Psychotheraputic State

What should be the role of the Federal Government in promoting mental health? This topic will be debated increasingly within the coming year. The presidentially appointed New Freedoms Commission on Mental Health issued a report in July 2003 urging enactment of widespread screening for children to identify and treat mental illnesses. Defenders of constitutional liberties have good reason to be very skeptical of at least one objective.

The report in Recommendation 4.2 states: "The key to improving academic achievement is to identify mental health problems early and, when needed, provide appropriate services or links to services. The extent, severity, and far-reaching consequences make it imperative that our Nation adopt a comprehensive, systematic approach to improving the mental health status of children."

Later, the Commission's report in Recommendation 4.3 states its backing of "systematic screening procedures to identify mental health and substance use problems and treatment needs in all setting in which children [and] youth...are at high risk for mental illnesses or in settings in which a high occurrence of co-occurring mental and substance use disorders exists. In addition to specialty mental health and substance abuse treatment settings, screening for co-occurring disorders should be implemented when an individual enters the juvenile or criminal justice systems, child welfare system, homeless shelters, hospitals..."

Bit by bit, bureaucrats at HHS could take such language and slowly but surely push its boundaries, continually expanding its reach. Unless institutional checks are put in place to prohibit unwarranted expansion, eventually your child could visit the hospital to have his tonsils removed and also receive a free mental health checkup, too, courtesy of Uncle Sam. If your child is full of energy, as many children are, his rambunctiousness could be grounds for receiving a prescription for Ritalin.

The report in Recommendation 4.2 includes a section on a "Model Program: Screening Program for Youth" that promotes the Columbia University TeenScreen® Program clearly states that one of its goals should be "To ensure that all youth are offered a mental health check-up before graduating from high school."

Rep. Ron Paul (R-TX), who is a physician, is concerned that the recommendations of this report threaten to take on a life of their own. That "comprehensive" and "widespread" could easily become "universal." He wrote in his commentary Mental Health Screening for Kids: Part II: "It's not hard to imagine a time 20 or 30 years from now when government psychiatrists stigmatize children whose religious, social, or political values do not comport with those of the politically correct, secular state."

Rep. Grace Napolitano (D-CA) introduced House Concurrent Resolution 292 on October 2, 2003, which expresses "the sense of Congress that Congress should adopt and implement the goals and recommendations provided by the President's New Freedom Commission on Mental Health through legislation or other appropriate action to help ensure affordable, accessible, and high quality mental health care for all Americans."

The fact that House Concurrent Resolution 292 has been introduced by a member of the minority party and that its 33 co-sponsors are primarily litmus-test liberals, such as Howard Berman (D-CA), Carolyn McCarthy (D-NY), Patrick Kennedy (D-RI), Jim McDermott (D-WA) and Fortney "Pete" Stark (D-CA), should be of little comfort to defenders of constitutional liberties. Experienced legislators such as Berman and Stark realize that it may take years to enact this legislation but the way to do so is to be relentless in advocating its passage.

Fortunately, there are defenders of constitutional liberties who realize the threat that this legislation represents to parental rights and Federalism.

First and foremost is Representative Paul, who contends this legislation represents one more step to remove power from parents and place it in the hands of bureaucrats. He also worries that important lobbies -- namely, those associated with the pharmaceutical industry -- could very well become active in promoting this legislation because it would help them to more effectively market their wares to children.

Earlier this fall, when the House was considering the Labor, Health & Human Services, and Education Appropriations Bill, Rep. Paul, acting as "a medical doctor, as a civil libertarian, and a strict [constitutionalist]," offered an amendment to deny funding to implement the kind of "universal mental health screening" system recommended by the Commission. No money in the Appropriations Bill was designated to initiate a "universal mental health screening program" but he argued that the Commission's goals could be accomplished by regulation. The amendment represented a precautionary measure to make clear the House's opposition to universal mental health screening. "[T]he whole point was to prevent the proposal from being implemented in the first place," Paul explained after the vote.

Rep. Ralph Regula (R-OH), a member, like Rep. Paul, of the majority party, took offense to the introduction of the amendment, suggesting it would lead to denial of mental health screening and treatment for cases in which it was clearly warranted.

Paul countered that Regula had "misconstrued" the purpose of the amendment in that "it would not deny medical care. What it does is it denies the authority to the administration to have universal screening of all children in public school. It does not deny care to any individual that may qualify." Furthermore, in his commentary, Mental Health Screening for Kids, Part II, Paul disputed the notion advanced by his amendment's opponents that no money has been appropriated to institute mental health screening. The Labor/HHS/Education Appropriations Bill included $20 million for state programs that Paul considers to be the "precursors" to the Commission's recommendations for a significant expansion of mental health screening.

"Anyone who understands bureaucracies knows they assume more and more power incrementally," Paul wrote in his commentary. Today's model program at the local level can become tomorrow's model federal program, and then become a universal one.

