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Illinois became the first state to hop on the bandwagon for
President Bush's New Freedom Commission's plan to subject all
American school children to mental health screening. In 2003,
Illinois lawmakers passed the $10 million Illinois Children's Mental
Health Act, creating a Children's Mental Health Partnership, which
many expect to become a model for other states. The final report
by the Illinois Children's Mental Health Task Force was released in
April 2003, and it is filled with intrusive and expensive
recommendations. The Illinois Children's Mental Health Partnership
had hearings in various locations across the state in 2004 to gather
public feedback on the plan.
While its proposals seem harmless enough at first glance,
comments from parents during the hearings raised many valid
concerns. The state, critics said, no longer assumes that Illinois
children are mentally healthy; it presumes all children need mental
health screening.
The task force report calls for a comprehensive, coordinated
children's mental health system comprised of prevention, early
intervention and treatment for children from birth to age 18; a
statewide data-reporting system to track information on each person;
and social-emotional development screens with all mandated school
exams (kindergarten, fourth grade and ninth grade).
The task force wants to start early, beginning prenatally and at
birth, and continue throughout adolescence, including efforts to
support adolescents in making the transition to young adulthood.
Karen Hayes, associate director of Concerned Women for
America-Illinois, published an opinion piece in the Illinois Leader
on July 23, 2004, and had a great idea. She said maybe the
legislators should be mentally evaluated.
Concerned parent Joseph Volpendesta feels the same way. In a June
13 letter to the editor of the Illinois Leader, he said: "Mental
health screening might be much more usefully employed on these
people who come up with these brainstorms. It is obvious that they
have far too much time on their hands and too little regard for
those of us who are paying the bills. What is needed, and at the
earliest opportunity, is a bill to rescind this piece of legislative
claptrap. ... There is no doubt in my mind where the mental health
screening is most needed, and it ain't the kids."
TeenScreen customer recruitment scheme
At the center of the controversy is program called TeenScreen,
designed by pharmaceutical-backed officials at Columbia University.
TeenScreen is supposedly a suicide-prevention program and is
recommended by the New Freedom Commission, even though a recent U.S.
Preventive Services Task Force study found "no evidence that
screening for suicide risk reduces suicide attempts or mortality."
Columbia claims the TeenScreen survey can assess the symptoms of
eight disorders associated with the risk of suicide or mental
illness. On March 2, 2004, the program's executive director, Laurie
Flynn, testified at a congressional hearing and said that in the
screening process, "Youth complete a 10-minute self-administered
questionnaire that screens for social phobia, panic disorder,
generalized anxiety disorder, major depression, alcohol and drug
abuse, and suicidality."
In May 2004, Illinois lawmakers passed a resolution approving the
implementation of TeenScreen in public schools. The resolution said
in part (1) that the Columbia TeenScreen program has been proven
successful, offers technical assistance for implementation of a
screening program and provides all the components for such a program
at no charge at this time; (2) that we recognize that mental illness
and suicide among young people are public health crisis in this
state and that all residents of Illinois should make the
identification of mental disorders and the prevention of suicide
among the young people a public health priority; (3) that every
young person should be screened ... to identify mental illness and
prevent suicide; and (4) that such a screening and identification
process should employ sound, evidence-based tools.
The problem is that TeenScreen is not an evidence-based tool. The
program had already been in place for six years in Tulsa, Okla.,
when the suicide rate rose drastically, causing Michael Brose, the
leader of a mental health partnership organization there, to say,
''To the best of my knowledge, this is the highest number of youth
suicides we've ever had during the school year -- a number we find
very frightening."
TeenScreen is an invention of the pharmaceutical industry and is
nothing more than a customer recruitment scheme to help generate
high-volume sales of costly psychiatric drugs. By infiltrating the
nation's public school system, it will generate millions of new
prescription drug customers.
