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Why Screening Teens for Mental Illness Is a Terrible Idea

The views expressed are those of the author and are not necessarily those of Scientific American.

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teen sitting on floor with head in handsMental illness can afflict children, just as cancer and other diseases do. Many young people quietly struggle with depression and other disorders, which may provoke them to commit suicide, the third-most common cause of death among teenagers. So from one perspective, programs like TeenScreen—designed by a group at Columbia University and now operating in schools and community centers in 43 states—make perfect sense. Students fill out a free, computerized form that asks, among other questions: In the past three months, has there been a time when nothing was fun for you and you just weren’t interested in anything? Have you had problems with your schoolwork or grades because you felt sad or depressed? And so on. Kids deemed at risk for psychological problems are referred to a mental health provider.

“Support for screening teens is increasing along with recognition of the role mental health checkups can play in improving mental health,” Wall Street Journal health columnist Laura Landro remarked in a story on TeenScreen. Although her report is largely positive, Landro does mention that school screening programs “aren’t without controversy. Some groups oppose them, arguing that they interfere with issues that should be the domain of the family and lead to over-prescription of psychiatric medications.”

Indeed. Given the recent trend toward prescribing powerful, profitable and potentially harmful psychiatric medications to children in the U.S., I fear that TeenScreen and similar programs may end up hurting more children than they help. Here’s some background information, most of which comes from Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown, 2010), a book by the journalist Robert Whitaker that I have mentioned previously.

*Several decades ago, children were rarely diagnosed with mental illness. Today leading psychiatrists estimate that more than 10 percent of all children suffer from mental illnesses—from attention-deficit hyperactivity disorder (ADHD) to full-blown psychosis. In 2008 the General Accounting Office estimated that one in 16 children is “seriously mentally ill.” The number of children so mentally disabled that their families are eligible for government assistance has swelled from 16,200 in 1987 to 561,569 in 2007, a 35-fold increase. During this same period the number of children requiring government assistance for all other ailments—from cancer to retardation—declined from 728,110 to 559,448.

*3.5 million American children are now taking Ritalin and similar medications for ADHD, up from only 150,000 or so in the late 1970s. That comes to about one out of every 23 children from four to 17 years old. American children consume three times as many ADHD medications as the rest of the world’s children combined. One study cited by Whitaker, which was funded by the National Institute of Mental Health, concluded that long-term drug treatment of ADHD was associated with increased rather than decreased symptoms.

*Since the selective serotonin reuptake inhibitor (SSRI) Prozac was introduced in the late 1980s, the number of children treated with SSRIs and other antidepressants has soared. A 2002 study estimates that one in 40 children 18 years old or younger takes antidepressants. Whitaker cites numerous studies indicating that whereas antidepressants can provide short-term relief for some children, over the long run are at best ineffective and at worst harmful. Children treated with antidepressants may experience side effects ranging from anxiety and insomnia to full-blown mania and psychosis.

*The most startling trend in pediatric psychiatry is the surge in diagnoses of bipolar disorder, which just a few decades ago was viewed as almost exclusively an adult disease. Since 1995 the number of children diagnosed with bipolar disorder has multiplied more than 40-fold to roughly 800,000. Whitaker presents persuasive evidence that this epidemic may be driven, at least in part, by increased consumption of stimulants (for ADHD) and antidepressants. These medications can trigger bouts of mania followed by sluggishness in children, who are then re-diagnosed with bipolar disorder.

*Children diagnosed as bipolar are treated with drugs—notably antipsychotics normally prescribed for adult schizophrenics—that have severe physiological as well as mental side effects, including obesity, diabetes and involuntary tremors. More than half a million children (including infants less than two years old!) are now ingesting antipsychotics. This trend, The New York Times reported last year, has been aggressively promoted by manufacturers of antipsychotics, which have become the most lucrative class of drugs in the world.

The promoters of TeenScreen, you will surely not be surprised to learn, have ties to the pharmaceutical industry. The program was designed by David Shaffer, a professor of child psychiatry at Columbia who, according to one watchdog group (which is not, I should add, affiliated with Scientology), has served as a paid consultant for GlaxoSmithKline and other manufacturers of psychiatric drugs. The executive director of TeenScreen, Laurie Flynn, previously headed the National Alliance on Mental Illness, a group that lobbies for improved care for mental illness. Both under Flynn’s leadership and since she left, NAMI has been criticized for its close ties to manufacturers of psychiatric drugs. According to a 2009 investigation by The New York Times, NAMI receives about three quarters of its donations from drug companies.

