File this in the Big-Brother-is- watching-you-but- you-may-not-mind category. After the death of 4-year-old Rebecca Riley last year in Massachusetts, state officials have decided to take action in the form of an
early warning system (via The Boston Globe).
By combing through its Medicaid records, the system analyzes children under the age of 5 who are taking at least 3 psychiatric drugs, or a single prescription of certain more powerful psychiatric medications. It then flags those cases, which are then reviewed by mental health professionals. Ostensibly, the mental health professionals will then be able to contact individual doctors to verify the facts of the case.
According to the report, 35 children’s cases have already been flagged for followup. And its goals are admirable:
The reviewers will be looking to make sure that the high rate of prescriptions is not an error caused by more than one doctor writing them, and checking to make sure the drugs don’t have dangerous side effects when taken together, Straus said. They will also look at the child’s history for signs of abuse, evidence of emotional problems, and other issues aside from mental illness that could explain behavior problems. The point is to make sure doctors try other forms of treatment or social services before turning to drugs, Straus said.
Like all government-driven programs, the devil will be in the details. These kinds of programs often are announced with much fanfare, but then left unfunded or understaffed after the first year. In fact, check back on this program in two years and see whether it still even exists.
The challenge is that that the tragic Rebecca Riley case was an example of an extreme situation, so it’s not likely to be repeated very often (with or without such a system in place). Of course, it makes the headlines and catches people’s attention (especially our politicians — “We must do something!”), but folks often miss the point.
We need to have a larger societal conversation about overmedicating such young children in general. Very few medications are FDA-approved for such young ages, and that’s for a very good reason — we have little idea of what most of their long-term effects are, especially when the body is undergoing significant and important development.
I have mixed feelings about this sort of system, but if it does help us prevent, or try to prevent, cases like Rebecca Riley in the future, I suppose it is worth a try. I hope it works.