Guest guest Posted August 13, 2004 Report Share Posted August 13, 2004 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. > Quote Link to comment Share on other sites More sharing options...
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