"More screened kids means more money for psychiatrists and the
pharmaceutical industry," said Vera Hassner Sharav, president of the
Alliance for Human Research Protection, a patient advocacy group, to
the Chicago Tribune on June 5.
"It is important to understand that powerful interests, namely
federal bureaucrats and pharmaceutical lobbies, are behind the push
for mental health screening in schools. ... The pharmaceutical
industry is eager to sell psychotropic drugs to millions of new
customers in American schools," said Rep Ron Paul, R-Texas, who
happens to be a physician.
TeenScreen made its Illinois debut last fall at the Brimfield
High School in the Peoria area, and reports indicate that several
more Illinois schools will be implementing the program next year,
according to investigative reporter Rhonda Robinson.
TMAP and IMAP
Parent Dennis McLouth of Roseville wrote in a letter to the
editor of the Illinois Leader on June 13: "Do the big drug companies
have so much power? Why else would this be happening? It looks like
a way to make more young people dependent on prescription drugs
earlier in life, when all they really need is to deal with growing
up, just like we all did before there was a drug for every ailment
and new ailment to justify even more new drugs."
My answer to Dennis is: Yes, the drug companies are that
powerful, and it gets worse. The New Freedom Commission recommends a
drug treatment program called the Texas Medical Algorithm Project,
which specifically requires doctors to prescribe the newer
generation of psychiatric drugs to children, including the
antidepressants known as the selective serotonin reuptake
inhibitors, or SSRIs, which can lead children to commit suicide or
other violent acts.
According to the American Hospital Formulary Service Drug
Information 2005, the "FDA now states that it has determined that
antidepressants increase the risk of suicidal thinking and behavior
in children and adolescents with major depressive and other
psychiatric disorders."
Dr. Ann Blake Tracy is the executive director of the
International Coalition for Drug Awareness and the author of
"Prozac, Panacea or Pandora: Our Seratonin Nightmare." She testified
at a February 2004 FDA hearing on the adverse effects of SSRIs and
said: "Research on serotonin has been clear from the very beginning
that the most damaging thing that could be done to the serotonin
system would be to impair one's ability to metabolize serotonin. Yet
that is exactly how SSRI antidepressants exert their effects."
Tracy said that for decades research has shown that impairing
serotonin metabolism will produce numerous health problems including
"pains around the heart, difficulty breathing, tension and anxiety
which appear from out of nowhere, depression, suicide -- especially
very violent suicide, hostility, violent crime, arson, substance
abuse, psychosis, mania," and the list goes on and on.
"How anyone ever thought it would be 'therapeutic' to chemically
induce these reactions is beyond me," she said.
In one study reviewed by the FDA panel, in a pool of 931
depressed patients taking SSRIs listed on the Texas Medical
Algorithm Project, versus 811 depressed patients taking a placebo,
there were 52 suicidal acts by people on the SSRIs versus 18 on
placebo.
The drug companies withheld the studies that showed the drugs
were basically ineffective on kids and that they were in fact
dangerous. Most of the studies that have surfaced over the past
couple years were unearthed during the discovery process of recent
lawsuits against drug companies.
Pediatrician Dr Karen Effren questions whether the Texas Medical
Algorithm Project list should be used at all. "If data is withheld
about the dangers or lack of effectiveness of the new psychiatric
drugs, why should physicians believe and carry out the
recommendations of the New Freedom Commission for treatment, such as
the Texas Medication Algorithm Project, that uses those drugs as
paid for the state incentive grants?"
These same sentiments had already been expressed in January 1999
by Peter Weiden, M.D., who was one of the participants on the
original panel that approved drugs to be on the Texas Medical
Algorithm Project list, when he openly criticized the process in the
Journal of Practice in Psychiatry and Behavioural Health.
Weiden pointed out the fact that drug company money was involved
in the approval of the list. "Another problem is potential bias from
funding sources," he said. "The 1996 guidelines were funded by
Janssen (makers of Risperidone [Risperdal]), and most of the
guidelines' authors have received support from the pharmaceutical
industry. This potential conflict of interest may create credibility
problems, especially concerning any recommendations supporting the
use of atypical antipsychotics."
