On Tuesday, February 9th, after 19 hours of deliberation, a jury found Rebecca Riley’s mother, Carolyn Riley, guilty of second degree murder in Rebecca’s death in December 2006 due to an overdose of psychiatric medication. It made me sad to read this, mostly because it doesn’t bring Rebecca back and it doesn’t solve the bigger problems raised by this case. The system – including many well meaning and caring individuals – failed Rebecca, and these failures killed her. Rebecca’s mother appears to have been so broken that she could not effectively keep her daughter safe. But that is why we look to the village – to our systems of care, education, social services, family, and neighbors – to keep a safety net under children who are not safe in their parents’ care.

People are pretty vocal about what they perceive to be the dangers of diagnosing and medicating children who have psychiatric disorders, and you can find plenty of horror stories, including the case of Rebecca Riley, but what about the dangers of not medicating children who fail to respond to non-medication interventions and could really benefit with the right diagnosis and medications?

The Rebecca Riley case underscores the need for professionals to obtain as full a picture as possible to reduce the risk of operating on false or misleading information – from any source.

If it takes a village to raise a child, it might just take a village to kill one, too, which is what I believe happened to Rebecca Riley. Here are some facts about and testimony from some of Rebecca Riley’s “caregivers” as reported by Boston.com, The Patriot Ledger, and Carolyn Riley herself during her 60 Minutes interview with Katie Couric, along with some commentary.

Patricia Wen of the Boston Globe posted an article today entitled “Psychiatrist admits she approved higher drug dosage in Riley trial. In it, she recounts the testimony given today by Dr. Kayoko Kifuji, the psychiatrist who had diagnosed and treated Rebecca Riley for bipolar disorder and attention deficit hyperactivity disorder (ADHD). I read the article cautiously, because there are so many facets to consider in watching this trial unfold, but the psychiatric testimony carries a lot of weight.

Many people are shocked to hear that anyone as young as Rebecca Riley could be diagnosed as having bipolar disorder and prescribed powerful psychotropic medications. Following are several questions I have been hearing about the case recently that are related to early childhood diagnosis and treatment followed by my answers:

The Patriot Ledger seems to be following Carolyn Riley’s murder trial closely. For Lane Lambert’s report on the second day of the trial (Wednesday), see “Teachers say Rebecca’s parents shed no tears.” On Patriot.com, you can also view a video of the prosecutor’s opening remarks delivered on Tuesday.

Rebecca Riley was four years old when she died three years ago. She had been diagnosed as having bipolar disorder and ADHD and was being treated with clonidine (a blood pressure medicine sometimes used as a sedative for ADHD) and Depakote (for bipolar). (See Department of Social Services (DSS) case file recounting the timeline of DSS involvement with the family of 4-year-old Rebecca Riley.)

Mark Olfson, professor of clinical psychiatry at Columbia University, just published results of his study in the Journal of the American Academy of Child & Adolescent Psychiatry, in which he found that “the number of children aged 2 to 5 who have been diagnosed with bipolar disorder and prescribed powerful psychiatric medications has doubled over the past decade.” (To read more about the study, check out today’s story from Reuters reporter Ros Krasny entitled “Bipolar diagnosis jumps in young children: study.”)

Danielle Asks…

My 4 year old son was diagnosed with bipolar disorder about six months ago…he is currently on Seroquel, and the doctor added lithium today. I am scared that my baby has to be on these medications at such a young age and I am wondering if there is anyone out there with children (or yourself) that started these meds so young.