December 15, 2005
By Sue Weibert
The Genesis of President Bush’s New Freedom Commission on Mental Health
Screening for mental illness is the most controversial topic concerning mental health today. Various government entities, private foundations, organizations, think tanks and universities, all flanked by cunning public relations firms, are hard at work trying to make mental health screening as common as a dental checkup. Despite public outrage over screening, these entities are working feverishly to establish this system. With so much clamor of disagreement for such a program, why, then, do these entities push forward with such ferocity? This article reveals exactly how this all got started, who’s really behind “the big push,” and how President Bush was tricked into establishing what might be the most detrimental program in the history of mankind.
In 2002, President George W. Bush established the New Freedom Commission on Mental Health (NFC) and charged it with the mission of reviewing mental health care in the United States. The following year the NFC released its findings and recommendations. The report called for the establishment of an ambitious, Orwellian plan to screen every American for mental illness, from pre-natal to the elderly. The NFC recommended that screening is to be followed by “treatment” and “support,” but these help-oriented euphemisms are a major cover-up for barbaric psychiatric methodologies that include, but are not limited to, powerful, mind-altering drugs to Electro-Convulsive Therapy (ECT) – ultimately proven to create zombies, mass murderers and even death in those subjected to these kinds of “treatments.” Sound comforting? So, then, why would anyone want to forward the progress of such a system? The answer is the same for all of the horrific things committed against the people since the beginning of time – money, power and control.
So who stands to gain from widespread screening? To answer this question, one need only to look at these sister programs: the Texas Medication Algorithm Project (TMAP) and Columbia University’s TeenScreen - both were recommended in the NFC’s final report as “model programs”. How did these two make the cut when hundreds of public, private and faith-based programs are available to deal with mental health issues? Finding out who lobbied for their inclusion, we quickly see who stands to gain billions of dollars, reputation and power if these programs are implemented.
What is TeenScreen?
The TeenScreen Program is a controversial mental health screening program developed by Columbia University’s Child Psychiatry’s Research Department. The ultimate goal of the Columbia TeenScreen Program is to establish screening programs throughout our nation’s communities so that all children can be screened and treated for mental illness. Establishing the program in every school in the nation, and possibly the rest of the world, is clearly the objective.
Columbia University is not alone in this desire for TeenScreen’s universal acceptance and advance into the schools. The National Alliance on Mental Illness (NAMI), billed as the voice of the mentally ill, is collaborating on achieving that goal. NAMI is, itself, controversial because of extensive pharmaceutical company funding. While NAMI claims to be a grassroots organization structured to benefit those diagnosed as mentally ill, its critics claim that NAMI’s main activity is to spread fraudulent information about what “mental illness” actually is in order to claim more victims to treatment and psychotropic drug prescriptions. There are also strong allegations that NAMI is lobbying on behalf of pharmaceutical companies, which give NAMI millions in funding every year.
At a conference given this year, supported in part by pharmaceutical manufacturer, AstraZeneca, TeenScreen reported that 80% of the teens identified through the use of their screening tool “are not truly at risk.” This presentation also included the fact that 24% of the referred students were then prescribed medication.
What is TMAP?
TMAP is a medication protocol for the treatment of mental illness that originated in Texas when George Bush was governor of the state. TMAP set uniform guidelines for treatment of certain psychiatric-deemed “disorders” using the “newer,” brand name psychiatric medications and culminating with Electro-Convulsive Therapy (ECT) - better known as “shock treatment”- as the final solution when medications are judged as being ineffective.
No other therapy or treatment of any kind is included in the algorithm (problem-solving procedure) of TMAP; it is strictly medication and ECT. This chart is intended to ensure that in every location, from California to DC, a person with the symptoms of a psychiatric “disorder,” which could be anything from schizophrenia and bi-polar disorders to major depressive disorder, will receive the same treatment – namely, a prescribed sequence of brand-name drugs and even shock treatment.
When TMAP was developed, with help from the pharmaceutical industry, the most expensive, newer-generation antipsychotic drugs - called “atypicals” - were the ones to make the list. In TMAP, the older drugs and generic drugs, which are less expensive, have been completely omitted.
Based on TMAP, before a drug can be prescribed by a state physician for someone in the state system, it has to be on the TMAP list. It is then no surprise that states who have implemented TMAP are going broke due to the costs of these high-priced medications. No surprise, either, is that the pharmaceutical company coffers are growing in proportion to the states’ increasing financial woes.
