The first question, which is alluded to but is not the topic of the book, is how does having a mental illness and all that entails, color the child’s life, relationships, self-attitude, and future? I don’t believe the two questions – how does medicine change you, versus how does mental illness change you –c an ever fully be separated, and in all fairness, the author didn’t actually try to separate them, she simply emphasized the medication aspect and all the unknowns that go along with that.
My second issue with the book is a bigger gripe, one I’m not giving a pass to. There are many references to how medications are prescribed – quickly and sometimes thoughtlessly – and the role of psychotherapy – mostly cognitive-behavioral therapy – in the treatment of mental disorders. The author talks about the “15-minute medication check” and how psychiatry doesn’t allow the time for doctors to get to know their patients in the full context of their lives, much less allow time for the patients to discuss how they feel about their medications. Ah, psychiatry is reduced to a symptom checklist followed by medication adjustments.
And while this may be how psychiatry is practiced by some doctors or in some settings, it’s not how everyone practices, and there are certainly child psychiatrists who see patients for psychotherapy, or who see patients for 50-minute sessions to monitor medications, even if formal psychotherapy is not being done. The author does not mention, except as an afterthought at the very end of the book, the option of seeing a psychiatrist for more than a rushed visit.
I’ll let the young people’s histories speak for themselves; they did not all turn out as I would have expected and the reader will enjoy following their stories.
The book is thoughtfully written, a wonderful presentation of the full range of the issues everyone should be thinking about when prescribing psychotropics to children and teens, and Kaitlin Bell Barnett does a commendable job of communicating her masterful understanding of a complex topic.
—Dinah Miller, M.D.
If you’d like to see Kaitlin Bell Barnett talk about her book, her video is posted on Shrink Rap here (taken from the Kickstarter site).
DR. MILLER is the co-author of Shrink Rap: Three Psychiatrists Explain Their Work, recently released by Johns Hopkins University Press.