Dr. Patch Adams: “Let me screen the President!”

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Mind Freedom

Is it true that the Bush administration has announced a plan to screen all Americans for “mental illness”?

Yes, this is true. The British Medical Journal (BMJ July 2004) reported that Bush plans to unveil a sweeping mental health initiative that would screen every single American for “mental illness.”

As predicted, President Bush did endorse the plans promoted by the President’s New Freedom Commission on Mental Health. A task force was initiated to evaluate the current mental health industry and look for ways that it could be improved. These plans include screening every single American, with youth as a priority, for signs of “mental illness.”

How will people like me be screened?

As the BMJ reported, everyone is at risk of being labeled under Bush’s plan. Bush’s New Freedom Commission identified a program called the Texas Medication Algorithm Project (TMAP) as the model program to be implemented across the US to identify people with “mental illnesses” who have previously been undiagnosed.

TMAP would call for general health practitioners to screen their patients for mental illness. The Bush administration wants your family physician trained to screen you for mental health problems. So if you go to your doctor for a cough, you would also be asked questions about your mental health.

Anyone involved with the public school system, including kids, educators and other school staff, would be especially vulnerable. Doctors are trained to recognize that the way children act in the doctor’s office is not a good indicator of the children’s actual behavior. Because of this fact, doctors are more likely to follow the suggestion of a teacher, rather than their own experience interacting with the child. This results in a situation where teachers, not doctors, are, in essence, prescribing medication to kids.

What is TMAP?

TMAP is a program started in Texas in 1995, which coincidentally was when Bush was serving as the governor of Texas. While the name might be confusing, the Texas Medication Algorithm Project is nothing more than a series of flowcharts to standardize the steps taken to treat a vast array of “disorders” ranging from schizophrenia to depression.

“Algorithm” is just a mystifying way to describe those steps to screen everyone, label some, and then place those that are labeled on the most expensive psychiatric drugs first. TMAP is an unscientific cookie cutter method where “one size fits all,” and where the drug companies that designed the model can make huge profits, often at the expense of taxpayers and insurance customers.

But aren’t programs like TMAP and “Teen Screen” good ideas? Don’t we want to find out if people have mental and emotional problems, especially young people?

The idea of looking for people who need help sounds great. But too often when it comes to mental health issues, citizens let the experts handle it. It’s time to pop the hood and look inside. What does TMAP really do? And who came up with the idea?

Unfortunately, TMAP and similar programs are like conveyor belts, bringing more and more customers to the psychiatric drug industry. The origin of TMAP is with powerful psychiatric drug corporations. TMAP has come under fire recently because of a strong link between the politicians who helped make TMAP a reality in Texas and the large pharmaceutical companies who stand to make a huge profit from TMAP has been discovered. The drug corporations made sure that TMAP is programmed so that when a person with emotional and mental problems is identified, the first step is often the prescription of the most expensive psychiatric drugs, and sometimes multiple psychiatric drugs.

This corruption is the central focus of a lawsuit in Pennsylvania filed by Allen Jones.

Who is Allen Jones?

Allen Jones, until his recent interview with the British Medical Journal, was a state employee in Pennsylvania working as an investigator with the Office of Inspector General (OIG). While working as an inspector he discovered that politicians in Pennsylvania were receiving gifts from drug companies at the same time they were deciding whether or not to adopt TMAP in Pennsylvania.

Throughout his investigation into TMAP, Mr. Jones met resistance from his superiors who attempted to curtail his investigation by telling him that, as he says in court documents, “pharmaceutical companies are major political contributors and that I should not continue my probe.”

Mr. Jones ignored the overt threats and suggestions made by OIG officials, and despite being removed from the investigation he continued probing as a concerned citizen. Through this investigation he also learned that policy makers in Texas had also been influenced by the drug companies.

He reports in court documents in his law suit that, “The pharmaceutical industry has methodically compromised our political system at all levels and has systematically infiltrated the mental health service delivery system of this nation. They are poised to consolidate their grip via the New Freedom Commission and the Texas Medication Algorithm Project.” His complete lawsuit is available on-line – check out the links to read more.

What’s wrong with TMAP?

As the BMJ reported, TMAP has been criticized by many people of protecting drug companies’ profits at the expense of mental health consumers. What is questionable and alarming about TMAP is that doctors do not have the leeway to deviate from the treatment model.

Whether the patient is diagnosed with “depression”, “ADHD” or “schizophrenia,” TMAP inevitably leads to the most expensive, brand named drugs currently manufactured. Doctors in TMAP are required to prescribe these drugs, which happen to be the highest priced, patented drugs on the market, and they cannot prescribe less expensive, generic drugs unless the patented ones fail to work. And of course, non-drug alternatives are not a priority in TMAP. If implemented nationwide, TMAP will result in millions of dollars flowing into the pharmaceutical companies who lobbied the politicians to make TMAP a reality.

TMAP is not democracy in action; rather it is big business buying a place in American government policy. While this might not be anything new, this is one of the first times a presidential initiative has had the potential to result in the screening of all American citizens for possible psychiatric drugging. Not only is this an infringement on our civil liberties, but because the drugs most commonly prescribed under TMAP are the most expensive drugs currently manufactured, programs like Medicaid and Medicare would need significant budget increases to support the cost of the medication.

Some people have argued that the high prices of the drugs that TMAP promotes is not a legitimate worry because in the long run there would be a net savings because people diagnosed with psychiatric disabilities would receive “proper treatment” and would not end up in jail. However, this argument is flawed because it is based upon the assumption that the newer more expensive drugs prescribed under TMAP work better than the older less expensive drugs, or better than non-drug alternatives. There is not enough empirical evidence to support this assumption, and certainly not enough research to implement this program nationwide. There is also no scientific evidence of any biological chemical imbalance despite advertising claims by the drug companies.

