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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: cajungirl

People of Eastern European bloodlines have a twenty times greater rate of mental illness than people with English ancestors.


61 posted on 07/04/2004 10:48:01 PM PDT by henderson field
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To: NewRomeTacitus

Actually, I don't think Hitler went that far.


62 posted on 07/04/2004 10:49:34 PM PDT by henderson field
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To: The_Media_never_lie

man, i thought we wuz all on prozac ALREADY!


63 posted on 07/04/2004 11:02:30 PM PDT by drhogan
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To: SkyRat

Hey, I'm happy living with my "undiagnosed" mental illness. People leave me alone and I like it that way.


64 posted on 07/04/2004 11:08:48 PM PDT by Calpublican
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To: Intolerant in NJ

they seem to be planning on using the schools for the initial screening. they can simply give the kids a brief questionnaire, and when kids score above a cut-off point, refer them to the school psychologist for further evaluation.
it wouldn't be hard to screen the entire school-aged population. they could also require all doctors to do the screenings. then they could spread out from there.
and most people in our country go thru the schools at some point in their lives.


65 posted on 07/04/2004 11:10:23 PM PDT by drhogan
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To: henderson field
People of Eastern European bloodlines have a twenty times greater rate of mental illness than people with English ancestors.

Is this true? It would explain a lot if it is.

66 posted on 07/04/2004 11:10:48 PM PDT by Calpublican
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To: drhogan

the schools in NY have been screening for vision and hearing problems for decades. preliminary screenings for mental illness wouldn't be that hard to do.


67 posted on 07/04/2004 11:11:44 PM PDT by drhogan
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To: henderson field

Hitler actually went further. He had the mentally ill steralized by the thousands.

It sure is Hitleresque tho


68 posted on 07/05/2004 6:52:49 AM PDT by aSkeptic (I am a computer chair critic, so please don't get too excited.)
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To: SkyRat

Think happy thoughts


69 posted on 07/05/2004 7:22:16 AM PDT by MissAmericanPie
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To: SkyRat

This stupid thing is back, AGAIN?


70 posted on 07/05/2004 7:41:41 AM PDT by JimRed (Fight election fraud! Volunteer as a local poll watcher, challenger or district official.)
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To: aSkeptic

Hitler actually went further. He had the mentally ill steralized by the thousands.

It sure is Hitleresque tho


For one thing, it's also happened here with the eugenics movement of the early 20th century. For another thing, as late as 1968, adoption agencies were removing newborns from single white mothers by claiming they were mentally ill, simply because they refused to sign termination of parental rights that would free their babies for adoption. The women were involuntarily committed, and then their parental rights were terminated by the courts. Some of women were given shock treatments, although there was nothing wrong with them, besides the fact they refused to part with their own babies. Some were threatened with involuntary sterilization, an atrocity regularly committed against female inpatients in mental hospitals until well into the 1970s. In each case, the newborns were adopted out to strangers aganst the mother's will, and in at least one of these cases that i am aware of, the male adoptor was a homosexual.

Many of these women suffered the fallout from this emotional torture for decades. Adoption agencies and social workers have yet to acknowledge, much less apologize, for this torture of American women on American soil in the 1960s.

It's happened here before, and it can happen here again, folks.


71 posted on 07/05/2004 3:55:26 PM PDT by ladysusan ("It was horrible, a monster...like, like, with the body of a crab and the head of a social worker")
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To: SkyRat

"Mental illness": a metaphorical disease.


72 posted on 07/05/2004 5:12:26 PM PDT by secretagent
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To: drhogan
First you'd have the problem of coming up with a reasonably valid paper-and-pencil screening instrument for children, especially a "brief" one - then you'd have the problem of the unreliability of giving a paper-and-pencil screening instrument to large numbers of kids (how would you know, for instance, if the kid scored badly because he/she was really messed up, or merely had an upset stomach when taking the test and failed to answer numerous questions, or maybe wasn't quite bright enough to know what all the questions really meant) - then you'd have the problem of getting enough doctors to provide further evaluation of all those failing the screen, including all the false positives - then you'd have to come up with treatment to provide to the pool of "disturbed" kids you ended up with (a major complaint I've heard about school psychologists is that they just want to evaluate, but provide little follow-up care to those referred to them). The whole idea seems impractical and fruitless to me.

Parenthetically perhaps, I have a niece who's going into her senior year of college on the way to medical school - she was telling me today that last year she took an observational internship at a hospital in Philly, following various physicians around to watch how they did their job - she said that every one of the docs who mentored her during this experience at one time or another told her specifically that she should reconsider and not go into medicine for a career (because of factors such as law suits, too much paperwork, government interference, and so forth) - it's possible that in a few years we won't have enough qualified physicians to treat the everyday medical problems we have, let alone take part in a grand scheme like this.....

73 posted on 07/05/2004 9:45:59 PM PDT by Intolerant in NJ
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To: L_Von_Mises
Spot on.

I agree with you. Goal 4 of this "New Freedom" Project is the most troubling part for me, too.
I'm following this story for quite some time now. I thought it was overblown at first. I hope it won't get implanted.

Thanks for your info on the EO, didn't know that. And could you explain what you mean with "Goals 2000"? I'm afraid I don't know what your are referring to.

BTW, you've got a good Nickname. The Mises.org site is one of my favorites.
74 posted on 07/06/2004 7:32:00 AM PDT by SkyRat (If privacy wasn't of value, we wouldn't have doors on bathrooms.)
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To: Intolerant in NJ

I think there is already a screening program in place. From the report:

Figure 4.2. Model Program: Screening Program for Youth

Program

Columbia University TeenScreen® Program

Goal

To ensure that all youth are offered a mental health check-up before graduating from high school. TeenScreen® identifies and refers for treatment those who are at risk for suicide or suffer from an untreated mental illness.

