Shirah Vollmer MD

The Musings of Dr. Vollmer

Maybe We Have Too Many Child Psychiatrists?

Posted by Dr. Vollmer on June 29, 2016



If child psychiatrists spend their time prescribing medication, and if foster children are over medicated, then it stands to reason that child psychiatrists are exacerbating the problem and then the so-called shortage of child psychiatrists, might, in fact, be a good thing. It is true that foster children are not only treated by child psychiatrists, as these medications may be prescribed by pediatricians, neurologists, primary care physicians or nurse practitioners, it is still true, that if child psychiatrists stop prescribing these medications, then these other providers would not feel comfortable prescribing them. The use of these medications for behavioral management is simply inhumane because of the metabolic and cognitive side effects. There, I have said it again, as I will again, as this has got to stop.


4 Responses to “Maybe We Have Too Many Child Psychiatrists?”

  1. Shelly said

    Not having had time to read the article, are the kids in foster care because their parents can’t deal with their behavior and put them in “the system” hoping they will get taken care of (i.e. medicated, treated, etc.)? Are there more mentally ill kids in the system than not? Or do they use medication to treat uncontrollable behaviors instead of teaching the kids how to cope with anxiety and pressure, a “quick fix” as you will?

    • Children in foster care mostly suffer from trauma, and hence the antidote is developing trusting relationships and coping skills, but unfortunately it is quicker and cheaper to medicate the symptoms of trauma, and thereby label these children as mentally ill, as opposed to victims of terrible circumstances. Child psychiatrists collude with this inhumane treatment of these kids and hence my rant. Thanks.

  2. Ashana M said

    The foster care system generally does a terrible job of supporting foster parents in providing care to children who have really significant trauma and few relationship skills, even in terms of providing accurate information about the child’s needs. There is a lot of wishful thinking that, once out of an abusive situation, the child will naturally thrive when, realistically, that’s just the first step. The hard work begins when a child who has previously experienced a bond as being a source of danger now has a chance to form a positive bond. It’s even harder when the child (rightly) understands that bond is one he or she is destined to lose. Providing psychiatric treatment that involved helping the parent understand the child’s behaviour so that the parent can discern and meet the child’s needs would be just as helpful as medication. Foster parents have an incredibly difficult job and very little support or understanding.

    • I agree with all except that sometimes medication is a crucial addition to helping foster parents, but this is a more rare situation, in which the common scenario is that the foster parents need education and support. Thank you again for chiming in.

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