Mental Illness Screening
Squad On the Move
By Evelyn Pringle
11 July, 2006
The tax dollar funded mental
health screening programs popping up in every corner of the nation represent
an enormous gift to Big Pharma from the Bush administration. After all,
drug companies can't push drugs without a lucrative customer base, so
the screening programs are a great solution for that little problem.
On April 29, 2002, Bush kicked
off the whole mental health screening scheme when he announced the establishment
of the New Freedom Commission (NFC) during a speech in in New Mexico
where he told the audience that mental health centers and hospitals,
homeless shelters, and the justice and school systems, have contact
with individuals suffering from mental disorders but that too many Americans
are falling through the cracks, and so he created the NFC to ensure
"that the cracks are closed."
In words relevant here, the
late President Ronald Reagan aptly described government intervention
this way: "The nine most terrifying words in the English language
are, "I'm from the government and I'm here to help."
According to award-winning
investigative reporter, Kelly O'Meara: "Nowhere is this quote more
appropriate than when applied to George W. Bush's New Freedom Commission
on Mental Heath."
A little over a year after
Bush announced the formation of the NFC, on July 22, 2003, government
report was released that called for redesigning the mental health systems
in all 50 states. A press release previewing the report stated:
"Achieving this goal
will require greater engagement and education of first line health care
providers-primary care practitioners-and a greater focus on mental health
care in institutions such as schools, child welfare programs, and the
criminal and juvenile justice systems. The goal is integrated care that
can screen, identify, and respond to problems early."
About 7 months later, on
February 5, 2003, a subcommittee report was released titled, "Promoting,
Preserving and Restoring Children's Mental Heath," and stated in
"The extent, severity,
and far-reaching consequences of mental health problems in children
and adolescents make it imperative that our nation adopt a comprehensive,
systematic, public health approach to improving the mental health status
The NFC's final report calls
for screening every child in America, including preschoolers, and points
our that, "schools are in a key position to identify mental health
problems early and to provide a link to appropriate services."
In addition, according to
the final report, every child plugged into a government program, will
automatically be screened in accordance with the following recommendation:
"Screening should be
implemented upon entry into, and periodically thereafter in, the juvenile
justice and child welfare systems, as well as in other settings and
populations with known high risk, such as the Medicaid population."
"When mental health
problems are identified," the report says, "youth should be
linked with appropriate services and supports."
Critics say "appropriate
services and supports" means doctor's prescribing drugs. According
to the results of a 2002 survey of recently trained child psychiatrists,
in the Journal of American Academy of Child Adolescent Psychiatry, nine
out of 10 pediatric patients under their care were treated with prescription
The NFC specifically calls
for all screening programs to be linked to "state-of-the-art treatments"
using "specific medications for specific conditions."
The Texas Medication Algorithm
Project (TMAP) is the centerpiece of the NFC's recommendation for "specific
medications." Algorithms are lists of drugs with guidelines that
medical professionals must follow when prescribing medication to patients
for specific mental illnesses, and contain flow charts that illustrate
step-by-step prescribing process.
The TMAP drug lists and guidelines
were developed and approved in Texas while Bush was Governor, through
an "expert opinion consensus" by a panel of medical professionals
chosen by the pharmaceutical sponsors of the program that included Janssen
Pharmaceutica, Eli Lilly, Johnson & Johnson, Astrazeneca, Pfizer,
Novartis, Janssen-Ortho-McNeil, GlaxoSmithKline, Abbott, Bristol Myers
Squibb, Wyeth-Ayerst and Forrest Laboratories.
Critics say TMAP is a marketing
scheme thought up by Big Pharma after a slew of new psychiatric drugs
were approved for sale in the 1990's, and drug companies realized that
there was no way to advertise and promote psychiatric drugs to recruit
Once approved, TMAP guaranteed
an avalanche of sales for Big Pharma in Texas, because medical professionals
were required to follow the TMAP guidelines with all patients in state
institutions, such as mental hospitals and prisons, and when prescribing
drugs to children in foster care or juvenile justice programs, and for
all patients covered by government funded health care programs.
