Drugging Our Poor

Many public schools have begun incorporating mental health screening tests into their curriculum, and may soon be analyzing family circumstances as a factor influencing low school performance under the No Child Left Behind requirements (NCLB). The proposed We Care Act (H.R. 3762) would amend the NCLB Act to stipulate that “Each State plan shall include an assessment of the nonacademic factors influencing student achievement, a description of public and private organizations and agencies within the State that are working to impact… including but not limited to state departments….and nonprofit youth development and community-based organizations and other entities as appropriate…” Dr. Karen Effrem, an International Center for the Study of Psychiatry and Psychology (ICSPP) and EdWatch board member, announced at the ICSPP 2007 Conference congressional meeting that she worries this legislative language will increase government investigation into families’ private lives, arguing that “this is the kind of vague, subjective, intrusive kind of activity that the federal government absolutely should not be doing.” However, such language would also allow school officials to examine the effect of learning disabilities, ADHD, and divorces on student performance.

TeenScreen, a suicide prevention program for 9-18 year olds, works closely with middle and high school professionals to administer either the Columbia Health Screen (CHS) or The Diagnostic Predictive Scales (DPS), and then encourages parents of positively-diagnosed candidates to contact a mental health professional for treatment. TeenScreen is active in 43 of the 50 states, and operates in 450 locations nationwide. A combination of factors, including TeenScreen’s earlier reliance on passive parental consent, the program’s high rate of false positives, and concerns about privacy invasion have caused many groups to publicly denounce its policies.

However, TeenScreen advocates, psychiatrists, and other professionals view psychological testing as an important healthcare component, and argue that public screening services largely benefit society. In response to what it sees as defamation campaigns, TeenScreen defends its success as “being used by some to advance their own anti-mental health agendas.” “For example,” the website adds, “some organizations that have strong feelings against mental health programs persist in claiming that the program is funded by drug companies or is trying to encourage anti-depressant use. Both of these assertions are untrue.” The New Freedom Commission on Mental Health, established by President Bush in 2002, considers the purpose of mental healthcare to “to attain each individual’s maximum level of employment, self-care, interpersonal relationships, and community participation.” In other words, mental services are meant to empower individuals to achieve maximum success in all areas of life, thereby enhancing the common good.

The increasing correlation between psychiatric visits and medicated therapy may call into question whether mental screening actually benefits the public. In 2002, the Journal of the American Academy Child & Adolescent Psychiatry (JAACAP) reported that 9 of 10 children referred to a psychiatrist received psychotropic medications as part of their treatment. Dr. Peter Breggin, psychiatrist and founder of ICSPP, asserted that psychotropic drugs are insufficient treatment because they “deaden the person’s response to life. That is not dealing with psychosis. Psychosis has to do with a very complex way of thinking.”

Antidepressants, ADHD amphetamine-based medication, and Selective Serotin Inhibitors (SSRIs) may produce serious side effects, such as cardiac arrhythmia, suicidal behavior, neurological damage, and sudden death, according to the ICSPP, a group dedicated to evaluating “the impact of mental health theories on public policy” and the dangers of specific psychiatric policies. ICSPP leaders argue that the risks of psychotropic drugs outweigh their benefits, especially after an Oregon Drug Effectiveness Review of 2,287 studies found no evidence of long-term effectiveness of ADHD drugs. In 2004, an internal Food and Drug Administration report revealed an association between antidepressants and suicidal behavior.

Even more seriously, increased usage of psychotropic drugs by publicly-subsidized individuals has the potential to greatly expand America’s fiscal burden. The Government Accountability Office predicts that the combined costs of Medicare, Medicaid, and Social Security will exceed 20% of U.S. GDP by 2020. The GAO reports that Medicaid and Medicare have rapidly doubled their proportion of government expenditures in the last 20 years, growing from 10% of federal expenditures in 1986 to 19% of federal spending in 2006.

The use of psychotropic drugs to treat mental disorders such as attention deficit hyperactive disorder (ADHD), bipolar syndrome, and depression have increased dramatically over the last half century, and new public policies which increase mental health screening for infants and children will likely further boost sales of psychotropic medications. ADHD diagnoses increased at an annual rate of 9.5% for children and 15.3% for adults, according to the 2007 Medco Drug Trend Report.

Foster children, minorities, and incarcerated prisoners are most likely to be prescribed psychotropic drugs. In 2004, Texas Comptroller Carole Keeton Strayhorn found that 60% of Texas foster-care participants were receiving antipsychotic drugs. Texas is the originator of the Texas Medication Algorithm Project (TMAP), which links mental illnesses with specific medications. According to the ICSPP, nearly 2/3 of Massachusetts foster children and 55% of Florida foster children take psychiatric drugs beginning as early as 3 years old.

There is a disproportionate concentration of psychotropic drug use among African-American males, with a New York study reporting that African-American boys are 11 times more likely to be placed on mind-altering drugs. In 2003, the National Association for the Advancement of Colored People (NAACP) responded to the study’s findings with an action alert asserting that “In some cases these psychiatric prescription drugs are prescribed for what are essentially problems of discipline that may be related to lack of academic challenges or success.”

Bethany Stotts is a Staff Writer at Accuracy in Academia.