Currently, in Canada, there is no explicitly stated policy or practice guideline outlining when it is necessary to provide psychiatric medication for children with Autism and related conditions. As I have previously mentioned, the Canada Health Act gives a vague overview of when it is necessary, but it does not have enough detail. To solve this problem, I will propose some standards that should be met before children (and sometimes adults) with autism and related conditions are prescribed psychiatric medications.
The first standard is to determine if non-medical treatments are effective; if they are effective medication will be unlikely to be necessary. However, some cases may be so severe that it is evident that non-medical treatments may not be effective, or at least require non medical treatment in combination with medication. In recognition of these cases, a policy should be put in place to guide the prescription of medication.
It is currently well known that doctors are trying to restrict how much they prescribe antibiotics, due to antibiotic resistant bacteria[1]. Additionally, it is well known that the overprescription of opioids is currently a problem[2] , and guidelines for opioid prescription have been adopted[3]. It would be useful to implement a similar approach to the prescription of psychiatric medications. Hopefully, such a policy will be instituted in the near future.
My proposed plan would require that a child be on non-medical treatments for a mental health issue for at least six months for a doctor be allowed to prescribe medication, unless under extreme circumstances, such as violence, self-harm or suicide is a realistic or plausible risk . I would also propose that the doctor be required to provide written justification why the requirements for the prescription are met every time they prescribe a child psychiatric medication, that must be reviewed by a higher authority.
If the higher authority feels that there is insufficient reason for the prescription, they should be authorized to revoke the prescription.
In short, if the same types of measures used to prevent the overprescription of opioids and antibiotic resistant bacteria are implemented, it will prevent the overprescription of potentially harmful medications to children with autism and related conditions. If these policies and standards are implemented, it will potentially help a large amount of children with autism and related conditions in Canada.
[1] https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/antibiotics/art-20045720 [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6741787/
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