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Bush plans to screen whole US population for mental illness
Bmj Journals ^ | 19 June, 2004 | Jeanne Lenzer

Posted on 07/04/2004 6:39:03 PM PDT by SkyRat

A sweeping mental health initiative will be unveiled by President George W Bush in July. The plan promises to integrate mentally ill patients fully into the community by providing "services in the community, rather than institutions," according to a March 2004 progress report entitled New Freedom Initiative (www.whitehouse.gov/infocus/newfreedom/toc-2004.html). While some praise the plan's goals, others say it protects the profits of drug companies at the expense of the public.

Bush established the New Freedom Commission on Mental Health in April 2002 to conduct a "comprehensive study of the United States mental health service delivery system." The commission issued its recommendations in July 2003. Bush instructed more than 25 federal agencies to develop an implementation plan based on those recommendations.

The president's commission found that "despite their prevalence, mental disorders often go undiagnosed" and recommended comprehensive mental health screening for "consumers of all ages," including preschool children. According to the commission, "Each year, young children are expelled from preschools and childcare facilities for severely disruptive behaviours and emotional disorders." Schools, wrote the commission, are in a "key position" to screen the 52 million students and 6 million adults who work at the schools.

The commission also recommended "Linkage [of screening] with treatment and supports" including "state-of-the-art treatments" using "specific medications for specific conditions." The commission commended the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan that "illustrates an evidence-based practice that results in better consumer outcomes."

Dr Darrel Regier, director of research at the American Psychiatric Association (APA), lauded the president's initiative and the Texas project model saying, "What's nice about TMAP is that this is a logical plan based on efficacy data from clinical trials."

He said the association has called for increased funding for implementation of the overall plan.

But the Texas project, which promotes the use of newer, more expensive antidepressants and antipsychotic drugs, 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 (15 May, p1153). He was sacked this week 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. The project was funded by a Robert Wood Johnson grant—and by several drug companies.

Mr Jones told the BMJ that the same "political/pharmaceutical alliance" that generated the Texas project was behind the recommendations of the New Freedom Commission, which, according to his whistleblower report, were "poised to consolidate the TMAP effort into a comprehensive national policy to treat mental illness with expensive, patented medications of questionable benefit and deadly side effects, and to force private insurers to pick up more of the tab" (http://psychrights.org/Drugs/AllenJonesTMAPJanuary20.pdf).

Larry D Sasich, research associate with Public Citizen in Washington, DC, told the BMJ that studies in both the United States and Great Britain suggest that "using the older drugs first makes sense. There's nothing in the labeling of the newer atypical antipsychotic drugs that suggests they are superior in efficacy to haloperidol [an older "typical" antipsychotic]. There has to be an enormous amount of unnecessary expenditures for the newer drugs."

Drug companies have contributed three times more to the campaign of George Bush, seen here campaigning in Florida, than to that of his rival John Kerry

Credit: GERALD HERBERT/AP

Olanzapine (trade name Zyprexa), one of the atypical antipsychotic drugs recommended as a first line drug in the Texas algorithm, grossed $4.28bn (£2.35bn; 3.56bn) worldwide in 2003 and is Eli Lilly's top selling drug. A 2003 New York Times article by Gardiner Harris reported that 70% of olanzapine sales are paid for by government agencies, such as Medicare and Medicaid.

Eli Lilly, manufacturer of olanzapine, has multiple ties to the Bush administration. George Bush Sr was a member of Lilly's board of directors and Bush Jr appointed Lilly's chief executive officer, Sidney Taurel, to a seat on the Homeland Security Council. Lilly made $1.6m in political contributions in 2000—82% of which went to Bush and the Republican Party.

Jones points out that the companies that helped to start up the Texas project have been, and still are, big contributors to the election funds of George W Bush. In addition, some members of the New Freedom Commission have served on advisory boards for these same companies, while others have direct ties to the Texas Medication Algorithm Project.

Bush was the governor of Texas during the development of the Texas project, and, during his 2000 presidential campaign, he boasted of his support for the project and the fact that the legislation he passed expanded Medicaid coverage of psychotropic drugs.

Bush is the clear front runner when it comes to drug company contributions. According to the Center for Responsive Politics (CRP), manufacturers of drugs and health products have contributed $764 274 to the 2004 Bush campaign through their political action committees and employees—far outstripping the $149 400 given to his chief rival, John Kerry, by 26 April.

Drug companies have fared exceedingly well under the Bush administration, according to the centre's spokesperson, Steven Weiss.

