TALKING IT OVER
HILLARY RODHAM CLINTON
March 22, 2000
When our children come to us hurt or sick -- whether it's with a simple cold or a life-threatening illness -- there is nothing more frightening than not knowing how to make them better. It's no different for the parent of a child who is sad or misbehaving.
Sometimes, these children have problems that are simply typical of childhood or adolescence. Some need only a parent to love them, or a person to listen. But others have severe behavioral or emotional problems -- problems for which there are now a number of treatments, including therapy, behavior modification and prescription drugs.
Recently, the Journal of the American Medical Association reported that the number of preschoolers taking prescription drugs increased dramatically between 1991 and 1995. The increase for Ritalin alone -- the drug most widely used to treat attention-deficit/hyperactivity disorder -- was 150 percent. The use of antidepressants grew 200 percent.
When I read these results, I was alarmed -- and I was not alone.
I know that prescription drugs have been a godsend for countless young people suffering with emotional and behavioral disorders. And research tells us that, if left untreated, many would fail to reach their full potential later in life.
But despite this good news, it is time to look carefully at some important unanswered questions: How are we diagnosing, treating and caring for children with behavioral and emotional conditions? Do we have the best tools to make the most accurate diagnoses? Why are there dramatic variations in treatment among different communities and races? And what effects do overuse -- and underuse -- of medications have on children?
Further, we need to ask: Why aren't we doing a better job of combining drugs, when necessary, with therapy and other treatments? And what about the fact that these drugs have never been tested on our very youngest children, whose brains are at their most critical stage of development.
These are tough questions, but over the past few years, we have begun to tackle the answers. We have taken critical steps to ensure that drugs are tested and labeled specifically for children. In the process, we have learned that finding the right prescription for a child is not always as simple as decreasing an adult's dose.
And thanks in large part to the leadership of the President's Mental Health Policy Advisor, Tipper Gore, we have come a long way in our effort to bring these problems out of the shadows. In the wake of last summer's White House Conference on Mental Illness, which she led, and the subsequent Surgeon General's Report on Mental Illness, we learned that children suffer the stigma of these conditions more than adults; too many professionals lack training in this area; and it is time to increase public awareness of children's mental health issues.
This week, at the White House, along with the Secretary of Health and Human Services, Donna Shalala, I hosted a meeting of health professionals, educators and parents to take steps toward increasing awareness and improving the diagnosis and treatment of children with emotional and behavioral conditions. By the end of the meeting, it was clear that, although there is much we already know, critical information has never reached the people who need it most.
In order to change that, we have now launched an unprecedented effort to ensure that children are appropriately diagnosed, treated, monitored and managed by their parents, their teachers, their doctors, and other professionals.
To that end, the National Institute of Mental Health is releasing an easy-to-understand fact sheet that parents can use to make treatment decisions for their children. The Education Department will issue an information kit for parents and teachers helping youngsters with ADHD.
The American Academy of Pediatrics will give each of their 55,000 members up-to-date guidelines for diagnosing and treating patients with emotional and behavioral problems. And as part of a year-long focus on mental health, the American Academy of Family Physicians will sponsor continuing education courses for their 90,000 members.
The NIMH will undertake a study of ADHD and Ritalin use in preschoolers. The FDA will investigate appropriate doses of some common drugs prescribed for very small children. And the Surgeon General's office will coordinate a National Conference for the Treatment of Children with Behavioral and Mental Disorders.
I hope that this week's meeting will move us closer to the day when the stigma surrounding these issues disappears, and we treat problems of the mind with the same care and understanding that we bring to problems of the body. And I hope that we will be even more committed to making sure that our children get the help, support and love they need.
To find out more about Hillary Rodham Clinton and read her past columns, visit the Creators Syndicate web page at www.creators.com.
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