(U.S.) Go slow on Mental Health Screening

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Fri, 12 Nov 2004 20:06:29 -0500

Subject:[sSRI-Research] Go slow on Mental Health Screening

 

ALLIANCE FOR HUMAN RESEARCH PROTECTION

 

Promoting Openness and Full Discloure

 

www.ahrp.org

 

FYI

 

A letter to the editor in the Washington Times-Go slow on Mental Health

Screening-by AHRP's newest board member, pediatrician Dr. Karen

Effrem, is a

powerful refutation of New Freedom Commission chairman, Michael Hogan's

defense of mass screening for mental illness.

 

Dr. Effrem writes:

 

" Given the very real problems of already existing coercion, subjective

criteria, dangerous and

ineffective medication, and the failure of screening to prevent suicide,

none of which are covered

in the NFC report, Congress would be wise to withhold the $44 million

requested for state grants to

implement the NFC recommendations.

 

Whatever good may come from the other recommendations is completely

overshadowed by the loss

of freedom and damage that would come from labeling and drugging

potentially

millions of children

based on these unsupportable screening and treatment programs. "

 

Appended to Dr. Effrem's letter is the original OpEd piece by Sheldon

Richmond and Michael Hogan's

letter.

 

If we don't act now, every child in America will be screened for mental

illness: thousands,

perhaps millions will be deemed " at risk " of developing mental health

problems for which they will be

prescribed powerful psychotropic drugs. The screening plan has been called

Orwellian and

diabolical-the treatment " model " the New Freedom Commission report

recommends is a drug industry-sponsored guideline-- the Texas Medication

Algorithm Project (TMAP). The treatment of choice mandated under TMAP

guidelines are the most expensive, profit-enhancers. TMAP is a blatant

profit-enhancing scheme that is already bankrupting Medicaid budgets. For

links to reports from Massachusetts, Florida, Texas, Illinois, and for

more

information visit www.ahrp.org

 

For example, in Texas :

 

*Pfizer contributed $232,000 to the Texas department of mental health to

" educate " mental health

providers about TMAP

 

(i.e., to promote TMAP).

 

*Texas Medicaid spent $233 million for Pfizer drugs such as, Zoloft

(sertraline).

 

*Johnson & Johnson (Janssen Pharmaceutica) contributed $224,000 to the

state,

 

*Texas Medicaid spent $272 million in Medicaid funds for J & J

antipsychotic

drug, Risperdal

(risperidone).

 

*Eli Lilly contributed $109,000 to " educate " state mental health

providers.

 

*Texas Medicad spent $328 million for Lilly's antipsychotic, Zyprexa

(olanzapine).

 

 

We urge everyone to send in a letter to Congress to ensure that the

Orwellian screening plan is

not implemented.

 

It just takes a minute to send in the information.

 

Please check the prepared letter that was developed by Karen Effrem,

Michael

Ostrolenk, and Vera

Sharav at:

http://www.healthactioncenter.com/action/index.asp?step=2 & item=22356 or

 

http://www.healthactioncenter.com/action/index.asp?step=2 & item=22665

 

 

Please pass this on to all of those in your circle of influence, please

consider putting it on

your websites, and please contact me with any questions.

 

 

Contact: Vera Hassner Sharav

 

212-595-8974

 

veracare

 

 

Go slow on mental health screening

 

Michael F. Hogan's letter ( " Long-term study needed, " Oct. 21) accuses

Sheldon Richman of

misstatements and " misrepresentations " in his Oct. 17 forum ( " Bush's Brave

New World " ). I contend that

the misrepresentations are not coming from Mr. Richman, but from Mr.

Hogan.

 

Despite Mr. Hogan's protestations to the contrary, the New Freedom

Commission (NFC) clearly

wants universal mental health screening, recommending " screening for

mental

disorders ... across the

life span. "

 

Mr. Hogan himself admits that he wants universal screening but that

there are problems with

it. Psychiatric Times noted, " Hogan himself has strong feelings about the

need for much more

thorough screening of children. But he acknowledged that 'science and

public

opinion' have not advanced

to the point where universal mental health screening is acceptable. "

 

There is much agreement that screening is scientifically

unsupportable.