TeenScreen is subtle compared with other psychiatric-intervention programs. Some psychiatrists have advocated medicating young people who are deemed to be “at risk” of schizophrenia—because they exhibit signs of mental instability and/or have schizophrenic relatives. Several trials of this “early intervention” approach have produced inconclusive results, and a proposed trial in Australia was canceled recently after critics complained that the risks far outweighed any potential benefits.

The Australian plan, for an estimated  cost of $400 million, would have treated adolescents with the antipsychotic drug Seroquel, according to an Australian newspaper. The drug’s manufacturer, AstraZeneca, recently paid $647 million to settle a U.S. lawsuit that claimed the firm failed to properly disclose evidence linking Seroquel to diabetes. Previous studies have shown that the false-positive rate of predicting schizophrenia exceeds 80 percent. I hope that the cancellation of the Australian program portends a backlash against the overmedication of young people worldwide.

Mental illness is devastating for children as well as adults, and medication, when used wisely and sparingly, can help. But clearly our current approach to treating disturbed young people is broken. Let me give Whitaker the last word: “Twenty years ago, our society began regularly prescribing psychiatric drugs to children and adolescents, and now one out of every 15 Americans enters adulthood with a ‘serious mental illness.’ That is proof of the most tragic sort that our drug-based paradigm of care is doing a great deal more harm than good.”

Photo courtesy Wikimedia Commons

John Horgan About the Author: Every week, hockey-playing science writer John Horgan takes a puckish, provocative look at breaking science. A teacher at Stevens Institute of Technology, Horgan is the author of four books, including The End of Science (Addison Wesley, 1996) and The End of War (McSweeney's, 2012). Follow on Twitter @Horganism.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. rgcorrgk 5:33 am 09/3/2011

    Follow the money.

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  2. 2. JustinShariat 11:02 am 09/3/2011

    Thanks for writing this article. This disturbing trend really needs more coverage.

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  3. 3. ralph234 11:22 am 09/3/2011

    You argue persuasively for caution in treating children with psychotropic medications, however, the argument seems unrelated to the benefit of screening children for mental health problems and completely ignores the social, behavioral and psychological inteventions available to help children who may die because we fail to address their mental health problem.

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  4. 4. PeterWalsh 2:18 pm 09/3/2011

    I agree with your article a 100 percent. I am among those children diagnosed with ADD. I have been taking Adderall/Strattera ever since i was in elementary school. These drugs completely change my personality and make me extremely antisocial. It was only during my junior year of high school i questioned the benefits of the drug and stopped taking it. In fact i am still prescribed the meds right now and i am a sophomore in college. I have been hiding this from my parents for 3 years. A questionnaire that asks children if they actually do not take there medication but say they do will most likely be very high. Because when my parents find out i have not been taking meds get angry and dont understand my reasoning. I firmly believe that there is no reason children need to ingest any kind of medication daily we’ve lived for thousands of years without giving children meds why do we need to start now so badly? People rely on there drugs way too much.

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  5. 5. mhilm 3:30 pm 09/3/2011

    “In the past three months, has there been a time when nothing was fun for you and you just weren’t interested in anything? Have you had problems with your schoolwork or grades because you felt sad or depressed?”
    I realize these are only two example questions from a (hopefully) much larger and more subtle survey. But replace school work and grades with work and social life, and how many adults would answer yes?
    Occasional angst is the norm for adolescence.
    Everyone has times when the world seems gloomy. Catch someone when they’re ill, or just tired, or in one of those gloomy patches, and, if this is the sort of question they are asked, they will almost certainly be diagnosed with mental health issues.
    At the very least such questionnaires should be given several times over a period of months before any conclusions are based off them. Someone who seems at risk can be monitored, not drugged, until an assessment over time provides a more accurate picture of the person’s mental state.