The NFC recommends TMAP as
the model program for "specific medications" to be used in
all 50 states. The "specific medications" are the most expensive
drugs on the market and include drugs known as selective serotonin reuptake
inhibitors antidepressants (SSRIs), like Paxil, Prozac, Zoloft, and
Effexor, and the atypical antipsychotics, that include Zyprexa, Risperdal,
Geodon, Seroquel, Clozaril, and Abilify.
Other "specific medications"
include the ADHD drugs, fondly known as "speed" to street
addicts, such as Adderall, Dexedrine, Concerta, Ritalin and Strattera,
and a garden variety of "downers," like Valium, Xanax, Librium
and sleeping pills.
Critics have constantly attacked
Big Pharma's involvement in choosing the drugs on the lists. As far
back as January 1999, Peter Weiden MD, one of the "experts"
on the original Texas panel, openly criticized the approval process
in the Journal of Practice in Psychiatry and Behavioural Health, because
so drug company money was involved.
For instance, he said, the
guidelines for the atypical antipsychotics were funded by Janssen, the
maker of Risperdal, and most of the guidelines' authors also had received
financial support of one kind or another from the drug companies with
atypical drugs on the list. "This potential conflict of interest
may create credibility problems," he wrote, "especially concerning
any recommendations supporting the use of atypical antipsychotics."
The way the NFC scheme is
set up, tax dollars not only fund the implementation of the screening
programs, but also a large portion of the costs for "specific medications"
that are prescribed to patients to treat mental disorders detected by
the screenings through overnment health care programs like Medicaid.
The fact is, when Bush took
office, he owed Big Pharma a lot favors in return for all the money
he raked in from the industry and the mental health screening scheme
represents a major part of his efforts to cover those debts.
The financial backing that
Bush received from Big Pharma is legend and its safe to say that he
would not be sitting in the White House today without it.
In 2004, a report by the
advocacy group, Public Citizen, listed 21 drug industry and HMO executives
or lobbyists among Bush's Rangers and Pioneers - titles given only to
those people who have raised at least $200,000 or $100,000, respectively,
for one of his presidential campaigns.
The list includes 5 executives
from drug companies, 6 officials from HMOs, the CEO of a pharmacy services
company, the head of a direct-mail pharmacy, and 8 lobbyists who represent
drug companies and HMOs at the time.
Eli Lilly, a manufacturer
of many of the "specific medications" chosen for the lists,
has multiple ties to the Bush family dating back decades. Before becoming
President Reagan's Vice President, the first President Bush was a member
of Lilly's board of directors and the current President Bush appointed
Lilly CEO, Sidney Taurel, to the Homeland Security Council.
In the year 2000, eighty-two
percent of Lilly's $1.6 million in political contributions went to Bush
and the Republican Party.
Another industry big-wig,
retired Bristol-Myers Squibb Vice-Chairman, Bruce Gelb, was a Bush Pioneer
who also had longstanding ties to the Bush family. Gelb was appointed
chief of the US Information Agency, and ambassador to Belgium, by the
first President Bush.
Before the 2000 election,
Bristol-Myers executives reportedly were pressured to make maximum donations
to the Bush campaign and reluctant donors were warned that CEO, Charles
Heimbold Jr, whom Bush later named ambassador to Sweden, would be informed
if they failed to give, according a September 5, 2003 New York Times
Pfizer CEO, Hank McKinnell,
was a 2004 Bush Ranger and until 2003, served as chairman of the board
of Pharmaceutical Research & Manufacturers of America, the industry's
gigantic trade group, until Republican lawmaker, Billy Tauzin, quit
Congress and took over the position that came with a multi-million dollar
package in combined salary and perks.
Although all of the TMPA
medications are only approved by the FDA for treatment of a limited
number of mental illnesses like schizophrenia or major depressive disorder
or bipolar disorder, in specific age groups, and with specific dosages,
drug makers have doctors prescribing the medications off-label for unapproved
uses to persons of all ages for just about any ache and pain, and especially
with patients being screened for mental illness by the government backed
To accomplish this mass screening
of the nation's 52 million school children, the NFC recommends that
the TeenScreen program, billed as a suicide prevention survey, be set
up in public school system nationwide. In May 2004, Illinois passed
a resolution approving the implementation of TeenScreen in all public
schools in that state.
