Published on Wednesday, October 20, 2004 by Inter Press Service
Critics See Drug Industry Behind Mental Health Plan
by Ritt Goldstein

STOCKHOLM - Bush Plans to Screen Whole U.S. Population for Mental Illness', read the headline in the 'British Medical Journal' (BMJ) and the project, with increasingly controversial drug treatment at its core, is underway as you read this.
Structures to put the scheme in place have been developed under a so-called "Federal Action Agenda," announced in Washington on Jun. 9, and include mandatory mental health screening, which the plan recommends be linked with "treatment and supports".

The plan's full details have yet to emerge as the Action Agenda still "has not been publicly released," according to A Kathryn Power, director of the Centre for Mental Health Services (CMHS), the Bush administration body spearheading the effort.

Developed by the President's New Freedom Commission On Mental Health, the effort, critics charge, is a pharmaceutical industry marketing scheme to mine customers and promote sales of the newest, most expensive psychiatric medications.

Under 'New Freedom', mental health screening of adult Americans is slated to occur during routine physical exams while that of young people will occur in the school system. Pre-school children will receive periodic "development screens."

The plan highlights the importance of "state-of-the art medications," though a scandal has erupted recently regarding the safety and effectiveness of the main types of drugs in question, particularly antidepressants. Deadly side effects of these drugs have already claimed numerous lives.

In mid-September an advisory committee of the U.S. Food and Drug Administration (FDA) said antidepressants should come with "the nation's strongest warning" that they can cause suicidal behaviour in children and young people.

Recently released studies by famed British scientist and psychiatrist Dr David Healy highlight that some of these drugs -- Seroxat and Prozac, both SSRI antidepressants -- appear linked to "homicidal" behaviour in adults.

"In the last 50 years, the quality of the new drugs hasn't matched the hype," says Healy, author of 'Let Them Eat Prozac' and the person responsible for originally blowing the whistle on the link between antidepressants and suicide in children.

Asked if he was saying: "the major breakthroughs, then, have been in terms of marketing instead of medicine," the drug scientist told IPS: "Yes, I think so. And that extends all the way to having their (the pharmaceutical industry's) policies put forward by departments of health in the U.S., the UK -- things like the Bush plan."

Drug therapy based upon "evidence-based" practices is the backbone of the New Freedom programme's approach to treatment. But such practices have now been badly tarnished, with recent findings indicating the drug industry (called 'Big Pharma' by critics) has manipulated what were thought to be independent evaluations of new drugs, as reported in previous IPS stories.

An Apr. 24, 2004 article in the British medical journal 'Lancet' said while, "selective reporting of favourable research should be unimaginable," it appeared ongoing, distorting findings in the drug industry's favour.

"In a global medical culture, where evidence-based practice is seen as the gold standard for care, these failings are a disaster," the journal charged.

While questions surround the dangers of drugging large numbers of citizens, also notable is who the New Freedom plan envisions will deliver psychiatric services.

"Mental health education and training will be provided to general health care providers, emergency room staff and first responders, such as law enforcement personnel and emergency medical technicians, to overcome the uneven geographic distribution of psychiatrists, psychologists and psychiatric social workers," the plan states.

New Freedom, "the future of mental health care in America," is being rolled out on a state-by-state basis, according to Power, who added in an Aug. 13 speech that the federal role is to "motivate, facilitate, and compel change."

According to Dr John Read -- one of the Pacific's leading authorities on psychiatric medications, author of 'Models of Madness', and director of clinical psychology at the University of Auckland -- "this is all about expanding the market for drug companies."

On Sep. 13, U.S. Congressman Ron Paul, a medical doctor, denounced the Bush plan for its "forced mental health screening for every child in America," pointedly writing in a weekly column on his website, the "obvious beneficiary of the proposal is the pharmaceutical industry."

According to Paul, who had introduced an amendment to eliminate funding for the plan, "Soviet communists attempted to paint all opposition to the state as mental illness."

