Posted On: September 25, 2007

Child and Teen Suicide Up and Anti-Depressant Use Down

Sometimes children pose a greater risk to themselves than their surroundings do, as any mental health specialist could tell you. An alarming new study shows that the recent decline in the use of anti-depressants in children and teenagers has coincided with an increase in youth suicides.

Anti-depressant use among youths began to go down four years ago, when the Food and Drug Administration (FDA) issued an advisory regarding children and teens who were on anti-depressants and subsequently committed suicide. Later, in 2004, the FDA made a rule saying that anti-depressants had to be labeled for increased suicide risk in pediatric patients. In December 2006, the FDA expanded this rule so that it covered anti-depressant use in young adults as well.

Evidently there was cause for concern four years ago, but this new research suggests that these warnings are doing more harm than good. Prescriptions for these medications declined sharply after the FDA issued the warnings. But the youth suicide rates went up. Likewise, before 2003, an increase in anti-depressant prescription correlated with a decrease in youth suicide:

The researchers found that the reverse corollary was true. Increases in SSRI prescription rates coincided with decreases in suicide rates from 1998 to 2003. In the U.S., a 91 per cent increase in prescription rates coincided with a 33 per cent decrease in suicide rates.

The researchers therefore concluded that the FDA's analysis was flawed, pointing out that the FDA's study (suggesting a link between anti-depressant use and higher youth suicide rates) relied on a biased sample.

That said, there is always some ambiguity in this kind of research. That's why researchers must do multiple studies and why people need to get information from multiple sources. To find more information on mental health in children and teenagers, these links are a good place to start:

National Institute of Mental Health--Depression

National Institute of Mental Health--Children and Adolescents
and Treatment of Children with Mental Disorders

Mental Health America--Disorders and Treatments

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Posted On: September 5, 2007

Challenges to Medicaid Rules

As discussed in a previous post "New Federal Guidelines Would Increase Numbers of Uninsured Children", some states have responded to the health insurance crisis by increasing eligibility for SCHIP (the State Children's Health Insurance Plan) and allowing more families above the poverty line to benefit from it.

The federal government has reacted to this by announcing that it will impose new rules on these states--including, most controversially, a one-year waiting period without insurance before a child can be eligible for SCHIP.

However, states are challenging the federal government's impositions. For instance, Governor Christine Gregoire of Washington state, Governor Arnold Schwarzenegger of California and Governor Eliot Spitzer of New York have all protested the federal government's actions and have questioned the legality of the new federal rules. The outcome of this battle will be interesting not only for its consequences for public health but also for its potential re-shaping of the boundaries between state and federal power.

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