2023-06-212022/23:SoU15 · p.2SoUHealth & social services

Medicines for children and young people

What's at stake: The decision affects how children and young people with mental ill health, particularly girls and young women, are treated within healthcare, and whether there is sufficient follow-up of how much antidepressant medication is prescribed to them. It matters for patient safety in a group that cannot always assess the risks of their own medication.

Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.

What the vote decides

The question is whether parliament should now direct the government to specifically review and map the rise in antidepressant medication among children and young people, or whether existing assignments on mental health and current regulations on medicine prescribing already address the need.

Yes Yes — the committee proposal

The committee notes that it is already part of the Medical Products Agency's mandate to work for more effective and safer medicine use for children, that the National Board of Health and Welfare's regulations contain specific provisions on prescribing to children, and that a government assignment on mental health and suicide prevention with a focus on safer medicine use is already under way. Against that background, the committee considers there is no reason for parliament to take its own initiative, and the motions are rejected.

No No — the reservations

Reservation 4 (SD)

The reservation (SD) calls for the government to review the rise in antidepressant medication among children and young people in Sweden and map its causes. The reasoning is that mental ill health is increasing and spreading to younger ages, more so among girls and young women, and that a shortage of resources within psychiatric care risks leading to antidepressants being prescribed too extensively instead of other support and treatment.

Summarised from the committee report. Party labels in the summary come from the report, not from the vote.

VSMPCLKDMSD
YesNoAbstainAbsent

What do the votes mean here?

Yes The committee proposal: rejecting the motions (keeping things as they are).

No Backing the counter-proposal: reservation 4 by SD.

Abstain The party marks a position of its own that is not one of the two final alternatives.

What each plan points to — and how the party voted

For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.

PlanVoteConfidenceEvidence
VNoAbstain 0/0/21/3departs from the planconfidence: mediumnot addressed
SNoYes 93/0/0/14departs from the planconfidence: lownot addressed
MPNoAbstain 0/0/15/3departs from the planconfidence: highnot addressed
CNoYes 21/0/0/3departs from the planconfidence: mediumnot addressed
LNoYes 14/0/0/2departs from the planconfidence: mediumnot addressed
KDNoYes 16/0/0/3departs from the planconfidence: mediumnot addressed
MNoYes 60/0/0/8departs from the planconfidence: mediumnot addressed
SDown reservationNoNo 0/63/0/9follows the planconfidence: highexplicit

Committee proposal

Parliament rejects the motions 2022/23:286 by Ann-Christine From Utterstedt (SD), 2022/23:922 by Linda Lindberg et al. (SD) claim 3, 2022/23:1229 by Karin Rågsjö et al. (V) claims 6-8 and 2022/23:1636 by Martina Johansson (C).

Original (Swedish)

Riksdagen avslår motionerna 2022/23:286 av Ann-Christine From Utterstedt (SD), 2022/23:922 av Linda Lindberg m.fl. (SD) yrkande 3, 2022/23:1229 av Karin Rågsjö m.fl. (V) yrkandena 6-8 och 2022/23:1636 av Martina Johansson (C).

Riksdag decision: Parliament said no to approximately 50 proposals relating to dental care and medicines. The proposals were submitted during the general motion period 2022 and relate, among other things, to medicine use, pharmacies, access to medicines and dental care. Parliament rejects the motions and refers, among other things, to the fact that investigative work in the area is ongoing.

Counter-proposals

Plan vs actual vote

Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.

VVänsterpartietNoAbstaindeparts from the plannot addressed

The plan states that mental ill-health increases especially among young people and women without this leading to expanded care, and that far too many children are suffering.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan states that mental ill-health increases especially among young people and women without this leading to expanded care, and that far too many children are suffering. It requires a right to help in good time regardless of whether one has broken a bone or burned out, and that the child's best interests come first. Reviewing the increased antidepressant medication of children and mapping the causes follows from the fact that inadequate care resources must not be replaced with medication.