TeenScreen is also an invention
of Big Pharma developed and promoted through back door funneling of
money through front groups that bill themselves as advocates for the
mentally ill and promoting suicide prevention.
By far, TeenScreen has become
the most controversial of all screening programs, and critics are quick
to point out a number of reasons. According to the June 16, 2006, Washington
Post, there were only 1,737 suicides by children and adolescents in
the US during 2003, the last year for which national statistics are
According to the Department
of Health and Human Services, in 2003, for every 100,000 children the
rate of suicide for boys was 11.6 and the rate for girls was 2.7, which
amounts to less than 2 boys in every 10,000 kids, and the number of
suicides by girls in every 10,000 children, is too low to even calculate.
In perhaps one of their best
arguments against TeenScreen, critics are asking how such a low suicide
rate, when measured against the total student population, can possibly
justify subjecting 52 million children to mental health screening and
the distinct probability that a high number of children will end up
on psychiatric drugs with side effects that cause many more deaths each
year than the number of child suicides.
In fact, overall, the statistics
for people injured or killed each year due to prescription medications
are extremely high. According to a study published by Adverse Drug Reactions,
more than 1.5 million people are hospitalized each year and more than
100,000 die from largely preventable adverse reactions to drugs that
should not have been prescribed in the first place.
Advocacy groups against TeenScreen
have posted a petition online with plans to send it to state and federal
lawmakers. Persons interested in signing the petition can click on the
following link: http://www.petitiononline.com/TScreen/petition.html
Ken Kramer, a records research
specialist from Florida, who has been investigating the TeenScreen program
for several years, says the petition is an excellent way to educate
people because it conveys many of the facts about mental health screening
and can be printed off and presented to school board members or legislators.
In 2004, Illinois became
the first state to implement mental health screening programs. Its plan
calls for both children and adults to be screened during their routine
physical exams. To that end, the state legislature passed the Illinois
Children's Mental Health Act (ICMHP), which is expected to become a
model for other states.
The final report by the ICMHP
Task Force calls for a comprehensive, coordinated children's mental
health system comprised of prevention, early intervention, and treatment
for children ages 0-18, along with a statewide data-reporting system
to track information on each person.
It requires social-emotional
development screens with all mandated school exams (K, 4th, and 9th),
and says to: "Start early, beginning prenatally and at birth, and
continue throughout adolescence, including efforts to support adolescents
in making the transition to young adulthood," and includes a plan
to screen all pregnant women
Critics of the Illinois plan
say they are especially curious about what might be in store for the
infants screened prenatally and at birth, at the ripe old age of 0.
The Illinois task force stressed
the need to (1) improve Medicaid reimbursement for prevention, intervention
and treatment services; (2) recognize diagnoses for young children described
in DC:0-3 and pay for mental health services for children with any of
these diagnoses; and (3) clarify for providers the diagnoses that create
eligibility for children to obtain Medicaid services.
According to former medical
services billing analyst, Chris Kelly, in plain language, this means
to make sure and have doctors diagnosis patients with specifically coded
mental illnesses for which Medicaid will pay the costs of the prescription
drugs for treatment.
And studies reveal that talk
therapy is a thing of the past because pushing pills is by far more
profitable. A 2003 study by the American Psychiatric Association, on
"financial disincentives" for psychotherapy, found doctors
could earn about $263 an hour for doing three 15-minute "medication
management" sessions, verses about $156 for a single 45- to 50-minute
therapy session. Thus, conducting therapy verses medication management
would represents an hourly pay cut of 41%, the APA study said.
On August 17, 2005, the Wall
Street Journal quoted, Juan Riestra, associate director of medicine
in the department of psychiatry at Mountainside Hospital in Montclair,
NJ, as saying a psychopharmacologist is often someone "using a
trendy word as a marketing device."
When a psychopharmacologist
sees 30 or 40 patients a day, as some do, Mr Riestra told the Journal,
"it becomes like a factory."
