Wednesday 6 February 2013

World-Wide Betrayal

Take a look at the Aviva "Health of the Nation" survey of GPs in England and Wales here especially page 26 onwards which covers mental health - the research dates back a while but it was only published last week. This indicates great concern among GPs about the state of mental health services and their own capacity to help people.

Two points stand out: first, doctors are increasingly concerned about the volume of problems raised by or about children and young people; second, 65% of doctors admit to prescribing anti-depressants when psychological therapies or "social care" would have been preferable. A major factor in the increase in young people presenting problems is acknowledged to be greater knowledge about mental health matters.

Now, greater knowledge is a good thing but you have to ask if it is a good net result if people end up getting the wrong treatment and, more sinister, if people without mental health problems get medical treatments such as anti-depressants when they really need practical support with a problem which is external such as unemployment or debt. These external problems can of course lead to mental health problems but by no means necessarily. If in fact somebody has concerns or sadness which are proportionate to their circumstances then drugs may just hold them back from sorting out the problem or working through their sadness.

In the case of children the massive increase in using drugs to deal with "behavioural problems" is nothing less than a world-wide betrayal of huge numbers of young people. There are of course children with major problems for whom medication may be a last resort but that does not remotely justify the almost casual use of drugs as a "panacea" for dealing with difficult or troubled children. There has been some admirable resistance in the UK to the trend in the USA towards diagnosis encroaching ever earlier into childhood - not least "paediatric bipolar disorder" which is a highly suspect diagnosis.

Nevertheless there seems to be a disturbing move away from the working assumption that children should be able to find their way to adulthood in sometimes odd ways but you really don't want to intervene with drugs to make them conform to society's expectations. We should try to reverse that trend and think twice before medicating adults too except where really necessary for them to be safe and functioning.