Original (Swedish)

Planen konstaterar att psykisk ohälsa ökar särskilt bland unga och kvinnor utan att det leder till utbyggd vård, och att alltför många barn far illa. Den kräver rätt till hjälp i tid oavsett om man brutit benet eller blivit utbränd och att barnens bästa kommer i första rummet. Att se över den ökade antidepressiva medicineringen av barn och kartlägga orsakerna följer av att bristande vårdresurser inte får ersättas med läkemedel.

  • mental ill-health requires caredecisive»Stressrelaterade sjukdomar blir allt vanligare och psykisk ohälsa ökar särskilt bland kvinnor och hos unga utan att det leder till utbyggd vård eller förändrad arbetsmiljö.« (2022 manifesto ↗)“Stress-related diseases become increasingly common and mental ill-health increases especially among women and among young people without this leading to expanded care or changed working environment.”
  • right to help in good time»Du ska ha rätt till hjälp snabbt oavsett om du har brutit benet eller blivit utbränd.« (2022 manifesto ↗)“You must have a right to help quickly regardless of whether you have broken a bone or burned out.”
  • children's mental ill-health»Alltför många barn far illa idag och den psykiska ohälsan bland unga är utbredd.« (2022 manifesto ↗)“Far too many children are suffering today and mental ill-health among young people is widespread.”
  • children's best interests first»Vänsterpartiets politik ska utformas så att barnens bästa kommer i första rummet.« (party programme ↗)“The Left Party's policy must be shaped so that children's best interests come first.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

SSocialdemokraternaNoYesdeparts from the plannot addressed

The plan is based on all children having the right to a secure upbringing according to the Convention on the Rights of the Child and that welfare services are distributed according to need, not according to available resources.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan is based on all children having the right to a secure upbringing according to the Convention on the Rights of the Child and that welfare services are distributed according to need, not according to available resources. That antidepressants risk being prescribed instead of other treatment when psychiatry lacks resources contradicts this. To review the increase and map the causes is therefore supported in substance, even if the plan does not address the issue directly.

Original (Swedish)

Planen bygger på att alla barn har rätt till en trygg uppväxt enligt barnkonventionen och att välfärdstjänster fördelas efter behov, inte efter tillgängliga resurser. Att antidepressiva läkemedel riskerar skrivas ut i stället för annan behandling när psykiatrin saknar resurser strider mot detta. Att se över ökningen och kartlägga orsakerna stöds därför i sak, även om planen inte behandlar frågan direkt.

  • children's right to healthdecisive»Alla barn ska ha rätt till en trygg uppväxt i enlighet med FN:s barnkonvention.« (party programme ↗)“All children shall have the right to a secure upbringing in accordance with the UN Convention on the Rights of the Child.”
  • care according to need»välfärdstjänsterna fördelas efter behov.« (party programme ↗)“welfare services are distributed according to need.”
  • timely care»Ingen ska behöva känna oro över att få vård i tid.« (2022 manifesto ↗)“No one should have to worry about receiving care in time.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MPMiljöpartietNoAbstaindeparts from the plannot addressed

The party programme stipulates that medication consumption today is a problem for patient safety and that alternatives to medication such as exercise on prescription and psychotherapy must be developed, which is precisely the question the counter-proposal wants to review when antidepressants are prescribed to children and young people.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The party programme stipulates that medication consumption today is a problem for patient safety and that alternatives to medication such as exercise on prescription and psychotherapy must be developed, which is precisely the question the counter-proposal wants to review when antidepressants are prescribed to children and young people. The plan also requires active cooperation between student health, primary care, youth health services and psychiatry for young people with mental ill-health. Increased access to mental health care is the election manifesto's answer to the resource shortage.

