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Poorer Children More Likely To Get Antipsychotics

kdawson posted more than 4 years ago | from the artifact-of-the-system dept.

Medicine 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."

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The short answer... (4, Interesting)

MindPrison (864299) | more than 4 years ago | (#30425838)

...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... (3, Insightful)

MindlessAutomata (1282944) | more than 4 years ago | (#30425926)

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

Acts of the Apostles (3, Interesting)

calidoscope (312571) | more than 4 years ago | (#30426288)

I wonder how many people using that quote realize that it is a paraphrasing of chapter 2, verses 44 and 45 of "Acts of the Apostles".

Dumbass (-1, Troll)

Anonymous Coward | more than 4 years ago | (#30426322)

Before you go getting all smarter-than-though, you should check your sources....

It's Karl Marx, DUMBASS.

Maybe you should read those verses you attribute it to before spouting off.
"From each according to his ability, to each according to his need", is a direct quote (translated, of course) from Marx.

Your reference to the Book of Acts isn't really even close.

Re:Dumbass (5, Informative)

icannotthinkofaname (1480543) | more than 4 years ago | (#30426520)

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 (0)

Anonymous Coward | more than 4 years ago | (#30426552)

Actually, you're both wrong. calidoscope because that isn't even hinted at anywhere near verses 44 and 45, and AC because "From each according to his ability, to each according to his need" means something different than "From each according to his ability, to each according to how valuable he is to others".

(What is in verses 44 and 45, however, does look more like Karl Marx's oft-quoted phrase)

Confounding Variables (4, Insightful)

TheMeuge (645043) | more than 4 years ago | (#30426010)

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:Confounding Variables (2, Interesting)

MindPrison (864299) | more than 4 years ago | (#30426068)

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 (4, Interesting)

TheMeuge (645043) | more than 4 years ago | (#30426170)

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 (3, Insightful)

Surt (22457) | more than 4 years ago | (#30426258)

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.

And then again... (1)

MindPrison (864299) | more than 4 years ago | (#30426264)

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 judgment. So for what it's worth - this might have saved some lives.

I'm sure we haven't even seen the beginning of the end yet, as I'm equally sure there's lots of tinfoil-hat people out there as well ;)

Re:Herein lies the answer (5, Informative)

Anonymous Coward | more than 4 years ago | (#30426466)

"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:Confounding Variables (2, Insightful)

timmarhy (659436) | more than 4 years ago | (#30426152)

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.

Re:Confounding Variables (5, Informative)

Trepidity (597) | more than 4 years ago | (#30426160)

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 (0)

TheMeuge (645043) | more than 4 years ago | (#30426308)

Granted.

However, there are plenty of others I could come up with, which are not accounted for.

But none of this would matter, if NYTimes correlation articles weren't used by stupid politicians to try to appease their constituents with policy, or by more nefarious people to sucker others into creating even more rules and regulations.

Re:Confounding Variables (3, Interesting)

timeOday (582209) | more than 4 years ago | (#30426430)

Maybe it's because well-to-do people are more averse to the stigma of mental illness in their family.

Re:Confounding Variables (0)

Anonymous Coward | more than 4 years ago | (#30426642)

This article isn't really as you say it is, though: it mentions that richer people tend to get a different kind of treatment. They mention some possible causes. They don't make any conclusions about the actual cause (which would indeed violate the correlation!=causation rule).

Re:The short answer... (-1, Redundant)

Anonymous Coward | more than 4 years ago | (#30426040)

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. Alas it is not. This is what leads some to believe that these people are not merely unfortunate but are poor for a reason, namely that they don't make good decisions. Maybe that's true and maybe it isn't, but it's where the idea comes from.

This especially makes the point. From the summary:

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'.

Really. So even when such help is made available to them, these parents won't do it? Not even for the well-being of their own children? They can't find some way or some how to do this, not even when it's a health issue for their own offspring? Poor or rich, if I had children and anything stood between me and securing their well-being, I truly pity whatever it is that is foolish enough to get in my way. Why don't these people feel that way? They don't care, or what? Just another reason they should not be having children...

Re:The short answer... (2, Insightful)

ZeroExistenZ (721849) | more than 4 years ago | (#30426102)

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.

Re:The short answer... (3, Insightful)

Anonymous Coward | more than 4 years ago | (#30426454)

"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:The short answer... (1)

RockModeNick (617483) | more than 4 years ago | (#30426204)

Maybe, just maybe, their bosses dont' CARE if they need a specific day and time off for their kid's therapy, and if they keep calling in late, etc, just fire them. No better way to secure your kids future than getting even MORE poor.

