Nationwide Mental Health Screening Proposed
The first BMJ article focused on the Texas Medication Algorithm Project (TMAP)--which
was developed by University of Texas psychiatrists, paid for by Big Pharma,
and adopted during the Bush governorship. See:Whistleblower removed from
job for talking to the press by Jeanne Lenzer
BMJ 2004;328:1153 (15 May), doi:10.1136/bmj.328.7449.1153
http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7449/1153
The documents uncovered by Jones show that TMAP is the biggest
pharmaceutical / state mental health marketing rip off scheme masquerading
as "evidence-based" treatment guidelines. (See Allen Jones report:
http://psychrights.org/Drugs/AllenJonesTMAPJanuary20.pdf
The current BMJ article focuses on documents that expose an even more
ambitious "mental health" initiative--a nationwide screening for "mental
illness" campaign that is about to be unleashed on the American public in
July. This dubious, government sponsored initiative, will implement the
TMAP formula nationally. The first target population for this massive
screening for mental illness initiative is in America's schools: 52 million
American school children and 6 million school personnel are about to be
ordered to undergo screening tests for hidden mental illnesses--as if mental
illness needs to be ferreted out and captured like a rabid animal.
This massive screening initiative was formulated by President Bush's New
Freedom Commission on Mental Health (2002). It is the culmination of a
series of dubious federally sponsored, "mental health" initiatives--begun
during the Clinton Administration--that focus especially on children. See:
U.S. Surgeon General. Report of the Surgeon General's Conference on
Children's Mental Health: National Action Agenda. January 3, 2001.
http://www.surgeongeneral.gov/cmh/childreport.htm.
These "mental health" initiatives have methodically inflated the number of
American children (and adults) being labeled with a mental illness; they
have inflated the number of dependents with "mental illness" on social
security disability (SSDI & SSI); and they have led to the depletion of
public and private health insurance budgets because of disproportionate
skyrocketing expenditure for the most expensive psychotropic drugs--even as
scientific evidence is lacking to demonstrate the benefit of these drugs.
Robert Whitaker, author of the prize winning book, Mad in America, that laid
bare the mistreatment of patients with schizophrenia, and the unprecedented
profitable marketing of the atypical anti-psychotic drugs, has recently
gathered the following data from government sources about the extraordinary
increase in use of these drugs and the cost to taxpayers. He chose 1987 as
the benchmark date because the following year Prozac-the first of the new
generation of "wonder drugs"--was introduced.
Social Security Disability Payments (SSDI)
In 1987, 875,000 people received SSDI payments because of mental illness.
By 2002, that number had grown to 1.7 million people who received SSDI
because of mental illness. That an increase of 825,000 people over 15 years,
or about 55,000 people per year.
SSI -- PAYMENTS
In 1987, 2.63 million people received SSI payments because of a mental
disorder.
In 2002, 4.07 million received SSI because they had a diagnosable mental
disorder.
Thus, the number of people with a mental disorder receiving SSI grew 1.44
million people over this 15-year period, or about 95,000 people per year.
TOTAL DISABILITY.
In 1987 the number of people receiving SSI or SSDI payments because of
mental disorders was 3.505 million.
In 2002, the number receiving SSI or SSDI payments was 5.77 million.
That's an increase of 2.265 million people in the past 15 years, or about
150,000 people per year.
$$ EXPENDITURE
In 1987, psychotropic drug expenditure was $1 billion.
By 2002, it was $23 billion--23 times the amount spent 15 years earlier.
Screening for mental illness serves no useful medical or societal purpose
inasmuch as there are no reliable diagnostic tools for mental illness, and
no proven safe and effective treatments. Clinical trial data from SSRI
antidepressants and so-called atypical anti-psychotics failed to demonstrate
either these drugs' safety or a benefit greater than placebo. But, as Allen
Jones' documents make clear, the TMAP practice guidelines designate these
very drugs as the treatment of choice--not on the basis of evidence, but on
the basis of a consensus panel. A panel under the direct influence of Big
Pharma.
Indeed, as the BMJ reports, “Dr Peter J Weiden, who was a member of the [TMAP]
project's expert consensus panel, charges that the guidelines are based on
"opinions, not data" and that bias due to funding sources undermines the
credibility of the guidelines since "most of the guideline's authors have
received support from the pharmaceutical industry." ( BMJ 2004;328:1153 )
COERCIVE NATURE OF SCREENING FOR MENTAL ILLNESS:
If implemented, this "new freedom" initiative establishes a coercive
selection policy that opens the door to discrimination and forced treatment
with powerful, psychotropic drugs that have caused more harm to children
(and adults) than the conditions for which they were prescribed. Children
and adults who will be labeled mentally ill on the basis of unreliable,
subjective tests (essentially questionnaires), can expect to lose their
autonomy as a brigade of mental health providers intrudes on their lives and
takes over their decision-making authority. Those labeled mentally ill can
expect to be stripped of their civil and human rights.