Original (Swedish)

Partiprogrammet slår fast att läkemedelskonsumtionen i dag är ett problem för patientsäkerheten och att alternativ till läkemedel som motion på recept och psykoterapi ska utvecklas, vilket är precis den fråga motförslaget vill se över när antidepressiva skrivs ut till barn och unga. Planen kräver också aktiv samverkan mellan elevhälsa, primärvård, ungdomsmottagning och psykiatri för unga med psykisk ohälsa. Ökad tillgång till vård för psykisk ohälsa är valmanifestets svar på resursbristen.

  • reduced medication usedecisive»läkemedelskonsumtionen i dag är ett problem både« (party programme ↗)“medication consumption today is a problem both”
  • alternatives to medication»alternativ till läkemedel, exempelvis motion på« (party programme ↗)“alternatives to medication, for example exercise on”
  • mental health care»satsa på primärvården och öka tillgången till vård för psykisk ohälsa.« (2022 manifesto ↗)“invest in primary care and increase access to mental health care.”
  • cooperation around young people»unga krävs det en aktiv samverkan mellan elevhälsa, föräldrar, primärvård, ungdomsmottagning« (party programme ↗)“young people require active cooperation between student health, parents, primary care, youth health services”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

CCenterpartietNoYesdeparts from the plannot addressed

The plan establishes that mental illness among children and young people is too high, that work must become more preventive, that queues to child and adolescent psychiatric care must be eliminated, and that healthcare must receive better tools for treatment.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan establishes that mental illness among children and young people is too high, that work must become more preventive, that queues to child and adolescent psychiatric care must be eliminated, and that healthcare must receive better tools for treatment. Reviewing and mapping the increase in antidepressant medication in children follows from the fact that lack of resources must not replace other support and treatment. The plan does not specifically mention medication use.

Original (Swedish)

Planen slår fast att den psykiska ohälsan bland barn och unga är för hög, att arbetet måste bli mer förebyggande, att köerna till BUP ska arbetas bort och att vården ska få bättre verktyg för behandling. Att se över och kartlägga ökningen av antidepressiv medicinering hos barn följer av att brist på resurser inte får ersätta annat stöd och behandling. Planen nämner inte läkemedelsanvändningen särskilt.

  • prevent mental illness in young peopledecisive»Den psykiska ohälsan hos våra barn och unga är alldeles för hög och vi måste arbeta mer förebyggande och skapa enkla vägar till vården, så att barn och unga snabbt får vård oavsett om det handlar om enklare psykisk ohälsa eller psykiatrisk sjukdom.« (2022 manifesto ↗)“Mental illness among our children and young people is far too high and we must work more preventively and create simple paths to care, so that children and young people quickly receive care regardless of whether it is a matter of milder mental illness or psychiatric disease.”
  • reduce the queues to child and adolescent psychiatric care»Köerna till BUP måste arbetas bort.« (2022 manifesto ↗)“The queues to child and adolescent psychiatric care must be eliminated.”
  • unified support for mental illness»Stödet för personer med psykisk ohälsa måste förbättras, inte minst för unga. Den som söker hjälp ska ha en enkel och samlad väg in till vården.« (2022 manifesto ↗)“Support for people with mental illness must be improved, especially for young people. Those seeking help should have a simple and unified pathway into care.”
  • the child's perspective»Samhällets aktörer ska inta individens perspektiv. Av största betydelse är då barnens rättigheter och perspektiv.« (party programme ↗)“Society's actors must take the perspective of the individual. Of paramount importance are then the rights and perspective of children.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

LLiberalernaNoYesdeparts from the plannot addressed

The plan requires that children's and young people's special needs be considered in all healthcare, that mental ill-health is treated on the same terms as physical and on a scientific basis, and that healthcare-related statistics are analysed from a gender perspective.

Plan documents: party programme

Reasoning and quotes

The plan requires that children's and young people's special needs be considered in all healthcare, that mental ill-health is treated on the same terms as physical and on a scientific basis, and that healthcare-related statistics are analysed from a gender perspective. Mapping the causes of increased antidepressant use in children and young people, which strikes differently against girls and boys, follows from these commitments. Medication use in children is not addressed explicitly.