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  6. 6. jfk104 4:45 pm 09/3/2011

    I had a terrible experience with prescribed ADD and antidepressant drugs. In my junior year of high school I had a tough time with depression. I went to a psychotherapist and eventually a psychiatrist. This psychiatrist seemed like a glorified drug dealer. I was given a checklist for ADD symptoms and was asked to answer true or false questions like “Do you have trouble concentrating on schoolwork.” That’s all it took for me to be subscribed Vyvanse. I was also given an antidepressant (Lexapro, I believe) and Lamictal for bipolar disorder. I thought maybe these would help me take things down a bit, but all it really did was suppress everything that I was. After a few months I couldn’t avoid the fact that this person was completely unprofessional and I stopped taking prescription drugs. I think that our teenage years are much too volatile to make any accurate diagnosis for some mental illnesses.

    I personally believe that the trend of online social networking stifles our ability to connect at a personal level, which in turn harms our mental development. I didn’t feel comfortable until college, where I am now able to see my friends more frequently in person than online. Text-based conversations do not allow us to appropriately convey our emotions.

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  7. 7. JustinShariat 8:01 pm 09/3/2011

    ralph234, your argument makes no sense. How is discussion on the gross over-prescribing of psychoactive drugs to children, encouraged by the drug companies themselves, at all ignoring the issue of childhood mental health? Nowhere in this article does it say that there isn’t a small percentage of kids that can benefit from certain medications; it only says that this number is small, and much more caution should go into giving any child medicine.

    It seems to me you’re not aware of how drastically these medicines impact a child’s development. I suggest reading about the drugs that are being given to these children… It’s truly unbelievable.

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  8. 8. Jumanji 2:42 am 09/4/2011

    Interesting article, thanks John. Please note though from an Australian reader that at the date of writing this comment the Australian government have not cancelled this $400 million program. The research trial only has been cancelled.   McGorry’s EPPIC early psychosis programs and the $400 million dollar drop-in-centre headspace services both to be run by the private health company, Orygen Youth Health (of which McGorry is Executive Director) are proceeding with complicit government backing. The ethical and scientific concerns raised by the Cochrane Collaboration review, international peers and Australians, in addition to Australians who are concerned about the loss of alternate services funds have  been diverted away from, to fund this dangerous public health experiment have gone unheeded. McGorry and the Australian government are going ahead full steam ahead with a minor blip of trial cancellation and scant media attention to any of these concerns. 

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  9. 9. Dan45 10:04 am 09/4/2011

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  10. 10. SK1973 11:16 am 09/4/2011

    I have a 17 year old child who has a serious mental health issue, without medications he would be a danger to himself, he falls into the 1% of Americans who have a schizophrenic condition typically these conditions arise between the ages of 15 and mid 20′s, he was diagnosed at 16 after being symptomatic of psychosis for a full year. I believe that pre-screening for youths could be helpful if it were to give them empowering information on how to help protect their minds, especially concerning the importance of Omega 3′s and avoiding street drugs and why it is different for people with a predisposition to these types of conditions and the general population. Increasing pleasurable activities, stress reduction techniques, cognitive behavioral therapy techniques, dbt, etc. My son is in a program for persons experiencing their first year of psychosis and to be accepted into the program the psychosis did have to be full blown. Medications are not mandated but encouraged and we are fully aware of the risks, but also the risks of not taking the medication. It’s tricky, and complicated and a decision for the family to make and I think this would be great if it weren’t driven by Pharma and handled in a sensitive way, but once you get corporations and government involved I would be concerned about scare tactics… it’s a complex issue.

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  11. 11. ralph234 11:47 am 09/4/2011

    JustinShariat did you read my comment?

    I agreed the article made a good point regarding problems of giving osychotropic medications for chiildren.

    I said the article did not address how other non-medication interventions (“social, behavioral and psychological inteventions available”)could be used to help children after a sceeening for mental health problems, therefore it did not answer the original question posed in the article.

    The question posed at the begining of the article was not how deterimental psychotropic medications are for children, rather it asked whether or not mental health screening is beneficial.

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  12. 12. mighty_archemedes 12:36 pm 09/4/2011

    As a teacher and neuroscientist, I have to disagree with your analysis entirely.

