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November 1, 2005
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

         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.

         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 parents 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 SAMSHAs 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, SAMSHAs 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 governments 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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