Original (Swedish)

Planen kräver att barns och ungas särskilda behov beaktas i all hälso- och sjukvård, att psykisk ohälsa behandlas på samma villkor som fysisk och på vetenskaplig grund, och att vårdrelaterad statistik analyseras ur ett genusperspektiv. Att kartlägga orsakerna till ökad antidepressiv medicinering av barn och unga, som slår olika mot flickor och pojkar, följer av dessa åtaganden. Läkemedelsanvändning hos barn behandlas inte uttryckligen.

  • children's needs in healthcaredecisive»Barns och ungas särskilda behov ska beaktas i all hälso- och sjukvård.« (party programme ↗)“Children's and young people's special needs shall be considered in all healthcare.”
  • mental health on equal terms»Rätten till vård och behandling är lika självklar för både fysiska och psykiska sjukdomar.« (party programme ↗)“The right to care and treatment is equally obvious for both physical and mental illness.”
  • scientifically-grounded treatment»Personal i legitimationsyrken ska alltid arbeta i enlighet med vetenskap och beprövad erfarenhet.« (party programme ↗)“Personnel in licensed professions shall always work in accordance with science and proven experience.”
  • gender-divided follow-up»All vårdrelaterad statistik ska analyseras ur ett« (party programme ↗)“All healthcare-related statistics shall be analysed from a”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

KDKristdemokraternaNoYesdeparts from the plannot addressed

The plan requires particular emphasis on rapid and accessible expertise for children and young people with mental ill-health and that care shall be evidence-based and safe for patients.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan requires particular emphasis on rapid and accessible expertise for children and young people with mental ill-health and that care shall be evidence-based and safe for patients. The manifesto promises significantly strengthened school health and integrated child and youth health care. Examining the increase in antidepressant medication and charting the causes follows from the fact that medicine should not replace other support.

Original (Swedish)

Planen kräver särskild vikt vid snabb och tillgänglig kompetens för barn och unga med psykisk ohälsa och att vården ska vara evidensbaserad och säker för patienterna. Manifestet lovar kraftigt stärkt elevhälsa och sammanhållen barn- och ungdomshälsovård. Att se över ökningen av antidepressiv medicinering och kartlägga orsakerna följer av att läkemedel inte ska ersätta annat stöd.

  • mental ill-health in young peopledecisive»Särskild vikt ska läggas vid snabb och tillgänglig kompetens för barn och ungdom med psykisk ohälsa.« (party programme ↗)“Particular emphasis shall be placed on rapid and accessible expertise for children and young people with mental ill-health.”
  • strengthened school health»Kraftigt stärkt elevhälsa med en sammanhållen barn- och ungdomshälsovård och föräldrastödsprogram som erbjuds alla föräldrar.« (2022 manifesto ↗)“Significantly strengthened school health with integrated child and youth health care and parental support programmes offered to all parents.”
  • evidence-based care»Den solidariskt finansierade hälso- och sjukvården ska vara ändamålsenlig och kostnadseffektiv, säker för patienterna och baserad på kunskap och beprövad erfarenhet, det vill säga evidensbaserad.« (party programme ↗)“Solidarily financed health and medical care shall be appropriate and cost-effective, safe for patients and based on knowledge and proven experience, that is, evidence-based.”
  • the role of medicine»Läkemedel är en väsentlig del av de flesta« (party programme ↗)“Medicine is an essential part of most”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MModeraternaNoYesdeparts from the plannot addressed

The plan makes children's mental wellbeing one of the most important priorities and wants to strengthen child and youth psychiatry so that help is provided quickly, with a statutory care guarantee for children and a national strategy against suicide.

