NONFICTION
We’ve Got Issues: Children and Parents in the Age of Medication
by Judith Warner, $25.95
By Susan Okie
Washington Post Writers Group
I opened Judith Warner’s new book with a certain dread, fearing that I would have to slog through yet another polemic about the overuse of stimulants and other psychiatric drugs in America’s children. Instead, I found a refreshing surprise: a confession by the author that she had indeed gotten a book contract and embarked on her research with that mind-set, only to change her views after talking with the parents of mentally ill children.
“I was erecting a whole intellectual edifice based on ignorance,” says Warner, who writes frequently for the New York Times and is also the author of “Perfect Madness: Motherhood in the Age of Anxiety.”
Nowhere did Warner encounter mothers or fathers eager to medicate healthy kids for trivial reasons. Instead, she found parents struggling to find and afford decent treatment for children disabled by their symptoms or their behavior, parents who had turned to psychiatric medicines only out of desperation — and a society that persists in stigmatizing mental illness, blames parents when kids are affected and has done far too little to ensure that such kids can get access to treatments that have been shown to work.
Instead of an epidemic of over treatment, Warner describes an epidemic of undertreatment of children with mental illness. “Five percent of kids in America take psychotropic drugs,” she writes — stimulants, antidepressants or other psychiatric medications — while “five to 20 percent have psychiatric issues.”
Among the disadvantaged, the majority of mentally ill children receive no treatment at all, while many others are prescribed drugs or combinations that are inappropriate for their problems.
But what about the startling numbers: a tripling since the 1990s in the number of U.S. children receiving mental health diagnoses, a recent government estimate that 8 percent of children have ADHD, a 3,500 percent increase between 1991 and 2006 in the number of kids identified as autistic in special-education programs? Aren’t they evidence of over-diagnosis?
Warner argues, convincingly, that much of the increase in such diagnoses is explained by better recognition and understanding of children’s behavioral and emotional symptoms.
Interweaving stories of children and families with scientific information and well-researched arguments, Warner makes a compelling case that, as a society, we should do much more to make mentally ill kids feel better. Among her prescriptions: better insurance coverage, more financial support for mental-health services, an increase in the number of trained child psychiatrists, a research agenda that will speed identification of the most effective psychiatric medications in children, and quality control to reduce the frequency of inappropriate diagnosis and substandard treatment.
FICTION
The Hand That First Held Mine
by Maggie O’Farrell, $25
By Heller McAlpin
Washington Post Writers Group
Irish-born writer Maggie O’Farrell’s new book revolves around two fiercely independent, unmarried mothers — one a journalist, the other an artist — nearly 50 years apart.
Lexie Sinclair, kicked out of university for walking through a door for men only and then refusing to apologize, flees her family in Devon for bohemian London in the mid-1950s. When she moves in with a brilliant, flamboyant magazine editor — 13 years her senior and separated, but not yet divorced — her family disowns her.
Alternating with Lexie’s tale is an initially less-absorbing story set in contemporary London. Elina Vilkuna is a Finnish artist who nearly dies while delivering her child by Caesarean section.
Motherhood is a terrible adjustment for exhausted, aching Elina, who wonders, “How did she become this — a woman in stained pajamas, standing weeping at a window, a woman frequently possessed by an urge to run through the streets, shouting, will somebody please help me, please?”
The birth also has a traumatizing effect on the baby’s father, a film editor. Deeply shaken by nearly losing his girlfriend, he experiences disturbing flashes of long-buried memories that don’t jibe with the childhood he knows as his own, raising questions about his very identity.
As we begin to sense connections between these two plotlines, the contemporary narrative achieves greater resonance. In viscerally poetic prose, O’Farrell captures “the utter loneliness” of motherhood and “the constant undertow of maternal anxiety.” Each mother struggles to maintain her individuality in the face of all-consuming, overwhelming love for her son.
The two strands of O’Farrell’s plot advance steadily toward a point of convergence. “The Hand That First Held Mine” evokes Shirley Hazzard’s 1980 masterpiece, “The Transit of Venus,” with a similar early warning that a character will die young and a sense that they are all on a collision course with fate. The result is an uncommonly gripping and moving read.
