Child psychiatrist slams doctors for over-medicating kids

Children and teens are being overprescribed antidepressants for feelings often linked to “life circumstances”, an expert says. WATCH THE PANEL DISCUSSION.

A leading child psychiatrist has lashed out at doctors for overprescribing antidepressants for feelings often linked to “life circumstances”.

It comes as Health Minster Greg Hunt told News Corp Australia’s Mental Health 360 panel he was waiting on the findings of a review he had ordered into whether such medicines were being over prescribed.

“The department is looking at whether there are individual practices where the rates are higher than they should be,” Mr Hunt said.

Professor Jon Jureidini says psychiatrists need to understand, not over-medicate.

Mental Health 360 panel expert Professor Jon Jureidini said if used according to clinical guidelines, such medicines should only be taken for a maximum of six months – instead “very few people who’ve been taking them for any length of time will stop taking them”.

“When we medicalise people’s problems and say ‘I’ve got a disease’ when in fact ‘I’ve got what is a very often a realistic response to their life circumstances’, that’s when things become problematic,” Prof Jureidini from Adelaide University said.

“It’s easy to drift down the pathway of a biological solution to a social problem,” he said.

“When somebody turns up in a psychiatrist’s office the response shouldn’t be to make a diagnosis and reach for medication, the response should be to try to understand what’s distressing the person and, you know, help them to accept what can’t be changed and to change what can be changed.”

News Corp Australia yesterday revealed more than 220,000 Australian children are being prescribed mental health medications and the UN has expressed serious concern over the high use of psychostimulant drugs in children here.

The federal government’s Productivity Commission into Mental Health has also raised concerns about with the number of Aussies being medicated – with Australians the third highest users of antidepressants in the world.

More than 4.3 million Australians – or in every six people – are taking a mental health medication with the COVID-19 pandemic sparking a national 7.3 per cent increase in the use of the medications between January and September this year compared to the same period in 2019.

Australian Medical Association vice president and GP Dr Chris Moy defended the use antidepressants and said “at least 30 per cent of GP consults would involve mental health”.

“There’s definitely a place for prescribing antidepressants they definitely have a role, as long as it be used appropriately, that people fit the criteria for treatment,” Dr Moy said.

“I’ve definitely seen people that have needed it all their life,” he said.

Panel member and Co-Director of Health and Policy at The University of Sydney’s Brain and Mind Centre Professor Ian Hickie also said medication for mental health issues was an important part of the treatment.

“We don’t diagnose unemployment as an illness. We don’t diagnose social dysfunction, family dysfunction – but they are risk factors,” Prof Hickie said.

“If you have an unemployment problem and you have a heart attack, we don’t turn around and say you didn’t have a heart attack.

“If you are unemployed and you are depressed, if you are unemployed and have a major drug and alcohol problem – we recognise that we need to deal with the social setting ... but you can’t at the same time turn around and say ‘we are not going to treat those people who’ve actually become unwell in that particular situation.

“So to confuse risk factors all the time with the need to provide care also does not help with public understanding.”

A 2019 study into child poisonings in NSW suggested the antidepressants used to cure depression were actually being used in suicide attempts.

A review of PBS and child poisoning data between 2006-2016 found a 40 per cent increase in prescription of mental health drugs to young people aged under 25 and that these drugs -fluoxetine, quetiapine, sertraline (Zoloft) and escitalopram along with paracetamol and ibuprofen – were associated with a 98 per cent in child poisonings.

The Productivity Commission’s Report released last month called on the federal government to take immediate action in requiring all mental health prescriptions “include a clear and prominent statement saying that clinicians should have discussed possible side effects”.

Tasmanians are the highest users of the drugs with Queenslanders the next biggest users.

In the first nine months of 2020, prescriptions for antidepressants rose 6.43 per cent in NSW, 8.12 per cent in Victoria, 7.53 per cent in Queensland, 6.73 per cent in South Australia, 8.89 per cent in Tasmania, 7.37 per cent in Western Australia.

Analysis of GP attendance data of 1,000 medical practices covering 6 million patients in NSW and Victoria by Outcome Health found a 20.5 per cent increase mental health presentations from May to September.

There was a steady increase in the use of antidepressants but also a marked recent increase in prescriptions for anxiety medications.

Mental disorder diagnoses in children of all ages increased, including anxiety, depression and eating disorders, the analysis found.

The Productivity Commission said there was little evidence that antidepressants were of any more benefit that psychological therapy for treating depression while side effects included dramatic weight gain, disabling lethargy, sexual dysfunction and suicidality, it found.

More than three times as many people use mental health medication as access psychological therapy and the Productivity Commission called for the GPs who prescribe the drugs to be re-educated.

The Commission also questioned why, if only six per cent of the population suffered from depression, more than 12 per cent of the population was taking antidepressants.

It called for off label prescribing of the drugs to be made the subject of an urgent review.