Already, a surgically implanted psychotropic drug dispenser--to assure compliance with prescribed drug regimens--is under development in clinical trials at the University of Pennsylvania. See: http://www.ahrp.org/infomail/03/10/07.html and ethics debate at: http://www.ahrp.org/ethical/WolpeSharav.html
We don't have policies to screen innocent people for crimes they have not committed on the theory that early intervention is a justifiable crime prevention measure. We don't have screening policies to ferret out would-be terrorists. What possible justification does the government have to put children through a dubious screening process for suspected mental illness?
This involuntary, pseudo-medical government sponsored selection policy is a chilling example of the illegitimate intrusion by government into personal, and confidential healthcare decisions.
The public needs to be ever vigilant against such overreaching government policies which have historically proven harmful. Being labeled "mentally ill" and being forced to ingest psychotropic drugs whose harmful effects are only beginning to be disclosed--is not in the best interest of children.
An examination of Germany's mental and racial "hygiene" policies and the implementation of those policies, before the Holocaust, is a sobering awakening. German children were screened and tested for disabilities ("deformities"), then removed from their families, institutionalized, and eventually gassed by Nazi doctors--many of whom were prominent psychiatrists.
See, Hitler's Unwanted
Children: Children with Disabilities, Orphans, Juvenile Delinquents and
Non-Conformist Young People In Nazi Germany (1998), by AHRP board member,
Dr. Sally Rogow.
http://www.nizkor.org/ftp.cgi/people/r/rogow.sally/hitlers-unwanted-children
Contact: Vera Hassner Sharav
Tel: 212-595-8974
e-mail: veracare@ahrp.org
~~~~~~~~~
http://bmj.bmjjournals.com/cgi/content/full/328/7454/1458
Bush Plans to Screen Whole US Population for Mental Illness
by Jeanne Lenzer -
BMJ 2004;328:1458 (19 June)
A sweeping mental health initiative will be unveiled by President eorge 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 <http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7449/1153>
). 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, {far cheaper} "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 W. Bush, seen here campaigning in Florida, than to that
of his rival John Kerry]
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,
www.madinamerica.com 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."
Rapid Responses:
Read all Rapid Responses
<http://bmj.bmjjournals.com/cgi/eletters/328/7454/1458>
Other related articles in BMJ:
http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7449/1153
BMJ 2004;328:1153 (15 May), doi:10.1136/bmj.328.7449.1153
Whistleblower removed from job for talking to the press by Jeanne Lenzer
New York A whistleblower who uncovered evidence that major drug companies
sought to influence government officials has been removed from his job and
placed on administrative leave. Allen Jones, an investigator at the
Pennsylvania Office of the Inspector General (OIG), was escorted out of his
workplace on 28 April and told "not to appear on OIG property" after OIG
officials accused him of talking to the press. Reports of Mr Jones's
findings were widely reported in the New York Times, BMJ (7 February, p
306), and elsewhere. His findings showed that the pharmaceutical company
Janssen had paid honorariums to key state officials who held influence over
the drugs prescribed in state-run prisons and mental hospitals.
Mr Jones filed a suit on 7 May against his supervisors charging that the
OIG's policy of barring employees from talking to the media was
"unconstitutional." Mr Jones claims, in the complaint filed in the Middle
District Court of Pennsylvania, that he is being harassed by his superiors
and Pennsylvania governmental institutions in order to "coverup, discourage,
and limit any investigations or oversight into the corrupt practices of
large drug companies and corrupt public officials who have acted with them."
Mr Jones had been earlier removed as lead investigator on the case after
being told by a manager that "drug companies write cheques to politicians on
both sides of the aisle."
In July 2002 Mr Jones was appointed lead investigator when he uncovered
evidence of payments into an off-the-books account. The account, earmarked
for "educational grants" was funded in large part by Pfizer and Janssen
Pharmaceuticals. Payments were made from the account to state employees who
developed formulary guidelines recommending expensive new drugs over older,
cheaper drugs with proved track records.
One of the recommended drugs was Janssen's antipsychotic medicine
risperidone (Risperdal)—a drug that has recently been found to have
potentially lethal side effects. The Food and Drug Administration issued a
warning letter to Janssen on 27 April saying that Janssen's "Dear Healthcare
Provider" letter about risperidone was "false or misleading" because it
failed to disclose or minimised risks of the drug relating to "serious
adverse events including ketoacidosis, hyperosmolar coma, and death."
Don Bailey, Mr Jones's attorney, said the case is a critical test of the
right to a free press. "If they shut the employee up and they have all the
documents locked up in a drawer there is no free press," he said.
Amy Wasserleben, spokeswoman for the OIG, said they would not comment on Mr
Jones or the corruption allegations. When asked about the status of the
corruption investigation she refused to answer. In response to a question
about whether the state OIG could withhold information of public interest,
she said, "The OIG is specifically exempt from right-to-know laws."
The Pennsylvania formulary is based on the Texas Medication Algorithm
Project that has been exported to about 12 states and was recently commended
as a model programme by President Bush's New Freedom Commission. However, Dr
Peter J Weiden, who was a member of the project's expert consensus panel,
charges that the guidelines are based on "opinions, not data" and that bias
due to funding sources undermines the credibility of the guidelines since
"most of the guideline's authors have received support from the
pharmaceutical industry."
Read all Rapid Responses
http://bmj.bmjjournals.com/cgi/eletters/328/7449/1153#59544
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