2/3 of foster care children in Mass on psych drugs_Globe / Psychiatry: Soviet Style

[Guest guest]

There is a high number of foster children on psychotropic medication in most

states. It grew as policy not by accident. F.

 

 

--- SSRI-Research wrote:

 

 

> SSRI-Research

> Fri, 13 Aug 2004 01:09:25 -0000

 

> [sSRI-Research] Two-thirds foster care

> children in Mass on psych drugs_Globe / Psychiatry:

> Sovie

>

> ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)

> Promoting openness and

> full disclosure http://www.ahrp.org

>

> FYI

>

> The Boston Globe reports that 2/3 of children in

> state care in

> Massachusetts are being " treated " for mental illness

> with

> psychotropic drugs. Marie Parente, a legislator, and

> parents call for

> disclosure of " how many children in state care are

> being given

> psychotropic drugs, and for government agencies to

> take a critical

> look at the procedures for allowing these medicines

> to be

> prescribed. " Parente suggested that " the state may

> be motivated to

> label children as mentally ill because of the

> reimbursement checks

> they receive from the federal government, which

> compensates

> Massachusetts for half of all Medicaid

> expenditures. " (below)

>

> If psychiatry is sometimes regarded as " a mirror of

> society, " then

> America is mindlessly heading in the wrong

> direction, driven by an

> unproven biochemical theory for mental illness.

> Inasmuch as

> psychiatry lacks scientific diagnostic tools, and no

> proven cures or

> safe medicines, the skyrocketing prescribing of

> harmful psychotropic

> drugs to America's children can only be classified

> as child abuse.

> [1, 2]

>

> Spiraling state Medicaid expenditures for

> psychotropic drugs are best

> explained by the drug industry's inordinate

> influence on psychiatric

> practice--not these drugs' effectiveness.[3]

>

> Dr. Irwin Savodnik, a psychiatrist and philosopher

> who teaches at

> UCLA, has studied the shifting winds in psychiatry

> in the former

> Soviet Union. He found, that once psychiatrists were

> freed from

> Soviet dictatorship in 1992, they shed the

> straightjacket

> of " biological determinism. " Today, those

> psychiatrists are avidly

> reading Freud in an effort to regain a humanistic

> perspective of

> human nature that biological psychiatry had

> eradicated.

>

> " The great irony, " Dr. Savodnik observes, " is that

> American

> psychiatry is moving in exactly the opposite

> direction.In the past 30

> years, the overriding ideology of American

> psychiatry has shifted to

> a biological model. Psychopharmacology has become

> its therapeutic

> backbone. " Dr. Savodnik points out, that the problem

> is that " this

> model doesn't tolerate free agency. It views

> psychiatric problems --

> moral problems, really -- as medical ones, just as

> Soviet psychiatry

> did. "

>

> " The Soviet example places in bold relief the

> deficiencies and

> fallacies of a truncated view of human life...as the

> Soviet system

> came undone and its psychiatrists freed themselves

> from the confines

> of a strangulating ideology, American psychiatrists

> have embraced

> uncritically the same narrow vision. But as the

> Soviet example

> demonstrates with distressing clarity, a conception

> of people as

> little more than biochemical bundles fails to

> address those aspects

> of ourselves that make us human. "

>

> Soviet psychiatry was used primarily as a political

> tool to control

> dissident adults: psychotropic drugs were used to

> punish political

> dissidents and others the government deemed to be

> " troublemakers. "

> American psychiatry is more ambitious than Soviet

> psychiatry ever

> was. US psychiatrists collaborate with government

> agencies by

> providing a seal of approval for involuntary

> " treatment " of persons

> loosely deemed to have a " mental disorder " , or to be

> unruly. US

> psychiatrists also collaborate in the formulation of

> state-sponsored

> mental health policies--such as, " screening for

> mental illness " --

> initiatives which primarily target children. In

> Illinois, pregnant

> women are targeted for screening as well. [4]

> Psychiatrists serve as

> experts on pharmaceutical industry sponsored

> " consensus " panels,

> issuing practice guidelines that promote the

> extensive use of

> psychotropic drugs to control behavior-and to enrich

> the drug

> industry. [5] For these services, the drug industry

> provides

> psychiatry with high financial rewards.

