The American Psychiatric Association (APA) recently issued a disingenuous, false and misleading statement to members of Congress that "The President's New Freedom Commission [on mental health] recommendations do not call for universal mandatory involuntary mental health screening," and, "There are no such programs, and none are contemplated by the New Freedom Commission (NFC) or any other federal agency or program of which we are aware."¹

If this were the case, then the NFC's Final Report is extremely ambiguous because scores of groups and victims of psychiatric abuse see the NFC recommendations as a constitutional violation creating a "Brave New World" of state-sanctioned mental health control over the lives of Americans.

In fact, the NFC report recommends:

• Mental health screening of "consumers of all ages," where "both children and adults will be screened for mental illness throughout their routine physical exams," and that this would occur "across the lifespan."²

• Screening all 52 million school children for mental disorders, as "schools are in a key position to identify mental health problems early and to provide a link to appropriate services."³

• "…the early detection of mental health problems in children and adults-through routine and comprehensive testing and screening—will be an expected and typical occurrence."⁴

• "Quality screening and early intervention will occur in readily accessible, low-stigma settings such as primary health care facilities and schools and…juvenile justice and child welfare."⁵ "Services" should be expanded to "children ages 3 through 21."⁶ This includes "social and emotional check-ups" in primary health care.⁷

• Furthermore, "While schools are primarily concerned with education, mental health is essential to learning as well as to social and emotional development. Because of this important interplay between emotional health and school success, schools must be partners in the mental health care of our children."⁸

Illinois already proposed "required" screening:

The state of Illinois already proposed a plan to implement mental health policy that, in turn, utilized the NFC recommendations and recommended that mental illness screening "be required" for all schoolchildren and pregnant women.

• "Include social/emotional development screening as part of required medical exams in schools (K, 4th, and entering 9th grade)…."

• "Screen all pregnant women for depression prior to delivery and periodically in the six months following the birth of a child."

• "Develop and fully implement policies and programs to ensure that all children coming through key public systems are assessed for mental health concerns and receive follow-up services as appropriate."

• "Change the state mental health code to increase to twelve the number of times adolescents age 12-18 years can receive mental health services without parental consent."

• In June 2004, the prestigious British Medical Journal—like thousands of individuals—construed the NFC report for what it is: a plan "to screen [the] whole U.S. population for mental illness."

• Other organizations exposing the massive curtailment of rights the NFC's recommendations will cause include Eagle Forum, The Liberty Committee, The Conservative Caucus, Rutherford Institute and CATO Institute; education groups such as EdWatch; psychiatric survivor, parental rights and human rights groups, and the National Foundation for Women Legislators. Additionally, Congressman Ron Paul and several other members of Congress introduced an amendment to stop any federal funding in State Incentive Grants to go toward the establishment of any mandatory mental health screening. Despite this, $20 million was approved.

The APA also claims: "Nor are the [NFC's] recommendations…a pretext for involuntary mental health treatment, excessive and inappropriate use of psychotropic medications in children…"

This is unconscionably misleading.

• The British Medical Journal (BMJ) article reports that NFC recommends "Linkage [of screening] with treatment," including using "specific medications for specific conditions." These "specific medications" were part of a model medication treatment plan known as the Texas Medication Algorithm Project (TMAP)-a psychiatric drug "flow chart" that states that doctors must first treat their patients with the newest, most expensive drugs. The latest antipsychotics, for example, have sold at significantly higher prices, in one case at 30 times the price of the older drugs.

• In what can only be seen as a conflict of interests, the chairman of the NFC sat on the Board of TMAP. TMAP sparked off controversy when Allen Jones, an employee of the Pennsylvania Office of the Inspector General, revealed that key officials with influence over the medication plan in his state received money and perks from drug companies with a stake in the medication algorithm. He was fired for speaking to the BMJ and The New York Times. The Texas project started in 1995 as an alliance of individuals from the pharmaceutical industry, the University of Texas, and the mental health and corrections systems of Texas.⁹

• Four months prior to the NFC releasing its report, the British Medicines and Healthcare Products Regulatory Agency issued warnings about Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants causing suicidal behavior in under 18- year-olds.¹⁰ This information was omitted from the NFC report.

• On October 15, 2004, the U.S. Food and Drug Administration ordered a "black box" label to be placed on all SSRIs and other antidepressants, stating that antidepressants increase the risk of suicidal thinking and behavior in children and adolescents.¹¹

• Instead of calling attention to a serious risk to children being prescribed these antidepressants, the NFC and a number of psychiatric organizations have continued to lobby Congress for funding for TMAP. Psychiatric drugs are big business. SSRIs are already a $12 billion a year industry in the United States and antipsychotic drug sales have reached $8 billion.