Plan documents: 2022 manifesto

Reasoning and quotes

The plan makes children's mental wellbeing one of the most important priorities and wants to strengthen child and youth psychiatry so that help is provided quickly, with a statutory care guarantee for children and a national strategy against suicide. The counter-proposal's requirement to review the increased antidepressant medication of children and map the causes follows from the same concern, and its reasons — insufficient psychiatric resources — is precisely what the plan wants to address. The plan therefore supports the requirement in substance.

Original (Swedish)

Planen gör barns psykiska mående till en av de viktigaste prioriteringarna och vill stärka barn- och ungdomspsykiatrin så att hjälp ges snabbt, med en lagstadgad vårdgaranti för barn och en nationell strategi mot självmord. Motförslagets krav på att se över den ökade antidepressiva medicineringen av barn och kartlägga orsakerna följer av samma oro, och dess skäl — bristande psykiatriresurser — är precis det planen vill åtgärda. Planen stöder därför kravet i sak.

  • strengthened child and youth psychiatrydecisive»Stärka barn- och ungdomspsykiatrin så att barn och unga som mår dåligt får hjälp snabbt« (2022 manifesto ↗)“Strengthen child and youth psychiatry so that children and young people who are struggling get help quickly”
  • care guarantee for children»Införa en ny lagstadgad vårdgaranti för barn« (2022 manifesto ↗)“Introduce a new statutory care guarantee for children”
  • strategy against mental ill-health»Ta fram en nationell strategi mot självmord, med särskilt fokus på barn och unga« (2022 manifesto ↗)“Develop a national strategy against suicide, with particular focus on children and young people”
  • children's mental health prioritized»Få saker är viktigare att prioritera än barns psykiska mående.« (2022 manifesto ↗)“Few things are more important to prioritize than children's mental wellbeing.”

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

SDSverigedemokraternaNoNofollows the planexplicit

The election manifesto states that research is crucial for finding the causes of growing mental health problems and that effective treatment measures such as talk therapy should be offered to a greater extent.

Plan documents: 2022 manifesto

Reasoning and quotes

The election manifesto states that research is crucial for finding the causes of growing mental health problems and that effective treatment measures such as talk therapy should be offered to a greater extent. The plan also wants to strengthen resources for psychiatry and efforts for young people's mental health. The counter-proposal's demand to review the increase in antidepressant medication for children and map the causes thus responds directly to the plan's commitments.

Original (Swedish)

Valmanifestet slår fast att forskning är avgörande för att hitta orsakerna till den växande psykiska ohälsan och att effektiva behandlingsåtgärder som samtalsterapi i högre grad bör erbjudas. Planen vill dessutom stärka resurserna till psykiatrin och insatserna för ungas psykiska hälsa. Motförslagets krav på att se över ökningen av antidepressiv medicinering av barn och kartlägga orsakerna svarar därför direkt mot planens åtaganden.

  • map the causes of health problemsdecisive»Forskningen är avgörande för den fortsatta kunskapsutvecklingen inom området psykisk hälsa samt för att hitta orsakerna till den växande psykiska ohälsan i samhället.« (2022 manifesto ↗)“Research is crucial for continued knowledge development in the field of mental health and for finding the causes of growing mental health problems in society.”
  • talk therapy as treatment»Effektiva behandlingsåtgärder, i form av exempelvis samtalsterapi, bör i högre grad erbjudas för att den psykiska hälsan hos patienten inte ska riskera att försämras.« (2022 manifesto ↗)“Effective treatment measures, in the form of for example talk therapy, should be offered to a greater extent so that the patient's mental health does not risk deteriorating.”
  • more resources for psychiatry»Stärka resurserna till psykiatrin« (2022 manifesto ↗)“Strengthen resources for psychiatry”
  • young people's mental health»Stärka insatserna för att förbättra ungas psykiska hälsa« (2022 manifesto ↗)“Strengthen efforts to improve young people's mental health”

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Sources and documents

Documents under consideration

Source: The Swedish Parliament