NAMI Condemns Congressional Hearing for Putting Children at Risk

Posted on October 6, 2000

Arlington, VA - The National Alliance for the Mentally Ill (NAMI) is protesting a recent Congressional hearing held on "Behavioral Drug Use in Schools" for presenting a "skewed, inflammatory perspective" on issues surrounding the roles and responsibilities of parents, physicians and schools in screening children for mental illnesses and selecting treatment options.

U.S. Rep. Peter Hoekstra (R-MI) chaired the September 29th hearing of the oversight subcommittee of the House Committee on Education and the Workforce, in which U.S. Rep. Bob Shaffer (R-CO) also participated. The witnesses included a member of the Colorado Board of Education..

"The hearing offended me and thousands of other parents who conscientiously struggle to get diagnosis, treatment and support services for our children," said NAMI Executive Director Laurie Flynn in an October 6th letter to Chairman Hoekstra. "Unfortunately, the largely one-sided rhetoric presented at the hearing serves primarily to scare or discourage parents who are seeking help for their kids. In that respect, it puts children at risk."

"Our common goal should be to offer the highest standard of evaluation and appropriate treatment, Flynn said. "Some children do not need to be on medication, but many children are not being screened at all. Some children need treatment and are not getting it. Their entire lives will be affected by the failure to identify and treat their illnesses."

"Some may even kill themselves," Flynn warned. Suicide today ranks as the third-leading cause of death for youth, ages 15 through 24.

NAMI took strong exception to Hoekstra's closing remarks that "no professional consensus" exists about attention deficit/hyperactivity disorder (ADHD) and other mental illnesses. Two physicians who testified before the subcommittee, Flynn said, "hardly represented the main body of scientific expertise and opinion." One called ADHD and other mental illnesses "a biological lie." Another attacked the use of medications approved by the Food & Drug Administration (FDA) and shown to be effective for ADHD, calling them, inaccurately, "the most addictive drugs known in medicine today."

The Colorado School Board member similarly raised "an inaccurate, stigmatizing allegation" that violence is a side effect of psychotropic medications, and attacked assistance to children challenged by what she termed "vague psychiatric disorders."

What the hearing did not mention was the landmark 1999 Surgeon General's Report on Mental Health, which provides the current national baseline for understanding mental illnesses and treatment options. Almost 21 percent of children, ages 9 to 17, today suffer from mental or addictive disorders. Scientific reviews also indicate strong support for the "safety and efficacy" of several classes of medication for specific disorders, including ADHD. The hearing also completely ignored two recent, major federal conferences on children, mental health, and psychopharmacology, which will provide the foundation for an expected Surgeon General's call to action later this year.

"Neither the Surgeon General or the National Institute of Mental Health testified at the hearing, said Flynn. "Not a single family with children who have been successfully screened, diagnosed and treated was heard."

NAMI noted that the hearing stands in ironic contrast to one recently conducted by the House Judiciary Subcommittee on Crime, which focused on the increasing, unfair burden that untreated mental illness imposes on individuals, communities, police officers, and the criminal justice system. Flynn emphasized the importance of the Education's Committee's role in supporting early screening, diagnosis and treatment of mental illness "as part of a greater continuum of social interests."

Last week, Congress also approved several pro-science, pro-treatment measures as part of H.R. 4365, the Children's Health Act of 2000.

"Please do not ignore the existing, bipartisan consensus that already exists on such issues," Flynn asked Hoekstra. "Please do not seek to undermine the progress that already is being made."

October 6, 2000

The Honorable Peter Hoekstra
Chairman
Subcommittee on Oversight & Investigations
Committee on Education & The Workforce
U.S. House of Representatives
Washington, D.C. 20515-6100

Dear Mr. Chairman:

On behalf of more than 210,000 members of the National Alliance for the Mentally Ill (NAMI), with 1200 affiliates nationwide, I wish to take strong exception to the hearing you chaired on September 29, 2000 on "Behavioral Drug Use In Schools: Questions & Concerns," including your summary and characterization of testimony in your closing remarks.

