EDUCATION FOR A FREE NATION
105 Peavey Rd, Suite 116, Chaska, MN 55318
SF 2841 - Preschool Socioemotional Screening
Thank you Mr. Chairman and members of the Committee. My name is Dr.
Karen Effrem. I am a mother of three wonderful children, a
pediatrician, and a policy analyst that serves on the boards of several
national organizations, including EdWatch, the Alliance for Human
Research Protection, and the International Center for the Study of
Psychiatry and Psychology. I am here in vigorous opposition to SF
2841 that would implement mental health screening for three-year-old
children entering public school.
Minnesota Senate Early Childhood Finance
March 9, 2006
Karen R. Effrem, MD
EdWatch Board of Directors
Alliance for Human Research Protection Board of Directors
ICSPP Board of Directors
Government sponsored and controlled universal mental health screening, no
matter how sweetly wrapped in the fig leaf of parental consent, should
never, ever be implemented. It is never, EVER, the proper role of
government to set norms for, assess or intervene in the thoughts and
emotions of free citizens, much less innocent, vulnerable, and still
developing children. It is our thoughts and emotions that make each
of us uniquely and individually human, and we use these thoughts and
emotions to understand the world and maintain our inalienable right to
We are all well aware that the parental consent or opt-out language
referred to for this bill is just a way to assuage concerns long enough
to put this dangerous system into place. Once it is passed with
parental consent, that language will either be changed by future
legislators, not enforced, or side stepped in some other way. The
non-existent enforcement of the federal Protection of Pupil Rights
Amendment on invasive surveys is a classic example of this phenomenon.
Another is the lack of parental notification of their rights in current
Minnesota statute 121A.17 to decline to answer the part of the screening
that involves invasive and subjective assessment of family risk factors,
or that parents may have their childs screening administered by private
providers, or that no preschool screening is required if it is against
the conscientiously held beliefs of the parents.
SF 2841 is proposed as part of the Roadmap for Mental Health System
Transformation in Minnesota, which is an outgrowth of the federal New
Freedom Commission report and the federal Mental Health Action Agenda.
The Minnesota Roadmap clearly states what that plan is for young
children. It proposes to, integrate early childhood screening
systems to assure that all children ages birth to five are screened early
and continuously for the presence of health, socioemotional or
developmental needs and then to implement, among other things, mental
health services and early care and education.
Members of the New Freedom Commission as well as groups advocating the
Minnesota Roadmap plan have inherent financial, professional, and policy
conflicts of interest and do not mention any scientific or medical
problems with screening or treatment. For example, Michael Hogan,
the chairman of the New Freedom Commission, was paid by the Janssen
Pharmaceutica, the manufacturer of one of the drugs advocated in the
model psychiatric drug treatment program (TMAP) in the commissions
report. The National Alliance for the Mentally Ill and the National
Mental Health Association, both supporters, of this legislation and the
Minnesota Roadmap received tax dollars from the federal mental health
agency, SAMHSA, to help implement the New Freedom Commissions
recommendations, including universal screening and TMAP.
Even if mental health screening did not have these fatal policy and
philosophical flaws, the medical and scientific justification for this
idea is equally lacking. Proponents tell us that mental illnesses
are biological brain disorders due to chemical imbalances of
neurotransmitters, and that mental health screening is therefore
scientific and objective and fully equivalent to hearing or blood
pressure screening. They also tell us that children who screen
positive will merely be sent for further evaluation, that screening does
not yield a diagnosis, and that services do not necessarily mean
drugs. Here is but a small sample of facts and statements from
experts and the medical literature that contradict that view:
In summary, universal mental health screening and treatment for
preschool aged children is far beyond the proper role of government,
lacks scientific and medical justification and will have dangerous
effects on our youngest citizens. The premier dictum of medicine is
First, do no harm. Both the psychiatric profession and policymakers
would do well to heed that advice.
- Not a single peer reviewed study exists to support the theory of a
neurotransmitter (chemical) imbalance as the cause of mental illness or
the means of treatment.
- There are no structural, functional, or laboratory tests or chemical
markers that can consistently identify any of the mental illnesses.
- Experts like the US Surgeon General, the World Health Organization,
the chief of child psychiatry at the National Institutes of Mental
Health, psychiatric textbook authors, and the authors of psychiatrys
Diagnostic and Statistical manual, considered the gold standard of
psychiatric diagnosis, call these criteria subjective,
impressionistic and social constructions.
- These same experts also state that it is very difficult to accurately
diagnose children due to rapid developmental changes.
- The screening instruments are based on these highly subjective
diagnostic criteria and are not at all like medical screening tests, such
as for hearing or vision.
- In fact, the technical data for the Ages and Stages questionnaire
being promoted for this legislation admits that its overall positive
predictive value is only 27%. That means that for every 27
children that are supposedly correctly identified by the admittedly
subjective DSM or other impressionistic screening instruments, 73 are
falsely told that something is wrong with them and referred for further
evaluation. That is three times the rate of false positives to
putative true positives and worse than a coin flip. Any other screening
procedure with that large a false positive rate would be eliminated from
consideration with hysterical laughter.
- A movement already exists within organized psychiatry to label and
drug people mentally ill based on highly controversial political and
religious criteria, such as intolerance.
- Due to reimbursement patterns, government promotion, and
pharmaceutical industry influence, treatment almost always means use of
- According to a survey of members of the American Academy of Child and
Adolescent Psychiatry, 9 out of 10 children that see a psychiatrist
receive a prescription for psychoactive drugs.
- Dr. David Willis, medical director of the Northwest Early Childhood
Center said, Psychopharmacology is on the horizon as preventive therapy
for children with genetic susceptibility to mental health
- Rates of psychotropic drug use in children, often in unapproved,
unstudied multi-drug cocktails, as young as age two, have already
skyrocketed and will only increase with widespread mental health
screening. Psychiatric drugging coerced by schools has resulted in
several deaths and has prompted at least 7 states and the US House of
Representatives to pass legislation against it.
- No psychiatric drug has been found to be effective in the long term
for treating ADHD or depression in children.
- Every class of psychotropic drug is either under the FDAs most
stringent black box warning short of a ban for serious or fatal side
effects or is being so considered. These side effects include
suicide, violence, psychosis, diabetes, and cardiac sudden death. There
are no studies available of longterm safety or effectiveness or the
effects on the brains and bodies of growing children.
- Government and pharmaceutical industry promoted drug regimens are
rapidly depleting Medicaid budgets.
- Even if psychosocial or educational programs were used instead of
medications, Dr. Benedetto Vitiello, head of child psychiatry at NIMH
said in 2002, Little research has been conducted to study the
effectiveness of psychosocial interventions in young children, and the
long-term risk-benefit ratio of psychosocial and pharmacologic treatments
is basically unknown.
- In November of 2005, researchers at the University of California and
Stanford released a study that said, Attendance in preschool centers,
even for short periods of time each week, hinders the rate at which young
children develop social skills and display the motivation to engage
classroom tasks, as reported by their kindergarten teachers...Our
findings are consistent with the negative effect of non-parental care on
the single dimension of social development first detected by the NICHD
research team [in 2002] This data is suggesting that not only is
there no scientific justification for psychosocial interventions
including preschool education, but that these interventions may be
causing some of the very problems that supposedly justify screening and
that they are purported to treat.
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