Is the Psychiatric Drugging of Youth a Form of Child Abuse?

A Not So Radical Idea

I recently came across an essay published in Ethical Human Psychology and Psychiatry in 2017 written by Bonnie Barstow, PhD titled: “Psychiatric Drugging of Children and Youth as a Form of Child Abuse: Not a Radical Proposition”. Click here to read.

Even before I became a clinical psychologist with the ability to dissect and critically analyze medical research, I harbored doubts about the concept of classifying variations in behavior and thought as medical disorders that can be readily remedied with pharmaceutical interventions.

During my early career experiences at a children's psychiatric hospital, within the juvenile justice system, and while working for community-based in-home family services, I observed a troubling trend: child behavior, regardless of its underlying cause, was swiftly classified as disordered, with an immediate presumption that pharmaceutical intervention was necessary to rectify an underlying chemical abnormality. Picture living in an abusive environment, enduring nutritional deprivation, and experiencing a lack of fundamental safety and security, only to have the resulting consequences labeled as a psychiatric disorder. As a young man, this concept puzzled me, and now, with the benefit of experience and knowledge, it appears even more irrational.

I acknowledge the opposing perspective; that there are indeed cases where children are so profoundly affected by depression, anxiety, hyperactivity, or even aggression that without pharmaceutical interventions to manage these behaviors, they can pose a threat to themselves or those around them. I wholeheartedly agree that in the most severe and extreme situations, there may be a role for short term emergency medical intervention.

Nonetheless, this is not the manner in which it is typically conveyed to the broader public, nor is it the approach we commonly adopt when addressing the emotional and behavioral challenges faced by young individuals. Frequently, these issues are portrayed as medical problems with underlying biological causes. The response often involves prescribing one or multiple medications that have not been evaluated for use in this age group. In fact, most of these drug combinations have never undergone evaluation, not even within the adult population. This essentially amounts to experimentation aimed at anesthetizing and subduing what are frequently natural responses to perilous circumstances. In the most concerning cases, it is suggested that the disorder necessitates lifelong management through pharmaceuticals, which is misleading and harmful.

What is the Definition of Child Abuse?

Federal legislation provides guidance to states by identifying a minimum set of acts or behaviors that define child abuse and neglect. The Federal Child Abuse Prevention and Treatment Act (CAPTA) - PDF (42 U.S.C.A. § 5106g), as amended by the CAPTA Reauthorization Act of 2010, defines child abuse and neglect as, at minimum:

• "Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation"; or

• "An act or failure to act which presents an imminent risk of serious harm."

This definition of child abuse and neglect refers to parents and other caregivers. A "child" under this definition means a person who is younger than age 18 or who is not an emancipated minor.

The central question at hand revolves around whether the prescription of one or multiple mind- and mood-altering pharmaceuticals, which carry the potential, and frequently result in, harm, would meet the criteria for causing physical or emotional harm.

Rationale #1: No Identifiable or Measurable Biological Foundation for “Mental Disorders” Exists

If we could pinpoint a biological abnormality that a drug could effectively modify or correct, it would provide a reasonable basis for justifying the associated risks. We could then approach cases empirically, assessing responses through measurement. However, the challenge lies in the fact that psychiatric diagnoses lack coherence, reliability, and validity. They tend to be highly subjective, yet are presented as if they possess scientific legitimacy. In reality, they are better characterized as heuristics, initially developed as a rudimentary classification system to facilitate insurance reimbursement within the broader medical framework.

Consider the profound impact on parents and children when they start identifying themselves with a psychiatric diagnosis. They may begin to view themselves through the lens of "I am disordered" or "There's something wrong with the way I think or behave." They might feel that they are fundamentally different from others and believe that they need medication to attain a sense of normalcy. This can lead to the belief that there is something inherently wrong with their brains. Shouldn’t this be categorized as a form of emotional abuse?

The flawed biomedical model of psychiatric disorders misleadingly conveys that the intricate realms of human cognition, emotion, and behavior can be simplistically attributed to a medical abnormality treatable with medication. However, any genuine medical disease found to underlie psychiatric symptoms would reclassify it as a medical condition rather than a psychiatric one. For instance, if an obsessive-compulsive disorder was caused by a streptococcal (strep) infection, the primary course of treatment would involve antibiotics to combat the strep infection. Similarly, cases where nutrient deficiencies manifest as attentional issues, anxiety, or lethargy would be appropriately addressed through dietary adjustments and nutritional supplements.

If we affix a psychiatric disorder label to a child, irrespective of its underlying cause, especially one that cannot be objectively confirmed, and proceed to treat it with an array of mood and mind-altering medications—many of which may induce significant discomfort and, in numerous instances, exacerbate the condition—shouldn't this be categorized as a form of abuse or neglect?