Key Players in the NFC, TMAP and TeenScreen
In 2002, Bush appointed Michael F. Hogan, Ph.D., the director of the Ohio Department of Mental Health, to chair his NFC. Hogan has close ties to both TeenScreen, TMAP and with pharmaceutical companies.
Hogan is a member of TeenScreen’s Advisory Council and a member-at-large of the National Association of State Mental Health Program Directors (NASMHPD). Hogan’s resume includes his connection to TMAP. He is the past president of both NASMHPD and the NASMHPD Research Institute (NRI), and is currently on the NRI Board of Directors. Both entities are heavily supported by Janssen Pharmaceuticals and Eli Lilly through "educational grants."
Through NASMHPD, the pharmaceutical companies had to influence only fifty key people in order to introduce TMAP to every state in the nation. Allen Jones, a whistleblower in Pennsylvania, had this to say about NASMHPD: “Janssen’s influence of state Mental Health Directors was not limited to NASMHPD funded events. Janssen also formed “Advisory Boards” comprised entirely of State Mental Health Directors and regularly treated these “Advisory Board” members to trips and conferences, with all expenses paid by Janssen.”
About Parexel, Jones had this to say: “If you click on their ADAP [AIDS Drug Assistance Programs] Report and Medicaid Pharmacy Bulletin you will find other state level Directors participating. Different drug companies pay for each publication. What is significant here is that these publications are fluff pieces generated after ‘advisory board’ meetings in various locations throughout the country. The Directors are treated to trips, first class accommodations and other perks in exchange for showing up and listening to a spiel. The PA director, Steven Karp, admitted that the sessions were attended by Janssen sales personnel who directed the course of the meetings.” Jones continued: “Also significant is the fact that several members of the New Freedom Commission attended these marketing sessions, including Hogan, [Steven] Mayberg from California and Carlos Brandenburg from Nevada. Janssen had multiple cracks at 3 of 22 NFC members, including the chairman, during the time the NFC recommendations were being formed.”
Laurie Flynn was the Executive Director of NAMI but left in December of 2000 after a no-confidence vote from the board. She was then hired by Columbia to co-direct its Carmel Hill Center and eventually to direct the TeenScreen Program. She had been with Columbia University for just over a year when the NFC was formed. Flynn, well connected to pharmaceutical companies through NAMI, now works diligently to expand TeenScreen through every possible avenue. But she has even more connections.
Hogan and Flynn
Hogan and Flynn have known each other for some time. Prior to Hogan’s appointment to the NFC and Flynn’s hiring by Columbia, they collaborated on at least one other project, the “Expert Consensus Guideline Series: Treatment of Schizophrenia 1999”. And the purpose of this project? To establish uniform medication guidelines for schizophrenia. Sound familiar?
The “Expert Consensus Guideline” is explained by Allen Jones: “Essentially, TMAP opted to “establish” new drugs as the best drugs for various illnesses by surveying the opinions of doctors and psychiatrists of TMAP’s own choosing. No hard science, no patients, no study review, and no clinical trials – just the “Expert Opinions” of persons TMAP elected to survey.”
Hogan, Flynn and several members from the TMAP Project in Texas took part in this “Schizophrenia Consensus.” In agreement with TMAP protocols the newer, expensive, atypical, antipsychotic drugs ended up as the drugs of choice in the “consensus.”
NAMI was not only given credit for their collaboration on the overall TMAP project, but 51 representatives from chapters of NAMI are listed as "Policy Experts" in the “Expert Consensus Guideline Series for Schizophrenia”.
This consensus was generously supported exclusively by 6 pharmaceutical companies: Eli Lilly and Co., Janssen Pharmaceutica, Inc., Novartis Pharmaceuticals Corporation, Ortho-McNeil Pharmaceutical, Pfizer, Inc. and Zeneca Pharmaceuticals.
The NFC is Born
By 2002, Flynn, Hogan, TMAP, TeenScreen, big pharma and NAMI, were allied in their plan to implement widespread screening. The next step? Bush’s New Freedom Commission on Mental Health (NFC).
While Hogan is chiefly known for his appointment as head of Bush’s NFC, other factors have not been widely known. How he gained that important appointment and the key role he played in getting both TeenScreen and TMAP listed in the recommendations as "model programs” can all be explained by Laurie Flynn.
At the 2004 American Academy of Child and Adolescent Psychiatry’s (AACAP) annual meeting, Laurie Flynn made an eye-opening statement while giving a presentation on TeenScreen. She admitted her own covert role in creating the NFC by inserting a few words into Bush’s campaign speech prior to his election. Once Bush was "on the record" that he would form a commission, Flynn and others coerced President Bush into keeping that “promise.” In the same presentation, she said that Hogan’s appointment as the chair of the NFC was “not entirely by accident.”
