Screening America’s Children For Mental Illness: Fallacy Or Fraud?

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Screening America’s Children For Mental Illness:

Fallacy Or Fraud?

http://www.redflagsweekly.com/lehrman/2005_jan24.htm

 

" Routine and comprehensive testing and screening " for early detection of " the

mental health problems of children " is being recommended by President Bush’s

New Freedom Commission on Mental Health (NFC). Its stated purpose is to help

sufferers from these difficulties by helping them start treatment early. The

proposal is fallacious, if not openly fraudulent, in terms of both " diagnosis "

and treatment.

 

Diagnosing Mental Illness . . . But mental health problems in children or

adults, however we define them, cannot be found by simple screening. Nobody can,

by merely looking at someone, or on the basis of a pen-and-pencil

questionnaire, differentiate the transient emotional disturbances we all have

from those

which may last longer. Only when gross insanity exists can " mental illness " be

recognized on inspection -- and here we don’t need expert opinion.

 

Time and trust are necessary for valid psychiatric diagnosis. Neither is

present in the proposed screening procedures. Indeed, the mere process of

seeking

out mental illness, rather than relying on the troubled to seek help for

themselves, violates the privacy of those in whom these illnesses are sought.

 

If mental health care is to be ethical and effective, it must be voluntary.

Public awareness of the possible dangers of involuntary treatment is

responsible for the laws restricting it.

 

Sending experts into classrooms to seek out mental illness is therefore

questionable on its face. Indeed, such efforts to find illness can help create

it.

The fear evoked by the search itself can cause psychiatric symptoms. It has

long been known how harshly interrogating disturbed people about whether they

hear voices increases the likelihood of their saying -- and then believing --

that they had.

 

The proposed screening process itself evokes memories of the Malleus

Maleficarum, the medieval witch-hunters’ handbook, which was used to determine

from

the spots on people’s bodies which of them had compacted with the Devil. And

it

was the late Dr. Karl Menninger, a past president of the American Psychiatric

Association, who compared the Association’s huge Diagnostic and Statistical

Manual of Mental Disorders to the Malleus.

 

Treating Mental Illness: How Effective is Psychiatric Treatment Today? . . .

The purpose of seeking out the mentally ill is to get them into early

treatment. Medications are the heart of today’s psychiatric treatment.

Although

millions of children are already receiving cocaine-like drugs (such as Ritalin)

for

conditions such as attention deficit and hyperactivity disorder, and the

public is becoming increasingly aware of the dangers of these drugs, the new

screenings will increase still further the number of youngsters given

medication.

And recent events suggest that many will have treatment forced upon them over

their parents’ objections.

 

The proposed screening process is based on the assumption that psychiatric

treatment helps. But that is not necessarily the case. The mentally disabled --

the insane -- were psychiatry’s first patients. Over the past fifty years,

drugs have become the core of their treatment. Since their introduction, the

level of severe mental distress in the country has quadrupled (as measured by

what

the government calls patient care episodes per capita). Over the past 15

years, the number of people deemed disabled by mental illness -- those receiving

either SSI or SSDI payments with mental disorder as their category -- has

almost doubled, from 3.505 million to 5.77 million. In 1987, national

psychotropic

drug expenditure was $1 billion. By 2002, it was $23 billion -- 23 times the

amount spent 15 years earlier.

 

It is also noteworthy that the treatment model recommended by the NFC is a

drug industry-sponsored guideline -- the Texas Medication Algorithm Project

(TMAP). At a time when drug costs are bankrupting Medicaid budgets, the TMAP

relies on the newest, and for the most part, the most expensive drugs: drugs

which

are admittedly little more efficacious than earlier ones, but which have

slightly fewer side effects.

 

That’s why the entire proposed program for screening youngsters for mental

illness, so they can then be treated with drugs, is a multilevel fallacy -- if

not an outright fraud.

 

Nathaniel S. Lehrman, MD

 

Nathaniel S. Lehrman, MD, is former Clinical Director, Kingsboro Psychiatric

Center, Brooklyn, New York.