One of the more recent screening
programs that has caught the attention of anti-drugging activists, is
a survey called "Signs of Suicide" (SOS), which is being touted
as a self-assessment screening tool and is provided free online on the
This particular psychiatric
screening program claims it is being promoted as an effort to reduce
suicides, alcoholism, depression and eating disorders, to be used in
high schools, colleges, the workplace, and the military.
SOS comes highly recommended
by the Bush for members of the military and their families. As of May
26, 2006, Air Force Colonel Joyce Adkins, a psychologist at the Pentagon's
Health Affairs office, claims that several thousand military people
have been screened with the program since it went online around the
beginning of 2006.
According to the May 26,
2006, Boston Globe, if the responses to the screening indicate possible
trouble, SOS suggests options for seeking help.
Obtaining a diagnosis of
mental illness could not get any easier than with SOS. This online survey,
"is always available," Ms Adkins told the Globe. "You
don't have to go anywhere," she said. "You don't have to have
child care or change your clothes."
SOS claims it is the creation
of the "nonprofit" Massachusetts-based corporation, Screening
for Mental Health, Inc (SMH). However, as it turns out, the development
of the firm's screening programs, was funded with millions of dollars
from Big Pharma.
A picture taken at the company
during an event in honor of, "National Depression Screening Day,"
(whatever that is), on October 18, 2001, shows Eli Lilly presenting
SMH with a check for $500,000.
But Lilly's half-million
dollar grant was just the tip of the iceberg. SMH has also received
millions of dollars in grants from other drug giants including Pfizer,
Solvay, Abbott Labs, Wyeth, Forest Pharmaceuticals, the Robert Johnson
Foundation, AstaZeneca and GlaxoSmithKline.
Kevin Hall, New England director
of the Citizens Commission on Human Rights, has been investigating mental
health screening programs for a number of years, and was able to obtain
the SMH's tax returns that reveal just how much money has been funneled
to the company to develop and promote the mental health screening programs
All total, the tax records
show that Lilly poured $2,157,925 into SMH between 2001 and 2004, and
for the year 2004 alone, in addition to Lilly's $600,000, Pfizer gave
SMH $125,000, Wyeth ponied up $100,000, and Forest Labs gave $153,000
These "free" online
mental health screening programs are also being promoted in colleges
all across the country. Brian Hokanson is a college student in Minnesota
who wrote a commentary describing his experience with an online survey.
At the beginning of last
fall's semester, Brian noticed fliers in his residence hall that were
encouraging students to take a free online screening test for depression.
Brian says he soon found
out that any combination of answers on the screening resulted in a recommendation
to see a doctor. The first section of the test, he says, listed negative
behaviors such as "feeling bad about yourself" and "feeling
tired or having little energy."
For each statement checked,
Brian was instructed to chose how often the statement applied to him
in the previous two weeks, ranging from "not at all" to "nearly
In the second part of the
test, the student is asked to rate how difficult each of the behaviors
checked has made it to function in daily life, ranging from "not
difficult at all" to "extremely difficult."
Brian says he decided to
"test the test," and chose "not at all" for all
of the behaviors except for "poor appetite or overeating,"
and he said that statement applied to him for "several days."
On the second section, he stated that the problem made it "not
difficult at all" for him to function in daily life.
Upon clicking on the results,
Brian was told: "Your screening results are consistent with minimal
depression . You are advised to see your doctor or a mental health professional
for a complete evaluation as soon as possible."
As for the inventor of this
particular screening tool, Brian reports that the fine print at the
bottom of the page of the survey reads: "Copyright 1999 Pfizer,
The good news is, that after
"testing the test," things did not go according to plans because
Brian did not become a new SSRI customer for Pfizer, which means he
won't be experiencing any horrific side effects from SSRI use.
The NFC also recommends screening
for all pregnant women that will predictably lead to the use of SSRIs,
even though a study as far back as the February 2, 2004, American Journal
of Pediatrics, said that pregnant women who use SSRIs "to combat
depression could be damaging the brains of their unborn babies."
According to the study, direct
evidence of a link between fetal exposure and disrupted neurological
development was apparent in a study of American mothers and their infants.
