Cong. to act on GAO Finding: Families Give Up Kids to Get Treatment

Tue, 29 Apr 2003

A report by the General Accounting Office (GAO) confirms that draconian state policies are causing families to break up when parents across America are forced to give up custody of their children in order to qualify for mental health services.

The GAO report surveyed child welfare directors in 19 states, and juvenile justice officials in 19 counties. “They said more than 12,700 children were placed into some kind of care so they could get needed treatment.”

An amendment to the Individuals With Disabilities Education Act (IDEA) has been introduced by Rep. Max Burns (R-Ga.) HR 1350: the Child Medication Safety Act. It requires no taxpayer funding but mandates that “State educational agencies develop and implement policies and procedures that will prohibit school personnel from requiring a child to obtain a prescription [for a controlled substance such as Ritalin] as a condition of attending school or receiving services.”

In other words, school officials will no longer be in a position to dictate to families what’s best for their children’s mental health.

Insight Magazine (Washington Times) reports that the bill is opposed by pharmaceutical funded “advocacy” groups, such as, Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD). Insight reports that last year CHADD received $500,000 dollars from drug companies, including Novartis, the manufacturer of Ritalin.

CHADD carefully excludes information that might inject doubts about the justification of exposing children to a psychoactive, addictive drug– when the disorder cannot be scientifically validated. CHADD also fails to disclose the drug’s hazards as documented by the Drug Enforcement Agency.

According to CHADD’s annual report the National Institute of Mental Health (NIMH) provided $180,000 in taxpayer funds. The CHADD website serves as a clinical trial recruitment site–including recruitment for the controversial, NIMH-sponsored clinical trial preschool ADHD Treatment Study (PATS) which targets preschool children 2 to 5 years old as test subjects in a Ritalin dose tolerance experiment. See: http://www.chadd.org/research.cfm?cat_id=11

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Monday, April 21, 2003
REUTERS
Families Give Up Kids to Get Treatment, Study Says
by Maggie Fox

WASHINGTON – Thousands of U.S. parents are being forced to give up their mentally ill children to foster care or even the juvenile justice system because they cannot otherwise pay for treatment, a report said on Monday.

The report by the General Accounting Office has probably found only the tip of the iceberg, mental health groups said, as only a few states cooperated with the investigation.

But they said the implications are clear. “Families across America are being ripped apart because they can’t find the help their children with mental and emotional disorders need,” Laurel Stine of the nonprofit Bazelton Center for Mental Health Law said in a statement.

The GAO, the investigative arm of Congress, was asked to write the report by U.S. Senator Susan Collins, a Maine Republican, and Democratic House of Representatives members Pete Stark of California and Patrick Kennedy of Rhode Island after a series of media reports on the issue.

Child welfare directors in 19 states, and juvenile justice officials in 19 counties answered survey questions for the report. They said more than 12,700 children were placed into some kind of care so they could get needed treatment.

“Nationwide, this number is likely higher because many state child welfare directors did not provide data,” the GAO report said.

“Although no agency tracks these children or maintains data on their characteristics, officials said most are male, adolescent, often have multiple problems and many exhibit behaviors that threaten the safety of themselves and others.”

But the children had not committed crimes, nor had they been abused or neglected, said Elizabeth Adams, a spokeswoman for the National Alliance for the Mentally Ill.

“When children have mental health problems, they are often demanding on the family and family structure,” Adams said in a telephone interview. “Sometimes they have outbursts and rage and behavior that is destructive to the child and others.”

This requires care — expensive care that can include intensive counseling for the patient and the family, respite care to give parents a break, and drug treatment.

But many insurance plans will only pay for such treatment for a limited time, said Ralph Ibson of the National Mental Health Association.

And states cannot pay unless the child is in their physical custody.

“In extreme cases, as this report documents, they literally give up custody to meet the requirements as a last-chance opportunity for their children, give up custody to a system that will place the kids in mental health services. That’s how desperate they are,” Ibson said.

“You have to ask yourself why they can supply money for child mental health services in a foster care home and you won’t give the same money to a parent?” asked Adams.

© Copyright 2003 Reuters Ltd

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Posted: April 28, 2003
http://www.insightmag.com/news/426722.html
INSIGHT MAGAZINE (WASHINGTON TIMES)
Putting Power Back In Parental Hands
By Kelly Patricia O Meara
Issue: 05/13/03

Congress soon will vote on legislation that has the psychiatric and mental-health communities agitated. Advocates of the bill say it will return to parents the power to decide whether a child should be medicated to get in school or stay there, and many see this measure as a warning bell for future debate about the legitimacy of childhood psychiatric disorders.

The Individuals With Disabilities Education Act (IDEA) has been scheduled for reauthorization in May as HR 1350. An amendment to it, the Child Medication Safety Act, introduced by Rep. Max Burns (R-Ga.), requires no taxpayer funding but mandates that “State educational agencies develop and implement policies and procedures that will prohibit school personnel from requiring a child to obtain a prescription [for a controlled substance such as Ritalin] as a condition of attending school or receiving services.”

In other words, the amendment would prohibit teachers and school administrators from requiring a child to take a controlled substance to receive a public education, returning the decision to parents and their physicians. Already a handful of states have passed similar or more stringent guidelines prohibiting schools from requiring that children be drugged to control behavior, and a dozen more states currently are considering such legislation.

Surprisingly, opponents claim it is a battle about who will legislate rather than what will be legislated. E. Clarke Ross, chief executive officer of Children and Adults With Attention Deficit/Hyperactivity Disorder (CHADD), the nation’s leading nonprofit organization representing individuals with ADHD, even tells Insight that, “We’re not opposed to the intent and policy language of the bill.” Rather, according to Ross, “The question is whether the government should enact national legislation mandating every school district in America to go through the procedures and process of implementing this legislation.” The question, he stresses, is “whether a few highly publicized cases are typical of thousands of people across the country – whether the instances of abuse are so rampant that it requires a national law or bureaucracy.”