Flynn stated: "...one of the things that we did here was to build on President Bush, not a major promoter of these kinds of initiatives, but to build on actually an opportunity that came to me while I was still at NAMI. I had worked for many years with Senator Pete Domenici and Paul Wellstone around the parity issue. And Senator Domenici hosted Candidate Bush, in New Mexico, where Candidate Bush declared his support for parity. This was as far as we could tell the last time that he has supported parity, - [laughter] - but he supported it that day in Albuquerque in front of the media, and I was one of a couple of people invited to add some remarks to his speech. And I was able, with a colleague, whose idea it was, it wasn't even my idea, in fact, I tried to talk him out of it, I'll confess, I said to him, ‘What the heck good is a Commission?" He was, at that time, Commissioner of Mental Health in Virginia and said, ‘Listen, they have, ya know, beat me up with Commissions in Virginia, this could be good!’. So, we put into this speech, and it survived the edit process, a line that Candidate Bush spoke, ‘And if I'm elected, I will convene a Commission, to look at why our public sector and our mental health system are not able to do the job our citizens deserve,’ or some such....anyways, he said ‘I'm havin' a Commission’. We had him on the record, once he was elected it took awhile, alot of r-e-m-i-n-d-e-r-s had to come to him that he had said this, we had to keep pushing this message and ultimately Senator Dominici had to r-e-m-i-n-d him that he had promised this. But indeed, a Commission was convened..."
Flynn went on to say, "...and not entirely by accident, uhmm, Mike Hogan from Ohio, the Commissioner of Mental Health in Ohio and one of our most distinguished Commissioners, was appointed as Chair."
Hogan was now in an ideal position to get TeenScreen and TMAP inserted into the New Freedom Commission recommendations. In December of 2002, Flynn plugged the TeenScreen program in a presentation to Hogan and members of the NFC. The result of their collaboration is that TeenScreen and TMAP both received prominent mention as “model programs” in the NFC recommendations to the president. This gave the TeenScreen Program the highly desirable “third party credibility” that their PR firms were looking for.
TeenScreen’s public relations firm seized upon this as a marketing ploy and to this day crows that “TeenScreen has been recommended by the NFC.”
Pushing the NFC Recommendations
Rabin Strategic Partners, Inc., one of TeenScreen’s hired PR companies, put together a key publication called, “Catch Them Before They Fall; How to Implement Mental Health Screening Programs for Youth as Recommended by the President's New Freedom Commission on Mental Health”. Hogan and Flynn’s intention on mental health screening becomes clear in the “Forward” of this publication, where it is stated, “It will take the effort of people like you to make mental health screenings for youth as commonplace as other preventive health efforts like hearing and vision screenings.” When states were slow in coming up with their own mental health action plans, per the NFC recommendations, TeenScreen decided a little push was needed. So along with Rabin, they sent out that publication and a copy of a "model resolution" that they wrote, to key players in all the states. Of course, TeenScreen was mentioned in that model resolution.
Flynn was quoted at that 2004 AACAP Meeting as saying, "One of the things that we did was to mail a copy of our report "Catch Them Before They Fall" and we mailed a model resolution, ahh, to all the 50 states, we sent this as a very friendly, ‘Here's some information you might like to use since you're on a health committee’ – we mailed it only to people who were in key committees – ‘you might like to have this resolution, to introduce the notion that every child should be screened for mental illness, at least once in their youth, in order to identify mental illness and prevent suicide.’ So we offered them up some language and some tools, and a surprising number of folks, in fact, introduced it exactly the way we sent it and made some real strides with it."
TeenScreen now had their program specifically mentioned in individual state mental health resolutions. States could then apply for federal funding and begin the task of expanding TeenScreen's goal to screen every child for mental illness.
The Pharmaceutical Industry
The pharmaceutical companies are positioned to gain billions in profit from TMAP and TeenScreen. Naturally, they have been ready and able to help with funding every step of the way. Who else would be in a better position to ‘help all those poor children’ that were now labeled with so-called “disorders” by TeenScreen? Who else had medications, at the ready, per TMAP recommendations? The NFC recommendations opened the door for the pharmaceutical industry.
Eli Lilly was quick to recognize the efforts of Mike Hogan by announcing the winners of their “2004 Helping Move Lives Forward Reintegration Awards.” First-place winners received a $5,000 cash contribution “to their respective institutions to further the success of their programs.” Lilly’s press release announced: "A First Place Lifetime Achievement Award will be presented to Michael Hogan, PhD, chair of President Bush's New Freedom Commission on Mental Illness…Dr. Hogan has [since] delivered over 75 presentations urging for the implementation of goals set forth in the Commission's Report.”
