Editor's Note: Although the SOAR team is concerned about the dramatic increase in the prescribing of psychiatric drugs to the general population in Canada, we have chosen to particularly focus on the issues around prescription of these medications to neuro-diverse individuals. This blog post addresses some of the reasoning behind this choice.
Many people, including me, are critical of the amount of psychiatric medication prescribed these days, specifically, the amount of psychiatric medication prescribed to children, elderly people and people with disabilities. This is an issue of particular concern because these groups of people may have limited capacity to give consent and they may defer to others in making medical decisions. They may be encouraged or even pressured to take medications by family members or others involved in their care. With the large number of side effects that psychiatric medications may cause and with non-medical treatments available for many mental health issues, the widespread use of these medications among vulnerable groups should be questioned even further.
Although these medications can offer significant benefits to some, they are not a panacea. Consider an example: According to Statistics Canada, in 1950, (prior to the introduction of modern psychiatric medications) 9.06/100 000 deaths in Canada were by suicide; in 2009 (the most recent year for which data were available) 10.72/100 000 deaths were by suicide. In other words, the suicide rate in Canada was lower prior to the introduction of psychiatric medications such as antidepressants. This suggests that these medications are, at best, only one piece of a complex puzzle involved in improving our nation's mental health.
The widespread prescription of psychiatric medications should be questioned even further with the issue of prescription drug abuse. The Government of Canada states that the most commonly abused types of prescription drugs are opioids, benzodiazepines and stimulants. All of the previously mentioned categories, excluding opioids, are types of psychiatric medication. If more people sought non-medical treatment for mental health issues, demand for and production of these drugs would be reduced. This could only help in the battle against prescription drug abuse.
Finally, the medicalization of normal emotions and differences in neurology appears to violate the Canada Health Act. This Act states that in order for the government to pay for a health service, there must be proof that the service is medically necessary, which means the treatment must be: “for the purpose of maintaining health, preventing disease, or diagnosing or treating an injury, illness or disability.” Since many normal human emotions are not disabling, they do not justify medical treatment under the Canada Health Act.
One thing that has always puzzled me is that our culture condemns the use of illegal drugs and also condemns the abuse of legal substances such as alcohol, but encourages and even praises the use of mood altering drugs among people who are considered “mentally ill”. Given the concerns laid out above, alternatives to psychiatric medications should always be considered. For example, if somebody does have a mental health condition that is potentially disabling, such as a learning disability, their doctor could recommend accommodations for them if practical, instead of prescribing medication.
Of course, there are definitely cases in which psychiatric medication are necessary. If someone has a mental health condition that causes them to be a danger to themselves and/or others, a prescription for psychiatric medication would certainly be justified. Similarly, if somebody had a mental health condition that was disabling and the disability could not be accommodated, psychiatric medications might be necessary to enable them to function at home, at school or in the workplace. Psychiatric medications do have their place. However, my observations suggest that many people who are currently on psychiatric medications may not need them, and in some cases should not be prescribed them under the standards of the Canada Health Act. These concerns are relevant to all Canadians, and even more so for those who are vulnerable and may have no voice in their medical care.
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