As an advocacy organization representing 20,000 dues-paying members diagnosed with the alleged psychiatric disorder ADHD, the Ross group reported in its yearly financial statement that last year it received more than $500,000 in financial support from various pharmaceutical companies, including Novartis, the makers of Ritalin, the No. 1 stimulant “treatment” for ADHD. And as an advocacy group representing people with ADHD, the CHADD lobby supports the mental-health community’s theory that ADHD is a “real” disorder and further reports that it “disseminates the science-based information” about ADHD. Insight asked Ross to describe the scientific information disseminated by CHADD to support its contention that ADHD is a brain disease.

“The surgeon general of the United States [David Satcher],” Ross explains, “called ADHD a brain disorder with a neurological origin in his 1999 Report on Mental Health. It’s not a CHADD position, it’s the surgeon general’s position.” While the former surgeon general did suggest that ADHD is a brain disorder with a neurological origin, no conclusive scientific evidence was presented in the report to support the theory.

Moreover, later in that same report the surgeon general emphasized “the diagnosis of mental disorders is often believed to be more difficult than diagnosis of somatic or general medical disorders since there is no definitive lesion, laboratory test or abnormality in brain tissue that can identify the illness.” Trouble is that this statement also applies to the diagnosis of ADHD, though CHADD did not disseminate the surgeon general’s caveat as part of the “science.”

In an effort to get the “science” it favors to its membership, CHADD also cites the 1998 National Institutes of Health (NIH) Consensus Statement that “there is evidence supporting the validity of the [ADHD] disorder.” Again, CHADD does not mention that no science ever was cited to support this statement. Nor did the advocacy group mention that the NIH statement was revised after its initial publication. The original NIH Consensus Statement from the conference reads: “We don’t have an independent, valid test for ADHD; there are no data to indicate that ADHD is due to a brain malfunction; existing studies come to conflicting conclusions as to whether use of psycho-stimulants increases or decreases the risk of abuse; and finally after years of clinical research and experience with ADHD, our knowledge about the cause or causes of ADHD remains speculative.”

It also is of interest that CHADD does not include the 1995 report from the Drug Enforcement Administration (DEA), which concludes that “there is a considerable body of literature on the short-term efficacy of stimulant pharmacotherapy on the symptoms of ADHD. From 60 to 90 percent of children have been judged as positive drug responders to methylphenidate [Ritalin] medication. However, contrary to popular belief, stimulants like methylphenidate will affect normal children and adults in the same manner they affect ADHD children.” In short, whether diagnosed with ADHD or not, the mind-altering drug will elicit the same effect and, according to the DEA, “behavioral or attentional improvements with methylphenidate treatment therefore are not diagnostic criteria of ADHD.”

Finally, Insight asked Ross why it is that only the “science” that supports the validity of ADHD is disseminated by CHADD. “It really is a matter of belief,” Ross says. “Do you want to believe the surgeon general of the United States? He said ADHD is a valid disorder and has serious symptoms and we don’t know 100 percent of the cause of it yet. It’s like schizophrenia. Do you dismiss everything until science at some point has definitive answers?”

Is Ross suggesting that he is aware of science to support, say, 65 percent of the cause of ADHD? Is he admitting that there is no science to support either the ADHD diagnosis or the diagnosis of schizophrenia? Whatever, say critics, he raises a good question. But those who argue that ADHD and other psychiatric diagnoses are not based in science, which according to the former surgeon general appears to be the case, legitimately may respond by asking whether it is right without causative proof that a disease exists to medicate children with mind-altering drugs.

Despite the fact that documents provided on CHADD’s Website declare that ADHD not only is a “neurobiological” disorder but also a “neurological” disorder, the bottom line apparently has little to do with science. As Ross states, it “is a matter of belief.” And that is precisely what opponents of the alleged disorder have been saying for years – that psychiatric diagnoses are subjective opinion unallied by science. All of which appears to observers in Congress to be what is driving this new legislation.

Mike Stokke, deputy chief of staff to Speaker of the House J. Dennis Hastert (R-Ill.), tells Insight that “this is a very limited first step, and I think it will lead to a whole line of other questions once parents figure out that this kind of stuff is going on in schools. Some of the questions that are involved in this issue are not things that most people contemplate when they put their kids on drugs, and sometimes there are bad outcomes.”

Stokke explains: “This bill basically says that teachers and school personnel cannot demand that children be put on these drugs as a prerequisite to staying in the classroom. We’re trying to make it clear in places where it’s been a problem around the country, and it’s been a problem in more places than I would have ever imagined.”

In case after case, Stokke continues, “when we started meeting some of these families who have been through this problem, such as in New York, New Jersey and Connecticut, we saw the coercive action of the state come in and say that the teacher says you have to take these drugs. And if you don’t it’s child neglect and the child is taken away from the parents. That’s more than a little beyond the pale.”

Stokke concludes, “We’ve listened to some of the horror stories of what happens to parents who refuse to medicate their kids [for alleged ADHD]. Many of the parents that we talk to are people who have the means to fight back, but what is troubling about it, and why there needs to be federal legislation, is that there are many families out there in similar situations who don’t have the means to fight the system. The speaker [Hastert] believes that parents should have more of a role in the kind of things that happen to their kids. There is an alarming rise in the number of children who are being medicated for alleged behavioral problems, and it’s definitely something that should be looked at. Our goal with this legislation is to bring some attention to this issue and to put some people on notice.”

Kelly Patricia O’Meara is an investigative reporter for Insight magazine. email the author

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