>

> The most expansive (and expensive) US mental health

> initiatives are

> sure-bet profit enhancers: Leading psychiatrists,

> primarily from the

> University of Texas, backed by funding from Eli

> Lilly, Johnson &

> Johnson and 9 other major pharmaceutical companies,

> formulated the

> Texas Medication Algorithm Project (TMAP). [5] TMAP

> is a template for

> physicians, purporting to improve their prescribing

> practices for

> antipsychotics, antidepressants, mood stabilizers,

> stimulants,

> anticonvulsants and other psychotropic drugs. TMAP

> has been endorsed

> by a dozen or so, state mental health agencies, and

> by President

> Bush's New Freedom Commission on Mental Health

> (NFC). The TMAP

> algorithm model " is limited to medication

> strategies, " and TMAP

> recommendations require the use of the most

> expensive (profit

> generating) psychotropic drugs.

>

> For depressed children, TMAP recommends SSRI

> antidepressants as first

> line treatment " because of supporting efficacy data "

> from fluoxetine,

> paroxetine and sertraline. [5] This statement is

> patently false as

> the scientific evidence refutes it. [6, 7]

>

> NCF recommends mass screening for hidden mental

> illness--with

> emphasis on school children. [8] This dubious

> initiative is a radical

> invasion of privacy, leaving no room for individual

> choice--or the

> freedom for parents to say no, to psychotropic drugs

> for their

> children. [4] Such mandatory, government-endorsed

> screening programs

> contradict the freedoms guaranteed in a democratic

> society.

>

> If implemented, this " new freedom " initiative

> establishes a coercive

> selection policy that opens the door to

> discrimination and forced

> treatment with powerful, psychotropic drugs that

> have caused more

> harm to children (and adults) than the conditions

> for which they were

> prescribed. Children and adults who will be labeled

> mentally ill on

> the basis of unreliable, subjective tests

> (essentially

> questionnaires), can expect to lose their autonomy

> as a brigade of

> mental health providers intrudes on their lives and

> takes over their

> decision-making authority. It is insidious because

> the built-in full

> employment incentive for the mental health service

> industry-including

> psychiatrists, psychologists and social workers-is

> dependent upon

> taking away freedom from those declared " mentally

> ill. "

>

> Inasmuch as drugs are the backbone of psychiatric

> treatment in the

> US, screening for mental illness is a strategy that

> will increase

> drug sales. The TMAP psychotropic drug guidelines

> promote the

> increased use of particular antidepressants and

> antipsychotics--even

> as the evidence raises doubts about these drugs'

> safety and

> therapeutic efficacy.

>

> Ironically, the failed Soviet approach of using

> psychotropic drugs to

> subdue political critics, is now being applied en

> masse in America--

> vulnerable children are especially targeted. Just as

> Soviet

> psychiatrists disregarded the harm done to patients,

> American

> psychiatrists who embrace the same dehumanizing

> biological approach

> disregard known and foreseeable adverse

> consequences. American

> psychiatry (and the mental health industry) has an

> added motivation

> that the Soviets lacked; namely, a financial stake

> in the

> profitability of the pharmaceutical industry.

>

> A Whistleblower Report by Allen Jones, the fired

> Investigator in the

> Office of the Inspector General (PA), documents the

> pharmaceutical/political alliance that led to the

> dubious

> recommendations of TMAP and NFC:

>

http://psychrights.org/Drugs/AllenJonesTMAPJanuary20.pdf

>

>

> An editorial in Psychiatric News confirms Allen

> Jones' allegations

> that TMAP is a pharmaceutical industry funded model.

> It helps explain

> why TMAP is biased toward the most expensive drugs

> and why state

> Medicaid budgets are being depleted by TMAP

> recommended drugs:

>

> " TMAP received a total of $285,000 from 11

> pharmaceutical companies

> for start-up of the project. In the development of

> the guidelines for

> depression, schizophrenia, bipolar disorder, ADHD,

> and pediatric

> depression, TMAP to date has spent more than $6

> million. The list of

> funding sources is long. " [9]

>

> References:

> 1. Prozac Found In System Of CYA [California Youth

> Authority] Teens

> Found Dead - Drugs forced on children without

> parental permission.

> Feb. 26, 2004

>

http://www.thekcrachannel.com/news/2878886/detail.html;

>

> 2. Lawsuit: State fired shrink for exposing abuse By

> NICOLE

> WEISENSEEEGAN. Philadelphia Daily News:

>

http://www.philly.com/mld/dailynews/news/local/9095033.htm;

> http://www.ahrp.org/infomail/04/07/07.html

>

> 3. Florida Medicaid Mental Health Drug

> Recommendations, FY 2004-2005

>

http://www.fdhc.state.fl.us/Medicaid/deputy_secretary/recent_presentat

> ions/m

> ental_health_options_021004.pdf

>

> 4. IL launches compulsory mental health screening

> for children and

> pregnant women Monday, July 19, 2004.