The authors of

psychiatry's Diagnostic and Statistical Manual call mental health

diagnostic

criteria " subjective " and

" social constructions. "

 

The NFC treatment recommendations include lauding the Texas Medication

Algorithm Project that

is used in other states and pushed by Mr. Hogan in Ohio.

 

This is despite the fact that members of TMAP were heavily

influenced by

the pharmaceutical

industry to recommend drugs like the Selective Serotonin Reuptake

Inhibitors

(SSRI) antidepressants.

SSRIs are more expensive, not effective in children in 19 of 22

studies, and

have severe side

effects, including suicidal thoughts and attempts. The suicidality

combined

with lack of effectiveness

caused the Food and Drug Administration to finally require this month its

strongest drug warnings,

although such data has long been available. While laudable that the NFC

calls for study of the

long-term effects of psychotropic drugs, nowhere does it mention any of

these other problems.

 

Both Mr. Hogan and the NFC are rightly concerned about suicide.

However,

suicide is never once

mentioned as a possible side effect of the drugs recommended.

 

The report also fails to mention the U.S. Preventive Services Task

Force

study showing that

screening is useless in preventing suicide.

 

Mr. Hogan is right that the commission never calls for mandatory

treatment. However, neither

he nor the report acknowledge or condemn the numerous instances of

coercion

across the nation.

 

These incidents where parents have been threatened and charged with

child abuse for refusing

medication have inspired more than 20 state legislatures and the

Congress to

introduce or pass

measures to prohibit coercion.

 

Mr. Hogan's support of voluntary programs and parental consent rings

hollow, as well. The

phrase " parental consent " appears once and the word " voluntary "

appears not

at all in the NFC report.

But if he truly is in favor of voluntary parental consent, then he should

soundly endorse Texas

Republican Rep. Ron Paul's bill, the Let Parents Raise their Kid's Act, HR

5236.

 

Given the very real problems of already existing coercion, subjective

criteria, dangerous and

ineffective medication, and the failure of screening to prevent suicide,

none of which are covered

in the NFC report, Congress would be wise to withhold the $44 million

requested for state grants

to implement the NFC recommendations.

 

Whatever good may come from the other recommendations is completely

overshadowed by the loss

of freedom and damage that would come from labeling and drugging

potentially

millions of children

based on these unsupportable screening and treatment programs.

 

DR. KAREN R. EFFREM

Alliance for Human Research Protection Board of Directors

International Center for the Study of Psychiatry and Psychology

Board ofs

Plymouth,Minn.

 

The Washington Times

www.washingtontimes.com

 

Forum: Bush's Brave New World

 

By Sheldon Richman

 

Published October 17, 2004

 

 

 

President Bush's little-publicized New Freedom Commission on Mental Health

has proposed

comprehensive mental-illness screening for all Americans. If this proposal

is carried out, as Mr. Bush's

intends, no adult or child will be safe from intrusive probing by

" experts, "

backed by drug

companies, who believe mental illness is woefully underdiagnosed and many

millions of people should be

taking powerful and expensive psychiatric drugs. Schools and doctors'

offices will become

quasi-psychiatric monitoring stations.

 

Rep. Ron Paul, Texas Republican, tried to forbid the federal funding of

mental-health screening,

but the House turned down his amendment to the appropriations bill for the

Department of Health and

Human Services. Mr. Paul, a physician, said the program usurps parental

rights, noting parents can

already be charged with child abuse for refusing to give their children

Ritalin for alleged

attention deficit hyperactivity disorder. He said, " Psychotropic drugs are

increasingly prescribed for

children who show nothing more than children's typical rambunctious

behavior. Many children have

suffered harmful effects from these drugs. "

 

Dr. Karen Effrem also opposes the plan: " Universal mental-health

screening and the drugging of

children, as recommended by the New Freedom Commission, needs to be

stopped

so that many thousands if not millions of children will be saved from

receiving stigmatizing diagnoses that would follow

them for the rest of their lives. America's schoolchildren should not be

medicated by expensive,

ineffective and dangerous medications based on vague and dubious

diagnoses. "

 

People wrongly assume psychiatric diagnoses are like medical

diagnoses.

