On October 17, 2005, Charles Curie, administrator of Substance Abuse and Mental Health Services Administrator (SAMHSA), made the statements listed below at a meeting with representatives of a coalition of national groups of concerned citizens who requested the meeting for the purpose of raising our concerns about the New Freedom Commission report recommendations for mental health and their implementation via the Federal Mental Health Action Agenda (FMHAA or “Action Agenda”[1]).

Those recommendations—in particular TeenScreen and TMAP (the Texas medication algorithm project) are being funded by the federal government through the State Incentive Grants for Transformation, other federal laws, state laws, and private and government grants.  Together, they ensure the escalation of already spiraling prescriptions of dangerous and ineffective psychotropic drugs for children—without a medical need to justify that increase. [2]

In addition to statements indicating that TeenScreen and TMAP are no longer considered model programs for the purposes of the Action Agenda, despite the facts that they are still in place or being funded, the following are several other key statements made by Mr. Curie during this October 17th, 2005 meeting [3]:
“The New Freedom Commission (NFC) report is not official Bush Administration policy, but rather the unofficial recommendations of an appointed commission.”
The state incentive transformation grants (SITG), funded at $26 million in the FY 2006 appropriations bill, is merely for infrastructure for states to set up their individual transformation plans for a “recovery oriented system.”
The Federal Mental Health Action Agenda is “not really a blueprint or road map for implementing the NFC report.”

AHRP board member, Dr. Karen Effrem, reviewed the Action Agenda and other SAMHSA documents. She found evidence contradicting every one of the statements made by the SAMHSA director:
The NFC recommendations are clearly administration policy.  In the very first paragraph of the SAMHSA Action Agenda, it states that the five principles “around which the New Freedom Commission on Mental Health framed its work… embody the vision of transformation that will guide the challenging but necessary work that lies ahead.” [4]

The NFC report is the very foundation of the Action Agenda.  This Agenda involves at least 13 different offices and agencies within the Department of Health and Human Services (HHS) and at least five different cabinet level departments that have plans to implement the NFC recommendations, including the Department of Education where ineffective and dangerous federal mental health programs like Foundations for Learning [5] (for ages 0-7) and Early Warning, Timely Response [6] (based on politically correct attitudes) are already rampant from preschool to high school.

Contradicting the statements by Mr. Curie to us and to Congress, and protestations by Representatives Ralph Regula (R-OH) [7], Tim Murphy (D-PA) and Grace Napolitano [8] (D-CA) that the State Incentive Grants (funded by Congress at $26 million for FY 2006) are merely for planning, they are being used to implement the NFC recommendation which include “early” universal mental health screening “across the life span,” including all “52 million public school children” and “referral to treatment” which includes government psychiatric drug programs like TMAP. The 2004 SAMHSA Matrix brochure says, “SAMHSA is investing more than $517 million in transformation efforts, including $47 million to fund the State Incentive Grants for Transformation program to enable States to begin implementing the Commission’s findings.” [9]

The Action Agenda is the means to implement the NFC recommendations.  Both the Action Agenda itself and several other SAMHSA documents contain statements such as, “CMHS [Center for Mental Health Services within SAMHSA] has contracted with a number of national mental health organizations to provide technical assistance to States in the development of activities and plans to implement the New Freedom Commission recommendations.” [10]

One has to wonder, why would a top agency official deny that the NFC recommendations are public policy and that the Action Agenda is an implementation of those policies? What is Charles Curie afraid to admit to citizens and their representatives in Congress?

Not only is there an enormous discrepancy between SAMHSA’s statements and the truth, but the agency also admits in the Action Agenda and accompanying documents that it is using our tax dollars to recruit non-governmental organizations (NGOs) to implement the NFC recommendations:

The Center for Mental Health Services (CMHS) within SAMHSA, as part of the technical assistance program mentioned above, given taxpayer funds to contract with “the National Association of State Mental Health Program Directors (NASMHPD) to coordinate this project and to collaborate with six subcontractors: the Judge David L. Bazelon Center for Mental Health Law, the Federation of Families for Children’s Mental Health, the National Alliance for the Mentally Ill (NAMI), the National Association of Mental Health Planning and Advisory Councils (NAMHPAC), the National Council for Community Behavioral Healthcare (NCCBH), and the National Mental Health Association (NMHA) to “deliver written analysis or on-site training and technical assistance on a range of policy issues related to the implementation of the recommendations of the President’s New Freedom Commission on Mental Health” [11]

