2006 Lauren Claborn
A Call Towards Prevention of Mandatory Mental Health Screenings
In April of 2002, President Bush established an initiative called The New Freedom Commission on Mental Health (NFC). The stated purpose of the NFC is to “eliminate inequality for Americans with disabilities”, as well as to provide medical care and reintegration into their communities. The plan promises to implement routine and comprehensive mental health screening for every child between the ages of zero and eighteen. This mandatory screening would include regular social and emotional development examinations, a state-wide data reporting system for each individual, and report cards on childrens’ social-emotional development. The NFC also intends to screen all pregnant women for mental health issues throughout the duration of their pregnancies, as well as for up to a year postpartum.
Some parts of the country are already seeing the effects of this plan. In the spring of 2003, both houses of the Illinois state legislation passed the $10 million Illinois Childrens’ Mental Health Act (ICMHA), which planned to merge the state’s physical exam certificate with a mental health evaluation as a requirement for public school enrollment. This new step effectively linked the State Office of Mental Health with the Department of Public Aid, the Illinois State Board of Education, and every school district across the state. The plan promises to “ensure appropriate and culturally relevant assessment of your childrens’ social and emotional development with the use of standardized tools.” What exactly does the ICMHP mean by “standardized tools”? The guidelines for the New Freedom Commission, including the plan implemented in the state of Illinois, are actually based on a Texas program called Texas Medication Algorithim Project (TMAP) that was established in the mid 90s.
TMAP is a set of treatment guidelines intended for use by physicians, which recommends the primary method of treatment for mental health patients to be the newest and most expensive medications available. These medications include antidepressants and stimulants like Ritalin and Dexedrine, as well as the atypical antipsychotics Risperdal, Zyprexa, Geodon, Seroquel, Abilify and Sandoz. The TMAP guidelines are not a suggestion for doctors, but instead a requirement subject to state enforcement. When its regulations were codified by state legislation in 1999, doctors employed by state-funded mental health organizations were legally bound to follow TMAP protocols or rationalize a different method by a note in a patient’s file. Since the TMAP guidelines were put into practice in 1997, Texas Medicaid spending on antipsychotic medications has risen from $28 million to $177 million in 2004.
Aliah Gleason is one example of a student who has been personally effected by the results of TMAP, and the kind of programs intended to be established by the New Freedom Commission. During the seventh grade, Aliah was a B and C student who was disciplined for smartmouthing her teachers. This behavior resulted in school officials diagnosing her with an oppositional disorder. When psychologists from the University of Texas visited her school for a routine mental health screening of middle school students, they decided that Aliah placed high on a suicide rating and needed further evaluation. Several weeks later, after follow-up meetings with a UT psychiatrist, a child-protection worker went to Aliah’s school and called her father in for a meeting. When Calvin Gleason arrived at his daughter’s middle school, he was ordered to take her to Austin State Hospital, a state mental facility. At his refusal, the social worker placed Aliah in emergency custody and she was taken to the hospital in a police car.
Aliah spent the next nine months alternating between the state psychiatric hospital and residential treatment facilities. For the first five months that she was institutionalized, the Gleasons were not allowed to visit or even speak with their daughter. During that time period, Aliah was placed in restraints more than 26 times and forcibly medicated with at least twelve different drugs. During one incident, after she refused medication, five staff members came to her room insisting on treatment. “I started struggling and they held me down and shot me in the butt”, Aliah said. “Then they left and I lay in my bed crying.”
Throughout the duration of her stay at the hospital, Aliah’s diagnosis was constantly changing. Dr. Joseph Woolston, a Yale University professor and chief of child psychiatry at Yale-New Haven Hospital, commented on Aliah’s medication regimen that, “…it is sedating and would make it difficult for a child to experience the world in a normal way. If you or I were on that regimen, we would have a lot of trouble attending to work or school. We don’t have any idea what that combination of medications does to a developing child. It may have any number of long-term side effects.
After an extensive legal battle, the Gleasons finally regained custody of their daughter. They immediately transferred her psychiatric care into the hands of John Breeding, and Austin psychologist who is well known for his criticism of the excessive medication of psychiatric patients. Aliah soon began the process of tapering off of antipsychotics. “She’s coming back, starting to get that gleam in her eye”, Breeding commented. Aliah’s case is far from being an anomaly-in July and august of 2004 alone, 19,404 Texas teenagers were prescribed antipsychotics through a publicly funded program.
Critics of mandatory mental health screening have argued that the increasingly prevalent drugging of adolescents is directly related to a pharmaceutical industry that is driven by profit. Since the early 70s, the American Psychiatric Association has relied on drug company funding to keep afloat. Eli Lilly, a drug company that manufactures Prozac and Zyprexa, has had a close working relationship with the Bush administration: for many years, Bush sr, himself was a member of Lilly’s board of directors. Bush jr. even appointed Eli Lilly’s CEO, Sidney Taviel, to a seat on the Homeland Security Council. The many interlocking relationships between drug companies, scientific organizations and politicians have led many individuals, including psychiatrist Peter Breggin, to characterize psychiatry as as more of a business than a profession.
