Children & Psychiatric

Medications : Mental
Health
Megan Ready, Allison
Thelen, Alexandra Vasile
 Background
Mental health disorders in children:1

Anxiety

Depression

Obsessive-Compulsive Disorder

Personality disorders

Oppositional Defiant Disorder

Background
Prevalence2-4

• Incidence has skyrocketed past 10 years

• 2022: 34.5% mental health symptoms

• 16.5% ≥1 diagnosed mental health disorder

• 49.4% did not receive needed treatment or

counseling
• 2021: 14.9% ages 5-17 received mental health
treatment in the last 12 months
o 8% = prescription medications
o 11.5% = counseling
 Antidepressants Antipsychotics
• Depression • Control delusions /
• School phobias hallucinations
• Panic attacks • Disorganized thinking
• Bedwetting • Irritability
• Eating Disorders • Tics (Tourette’s)
• OCD

Background:
Mental Health Medications
for Children5 Mood stabilizers & Anti-anxiety
anticonvulsants • SSRIs for anxiety
• Bipolar disorder • Same meds as
• Severe mood swings antidepressants- adult
• Aggressive behavior anxiety medications rarely
• used in children
Impulse control disorder
Ethical Question
Is it ethically justifiable to
medicate children for
psychiatric mental health
disorders?
The Ethical Issue:
MORAL CONFLICT

Autonomy Non-maleficence Beneficence

Children are considered a Effects of medication Put child in best position to succeed
vulnerable population Effects on brain development
Research becomes difficult
Consent & compliance
 Prescription medication SHOULD be
an option for treatment of mental health
disorders in children
The Positions
Prescription medication SHOULD NOT
be an option for treatment of mental
health disorders in children
Prescription medication SHOULD be
an option for treatment of mental
health disorders in children

Strengths6,7,8
• Overall better health and potentially less suicide
seen in children
• Each child will achieve their best potential
o Involvement in school/extracurricular
environments/activities
o Can have an impact on the rest of the child's life
 Weaknesses7,8,9,10
• Black box warning
• Severe side effects
o Obesity, diabetes, and heart disease

Prescription medication • Developmental Freedom

SHOULD be an option for
treatment of mental health
disorders in children
Where is the Argument
Being Made?6,7,11

Prescription
medication SHOULD
be option for
treatment of mental
health disorders in
children
Prescription medication SHOULD NOT
be an option for treatment of mental
health disorders in children
Strengths8,9,10
• Black box warning
o Highest safety related warning for a medication
• Overmedicating --> Side Effects
o Other options
o Psychosocial impacts
• Developmental Freedom
 Weaknesses8
•Medications have also shown to prevent
suicide
•Medication side effects are short lived​
•Life > developmental freedom

Prescription medication
SHOULD NOT be an option for
treatment of mental health
disorders in children
Where is the Argument
Being Made? 6, 7, 11

Prescription
medication SHOULD
NOT be an option
for treatment of
mental health
disorders in children
Our Stance
We support the decision that prescription
medication SHOULD be an option to treat
mental health disorders in children
• Based on: Utilitarianism & Ethics of Care

More research needed!

 References
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text revision. Washington, DC: Psychiatry Online; 2022.
2. Zablotsky B, Ng AE. Mental health treatment among children aged 5-17 years: United States, 2021. NCHS Data Brief. No. 472. National Center for Health
Statistics; 2023. Accessed April 2, 2024. DOI: 10.15620/cdc:128144.
3. Liu J, Zhou Z, Cheng X, Vangeepuram N. Geographic and sociodemographic variations in prevalence of mental health symptoms among US youths, 2022.
Am J Public Health. 2023;113(10):1116-1119. doi:10.2105/AJPH.2023.307355
4. Whitney DG, Peterson MD. US national and state-Level prevalence of mental health disorders and disparities of mental health care use in children. JAMA
Pediatr. 2019;173(4):389-391. doi:10.1001/jamapediatrics.2018.5399
5. AACAP. Psychiatric medication for children and adolescents: part II - types of medications. Accessed April 18, 2024.
https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychiatric-Medication-For-Children-And-Adolescents-Part-II-Types-Of-
Medications-029.
aspx
6. Silkwood-Sherer D. Utilitarianism. PowerPoint and Lecture presented at: PTH 695 Ethics in Physical Therapy; February 6, 2024; Mount Pleasant, MI.
7. Silkwood-Sherer D. Ethics of care. PowerPoint and Lecture presented at: PTH 695 Ethics in Physical Therapy; February 20, 2024; Mount Pleasant, MI.
8. Dwyer JB, Bloch MH. Antidepressants for pediatric patients. Curr Psychiatr. 2019;18(9):26-42F.
9. Drake RE. Overmedicating vulnerable children in the U.S. Epidemiol Psychiatr Sci. 2019;28(4):358-359. doi:10.1017/S2045796018000689
10. Kepple A, Madaan V. Ethics and Pediatric Psychopharmacology. AACAP. Published online January 1, 2012.
https://www.aacap.org/app_themes/aacap/docs/member_resources/ethics/in_workplace/kepple_madaan_ethics_and_pediatric_psychopharmacology.pdf. Accessed April
23, 2024.
11. Silkwood-Sherer D. The Moral Role of Physical Therapists. PowerPoint and Lecture presented at: PTH 695 Ethics in Physical Therapy; February 27, 2024;
Questions?