Every one of the organizations listed above has a vested financial, power, and/ or professional interest in expanding the mental health system and has been a wholesale, uncritical supporter of the screening and medication recommendations in the NFC report. The State Mental Health Program Directors and NAMI alone have received millions of dollars in grants from the pharmaceutical industry.  These groups have an investment in expanding the roster of mental patients: thus, they completely ignore scientific and medical evidence that contradicts their agenda. It is, therefore, highly questionable that these same groups were selected to be the providers of technical assistance expanded to 45 states—all paid for by taxpayers via SAMHSA grants. [12]  Documents show that parents in the state of Missouri even received training in how to lobby for more taxpayer funds to pay for ineffective and highly controversial screening programs. [13]

NFC chairman Michael Hogan is the director of the Ohio Mental Health Department, which was one of the first to adopt TMAP (Texas Medication Algorithm Project). Hogan is one of TMAP’s most aggressive promoters, who has traveled across the country – all expenses picked up by drug manufacturers. Hogan also served on an “Advisory Committee” of Janssen Pharmacia, manufacturer of the antipsychotic Risperdal (risperidone) a TMAP recommended first line treatment [14]–and he sits on the advisory board of TeenScreen. [15] Thanks to Hogan and the other state mental health program directors, TMAP has spread to at least a dozen states and is affecting thousands of children, as young as age three, in juvenile justice, foster care and welfare programs. [16].  The cost of these psychiatric drugs is bankrupting state Medicaid programs.  In addition to being exorbitantly expensive, the TMAP recommended drugs are dangerous, carrying the FDA’s most stringent “Black Box” warning about fatal side effects. In clinical trials most have failed to demonstrate a clinical benefit greater than placebo, or a benefit exceeding existing older and cheaper drugs.

These points and more were discussed in a follow-up letter from the national coalition of concerned groups to SAMHSA on December 11, 2005. Mr. Curie’s January 12, 2006 reply to that letter did not address a single one of these concerns. [17]

It appears that SAMHSA was not really interested in answering the concerns of the AHRP and the others about these invalid and dangerous programs.  It also appears that interests of the pharmaceutical industry and psychiatric establishment are more important to their lapdogs in Congress and the bureaucracy than the rights of parents, children and citizens.

The Abramoff scandal pales in comparison to the stench of mental health establishment’s influence over so many parts of the federal government and in turn, so many state governments to label our children in infancy and create a never-ending market of psychoactive drugs.  These drugs produce serious chronic side effects, including obesity and diabetes—thereby necessitating the life-long use of additional drugs to treat debilitating, chronic disease produced by psychoactive drugs. Thus, drug company sales and profits will be increased, while bankrupting taxpayer-funded programs.

The tragedy is young children are being labeled mentally ill by vague, scientifically unsound criteria and becoming lifelong dependents on dangerous drugs whose long-term ill effects have yet to be analyzed; our freedoms of conscience; our parental authority; and our treasury will bear the cost of these deceptions.

What will you do to stop it?  Stay tuned for more of this story and for what you can do.

[1] Federal Mental Health Action Agenda (FMHAA) at http://www.samhsa.gov/Federalactionagenda/NFC_FMHAA.aspx
[2] See our statement on mental health screening at https://ahrp.org/infomail/05/11/02a.php for a summation of the medical dangers of these drugs.
[3] For a detailed description, see our report at https://ahrp.org/infomail/05/10/24.php
[4] FMHAA
[5] See Dr. Effrem’s description of this program at http://www.edwatch.org/updates/070802.htm
[6] See the quote regarding “intolerance” from the Department of Education’s website for this program at  http://www.ed.gov/admins/lead/safety/actguide/action_guide.txt
[7] See an excerpt from Regula’s floor speech against the Ron Paul amendment to deny funding for universal mental health screening programs http://edaction.org/2005/062705-mhs.htm
[8] See the Napolitano/Murphy letter against the Paul amendment at http://www.teenscreen.org/cms/images/stories//mental%20health%20dc2.pdf
[9] http://www.samhsa.gov/Matrix/brochure.aspx, emphasis added
[10] FMHAA
[11] http://www.nasmhpd.org/targeted_ta.cfm, emphasis added
[12]http://www.nasmhpd.org/general_files/publications/tta_pubs/NASMHPD/IDIQ%20II/Mental%20Health%20Transformation%20Survey%20070105.doc
[13] http://www.nasmhpd.org/general_files/CPT%20Final%20Report%20justin%20revisions.pdf
[14] https://ahrp.org/infomail/05/09/19a.php
[15] http://www.teenscreen.org/cms/content/view/19/47

[16] Over 60% of foster children in Texas (https://ahrp.org/infomail/04/11/13.php),
nearly two-thirds in Massachusetts (https://ahrp.org/infomail/04/08/11.php),
and 55% of foster children in Florida (https://ahrp.org/infomail/03/09/24.php)
are on as many as 16 different psychiatric drugs, starting as young as age 3.

[17] Both letters are available at https://ahrp.org/cms/content/view/49/28/

Karen R. Effrem
[kreffrem@pro-ns.net]

Contact: Vera Hassner Sharav
veracare@ahrp.org