Kids with Medicaid given powerful antipsychotic meds at a rate 4X higher than kids with private ins.

[Are_grits_groceries]

New federally financed drug research reveals a stark disparity: 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, the data shows.
Those findings, by a team from Rutgers and Columbia, are almost certain to add fuel to a long-running debate. 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?

The questions go beyond the psychological impact on Medicaid children, serious as that may be. Antipsychotic drugs can also have severe physical side effects, causing drastic weight gain and metabolic changes resulting in lifelong physical problems.

<...>

Some experts say they are stunned by the disparity in prescribing patterns. But others say it reinforces previous indications, and their own experience, that children with diagnoses of mental or emotional problems in low-income families are more likely to be given drugs than receive family counseling or psychotherapy.

Part of the reason is insurance reimbursements, as Medicaid often pays much less for counseling and therapy than private insurers do. Part of it may have to do with the challenges that families in poverty may have in consistently attending counseling or therapy sessions, even when such help is available.

"It's easier for patients, and it's easier for docs," said Dr. Derek H. Suite, a psychiatrist in the Bronx whose pediatric cases include children and adolescents covered by Medicaid and who sometimes prescribes antipsychotics. "But the question is, 'What are you prescribing it for?' That's where it gets a little fuzzy."

Take a pill! After all, it's easier! And if the parents of these kids were willing to do the hard work, they wouldn't be poor, right? What's a little childhood obesity, metabolic disorders and Type II Diabetes in a population that was written off in kindergarten anyway?
http://www.nytimes.com/2009/12/12/health/12medicaid.html?pagewanted=1&em

Who knew that Nurse Ratched worked in the schools? Juicyfruit anyone?

[ensho]

1. this is bad - our kids deserve better medical protection and not be

nothing but a profit for the pharma barons

[EndersDame]

2. My mom is on medicaid and is on several heavy drugs but no counseling

her appointments at MHMR with her psychiatrist are less than 15 minutes once a month . Up until recently they were not providiing lab work for her while she was on lithium!!

[sui generis]

3. see this is a problem of interpretation

The link isn't medicaid = antipsychotics.

The link is healthcare providers who focus on medicaid patients have a different standard for medicating poor children. Typically in private insurance you CAN go see a therapist who has a pediatric practice, while in medicaid the quality of access to holistic care may be limited if not entirely absent, starting with the family and their financial situation.

Not a justification but there are more factors at play in that difference in treatment than medicaid alone.

[niyad]

4. keep the kids comatose and compliant. kind of like prescribing valium for all those bored, "sick"

suburban housewives back in the '50's.