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March 13, 2006
Mental health
screening bill "ethically challenged"
Hottinger covertly adds mental health into
SF2841
Calling
the Minnesota Senate's preschool mental health screening bill
"ethically challenged," EdWatch President Renee Doyle charged
its author, Senator Hottinger (DFL-St. Peter), with trying to mislead the
public. Doyle was responding to the passage of SF2841 out of the Senate
Early Childhood Committee last Thursday.
"He
describes his bill as Expanding screening to include
socioemotional development screening," Doyle stated.
"Sometime between Wednesday afternoon and Thursday afternoon, the
Senator decided that, rather than support his own bill to add mental
health screening into preschool developmental screening, he would deceive
the public into thinking that mental health screening has been there all
along and bypass the whole public debate."
SF2841 was
first introduced in the Senate March 8th with clear language
expanding preschool screening to include "socioemotional development
screening." A new version of that bill appeared at the next day's
hearing, however, with all references to adding socioemotional screening
removed -- instead stating only the following:
- "The social/emotional component of the developmental
assessment must be completed using a social/emotional screening
instrument approved by the commissioner of education, and consistent with
the standards of the commissioners of heath and human services."
The
changed SF2841 passed with four Senators voting yes. Two members opposed
it -- Sens. Wergin (R-Princeton) and Nienow (R-Cambridge).
"It's
a outrage," Doyle continued, "to use a slick political move
that circumvents the entire process in order to insert government into a
place that is clearly not its business -- the minds of our youngest
children. Not a single reference to 'social/emotional' exists anywhere in
state law. Those four Senators are apparently willing to deceive the
public about what they're doing." The other three Senators voting
yes were Sens.Pappas (DFL-St. Paul), Scheid (DFL-Brooklyn Park),
and Sparks (DFL- Austin). Sens. Kierlin (R-Winona) and Kubly (DFL-Granite
Falls) were absent. Sen. Kelley (DFL-Hopkins) and Scheid are
co-authors.
"It's parents and the public at
large who are...not being told that socioemotional means mental
health."
Dr. Karen Effrem, who testified against the bill, suggested that even the
words "socioemotional screening" are misleading to the public.
"Everyone at the hearing was discussing mental health screening for
preschoolers," stated Effrem. "It's parents and the public at
large who are being deliberately misinformed -- not being told that
socioemotional means mental health."
Last
year's similar attempt to expand preschool screening was described as
"Children's mental health screenings and assessments" (SF 1365
-- Sen. Tomassoni, DFL-Chisholm). This year, the words "mental
health" were removed.
"They
are covertly adding mental health screening to what is required in the
developmental assessment," Dr. Effrem continued. "This will
limit parents' freedom to access alternative developmental assessments
outside of the government system. Most pediatricians presently perform
objective assessments of cognitive and physical milestones, such as when
a child walked or began to talk. New legal requirements for mental health
assessments in the already required developmental screening would force
pediatricians and other doctors outside of the education establishment to
include these subjective, non-scientific assessments in order to provide
the 'equivalent' screening the law requires."
Also
providing testimony opposing SF 2841 were Tom Prichard, President of the
Minnesota Family Council, and Dr. Willard Harley, a licensed psychologist
who has overseen a network of 41 mental health clinics in Minnesota with
over one hundred psychiatrists, psychologists, social workers and
chemical dependency counselors. SF2841 will next move to the full Senate
for a vote.
EXCERPTS FROM THE HEARING
-- Karen R. Effrem, M.D., Pediatrician
- "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
liberty."
-- Sen. John Hottinger, author of SF2841
- "There have been many claims that social/emotional screening is
unreliable and subjective. 'Ages and Stages' is a Social/Emotional
screening tool that has 93% validity and 91% reliability."
-- Willard F. Harley, Jr., Ph.D, Licensed Psychologist
-
"Your data is wrong. For one thing, the reliability can never be
less than the validity."
-- Dr. Effrem
- "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."
-- National Association for the Mentally ill (NAMI), an
organization which has received tax dollars from the federal mental
health agency to help implement the
New Freedom
Commissionís recommendations, including universal screening
- "The President's New Freedom Commission on Mental Health
recommended that quality screening occur in school... 21% of children
have a diagnosable mental, emotional or behavioral disorder."
-- Sen. Betsy Wergin, member of the Senate Early Childhood
Committee
- "Just looking at that number -- 21% have a diagnosable disorder
-- I think we are over-diagnosing and we are over-medicating our
kids."
-- Dr. Harley
- "Therapy is not benign. It can hurt people, especially
misdiagnosed children. Only a small percentage of children have severe
emotional problems that should be treated."
-- Dr. Effrem
- "Even if psychosocial or educational programs were used instead
of medications, Dr. Benedetto Vitiello, head of child psychiatry at the
National Institutes of Mental Health 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.' î
-- Sen. Sean Nienow,.member of the Senate Early Childhood
Committee
- Sen. Nienow persuasively argued that, while preschool screening is
technically voluntary and districts make required statements that parents
have the right to refuse to participate, the message to parents is
confusing and contradictory. Parents seldom understand that it's
voluntary, Nienow stated repeatedly. He distributed an example from a
Parent Consent form that a parent received in the past week, which
stated:
- "The parent or guardian has the right to refuse participation
for their child, in any component of the screening program, and still be
eligible for any other component; however, Minnesota Law requires
parents to have children screened before school
entrance."
- [Emphasis in the original.]
- Sen. Hottinger dismissed Sen. Nienow's concerns.
For more information, link to these
resources:
Infant
mental health (11/23/05)
Myths and Facts Regarding Mental Health Screening Programs and
Psychiatric Drug Treatment for Children (pdf)
Dangers of Universal
Mental Health Screening, Briefing Book (Newly Updated)
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