Psychotropics and Youth, Part 3 – Equip Teachers with Prescription Pads?

Contentious debate is brewing over the large role educators play role in recommending what students receive psychotropics, even though they have limited knowledge of treatment. Consider the standards by which one teacher described the benefits of psychotropics to researchers in a recent pilot investigation: the children are “better able to attend to their work… they can stay on task, they can stay in their seat, and are generally more compliant.” Not surprisingly, society and now the government are taking a hard look at the golden rules for educator intervention in student psychopharmacology.

The Pilot Investigation of Teachers’ Perceptions of Psychotropic Drug Use in Schools by Lien, Carlson, Hunter-Oehmke and Knapp presents a startling finding — “more than half the parents seeking medication treatment for their child’s externalizing behavior in one pediatric setting were doing so as the result of recommendations from school personnel.” Yet, the teachers in their study responded that they had “none or limited” (88.9% and 100% respectively) training on children’s mental health problems or the medications prescribed to treat them.

The teachers involved in the study’s answer to this dilemma? They want more training in the area of child psychopharmacology and more collaboration with parents and physicians who prescribe the medication, which at present is a near non-existent relationship. In short, they want to become an integral part of the child’s treatment plan.

Society at large however, begs to differ. Legislation is markedly on the rise to limit the role of educators of all stripes in student psychopharmacological treatment. In fact, while the American Psychiatric Association (APA) and others advocate in favor of certain psychotropics for youth, an increasing number of lawsuits are challenging the use of this medication altogether. The legal actions involve questions such as the validity of psychiatric tests, the need for side effect warnings, and studies indicating psychotropics like Ritalin can lead to substance abuse.

In the United Kingdom, the National Institute of Clinical Excellence (NICE), an organization that issues health guidelines, has questioned to the exorbitant uptake in young people on psychotropics, as well as studies indicating that some antidepressants may increase suicidal tendencies. NICE’s most current report flatly asserts that only in cases of “severe depression” should psychotropics be administered in combination with “talking therapies.”

While the two schools of thought slug it out, The No Child Left Behind Act of 2001 prohibits federal intervention in education issues, placing the ball in state and local courts. As it currently stands, legislation against school and child psychotropic liaisons is the trend du-jour. What do you think?

References

Wegner, L. (2005). Pediatricians and Antidepressant Medications: Black Box or Black Hole? PEDIATRICS, 116 (1), 233-235 DOI: 10.1542/peds.2005-0928

Lien, M., Carlson, J., Hunter-Oehmke, S., & Knapp, K. (2007). A Pilot Investigation of Teachers’ Perceptions of Psychotropic Drug Use in Schools Journal of Attention Disorders, 11 (2), 172-177 DOI: 10.1177/1087054707300992

Lakhan, S., & Hagger-Johnson, G. (2007). The impact of prescribed psychotropics on youth Clinical Practice and Epidemiology in Mental Health, 3 (1) DOI: 10.1186/1745-0179-3-21