>

http://www.illinoisleader.com/news/newsview.asp?c=17748

>

>

> 5. The Texas Children's Medication Algorithm

> Project: Report of the

> Texas Consensus Conference Panel on Medication

> Treatment of Childhood

> Major Depressive Disorder. Carroll W. Hughes.

> Journal of the American

> Academy of Child and Adolescent Psychiatry Nov,

> 1999.

>

> 6. Jon N Jureidini, Christopher J Doecke, Peter R

> Mansfield, Michelle

> M Haby, David B Menkes, Anne L Tonkin, Efficacy and

> safety of

> antidepressants for children and Adolescents,

> British Medical

> Journal, online free at:

>

http://bmj.bmjjournals.com/cgi/content/full/328/7444/879?

>

>

> 7. Craig J Whittington, Tim Kendall, Peter Fonagy,

> David Cottrell,

> Andrew Cotgrove, Ellen Boddington. Selective

> serotonin reuptake

> inhibitors in childhood depression: systematic

> review of published

> versus unpublished data. The Lancet. Volume 363,

> Number 9418, April

> 24, 2004, online free at:

> http://www.thelancet.com/journal/journal.isa

>

> 8. Bush Plans to Screen Whole US Population for

> Mental Illness by

> Jeanne Lenzer - BMJ 2004;328:1458 (19 June)

>

http://bmj.bmjjournals.com/cgi/content/full/328/7454/1458

>

> 9. Putting Clinical Trial Results in Perspective.

> Psychiatric News

> August 6, 2004 Volume 39 Number 15, p.35.

>

>

> Contact: Vera Hassner Sharav

> Tel: 212-595-8974

> e-mail: veracare

> ~~~~~~~~~~~~~

>

>

http://www.boston.com/news/local/articles/2004/08/09/prevalence_of_dru

> gs_for

> _dss_wards_questioned?mode=PF

> THE BOSTON GLOBE

> Prevalence of drugs for DSS wards questioned

> By Jessica E. Vascellaro, Globe Correspondent

> August 9, 2004

>

> A lawmaker and some parents are calling on the

> Commonwealth to

> disclose how many children in state care are being

> given psychotropic

> drugs, and for government agencies to take a

> critical look at the

> procedures for allowing these medicines to be

> prescribed. They cite

> what they call an alarming statistic about the

> number of children in

> the care of the state Department of Social Services

> who are being

> treated for mental illness.

>

> Figures from the Massachusetts Behavioral Health

> Partnership, an

> organization contracted by DSS to coordinate mental

> health coverage

> for children in foster care, guardianship programs,

> and some adoption

> cases, show that almost two-thirds of children in

> DSS care received

> either inpatient or outpatient mental health

> counseling or treatment

> during the 2003 fiscal year.

>

> According to the data, the partnership provided

> 12,722 of 19,856 DSS

> children with mental health counseling or treatment.

> The organization

> says it does not keep track of how many children are

> prescribed

> psychotropic medicines such as Ritalin, Adderall,

> and Prozac. " We

> need to look into the use of these drugs on

> children, " said state

> Representative Marie Parente, chairwoman of the

> state special

> committee on foster care. " We need a commission to

> examine the whole

> practice of administering these psychotropic drugs

> to children in

> foster care. "

>

> Parente said the two-thirds percentage demands a

> closer look because

> it is inordinately high, compared with the incidence

> of mental health

> disorders in the general population. For example,

> the National

> Institute of Mental Health estimates that up to 2.5

> percent of

> children and up to 8.3 percent of adolescents in the

> United States

> suffer from depression, and 4.1 percent of

> 9- to 17-year-olds suffer from attention deficit

> hyperactivity

> disorder, two of the most common mental illnesses

> for which the young

> are treated.

