Federal Mental Health Agency Responds to EdWatch

Federal Mental Health Agency Responds to
EdWatch and Other Groups
 
Federal Mental Health Action Agenda Discussed Progress on
parental consent, but more work to do

An e-letter produced
by
EdWatch, a nonprofit organization.

October 31, 2005

         EdWatch board members Dr. Karen Effrem and Julie
Quist attended a Washington DC meeting with the head of the federal agency
that will implement the Federal Mental Health Action Agenda. Mr. Charles
Currie, the administrator of the Substance Abuse and Mental Health
Services Administration (SAMHSA), met with representatives of
several national  groups to discuss the Federal Action Agenda, with some
individuals participating by conference call. The Federal Mental Health
Action Agenda is the federal agency’s response to recommendations made by
the New Freedom Commission (NFC) report on mental health.

        Many national groups
were present that have been prominent and outspoken critics of NFC
recommendations on mental health screening and psychiatric drugging,
beginning in early childhood. Besides EdWatch, groups in attendance were:
Eagle Forum, The Alliance for Human Research Protection (AHRP), The
International Center for the Study of Psychiatry and Psychology (ICSPP), The
Association of American Physicians and Surgeons (AAPS), The American
Psychoanalytic Association, and Mind Freedom. Michael Ostrolenk, EdWatch
Director of Government Affairs and founder of the Liberty Coalition,
organized the meeting.

Progress:
         EdWatch commends the Bush administration
for being willing to both hear concerns and face criticism, as well as for
progress made on several important issues. Although it remains to be seen
how Mr. Currie’s statements will be implemented, he stated the following key
points integral to this entire controversy:

        
* The critical importance of informed
parental consent was reinforced. 
The Action Agenda mentions parental consent numerous times compared to
the NFC report which only uses the phrase once in reference to TeenScreen,
which employs passive (opt-out) consent at come of its sites. Mr.
Currie unequivocally stated that parental consent must be fully informed,
active and opt-in.  He said in response to a question by Dominic Riccio of
ICSPP that consent must be “full knowledge” consent “with a parent’s
signature before screening,” and that “if screening should lead to step 2
[further evaluation and treatment], parental consent must be revisited.” 
EdWatch believes that the parental consent language of the Action Agenda,
although significantly improved over the NFC report, can and should be
strengthened to reflect those statements and that those statements should
translate into support for current legislation so that the emphasis on
parental consent does not end with this administration (see below).

         * Bush
Administration disavows TeenScreen.
Mr. Currie said, likely in response to the enormous amount of
criticism from many quarters and the pending TeenScreen federal lawsuit,
“You will notice that TeenScreen is not a model program nor is it or any
other screening program mentioned anywhere in the Federal Mental Health
Action Agenda.” This public admission is an incredible testament to
the informed and persistent work against this screening program by EdWatch,
Eagle Forum, AHRP and groups around the country.

TeenScreen uses vague, subjective questions based on unscientific diagnostic
criteria; is itself scientifically not valid; is used without evidence that
screening programs are safe or prevent suicide; employs passive consent
procedures; and results in high rates of false positives so that children
are over identified with mental disorders that can result in medication with
dangerous and ineffective psychiatric medication. Sadly, this assurance may
be more symbolism than substance.  Since this meeting, EdWatch and
AHRP have learned of a SAMSHA announcement that it will give $9.7 million in
grants to four states — Arizona, Nevada, New Mexico and New York — to
implement the TeenScreen mental health screening program (10/30/05
Disease Risk Factor Week)

         * Informed
parental consent will be emphasized in mental health grants. 

He also responded to a major concern raised by Dr. Effrem about the
priority given to parental consent in grants funded by SAMSHA, such as Safe
Schools, Healthy Students that inspired a grant from a Minnesota county
stating that “…TeenScreen will be administered to all county school
districts in the first year of this project to determine needs and
baselines,” never once mentioning parental consent for that or in the entire
133 page grant. 

Dr. Effrem wondered what, if any, information or emphasis on parental
consent is communicated by SAMSHA and other relevant federal agencies to
grant applicants.  Mr. Currie then promised to take that information
back to the agency and make sure that any requests for application for
grants involving children would emphasize parental consent.

         * Agency
backs away from pre-set medication prescriptions. 
The New Freedom Commission recommended using certain
pre-determined medical prescriptions for identified mental health diagnoses.
This is called an “algorithm,” and this plan for medicating mental health
came out of a program called the Texas Medication Algorithm Project, or TMAP,
for short. The pharmaceutical industry was involved in the recommendations
of TMAP, which included more expensive, more powerful,  and less-well-tested
medications.