In September 2004, mandatory mental health screening was on the verge of becoming a federal program. This dramatic turn of events spurred Representative Ron Paul to introduce a bill that would have prevented any federal funding from being used for the establishment of the NFC. In a letter distributed to congressional colleagues, Paul wrote “As you know, psychotropic drugs are increasingly prescribed for children who show nothing more than childrens’ typical rambunctious behavior. Many children have suffered harmful effects from these drugs. Yet some parents have even been charged with child abuse for refusing to drug their children. The federal government should not promote national mental health screening programs that will force the use of these psychotropic drugs such as Ritalin.”
Paul’s amendment was supported by a loose coalition of groups that organized a letter-writing campaign to raise public awareness of the mental health screenings proposed by the NFCMH. Groups involved with the campaign included the Alliance for Human Research Protection, Concerned Women for America, the International Center for the Study of Psychiatry and Psychology, Gun Owners of America, and the Texas Eagle Forum. Reasons cited to oppose the legislation include the following:
Screening programs are a violation of parental rights;
Mental health screenings do not prevent suicide, as the NFCMH claims;
Mental health diagnoses are social constructions that are open to interpretation;
Medications produce dangerous side effects;
The influence of the psychiatric industry makes objective science an impossible standard to follow.
Some critics have even voiced concerns that the bill could create a “caste system” based on varying degrees of what is deemed to be mentally and emotionally healthy. The inclusion in the Diagnostics and Statistical Manual of Mental Health Disorders (DSM IV-TR) of “intolerance” as a diagnostic criteria has led some groups to conclude that families who believe in traditional values could become stigmatized because of their political beliefs.
The claim that psychiatric medications produce dangerous side effects is not a hard one to prove. Researchers have even acknowledged a particular form of brain damage caused by taking atypical antipsychotics. They call this new disease neuroleptic-induced deficit syndrome (NIDS). The symptoms of NIDS are very nearly identical to those of Parkinson’s disease. NIDS is estimated to effect anywhere from 67 to 100 percent of drug-treated patients. Other side effects produced by antipsychotics include blindness, fatal blood clots, blunted emotions, arrhythmia, heat stroke, impotence, leaking breasts, obesity, sexual dysfunction, blood disorders, skin rashes, seizures, and for patients who have children, offspring with birth defects. 1 Another drug known to cause brain damage is Ritalin, the stimulant frequently prescribed for attention deficit hyperactivity disorder (ADHD), which has been proven to cause brain tissue shrinkage as a result of long-term use.2
In addition to the damaging neurological effects of psychiatric medications, there is also a risk of developing violent ideation after as little as a few days on a course of antidepressants. A clinical trial testing the antidepressant Paxil in children revealed that “those taking the drug were nearly three times as likely to consider or attempt suicide as children taking placebos.” After results of the study were publicized, the British Medicines and Health Care Products Regulatory Agency announced that doctors should stop prescribing antidepressants because they carry a risk of increased suicidal thoughts and actions.
It is not much of a stretch to suggest that the United States could one day use psychiatry to police people’s thoughts and actions. As recently as the 1970s, the Soviets used psychiatric medications as a way to quiet and punish political dissidents. People whose ideas were threatening to the Soviet government were diagnosed with schizophrenia and their reformist ideas interpreted as proof of their delusions. In 1972, the U.S. Senate began an investigation into the Soviets’ “abuse of psychiatry for [the purpose of] political repression.”
One patient, Leonid Plyushch, a mathematician who spent several years in Soviet concentration camps, spoke before a meeting of the New York Academy of Sciences: “The purpose was to force the patient to change his convictions. Along with me there were common criminals who simulated [mental] illness to get away from the labor camps, but when they saw the side effects – twisted muscles, a disfigured face, a thrust-out tongue – they admitted what they had done and were returned to camp.”
Another patient remembers: “…[A]s a result of the treatment, all the subtle distinctiveness of a person is wiped away…. Those who take aminazine completely detereorate after taking it. Intellectually, they become more and more uncouth and primitive. Although I am afraid of eath, let them shoot me rather than this. How loathsome, how sickening is the very thought that they will defile an crush my soul.”3
What is truly disturbing about these patients’ experiences is that the current political climate in our own country could easily allow for a similar turn of events. The past few years have seen the suspension of habeas corpus and the establishment of concentration camps for Arab Americans. How long will it be before the U.S. government turns on its own citizens who are “guilty” of criticizing its imperialistic foreign policies?
Of course, the student population would be the best place to begin policing thought crimes, because universities have traditionally been hot beds of activism and social justice movements. Eventually, programs like the New Freedom Commission will be recognized for what they are – a violation of civil liberties and basic human dignity.
Notes;
1.Information on the New Freedom Commission: Health Care News, March 1, 2005, pub: The Heartland Institute
2.Information on Aliah and TMAP: Mother Jones magazine, May/June 2005 issue. “Medicating Aliah”
3.Information on drug company relationships: http://www.mindfully.org/Health/3004/Bush-mental-illness19jun04.htm
4.Ron Paul’s letter to congress: http://www.aapsonline.org/confiden/mhspaul.htm
5.Psych meds and brain damage: Mad in America, Robert Whitaker, p.255-256
6.antidepressants and suicide: SFGate, January 4, 2004, “A Suicide Effect? What parents aren’t being told about their kids’ antidepressants”
7.Soviet concentration camps. Mad in America, Robert Whitaker, p.215-219
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