Re:The short answer... (0, Interesting)

Anonymous Coward | more than 4 years ago | (#30426410)

typical american fascist claim that tries to pass as some kind of clever libertarian critique from common sense. sure, the poor are poor because they are stupid, or want to be poor. the poor don't go to therapy because they don't give a fuck about their children. they commit crimes because they are some kind of infrahuman savages. they are unemployed because they can't be bothered to work. oh, and they should think about buying condoms before risking having children more than middle class white people.

fuck you. i don't even thik that it is necesary to actually respond to your blabering nonsense with nothing more than that.

it's cheaper and easier to pump a child in antipsicothics than put him through therapy. it is a logical consequence that poor people are going to get the cheaper treatment.

THAT'S WHAT "POOR" MEANS, YOU FUCKING GLENN-BECK WANNABE.

Poor children in Catalonia (-1, Offtopic)

Anonymous Coward | more than 4 years ago | (#30425842)

Hello I am Pep Guardiola from Catalonia, where poor children live. I do drink powerfull antipsychotic and now I think Catalonia is not Spain.

Brave New World (2, Insightful)

Torodung (31985) | more than 4 years ago | (#30425844)

Take your soma and like it, kids.

Deeply troubling, but not unexpected.

--
Toro

Re:Brave New World (2, Interesting)

Ethanol-fueled (1125189) | more than 4 years ago | (#30425936)

Soma sounds kinda fun. I'd take it willingly.

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 New World.

There's only 1 benefit to taking antipsychotics, assuming that you are not a raving lunatic who actually needs them: intense, vivid, profound, lucid dreams. YMMV.

Re:Brave New World (0)

couchslug (175151) | more than 4 years ago | (#30425962)

There is no other way to control problem children, be the "problems" real or fictitious.

Physical discipline is assault, reasoning with them relies on their consent, so meds are the only practical option.
That's not good, but there is no way to make things different.

Re:Brave New World (3, Insightful)

pwizard2 (920421) | more than 4 years ago | (#30426042)

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 (4, Insightful)

TubeSteak (669689) | more than 4 years ago | (#30426228)

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 (4, Insightful)

FlyMysticalDJ (1660959) | more than 4 years ago | (#30426484)

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:Brave New World (2, Insightful)

bertoelcon (1557907) | more than 4 years ago | (#30426064)

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:Brave New World (1)

Surt (22457) | more than 4 years ago | (#30426176)

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).

Re:Brave New World (1)

bertoelcon (1557907) | more than 4 years ago | (#30426256)

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.

Re:Brave New World (1)

Surt (22457) | more than 4 years ago | (#30426624)

Right, but the point being, a teacher who violates that legal fact will not enjoy the time in jail.

Re:Brave New World (2, Interesting)

pwizard2 (920421) | more than 4 years ago | (#30426290)

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).

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 paddling done gently with love, control on your part, and an intention to correct bad behavior is not child abuse and is integral to producing well brought-up kids. If you discipline your kids in anger you are close to stepping over the line as far as I'm concerned because it can be easy to overreact. With parenting, you have authority over your children and a responsibility to properly wield it.

Re:Brave New World (1)

Surt (22457) | more than 4 years ago | (#30426616)

Sorry, to clarify, I was referring to teachers using CP, not parents. And yes, even for parents, there is a reasonably clear legal limit where it turns into abuse.

Two parents (1)

p51d007 (656414) | more than 4 years ago | (#30426556)

Most of the dealings I've had with "poor people" come from the fact they are in a ONE parent house. Perhaps if we went back to the nuclear family, and we had parents that actually gave a rats a** about their kids, we wouldn't have problems like this.

Eugenics (-1, Troll)

Anonymous Coward | more than 4 years ago | (#30425854)

This is just a government eugenics operation.

The more likely scenario (0)

Anonymous Coward | more than 4 years ago | (#30425876)

Poor parents are using their children as an excuse for getting drugs. They bribe or beg the doctor for the prescription, then they sell the drugs on the street.

Re:The more likely scenario (1)

wizardforce (1005805) | more than 4 years ago | (#30425978)

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...