The commission's recommendation for increased screening has also been questioned. Robert Whitaker, journalist and author of Mad in America, says that while increased screening "may seem defensible," it could also be seen as "fishing for customers," and that exorbitant spending on new drugs "robs from other forms of care such as job training and shelter programmes."

But Dr Graham Emslie, who helped develop the Texas project, defends screening: "There are good data showing that if you identify kids at an earlier age who are aggressive, you can intervene... and change their trajectory."


TOPICS: Culture/Society; News/Current Events
KEYWORDS: drug; health; mental; mentalhealth; newfreedom; newfreedominitiative
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To: Intolerant in NJ

the Brief Symptom Inventory, a short version of the SCL-90, is in wide use for screening adults. it takes 8-10 minutes to fill out. it is reasonably valid for adults. i don't know if there is a version for kids yet, but you could probably do a ten minute interview version using minimally trained technicians.
the technical part is the easy part. the only thing to stop this would be popular opposition.


81 posted on 07/06/2004 9:14:51 PM PDT by drhogan
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To: SkyRat
Figure 4.2. Model Program: Screening Program for Youth ...the problem IMO comes in trying to move to a system which would evaluate the "entire" US population - many schools have screening programs of one form or another adapted to their own needs and resources, but extending them all over the country for every child would be a real problem - "model" or "demonstration" social services programs are notorious for losing effectiveness once they are expanded to serve larger populations, in part because the people who started them with dedication and enthusiasm are eventually replaced by other "administrators" who don't have the same verve and skills as the originals - even the "outcomes" of this program seem weak - for instance do we really need any screening program at all to know that the "vasr majority" of students with problems are not in treatment? - I'm sure the psychiatric and psychological associations will be all for such a scheme as a great make-work project for their members, but as an effective and meaningful program for the country, it seems a non-starter.....
82 posted on 07/06/2004 9:51:41 PM PDT by Intolerant in NJ
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To: drhogan

Well yes, there are a number of brief questionnaires and inventories for use with children to spot issues such as depressed mood and potential for drug abuse ("The Children's Depression Inventory" and the "Personal Experience Inventory", as examples), but most are used as part of an individualized assessment battery - to try to apply them for screening en masse to the "entire" population of US children, no matter what validity and reliability they boast in a facility setting, would most probably result in literally millions of misclassified "emotionally disturbed", especially if evaluation and follow-up are provided by "technicians" trained to whatever minimal standards the government wants - to do the technical part at a level I would want for my kid is impossible, but public opinion will put a stop to the program once the populace finds out what a farce it is......


83 posted on 07/06/2004 10:19:03 PM PDT by Intolerant in NJ
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To: Intolerant in NJ

i hope it gets stopped before it gets very far. it is very hard for anyone to DISPROVE that he/she or his/her child is mentally ill.
and why should the federal government be pushing this? it seems that this should fall within a state's jurisdiction.
i am against the idea, for all sorts of reasons. the problem is, it could be done very easily, but not necessarily very accurately.


84 posted on 07/06/2004 10:37:00 PM PDT by drhogan
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To: BearWash
Thank you for that.
To have Mental Health you must first have Mental Illness.
and if mental illness doesn't exist you create it!
85 posted on 07/06/2004 10:40:58 PM PDT by philman_36
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To: bikepacker67

If he loses, who will tell him?


86 posted on 07/06/2004 10:53:53 PM PDT by Old Professer (Interests in common are commonly abused.)
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To: drhogan
i hope it gets stopped before it gets very far...me too - it'll be interesting to see how far this idea develops - hopefully not far at all.....
87 posted on 07/07/2004 9:46:29 PM PDT by Intolerant in NJ
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To: ladysusan
Not country in the world could pull off a screening of its "whole...population" for mental illness, not even the great and mighty USA.

Much less make sure that 300 milion people take their pill every day.

So what.

No dictatorship can ever implement all of its programs compltely. Hell, no dictatorship can ever implement any of its programs completely.

That doesn't stop 'em from trying.

Is Cuba a "no worry here, mate" scenario simply because Castro cannot silence or jail all of his critics?

I think that if you think about it you'll conclude that the ability to completely meet an expressed goal is meaningless, once the state in question decides to go about implementing its agenda.

The USSR didn't "help" all of its dissidents. It couldn't. It was logistically impossible. They just didn't have enough psychologists and psychiatrists.

I'm sure we'll be more efficient, but still fall short.

Somehow, I don't find the thought comforting.

And on that thought, I leave you(all) with two more thoughts.