Other drug companies besides Janssen were involved in the
creation of the list. And drug company money was also used to grease
the palms of politicians who would ultimately have to approve the
Texas Medical Algorithm Project scheme.
For instance, Eli Lilly helped fund the guidelines and also has
well-known ties to both Bush administrations. After Bush Sr. left
the CIA in 1977, he became a member of Lilly's board of directors.
When he left the company to become Reagan's vice president in 1980,
he forgot to mention that he still owned stock in the company at the
same time that he was lobbying for tax breaks for Lilly, even though
it manufactured drugs in Puerto Rico.
Bush Jr. made Eli Lilly CEO Sidney Taurel a member of the
Homeland Security Department, and his former director of the Office
of Management and Budget, Mitch Daniels, was also a former senior
vice president of Lilly.
In the 2000 election the company contributed over $1.5 million to
political candidates, with over 80 percent going to Bush and the
Republican Party.
According to the Center for Responsive Politics, in his two bids
for the presidency, Bush has been the No. 1 recipient from either
party for campaign donations from the pharmaceutical industry. The
same Robert Wood Johnson IV who has ties to the foundation that
funded the Texas Medical Algorithm Project is also heir to the
Johnson & Johnson fortune, and he raised over $100,000 for Bush's
2000 campaign and over $200,000 for the 2004 campaign.
The Robert Wood Johnson Foundation also helped fund the Illinois
Children's Mental Health Task Force, which produced the report that
the Illinois' Children's Mental Health Act of 2003 is based on,
according to investigative reporter Rhonda Robinson.
The Illinois version of the Texas Medical Algorithm Project list
is the IMAP, and it is already in place in 23 Illinois counties,
Robinson reports.
Tax-dollar-funded drug pushers
Let there be no mistake about it: Kids sent to shrinks will end
up on drugs. In 2002, a survey of recently trained child
psychiatrists found that only one in 10 children in their practices
did not receive a medication. ("A survey of early-career child and
adolescent psychiatrists," D.E. Stubbe and W.J. Thomas, Journal of
the American Academy of Child & Adolescent Psychiatry, 2002)
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A 2004 review by Medco Health Solutions of prescription data for
300,000 children ages 19 and younger concluded that for the first
time in history, spending for medications for childhood behavior
problems eclipsed expenditure for any other drug category, including
antibiotics.
The final draft of the Illinois plan issued this month wants to
promote effective use of Medicaid's early periodic screening,
diagnosis and treatment benefit in Illinois to support voluntary
screening of children from birth to 18 years and wants to "clarify
for providers the diagnoses that create eligibility for children to
obtain Medicaid services."
I wonder how many people are curious as to what might be in store
for the kids they want to screen at birth. To answer that question,
an investigation of the drugs being prescribed to Illinois kids on
Medicaid might be helpful.
On April 25, the headlines of the Ohio Columbus Dispatch read:
"Drugged into submission, even babies getting treated as mentally
ill." Doctors prescribed sedatives and powerful, mood-altering
medications for nearly 700 Ohio babies and toddlers on Medicaid last
summer, according to a Dispatch review of records.
An investigation by the Dispatch revealed that at least 696 Ohio
children who were newborn to 3 years old received mental health
drugs paid for by Medicaid in July 2004. Hydroxyzine was prescribed
most often, with about three-quarters of the kids on it. The drug, a
long-acting antihistamine, relieves itching caused by allergies,
controls vomiting and reduces anxiety, but it is given to young
children most often for its sedative effects.
In addition, more than 90 kids were on another antihistamine, 48
were taking antianxiety medication and 28 were prescribed
antidepressants, including the SSRIs Paxil, Prozac and Zoloft.