Re:The more likely scenario (2, Informative)

Ethanol-fueled (1125189) | more than 4 years ago | (#30426038)

That's B.S. Opioid painkillers and benzodiazepines* are where the money's at. Recreational abusers usually get their pills from their parents or from friends (I knew a healthcare worker who even took cuts from her patients' prescriptions) if not their own prescriptions -- as in, they sprained their ankle 2 years ago and still need meds for it ;)

*Can't get behind the paywall to determine if benzos were considered to be antipsychotics

Re:The more likely scenario (1)

m.ducharme (1082683) | more than 4 years ago | (#30426354)

*Can't get behind the paywall to determine if benzos were considered to be antipsychotics

It's not really a paywall, since it doesn't actually ask you to pay anything (without getting into the discussion about whether "viewing ads" is another form of payment, which I believe it is). You do have to register, but that's it.

Here's a link to the study that the reporter used. linky [healthaffairs.org]

Parent pushback (2, Insightful)

andy1307 (656570) | more than 4 years ago | (#30425894)

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

Re:Parent pushback (5, Interesting)

Lemmy Caution (8378) | more than 4 years ago | (#30425924)

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 (0)

Anonymous Coward | more than 4 years ago | (#30426044)

All of the above, and probably more as well. Only further research can determine which reason is more prominent, if the study results are even largely determined by any of the reasons in your list. What does your litmus test say about my political ideology?

Re:Parent pushback (1)

Lemmy Caution (8378) | more than 4 years ago | (#30426426)

All of the above, and probably more as well. Only further research can determine which reason is more prominent, if the study results are even largely determined by any of the reasons in your list. What does your litmus test say about my political ideology?

That you are cautious in the way that I am.

Re:Parent pushback (5, Informative)

Trepidity (597) | more than 4 years ago | (#30426194)

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 (1)

Lemmy Caution (8378) | more than 4 years ago | (#30426448)

Good point, and I suspect point 4 is definitely in play (and point 3 comes into play when you ask about prognosis, too.) But, are those diagnoses binary, or graded?

Re:Parent pushback (1)

rattaroaz (1491445) | more than 4 years ago | (#30426590)

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.

What you may not be taking into account is a condition's severity. With the same diagnosis, major depression could cause suicide, or just difficulty with school activities. The more intense the severity, the more likely to prescribe medications. This is why I dislike studies based upon coded diagnoses: little insight into the individual cases leads to little insight as to the meaning of the study. I didn't RTFA since it is behind a paywall.

Re:Parent pushback (3, Insightful)

TubeSteak (669689) | more than 4 years ago | (#30426254)

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:Parent pushback (2, Funny)

jimfinity (849860) | more than 4 years ago | (#30426374)

There are many explanations, none of them happy-making

There's a drug for that.

Re:Parent pushback (0)

Anonymous Coward | more than 4 years ago | (#30426402)

One more: Poor kids are more likely to be lead poisoned which causes psychotic symptoms.

Re:Parent pushback (1)

Dunbal (464142) | more than 4 years ago | (#30426222)

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?

Re:Parent pushback (0)

Anonymous Coward | more than 4 years ago | (#30426428)

Or could it be that poor people are fucking angry about being constantly screwed by dicks like you, and medicating them is an easy method of control?

Re:Parent pushback (1)

Ironsides (739422) | more than 4 years ago | (#30426304)

Or, more likely to ask questions and investigate the drugs? In first grade, my teacher told my mother I had ADD and needed medication. She asked me why I was 'spacing out' in class. The reason was I was bored. It seems that if a kid doesn't behave 'perfectly', they need to be put on medication. I sometimes wonder if this need for meds is part of the problem. Hm. On a related note, I wonder if there is a difference in the likelyhood of medication between boys and girls.

Re:Parent pushback (0)

Anonymous Coward | more than 4 years ago | (#30426364)

Absolutely. They are more likely to see the long-term repercussions of having their children labeled as anything undesirable. I suspect this is reflected in the recent trend towards 'autism' over 'retarded' in diagnosing kids who score low on IQ tests. The middle class parent is conscious of their class status and eager to protect it in their kids who are a property-extension of themselves (to speculate broadly).

is this restricted to medicare? (2, Interesting)

wizardforce (1005805) | more than 4 years ago | (#30425904)

Does this also happen with other public health care systems or is this mostly limited to Medicare in the US?

Note about the link (1)

snl2587 (1177409) | more than 4 years ago | (#30425952)

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.

Re:Note about the link (1)

krou (1027572) | more than 4 years ago | (#30426154)

The paywall they're referring to is on the first link, which is not the NY Times.

Re:Note about the link (1, Informative)

Anonymous Coward | more than 4 years ago | (#30426182)

If you have firefox, download the RefControl extension. Set it so that all pages from nytimes.com have a referrer of http://google.com/ [google.com] and suddenly you don't need to log in. I suppose you could also enter the URL into google and then click the result.