I'm still making my way through this thread, but I haven't yet seen a reference to the other thread on this topic, which resulted in a knock-down, drag-out 1000+ post thread, Bush to screen population for mental illness, started on June 22. (I don't recall seeing a reference to this thread in that one either, but I may have missed it.)

Finally -- and I don't know if it's been posted to FR at all -- there is already an active agitprop campaign for this travesty.

As all agitprop campaigns, it is indirect, and aims below the belt.

In this article -- U.S. senator, sobbing for son, pleas for suicide bill -- you need to go all the way to the last paragraph if you want to see the connection to the atrocity under discussion in this thread.

Welcome to Newmerica. Roll up your sleeve and obey your "helper," OK? Don't make waves. Go with the flow. Enjoy!

88 posted on 07/09/2004 10:25:02 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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To: L_Von_Mises

bump


89 posted on 07/09/2004 10:25:35 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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To: festus

bump


90 posted on 07/09/2004 10:26:21 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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To: Old Professer

Better have the fainting couch ready. I would hate to be in that room.


91 posted on 07/09/2004 10:29:04 PM PDT by cyborg (the NYT is slipping down the hypotenuse of relevancy)
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To: Finalapproach29er
How much is this compassion going to cost?

My initial impulse was to reply, "How much have you got?" but then I recalled a line from an old -- a very old -- song, by a very obscure group, with what turns out to be a very chilling name.

The band's name was, "The United States of America"

The line from the song goes, "and price is right, the cost of one admission is your mind."

92 posted on 07/09/2004 10:30:20 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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To: Don Joe

I think the reason why that thread went so long because this proposition is wrapped up with a lot of sensitive issues. Taxes and more importantly the most cherished and invaluable forms of rights and that is private and property rights of one's mental situation. Think about it. Once the government invades the privacy of one's mental state, then what else is there?


93 posted on 07/09/2004 10:31:22 PM PDT by cyborg (the NYT is slipping down the hypotenuse of relevancy)
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To: SkyRat

I don't see anything in the Constitution authorizing anything like this activity. Oh, wait. What Constitution?


94 posted on 07/09/2004 10:34:55 PM PDT by BnBlFlag (Deo Vindice/Semper Fidelis)
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To: Paleo Conservative
"Is opposition to gay marriage a 'mental illness'?"

Either 'mental illness' OR 'hate speech.'

One way or another, the fascist left needs to silence the truth -- led by those infamous arbiters of "normal" -- the psychiatric industry.

95 posted on 07/09/2004 10:35:32 PM PDT by F16Fighter
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To: SkyRat
All youngsters in a school, with parental consent, are given a computer-based questionnaire that screens them for mental illnesses and suicide risk.

Happytalk Slogantime(tm)!

"Computer-based, so you know it's good!"

Welcome to the future.

Man, it really sucks here.

PS: gotta love that "with parental consent" part, eh? (Do you really want to know what will happen if you don't consent?)

96 posted on 07/09/2004 10:43:37 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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To: SkyRat

No thank you President Bush. Keep your lousy stinking globalist government away from my brain.


97 posted on 07/09/2004 10:48:00 PM PDT by Colorado Buckeye (It's the culture stupid!)
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To: L_Von_Mises
The school to work program was a way to tie current students to future jobs. Only problem is that they determined at an early age what you were going to be when you grew up and educated you accordingly. This would be based on supply - assesments of students in grade school, and demand - database of projected workforce demand from business, etc. It sounded an awful lot like the old Soviet system.

It sounded an awful lot like the old Soviet system?

I disagree. It doesn't sound "an awful lot" like it. It sounds identical to the centrally planned state-controlled socialist "planned economy."

98 posted on 07/09/2004 10:48:05 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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To: drhogan
the Brief Symptom Inventory, a short version of the SCL-90, is in wide use for screening adults. it takes 8-10 minutes to fill out. it is reasonably valid for adults. i don't know if there is a version for kids yet, but you could probably do a ten minute interview version using minimally trained technicians.
the technical part is the easy part. the only thing to stop this would be popular opposition.

Do you see that as a problem?

What do you propose to do with those citizens who do not want the government probing into their minds?

Does "privacy" have no meaning other than "the right to abort"?

99 posted on 07/09/2004 10:57:25 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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To: drhogan
i hope it gets stopped before it gets very far. it is very hard for anyone to DISPROVE that he/she or his/her child is mentally ill.

And, most likely, parents who resist will be flagged as troublemakers -- and, made examples of.

100 posted on 07/09/2004 10:58:55 PM PDT by Don Joe (We've traded the Rule of Law for the Law of Rule.)
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