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Sunday, October 14, 2012

There's A Pill For That...

5:52 AM Posted by Tiffany Taft , , ,
Take 12 of these and call me in a month
There's an article out via the New York Times about a physician in Georgia who's prescribing ADHD meds to children who live in poor neighborhoods, and don't have ADHD, to help them concentrate and boost school performance.  His rationale is because we, as a nation, aren't investing in changing these kids' environments, the only other option is to "change the kid."  This story bothers me immensely for several reasons, but it got me thinking about my role as a clinical psychologist; or specifically psychologists as a collective, especially those in private practice.

I did a poll with my friends at the Great Bowel Movement about mental health care and living with IBD.  One of the questions I asked was "If you've considered seeing a therapist, what are some of the barriers that you've encountered." People could check off as many items as they wanted - things such as "not enough time," "finding a therapist who specializes in IBD," "bad experience with a past therapist," etc.  27% endorsed "many therapists don't accept insurance" as a barrier.  

There's a debate among psychologists in private practice about accepting insurance that I first learned about while in graduate school.  There are some compelling (and not so compelling) arguments out there as to why psychologists shouldn't accept insurance.  I read on one practitioner's website that a psychologist who accepts insurance isn't nearly as experienced or maybe not as competent because they accept insurance because they can't generate referrals elsewhere.  Needless to say, as someone early in their career and who believes in accepting insurance, I was slightly offended.  With attitudes like this floating around, it's not surprising that many psychologists either accept 1 plan or none at all.  Personally, I've always felt that it was a professional responsibility to allow clients to use their insurance for psychological care.  

Back to the original article, which is about low-income children.  Although I don't doubt that there are kids in middle through upper classes who are getting these meds for the same reasons.  Depending on the state, Medicaid will not pay for seeing a psychologist - Illinois is one of them.  There is also variability in what private insurance companies will cover for mental health, although recent laws have been put in place to remove these limitations.  Unfortunately, their enactment has been painfully slow.

So why is it even shocking that parents are turning to these pills to help their children?  We can blame our "quick fix" society, I suppose.  But how much of the above has contributed to this attitude?  Maybe parents and kids don't want to take powerful psychiatric medications and would prefer to learn skills or work through issues to make lasting changes in their behavior.  But it's just not easily accessible, making the prescription that is cheaper and convenient to fill (can there be any more Walgreen's in the greater Chicago area?) the more attractive option.  I realize I'm ignoring many other factors at play in this incredibly complex issue.  But I do believe that we, as psychologists, need to do more.