Back in 2003, a federal commission created by President Bush recommended improving and expanding mental health programs in schools to provide help as early as possible to students with learning problems or those who might turn violent or disruptive.
The commission highlighted one means of early diagnosis, the Columbia University “TeenScreen” program, that allows students — with parental permission — to get a mental health “check-up” via a computer-based questionnaire before graduating from high school.
The commission’s 86-page report included this suggestion among a long list of recommendations to improve the U.S. mental health system. The report attracted little attention outside mental health circles.
But over the past two years, a cottage industry of fiery opposition has grown up around the proposal to expand mental health programs in the schools and has become a popular rallying cry for conservatives who see it as unwarranted government intervention in family life.
Opponents of school-based mental health programs point to parents who say their children have been misdiagnosed with problems such as attention deficit hyperactivity disorder (ADHD) and forced to take medication under pressure from school officials.
To these parents, the commission suggestion to “improve and expand” school mental health programs is the first, inexorable step toward mandatory school mental health screening for all students, and mandatory medication for many, despite repeated assurances by commission members, school officials and congressional experts that this won’t happen.
Led by groups like Ablechild.org and EdAction, these parents want to prohibit schools from having anything to do with the mental health of their students, saying it is the job of parents to ensure their children’s well-being.
As a first step, the groups are pushing Congress to pass legislation, sponsored by Rep. Ron Paul, R-Tex., and supported by House Majority Leader Tom DeLay, R-Texas, to prohibit any federal funding for mental health screening of students without the written consent of their parents.
“If [this legislation] is passed, it will prevent wasteful and potentially devastating federal funding while safeguarding the informed consent rights of all parents in what is a most serious matter — their children’s health and safety,” said Patricia Weathers, president and co-founder of Ablechild.org.
The educators and medical professionals on the other side of the debate agree parental consent should be required for screenings. But they also think it’s worth studying the idea of promoting voluntary screenings to get help for children who need it as early as possible.
“There is this curious coalition of people who are concerned about stuff that we didn’t recommend, and are making a big noise about it,” said Michael Hogan, director of the Ohio Mental Health Department and chairman of what was then called the New Freedom Commission.
“The core thing that the commission was concerned about is the fact that a lot of these mental health problems are pretty clearly problems of childhood and adolescent onset… Added to this is the fact that most children never get to see a mental health specialist.
“The fundamental logic of what the commission said is that we should take steps to facilitate access to care where children are.”
The debate over school screenings is just part of a larger discussion over the role schools should play in ensuring children’s mental heath. Many educators point to a clear connection between mental health and academic achievement.
“There are a whole slew of intra-personal variables that contribute to a kid’s ability to learn and are heavily related to their academic success,” said Stacy Skalski, public policy director for the National Association of School Psychologists.
“There are also inter-personal variables. Kids don’t come into the world knowing how to relate to others. They need to learn that.”
Bruce Hunter, a veteran policy official with the American Association of School Administrators, said it’s clear “the education business is tough enough without getting into the mental health business.
“But if a kid is going to beat the hell out of other kids regularly, and is disrupting the classroom, that’s a child that needs some mental health assistance. One of the things that our members have expressed is a rising concern about students’ mental health, and the ability to get them help when they have a problem,” Hunter said.
A complicating factor is that the debate over school mental health problems has become enmeshed in the vehement opposition of some people to medicating children for depression, hyperactivity and other problems. These opponents point to the nasty potential side effects of some commonly prescribed drugs, including suicide, and argue that they simply aren’t safe for children.
Hogan and others supporters of school mental health programs agree that more long-term testing should be done on antidepressants and other emotion-altering drugs prescribed for children and teens.
“We [commission members] recommended that the scientists and regulatory officials get on top of the safety issue,” Hogan said.
Weathers, of Ablechild.org, is among those who believe more attention should be paid to children’s nutrition and behavior management, instead of “being so quick to prescribe a drug.” Her group supports legislation, sponsored by Rep. John Kline, that would prohibit schools from requiring parents to have their children medicated to attend classes.
Kline’s bill would expand protections in the Individuals with Disabilities Act, which prohibited schools from requiring special education students to take certain medications, to all students. The bill also would cover more types of medication than in the disability law.