meds, kids, and schools

Nicholas Rose, working from the ideas of Foucault, invites us to look at institutions and practices and ask, what problems do they solve and for whom? This outlook helps me in trying to identify “what is” and then deciding what if anything I would like to do about it.

In my opinion, to understand the current approach to children’s “misbehavior” in school and society’s response, we need to understand not just the profit motive of drug companies, but also the public school, the family, the social world of the child or teen, “psy” academia (psychologist, psychiatrist, social work, marriage and family, etc), media, government, and insurance companies (I am sure I am missing some other “players”.

Since examining these influences would take one or more books itself, I would like to point to only a few striking factors. First and foremost is the question of social class. Diagnosis and treatment of ADHD and bi-polar “illness” vary dramatically depending upon the wealth of the parents and the school system. A child is far more likely to get a diagnosis if the class is too large given the needs of the students. The poor child is also more likely to get prescribed meds without psychotherapy.

Authors like Jonathan Kozol have shown how even the purpose of the school is dramatically different dependent upon the social class being served. Philip Cushman and others in the Critical Psychology movement have observed that therapy, academia, and the psys are political in nature, that is, subject to the power of individuals and institutions serving some and not other interests.

Behavior that is acceptable and “normal” in a wealthy community, is not OK in a poor one because the classes are larger, the resources fewer, physical activity scarcer, and the children are being trained to SIT STILL and BE QUIET. Some kids are glad to get medicated so that they can succeed and teachers and parents are happier to have kids not getting into trouble.

So we have to question, what is working when we say that meds do work for some kids. And, if we are in this field, while it may be quite satisfying to demonize drug and insurance companies (I do it too), change requires a broader, political perspective, questioning, for what are kids in various socio-economic sectors being educated / trained? How do all kids and schools get the resources they need to educate every kind of child as a full and capable person?

The current No Child Left Behind testing movement has exacerbated this problem, stripping many poor schools of adequate gym, music and art, expecting kids to sit longer, attending to academics of sometimes questionable relevance. If we can address the social justice and equality issues in the schools, we might find some children and teens getting medicated, but it would be a fraction of the current numbers.