The hearing offended me and thousands of other parents who conscientiously struggle to secure adequate diagnosis, treatment and support services for our children. Your statement at the end of the hearing that "there is no professional consensus" about attention deficit/hyperactivity disorder (AD/HD) and other mental illnesses is simply untrue. The hearing presented a greatly skewed, inflammatory perspective on important issues surrounding the roles and responsibilities of parents, physicians, and school systems in assessing children for mental illnesses and choosing appropriate treatment options:

• Not a single reference was made to the landmark 1999 Surgeon General's Report on Mental Health, issued less than a year ago, which currently stands as the national baseline for understanding mental illness and treatment options. The report estimates that almost 21 percent of children, ages 9 to 17, today suffer from mental or addictive disorders and considers scientific reviews to support strongly the "safety and efficacy" of several classes of medication for specific disorders, including ADHD.
• The hearing also ignored completely the national conference the Surgeon General convened the previous week on Children's Mental, Health, as well as the joint conference by the Food and Drug Administration (FDA) and National Institute of Mental Health (NIMH) scheduled three days later-which together will contribute to a Surgeon General's call to action later this year.
• Neither the Surgeon General, NIMH or other scientific experts testified at the hearing.
• Two of the physicians who testified before the subcommittee hardly represented the main body of scientific expertise and opinion. One called ADHD and other mental illnesses "a neuro-biological lie" and psychiatry as a profession "a fraud." The other claimed that ADHD is not an illness, but rather, normal behavior, requiring only "discipline and better instruction." He attacked the use of medications approved for use by FDA and shown to be effective for ADHD in a large number of studies, calling them inaccurately "the most addictive drugs known in medicine today."
• A member of the Colorado State Board of Education raised an inaccurate, stigmatizing allegation that violence is a side effect of psychotropic medications and attacked assistance to children who are challenged by what she called "vague psychiatric disorders."
• Only one parent was called as a witness, who similarly reflected an anti-psychiatry point of view. Not a single family with children who have been successfully screened, diagnosed and treated was heard.

NAMI underscores the testimony of the U.S. Assistant Secretary of Education for Special Education & Rehabilitative Services who called the statements by the two professional anti-psychiatry witnesses "unfortunate and misleading" and cautioned that we need to "grapple with these issues in a reasonable way." We also concur with the testimony of Dr. David Fassler, representing both the American Psychiatric Association and the American Academy of Child & Adolescent Psychiatry, who pointed out that diagnoses require careful physical examinations and extended behavioral observation. They cannot be made in a 20-minute office visit, and medication should not be regarded as a "quick fix" to make a problem go away. Successful treatment takes time. It requires choices made by parents, working with an appropriate physician. It also deserves the support of schools and communities.

The hearing also stands in ironic contrast to one conducted by the House Judiciary Subcommittee on Crime on September 21, 2000 on the "Impact of Mentally Ill Offenders and the Criminal Justice System," which focused on the increasing, unfair burden that untreated mental illness imposes on individuals, communities, law enforcement, and the criminal justice system. People with mental illness are no more prone to violence than the rest of the population, but I mention the Judiciary Committee's concerns in this area to emphasize the importance of the Education Committee's role in supporting the early assessments, diagnosis and treatment of mental illness as part of a greater continuum of social interests.

Last week, Congress also approved pro-science, pro-treatment provisions as part of H.R. 4365, the Children's Health Act of 2000. Please do not ignore the existing, bipartisan Congressional consensus that already exists on such issues, and please do not seek to undermine progress that already is being made.

Unfortunately, the largely one-sided rhetoric presented at the hearing serves primarily to scare or discourage parents who are seeking help for their children. In that respect, it puts children at risk, particularly when suicide today ranks as the third-leading cause of death for youth, ages 15 to 24-nearly triple the rate 40 years ago. Our common goal should be the highest standard of evaluation and appropriate treatment. Some children do not need to be on medication. They should be identified through better evaluations before any treatment is begun. But many children are not being screened at all. Some children need treatment and are not getting it. Their entire lives will be affected by the failure to identify and treat their illnesses now, when intervention can make a difference. This should be one of the subcommittee's paramount concerns. NAMI stands ready to work with you to address it and related issues constructively.

Sincerely,

Laurie Flynn
Executive Director