• The recommended drugs are far from "appropriate." Neuroleptics prescribed for supposed "serious mental disorders" have produced a miserable record. A 1999 patient survey found 90% of neuroleptic patients felt depressed, 88% felt sedated, and 78% complained of poor concentration.¹²

• Psychiatric opinion has been recruited to disseminate claims that "There is clear scientific evidence that newer classes of medications can better treat the symptoms of schizophrenia and depression with far fewer side effects." The opinions were tagged "Expert Consensus Guidelines" despite their complete absence of scientific analysis, study reviews or clinical trials.¹³

• Consider also that in an eight-year study, the World Health Organization found that severely mentally disturbed patients in three economically disadvantaged countries whose treatment plans do not include a heavy reliance on drugs—India, Nigeria and Colombia—found that patients did dramatically better than their counterparts in the United States and four other developed countries. A follow-up study reached the similar conclusion.¹⁴

• Meanwhile, national psychiatric strategies include influencing state laws to increase psychiatrists' power to involuntarily commit or force patients to take these expensive (and potentially lethal) psychiatric drugs in the community, or to enforce mandatory drugging through state-funded "mental health courts."

Mental Illness Screenings are not based on evidence-based science:

The APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the basis for much of the proposed mental health screening does not stand up to scientific scrutiny. The NFC report stated, "mental illnesses are shockingly common," but ignored the fact that there are no blood tests, brain scans or "chemical imbalance" tests to validate any mental "disorder" as an illness or disease. The methodology behind the proposed screening is completely subjective.

• According to Professors Herb Kutchins and Stuart A. Kirk, authors of Making Us Crazy: "There are indeed many illusions about DSM and very strong needs among its developers to believe that their dreams of scientific excellence and utility have come true, that is, that its diagnostic criteria have bolstered the validity, reliability, and accuracy of diagnoses used by mental health clinicians."¹⁵ The "bitter medicine" is that DSM has "attempted to medicalize too many human troubles."¹⁶

• The late Loren Mosher, M.D. and Clinical Professor of Psychiatry stated, "DSM-IV is the fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than scientific document...The issue is what do the categories [of mental disorders] tell us? Do they in fact accurately represent the person with a problem? They don't, and can't, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder."

• Harvard psychiatrist Joseph Glenmullen says the questionnaire used to diagnose depression "may look scientific," but "when one examines the questions asked and the scales used, they are utterly subjective measures…."¹⁷

• Dr. Julian Whitaker, director of California's Whitaker Wellness Center warns that the motive behind mandatory mental health screening of children is obvious: "That means drugging them!" For psychiatry, this means, "52 million potential customers." His advice to parents is to "refuse to sign those consent forms when they come home from your child's school—if they can't test them, they can't drug them."

Summary

The public is justifiably outraged by the recommendations of the NFC and the fact that the APA is blatantly obfuscating the facts to protect a multi-billion dollar mental health industry clearly shows that they are more interested in their own funding than in public safety.

Congress should absolutely refuse to support any proposed mental health screenings. The only group to benefit from such screenings and coercive drug treatments is the mental health industry, not the public or people in need of real care.

References:

¹ James H. Scully, Medical Director, American Psychiatric Association, "Dear Representative" letter, 18 Nov. 2004.
² Achieving the Promise: Transforming Mental Health Care in America, Recommendations of the New Freedom Commission on Mental Health, July 22, 2003, p. 11.
³ Achieving the Promise: Transforming Mental Health Care in America, New Freedom Commission on Mental Health Report, July 22, 2003, p. 58.
⁴ Ibid., p. 11.
⁵ Ibid., p. 60.
⁶ Ibid., p. 61.
⁷ Ibid.
⁸ Ibid., p. 58.
⁹ Jeanne Lenzer, "Bush plans to screen whole US population for mental illness," British Medical Journal, 19 June 2004, Vol. 328, p. 1458.
¹⁰ "British Warning on Antidepressant Use for Youth," The New York Times, 11 Dec. 2003.
¹¹ "FDA Launches a Multi-Pronged Strategy to Strengthen Safeguards for Children Treated With Antidepressant Medications," U.S. Food and Drug Administration FDA News, 15 Oct. 2004.
¹² Robert Whitaker, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, (Perseus Publishing, 2002), p. 256.
¹³ Allen Jones, Investigator in the Commonwealth of Pennsylvania Office of Inspector
General (OIG), Bureau of Special Investigations, paper written 20 Jan. 2004.
¹⁴ Op. Cit., Robert Whitaker,, pp. 227-228, citing L. Jeff, "The International Pilot Study of Schizophrenia: Five-Year Follow-Up Findings," Psychological Medicine, Vol 22, 1992, pp. 131-145; Assen Jablensky, "Schizophrenia: Manifestations, Incidence and Course in Different Cultures, a World Health Organization Ten-Country Study," Psychological Medicine, supplement, (1992): 1-95.
¹⁵ Herb Kutchins and Stuart A. Kirk, Making Us Crazy: The Psychiatric Bible and the Creation of Mental Disorders, (The Free Press, New York, 1997), pp. 260, 263.
¹⁶ Ibid.
¹⁷ Joseph Glenmullen, M.D., Prozac Backlash, (Simon & Schuster, New York, 2000), p. 206.