    It’s true that more teens are being diagnosed with depression, bipolar disorder, and schizophrenia today than fifteen years ago; but there are numerous factors in that that you have failed to mention. The first is the monumental change in our society over that time period–a financial collapse, an ongoing war overseas, the rise of social networking; all of these things and more have had documented and significant effects on mental health at home. I see no reason why it would not extend to the comparatively fragile mind of teenagers and the younger. Additionally, our understanding of your mentioned mental illnesses has grown exponentially in the last ten years, particularly schizophrenia, and we are simply more capable of determining these things.
    Now, if one were to compare the number of cancer drugs being administered today to the number administered in the 1960s, one could make the shortsighted argument that the cancer drugs are causing the cancer. But correlation is not causation, and diagnosis is definitively not cause. Why should we prevent students from having access to potentially much needed health care?
    I am well aware of the number of children that are taking Ritalin today, along with a plethora of other drugs for diseases of cognitive fatigue and other mental incapacities. This doesn’t prove anything, nor does it even prove, though I am inclined to agree with you on this, that it is being overprescribed. I have also, in my entire career and education, never seen the 80 percent misdiagnosis rate studies for schizophrenia that you mentioned, and would like it if you would state your source so I could further educate myself on this or send the team a challenge to its results. Schizophrenia is, as it is, a diversified and general label-illness, much like lupus, or arthritis. It says little of its cause, and the only hardened objective diagnosis techniques I know of can only be done on a corpse. Even they can’t definitively disprove it.

    I’m assuming that Scientific American would never publish an unverified witch-burning article, but your editorial strays dangerously close to it.

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  13. 13. rosabw 5:12 pm 09/4/2011

    Whatever y’all think is best for my child….When did psychiatrists become the turn-to for raising children? Talk about Dr. Spock screwing up out generation, how about Novartis for our children? It’s just cold…

    Yeah, yeah…my son took Vitamin R for 8 years, but then we started homeschooling him and he didn’t seem to need it. He won’t go back now. He must have really hated it, but he had no choice.


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  14. 14. Bops 5:53 pm 09/4/2011

    We all know people who say they won’t even take a asprin for any reason.
    If someone enjoys pain…fine…don’t take anything.

    Most people are helped by Prozac, SSRIs and other antidepressants deal with cronic pain and other problems.

    A family member, likes the high he gets so much that he won’t get help. It’s not uncommon. He loves all the “6 feet from the edge music”…and the life style that goes with it.

    It all started about age 12, now he’s 30 with friends just like himself. He says that he likes his freedom…diagnosed with depression, bipolar disorder, and schizophrenia. (like his mom)

    That’s a lot of money for one program…maybe there’s a better way. It’s a complex issue.

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  15. 15. Byteryder 12:48 am 09/5/2011

    “Folllow the money” as another poster said. First make it profitable by making it a run-away crisis. This is done by broadening the symptomatology until it is inclusive of sufficient numbers be alarming.

    Then, offer a solution. Like White Rabbit (Jefferson Airplane) the answer to everything is in a pill. A pill, small, quick, and in the case of psychoactive meds, the only trail left behind is qualitative, subjective at best, not quantifiable, objective.

    Create the mountain out of the mole-hill. Then sell rides to the top for outlandish fares.

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  16. 16. zstansfi 3:23 am 09/5/2011

    Archemedes, while I think that it is clear the concluding statements of this article are ridiculously flawed, I don’t think that the general point of this article is particularly offensive. It is quite apparent that there has been a radical increase in the rate of diagnosis of mental illness in western society over the past few decades. Now, there is certainly a strong possibility that over-diagnosis plays a part. And, I think a major part of the criticism of medicating young children is that it frankly is very difficult to accurate diagnose people in this age group with any sort of disorder, which makes our current use of medications seem simply bizarre.

    On the other hand, I won’t deny that much of the increase in mental illness could be accounted for in terms of changes in how our society operates. But does this not suggest that we ought to make changes to our social structure, rather than over-medicating young people?

    Horgan may display the subtlety of a farm animal, but I don’t think he’s wrong on this point. It seems to me that the children who truly are having the most trouble are probably already being referred for treatment. So then what is the use of enhanced screening procedures if our physicians are so trigger-happy with their prescription pads? I think that it is perfectly conceivable that the potentially massive increase in false positive diagnoses might not be worth the small potential for increased numbers of correct detections.