In looking over some of those “75 presentations,” it was found that these conferences were heavily funded by the pharmaceutical industry, who also traditionally pay for the keynote speaker. The Pharmaceutical Research and Manufacturers of America (PhRMA) and NASMHPD were heavy contributors as well.
Ohio’s Mental Health System under Hogan – Will the entire U.S follow?
What is Hogan’s personal stance on mental health screening? He would have preferred universal mental health screenings for the population, but he acknowledged that "science and public opinion" have not advanced to the point where universal mental health screening is acceptable. Hogan has expressed his frustration that implementations of the NFC recommendations have not proceeded faster. He conceded that “we in the field, would have an easier time convincing the public of the need for at least broader, if not universal, screening if the CMHS (Center for Mental Health Services) had published the NFC Action Plan that has been delayed.” CMHS is the federal agency within the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) that is charged with the efforts to implement the recommendations of the NFC.
The following two stories indicate what has happened in Ohio under Hogan’s watch and what might happen in other states if Hogan, Flynn, NAMI and the drug companies achieve their aims.
Drugging Babies in Ohio
In a Columbus Dispatch article dated April 25, 2005, the headlines read, “EVEN BABIES GETTING TREATED AS MENTALLY ILL; Prescriptions on the rise even though they haven't been tested on children”.
The Dispatch reported, “Nearly 40,000 Ohio children on Medicaid were taking drugs for anxiety, depression, delusions, hyperactivity and violent behavior as of July . For the entire year, the Ohio Department of Job and Family Services paid out about $65.5 million for kids' mental-health drugs.” They also reported that 696 Ohio children, ages newborn to 3 years old, received sedatives and powerful, mood-altering, mental-health drugs through Medicaid in July of 2004.
Valid research shows that ages 0-3 are the most critical years for the development of children. Combine that data with the recent FDA black box warnings on these drugs that list the physical side effects ranging from headaches, nausea and weight gain to heart attacks, liver damage, suicidal ideations and sudden death.
Hogan’s views on all this? The Dispatch reports, "The biggest public-health crisis facing the state and nation is the number of children with mental illness who fail to receive any care or treatment," said Michael Hogan, director of the Ohio Department of Mental Health. "It's true children are more likely to get medication than counseling or other behavioral therapy if they go to their pediatrician or family doctor. But at the end of the day, meds are quite safe and effective."
Medicaid Funding Crisis in Ohio
Medicaid spending in Ohio currently accounts for 37 percent of the state's $49-billion budget. Ohio is spending $2 billion this year alone on prescription drugs - a 94-percent increase since 2001. In 1999, under Hogan’s direction, Ohio’s version of the costly TMAP program was implemented in the state. It’s called OMAP, which was put into place in conjunction with Janssen Pharmaceutica, Eli Lilly and AstraZeneca. The Ohio Department of Mental Health and Ohio-NAMI were two of the primary movers of this program.
Medicaid is the primary funding source for mental health services with public funds currently accounting for 63% of all national mental health spending. The October 23, 2005 San Francisco Chronicle reported that, "Nationwide, Medicaid programs purchase an estimated 60 to 75 percent of antipsychotic drugs."
The cost to Medicaid for reimbursement of prescription drugs has grown faster than any other area of the program. More specifically, according to a report issued by the United States Surgeon General, expenditures for psychiatric drugs are among the fastest-rising costs, currently representing an estimated 20 percent of Medicaid’s total payment for pharmaceuticals. For Ohio, in 2002, psychotropic drugs were 23 percent of their Medicaid pharmacy budget. Typically, the costs for psychiatric drugs out-strip the costs for heart, asthma, antibiotics and blood pressure medications combined.
According to the National Pharmaceutical Council, Ohio has been rated one of the top 10 states in terms of the highest amount of Medicaid reimbursement for prescription drugs. Those 10 states alone, account for 58 percent of the total Medicaid drug payment amount ($7.9 billion out of $13.7 billion), with two antipsychotics - Zyprexa and Risperdal - representing almost 20 percent of all of the prescriptions.
The Washington Post, on June 16, 2005, reported a statement by House Energy and Commerce Committee Chair, Joe Barton (R-Texas), about the current conditions of Medicaid throughout the nation. He said, “We have reached a point where there just are not enough taxes or taxpayer money to keep Medicaid going,” adding, “Medicaid eventually will bankrupt every state in the nation.”