Features

All youngsters in a school, with parental consent, are given a computer-based questionnaire that screens them for mental illnesses and suicide risk. At no charge, the Columbia University TeenScreen® Program provides consultation, screening materials, software, training, and technical assistance to qualifying schools and communities. In return, TeenScreen® partners are expected to screen at least 200 youth per year and ensure that a licensed mental health professional is on-site to give immediate counseling and referral services for youth at greatest risk. The Columbia TeenScreen® Program is a not-for-profit organization funded solely by foundations. When the program identifies youth needing treatment, their care is paid for depending on the family's health coverage.

Outcomes

The computer-based questionnaire used by TeenScreen® is a valid and reliable screening instrument.151 The vast majority of youth identified through the program as having already made a suicide attempt, or at risk for depression or suicidal thinking, are not in treatment.152 A follow-up study found that screening in high school identified more than 60% of students who, four to six years later, continued to have long-term, recurrent problems with depression and suicidal attempts.153

Biggest challenge

To bridge the gap between schools and local providers of mental health services. Another challenge is to ensure, in times of fiscal austerity, that schools devote a health professional to screening and referral.

How other organizations can adopt

The Columbia University TeenScreen® Program is pilot-testing a shorter questionnaire, which will be less costly and time-consuming for the school to administer. It is also trying to adapt the program to primary care settings.

Website

www.teenscreen.org


75 posted on 07/06/2004 7:40:28 AM PDT by SkyRat (If privacy wasn't of value, we wouldn't have doors on bathrooms.)
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To: L_Von_Mises

Re: EO from April 2002
Executive Order 13263
President's New Freedom Commission on Mental Health

I found it at http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2002_register&docid=02-11166-filed.pdf

But I'm unable to download the actual document. Server seems to be down. However EO 13263 has been revoked by EO 13316
Continuance of Certain Federal Advisory Committees
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2002_register&docid=02-11166-filed.pdf

I can't download this either. Gonna try it again later.


76 posted on 07/06/2004 7:49:14 AM PDT by SkyRat (If privacy wasn't of value, we wouldn't have doors on bathrooms.)
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To: SkyRat
And could you explain what you mean with "Goals 2000"? I'm afraid I don't know what your are referring to.

First, let me preface by saying that "federal" funding has been eliminated for goals 2000. Anyway, where to begin? Goals 2000 was a 3 component program originally devised by Hillary Clinton and Ira Magaziner, among others that completely alters the way our education system works. It started out as a pilot program in Arkansas when Bill Clinton was governor. At the time he was president of the National Association of Governors. This gave him access to people in Washington that he mnight not otherwise have had. One of those people was Lamar Alexander, then Sec. of Ed. under Bush I.

Lamar Alexander signed onto the whole thing. Then when Clinton came into office he signed it into law. It was optional but states would not get any federal money at all (which they sent to Washington in the first place) unless they signed onto it and implemented it.

Anyway, it had three parts, outcome based education, parents as teachers, and school to work.

The outcome based education component basically dumbs down education. The really dangerous stuff was the "parents as teachers" part (which should read teachers as parents) and the "school to work" part. Parents as teachers was a way to identify "at-risk" kids. There was a list of questions or criteria that identified whether a child was "at-risk". It was either too much of this or too little of that. Unfortunately there was no "the right amount" category. They would either ask students a bunch of questions and then use their answers to fill out the questionaire or show up at the house and nose around and using their observations, fill in the questionaire.

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.

Tied to all this was a "certificate of mastery". You would not be able to get a job without this certificate and it would have your full permanent record tied to it.

Luckily, Goals 2000 was permanently defunded by the Federal Government in 2002, as part of the "No Child Left Behind Act". My only concern is how much of the mechanism that was put in place has been dismantled at the state and local level? And, how much of this new program is just a reincarnation of some of the more troubling parts of Goals 2000?

Here are some articles on it:
http://www.hslda.org/docs/nche/Issues/G/Goals2000.asp
http://www.wealth4freedom.com/truth/4/goals2000.htm
http://www.eagleforum.org/column/1997/feb97/97-02-19.html

77 posted on 07/06/2004 10:35:28 AM PDT by L_Von_Mises
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To: SkyRat

Is this going to be done before the presidential election in order to ban those deemed mentally ill from voting 'rat?


78 posted on 07/06/2004 10:45:56 AM PDT by reformed_dem (Two Johns don't make a right)
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To: Intolerant in NJ
First you'd have the problem of coming up with a reasonably valid paper-and-pencil screening instrument for children, especially a "brief" one - then you'd have the problem of the unreliability of giving a paper-and-pencil screening instrument to large numbers of kids

It depends whether the goal is to identify people who might have bona fide mental illnesses, or to identify people who might be politically dangerous. Even if there's no way a program like this could do the former even remotely effectively that wouldn't prevent its use for the latter.

79 posted on 07/06/2004 3:12:15 PM PDT by supercat (Why is it that the more "gun safety" laws are passed, the less safe my guns seem?)
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To: Intolerant in NJ

think about the vision and hearing tests. they do those in NY schools. remember, the government can decide whatever it wants. they could have "mental health technicians" do quick evaluations.
refer the kids to "psychiatric technicians" for medication. who needs doctors. the government is notorious for using whatever level of training it chooses to do what it wants accomplished.
remember, this is FOR THE CHILDREN!


80 posted on 07/06/2004 9:09:51 PM PDT by drhogan
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