Read also warns that the New Freedom plan "conjures up the image of 'state control' of private lives, extending to an individual's feelings ... the increasing medicalisation of life problems and the massive increase in the prescriptions of all types of psychiatric drugs is 'social control'."

According to noted Canadian-American psychologist, educator and author Dr Daniel Burston, "any number of things that are, or could be, perfectly natural responses to an environment can be construed as a sign of mental disorder."

Read told IPS that New Freedom appears essentially a way to "identify between 10 and 20 percent of the population who will be labelled … offered nothing other than medication in 90 percent of the cases, and the drug companies will be laughing all the way to the bank."

According to Power, about 20 percent of the U.S. population is "experiencing mental disorders in any given year."

In Auckland, on Sep. 16 to discuss the Bush plan, Power also said that an associate, Charles Curie, was working with mental health ministers from Australia, New Zealand, and the UK to "promote policy innovation that fosters improved mental health around the world."

Allen Jones, a "whistleblower" who worked as an investigator in the Pennsylvania State office of the Inspector General, voiced concerns similar to Read's, linking the pharmaceutical industry to many of those who developed Bush's New Freedom plan.

The industry was also instrumental in funding a prior state scheme that became a "model programme" for the Bush plan, the Texas Medication Algorithm Project (TMAP).

TMAP favours use of the newest medications over older, much less costly alternatives.

It began in 1995, while Bush was Texas' governor. According to the 'British Medical Journal', "the project (TMAP) was funded by a Robert Wood Johnson (as in Johnson & Johnson Pharmaceuticals) grant and by several drug companies."

On Jun. 19 the journal reported that Jones believed "the same 'political-pharmaceutical alliance' that generated the Texas project was behind the recommendations of the New Freedom Commission."

According to his report, the effort would "consolidate the TMAP effort into a comprehensive national policy to treat mental illness with expensive, patented medications of questionable benefit and deadly side effects," added the Journal.

New Freedom's pharma-oriented programmes have garnered considerable and broad support, including from the Carter Centre, the organisation founded by former President Jimmy Carter and best known for its human rights programmes and election monitoring.

The "Carter Centre Mental Health Programme supports the spirit and findings of the President's New Freedom Commission on Mental Health report," says Thomas H Bornemann, director of the Georgia-based centre's mental health programme.

He added the centre is, "engaged with a variety of partners to use the report as a platform to transform the current mental health system. Two of the programme's annual Rosalynn Carter Symposia on Mental Health Policy (2003 and 2004) are dedicated to meet the challenges of funding and achieving these goals."

According to the Carter Centre, 77 percent of its budget is devoted to health programmes, with 6.6 percent of the budget going to peace activities. Drug firms such as GlaxoSmithKline, Merck & Co, Pfizer, and Wyeth are listed as having provided one million dollars or more to the centre, as is the Robert Wood Johnson Foundation, associated with Johnson & Johnson and TMAP.

Queries to the Carter Centre regarding the total amounts of pharmaceutical industry funding, the programmes that that money was applied to and the industry's influence on the centre's policy, were not answered.

But in the "donated goods and services" section of the notes to the centre's annual report's financial statements it is written that unattributed "medication" donations totalled 54 million dollars in 2003 and 43 million dollars in 2002.

The centre's "total expenses" for those years were respectively 82 million dollars and 85 million dollars, according to its website.

Critics have repeatedly charged the drug industry with using its wealth and power to manipulate advocacy and professional groups. The non-profit National Alliance for the Mentally Ill (NAMI) has repeatedly faced such criticism, as has the American Psychiatric Association (APA), which have both endorsed New Freedom.

Nevertheless, Read observed of New Freedom: "I would guess that there are some ... who genuinely believe that these ideas are good for people, and completely unaware of the sinister connotations, the Orwellian connotations and the huge advantages for the drug companies ... well-meaning, but totally misguided people.".

Ritt Goldstein is an American investigative political journalist based in Stockholm. His work has appeared in broadsheets such as Australia's Sydney Morning Herald, Spain's El Mundo and Denmark's Politiken, as well as with the Inter Press Service (IPS), a global news agency.