Screening for Mental Illness: The Merger of Eugenics and the Drug Industry

By Sharav, Vera Hassner | Ethical Human Psychology and Psychiatry, Summer 2005 | Go to article overview

Screening for Mental Illness: The Merger of Eugenics and the Drug Industry


Sharav, Vera Hassner, Ethical Human Psychology and Psychiatry


The implementation of a recommendation by the President's New Freedom Commission (NFC) to screen the entire United States population-children first-for presumed, undetected, mental illness is an ill-conceived policy destined for disastrous consequences. The "pseudoscientific" methods used to screen for mental and behavioral abnormalities are a legacy from the discredited ideology of eugenics. Both eugenics and psychiatry suffer from a common philosophical fallacy that undermines the validity of their theories and prescriptions. Both are wed to a faith-based ideological assumption that mental and behavior manifestations are biologically determined, and are, therefore, ameliorated by biological interventions. NFC promoted the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan. The impact of TMAP is evident in the skyrocketing increase in psychotropic drug prescriptions for children and adults, and in the disproportionate expenditure for psychotropic drugs. The New Freedom Commission's screening for mental illness initiative is, therefore, but the first step toward prescribing drugs. The escalating expenditure for psychotropic drugs since TMAP leaves little doubt about who the beneficiaries of TMAP are. Screening for mental illness will increase their use.

Keywords: psychiatry; eugenics; screening; TMAP; "New Freedom Commission"; drue prescribing model

The catalyst for my article is the United States government's plan to implement an involuntary mental illness screening initiative as recommended by the President's New Freedom Commission on Mental Health. In no other democratic country has the government adopted a policy to screen the entire population-children first-for presumed, undetected, mental illness. According to the British Medical journal, President Bush instructed more than 25 federal agencies to develop an implementation plan to begin screening America's 52 million schoolchildren and 6 million school personnel for hidden mental illness (Lenzer, 2004).

The rationale behind this mind-boggling initiative is, in part, evidence of America's abiding faith in science and technology to provide solutions for complex human and societal problems. The "pseudoscientific" methods of screening for mental and behavioral abnormalities are a legacy from the discredited ideology of eugenics. Eugenics and psychiatry suffer from a common philosophical fallacy that undermines the validity of their theories and prescriptions. Both have adopted a faith-based ideological assumption that mental and behavior manifestations are biologically determined, and are, therefore, ameliorated by biological interventions.

The diagnosis of mental illness is neither scientific nor objective-inasmuch as it relies on the subjective assessment by mental health professionals using checklists and the catchall dragnet for mental disorders, the admittedly flawed DSM-IV. The subjective methodology for diagnosing mental illness was acknowledged by the U.S. Surgeon General Report on Mental Health: "Mental health is not easy to define. .. . what it means to be mentally healthy is subject to many different interpretations that are rooted in value judgments that may vary across cultures" (U.S. Surgeon General, 1999).

Screening will most likely inflate the number of American children (and adults) labeled with a mental illness. The New Freedom Commission (NFC) promoted the Texas Medication Algorithm Project (TMAP) as a "model" medication treatment plan that (the NFC report claims) "illustrates an evidence-based practice that results in better consumer outcomes" (p. 68). TMAP was a pharmaceutical company-sponsored pilot program whose flow charts guide mental health professionals on which psychotropic drugs to prescribe. TMAP has been adopted by at least 12 states, Ohio among the first. Ohio's director of the Department of Mental Health is Michael Hogan, PhD, chairman of NFC, who is an enthusiastic promoter of TMAP. …

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