Mental illness and children

A great image showing the extent of psychoactive drug prescribing in the US. While there are many
interesting explanations for such rampant pharmaco-terrorism, this post has another purpose.

A recent story caught my eye, in fact it was so striking it kidnapped my brain. Headlined, "Is that Thorazine in the babies bottle?", it discussed the relentless rise in diagnosing and treating psychiatric illness in chilren and infants. According to the story, 500,000 children in the US are prescribed anti-psychotics! When I went looking for data about the incidence/ prevalence of psychiatric illness in children, the numbers are mind boggling. According to childstats.gov, in 2008 8% of children aged 12-17 experienced a major depressive episode. Of course, some may question this data, but it does appear that the incidence of major psychiatric illness, especially depression is rising across the Western world, and it has been suggested that the major contributor to this increase is rising economic and social inequality. If this is the case, medicating children from a very young age is not the solution, and is really only addressing the symptoms of a societal problem. For a more detailed discussion, read The Spirit Level . This is a magnificent book, likely to be seen in 50 years as the seminal public health work.

Suicide

A very moving post by Anna Roth on her blog about the suicide of her brother in law. She has previously written about suicide, but not this powerfully. The statistics are terrifying, one of the most common causes of death in the 25-44 year old age group, worldwide! Incidence has increased worldwide by 60% over the last few decades. Most common methods are hanging, ingestion, (usually herbicides) and gun shots.
It is estimated that there are 30,000 suicides annually in the US. The most recent data I have seen for Ireland suggest that there are almost 600 reported deaths by suicide annually, a rate substantially higher than the US. The WHO report that the rate in Ireland (11.6 deaths/ 100,000 inhabitants) was 10-15% greater than the average rate in the EU-27.
Can anything be done, an especially pertinent question given our economic collapse and the likely toll that this will cause? While the HSE has a suicide office and a prevention strategy, I have no expertise with which to judge its efficacy. However there are healthcare delivery systems that have shown what can be achieved. The Henry Ford system in Detroit shows what can be achieved. In the first 4 years of the groups suicide prevention program, the rate decreased from 89 to 22 deaths/ 100,000 population. In the most recent analysis the rate over the previous two years had dropped further to zero deaths!
For details, click here. This in a city that has been battered economically over the last decade.
There is another very emotional piece in this weeks JAMA, again an account of suicide from the perspective of a family member. In a future piece, I hope to write about the risks of suicide amongst physicians and ways to reduce this risk.