Thursday, April 1, 2010

A Giant Loophole in Child Welfare

I attended a child advocacy conference in Laredo Texas this week. I was a guest presenter speaking on the effects of repetitive trauma long term on the children in our state. The room was filled with counselors, teachers, nurses, doctors and child protective service workers. The District attorney was there. At some point during the presentation, a question came from the audience. " What can we do about so many little kids on too many medications for no reason?" Being an RN and having a child psych background many things passed through my mind. Could they be referring to the needed higher does in small children due to the metabolic differences in kids?Or was there another issue beyond? Turns out, the second choice was the valid one. A school nurse told about many children who are put on multiple medications, for something like ADD simply to have the child qualify for SSI disability payments and more money for the family. At least that is the perception. Some of the nurses told of kids who have a diagnosis of ADHD but are on no medications, yet still apply for and get disability payments. They feel these families are bilking the system that was put in place to assist families who have kids with true long term disabling issues, like kidney disease, cerebral palsy and schizophrenia. The question they asked of me was what can be done about this issue. Without knowing the exact circumstances of each case, it is irresponsible for me to give a solution. But what I could do was talk about the need for more doctors who are willing to specialize in child psychiatry, easing the burden of pediatricians and family practice doctors from feeling they have to manage psychiatric disorders. With the coming addition of several million people to the health care roles, the need for qualified doctors in all specialities will be critical. We talked about how some doctors feel so pressured by rating systems to make their patients happy versus healthy, they prescribe based on the patent's request, with little clinical backup for those decisions. We also talked about the need for parents to be educated about how to raise healthy children and what kids need to have in order to grow up strong both mentally and emotionally. Lastly, we talked about who to call at the state level to report what can be described as massive fraud while many children who desperately need these funds go waiting months and sometimes years to get their first denial of benefits.
Because I started out talking about the effects of trauma on kids, we continued to talk about the trauma of our child serving systems on the kids and how much damage we end up doing with the very best of intentions. But I can't help but think about that one question. It seems the issue of people abusing a system set up to help people with a hand up until they can get back on their own again, is being used to provide a basis for a cultural dependence upon external supports, like government handouts, to raise the coming generation who will learn the same methods for their kids welfare.
For those of you who have an interest in the issue of the Culture of Poverty, I highly recommend a website and video post. Please check out this website:
I apologize that the link won't work. I am having major computer issues today. But please copy and paste into your browser. It is nothing short of astounding.
Do some fact finding. If you feel what I have described is occurring in your family or in your school, speak up. Talk to the families in question and by all means, let the elected officials know. Help us help those that truly need to find a way to have a hopeful future.
It is still our government and they are our kids and our future.


  1. You have brought up a very important issue. There is a problem with some children receiving medications that may not help. But this could be reduced by more competent child psychiatrists. I am impressed by how a good child psychiatrist can coordinate multidisciplinary care that includes medications, therapy, social services and parental training to make a big impact.

  2. Exactly! I have grave concern over the specialty not getting enough credit for the amazing job they do. We only have 40 in the entire state of Texas, and I think we are better off than most other states. Chidl psych docs ususally get slammed for over medicating kids, when they really are just trying to get the does right. Of course there are some bad apples in all practice areas! And yes you have to have other components.meds are not the cure all in and of themselves! Thanks for the comment you are right on the money!