"Abnormal sleeping patterns, heart rhythms and levels of alertness,"
the study found, "were linked by researchers to drugs called selective-serotonin
re-uptake inhibitors (SSRIs)."
The study leader, Philip
Zeskind, a psychologist and research professor of pediatrics at the
University of North Carolina, noted that SSRIs disrupt the neurological
systems of children, and said "this is more than just a possibility,
we're talking about hundreds of thousands of babies being exposed to
these drugs during pregnancy."
"These babies are bathed
in serotonin during a key period of their development and we really
don't know what it's doing to them or what the long-term effects might
be," he advised. The Professor warned that "these drugs are
being given away like smarties, and this is a big problem."
Drug makers have also been
successful in getting lawmakers to set up mandatory mental health screening
for pregnant women the minute their infants leave the womb. On June
16, 2006, Senators Robert Menendez (D-NJ) and Richard Durbin (D-IL)
announced legislation "that aims to eradicate the devastating effects
of postpartum depression on American families."
According their press release,
the "MOTHERS Act was introduced in response to a recently passed,
first-of-its-kind New Jersey law requiring doctors and nurses to educate
and screen expectant mothers about PPD."
"Many women have successfully
recovered from postpartum depression with the help of therapy, medication,
and support groups," Senator Menendez said in the press release.
"By increasing education
and early treatment of postpartum depression," it said, "mothers,
husbands, and families, will be able to recognize the symptoms of this
condition and help new mothers get the treatment they need and deserve."
Anyone interested in a quick
course on the potential dangers of this program, and the lethal effects
of the most commonly prescribed drugs for women with PPD, need only
go read the transcripts of the Andrea Yates' trials and check out the
drugs they were feeding her for PPD, at the time she drowned her 5 children
in the bathtub in November 2004.
Dr Anne Blake Tracy, is the
author of "Prozac: Panacea or Pandora?" and a well-known expert
on SSRIs and has served as a consultant for many high-profile cases
involving SSRI induced violence, including cases of mothers who have
killed their babies, and often themselves, after being placed on SSRIs.
According to Dr Tracy, investigators
found Zoloft in the apartment of Emiri Padron, after she smothered her
baby on June 22, 2004, and then stabbed herself in the chest twice.
On July 26, 2004, she says,
Mary Ellen Moffitt suffocated her 5-week-old infant before killing herself
after being prescribed Paxil for PPD.
In another tragedy in October
2002, Annie Mae Haskew smothered her 10-week-old baby after she was
diagnosed with PPD and placed on antidepressants.
At the other end of the life-cycle,
the mental health screening squad is swarming in on the nation's 36
million senior citizens, who already represent a gold mine to Big Pharma
because they use so many medications. The screening program for the
elderly is set up through the, "Positive Aging Act of 2005."
The Act provides federal
tax dollars for community-based mental health treatment outreach teams
and states: (a) In General- The Secretary ... shall award grants to
public or private nonprofit entities that are community-based providers
of geriatric mental health services, to support the establishment and
maintenance by such entities of multi-disciplinary geriatric mental
health outreach teams in community settings where older adults reside
or receive social services.
The Act wants outreach teams
(1) adopt and implement ...
evidence-based intervention and treatment protocols (to the extent such
protocols are available) for mental disorders prevalent in older individuals
(including, but not limited to, mood and anxiety disorders, dementias
of all kinds, psychotic disorders, and substance and alcohol abuse),
(2) provide screening for
mental disorders, diagnostic services, referrals for treatment, and
case management and coordination through such teams; and
This plan seeks to round
up seniors for screening wherever they can be found, including (1) senior
centers; (2) adult day care programs; and (3) assisted living facilities.
A new recruitment scheme
for senior citizens was totally unnecessary because Big Pharma has been
over-medicating these customers for years. Recent research reveals that
nursing home residents in particular are being drugged in record numbers.