>

> " Many children come from problem homes, but the

> children are really

> fine, " said Parente. But Dr. Elizabeth Childs,

> commissioner of the

> state's Department of Mental Health, said the high

> number of children

> in state care receiving mental health services is

> logical, given the

> children's tumultuous family histories. " These

> numbers are absolutely

> high, but if anything we need a heightened

> awareness, since these

> children might have an increased need for mental

> health services, "

> she said. " I would rather see that we did intervene

> with 64 percent

> of the children than have 50 percent of the children

> who need access

> not get it. "

>

> For the past two years, Parente has sponsored state

> budget amendments

> that would create a task force to study how many

> children in state

> care are prescribed psychotropic drugs. After her

> latest measure was

> approved by the House and the Senate, Governor Mitt

> Romney vetoed the

> amendment earlier this summer. Richard Powers,

> spokesman for the

> state Executive Office of Health and Human Services,

> said the

> governor supported an investigation but opposed the

> creation of a

> task force. " We don't oppose the study, but we

> didn't think a

> separate study was necessary, " he said. " We also

> thought that a study

> might be expanded beyond the psychotropics to all

> medications that

> children in foster care are taking. "

>

> Others say they are skeptical of the state's current

> approach. Gail

> Wilson-Giarratano of Springfield, who adopted her

> son in 2002, said

> that Richard, now 12, came out of the state foster

> care system on

> more medications than she could count and that she

> and her husband

> have been trying to get him off the prescriptions

> ever since. " He has

> been on meds for so long that nobody knows why they

> were issued, " she

> said. " He has been labeled as having behaviors he

> doesn't show. "

>

> Parente also suggested that the state may be

> motivated to label

> children as mentally ill because of the

> reimbursement checks they

> receive from the federal government, which

> compensates Massachusetts

> for half of all Medicaid expenditures.

>

> She said the state files a pre-expenditure report

> outlining expected

> costs and each patient's eligibility for Medicaid

> and other federal

> aid. While the state is not reimbursed until it

> submits a report of

> services actually provided, Parente said there is a

> lot of room for

> the state to fudge numbers and list services that

> were never

> delivered. " I am very concerned that they not label

> these children as

> having mental health problems in order to receive

> federal

> reimbursement, " she said. Powers said that such

> suggestions are

> baseless. " DSS does not label children to get more

> money, " he said,

> adding that the department depends on the assessment

> of mental health

> professionals for medical decisions.

>

> While national statistics on the number of children

> in state care

> being treated for mental illness do not exist, a

> 2004 study by the

> Chapin Hall Center for Children at the University of

> Chicago found

> that only 37 percent of 17-year-old foster children

> surveyed in

> Illinois, Iowa, and Wisconsin had received

> psychological and

> emotional counseling in the last year and almost

> one-quarter had been

> prescribed psychiatric drugs. Those numbers are much

> lower than the

> two-thirds figure recorded by the Massachusetts

> Behavioral Health

> Partnership. Loretta Kowal, a Massachusetts social

> worker on DSS's

> professional advisory committee, said Massachusetts

> doctors strongly

> endorse the use of psychotropic medicines. " We have

> seen them be

> successful over and over again, " she said. " There

> probably is a

> belief in the Massachusetts community that when all

> else fails, you

> try what's in the cabinet. "

>

> Copyright 2004 The New York Times Company

>

> http://www.techcentralstation.com/080904F.html

> Technical Central Station

> Freeing the Soviet Mind

> By Irwin Savodnik Published 08/09/2004

>

> MOSCOW -- Psychiatry, sometimes thought to be a

> mirror of society,

> has undergone a dramatic transformation in the

> former Soviet Union

> that offers an ironic vision of ourselves. From the

> austere view of

> man as a Pavlovian organism, the new Russian

> psychiatrists are

> reading Freud with a vengeance and retaliating

> against what one

> psychiatrist called the " attack on the mind " that

> the Soviets

> sustained throughout their tenure.

>

> Psychiatrists here and elsewhere in the former

> Soviet Union provided

> nearly univocal views of the changes that have

> transpired in their

> profession since 1992. They varied in age,

> background and ethnicity

> but they all felt strongly that the decline of the

> Soviet system was

> the best thing that had happened to them. Briefly,

> they were no

> longer bound by an ideological straight jacket that

> prevented them

> from inquiring into the basis of various psychiatric

> conditions. They

> were able to buy psychoanalytic books, learn

> psychoanalysis and other

> forms of psychotherapy and view their patients as

> free agents.

>

> The old Soviet psychiatry d to a harsh

> biological

> determinism. The psychiatric physician was an

> absolute authority

> while the patient's words mattered little more than

> raindrops at sea.

> That the patient might have something to add to the

> doctor's

> assessment of him made little sense since the origin

> of his

> difficulties was thought to be a disordered biology

> that had to be

> set right. The idea of a person was quaint but

> irrelevant.

