PART 2 of 2
Editor’s note: Read part 1 of this essay, “How ‘Mental Health Awareness’ Exploits Schoolchildren,” here.
During my career as a social work consultant and member of a multi-disciplinary team in Canadian schools, we staff were tasked with supporting, counseling, and advocating for students with academic, emotional, or behavioral issues, which were said to impede their ability to succeed in school. Beginning in the 1990s, however, we were urged to view our students’ difficulties as “mental health” problems, and to deliver our students over to medical experts, who would often prescribe drug treatments.
For example, one handbook, When Something’s Wrong: Ideas for Teachers by the Canadian Psychiatric Foundation, told administrators and school principals that a significant number of students were suffering from a brain dysfunction. But the causes of these “common” mental disorders — anxiety, autism, depression, eating disorders, impulse control disorders, schizophrenia, and others — were said to be unknown. Although there were no physiological tests to determine the existence of any of these disorders, the handbook assured teachers that they did exist, and drug treatment worked.
My experience was showing me otherwise. And the main force driving school-based “mental health awareness” initiatives was becoming increasingly clear to me. Adorning the back of When Something’s Wrong, alongside the names of sponsoring local businesses and non-profit organizations, were the names of drug companies: Lundbeck, Pfizer, Sanofi-Syntel, and Janssen-Ortho.
Then, I discovered a 1990 booklet titled ADHD: Attention Deficit Hyperactivity Disorder and Learning Disabilities Booklet for the Classroom Teacher, which filled in some of the missing pieces. The booklet, written by a psychiatrist named Larry Silver, was sponsored by the drug company Ciba-Geigy. Ciba-Geigy was clearly using it as a marketing tool to increase sales of Ritalin by promoting the disorder to teachers.
Documents like these, I realized, are part of the arsenal of tactics pharmaceutical giants and their allies have used to sell psychiatric drugs as healthful for children — and thereby maintain a steady stream of customers for their products.
How Pharma Entered Schools
The U.S. Surgeon General’s declaration of a childhood mental health crisis in 2001, which launched so many of these school-based initiatives, was itself heavily influenced by the pharmaceutical industry. The 2000 Surgeon General’s Conference on Children’s Mental Health, which preceded it, included a related meeting on “Psychopharmacology for Young Children: Clinical Needs and Research Opportunities” held by the National Institute of Mental Health and the Food and Drug Administration. Recommendations from these two meetings formed the basis of the national action agenda.
This alliance was not new. As Dr. Peter Breggin documented in his book The War Against Children of Color (1998), big pharma has been funneling money — both directly and indirectly — to National Institutes of Health research programs searching for biological markers for disruptive behaviors since the 1960s. This industry-government partnership ramped up in the early 1990s with the now-discredited federal “violence initiative,” which aimed to identify and medically treat alleged genetic defects in inner-city youth that were said to predispose them to crime.
Consequently, strategies such as the “talk to your doctor” campaign about any childhood problem have been extremely effective in helping the industry to marginalize traditional child-rearing practices to control children’s behavior and replace them with advice from mental health “experts” and the use of dangerous drugs. These campaigns are reminiscent of now-illegal vintage tobacco ads in which doctors endorsed cigarette smoking.
Other tactics, including illegal marketing of drugs for unapproved uses in children, along with health insurance fraud, kickbacks to doctors, and failure to disclose safety data, have been well documented in the news media but are little known to consumers. These crimes have led to billions in fines against pharma companies. Clearly, the fines have not been an effective deterrent.
Workshops as Drug Sales
The pathologizing of children has also led to opportunism. The schools where I worked were inundated with requests from various individuals and interest groups to get a piece of the action. Beginning in the 2000s, anti-bullying and anxiety-management programs, various forms of therapy, and psychological assessments began to proliferate. For example, the influential Collaborative Problem-Solving approach developed by psychologist Ross Greene in collaboration with Harvard-affiliated Massachusetts General Hospital became the rage. At a two-day workshop I attended in 2010, Greene encouraged teachers to lower their expectations for children with disruptive behaviors and view these kids as simply having developmental deficits that were biological in nature.
If these collaborative problem-solving strategies did not work with some children, Greene suggested, that could mean these youth were suffering from bipolar disorder and needed medication. (At the time, Greene was an associate of psychiatrist Joseph Biederman, who first promoted the notion of childhood bipolar disorder.) Teachers were advised to recommend Greene’s book The Explosive Child to their students’ parents, and it has since become a bestseller.
