Schizophrenia Daily News Blog

Bush Initiative Promotes Mass Mental Illness Screening, Use of Prescription Drugs

President Bush's newest mental health policy, part of the New Freedom Initiative, will be made public next month. The initiative will recommend mental health screening for every citizen, and promote the use of "specific medications for specific conditions."

Some people (notably Dr. Darrel Regier, American Psychiatric Association director of research) approve of the measure as "a logical plan based on efficacy data from clinical trials," Many patients groups and advocacy groups also support approach similar to this as it increases the likelyhood that a person with schizophrenia will get the newest and presumably better medications available with the least serious side effects. These groups argue that schizophrenia is finally starting to be recognized by the general public as the brain disease that it is, so why should it be treated any differently than high cholesterol, heart disease or cancer? Treatments of similar price (as atypical antipsychotics) are precribed all the time for these other diseases - why shouldn't similarly priced medications be available for brain diseases and be covered by insurance?

Additionally, research is increasingly suggesting that early identification and treatment of people who are developing schizophrenia results in better outcomes for the person (and this is from research performed in Canada, Australia and the US) - so at least from this perspective, it sounds like the new program may be of value in early treatment.

Other people are more skeptical of initiatives like this. Consider the Texas Medication Algorithm Project (TMAP), supported by Bush as governor of Texas in 1995 and several pharmaceutical companies. It also encouraged the use of atypical antipsychotic drugs as preferred treatments. Allen Jones, an employee of the Pennsylvania Office of the Inspector General, blew the whistle on certain officials who were apparently receiving money and perks from some companies who stood to benefit from TMAP's treatment promotion.

In Jones' opinion, the New Freedom Initiative is similarly "poised to consolidate the TMAP effort into a comprehensive national policy to treat mental illness with expensive, patented medications of questionable benefit..." While we take issue with many of the points that Allen Jones raises (in just one example, he and the group that is hosting his document is against assisted treatment (what they call "forced psychiatric drugging" for people with schizophrenia - but as Dr. E. Fuller Torrey and other researchers have noted there is a lot of research that has demonstrated that when the brain is damaged by schizophrenia it is frequently unable to understand that it is sick, and we at Schizophrenia.com believe that it is inhumane to not treat people just becuase they are too sick to understand they have a brain disease. We don't treat people with Alzheimers this way, and we don'be believe that we should treat people with schizophrenia differently. Allen Jones' paper (which we recommend you take with a grain of salt) is available at http://psychrights.org/Drugs/AllenJonesTMAPJanuary20.pdf

There are many difficult and complex issues brought up by this news story; certainly countless patients have benefited from the new generation of antipsychotic drugs, which may help control the negative as well as the positive symptoms of schizophrenia, and can do so with fewer of the old side effects (although they have side effects of their own, they tend to be less serious side effects). However, there is no denying that the atypical antipsychotics are much more expensive than the traditional (typical) medications.

Source: British Medical Journal, June 19, 2004

See Bush Plans to Screen Whole US Population for Mental Illness for the full report at www.bmj.com