Twenty-seven received Valium, and 18 were on antipsychotics.
This revelation set off alarms in Ohio. "It's troubling," said
John Saros, executive director of Franklin County Children Services.
"How do doctors even determine that a 2-year-old is anxious? There's
a reason they call it the 'terrible twos.'"
In total, nearly 40,000 Ohio children on Medicaid were taking
drugs for anxiety, depression, delusions, hyperactivity and violent
behavior when the investigation was conducted in July 2004,
according to the Dispatch.
Illinois' new program keeps stressing that treatment should be
funded by Medicaid. That means drugs, folks. Over-drugging kids on
Medicaid in Ohio is not an isolated practice. It's happening all
over the country.
On Jan. 15, the Miami Herald reported that nearly 1,900 children
under the care of Florida's child welfare system are taking
antidepressant drugs, despite a strong federal warning that such
medications are linked to an increased risk of suicidal thinking.
Similar findings held true in Tennessee for kids covered by the
state insurance program. A study conducted in 2004 by Dr. William
Cooper, an associate professor of pediatrics at Vanderbilt
University in Nashville, determined that the use of antipsychotic
drugs among low-income children in Tennessee had nearly doubled
between 1996 and 2001.
Cooper's report, published in the Aug. 3, 2004, issue of the
Archives of Pediatric Adolescent Medicine, found that young people
who are not psychotic are being prescribed antipsychotic drugs for
which there was no data on safety or effectiveness.
The study revealed that the proportion of TennCare children who
were prescribed antipsychotics nearly doubled in six years. The most
dramatic increases were among those aged 13 to 18 (116 percent) and
those 6 to 12 (93 percent). Cooper also found that use among
preschool children had increased by 61 percent.
If the Illinois governor signs the new law on June 30, in
addition to children, all pregnant women will be screened for
depression during pregnancy and for up to 1 year following a baby's
birth. The treatment for depression mandated by the IMAP drug list
will be the SSRI antidepressants, even though new studies indicate
that SSRIs taken by pregnant women can have serious adverse affects
on the unborn fetus.
"Newborn babies could be at risk of suffering withdrawal symptoms
if their mothers are prescribed antidepressants during pregnancy,"
according to a Reuters article on Feb. 4.
Professor Emilio Sanz of the University of La Laguna in Tenerife,
Spain, conducted a study that showed that SSRIs can cause
convulsions, irritability, abnormal crying and tremors in newborn
babies.
For the study, Professor Sanz and his team of researchers
searched the World Health Organization database from 72 countries
for the adverse drug reactions associated with the use of SSRIs,
Reuters reported.
Karen Hayes thinks the whole plan stinks. "Proposing that state
government set mental health competency standards for all Illinois
pregnant women and children to age 18 stuns human sensibilities,"
Hayes wrote. "This proposal calls for collection of mental health
data of women and children, together with bureaucratic linkage of
this information."
She's got that right, because according to the plan, the state of
Illinois will improve accountability, data tracking and reporting
for children's mental health in relevant programs and services and
will (1) institute contract and monitoring changes to increase the
accountability of current children's mental health providers; (2)
develop a statewide data-tracking and reporting system to collect
information on key indicators of children's social and emotional
development and mental health status; (3) develop policies and
protocols for the sharing of databases among relevant state and
local agencies; and (4) explore the development of uniform reporting
forms and tests in select programs for the tracking, reporting and
planning of services.
Follow the tax dollars
The task force says it wants to maximize the use of Medicaid and
KidCare by streamlining enrollment, capitalizing on federal
reimbursement and implementing key cost-saving strategies, with
savings deposited into a Children's Mental Health Fund.
It wants to (1) improve Medicaid reimbursement for prevention,
early intervention and treatment services; (2) recognize diagnoses
for young children described in DC:0-3 and pay for mental health
services for children with any of these diagnoses; (3) clarify for
providers the diagnoses that create eligibility for children to
obtain Medicaid services.
