It's only fair to share…

Children are seen as a group where medication use is low and hence a potential group for increased use (sales) of medications.

Two crazy ideas have been floated in different parts of the world. In the USA the latest idea is for cholesterol level screening in children. No doubt this will be presented as being about preventative health and early intervention of risk factors. In reality it is an opportunity to place children on statin medication hence opening up a brand new market just as patents expire.

There are major problems with this idea.

 

Firstly cholesterol is part of every cell in the body and is particularly prevalent in the brain. As children grow their bodies need the building blocks to do so. Removing one like cholesterol will have unexpected consequences in the medium and long term.

Of course those in “authority” will say it is safe. Yet no trials have been done in children and even if some were done it would be over a short space of time to assess how the drugs lower cholesterol. It will not (and can not) look at the effect on brain development and what this will mean for the child growing up and as an adult.

And of course, even if some children have elevated levels of cholesterol (and this will be a minor issue compared to the real ones), this will be occurring in a setting of bad eating patterns, obesity and probably lack of exercise. Hence a much better use of health dollars would be in providing better funding to schools to provide healthier lunches, as has been promoted by Jamie Oliver. Another option is providing trainers in parks to supervise exercise classes.

In other words do something about the cause rather than medicate the symptoms.

The other crazy idea has come in my own back yard. Health “experts” in Perth have suggested screening two year olds (that’s right 2 year olds) for signs of depression! Australian Association of Infant Mental Health president Lynn Priddis told the Sunday Times “Infant mental health can prevent future social and emotional mental health problems… and relationship failures”.

Really? And how will we do this? By analyzing baby behaviors, such as crying, (or not) and not looking people in the eye. According to a (self serving) paper 11% of two year olds have “significant” behavioral problems rising to 20% by age five.

These people obviously have not had children. Tantrums (behavioral problems) affect 100% of two year olds. They also have a misplaced sense of their own importance and capability. To believe that they can interpret baby behavior and place this in the context of adult conditions like depression and anxiety show how easy it is for people to both believe their own publicity but also detach from the real world into some academic fairly land.

Presumably the solution to these “problems” will be some form of medication. If this story had appeared on April 1st, it could be written off as a joke. Unfortunately (and I hope I am wrong) these people are serious. The notion of “early intervention” is all the rage and has been pushed by prominent psychiatrists like Patrick McGorry.  However ,even he has now backed away from using psychotropic medications in ‘at risk” teenagers.

Given the latest court ruling on one drug (Risperdal) we should be wary at any age.

I will be blunt. This notion of screening infants and children for “mental illness” is misplaced and dangerous. It seeks to look at all human behavior through a medical disease model. No longer is there a spectrum of normality. It also ignores the context of a child’s behaviour in relation to their life and assumes everything must have a medical causation. Most “mental health” problems in children are due to social or emotional, not medical reasons.

According to advocates of screening and intervention you either have “normal” behavior or a mental health illness. No doubt characters like Tom Sawyer and Huck Finn had mental health illnesses as do most musicians, to name a few. In the eyes of the early interventionists they need pills. The notion of a variety of behaviors is anathema.

Labeling children is bad at the best of times. Labeling them so that self appointed “experts” can save them from all sorts of future problems by intervention at age two would be laughable except there is a risk it may be taken seriously.