They're not. Medical

diagnoses are ultimately based on objective biological evidence.

Psychiatric

diagnoses, as retired

psychiatry professor Thomas Szasz shows, are based on what people say and

do. This means such

diagnoses are moral and political, not medical, judgments. It begs the

question to say brain science

is still in its infancy: Why is one kind of behavior interpreted as a sign

of mental or brain

disease but not another kind? Besides, Dr. Szasz writes, behavior has

reasons, not causes. That

principle is at the very core of what we mean by personhood. (Brain-scan

technology cannot refute this

principle because it does not identify causes of behavior. Correlation is

not causation.)

 

Thus the New Freedom Commission recommendation that everyone be

screened

for mental illness

whenever he goes to the doctor and that children be monitored for mental

illness in government

schools is simply a plan to stigmatize people for " inappropriate " behavior

and speech. It is also a

plan for the widespread drugging of adults and children under government

supervision. Besides the

Huxleyian aspects of this idea, there is also reason to fear the improper

influence of drug

companies.

 

Allen Jones, formerly of the Pennsylvania Inspector General's Office,

revealed a similar

program was started in his state after drug companies curried favor with

state officials. The British

Medical Journal reported: " In July 2002, Mr. Jones was appointed lead

investigator when he

uncovered evidence of payments into an off-the-books account. The account,

earmarked for 'educational

grants' was funded in large part by Pfizer and Janssen Pharmaceuticals.

Payments were made from the

account to state employees who developed formulary guidelines recommending

expensive new drugs over

older, cheaper drugs with proved track records. One of the recommended

drugs

was Janssen's ...

Risperdal -- a drug that has recently been found to have potentially

lethal

side effects. "

 

In a statement last January, Mr. Jones said: " The industry was

influencing state officials

with trips, perks, lavish meals, transportation to and first-class

accommodations in major cities.

Some state employees were paid honorariums of up to $2,000 for speaking in

their official capacities

at drug-company-sponsored events. "

 

Mr. Jones was relieved of his duties after blowing the whistle. In

court

papers challenging

the state's move, he said the government was trying to " cover up,

discourage

and limit any

investigations or oversight into the corrupt practices of large drug

companies and corrupt public officials

who have acted with them. "

 

The New Freedom Mental Health Commission has received little

publicity.

One hopes, as

Americans learn about its ominous proposal for wholesale mental-illness

screening and psychiatric drugging of adults and children, they will

vehemently object.

 

 

SHELDON RICHMAN

 

Senior fellow, The Future of Freedom Foundation (www.fff.org) in Fairfax,

Va.

2004 News World Communications, Inc. All rights reserved.

 

 

 

 

The Washington Times

www.washingtontimes.com

 

 

 

Letters to the editor

Published October 21, 2004

 

Long-term study needed

 

Sunday's Forum article on mental-healthscreening ( " Bush's Brave New

World, " Commentary)

misstates the findings of the president's New Freedom Commission on Mental

Health, which I chaired. The commission did not call for mandatory

universal

mental-health screening for all children. I am at

a loss to explain why this misrepresentation persists, since it is at odds

with the plain language

of our report to the president.

 

Recognizing the need to balance suicide-prevention and access to

medical

care with the rights

and responsibilities of parents, and being aware of the devastating impact

of youth suicide, the

commission proposed broad screening only in settings where many

children are

known to have

untreated behavioral problems. Beyond this, the commission promoted

programs

that provide voluntary

screening only with parental consent.

 

I also want to be clear that the commission did not recommend

mandatory

medication treatment

for children and teens. To the contrary, we cited the complexities of

treatment and the need for

greater knowledge about the long-term effects of psychotropic medications

(especially for children).

 

We recommended that the federal government study the long-term effects of

psychotropic medications

more carefully (again, especially for children) and also that the Food and

Drug Administration

provide better information on medications. These recommendations, I am

proud

to add, preceded similar

recommendations from the FDA by more than one year.

 

MICHAEL F. HOGAN

Director

Ohio Department of Mental Health

Columbus