Despite the expansion of Texas Medication Algorithm Project (TMAP) to about
twelve other states, the almost daily revelation of new studies shows a lack
of efficacy, and serious, even fatal, side effects of these drugs.
These developments seem to have caused SAMSHA to dissociate from the
algorithms. Mr. Currie said, “The Action Agenda does not support
medication algorithms,” and “Medication toolkits have been
removed from SAMSHA’s other public materials.”  In reference to

the CATIE trials, Mr. Currie also said, “Algorithms needed to be
revisited and revised on the basis of what science has taught us about these
drugs.” The lack of science and the dangers of these drugs have been
repeatedly pointed out by Dr. Effrem, AHRP, ICSPP and many other groups and
individuals around the country.

Concerns and Disappointments
While significant strides were made in the areas discussed above,
other issues were raised that were not well answered. These must be
revisited in order to ensure freedom of thought and conscience, parental
rights, and safety for American citizens. These issues include:

         ·        *
Closing Pandora’s box
Mr. Currie made the following statement during his presentation,
“The New Freedom Commission is not the official position
of the Bush administration.” 

This is nice to hear, but that statement has little practical
meaning. Congress appropriated

$20 million last year for the implementation of state mental health
transformation grants to implement the NFC recommendations, including
screening. The US House has passed $26 million for the same grants this
year. Unless funding is cut due to costs of hurricane damage, we will
definitely be seeing more state legislation and more state plans to do
screening.

The NFC recommendations for screening have trickled down to states such as

Illinois, Texas, and Minnesota. Proponents within each state used the

NFC recommendations to bolster their case in testimony, bill language,
or supporting documents. The Minnesota and Texas bills were thankfully
stopped by the informed testimony and grassroots work of EdWatch and Eagle
Forum, respectively, and by other state and national groups.  (See

here and

here.)  Concerned Women for America is fighting in Illinois. In how many
more states will this same battle need to be fought? 

Unless the federal government (SAMSHA) actually stops funding grants that
include screening and TMAP-style treatment, and unless the administration
puts out some sort of statement to the states that it does not recommend
either of these, Mr. Currie’s statement is just talk.

·         * Lack of position on
pending legislation
When asked by Dr. Effrem about support of pending federal
legislation (HR
181 – The Parental Consent Act by Rep. Ron Paul that prohibits coerced
screening and

HR 1790 – The Child Medication Safety Act by Rep. John Kline that
prohibits coerced psychiatric medication and that establishes in law the
very good statements in the Action Agenda about parental consent ) Mr.
Currie said that he couldn’t take any position on legislation. This is very
disappointing, given that Joe Faha, SAMSHA’s Congressional liaison, issued a
position statement on the Paul amendment to the Fiscal Year 2006 Labor/ HHS/Education
Appropriations bill that would have denied funding for screening that did
not require active, informed voluntary parental consent. The position
statement Faha issued distorted the intent of the Paul amendment and
contributed to its defeat. The statement was

quoted on the TeenScreen website. 

·         * Nanny State Initiatives
in the Action Agenda
The length and structure of the meeting precluded discussing many
other issues that are of concern to EdWatch. For example, we were not able
to discuss the merging of mental health and early childhood education. The
Action Agenda contains plans to fund grants that are “designed to develop
mental health promotion and early intervention services targeted to
infants…”  This is intervention in the lives of children even younger than
the preschoolers mentioned in the New Freedom Commission report.

Dr. David Willis, Medical Director of the Northwest Early Childhood
Institute, a key opinion leader, stated that, “Psychopharmacology is on the
horizon as preventive therapy for children with genetic
susceptibility to mental health problems.”  Psychiatric experts admit that
it is very hard to accurately diagnose young children, and that there is no
safety or efficacy established for treating these babies with powerful
psychotropic drugs. (See

Dr. Effrem’s testimony before Congress and her article,

“Myths and Facts Regarding Mental Health Screening Programs.”)

Most disturbing, the Action Agenda says, “HHS [Department of Health and
Human Services] and ED [Education Department] have launched a 5-year
research effort to find the best ways to prepare preschool children for
later success in school.”  This effort is to include preschool curricula,
teacher training, and parental involvement. None of these are the federal
government’s constitutional purview. Federal involvement in developing and
promoting curriculum in K-12 have led to the expansion of vague,
non-academic social and emotional standards from preschool to high school.
Even if the federal government had constitutional authority to do any of
this, no state or national preschool program, after forty years of trying,
has proven long-term academic or social benefit, for even poor at-risk
children. This is a greater concern for children who are not at risk, for
whom experts say early formal education is unnecessary and harmful to their
development.

Positive Actions Congress could take:
1) Cutting the State Incentive Transformation Grants and any funding for
Federal Mental Health Action Agenda as part of offsetting domestic spending
to pay for hurricane relief.
 
2) Passage of HR 181 (e-action alert link), The Parental Consent Act and HR
1790 (e-action alert link), the Child Medication Safety Act.  
 
What you can do:
1)  Become familiar with these issues and discuss them with your U.S.
House or Senate members.

2) Purchase a Mental Health Briefing book for evidence to help understand
these issues and to discuss them with your members of Congress.

3) Support the work of EdWatch.
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