Translation: That means to make sure "treatment" (aka pills) will
be paid for, people will be trained to diagnose kids only with
disorders that are covered by Medicaid.
The task force plan leaves no funding stone unturned. It even
wants to "change the Illinois KidCare and Medicaid eligibility
procedures to allow for self-attestation of a family's financial
circumstances in lieu of current financial documentation
requirements," which means all I have to do is swear I'm poor to
qualify for Medicaid in Illinois.
Drug companies smell the tax dollars, and they want these
Illinois kids. Over 2 million children were enrolled in Illinois
public schools, pre-K through 12th grade, during the 2001-02 school
year. Over 960,000 children were enrolled in Medicaid and KidCare in
2002, and a recent study in Chicago claimed that nearly 50 percent
of inner-city adolescents demonstrated signs and symptoms of
depression.
So let's do the math and see how much the psychiatric-industrial
complex stands to gain. The plans says to "ensure that all children
enrolled in Medicaid receive periodic developmental screens ... as
mandated under the early and periodic screening diagnostic treatment
program."
Let's say the initial diagnostic visit to the shrink costs $150.
What's 150 times 960,000?
The report said 50 percent of Chicago inner-city kids were
depressed, so we'll use that percentage for the kids on Medicaid.
Half of 960,000 means 480,000 kids are set to be prescribed
antipsychotic drugs right from the get-go.
Offhand I don't know how much all the different drugs cost, but I
have personal knowledge that the cost of Risperdal in 2001 was close
to $500 for a 30-day supply.
In 2001, The Miami Herald published a series of stories about the
common use of Risperdal among children in state care. Child welfare
advocates said the drug routinely was being used by foster care
providers as a ''chemical restraint'' on children whose unruly
behavior was a frustration to caretakers.
Risperdal is on the IMAP list as the leading drug used to combat
schizophrenia and other types of psychotic disorders and earns
Janssen about $2.1 billion in annual sales. The drug is prescribed
to more than 10 million people worldwide, according to the Herald.
I suspect a heavy-duty calculator will be needed to calculate
dollar amounts for the potential cost of Risperdal prescriptions to
the taxpayers of Illinois.
Taxpayers may foot entire bill
No doubt about it, the promoters of this scheme are looking to
grab tax dollars from every public trough known to man. The plan
lists a host of public funding sources to be examined and includes
Medicaid and the State Children's Health Insurance Program, the
Social Services Block Grant, Temporary Assistance for Needy
Families, the Child Care and Development Fund, the Title V Maternal
and Child Health Services Block Grant, Parts B (special education)
and C (early intervention) of the Individuals with Disabilities
Education Act, Juvenile Justice, and state funding sources.
In her opinion piece, Karen Hayes questioned the feasibility of
such a large publicly funded program: "Our government bureaucracies
continue to struggle with the job of tending to the social needs of
needy Illinois families, and ... trying to educate our children in
basic academics. How is it that these same bureaucracies can now be
asked to take on the additional role of being the mental health
evaluator and caretaker of all pregnant women and children in
Illinois?
"At a time when budget concerns are on the front pages of most
Illinois newspapers, we are being asked to give input to one of the
costliest expansions of government and bureaucracy we have seen in
recent years.
"In summary, it is neither beneficial to children, nor to
taxpayers, to ask government bureaucracies to set competency
standards for mental health. With some amount of lightheartedness,
may I propose that the mental health of the perpetrators of this
concept be evaluated?"
Another parent agrees with her. "The Illinois Legislature ought
to have their own heads subjected to adolescent mental health
screening for even considering passing such legislation," said Jack
Kime, in a June 13 letter to the Illinois Leader. "If there is
anything more dangerous than having the government put such a
program in place, I don't know what it might be," he said.
[Evelyn Pringle]
Evelyn Pringle is a
columnist for Independent Media TV and an investigative journalist
focused on exposing government corruption.
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