Planned therapeutic nanny state: no matter the motives, efforts to do routine mental health testing on children in America's schools need to be stopped before they do irreparable damage.

The "Final Report" of the New Freedom Commission on Mental Health, a federal panel created in 2002 to "promote successful community integration for adults with a serious mental illness and children with a serious emotional disturbance," calls for the "total transformation" of America's "mental health delivery system." If implemented, the commission's recommendations would ultimately lead to mandatory mental health screening of all of America's schoolchildren.

The commission's "Final Report" recommends that mental health screening take place "in both readily accessible, low-stigma settings, such as primary health care facilities and schools, ... during their routine physical exams." (Emphasis added.) This arrangement would be necessary to accomplish what the report calls "routine and comprehensive testing and screening." In fact, all Americans would need to undergo such screening, since, according to the report, "Mental illness ranks first among illnesses which cause disability" in the U.S., and it is presently "under-recognized as a public health burden." So for our own good, all Americans--starting with schoolchildren--must undergo federally mandated mental health examinations.

The commission's report repeatedly states that mental health testing in schools needs to be "transformed" and "expanded" It defines as a "serious mental disturbance" a mental condition that "substantially interferes with or limits one or more major life activities," and it defines those activities as "functioning in social, family, and vocational/educational contexts." Teachers are already required to assess the behavior of students who cannot function adequately in those contexts, so the report's recommendations would obviously lead to many more children who exhibit such behavior being diagnosed as mentally disturbed. In fact, routine mental health screening of all students would undoubtedly lead to many children who don't exhibit such behavior being deemed mentally impaired based on government test results.

The report cites examples of symptoms of mental impairment, including "an inability to build or maintain satisfactory interpersonal relationships with peers and teachers" and "inappropriate types of behavior or feelings under normal circumstances." Therefore, each judgment of whether someone is mentally ill or not will be completely subjective.

This government created testing is not only unnecessary, it is also dangerous because it will likely get abused, used not only to screen for mentally ill behavior but for unwanted attitudes. Karen Effrem, M.D., explained the danger: "I am concerned, especially in schools, that mental health could be ... [diagnosed] based on attitudes, values, beliefs, and political stances--things like perceived homophobia.... This mental health program could be used as an enforcement tool to impose a very politically correct, anti-American curriculum."

In addition to being dangerous in principle, universal mental health screening presents many grounds for specific objections, such as the following:

* To be accurate, mental health diagnoses must be made by qualified professionals over a period of time. "Quick and dirty" diagnoses of millions of children by poorly trained personnel will result in many misdiagnoses and unnecessary drugging of children.

* The criteria for diagnosing mental disabilities are hotly debated even within the medical profession itself. (Even the diagnoses for Attention Deficit Disorder, a perceived mental problem which is commonly diagnosed in school age children, cannot be agreed upon by members of the medical profession.)

* Normal childhood conditions are labeled mental health disorders by the American Psychiatric Association, including mild depression, sadness, shyness, forgetfulness, sleeplessness, difficulties doing math problems, bedwetting, and boredom. Using this definition of mental illness, virtually every child will become a candidate for "mental health treatment"!

* Tying federal funding to federal mandates which promote prescribing drugs to children may well lead schools to over-classify or "over-prescribe" in an effort to maintain or increase their funding levels.

* Increasing the number of drugs being pushed on children may lead to parents being negligently charged with child abuse. Cases are already on the books of parents being charged with abuse because they refused to drug their children with Ritalin.

* The antidepressant drugs recommended by the New Freedom Commission are dangerous. The FDA recently admitted that antidepressants have been tied to the increased risk of suicide. As a result, the FDA will require its most severe label, the "black box warning" to be placed on these drugs.

* A 1999 Surgeon General Report cautioned that "psychostimulants do not appear to achieve long-term changes in outcomes such as peer relationships, social or academic skills, or school achievement."

According to Rep. Ron Paul (R-Texas): "Once created, federal programs are nearly impossible to eliminate.... Anyone who understands bureaucracies knows they assume more and more power incrementally. A few scattered state programs over time will be replaced by a federal program implemented in a few select cities. Once the limited federal program is accepted, it will be expanded nationwide. Once in place throughout the country, the screening program will become mandatory. This is why we can never trust new bureaucratic programs: no matter how benevolent their proponents claim them to be, most programs morph into something much larger than originally foreseen. Those who view my concerns as alarmism fail to understand the inevitable nature of bureaucratic growth."

In September, Rep. Paul offered an amendment intended to deny federal funding to "any new universal mental health screening program." Although that amendment was defeated, it did focus public attention on the truly dire potential consequences of the commission's plan for transforming our mental health care system. And that plan has yet to be implemented and can still be stopped.