It's Christmas time and almost every store is encouraging us to give money to cure childhood cancer. It is certainly easy to feel sympathy for a child who has lost her hair, and to empathize with what her life will be like.
Unfortunately, the millions of children who are living with psychiatric disorders haven't the same well of support. Instead of our sponsorship, understanding and love, they and their parents are very often the targets of scorn and blame.
A recent federally funded study comparing the use of psychiatric medications in children on Medicaid versus those covered by private insurance (New York Times, Dec. 12) highlights a serious deficit in our children's healthcare: fifteen million children and teenagers in this country have a psychiatric disorder, and yet there are only 8,000 child and adolescent psychiatrists. And while poor children are four times more likely to receive a prescription for antipsychotic medication, 80 percent of all children with a psychiatric disorder will never get any treatment at all.
The math simply doesn't work.
The situation is even worse outside of the United States. Forty percent of all nations do not have a single child mental health program. In developing nations, 65 percent do not have a single child mental health program.
There are more children and teens with a psychiatric disorder than with leukemia, diabetes, heart disease, and AIDS combined, and the effects are staggering: suicide remains the third leading cause of death in adolescents; teens with untreated ADHD are ten times more likely to drop out of high school; children with untreated social anxiety disorder are significantly more likely to abuse alcohol; and nearly 50 percent of inmates in the juvenile justice system have dyslexia. A new model is needed to address this grave public health issue.
As Congress addresses healthcare reform, we need to recognize that child psychiatric disorders are real, common, and treatable. Diagnosis needs to drive treatment, we need more experts to care for our children, and we need to train pediatricians to act as the first line of defense and recognize when a child's symptoms are serious and significant.
Historically, treatments for childhood psychiatric disorders have been developed for adults and then modified for children and teenagers. We need new treatments specifically designed for children and teenagers. We need to create a network of pediatric neuroscientists and clinical researchers from academic institutions across the nation to tackle this problem with a translational research model.
And we need to educate students, parents, and teachers about psychiatric disorders by providing scientifically sound information in an easy to understand and accessible manner.
I fear we spend too much time discussing who is getting medication rather than working to demystify and advance research into these serious disorders. Unless we take action now to address this public health crisis, we will continue to see rising rates of children and teens who fail academically and drop out of school, struggle with substance abuse problems, and commit suicide.
We need to care for all of America's children, not just those whose physical symptoms command our attention--especially at this time of the year.
Harold S. Koplewicz, M.D.
President, The Child Study Center Foundation, Inc.
Director, Nathan S. Kline Institute for Psychiatric Research
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