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  17. 17. JamesDavis 8:36 am 09/5/2011

    When I attended the School Of Natural Healing in Utah in the late 70s and early 80s, ADD, ADDHD, and make believe illnesses like, phantom pain, was just starting to skyrocket into a costly run away train. We found that ADD and ADDHD could be reversed and eliminated with the elimination of certain foods in the child’s diet like processed sugars, as in sodas, and dairy products, as in candies, and replaced with green leafy vegetables and tropical fruits. We also found that ADD and ADDHD was not a disease, but a disorder that these sugars and dairy products caused, and should never be treated by a chemical medication; the chemical medication actually made the condition worse and created some very distasteful side effects that was actually worse than the condition.

    We also found that children suffering from allergies and chronic pain brought on by sugars and dairy products was caused by an imbalance in their immune system and when treated with echinacea and goldenseal, coupled with bee pollen, the immune system increased and the allergies went away in about six months and the breathing problems went away with some simple acupressure on certain pressure points in front of the arm pit and on the back shoulder blade.

    Children have an incredible ability to heal themselves of most inflictions when they have a healthy diet and healthy friends, and chemical medications are seldom needed.

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  18. 18. mighty_archemedes 11:40 am 09/5/2011

    Zstansfi, it’s the associations set forth in the article that I find burning. So suppose we are overdiagnosing, which is not to say that I’m confident that we are, but we’ll hold it as an axiom for now. If that’s the case, then should we work on our standards and practice in diagnosis to reduce false positives, or should we simply make an effort to diagnose fewer people? The first method will reduce the error and lead to better results and happier people as a whole. The second, what this man is proposing, will simply leave people behind and leave the net error alone entirely. It’s naïve. Problems like that are solved through diligence and hard work, not running from the issue.
    Second, I would like to point out that more often than not, psychiatric disorders simply lead to counseling. Not everyone that has a mental illness has a magic pill to look to, though believe me, nearly every one of them wishes they did. This program is not about jamming pills down the throats of our children, it’s about getting them legitimate help when they need it. Some of them will be on medication, but it’s not like it’s legally mandatory.
    The way that this editorial is written almost leads me to believe that it’s politically biased. I just can’t figure out for whom yet.

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  19. 19. JustinShariat 2:49 pm 09/5/2011

    All of you rationalizing this as fine seem to have skimmed over the parts about pharma controlling the diagnostic criteria.

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  20. 20. zstansfi 2:55 pm 09/5/2011

    Well, I wouldn’t argue that screening for mental illness is a flawed concept, in fact, I think that it’s a great idea. And this is because I am not as concerned with over-diagnosis so much as over-treatment. However, the argument of Horgan’s which really resonants with me is that we probably aren’t doing a very good job of discriminating between individuals who need medication and those who do not. Currently, the first and second lines of defense against mental illness in the medical profession are GPs and psychiatrists. While admittedly anecdotal, my experience has been that these individuals are usually pretty quick to write prescriptions for minor ailments. And this is supported by pretty widely available statistics on the increasing rate of drug prescriptions in the US. This certainly makes me question whether the average physician is making an informed decision about who gets medications and who gets therapy.

    You’ve claimed that people diagnosed with mental disorders are more likely to receive therapy than medication–however, this simply seems infeasible to me. Can you provide a citation that supports this? Also, I think we need to be clear that there is a difference between therapy and medication in that it is very easy to stay on medication for a year or a decade, but long-term therapy is a much more difficult undertaking. So it’s possible that a high proportion of individuals might might receive some therapy, but also a lot of medications.

    Now, I would say that it is pretty irresponsible for Horgan to imply that pharmaceuticals are causing mental illness. To the best of my knowledge, there is absolutely no evidence for this contention. On the other hand, it would be false to claim that we actually have a good understanding of what these drugs do to rapidly developing brains. We don’t. And I think it is a reasonable question to ask whether we might be medicating too many children.

    I suspect part of your objection to this article is that it really says nothing about the TeenScreen program, something which I think another commenter pointed out. In fact, I’m not entirely sure why it was mentioned at all. I suspect it simply provided a convenient excuse to write a screed against the pharmaceutical industry.

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  21. 21. LFlynn 2:39 pm 09/6/2011

    We welcome discussion and debate on the important issue of adolescent mental health, but we must correct several inaccuracies in your blog regarding mental health screening and TeenScreen. First, mental health screenings cannot and do not diagnose mental illness. Rather, they are a clinical tool that can help identify people who are potentially at risk for depression or other mental health disorder. A positive score on a mental health screening indicates that there could be a problem. A formal diagnosis requires subsequent follow-up with a health care professional for a comprehensive evaluation.