Kenneth Thomas, a registered
nurse with 29 years of experience, says elderly people in nursing homes
are regularly put on antidepressants, even though most of them,"
he notes, "lived 7 or more decades without drugging away their
"Based on my direct
observation and experience," he says, "many of the patients
I've seen with so-called "mental illness" actually have underlying
physical conditions that are easily treatable by medical, non-psychiatric,
He makes the point that anyone
who has been taken from their home and put into an unfamiliar place
confined to bed or wheelchair would be logically upset. "Any loss
of personal freedom," he explains, "tends to bring people
According to Mr Thomas, there
are many ways to help an elderly person gain more independence and have
some autonomy even in restricted environments such as nursing homes
and rehab centers. "Most of these elderly," he notes, "just
need someone to talk to, not another pill."
In October 2005, the Journal
of the American Medical Association, published a meta-analysis of 15
randomized trials of more than 5,000 elderly patients treated with atypicals
that found patients taking the drugs had a 54% increased chance of dying
within 3 months, compared with patients taking a placebo.
Another Big Pharma money-making
tactic is to promote the off-label prescribing of drugs at a higher
dose than necessary which, experts say, is extremely dangerous with
older people because their bodies cannot not metabolize or excrete drugs
as rapidly as younger patients.
In a study published in the
June 13, 2005, Archives of Internal Medicine, that examined the quality
of antipsychotic prescriptions for nearly 2.5 million Medicaid patients
in nursing homes, "over half (58.2%)," received antipsychotics
that exceeded the maximum recommended dosage or received duplicate therapy
or had inappropriate indications for the drugs to begin with.
The study found that more
than 200,000 nursing home residents received antipsychotic therapy with
"no appropriate indications for use."
As a result of concealing
negative information about these psychiatric drugs and the promotional
tactics by the drug makers of encouraging the off-label prescribing
of the medications for so many different uses, experts say, tens of
millions of people are now taking the medications without any valid
indication for their use.
In fact, so many people are
being prescribed these expensive drugs that the TMAP part of the marketing
scheme is coming apart at the seams due to pure and simple greed. State
lawmakers say that the costs incurred due to the over-prescribing of
the drugs are bankrupting state Medicaid programs and they have to stop
the practice of over-prescribing to keep from going broke.
According to the July 27,
2005, Wall Street Journal, antidepressants and antipsychotics are the
third and fourth biggest classes of drugs in the US after cholesterol
and heartburn medicines, with sales of $20.7 billion in 2004, with much
"of that cost is borne by government health-care plans," the
The prices per pill for these
drugs are themselves insane. For example, in South Carolina, Zyprexa
is the most expensive atypical covered by Medicaid, and according to
James Assey, a pharmacist with the South Carolina Department of Health
and Human Services, a one-month supply pills costs Medicaid over $700.
The state of Georgia totally
removed Zyprexa from its preferred drug list and any doctor who wants
to start a Medicaid patient on Zyprexa, must now submit a clinical rationale
stating why it's the only drug appropriate, according to the November
28, 2005, Indianapolis Business Journal.
Other states, including Tennessee,
Illinois, Louisiana, and Pennsylvania also now require doctors to obtain
prior authorization before prescribing Zyprexa to Medicaid patients,
the Journal reports.
Big Pharma is making a ton
of money off selling these drugs off-label for kids. A report in the
April 24, 2005, Columbus Dispatch, found that 40,000 children aged 6-18
who were covered by Medicaid were prescribed psychotropic drugs: 31%
of the children were in foster care, and 22% were in juvenile detention.
Medicaid spent $65.5 million for drugs used primarily as "chemical
restraints," according to Pyle, P, "Drugged into Submission."
According to FDA estimates,
11 million antidepressant prescriptions were written in 2003 for under
19-year-olds, representing a 27% increase in 3 years.
The sale of ADHD drugs, also
skyrocked in 2003. In 5 to 9-year-old children their use increased 85%,
and in preschoolers usage was up 49%, according to Medco Health Solution's,
2004 Drug Trend Symposium.
Overall, sales of psychiatric drugs totaled $26.7 billion in 2004, according
to NDC Health Corp, a Georgia-based health information firm.
Information for injured parties
can be found at Lawyers and Settlements.com
(Evelyn Pringle is a columnist for OpEd News and an investigative journalist
focused on exposing corruption in government and corporate America.
She can be reached at firstname.lastname@example.org)