Eagle Forum advised its members to contact their U.S. Representative to "Stop school-based mental health screening." The Association of American Physicians & Surgeons issued a similar appeal to its members. Paul's amendment to shut off funding for a universal mental health screening program fell to defeat, receiving 95 votes in support to 315 opposed. Conservative constitutionalists such as Roscoe Bartlett (R-MD, John Shadegg (R-AZ), Jeff Flake ((R-AZ), C.L. "Butch" Otter (R-ID) lined up with Paul. So did respected moderate Tom Petri (R-WI). Pro-family stalwarts Joe Pitts (R-PA), Mark Souder (R-IN), Trent Franks (R-AZ), Marilyn Musgrave (R-CO) and John Hostettler (R-IN) voted for it too. So did House Majority Leader Tom DeLay (R-TX). The only member of the minority party to offer support was Gene Taylor (D-MS).

Paul cautioned that the debate comes at a time when there is great concern that American children are being overmedicated by drugs, such as Ritalin, to treat hyperactivity. The problem of energetic school children is compounded in this era when television watching has become a substitute for real play and when many schools do not permit enough time for recess to allow children to work off energy.

Paul is intent on continuing his crusade, planning to introduce legislation late this year to cut off funding for universal screening before such a program can get started. Paul makes clear that the natural result of the Commission's call for widespread mental health screening for children and teenagers will be to force parents to surrender one more of their responsibilities to the state. Big Government Bureaucracy will move further and further into the realm of decision-making once reserved for parents and private physicians. Defenders of constitutional liberties, Libertarians and social conservatives alike need to realize that the best way to stop the cancerous idea of universal mental health screening from taking hold is very simple yet no doubt effective: an ounce of prevention is the best cure. In this case, it would be cutting off funding for universal mental health screening before such a program is even instituted.

Stephen M. Lilienthal is the Director of the Center for Privacy & Technology Policy ofthe Free Congress Foundation.

Michael D. Ostrolenk is the Director of Government Affairs of the Association of American Physicians & Surgeons.

Why Our Schools Teach Socialism -- September 2001 Education ... Chester M. Pierce, M.D., Professor of Education and Psychiatry at Harvard, had this to say: "Every child in America entering school at the age of five is mentally ill because he comes to school with certain allegiances to our Founding Fathers, toward our elected officials, toward his parents, toward a belief in a supernatural being, and toward the sovereignty of this nation as a separate entity. It's up to you as teachers to make all these sick children well - by creating the international child of the future." ....Bureaucrats, politicians and educators regularly appear on television blaming either parents or lack of funds for the failure of our schools. Their prescription is always the same: more money and more government control. For well over 50 years, American voters have fallen for these fallacies. Victor Gollancz, a famous socialist publisher, explained why he believed that socialism would take over America: "Christians are not exactly bright, so it will be easy for socialism to lead them down the garden path through their ideals of brotherly love and 'social justice.'"

Dr. Dennis Cuddy -- Mental Health and World Citizenship

Dennis Laurence Cuddy, historian and political analyst, received a Ph.D. from the University of North Carolina at Chapel Hill (major in American History, minor in political science). Dr. Cuddy has taught at the university level, has been a political and economic risk analyst for an international consulting firm, and has been a Senior Associate with the U.S. Department of Education.

Cuddy has also testified before members of Congress on behalf of the U.S. Department of Justice. Dr. Cuddy has authored or edited seventeen books and booklets, and has written hundreds of articles appearing in newspapers around the nation, including The Washington Post, Los Angeles Times and USA Today. He has been a guest on numerous radio talk shows in various parts of the country, such as ABC Radio in New York City, and he has also been a guest on the national television programs USA Today and CBS's Nightwatch.

By the late 1940s, Dewey's progressive education was becoming dominant in American public schools. And in 1948 an International Congress on Mental Health was held in London with publication of a document "Mental Health and World Citizenship," declaring that "world citizenship can be widely extended among all peoples through the application of the principles of mental health." The Congress promoted the U.N. as the vehicle for promoting this objective, and UNESCO's director-general Sir Julian Huxley the same year wrote in UNESCO: ITS PURPOSE AND ITS PHILOSOPHY that "political unification in some sort of world government will be required."

Dr. Dennis Cuddy -- Mental Health, Education and Social Control ...

In my last article, I focused on the connection between mental health and world citizenship. However, there is more to the use of mental health by the power elite than world citizenship. In MENTAL HEALTH, vol. 1, no. 4, October 1940, one finds a speech by John Rawlings Rees (deputy director of the Tavistock Institute for Medical Psychology begun in 1920) on June 18, 1940, in which he revealed: "We can therefore justifiably stress our particular point of view with regard to the proper development of the human psyche, even though our knowledge be incomplete. We must aim to make it permeate every educational activity in our national life....Public life, politics and industry should all of them be within our sphere of influence....Especially since the last world war we have done much to infiltrate the various social organizations throughout the country....Similarly we have made a useful attack upon a number of professions.

