Why TeenScreen (mental health screening) is a terrible idea

Scientific American talks sense! And Robert Whitaker’s work is breaking into the mainstream, finally, where it belongs that we might stop hurting vulnerable people of all ages.

From Scientific American: Why Screening Teens for Mental Illness Is a Terrible Idea

Given the recent trend toward prescribing powerful, profitable and potentially harmful psychiatric medications to children in the U.S., I fear that TeenScreen and similar programs may end up hurting more children than they help. Here’s some background information, most of which comes from Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America  (Crown 2010), a book by the journalist Robert Whitaker that I have mentioned previously.

*Several decades ago, children were rarely diagnosed with mental illness. Today, leading psychiatrists estimate that more than 10 percent of all children suffer from mental illnesses—from attention-deficit disorder to full blown psychosis. In 2008, the General Accounting Office estimated that one in 16 children is “seriously mentally ill.” The number of children so mentally disabled that their families are eligible for government assistance has swelled from 16,200 in 1987 to 561,569 in 2007, a 35-fold increase. During this same period, the number of children requiring government assistance for all other ailments—from cancer to retardation—declined from 728,110 to 559,448.

*3.5 million American children are now taking Ritalin and similar medications for attention-deficit hyperactivity disorder (ADHD), up from only 150,000 or so in the late 1970s. That comes to about one out of every 23 children from four to 17 years old. American children consume three times as many ADHD medications as the rest of the world’s children combined. One study cited by Whitaker, which was funded by the National Institute of Mental Health, concluded that long-term drug treatment of ADHD was associated with increased rather than decreased symptoms.

*Since the selective serotonin reuptake inhibitor (SSRI) Prozac was introduced in the late 1980s, the number of children treated with SSRIs and other antidepressants has soared. One 2002 study estimates that one in 40 children 18 years old or younger takes antidepressants. Whitaker cites numerous studies indicating that antidepressants, while they can provide short-term relief for some children, over the long run are at best ineffective and at worst harmful. Children treated with antidepressants may experience side effects ranging from anxiety and insomnia to full-blown mania and psychosis.

*The most startling trend in pediatric psychiatry is the surge in diagnoses of bipolar disorder, which just a few decades ago was viewed as almost exclusively an adult disease. Since 1995, the number of children diagnosed with bipolar disorder has multiplied more than 40-fold to roughly 800,000. Whitaker presents persuasive evidence that this epidemic may be driven, at least in part, by increased consumption of stimulants (for ADHD) and antidepressants. These medications can trigger bouts of mania followed by sluggishness in children, who are then re-diagnosed with bipolar disorder.

*Children diagnosed as bipolar are treated with drugs—notably antipsychotics normally prescribed for adult schizophrenics—that have severe physiological as well as mental side effects, including obesity, diabetes and involuntary tremors. More than half a million children—including infants less than two years old!—are now ingesting antipsychotics. This trend, The New York Times reported last year, has been aggressively promoted by manufacturers of antipsychotics, which have become the most lucrative class of drugs in the world. (rest here)

Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America is now available in paperback.

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