Psychiatric Treatment for Adolescents in the U.S. in the mid-/late-1970s

[verrucaria]

OK, this is actually for an assignment, but the point of the assignment is to conduct an initial psych assessment of the character. I swear that we are not graded on researching the history of psychiatry.

This assignment is based on the film Ordinary People, not the novel it's based on (which I've never read). According to Wikipedia, there appear

Comments

[lolmac]

I'm not sure how much use this will be to you, given that I've neither seen the movie nor read the book, and I'm not a medical professional or medical historian. I do have one piece of personal anecdotage that might be relevant.

I was born in 1960, so I turned 15 in 1975, etc. You can do the math. I was the target age during that period.

In 1968, my family moved from one part of the country to another. I adjusted very badly. I did well enough in school, but my social skills collapsed. I was sent to the school counsellor, with no results, including a diagnosis. I developed a terrible stammer, and was tested for brain damage. In my teens, I got myself into what passed for counselling (actual therapy not available), which helped a bit. In my late twenties, I was diagnosed, finally, with clinical depression dating back to the move.

The point is that there was no diagnosis or treatment while I was either a child or an adolescent. Conventional wisdom held that children did not suffer from depression, and teenagers only suffered from puberty, which eventually cured itself. Feed kids drugs for psychiatric problems? Are you kidding? They'll grow out of it; it's just a phase. Antidepressants? Don't be ridiculous.

Unless you can dig up specific examples showing that anyone under the age of 21 actually did get treated with medication, you'd better assume that they did not. The attitude was that any mental issues shown by anyone who wasn't an adult was a temporary thing that should be addressed with therapy, or a physical issue (mental retardation, for example) that wasn't treatable. In other words, based on my own experience, "My guess is that psychiatrists nonetheless might've been creative with prescribing to adolescents" is a bad guess.

Also, pay close attention to the drugs that were actually available at that time. It was a very small menu, especially compared to today. I think you'll find that the studies done on non-adult subjects focused on "how badly poisoned will they be if they accidentally swallow it?" rather than "will this be an effective treatment?" This is because of the prevailing attitudes, as described.

A good contemporaneous source is the play Equus, written in 1973. The teenage boy has just mutilated several horses -- and he's getting psychotherapy. No drugs. The psychiatrist offers him a placebo at one point and tells him it's a 'truth pill', since the kid has indicated that he wants the 'truth drug' so he can talk about what he did -- all talk, no drugs.

[verrucaria]

Thank you very much for your reply--and I'm glad you made it through! Now I realize that the fact that meds aren't mentioned in the movie is probably because they weren't used at all.

P.S. A major reason SSRIs and SNRIs are considered "safer" than the older antidepressants is that it is pretty hard to fatally overdose on them (unless you mix multiple drugs with a similar function).

[lolmac]

And thank you so much for the sweet reply in turn! And that's really interesting about the newer drugs being hard to overdose fatally; it makes a great deal of sense. Now I've learned something today!