Doctor calls President’s mental health Screening Initiative “Crazy” – UPI
Thu, 23 Dec 2004
Dr. Jane Orient, the Executive Director of the Association of American Physicians and Surgeons, has written a brilliant, clear-eyed blistering commentary–Are Your Children Crazy?
America’s 52 million school children and 6 million staff are the first population targeted for “mental health” screening, as outlined in the President’s New Freedom Commission on Mental Health. Dr. Orient challenges the proponents of “mental health” screening by raising basic questions that remain unanswered:
“What are the criteria for possible abnormality? What is the scientific validation? How often do different observers agree? Have any long-term studies shown a solid correlation with adult performance in life? Do today’s oddball children fail, or might they turn into our greatest achievers?”
She notes that “The main problem with about half of them [children] is that they are boys. Such children are obviously made of snips and snails and puppy dog tails. On the farm there is a solution for that: a procedure for turning boy lambs into non-ram lambs. After a quick little operation, they act like peaceful little lambs instead of aggressive, disruptive rams.
We don’t do surgery like that on little boys, of course, but we do have our methods: such as behavioral therapy and chemicals.”
Noting that “Teams of experts are awaiting the infusion of cash” she asks: “Who might profit from the program (perhaps discoverable by asking who lobbied for it)? Do drug companies expect to have a large number of new consumers of their psychoactive drugs? ”
Dr. Orient’s suspicion is shared by Dr. Marcia Angell, former editor of The New England Journal of Medicine, who told The New York Post: “such programs will boost the sale of antidepressants like Paxil, Zoloft and Prozac even after the FDA in September ordered a “black box” label warning that the pills might spur suicidal thoughts or actions in minors.”
The push to screen is belied by the highly credible US Preventive Services Task Force report which recently evaluated screening for suicide programs and found that screening did nothing to prevent suicide.
Furthermore, the USPSTF noted that the harmful consequences of screening have not been studied. Thus, The New Freedom Commission (NFC) recommendation for screening is without any scientific validity.
But then “mental health” providers have never had a scientific basis for ANY of their recommended treatments. As the recent examination of psychiatry’s claims about the safety and efficacy of antidepressants of the SSRI classs has proven, the research is fatally flawed, the claimed findings patently false, and children have been harmed by the drugs prescribed.
The NFC report recommends TeenScreen, an ambitious school screening program that’s sure to increase the use of antidepressants, thereby enriching drug manufacturers and mental health providers–including Columbia University’s TeenScreen project. According to its website (www.teenscreen.org) TeenScreen is already operating at “more than 200 sites in 41 states have been trained, and approximately 40,000 youth have been screened.”
TeenScreen gives itself high marks for “identifying” students it deems “at risk” without evidence:
“Research revealed that the program did effectively identify at-risk youth. It also showed that that most of the youth identified through the screening were not previously known to have problems…”
Similarly, Screening for Mental Health Inc, perfectly demonstrates that the screening instruments are inherently designed to “detect” “mental illness” where none is likely to exist:
SMH online screening results:
61% scored positive for depression
(Total Screenings 13,062)
28% scored positive for bipolar disorder (manic-depression)
(Total Screenings 4,084)
76% scored positive for generalized anxiety disorder
(Total Screenings 6,158)
76% scored positive for post-traumatic stress disorder
(Total Screenings 1,119)
Contact: Vera Hassner Sharav
December 15, 2004
Are your children crazy?
BYLINE: JANE ORIENT, M.D.
Congress and President Bush apparently think that a lot of children have a “mental health” problem. Or that enough of them do to justify taking millions of dollars from taxpayers to fund a universal “mental health screening” for children, and eventually for everyone.
Personally, I think — from the perspective of a person who never had any — that almost all children act crazy. Those who don’t are, by definition, abnormal, because they don’t act like the others.
The main problem with about half of them is that they are boys. Such children are obviously made of snips and snails and puppy dog tails. On the farm there is a solution for that: a procedure for turning boy lambs into non-ram lambs. After a quick little operation, they act like peaceful little lambs instead of aggressive, disruptive rams.
We don’t do surgery like that on little boys, of course, but we do have our methods: such as behavioral therapy and chemicals.
There are those who argue with some passion that society has to do something. Bad, disruptive, antisocial or depressed little kids make lots of trouble for parents and schoolteachers. Worse, they can grow up into dysfunctional, unhappy or troublemaking adults. That snotty little boy might become a dissenting, nonconformist or even a rebellious man, who could throw a monkey wrench into our smoothly functioning society. We have to catch them early — for their own good.
Teams of experts are awaiting the infusion of cash. They’ll be ensconced in your child’s school before you even know it. A bonus is that your little darlings will probably give them quite a bit of information about you also, and then you too can receive therapy you didn’t know you needed.
