Researchers from Rutgers and Columbia have found that poor children are more likely to be prescribed antipsychotic drugs. Children covered under Medicaid are given powerful antipsychotics at a rate four times higher than children who are covered under private insurance (4% of Medicaid patients age 6 to 17 are prescribed antipsychotics compared to 1% of privately insured children and adolescents). Furthermore, children under Medicaid are more likely to receive these drugs for less severe conditions than their middle-class counterparts. The possibility of over-prescribing is a concern because these are powerful drugs which can have sever physical side effects, including causing drastic weight gain and metabolic changes resulting in lifelong physical problems.
Some experts say that one possible explanation for why low-income children are more likely to be prescribed drugs than to receive counseling or psychotherapy could be insurance reimbursements. Medicaid often pays much less for counseling and therapy than private insurers do. Drugs can be cheaper than long-term therapy. Furthermore, there are also less psychiatrists that accept Medicaid. Experts say another possible explanation is that it might be more of a challenge for low-income families to consistently attend therapy sessions.
As one psychiatrist said about prescribing antipsychotics, "It's easier for patients, it's easier for docs. But the question is, 'What are your prescribing it for?' That's were it gets a little fuzzy." There is a concern that children are given drugs when it's not necessary. As there can be long waiting lists to see psychiatrists that accept Medicaid, it is often a pediatrician or family doctor that is prescribing the antipsychotic drugs to Medicaid patients. The FDA has approved antipsychotic drugs for children specifically to treat schizophrenia, autism, and bipolar disorder. But they are more frequently prescribed to children for other, less extreme conditions including attention deficit hyperactivity disorder, aggression, persistent defiance, and other so-called disorders. Doctors can legally prescribe antipsychotics for these "off label" uses, even though there has not been long-term studies of their effects when used for such conditions. The researchers found that Medicaid children were more likely than their private insurance counterparts to be given the drugs for these off label uses. In comparison, the private insurance children were more likely to receive the drugs for FDA-approved uses like for bipolar disorder.
"Experts generally agree that some characteristics of the Medicaid population may contribute to psychological problems or psychiatric disorders. They include stresses of poverty, single-parent families, poorer schools, lack of access to preventive care, and the fact that the Medicaid rolls include many adults who are themselves mentally ill. As a result, studies have found that children in low-income families may have a higher rate of mental health problems -- perhaps two to one -- compared with children in better-off families. But that still does not explain the four to one disparity in prescribing antipsychotics. " (Full Story)
A Pew Research survey found that only 56% of Americans think scientists generally agree that the earth is getting warmer because of human activity. When in actuality, 84% of scientists say the earth is getting warmer because of human activity.
And only 60% of Americans think scientists generally agree that humans have evolved. When in actuality, 97% of scientists say humans have evolved. (Full Story)
No comments:
Post a Comment