Question
How do you determine whether the risks outweigh the benefits when putting a child on meds? The thought of intentionally causing my child to experience something unpleasant really makes me angry just so they can be “controlled” at school.

Answer
The decision to have children take medications for emotional or behavioral difficulties should never be made lightly. The best decisions will always be made when there is a good, comprehensive evaluation of the situation and the problems displayed by the child.
You have correctly identified the importance of determining the risks versus the benefits. The decision to recommend medications involves a determination that the severity of the problems makes it worthwhile to consider medications, and that without the use of medications the child is likely to have significant problems. You also have to consider the possible side effects of medications, and decide whether the potential benefit of the medicine is worth the need to monitor for side effects.

Keep in mind that most children who take medications do not have severe problems with side effects. Also, no experienced mental health provider should recommend the use of medications simply for “control at school.” Medications are best used when there are consistent problems across multiple settings. Also, with the use of consistent monitoring of medications the chances of severe side effects is dramatically decreased.

Please send medical questions about your foster children to askdrholmes@nfpaonline.org.

William Holmes, M.D. is the Senior Medical Director and Medical Director of Foster Care for Cenpatico Behavioral Health in Austin, TX.