The trend continues today. Consider what school board superintendents were taught at a recent workshop in Vancouver by psychiatrist Stan Kutcher, the Sun Life chair of Adolescent Mental Health at Dalhousie University. According to his workshop guide for educators, “The exact cause of mental illnesses is not yet known…” But the guide then goes on to contradict this assertion by claiming or implying dozens of times that mental illnesses have biological causes just like physical illnesses, and that medications are the best way to treat them.
On page 25 of the guide, there is a link to a video called “Ellie’s Depression.” Toward the end of the video, formerly sad and struggling Ellie is shown happily taking pills, emphasizing the message that drugs are the solution to her problem. No parents or family are depicted.
It’s doubtful school administrators, parents, or students know that Kutcher was one of the authors of the infamous medical journal article on Study 329. The study, which downplayed the negative effects of the antidepressant Paxil in teenagers, was later discovered to have been ghostwritten by a PR company hired by the drug’s producer. Kutcher has also been a consultant and advisor to what drug policy researcher Alan Cassels called a “laundry list of the world’s biggest drug companies”: GlaxoSmithKline, Pfizer, Eli Lilly, and more.
Yet Kutcher and psychiatrists like him continue to hold such workshops across Canada.
Enough Is Enough
In my role as a social work consultant, I regularly informed parents of the serious side effects of psychiatric drugs. Speaking out led to disapproval from my superiors. I began to feel powerless in trying to support and counsel students, particularly high school students, who had been drugged with various cocktails since kindergarten and were subsequently experiencing tragic academic and life outcomes.
I was haunted by the trajectory of youths like Jordan, a then 15-year-old boy who was no longer attending school due to anxiety issues. In 2014, I was asked to assess and write a report on his academic needs. I had access to all his school reports from kindergarten to grade 10, including psychological, medical and psychiatric histories. In Jordan’s early grades, there was no sign that he was anything but a normal, inquisitive child. However, his teachers reported he had difficulty managing routines and was overly concerned with getting the right answer.
The school recommended a psychological assessment, which led to a diagnosis of anxiety and a prescription for Prozac from a psychiatrist. The boy was subsequently hospitalized for aggressive outbursts, suicidal threats, and severe anxiety. In the hospital, he was given an additional diagnosis of Asperger’s Disorder and prescribed Celexa and Risperdal before being released.
The medical industry likes to claim that the medical treatment this boy and others receive leads to successful academic outcomes and hopeful futures. This did not happen. As a result of his treatment with an array of mind-impairing drugs, Jordan reacted by becoming overly anxious, fearful, and refusing to go to school. By grade ten he was no longer attending at all.
I decided to suggest Robert Whitaker’s book Anatomy of an Epidemic to his parents. I did so nervously because I’d learned that some parents who bought into their children’s diagnoses can be offended by alternate information and might file a complaint to the school principal. I never found out if they read the book, or what happened to Jordan, because I ultimately resigned my post.
My supervisors had asked me to in-service teachers on a new government document that asked teachers to refer students suspected of mental disorders to health professionals. The document included detailed information on the incidence of mental health problems, descriptions of their symptoms, and strategies to support children with these conditions — with zero references to any evidence-based science. I couldn’t do it.
A Plea to Parents
I urge parents to educate themselves not only about the dangers of psychiatric diagnoses and drugs but also about the many hidden factors operating within our increasingly competitive school system, which are harmful to the well-being of children.
Among them: Recent test results track with socioeconomic status such that the richest and poorest school districts have average performance levels more than four grade levels apart. Although all children are at risk of being labeled with mental disorders in school, fewer middle-class children are prescribed psychiatric drugs because income inequalities are often at the root of children’s learning difficulties. A recent report on ADHD caseloads, for example, shows that there has been an explosion in ADHD diagnoses among lower- socioeconomic groups while the rates of diagnosis of those who are better off are declining. Low socioeconomic groups are an easy target within the school system. Any child lagging in skills is more likely to be tagged with ADHD or depression, as they were in my schools. Drug companies have capitalized on these inequities.
Parents, teachers, health professionals, child advocates, and consumer groups need to speak out against this destructive childhood trend and lobby their education and government officials to get the pharmaceutical industry and its “thought leaders” out of schools.
Parents! Be proactive. Tell teachers and experts that when it comes to your children’s behavior, you know what is best for them and you will not accept any suggestion that they need mind-altering chemicals.
Teachers! Stop helping to identify mental health disorders in your students. Instead, look for social and emotional factors at home or school that may be causing difficulties.
Health professionals! Stop using the term “mental health problems” when referring to children’s emotional or behavior issues. Children and adolescents need support and encouragement, not stigmatizing labels. Parents need accurate information about the dangerous side effects of Ritalin and other psychiatric drugs.
Our children’s future and well-being depend on all of us. We must act now.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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