    In addition, TeenScreen National Center does not and never has advocated for any specific treatment or therapy. Those decisions should be made exclusively by parents and teens following a diagnosis and in consultation with a health care professional.
    With respect to your discussion of funding channels, TeenScreen National Center is funded by private individuals, foundations and philanthropic organizations that are committed to youth mental health. TeenScreen has never been affiliated with, or funded by, any pharmaceutical companies. Regarding the 2009 New York Times article you cite on Sen. Grassley’s investigation, we cooperated fully and our funding profile was made public in this more recent article from 2010.

    Laurie Flynn
    Executive Director
    TeenScreen National Center for Mental Health Checkups
    at Columbia University

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  22. 22. djam45 11:09 am 09/7/2011

    Ralph234,respectfully I have to ask do you understand how the medical field works in our society. Are you familiar with the DSM, ICD, and/or the CPT code books. If you are not you do not know how this works. Research and manufacturing of medication is paid for by the pharmaceutical companies. They invest and pay to get results, period. In addition, screening is a precursor to diagnosis. Diagnosis allows someone to be eligible for treatment. Without the diagnosis these children cannot receive treatment with pharmaceuticals. The interesting thing is that you would prefer to discuss the screening. However, if the treatment makes a child’s symptoms worse the assumption is that the child didn’t get enough drug. You need to look at the chemistry of the medication, what it does to the physiology of the brain and once you know that, please give me the study(ies) that prove the efficacy of these medication in children. I can tell you I have looked and their are non. Non that are not paid by the companies that benefit from the success of selling the companies drugs. That would be like a car company paying JD power and associates to tell them how good their car did in testing. Then, assuring them a cut of sales of the car. How will you rate their car? High if you like your job. Would you recommend it? Yes, if you like money. Could you walk away if you committed fraud and people died. No, not unless you want to be indicted by a grand jury or involved in a large civil lawsuit. The story shows you why the screening is dangerous. The answer because for the future of our children it is the most slippery slope in to chaos you will ever see. What if what you were told was a solution actually made your life worse? What if it altered your perception? What if the person you trusted with a medical degree prescribed you something and you couldn’t get off without their permission. How does a drug deal in the street like it when you tell them you are getting clean. I can tell you I’ve seen people try and it never works well.

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  23. 23. djam45 11:16 am 09/7/2011

    Ms. Flynn, I apologize to you. Once I posted I realized that my blog may seem like you diagnose. I realize you do not. However, do you create leads that allow doctors to know who is at risk. Your organization is merely the first of many filters. In my opinion, children’s upbringings and personalities are so versatile that it is hard to diagnose one or another as “normal”. I don’t know what the experts think. But everywhere I look I cannot find what the definition of a “normal” child is, however, I can find a disorder for everything most children do. How can this be? How does one decide who is at risk if you don’t know what normal is?

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  24. 24. Big_Gig 12:46 pm 09/7/2011

    Apparently, the blogger assumes that screening is the problem. However, screening is just a tool. If a child is screened for poor eyesight, does that mean that child gets glasses? No. The child goes to an eye doctor who does an examination which then determines if the child needs glasses. If anyone, especially a child, is screened for poor hearing, does that mean that person/child will get surgery or hearing aids? No. It means that that person/child is sent to a doctor who does an examination which then determines if further steps are required.

    Your assumption that screening teens for mental illness automatically causes them to be put on medication is therefore based on falsehoods. Screening a child/teen for mental illness merely determines if that child/teen needs to be taken a closer look at. Depression and/or suicide(s) is/are caused by chemical imbalances in the brain, not by screening.

    As an advocate for mental health, and as someone who lives with depression and anxiety disorders, I find this article extremely irresponsible. There is no question that children/teens/adults are over prescribed anti-depressants, and other psych meds, as well as antibiotics and other types of medications. However, ceasing to look for signs of illnesses is not the way to stop the overuse of any kinds of medications. Early detection of mental illness, like early detection of any other type of illness, is critical and very beneficial.

