Eavesdropping On Judith Warner

Pardon me if I’m returning to a theme that I’ve dealt with before. I was going to critique a review of a book on school interventions for the purpose of preventing major mental illnesses that I read in the Irish Times, but when I looked more closely into the matter I figured maybe I should be praising the book rather than trashing it, and so I scratched that idea.

Judith Warner and certain others, such as yours truly, are in disagreement. My view is that people, not children alone, are being over-diagnosed and over drugged for what have been labeled ‘mental illnesses’. Judith claims the exact opposite to be true.

Judith Warner is the author of the book We’ve Got Issues: Children and Parents in the Age of Medication, and she recently did an interview for theglobeandmail.com, Are we overmedicating our kids – or undermedicating them?

I started to do some research and not just rely on my preconceptions and prejudices and the factoids that I had put together from the media. When I started to speak to doctors, including doctors who I had specifically chosen to interview because I thought they shared my point of view, I heard that overmedication and overdiagnosis were really not the major problems. The major problem was underdiagnosis and undertreatment, especially of children from poor or minority backgrounds.

If Ms Warners research method was merely a matter of asking Doctors of psychiatry for their opinions on the subject, I would call that method of research lacking in rigor and validity.

Then when it comes to children from poor or minority backgrounds, a New York Times article from December 1, 2009 that I took notice of at the time on this blog did a story on how children on Medicaid were more likely to receive prescriptions for neuroleptic drugs than children who were not on Medicaid. If that isn’t an example of overdiagnosis and overtreatment of children, mostly from poor or minority backgrounds, I don’t know what is. The article in fact stated that children on Medicaid were 4 times more likely to receive these powerful and potentially harmful neuroleptic drugs than children covered by a private insurance company.

We didn’t have these diagnoses before, or not as such. Large numbers of children in the past were diagnosed as mentally retarded and some of the children who are now diagnosed as autistic would have been called schizophrenic. There was no diagnosis of attention deficit disorder before 1980. It wasn’t believed that children could suffer from depression until the 1970s, or that anyone other than young adults could have bipolar disorder until the 1990s. So, basically, you have huge increases because you went from nothing to something.

Emphasis added.

Zero is nothing, a percentage is something. Mentally retarded is a term that has been misused, often in a derogatory fashion, and it is quickly gaining disfavor. The more preferred term these days is intellectually challenged. Judith Warner should know this. When it comes to the ‘large number’ she mentions we need some way to build a point of reference we don’t have. We need statistics to compare with current statistics. No ADHD, no major depression, no bipolar disorder. Has the paradigm suddenly shifted, and is this shift the kind of shift anybody needs? Well, I’d call this shift godsend for the drug manufacturers, and I’d question whether this shift wasn’t brought about less by the development of childhood ‘mental illness’ than by the desire to sell a pharmaceutical product.

On the question of whether children should be drugged at 5 or 6 years old, she says;

I think that most doctors really do try to wait with children that young before they diagnose something, unless the case is so severe and the problems are so great that there is an absolute urgency to do something. With school-aged children, the argument is that not giving children help is risky as well. Mental illness is actually bad for the brain. And it sets you up for having all kinds of negative experiences that then impact your personality and your brain further.

One problem, its not just at the age of 5 or 6. Children are being drugged as young as 2 years old. I’ve even heard of instances where children under the age of 1 were being drugged. We won’t go there though. If a person were to tell me that there was any reason to drug a kid at 2 years old, I would think that commitment proceedings ought to be in order for the person that did so.

There is a growing body of evidence supporting the conclusion that the drugs used to treat ‘mental illnesses’ are ‘bad for the brain’ as Ms. Warner puts it. The problem with the research purporting to show that the ‘mental illness’ has caused such harm is that the doctors doing this research, and recording such ‘impacts’, have seldom factored out the damaging effects of these drugs. Until this factoring out is done, we can’t say for sure that the harm attributed to ‘the illness’ isn’t in fact caused by the drugs used to ‘treat’ ‘the illness’.

She ends her interview by claiming that parents don’t single-handedly cause ‘mental illness’. Of course, no parent could do so without mental health professionals, school officials, neighbors, and other well meaning but meddling actors aiding and abetting them. I’m just not so quick to let all parents off the hook as Ms. Warner apparently is. When so many children are being brought up by their grandparents these days, I don’t think the claim can be made that sometimes the sins of the fathers and the mothers aren’t visited on their offspring. Before you start expecting perfect behaviour from children, you are going to need to evolve the perfect adult, and I don’t see anything of the sort happening at this point in time.