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Education Reporter

Mental Health Screening
National Plan Moves Ahead
More Drugging of Children Likely
Rep. Ron Paul
Rep. Ron Paul
A federal plan to subject all children to mental health screening in school and during routine physical exams moved forward in 2004 with Congress's appropriation of $20 million to fund recommendations of the New Freedom Commission on Mental Health created by President George W. Bush in 2002.

The commission recommends "routine and comprehensive" mental health screening and testing for every child in America, including preschoolers. It proposes utilizing electronic medical records for mental health data which would be integrated with electronic health records. Schools are in a "key position" to screen the 52 million students and 6 million adults who work in schools.

The commission further recommends "linkage" of mental health examinations with "state-of-the-art treatments" using "specific medications for specific conditions." Such medications would include antidepressants and anti-psychotic drugs.

Parental consent language in the 2004 bill was deleted by the Senate last year. As a result, Rep. Ron Paul (R-TX) has introduced a bill in the new Congress to forbid federal funds from being used for any universal or mandatory mental-health screening of students without the express, written, voluntary informed consent of their parents.

Congress's reauthorization of the Individuals with Disabilities Education Act in 2004 included language sponsored by Rep. Max Burns (R-GA) forbidding drug coercion of children as a condition of attending public schools. However, this law protects only special-needs children and covers only psycho-stimulants (such as Ritalin), not antidepressants or anti-psychotic drugs. Critics of drugging in schools are calling for a federal law prohibiting coerced drugging with any psycho-active medicine of any children in government schools.

TeenScreen flags 1/3 of students 
The New Freedom Commission has touted a Columbia University-based program called TeenScreen as a national model for mental health screening. Reaching 43,000 young people at nearly 170 sites in 36 states, the program screens 9th- and 10th-graders for risk of suicide, anxiety disorders, depression, and drug and alcohol disorders.

Questions asked in the screening cast a very wide net. It is hard to imagine any teenager who would not answer some of the questions in the affirmative. (Sample questions.)

TeenScreen officials say that generally up to one-third of the students who undergo screening show some signs of mental health problems, and about half of those are referred to mental health services — for a total of about 15% of the students screened. Parental consent is currently required for the screening questionnaire.

Sites have flexibility in who administers and scores the questionnaire. Often the test is conducted by a school psychologist, guidance counselor, social worker or college psychology student. Students whose scores raise red flags meet with a mental health professional - often a volunteer - and parents are notified.

The Alliance for Human Research Protection argues that screening "for hidden mental illnesses — as if mental illness needs to be ferreted out and captured like a rabid animal" — can open the door to discrimination and forced treatment. (The Brown University Child and Adolescent Behavior Letter, 8-1-04)

Texas Medication project under fire 
Another program lauded by the New Freedom Commission, the Texas Medication Algorithm Project, drew criticism when a Pennsylvania government employee revealed that state officials had received money and perks from drug companies who stand to gain from it.

In his whistleblower report, Allen Jones of the Pennsylvania Office of the Inspector General states that the "political/pharmaceutical alliance" that developed the Texas project - which promotes the use of newer, more expensive antidepressants and anti-psychotic drugs - was behind the recommendations of the New Freedom Commission. Those recommendations represent an effort to develop a "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," he asserts.

Moreover, Jones cites ties between members of the New Freedom Commission and the Texas project or companies that helped start it, as well as ties between manufacturers of drugs recommended in the plan and the Bush family, campaign or administration.

Antidepressants carry new warning 
While the New Freedom Commission appears poised to promote the use of antidepressants through schools, the Food and Drug Administration in late 2004 responded to mounting pressure to warn against risks associated with antidepressants given to minors. In October, the FDA ordered that all antidepressants carry warnings that they "increase the risk of suicidal thinking and behavior" in children who take them. The FDA's action, which followed a recommendation of its advisory panel, was driven by data showing that on average 2% to 3% of children taking antidepressants have increased suicidal thoughts.

The FDA decision came some ten months after regulators in the United Kingdom declared most antidepressants unsuitable for children under 18. (See Education Reporter, Feb. and June 2004 for a history of regulatory action on this issue.) It is unclear what, if any, effect the FDA decision will have on the New Freedom Commission's stated desire to increase the availability of antidepressants to schoolchildren.

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