||Bush to screen population for mental illness
Sweeping initiative links diagnoses to treatment with specific drugs
Posted: June 21, 2004
President Bush plans to unveil next month a sweeping mental health initiative that recommends screening for every citizen and promotes the use of expensive antidepressants and antipsychotic drugs favored by supporters of the administration.
The New Freedom Initiative, according to a progress report , seeks to integrate mentally ill patients fully into the community by providing "services in the community, rather than institutions," the British Medical Journal reported.
Critics say the plan protects the profits of drug companies at the expense of the public.
The initiative began with Bush's launch in April 2002 of the New Freedom Commission on Mental Health, which conducted a "comprehensive study of the United States mental health service delivery system."
The panel found that "despite their prevalence, mental disorders often go undiagnosed" and recommended comprehensive mental health screening for "consumers of all ages," including preschool children.
The commission said, "Each year, young children are expelled from preschools and childcare facilities for severely disruptive behaviors and emotional disorders."
Schools, the panel concluded, are in a "key position" to screen the 52 million students and 6 million adults who work at the schools.
The commission recommended that the screening be linked with "treatment and supports," including "state-of-the-art treatments" using "specific medications for specific conditions."
The Texas Medication Algorithm Project, or TMAP, was held up by the panel as a "model" medication treatment plan that "illustrates an evidence-based practice that results in better consumer outcomes."
The TMAP -- started in 1995 as an alliance of individuals from the pharmaceutical industry, the University of Texas and the mental health and corrections systems of Texas -- also was praised by the American Psychiatric Association, which called for increased funding to implement the overall plan.
But the Texas project sparked controversy when a Pennsylvania government employee revealed state officials with influence over the plan had received money and perks from drug companies who stand to gain from it.
Allen Jones, an employee of the Pennsylvania Office of the Inspector General says in his whistleblower report the "political/pharmaceutical alliance" that developed the Texas project, which promotes the use of newer, more expensive antidepressants and antipsychotic drugs, was behind the recommendations of the New Freedom Commission, which were "poised to consolidate the TMAP effort into a comprehensive national policy to treat mental illness with expensive, patented medications of questionable benefit and deadly side effects, and to force private insurers to pick up more of the tab."
Jones points out, according to the British Medical Journal, companies that helped start the Texas project are major contributors to Bush's election funds. Also, some members of the New Freedom Commission have served on advisory boards for these same companies, while others have direct ties to TMAP.
Eli Lilly, manufacturer of olanzapine, one of the drugs recommended in the plan, has multiple ties to the Bush administration, BMJ says. The elder President Bush was a member of Lilly's board of directors and President Bush appointed Lilly's chief executive officer, Sidney Taurel, to the Homeland Security Council.
Of Lilly's $1.6 million in political contributions in 2000, 82 percent went to Bush and the Republican Party.
Another critic, Robert Whitaker, journalist and author of "Mad in America," told the British Medical Journal that while increased screening "may seem defensible," it could also be seen as "fishing for customers."
Exorbitant spending on new drugs "robs from other forms of care such as job training and shelter program," he said.
However, a developer of the Texas project, Dr. Graham Emslie, defends screening.
"There are good data showing that if you identify kids at an earlier age who are aggressive, you can intervene ... and change their trajectory."