>

> Part of Soviet psychiatry involved the well-known

> use of psychiatry

> as an instrument for political ends. Indeed, there

> were few other

> ends in the system. The brothers Zhores and Roy

> Medvedev offer a

> shocking, though typical, picture of what things

> were like in the

> Stalinist era. In the Soviet scheme of things,

> political dissent was

> interpreted as a psychiatric disorder, a difficulty

> in reality

> testing, which justified confinement in a mental

> hospital. Such

> niceties as due process, length of stay and an

> appeals process meant

> nothing. In a state where individual freedom was a

> bourgeois myth,

> there was no need to respect basic human rights.

>

> Treatment modalities included medications,

> electroconvulsive therapy,

> insulin coma therapy and various other so-called

> " somatic

> treatments. " These aversive procedures were thought

> effective against

> political heresy. I suspect they were. For a

> psychiatrist to engage

> in Freud 's " talking cure " during the Soviet period

> would have been a

> criminal act. The reason: such a treatment presumed

> the patient was

> free to make his or her own decisions.

>

> Today in Russia, there are patient protections

> against involuntary

> psychiatric hospitalization similar to those in the

> United States.

> While some may argue that unwilling confinement is

> always wrong, such

> hard-core legislation recognizes the freedom of the

> individual, which

> represents a radical change from the pre-Gorbachev

> era.

>

> The movement from a narrow-minded, highly

> politicized, biological

> view of human nature to what we might call a

> libertarian one says a

> great deal about the way Russian life has changed.

> While many people

> I spoke with were reticent to declare that a

> revolution -- at least

> in thought - had occurred, none regarded this

> liberalizing process as

> routine.

>

> The great irony is that American psychiatry is

> moving in exactly the

> opposite direction. For the better part of the 20th

> century,

> psychiatry was dominated by psychoanalysis, so much

> so that in the

> public eye the two were nearly synonymous.

> Five-day-a-week-on-the-

> couch treatment was de rigueur. Psychoanalysts

> authored most of the

> prominent textbooks in the field. Gradually, though,

> psychoanalysis,

> under attack from some sectors of the intellectual

> community,

> perceived as too expensive and unscientific, began

> to lose its grip

> on the psychiatric community. Just as political

> science, history and

> sociology have strived to emulate the scientific

> methods of

> physicists, so too did psychiatry decide to embrace

> a mainstream

> biological approach to its subject matter. In the

> past 30 years, the

> overriding ideology of American psychiatry has

> shifted to a

> biological model. Psychopharmacology has become its

> therapeutic

> backbone.

>

> The problem, however, is that this model doesn't

> tolerate free

> agency. It views psychiatric problems -- moral

> problems, really -- as

> medical ones, just as Soviet psychiatry did. It has

> become more

> prominent in the courts as the hefty influence of

> medical diagnoses

> has replaced the literary-like " assessments " of

> psychoanalysts.

> Always, the emphasis is on relieving the individual

> of moral

> responsibility. Interpersonal problems, family

> conflicts, sexual

> malaise, even shyness, have become medical problems.

>

> So, as the Soviet system came undone and its

> psychiatrists freed

> themselves from the confines of a strangulating

> ideology, American

> psychiatrists have embraced uncritically the same

> narrow vision. But

> as the Soviet example demonstrates with distressing

> clarity, a

> conception of people as little more than biochemical

> bundles fails to

> address those aspects of ourselves that make us

> human -- the moral

> and esthetic dimensions of our lives about which

> chemical equations

> have little to say.

>

> To be sure, the United States is nothing like the

> Soviet Union. Nor

> are we in danger of descending into such darkness.

> Psychiatry,

> though, is a leading indicator, a barometer of

> social practice and

> political change. The Soviet example places in bold

> relief the

> deficiencies and fallacies of a truncated view of

> human life, one

> without freedom, without a soul. The metamorphosis

> of American

> psychiatry portends the danger of a loss of freedom

> as we relinquish

> a sense of ourselves as moral beings. We can't

> tolerate such a loss

> and the lesson of Soviet psychiatry is that we

> shouldn't.

>

> Irwin Savodnik is a psychiatrist and philosopher who

> teaches at UCLA.

> He has recently completed a book on the nature of

> consciousness and

> has written widely on philosophy, psychiatry and

> politics. His

> articles have appeared in the Baltimore Sun, the

> Chicago Tribune, The

> Jerusalem Post, TCS and other publications.

>