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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by bruin on February 1, 2005, at 18:47:42
Screening America's children for mental illness: fallacy or fraud?
Nathaniel S. Lehrman, M.D.
"Routine and comprehensive testing and screening" for early detection of
"the mental health problems of children" is being recommended by President
Bush's New Freedom Commission on Mental Health (NFC). Its stated purpose
is to help sufferers from these difficulties by helping them start treatment
early. The proposal is fallacious, if not openly fraudulent, in terms of
both "diagnosis" and treatment.Diagnosing mental illness
But mental health problems in children or adults, however we define them,
cannot be found by simple screening. Nobody can, by merely looking at
someone, or on the basis of a pen-and-pencil questionnaire, differentiate
the transient emotional disturbances we all have from those which may last
longer. Only when gross insanity exists can "mental illness" be recognized
on inspection - and here we don't need expert opinion.Time and trust are necessary for valid psychiatric diagnosis. Neither is
present in the proposed screening procedures. Indeed, the mere process of
seeking out mental illness, rather than relying on the troubled to seek help
for themselves, violates the privacy of those in whom these "illnesses" are
sought.If mental health care is to be ethical and effective, it must be voluntary.
Public awareness of the possible dangers of involuntary treatment is
responsible for the laws restricting it.Sending "experts" into class-rooms to seek out "mental illness" is therefore
questionable on its face. Indeed, such efforts to find "illness" can help
create it. The fear evoked by the search itself can cause psychiatric
symptoms. It has long been known how harshly interrogating disturbed
people about whether they hear voices increases the likelihood of their
saying - and then believing - that they had.The proposed screening process itself evokes memories of the Malleus
Maleficarum, the medieval witch-hunters' handbook, which was used to
determine from the spots on people's bodies which of them had compacted with
the Devil. And it was the late Dr. Karl Menninger, a past president of the
American Psychiatric Association, who compared the Association's huge
Diagnostic and Statistical Manual of Mental Disorders to the Malleus.Treating mental illness: how effective is psychiatric treatment today?
The purpose of seeking out the "mentally ill" is to get them into early
treatment. Medications are the heart of today's psychaitric treatment.
Although millions of children are already receiving cocaine-like drugs (such
as Ritalin) for sonditinos such as attention deficit and hyperactvity
disorder, and the public is becoming increasingly aware of the dangers of
these drugs, the new screenings will increase still further the number of
youngsters given medication. And recent events suggest that many will have
treatment forced upon them over their parents' objections.The proposed screening process is based on the assumption that psychiatric
treatment helps. But that is not necessarily the case. The mentally
disabled - the insane - were psychiatry's first patients. Over the past
fifty years, drugs have become the core of their treatment. Since their
introduction, the level of severe mental distress in the country has
quadrupled (as measured by what the government calls "patient care episodes"
per capita). Over the past 15 years, the number of people deemed disabled
by mental illness - those receiving either SSI or SSDI payments with mental
disorder as their category - has almost doubled, from 3.505 million to 5.77
million. In 1987, national psychotropic drug expenditure was $1 billion. By
2002, it was $23 billion - 23 times the amount spent 15 years earlier.It is also noteworthy that the treatment "model" recommended by the NFC is a
drug industry-sponsored guideline - the Texas Medication Algorithm Project
(TMAP). At a time when drug costs are bankrupting Medicaid budgets, the
TMAP relies on the newest, and for the most part, the most expensive drugs:
drugs which are admittedly little more efficacious than earlier ones, but
which have slightly fewer side effects.That's why the entire proposed program for screening youngsters for mental
illness, so they can then be treated with drugs, is a multilevel fallacy -
if not an outright fraud.
Posted by ron1953 on February 1, 2005, at 18:53:38
In reply to For those with children, posted by bruin on January 29, 2005, at 10:39:06
Pigeonholing children or anyone else with "mental health problems" is another form of bigotry, plain and simple.
Posted by Dinah on February 1, 2005, at 20:26:28
In reply to For those with children, posted by bruin on January 29, 2005, at 10:39:06
Hopefully it'll never happen.
As it is, drugs seem to be too often used to make life easier for parents and teachers. I know they're necessary and useful in some cases. And probably some grownups today wish the drugs had been available back then. But sometimes difficult kids are just difficult kids, and taking the time to help them would seem to be a better and more loving alternative than drugging them to be less difficult.
Posted by gardenergirl on February 1, 2005, at 23:45:07
In reply to Scary, posted by Dinah on February 1, 2005, at 20:26:28
It's my understanding that this concept came about initially as a recommendation from President Bush's New Freedom Commission on Mental Health. The issue was that mental disorders are being underdiagnosed across all ages, but children and the elderly were particularly overlooked. *One* of the recommendations to address this was to provide for some kind of screening in primary settings, such as schools and family doctor offices.
And then apparently some legislator got ahold of this idea and went a bit wild with it. APA has put out a statement (and I am working from a tired brain here, so I may be remembering it wrong or interpreting it wrong) that it does NOT support wide spread and mandatory screening without proper safeguards and properly trained screeners in place. In addition, they of course advocate for consent, confidentiality, and adequate treatment for those who truly need it.
gg
Posted by sunny10 on February 2, 2005, at 9:32:29
In reply to Re: Scary, posted by gardenergirl on February 1, 2005, at 23:45:07
my son was completely uncontrollable before being put on Ritalin (he's since switched to Adderall).
Teachers could not teach him; his complete inability to control his impulsiveness (even age-appropriately) got him thrown out of two DAYCARE centers before he even GOT to elementary school. He was a danger to himself and to others. He was known by name at the emergency room at the local hospital by the time he was four (and I live right outside of Philadelphia- NOT a small town where people remember names!)
Not ALL children are being pigeon-holed; some actually need it. And, frankly, if I had been diagnosed and treated myself, maybe I could have actually used school to make something out of myself instead of having a job paying about $100,000.00 less than my old classmates!
Just thought I'd offer a different opinion...
Posted by Dinah on February 2, 2005, at 12:05:14
In reply to Re: Scary, posted by sunny10 on February 2, 2005, at 9:32:29
I don't disagree. That's why I put in the caveat about children who really do benefit from the new drugs.
I just think that it is considered the answer to too many problems that probably have nonbiological components. Not that there are never biological components.
Posted by sunny10 on February 2, 2005, at 12:28:52
In reply to Re: Scary » sunny10, posted by Dinah on February 2, 2005, at 12:05:14
Sorry, I meant my diatribe to be against the original article- not my fellow babblemeisters' comments.....
Sorry if I offended anyone... whew, went off there for a minute, didn't I?!?
(obviously a favorite pet peeve of mine; I do believe that more kids are drugged than need it...but I'm really glad that my child wasn't one of the ones that fell through the cracks and his needs were noticed.)
This is the end of the thread.
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