Some Children Do Need Psychotropic Medication

Abstract

I would like to discuss the current trend I am seeing as a clinician in regards to medication not being prescribed to children because the primary care doctor and/or psychiatrist refuses to medicate a child after therapeutic interventions have been tried for several months with little or no success, and have been short-lived due to the fact that the child has not stabilized from symptomatology of a classifiable DSM-5 diagnoses. This commentary does not suggest that the medical profession does not have the skills or the knowledge to address mental health issues as a whole. One of the main reasons for non-medicating is the actuality that it is a child and not an adult, which weighs heavily on the medical professional’s psyche, as most of us do not think children require or need pharmaceutical assistance when they are at the beginning stages of their lives. I do understand that children do have developmental stages they must go through that occur over the child’s life span. It is also well known and documented that children go through behavioral periods in life, more particularly during teenage years, although it is also experienced at younger ages. I think the problem really arises when medical professionals, specifically primary care doctors and certain psychiatrists, have not been given the appropriate training in medical school or during residency in working with children with mental health issues. From this de facto, they feel uncomfortable treating a child with depression, trauma, anxiety, etc. I have worked in many arenas and the unwillingness of practitioners refusing to medicate a child goes against the child’s best interest, when it is medically indicated that the child meets the criteria for a medical diagnosis and can benefit from medication assistance. I have observed, in many instances, where children need medication to stabilize from depression in order for therapy / counseling to be effective, only to be prevented because the doctor feels that the child is too young for the medication. Recent research suggests that up to fifteen percent of children and adolescents have a mental disorder that is serious enough to cause some impairment, unfortunately, only one in five children receive services by appropriately trained mental health professionals. As a result, the child gets discharged from one counselor to the next, only to have the same issue arise of needing medication to stabilize. Parents end up having to take the child to their local ER to get temporary assistance, not long term help which they so badly need. On the other end of the spectrum, I have been at institutions in other states where I have been fortunate to have a child psychiatrist in-house who had the knowledge and the confidence in prescribing psychotropic medication to children combined with therapy, effectively stabilizing the child to receive services elsewhere.