Forum: Bush's Brave New World

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President Bush's little-publicized New Freedom Commission on Mental Health has proposed comprehensive mental-illness screening for all Americans. If this proposal is carried out, as Mr. Bush's intends, no adult or child will be safe from intrusive probing by "experts," backed by drug companies, who believe mental illness is woefully underdiagnosed and many millions of people should be taking powerful and expensive psychiatric drugs. Schools and doctors' offices will become quasi-psychiatric monitoring stations.

Rep. Ron Paul, Texas Republican, tried to forbid the federal funding of mental-health screening, but the House turned down his amendment to the appropriations bill for the Department of Health and Human Services. Mr. Paul, a physician, said the program usurps parental rights, noting parents can already be charged with child abuse for refusing to give their children Ritalin for alleged attention deficit hyperactivity disorder. He said, "Psychotropic drugs are increasingly prescribed for children who show nothing more than children's typical rambunctious behavior. Many children have suffered harmful effects from these drugs."

Dr. Karen Effrem also opposes the plan: "Universal mental-health screening and the drugging of children, as recommended by the New Freedom Commission, needs to be stopped so that many thousands if not millions of children will be saved from receiving stigmatizing diagnoses that would follow them for the rest of their lives. America's schoolchildren should not be medicated by expensive, ineffective and dangerous medications based on vague and dubious diagnoses."

People wrongly assume psychiatric diagnoses are like medical diagnoses. They're not. Medical diagnoses are ultimately based on objective biological evidence. Psychiatric diagnoses, as retired psychiatry professor Thomas Szasz shows, are based on what people say and do. This means such diagnoses are moral and political, not medical, judgments. It begs the question to say brain science is still in its infancy: Why is one kind of behavior interpreted as a sign of mental or brain disease but not another kind? Besides, Dr. Szasz writes, behavior has reasons, not causes. That principle is at the very core of what we mean by personhood. (Brain-scan technology cannot refute this principle because it does not identify causes of behavior. Correlation is not causation.)

Thus the New Freedom Commission recommendation that everyone be screened for mental illness whenever he goes to the doctor and that children be monitored for mental illness in government schools is simply a plan to stigmatize people for "inappropriate" behavior and speech. It is also a plan for the widespread drugging of adults and children under government supervision. Besides the Huxleyian aspects of this idea, there is also reason to fear the improper influence of drug companies.

Allen Jones, formerly of the Pennsylvania Inspector General's Office, revealed a similar program was started in his state after drug companies curried favor with state officials. The British Medical Journal reported: "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 ... Risperdal -- a drug that has recently been found to have potentially lethal side effects."

In a statement last January, Mr. Jones said: "The industry was influencing state officials with trips, perks, lavish meals, transportation to and first-class accommodations in major cities. Some state employees were paid honorariums of up to $2,000 for speaking in their official capacities at drug-company-sponsored events."

Mr. Jones was relieved of his duties after blowing the whistle. In court papers challenging the state's move, he said the government was trying to "cover up, discourage and limit any investigations or oversight into the corrupt practices of large drug companies and corrupt public officials who have acted with them."

The New Freedom Mental Health Commission has received little publicity. One hopes, as Americans learn about its ominous proposal for wholesale mental-illness screening and psychiatric drugging of adults and children, they will vehemently object.

SHELDON RICHMAN

Senior fellow, The Future of Freedom Foundation (www.fff.org) in Fairfax, Va.