Bush�s mental illness screening squad on the move
By Evelyn Pringle
Journal Contributing Writer
Jul 14, 2006, 00:54
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 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."
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, a 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."
On February 5,
2003, a subcommittee report was released titled, "Promoting, Preserving
and Restoring Children�s Mental Heath," and stated in part, "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 of children."
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."
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,
the juvenile justice and child welfare systems, as well as in other settings
and populations with known high risk, such as the Medicaid population."
health problems are identified," the report says, "youth should be
linked with appropriate services and supports."
�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 drugs.
specifically calls for all screening programs to be linked to
"state-of-the-art treatments" using "specific medications for
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 the 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 1990s, 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.
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.
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 drug company money
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 government 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.
backing that Bush received from Big Pharma is legend and it's 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 five
executives from drug companies, six officials from HMOs, the CEO of a pharmacy
services company, the head of a direct-mail pharmacy, and eight lobbyists who
represented 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 2000, 82 percent
of Lilly's $1.6 million in political contributions went to Bush and the
bigwig, 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
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 to a September 5, 2003, New York
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 programs.
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 systems 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 promote 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 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 available.
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 fewer than two 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
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.
against TeenScreen have posted a petition online
with plans to send it to state and federal lawmakers.
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 out and presented to school board members or
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.
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
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 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 percent, 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
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.
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 administration for members of the military and their
families. 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 Boston Globe, if the responses to the screening indicate possible
trouble, SOS suggests options for seeking help.
diagnosis of mental illness could not get any easier than with SOS. This online
survey, "is always available," Col. 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.
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 since 2001.
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 every day.�
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, Inc.�
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
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, 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.�
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.
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.�
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 five 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
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
- 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) . . .
- 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 seven or more decades without drugging away their blues.�
�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, methods.�
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 downward emotionally.�
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 percent increased chance of dying
within three 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 percent),� 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
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 overprescribing of the
drugs are bankrupting state Medicaid programs and they have to stop the
practice of overprescribing 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, and much "of
that cost is borne by government health-care plans."
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 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.
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 from selling these drugs for off-label use on 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
percent of the children were in foster care, and 22 percent were in juvenile
detention. Medicaid spent $65.5 million for drugs used primarily as
"chemical restraints," according to Encarnacion Pyle in her series �Drugged
into Submission� in the Columbus Dispatch.
According to FDA
estimates, 11 million antidepressant prescriptions were written in 2003 for
under 19-year-olds, representing a 27 percent increase in three years.
The sale of ADHD
drugs also skyrocked in 2003. In 5 to 9-year-old children, their use increased
85 percent, and, in preschoolers, usage was up 49 percent, 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.
injured parties can be found at Lawyers
Evelyn Pringle is a
columnist for OpEd News and an investigative journalist focusing on exposing corruption in government.
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