Sask. psychiatrist worried as province looks to change medications for kids in care

A number of kids in provincial care could be stuck with less effective mental health medication after a review by the Saskatchewan government.

Dr. Tamara Hinz, a child and adolescent psychiatrist in Saskatoon, works with many kids who are in provincial care and therefore are wards of the province.

Hinz said over the past few weeks, she has been given a heads-up by social workers and group home staff that some patients’ medication needs to be looked at because the provincial government won’t pay for it anymore.

“It was a bit of a shock and I guess I was kind of surprised to just hear about it piecemeal like that as opposed to a more co-ordinated announcement,” said Hinz.

The medications Hinz knows about are guanfacine, also known as Intuniv, and lisdexamfetamine, also known as Vyvanse. Both are used to treat ADHD, while Intuniv can also be used to treat severe tick disorders.

Those drugs aren’t on the provincial formulary, which lists the drugs the government will pay for, but Hinz has been able to write a letter in the past to explain that other medications aren’t working.

“I’ve written letters like that to the Ministry of Social Services to get coverage for it, but now, even a letter like that, apparently won’t be enough,” said Hinz.

The doctor admits the medications are expensive, but they’re not the first option for treating these kids.

“If they’re on this medicine and they remain on it, for the most part, in the majority of these cases, it means that they’re doing well and that we had to try a number of other medications that didn’t work as well,” said Hinz.

Having to switch medications could mean the kids going to something that doesn’t work as well, has side effects, or has to be taken three to four times a day instead of just once.

“Now we are in this really unfortunate situation where kids who have been responding really well to particular medications or who have been stable, we’re now going to have to potentially destabilize them by switching the medications because of coverage issues,” explained Hinz.

Hinz couldn’t say how many people the change could affect, but did say that ADHD is the single-most common mental health condition they treat in child psychiatry. So it’s not just a handful of kids who will be affected.

Hinz called the change shortsighted.

“When it comes to the mental health of youth who are already in a really vulnerable situation and who, just by the nature of the type of care they’re in, have already been through some pretty traumatizing stuff, I don’t think ethically (making a change) is the right idea and I also don’t think financially it’s the right idea,” said Hinz.

Not treating mental health problems properly in the first place can have spinoff costs, according to Hinz — from health, education, justice and social services.

Hinz has been working on trying to get the medications onto the provincial formulary in an urgent way. She said even before this situation, any child psychiatrist would say not including these drugs was an oversight.

“The type of medicine that we’re talking about, it’s not addictive, you can’t abuse it (and) it has no street value,” said Hinz.

Hinz said the medications often work really well and don’t have a lot of side effects.

In a statement, the Ministry of Social Services said kids in provincial care are eligible for supplementary benefits coverage, which is a policy it says supports family reunification because the ministry wants to make sure families will be able to meet their child’s medical needs in the future.

It went on to say the ministry conducts reviews every now and then, and in a recent review found that “a small number” of children and youth had been prescribed drugs that aren’t under the drug plan.

“Since then we worked with the Ministry of Health to better understand the coverage available and their processes related to coverage, and to clarify our policy. We will work with medical health providers to determine if any children or youth in care should be grandfathered on their current prescribed treatment,” read the statement.