Personally, I hate the referrer and disable it for sites not absolutely requiring it. Sites absolutely requiring it get spoofs.

None of the Above (3, Interesting)

grumpygrodyguy (603716) | more than 4 years ago | (#30425960)

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.

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 (3, Insightful)

wizardforce (1005805) | more than 4 years ago | (#30426098)

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 (5, Interesting)

Anonymous Coward | more than 4 years ago | (#30425970)

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 (4, Interesting)

Lord Kano (13027) | more than 4 years ago | (#30426070)

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

Serve, doc (1)

paxcoder (1222556) | more than 4 years ago | (#30425972)

I'm simply outraged, I don't know what to write. Dr., it's not your place to play with minds of children. Do your job well and fair, or quit it.

Perhaps (4, Interesting)

gad_zuki! (70830) | more than 4 years ago | (#30425990)

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:Perhaps (3, Interesting)

Ricomyer (1454553) | more than 4 years ago | (#30426090)

I agree, however I would say it in a different way. Messed up families are more likely to be poor (single parent homes for instance), and messed up families lead to kids who need more heavy meds.

Re:Perhaps (1)

forand (530402) | more than 4 years ago | (#30426094)

So you are suggesting that there exists a sub class of humans which are more likely to be mentally ill? Seems like a straight path towards eugenics to me. As for your statement how this is going to be used as a "OMG BIG GOVERNMENT/CAPITALIST CONSPIRACY:" who needs a capitalist conspiracy when we can 'scientifically justify' the position of people in society?

Re:Perhaps (0, Interesting)

Anonymous Coward | more than 4 years ago | (#30426300)

So you are suggesting that there exists a sub class of humans which are more likely to be mentally ill?

Yes - they're called the "highly religious". Believing that an invisible man is watching everyone is strongly passed from parent to child, and clearly bugfuck insane.

Re:Perhaps (2, Insightful)

fuzzyfuzzyfungus (1223518) | more than 4 years ago | (#30426316)

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 (2, Insightful)

Ironsides (739422) | more than 4 years ago | (#30426368)

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:Perhaps (1)

forand (530402) | more than 4 years ago | (#30426546)

True. However the situation that the OP was attempting to explain was for poor people being 4x more likely to be prescribed anti-psychotics. Since the poor are already dominate in terms of population I do not see how your explanation makes the OP's reasonable. You can't remove the class demarkation from 'poor.'

Re:Perhaps (1)

cenc (1310167) | more than 4 years ago | (#30426382)

How about the suggestion that medical community and society as whole has evolved western medicine over a 1,000 years that defines abnormal behaviors and abnormal physical conditions around what is also deemed "poor".

The history of the IQ test is a case in point.

Re:Perhaps (2, Insightful)

MindlessAutomata (1282944) | more than 4 years ago | (#30426096)

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

Re:Perhaps (5, Informative)

krou (1027572) | more than 4 years ago | (#30426138)

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:Perhaps (1)

Stradivarius (7490) | more than 4 years ago | (#30426192)

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:Perhaps (1)

oldhack (1037484) | more than 4 years ago | (#30426208)

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.

Bi-Polar at Three? (3, Interesting)

Pantero Blanco (792776) | more than 4 years ago | (#30425998)

"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? (3, Insightful)

Lord Kano (13027) | more than 4 years ago | (#30426120)

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:Bi-Polar at Three? (1)

Tacvek (948259) | more than 4 years ago | (#30426572)

Many conditions like OCD or bipolar in young children are generally guesses on the part of the doctor who prescribe something that tends to work on many mental illnesses, and if a positive improvement is noted, then this is cited as evidence that the original diagnosis was correct, despite potentially being completely wrong, and the actual condition being something else the medication is effective on.

Of course, that is not as horrible as it sounds. If the medication fixes the problem, the initial diagnosis is somewhat less important, although if looking for alternatives to medication, or alternate medications, the correct diagnosis becomes important again.

Re:Bi-Polar at Three? (1, Insightful)

Anonymous Coward | more than 4 years ago | (#30426394)

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.

How this works... (5, Interesting)

ZephyrQ (96951) | more than 4 years ago | (#30426014)

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! (3, Funny)

Greyfox (87712) | more than 4 years ago | (#30426020)

I think the shoddy private insurance plans aren't dishing out enough antipsychotics compared to the better-managed state-run plans. Someone needs to put together a panel to look at ways to get private plans to step up to the plate and start dishing out antipsychotics on par with the state run plan!

