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The Obama Plan: Spending Mental Health Money in All the Wrong Places

English: Barack Obama

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The Obama administration proposes investing $235 million dollars into a new mental health program for our schools that is meant to increase the safety of our children and prevent future Newtowns. The money will train teachers and master's level mental health professionals so that they may detect early signs of mental illness in their students.
 
This well-meaning program is a serious mistake for two reasons. First, it is no more than a politically correct, cosmetic solution that distracts attention from what really needs to be done. Second, it will likely wind up doing much more harm than good for the kids who are identified as being at risk for mental illness.
 
I really can't imagine the content of the training programs. There is nothing to teach -- no proven way of detecting early signs of mental illness in children and no proven way of preventing it. Predicting violence is like picking a needle out of a haystack. The rarity of the event makes accurate identification simply impossible.
 
Most of the kids singled out (and stigmatized) by the early warning system will be 'false positives' -- not really at risk for violence or mental illness and much better left alone to mature out of their problems. And most future mass murderers will be 'false negatives' -- completely missed by the broadly cast net.
 
Attempts at prevention and early treatment are likely to increase the already rampant overuse of inappropriate medication in children. Many, if not most, of the kids identified will have no more than self-limited developmental or individual differences. But many will get unnecessary and potentially harmful treatment.
 
A large Canadian study showed that the best predictor of Attention Deficit Disorder in a boy is whether his birthday is in January or December (January 1 being the cut off date for school assignment). The horrible conclusion: we are medicalizing as mental disorder being young, being immature and being male. We should let boys be boys and not have our teachers play amateur psychologist.
 
The experience of prevention screening of young kids in New Zealand should be cautioning. Shortly after its initiation there was a dramatic increase in the diagnosis of Attention Deficit Disorder.
 
Early screening and preventive treatment are no longer the darlings of medical practice. Accumulating evidence makes clear how ineffective and harmful are almost all the highly touted screening tests. The best example: Screening for prostate cancer doesn't save lives, but does lead to invasive surgical and medical treatments.
 
Encouraging mental health screening for children is unsupported by scientific evidence and amounts to a reckless public health experiment on children.
 
Meanwhile, the misguided Obama program will divert attention from the two ways we really could improve school safety. The first is most obvious -- guns kill kids and the more powerful the gun, the more kids who will be killed. We can't predict who the mass murderer will be, but we can predict that he will kill more people in proportion to the power of his weapon.
 
It is absurd to argue that private citizens have the right to own military style firearms and callous to ignore the great harms that have been inflicted by assault weapons in the past and will be inflicted by them in the future. Politicians must finally buck the NRA and do what is right for the kids (and the rest of us) -- or else wonder why they didn't when future mass murders keep piling up.
 
Second, our mental health system is currently a mess and is rapidly getting much worse. Curing it won't end violence because the mentally ill are responsible for only a small percentage of violent crimes. But this is a good place to start and providing decent psychiatric services is necessary anyway if we are to become a humane and productive society.
 
As President Obama himself has pointed out, it makes no sense that the mentally ill now have much more easy access to guns than to proper treatment.
 
State budgets for mental health services (never robust) have been slashed in recent years so that it takes months to get a first outpatient appointment and it is almost impossible to be admitted to a hospital bed. Money should not be wasted on futile preventive programs to detect mental health problems that don't exist.  Instead, resources should be invested where there is desperate need to properly treat and decently house psychiatric patients who are now shamefully neglected.

 

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