored and as well disiplined as her siblings. However, with meds she has lost her “special ed” help, because she is functioning SO well in school. I am involved with a wonderful group of parents that wish they never had to hosipalize or medicate their children again. These parents are the most skilled parents I have run across in all my years of working with children. Please do not dismiss us as “bad” parents. We lay down so much of what we thought life might be like. We grieve everytime something causes our child to have a relapse. We learn to fight for what our children need and are VERY involved in their lives in our homes and in school and in the community they live in. The next time you read about one psychitrists opinion, think of my daughter. She has a wonderful doctor who also wishes we never had to see him again. He doesn’t overprescribe, because of “bad” parenting. Maybe Elizabeth was describing what she did…