Schaefer: Kids are too medicated

GOP state senator makes subject an issue in her bid for re-election
By DEBBIE GILBERT
Gainesville Times
Oct. 28, 2006

Are America's children over-medicated with "psychotropic" drugs?

That's the view of state Sen. Nancy Schaefer, R-Turnerville, who has made it an issue in her re-election campaign.

Schaefer is running to keep her seat in the 50th District, which covers all or part of six mountain counties in Georgia's northeast corner. She has been criticized by some people, including her opponent, Democrat Carol Jackson, for attending an event that has ties to the Church of Scientology.

On Aug. 28, Schaefer cut the ribbon for the opening of an exhibit in Atlanta called "Psychiatry: An Industry of Death." She insisted she has no affiliation with Scientology, explaining that the exhibit focused on an issue that she has been involved with for several years.

In the 2006 General Assembly, Schaefer introduced Senate Bill 430, which would have made it illegal to screen schoolchildren for mental health problems without their parents' consent.

That bill failed to gain traction. But Schaefer is not giving up. In a recent newspaper ad, she stated that 10 million American children "are placed on mind-altering drugs to correct normal behavior misdiagnosed as a mental health disease."

In a position paper posted on her Web site, Schaefer says she fears Georgia will adopt a program to diagnose mental disorders in children and get them into drug treatment against their parents' will. She says there is a national initiative in this direction, aimed at reaping profits for "the big pharmaceutical companies and the psychiatric experts."

"I've had many parents call me, saying that their children were being overmedicated," she said Tuesday. "They thought the professionals were suggesting what was best for their child, but later regretted their decision."

Schaefer said she's trying to raise awareness of the issue and educate parents about what's going on.

"If children are fidgety, they may need discipline or physical activity. But we don't need to drug them into submission," she said. "To me, this is an invasion of family life."

Millions of American children take prescription stimulants such as Ritalin or antidepressants such as Prozac. But in Georgia, there is no evidence that schools have played a role in getting them medicated.

"There's no national conspiracy to force people into treatment. That's kind of a crazy notion," said Dr. Shannon Croft, assistant professor of psychiatry at Emory University and medical director of child psychiatry at Grady Memorial Hospital.

"In Georgia, a doctor cannot write any prescription for a child without the consent of a parent or legal guardian."

And school officials are careful to not even suggest the use of a drug.

"We do not make recommendations about taking medication," said Paula Rufus, coordinator of student services for Hall County Schools. "If a student is having a behavior problem, we may ask the parent if the child has had a medical exam recently. But we are not medical professionals. We don't make diagnoses."

Mamie Coker, director of health services for Hall County Schools, said the system doesn't keep track of how many students are on Ritalin or similar drugs.

"Now that there are controlled-release versions of these medications, many students may be taking their dose at home so it doesn't have to be administered by the school nurse," she said.

But from her own observations, Coker said she hasn't noticed an increase in students taking psychiatric drugs.

"In fact, I think the pendulum may be swinging the other way," she said. "I've seen some parents trying other methods, such as herbal remedies."

Coker said Hall schools do not have a formal program for screening students for mental or behavioral problems. But on an individual basis, school officials do help identify kids who might need assistance.

"Often, the teacher observes that the child is having difficulty in the classroom and mentions this to the parents," she said. "It's up to them whether they want to take the child to a doctor."

Georgia law requires schools to form a "student support team" for any child who seems to be having difficulty. The teacher, principal, counselor and others confer to try to determine the nature of the problem.

Anita Frederick, a school psychologist based at Mount Vernon Elementary, said sometimes what looks like a behavioral issue may turn out to have a different cause.

"We meet with parents and have them fill out a checklist," she said. "Do the behaviors happen only at school and not at home? If so, the problem could be a deficit in learning or cognitive ability. The child may feel overwhelmed in the classroom and is acting out as a result of that."

Frederick said it may be difficult for an untrained person to distinguish between normal childhood energy and attention-deficit hyperactivity disorder (ADHD).

"A big question that I usually ask teachers is, 'Is it interfering with their learning, or the learning of others?'" she said. "I see so many cases where (ADHD) medication makes a world of difference for the child. They can focus and achieve academic success for the first time."

But are some children put in Ritalin or other drugs unnecessarily? Yes, said Croft.

"It is true that some children are diagnosed and treated for illnesses that they do not have," he said. "There are some people, including doctors, who see drugs as a quick fix. But a doctor should never push a medicine on a patient. The risks and benefits must be weighed."

Croft said children are more likely to be misdiagnosed in small towns where there are few psychiatrists. In those circumstances, the prescription for a drug such as Ritalin is usually written by a pediatrician or family doctor, who may not have time to fully evaluate the child.

"A typical evaluation for ADHD by a child psychiatrist involves three or four visits and a detailed consultation with the school and parents," he said.

"Aside from simple ADHD, most childhood emotional and behavioral problems should be treated with therapy first. An ADHD drug can treat hyperactivity and inattention. But no medicine can create 'good' behavior. That's what therapy is for."

A study published last week in the Journal of the American Academy of Child and Adolescent Psychiatry concluded that for preschoolers with severe ADHD, the benefits of Ritalin outweigh the risks. But Croft said he's skeptical of those results.

"There's still controversy over how you can accurately diagnose ADHD in preschoolers, whose attention span is already short," he said. "If your child is younger than 5 and you are told he needs stimulants, get a second opinion."