While TMAP claims to be “evidence based,” the fact is that the logic behind TMAP is “drug company profit based.”

Are there any other lawsuits in progress like the one that Allen Jones filed?

Yes, the BMJ also reported that psychiatrist Stefan Kruszewski, was fired July 11, 2004 from his position at the Bureau of Program Integrity in the Pennsylvania Department of Public Welfare.

Dr. Kruszewski’s was in charge of the state’s mental health and substance misuse programs to protect against fraud, waste, and abuse. He was fired after he began investigating the cause of death of four children and one adult who were under the state’s care using TMAP. Some patients were on as many as five powerful “neuroleptic” psychiatric drugs at the same time. This is known as “polypharmacy” and is extremely dangerous.

He reported to his supervisors that this off-label treatment was dangerous and potentially a liability risk for the state. His supervisors replied that it was none of his business and he was ultimately fired for his continued interest in the subject. The entire BMJ article can be read on-line and can be accessed by following the link on the links page.

What happens to people that do not respond to the drugs prescribed under TMAP? Can they be prescribed an alternative form of treatment?

Actually yes. There is a back-up plan just in case the drugs do not work. Electro-convulsive therapy (ECT), also known as shock treatment, is part of TMAP. If patients diagnosed with “clinical depression” do not respond well to the first few expensive drugs that they are prescribed, they can expect to eventually get shocked, which causes brain damage.

Where can I go to see what the TMAP program looks like?

There are numerous government websites that specifically address TMAP. An effective way to find more information on the web about TMAP is to run a web search for TMAP and Texas. Or check out the links page below.

Besides Texas, is TMAP currently in use in any other locations?

As of August 2004, TMAP has been implemented in the following places: Nevada; Ohio; Pennsylvania; South Carolina; New Mexico; Atlanta and Athens, GA; Louisville, Kentucky; Washington, D.C.; San Diego County, CA; and private sector in Denver, Colorado

What happens if I go to see my doctor and I end up with a label and a treatment plan that I do not agree with?

Versions of “outpatient commitment” are growing throughout the USA, and internationally. Forty-two USA states now have laws that allow individuals to be court ordered to take their psychiatric drugs while living out in the community, even in their own homes.

Psychiatrist Sally Satel, author of the book PC MD, is a fellow working for the huge corporate think tank American Enterprise Institute (AEI) in Washington DC. The Bush administration, which has very close ties to AEI, appointed Dr. Satel to a position on the National Advisory Council of the US Center for Mental Health Services, a half-billion dollar federal agency. This means Dr. Satel sits on a committee that privately reviews all mental health service grants from the federal CMHS.

Dr. Satel and AEI are also major proponents of increasing the use of forced psychiatric drugging, including outpatient commitment. During the June 2004 meeting of the National Advisory Council for CMHS, members were asked to prioritize the main “systems change” they would like the Bush Administration to implement. Dr. Satel requested that outpatient commitment be vastly increased.

Dr. Satel is one of the major opponents of the social change movement led by mental health consumers and psychiatric survivors. Her book, PC MD, contains a chapter called “Inmates take over the asylum” that denounces activists and groups in our movement by name. In the chapter, Dr. Satel identified Support Coalition (now called MindFreedom Support Coalition International) as one of the top three groups that she opposes.

Dr. Satel’s opinions are cherished by the Bush administration. If TMAP is implemented across the U.S., Dr. Satel’s vision of increased court ordered drugging has the potential of creating a situation where every single American is not just an easy target for a screening program designed by big pharmaceutical corporations, but these citizens may also be unable to say “no” when their doctor pulls out the prescription pad following a few minute interview that has led to them into being branded as having a “mental illness.”

AEI itself has also held a special seminar promoting the increase of psychiatric drugs in the USA. One of the board members of AEI is from a major psychiatric drug corporation. AEI’s threat to push for more forced psychiatric drugging should be taken quite seriously. After all, Mother Jones magazine credits AEI as being the think tank that helped cook up plans for the war against Iraq. AEI is part of an “organized wealth” backlash since the 1960’s to fight social change movements. In fact, Satel has said that a common denominator for people she opposes is that her opponents believe that an imbalance of wealth in a nation can play a key role in adversely impacting health.

And so who is this Patch Adams?”

Patch Adams is a physician, clown, philosopher and all around human being who lives in Arlington, Virginia, USA. A film Patch was made of his life, starring Robin Williams. Patch is a psychiatric survivor who went on to become a doctor, including assisting people diagnosed with psychiatric disabilities. Since 1992, when he spoke at a MindFreedom counter-conference to the American Psychiatric Association Annual meeting in Washington, D.C., Patch has been a leader in MindFreedom, representing his Gesundheidt Institute on MindFreedom’s International Advisory Council. Gesundheidt is a “funny hospital” being created on several hundred acres of land to supporti empowered and humorous healing, and it is one of 100 sponsor groups in MindFreedom.

MindFreedom asked Patch to do the screening of President Bush and he answered, “He needs a lot of help. I’ll see him for free.” MindFreedom asks that, in keeping with its underlying principles, any mental health screening of President Bush – even symbolic – be completely voluntary, face to face, and without involving psychiatric labels.

President Bush, please let Patch Adams screen you first. He may be able to help, so that you’ll call off TMAP and institute some true, empowering, humane help for people in crisis.

For more information see MindFreedom Ph: 541-345-9106, or at the link above.