Presidential Panel: Mental Health System Dysfunctional

Sun, 3 Nov 2002

A panel of policy experts, convened by President Bush has issued a scathing “indictment” of the nation’s mental health care system. The Commission chair, Dr. Michael Hogan, director of the Ohio Department of Mental Health, stated: “We have trapped people in a system that is at least as dysfunctional as the old welfare system.” Dr. Hogan called for a massive shift in priorities.

This Presidential panel has validated the critics of this failed human experiment: thousands have been scarred by this inhumane, sub-standard care that is focused entirely on psychotropic drugs whose main function is to control not heal. The system has undermined efforts at recovery. The critics who have first-hand knowledge–include the patients and former patients (who call themselves “survivors” for good reason), their families, and a few courageous professionals who have risked their careers by speaking out against the psychiatric establishment.

It is especially revealing that the American Psychiatric Association–whose members are the foremost beneficiaries of the discredited, oppressive, and costly system–remains steadfast in its opposition to any shift in priorities that would put patients’ interests first.

The lack of ethics in psychiatric research–here and in Canada– is revealed in a report in the Hamilton Spectator (Alberta, Canada, Nov 2, 2002). A researcher from McMaster University who was unssuccessful at recruiting teenagers for a Prozac trial has sent a questionnaire about premenstrual syndrome (PMS)to young girls, aged 12 to 17, at Hamilton’s Catholic high schools.

The undisclosed purpose of the 6 page questionnaire is to identify girls for “recruitment into a drug-company-funded study of the antidepressant Prozac.” The questionnaire is suggestive and intrusive: “how often do [you] feel depressed, anxious, tearful, angry, irritable, tired, overwheleme, or out of control?” Also included is an “Embarassment Scale”. However, “the consent form does not mention a drug trial,Eli Lilly or Prozac.” http://www.hamiltonspectator.com/NASApp/cs/ContentServer?GXHC_gx_session_id_=
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http://www.reuters.com/news_article.jhtml?type=healthnews&StoryID=1670063 Mental Health System ‘Dysfunctional’: Panel Fri Nov 1, 5:34 PM ET By Todd Zwillich

WASHINGTON (Reuters Health) – America’s system for treating and rehabilitating people with mental illness is in financial and bureaucratic disarray and is plagued by complexities that make it nearly impossible for many patients to receive needed care, according to a report issued Friday by a presidential mental health commission.

The commission’s chairman, who called the report an “indictment” of the nation’s mental health care system, said that a massive shift in priorities was needed to improve care for mentally ill adults and children. The report paints a picture of a system plagued by fragmented services and inadequate funding, often losing patients in a maze of complexity.

Between 5% and 7% of Americans are believed to suffer from a serious mental illness in any given year, according to federal figures. While some patients have private insurance coverage, most receive care through a patchwork of federal and state programs.

The report is an interim step for the New Freedom Initiative, a comprehensive review of the nation’s mental health system ordered by President Bush (news – web sites) last April. It was written by a panel of policy experts from the government and the private sector, who are later expected to recommend ways to repair the system.

Dr. Michael Hogan, the commission’s chair, said that the panel’s deliberations lead it to conclude that the nation’s mental health delivery system is “maddeningly complex and dysfunctional.”

The report criticizes child mental health systems that often cut adolescents’ benefits as soon as they turn 18, forcing them to navigate a new system of care geared toward adults.

Adults with a combination of mental illness and drug or alcohol abuse, which according to the government number 3 million, often cannot get care for both problems in the same clinic or with the same government benefits.

“Because mental illness and substance abuse disorders are often long-term in nature, the inconsistencies of the system play out day-to-day, week-to-week, and year-to-year,” the report states.

The commission also pointed to studies showing that mental illness and substance abuse are the two leading causes of disability in North America and Europe, together accounting for more than one third of all claims. But disabled–and usually unemployed–persons who seek care in the US often risk their Medicaid healthcare benefits if they get well enough to rejoin the work force.

“They can’t afford to get back to work because they lose their health insurance. We have trapped people in a system that is at least as dysfunctional as the old welfare system,” said Hogan, who is the director of the Ohio Department of Mental Health.

Hogan made an example of the problem of suicide, which takes the lives of approximately 30,000 Americans each year, twice the number that die annually from AIDS (news – web sites).

Serious mental illness is implicated in upwards of 90% of all suicide cases, though the government spends some $3.2 billion per year on AIDS research and prevention and only about $40 million studying suicide, he said.

The commission is due to release a final report within 6 months giving the president recommendations on how to repair the mental health system.

The American Psychiatric Association released a statement criticizing the effort, saying that the commission has “unreasonably limited” its evaluation of the mental health care delivery system to budget-neutral solutions and did not look at disparities in privately funded insurance.

“The public at large, the media, opinion makers, and political leaders must be made aware of the perilous state of financing for mental health care today,” read a statement from Dr. Paul Appelbaum, the organization’s president.

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