Re:Nope! (1)

wizardforce (1005805) | more than 4 years ago | (#30426200)

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.

Re:Nope! (1)

Ironsides (739422) | more than 4 years ago | (#30426408)

It's sarcasm. Just in case you aren't in the US, the elected leaders have proposed a very big change in the US health insurance industry. Some versions include a public option and some do not. The OP appears to be a critic of the public option. Re-read it in this light and it should make more sense.

Re:Nope! (1)

oldhack (1037484) | more than 4 years ago | (#30426236)

Oh no! Not the dreaded PSYCHO PANEL!

Absolutely (1, Funny)

Anonymous Coward | more than 4 years ago | (#30426326)

Now if we could only put it in the water so everyone got them equally

rich v's poor (4, Insightful)

naeone (1430095) | more than 4 years ago | (#30426110)

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

Healtscare system.. (4, Interesting)

arikol (728226) | more than 4 years ago | (#30426178)

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.. (1, Informative)

Ironsides (739422) | more than 4 years ago | (#30426412)

Medicair/Medicaid is the public healthcare insurance, not the private healthcare insurance. This data would seem to support the removal of the government run insurance plan and its replacement with a private plan.

Drug Lobbies? (4, Insightful)

Bob9113 (14996) | more than 4 years ago | (#30426186)

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? (5, Interesting)

meehawl (73285) | more than 4 years ago | (#30426232)

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.

Re:Middle Classes Under-Medicated? (1)

Ironchew (1069966) | more than 4 years ago | (#30426312)

The subtext of this story is that medication is bad, that treatment of a disease state with chemicals is sub-optimal.

Well, yeah. It is sub-optimal, and anybody who says differently is trying to sell you a drug. There is no perfect medication, and while the adverse effects of a medication should not happen (stop taking the drug if they do), all medications have common side-effects that aren't intended for any single treatment, and are usually countered by other medications that have even more side effects. Preventative medicine should be practiced, and only when it fails should medications be considered.
As far as vaccines for deadly diseases are concerned, I am fully of the belief that the rare chance of adverse effects from the vaccine is very, very preferential to the disease it's preventing.

Re:Middle Classes Under-Medicated? (1)

electrons_are_brave (1344423) | more than 4 years ago | (#30426518)

I agree with you about the loopy middle class attraction to homeopathy and so on, but in the case of psychotropic drugs there is far too little known about them for me to be comfortable with their widespread use on children (whose brains are still developing).

It's not limited to children. (2, Interesting)

macraig (621737) | more than 4 years ago | (#30426240)

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 effect is more pronounced for adults: they're likely to have even less of a support system than the children.

It's hard not to perceive social Darwinism as evil when one is on the losing end of the process.

Hmnn (1, Interesting)

Vexorian (959249) | more than 4 years ago | (#30426266)

However, could it be that people with psychotic traits and their parents tend to be less likely to get an appropriate source of wealth?

In the UK this would be very Skewed (4, Interesting)

Anonymous Coward | more than 4 years ago | (#30426320)

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.

Class? (1, Funny)

Anonymous Coward | more than 4 years ago | (#30426502)

The article mentions the 'poor' children and the 'middle class' children. What defines these classes? Is it a disservice, and perhaps bad analysis, to treat them as a class instead of individuals?

I hadn't realized... (3, Funny)

praksys (246544) | more than 4 years ago | (#30426524)

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.

mental illnesses are hereditary (1)

Kartoffel (30238) | more than 4 years ago | (#30426528)

Poor people are more likely to have mental illness than average-income people. Mental illness runs in families. Are poor children more likely to need antipsychotic meds than children in average-income? Yeah, probably.

Next up: Poorer Children More Likely to Get Free School Lunches. Film at 11!

"news for nerds" or "news for US nerds" ? (0)

Anonymous Coward | more than 4 years ago | (#30426632)

My opinion on /. as a system (from a nerds perspective) isn't that great. A CMS which can't even delete an entry in its back-side database? Come on!

But being a EU citizen I cannot help wonder if /. maybe isn't aware of its impact on the Net. More and more do I see stories which solely impact the US and absolutely don't qualify in the common statement "news for nerds".

WTF?

So what gives guys? News for nerds or News for US nerds? Being a nerd I say you can't have it both ways you know; "the Net is vast and infinite" and it will certainly cross common Earth like borders.

Or is such a criticized comment "too nerdy" all of a sudden ?

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