HHS Secretary Robert F. Kennedy Jr. released the “Make America Healthy Again” report earlier this year aimed at addressing “overmedicalization” of children in the realm of behavioral health and shifting more focus on families and lifestyle choices.
But Susan Swick, MD, executive director at Monterey, Calif.-based Ohana Center for Child and Adolescent Behavioral Health, part of Montage Health, told Becker’s that turning the movement into an either/or situation could be most harmful.
Although Dr. Swick agrees that medication may not always be appropriate, vilifying effective medications can bring about an even greater set of harms. Moreover, suggesting that medications are creating the problems they are designed to solve can cause further harm, Dr. Swick said.
“We know when we got the black box warning for [selective serotonin reuptake inhibitors] and the risk of suicidality, the rate of prescribing them for depression in teenagers went way down. That was the first time in two decades that the suicide rate in teens started to climb,” she said.
Dr. Swick refers to herself as a “reluctant pharmacologist,” only recommending medications when she is confident the treatment will balance out the patient — and only proceeding after ensuring parents approve.
When presenting the treatment plan, Dr. Swick aims to provide a comprehensive overview of the options available. She explains the risks and benefits of taking the medication — including the risk of not taking the medication. But she states it is never just medication that serves as the solution.
“When we don’t use effective medications with our more serious or life threatening illnesses, the consequences are grave,” she said. “But it is never medication or family medication or learning. It’s always about how can medication be a part of this plan that’s going to support this child’s healthiest development?”
The message is clear, according to Dr. Swick.
“The biggest risk is when we begin to feel like we have to choose between medications and a family focused learning or lifestyle approach,” she said. “I think it’s all of the above.”
