The stereotypical medicated kid in America is wealthy and spoiled and retains a psychiatrist to guarantee him extra time on tests or to help process the emotional fallout of being neglected by high-powered working parents. In this formulation, rich kids have psychological problems, and poor kids have real problems. But the stereotype isn't accurate; the correlation is, in fact, the opposite. Children in poor families are significantly more likely to be diagnosed with emotional and behavioral problems and to be prescribed medication. Our national understanding of youth and mental health starts with an important mistake.
Commentators posit a variety of logical, common-sense explanations: Maybe poorer kids having inadequate access to high-quality health care means they get diagnosed less, or maybe poorer parents are less attentive, or less educated about psychiatric matters. Rich parents are single-mindedly invested in their children's success, while over-involved upper-class moms and dads need to label every hormonal swing with a new disorder. These pop-psychological explanations make sense, but they're not true — they describe an imagined set of facts.
Here's the data: The National Health Interview Survey from 2011–12 found that children between the ages of six and 17 from families under the poverty line were significantly more likely to be prescribed psychiatric medication than any other economic group. The same study found that children on Medicaid were 50 percent more likely to get a prescription than those with private insurance. An analysis of attention-deficit/hyperactivity disorder (ADHD) diagnoses among kids between the ages of five and 17 between 1998 and 2009 found rates rose twice as fast for working-class and poor kids. A measurable class gap has emerged among children when it comes to mental health.