Yesterday, the L.A. Times published an op-ed piece from a psychiatrist describing the epidemic of over-prescription of medications for our children.

The boy, a quiet slip of a 10-year-old, had been prescribed two antipsychotics, two mood stabilizers, one antidepressant, two attention deficit disorder medications and another medication to manage the side effects of the antipsychotics. [...]

During the last year, while they were in foster care, a doctor had diagnosed the 10-year-old with bipolar disorder and attention deficit disorder and prescribed eight medications.

Say what? Eight medications for a single child? Heck, I wouldn’t want to see an adult taking that many medications for a psychiatric disorder, much less a child of 10.

The article didn’t mention whether the original doctor was also a psychiatrist, or a pediatrician or family physician. I’d expect most psychiatrists, like the author of this piece, Dr. Laurel Williams, to recognize the challenge a child of 10 might present, and err on the side of caution when making medication recommendations.

Even if doctors weren’t short on time, the country is short on board-certified child and adolescent psychiatrists, the physicians best-trained to diagnose and treat child mental health problems. This shortage puts pressure on child psychiatrists to increase their patient loads, which then reduces the amount of time they can spend with individual patients.

I agree, general practitioners and physicians should never be diagnosing a child’s psychiatric condition unless they are a psychiatrist, plain and simple. They might offer a preliminary diagnosis, but then the rule should be that they refer on to a qualified mental health professional (a psychiatrist is fine, but psychologists and other mental health professionals are also well-qualified to properly diagnose and recommend a comprehensive treatment plan).

More importantly, we see that, in yet another single datapoint, how pervasive this problem has become. Compared to adults, few studies have been done to ensure the safety and efficacy of many of these psychiatric medications (except for childhood concerns like ADHD). Medications for children are sometimes necessary, absolutely. But it should be done only under the oversight of a specialist in mental health concerns (a psychiatrist) and treatment should, ideally, be conducted through a treatment of team of mixed mental health professionals.

A child who is taking eight medications should be a rarity, not commonplace.

Read the full article: Mental health and children

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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