Do you sometimes raise your voice? Ever spank them? Hug them inappropriately? Have politically incorrect attitudes? Use forbidden words? Own a gun? Smoke cigarettes, especially indoors? Read extremist literature? Refuse to recycle? Prepare for a knock on the door.
There are many tools at the disposal of the mental health squad. Counseling sessions. Drugs (Ritalin, antidepressants, tranquilizers, maybe some new ones that need to be tested on some experimental subjects of your child’s age). Group therapy. Removing the child from the home. (This may be a “last resort,” but often the mere threat can accomplish wonders.)
If an interview with a child raises concerns, the next step might be a home visit. This could discover poor parenting skills, inadequate housekeeping, harmful literature, or a baby who is crying or has a bruise (signs of abuse?).
It is true that some interventions have potential side effects, say drug dependence or suicide, but to assure the health of the population some shared sacrifice and risk is needed. We will have excellent means of tracking outcomes to improve future therapies. The mental health workers’ impressions will all be recorded in the school records. An added benefit could accrue to would-be employers or college recruiters.
Some cautions are in order. Democrats might think that potential future Republicans are crazy. Republicans might think the opposite. Should an extremist Christian be one of the screeners, he might think that nonbelievers are possessed by the devil. And an extremist secular humanist (if such exist) might think that an overly religious child is at risk for mental illness if not already impaired.
In fact, parents ought to be asking some very serious questions before the government experts interview the first child:
What are the credentials of the screeners? Most importantly, how many children have they raised to adulthood, and with what outcome?
What are the criteria for possible abnormality? What is the scientific validation? How often do different observers agree? Have any long-term studies shown a solid correlation with adult performance in life? Do today’s oddball children fail, or might they turn into our greatest achievers?
Will you be allowed to get a second opinion? Can you see the record and enter corrections if indicated? Will the record at any point be destroyed, or will the stigma of a diagnosis such as “personality disorder” follow the child throughout life?
What will happen if your child fails the screen? What sort of treatment will be given? Who will supervise it? What if you don’t approve of it?
What’s the very worst thing that the program will have the power to do to you or your child, say if your worst enemy was to gain control of it?
Who might profit from the program (perhaps discoverable by asking who lobbied for it)? Do drug companies expect to have a large number of new consumers of their psychoactive drugs?
What are the results of studies of long-term use of drugs like Ritalin, which has effects on the brain similar to those of cocaine? Have there even been any such studies?
Can you refuse to participate in the program? If you do refuse, what are the repercussions?
What is the evidence that the program, at best, will be anything other than a waste of millions of dollars? Miraculously, throughout human history most of those crazy children have become stable, productive adults without federally mandated psychiatric treatment. Still more amazingly, their parents have managed also.
Psychiatry in the hands of government, instead of independent physicians who are working for patients, reeks of Orwell’s “1984” or the Soviet era. The very need to ask the questions should tell us the right answer for this program: It’s crazy.
(Dr. Jane M. Orient is an internist practicing in Tucson, Ariz., and executive director of the Association of American Physicians and Surgeons.)
(United Press International’s “Outside View” commentaries are written by outside contributors who specialize in a variety of issues. The views expressed do not necessarily reflect those of United Press International. In the interests of creating an open forum, original submissions are invited.)
New York Post
‘PILL PUSHERS’ IN HS SUICIDE-SCREENING PROGRAM
By SUSAN EDELMAN
December 5, 2004 — A Columbia University psychiatrist who has advised drug companies and calls himself a “big proponent” of antidepressants wants to expand his suicide-screening program to thousands of kids in public and parochial high schools.
Dr. David Shaffer, Columbia’s chief of child psychiatry, contends his TeenScreen program can save young lives. But some critics blast it as “a way to put more people on prescription drugs.”
About 500 teens were given the TeenScreen questionnaire last spring in four city schools: Park East HS, Millennium HS and Middle School 56 in Manhattan, and Banana Kelly Collaborative HS in The Bronx, The Post has learned. Shaffer is also offering to bring the program, now in 41 states, to thousands more teens in both public and Archdiocese of New York high schools. “Kids who think about suicide often don’t tell other people,” Shaffer said. “This is a way to get kids with depression into treatment.” Under the program, students whose parents have given permission for the screening fill out a brief questionnaire in school asking things like whether they have suffered severe depression in the last few months or thought about killing themselves.
Students who answer yes, or say they want help for depression, are interviewed on the spot by a mental-health professional. Based on that assessment, kids may be referred to an outside psychiatric clinic.
But some critics are suspicious of the screenings. “It’s just a way to put more people on prescription drugs,” said Marcia Angell, a medical ethics lecturer at Harvard Medical School and author of “The Truth About Drug Companies.” She said such programs will boost the sale of antidepressants like Paxil, Zoloft and Prozac even after the FDA in September ordered a “black box” label warning that the pills might spur suicidal thoughts or actions in minors.
Shaffer called the evidence against antidepressants “not so convincing,” but insisted that TeenScreen has no say in what medication, if any, kids get.
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