Rationale #2 No Psychiatric Drug has Been Proven To Objectively Improve the “Mental Disorder” Assigned

Over the past 15 years, I've dedicated myself to gaining a deeper understanding of psychiatric drug trials, the FDA approval process, and the mechanisms through which drugs enter the market. To convey this knowledge succinctly, let me clarify a few key points.

These drug trials typically span a short duration, often as brief as six weeks and rarely extending beyond 12 weeks. To assess their effectiveness, researchers employ "symptom checklists" as tools for quantifying a reduction in what they classify as symptoms. It's important to note that many of these drugs primarily induce a state of emotional numbness or anesthesia, a state that registers as an apparent reduction in symptoms on these checklists. However, it's crucial to recognize that for many individuals, particularly children and adolescents, this emotional detachment can be distressing and potentially exacerbate their condition.

The objective here is to create a degree of sedation sufficient to generate a "statistical difference" compared to a placebo. Yet, this statistical variance should not be mistaken as evidence of a drug's efficacy in treating depression or stabilizing mood. Just as one wouldn't consider alcohol an approved remedy for social anxiety, emotional detachment or numbing should not be equated with antidepressant effects.

Furthermore, due to the brevity of these trials, there is little evidence to suggest that these drugs enable individuals to overcome their episodes in the long term. The persistent poor response often leads many medical professionals to diagnose the affected individual as mentally ill, necessitating ongoing monitoring.

The unsettling truth that emerges upon close examination of drug trials is that pharmaceutical companies have encountered significant challenges in substantiating the superiority of antidepressants and other psychiatric medications over placebos. It's imperative to dispel the illusion that we possess effective drugs for addressing emotional and behavioral issues in children and adolescents.

In reality, if we were to be completely candid, the primary approach employed by doctors often involves attempting to induce a certain level of emotional numbness and detachment in developing children. Regrettably, this truth is seldom communicated openly.

Rationale #3 Psychiatric Drugs Are Proven To Create Harm

Irrespective of the specific psychiatric drugs approved for children, a multitude of side effects abound, with many falling into the category of severe, some even carrying the potential for fatality. If you question this… feel free to visit the drug website.

To illustrate, let's consider one of the most commonly prescribed classes of drugs for anxiety and mood disorders: Selective Serotonin Reuptake Inhibitors (SSRIs). These medications come accompanied by what is known as a "black box warning," which represents the most stringent cautionary label issued by the FDA for drugs and medical devices available in the market. The purpose of a black box warning is to bring to the attention of the public and healthcare providers the presence of grave side effects, which may encompass risks of injury or even death. The FDA mandates pharmaceutical companies to affix a warning label to medications bearing a black box warning.

The FDA employs black box warnings to emphasize risks in the following scenarios:

1. When there is compelling evidence indicating that a drug can trigger a severe adverse reaction, potentially leading to fatalities, life-threatening situations, or permanent disability, and where the potential risks may outweigh the benefits.

2. In cases where appropriate utilization of the drug, such as avoiding its use in specific circumstances, closely monitoring patients, selective patient selection, or refraining from combining the drug with certain other medications, can mitigate or diminish the severity or frequency of a serious side effect.

3. When the FDA has sanctioned the drug exclusively for restricted usage in order to safeguard public safety.

4. When the drug exhibits reduced effectiveness or poses heightened dangers within specific populations, such as the elderly, children, or pregnant women.

Frequently, I've observed a children, teenagers and young adults become self-injurious and suicidal shortly after being introduced to psychiatric medications. This is more common practice than most people realize. Within clinical practice, medical professionals often combine medications (polypharmacy) in ways that have not been adequately investigated. Their aim is to induce sedation and emotional numbness (symptom reduction), while downplaying the associated risks and overestimating any perceived effectiveness.

Personally, I find it increasingly infuriating to witness the lives of young individuals significantly deteriorate under the guise of scientific and ethical treatment. When I see young people enduring substantial harm, especially when they have not provided informed consent for these treatments, it becomes evident that we are dealing with a situation that can be characterized as abusive. The negative reactions to the drugs are than misrepresented.

Rationale #4 The Psychiatric Drugs Induce Reactions Misinterpreted as “Mental Disorders” Leading to More Diagnoses and Drugs That Create Harm

This system thrives on a self-perpetuating cycle of ignorance and misconduct. It often begins when a medical professional erroneously attributes emotional and behavioral challenges to a simplistic concept of a chemical imbalance. Consequently, they prescribe drugs that can lead to neurological abnormalities. When the child inevitably displays typical adverse reactions, these responses are often misconstrued as manifestations of mental illness. This misinterpretation then becomes the basis for prescribing additional medications, assigning dubious pseudoscientific labels, and further fostering deterioration within the individual.

In essence, this system transforms episodic, and even typical variations in behavior into chronic disabilities.

This is Child Abuse!

Prove me wrong!

No More Bystanders