The two easiest of them naturally are the teaching profession and the Church: the two most difficult are law and medicine....If we are to infiltrate the professional and social activities of other people, I think we must imitate the Totalitarian and organize some kind of fifth column activity! If better ideas on mental health are to progress and spread we, as the salesmen, must lose our identity....Let us all, therefore, very secretly be 'fifth columnists.'...We have often been too spasmodic in our work and I feel we need a long-term plan of propaganda....I doubt the wisdom of a direct attack upon the existing state of affairs; even though there is a war on, that would still raise opposition, whereas the more insidious approach of suggesting that something better is needed---'why shouldn't we try so and so'---is more likely to succeed....Many people don't like to be 'saved', 'changed' or made healthy. I have a feeling, however, that 'efficiency and economy' would make rather a good appeal because there are very few people who would not welcome these two suggestions."

At the end of the Second World War, Canadian psychiatrist Brock Chisholm would pick up Rees' assault upon the Church in the February 1946 edition of PSYCHIATRY, writing that "a program of re-education or a new kind of education" needed to be charted whereby "the science of living should be made available to all people by being taught to all children in primary and secondary schools....Only so, can we help our children to carry out their responsibilities as world citizens as we have not been able to do....We have swallowed all manner of poisonous certainties fed us by our parents, our Sunday and day school teachers,our politicians, our priests....The reinterpretation and eventual eradication of the concept of right and wrong which has been the basis of child training, the substitution of intelligent and rational thinking for faith in the certainties of the old people, these are the belated objectives...for charting the changes in human behavior."

Dr. Dennis Cuddy -- Mental Health, Education and Social Control ...

In 2003, Illinois passed the Children's Mental Health Act requiring mental health screening for all Illinois children through age 18 and all pregnant women (this links with the current federal New Freedom Initiative). The Illinois law requires the Illinois Children's Mental Health Partnership to work with the State Board of Education in "drafting social and emotional development standards for incorporation into the Illinois Learning Standards...and developing assessments to measure children's progress against social and emotional development standards." This requirement is to meet federal "No Child Left Behind" (NCLB) standards, especially in the latter's "Safe and Drug Free Schools" section (see "Mental Health Merged With NCLB Standards/Tests in Illinois" by Karen R. Effrem, M.D., who is on the EdWatch Board of Directors). And in case you think parents will be informed about all that transpires, in Dr. Effrem's paper mentioned above, one reads: "The report that serves as the foundation for the Illinois law recommends on page 33 to '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.'"

TCS: Tech Central Station - Freeing the Soviet Mind

The old Soviet psychiatry subscribed to a harsh biological determinism. The psychiatric physician was an absolute authority while the patient's words mattered little more than raindrops at sea. That the patient might have something to add to the doctor's assessment of him made little sense since the origin of his difficulties was thought to be a disordered biology that had to be set right. The idea of a person was quaint but irrelevant.

Part of Soviet psychiatry involved the well-known use of psychiatry as an instrument for political ends. Indeed, there were few other ends in the system. The brothers Zhores and Roy Medvedev offer a shocking, though typical, picture of what things were like in the Stalinist era. In the Soviet scheme of things, political dissent was interpreted as a psychiatric disorder, a difficulty in reality testing, which justified confinement in a mental hospital. Such niceties as due process, length of stay and an appeals process meant nothing. In a state where individual freedom was a bourgeois myth, there was no need to respect basic human rights.

Treatment modalities included medications, electroconvulsive therapy, insulin coma therapy and various other so-called "somatic treatments." These aversive procedures were thought effective against political heresy. I suspect they were. For a psychiatrist to engage in Freud 's "talking cure" during the Soviet period would have been a criminal act. The reason: such a treatment presumed the patient was free to make his or her own decisions.

Today in Russia, there are patient protections against involuntary psychiatric hospitalization similar to those in the United States. While some may argue that unwilling confinement is always wrong, such hard-core legislation recognizes the freedom of the individual, which represents a radical change from the pre-Gorbachev era.

The movement from a narrow-minded, highly politicized, biological view of human nature to what we might call a libertarian one says a great deal about the way Russian life has changed. While many people I spoke with were reticent to declare that a revolution -- at least in thought -- had occurred, none regarded this liberalizing process as routine.

The great irony is that American psychiatry is moving in exactly the opposite direction. For the better part of the 20th century, psychiatry was dominated by psychoanalysis, so much so that in the public eye the two were nearly synonymous. Five-day-a-week-on-the-couch treatment was de rigueur. Psychoanalysts authored most of the prominent textbooks in the field. Gradually, though, psychoanalysis, under attack from some sectors of the intellectual community, perceived as too expensive and unscientific, began to lose its grip on the psychiatric community. Just as political science, history and sociology have strived to emulate the scientific methods of physicists, so too did psychiatry decide to embrace a mainstream biological approach to its subject matter. In the past 30 years, the overriding ideology of American psychiatry has shifted to a biological model. Psychopharmacology has become its therapeutic backbone.

The problem, however, is that this model doesn't tolerate free agency. It views psychiatric problems -- moral problems, really -- as medical ones, just as Soviet psychiatry did. It has become more prominent in the courts as the hefty influence of medical diagnoses has replaced the literary-like "assessments" of psychoanalysts. Always, the emphasis is on relieving the individual of moral responsibility. Interpersonal problems, family conflicts, sexual malaise, even shyness, have become medical problems.

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