With the rising Medicaid expenses to state budgets, states are scrambling to rein in costs and meet budgetary constraints. Ohio Representative, Catherine Barrett, expressed concerns for these issues: “Ohio's Medicaid spending on drugs for mental health, needs a Task Force and an Oversight Commission to investigate the spike in Medicaid spending on antipsychotic drugs.”
In an interview with WIMA-AM Radio in November 2005, Hogan had this to say on OMAP in Ohio: “…frankly it didn’t work very well for us and we’ve discontinued it…..Increasingly it’s clear that the scientists don’t have pretty good information to give the doctors about which works best……So we thought, and frankly I thought at one point in time that this kind of algorithm where you’d give the docs, ‘Try this first, try this second,’ would be a good idea but it just hasn’t worked that well.” That must have been a pretty expensive lesson in Ohio.
Today and Tomorrow
This is not a complete report on what is happening today regarding the implementation of these programs. Due to the secrecy employed by TeenScreen and the various hidden channels by which TMAP is being introduced into government and private treatment plans, it is impossible to report the complete story.
At the time of this writing, TeenScreen claims 460 active sites in 42 states. As of August 2004, TMAP had been implemented in at least the following locations on a state government basis: Nevada; Ohio; Florida; Pennsylvania; South Carolina; New Mexico; Illinois; Georgia; Kentucky; Washington, D.C. and California.
The final chapter to this report will be written in the upcoming years and perhaps decades. Children will be screened for mental illness or they won’t; they’ll be given a series of psychiatric drugs and ECT or they won’t – depending upon the actions taken today and tomorrow of concerned parents, citizens, civic groups, churches and legislators. There is no longer any mystery about the actions and intentions of psychiatric interests, including NAMI and drug companies. They will continue to push programs like screening and TMAP and will succeed if not stopped. They are well-funded and fairly well organized. However, that does not make them right or invincible. Our next generation deserves the very best in care when it is needed, and protection from fraudulent “care” that is implemented to line the pockets of others.
Perhaps if more teens start thinking for themselves, as Andrew Workman of Ohio has, the future will turn bright. Andrew is an astute 14-year-old and has this to say: “I've been reading through new statistics regarding TeenScreen in Ohio, and it appalls me. I've come to realize TeenScreen is just a front to get kids on drugs whether or not people want to realize this.” Andrew is currently writing to all of his legislators in Ohio, to inform them of the dangers of TeenScreen.
Cassandra Dawn Casey, President and Co-Founder of ASPIRE (The Alliance to Stop Psychiatry’s Influence in Religion and Education) says that it’s important to speak up. She says: “Talk to your neighbors, friends, relatives, members of your affiliated organizations, including your clergy and educational leaders and your local legislative leaders. Help them to become better educated on this most important and dangerous initiative.”
David Oaks is the Director of MindFreedom International, which has united 100 groups working for human rights and humane alternatives in the mental health system. Mr. Oaks states, “I see a terrible tragedy unfolding as literally hundreds of thousands of young people are placed onto, often, dangerous psychiatric drugs, without families being offered full information or a range of alternatives.” He goes on to say: “I see an amazing rebellion stirring that cuts across usual political lines. A federal bureaucrat recently called this a "curious coalition" in the media. We are seeing traditionally conservative groups working together with progressive social justice and libertarian groups. The psychiatric drug companies have overextended themselves, and the general public is showing signs of waking up. I just hope they wake up very soon!”
When asked, “What needs to be done to thwart these insidious programs?”, Oaks said, “On the national level, let's unite to push through legislation, and make our topics issues in elections. While we may all work in different groups, it's especially important that, at times, all of these groups unite on some specific projects and pull together. We are confronting one of the richest industries in the history of the planet - the psychiatric drug industry - and this will take a lot of people power.”
Given the concerns and the united force needed to give back the power of choice to families and individuals, Mr. Oaks asks the ultimate question, “The question is -- will there be enough people to speak out to stop, literally, millions of more people being put on psychiatric drugs internationally? That is not an exaggeration. The mental health system has said they feel that millions of people around the world need to be put on psychiatric drugs, so the stakes are incredibly high.”
According to a September, 2005 Pittsburgh Post Gazette story headlined: “FIERCE OPPOSITION ARISES TO MENTAL HEALTH SCREENING IN SCHOOLS”, Hogan complained about opposition from a "curious coalition of people".
Hogan now says that "my skin is a little thin" after being accused of being a "pill pusher and worse".
Brace yourself Mr. Hogan, the curious coalition is expanding and curiously coalescing.
For a copy of the references for this article, please e-mail Sue Weibert at: email@example.com
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