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  25. 25. djam45 1:42 pm 09/7/2011

    Can someone please tell me what is the objective test for screening and what evidence proves that a person has a mental disorder. Remember objective test, blood test, biopsy, hair follicle test, urine test. What is the physical examination that is done to require that a person be put on psychiatric medications. Oh, I forgot their isn’t one. It is a list of criteria that is agreed upon but is observed and subjective to the physician. It is true that screening is just screening I agree. However, if the screening is a subjective assessment how accurate is it. You may get a great deal of false positives, won’t you?

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  26. 26. patty.namicc 2:43 pm 09/7/2011

    Considering the Decade of the Brain was in the 1990′s, it is no wonder since 1987 the number of children diagnosed with MI has increased, since we know much more and can know make some diagnosis earlier. There is such a different level of environmental influence with today’s adolescents and teens, which can also impact the onset of MI. Moving on, there is a huge difference between children being put on meds for ADD/ADHD vs. meds for severe mental illness in children/teens/young adults. Most ADD/ADHD diagnosis are made in the elementary school years, yet the majority of severe mental illnesses begin in the late teens to mid-twenty age group, therefore screening at this time in a persons life is beneficial and should not be discounted. Any and every method of screening at that point is critical, and one screening should not be used alone, especially if a one time questionnaire/survey. That questionnaire should be done more than once along with other monitoring by medical doctors, psychiatrists, family members and so on. Medical tests should also be performed, to eliminate any other medical concerns/possible issues that could bring on symptoms or mimic symptoms that could be entirely unrelated to MI (brain tumor, hormone imbalance). Also, just because a person may have a family member with MI, is not a definitive yes you will also have the same illness or any MI at all (yes the chances are greater). Your article was to be on the terribleness of teen screening, yet it seems that it is the best time for screening to be considered. ANY SCREENING IS BETTER THAN NONE!!! SCREENING SHOULD TAKE PLACE AT ANY AGE AS SOON AS SYMPTOMS OCCUR. I have family members with MI, from depression to full blown Bi-P. God Bless them, they have had lives I do not know I could have managed to live through. I hate to think what their lives would have been like without proper diagnosis, especially for my wonderful brother who was diagnosed in his late teen years!!!!!!!!!!

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  27. 27. djam45 3:26 pm 09/7/2011

    I understand what you are saying. However, what studies have professional/private organizations or the FDA sighted to support the efficacy of using these medications on children. When you ask the FDA they say there are no studies to support it. Adults, they can show studies but doctors in the 80′s, 90′s, 00′s and today still give kids these drugs with no study showing before and after efficacy’s. They put adult drugs and lowered the dosages for children. Using carte blanche as their justification. Children’s brains are different than adults and develop differently then adults and that comes from basic psychology. The thing I am trying to get people to understand and I am not trying to be flippant is that you assume because someone has a degree that they know what they are doing. The truth is they don’t know if this will work. If it does and we reduce suicide, psychosis,etc I will eat crow but if that is what we are doing then why haven’t the suicides and psychotic behavior slowed down. Why are more kids picking up guns at school and why are a handful (not all) committing suicide or hurting others. The truth is that like the FDA, the psychiatric community, we don’t know how what we are doing to children today will end. But I know one thing. Giving kids these medications started over thirty years ago. Now we have more parents scared that their child has an issue and no one really points out the side effects of these medications. As a physician myself I am surprised at how many people ask me to prove to them that they have heart disease or diabetes but if I said that someone had a severe mental disorder many people might accept it more on faith than the disease I can tangibly show with testing. What happened to the educated patient/parent?

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  28. 28. LyndaMHD 10:48 am 09/11/2011

    Horgan…..Check your facts before disparaging a group like NAMI, no contribution by Pharma is greater than 5% with a total of less than 40%. Majority of their funds are spent to help families deal with their loved ones illness. And help those struggling with illness to regain their lives. You are so off base.

    Link to this
  29. 29. john14505 9:19 pm 09/11/2011

    I have been with Recovery Inc. for several years now. As a child i had a stamper which caused me much distress.
    there were other problems which lead my aprents to seek help with a psychiatrist. I fought alot with my sister.
    Anyways the kindly doctor said there was nothing wrong and sent me on my way.
    I have what all nervous people have who seek psychiatric help.
    It is called a allergy to tenseness caused by the working up process.Nervous patients differ only from ordinary nervous people because they “work up their symptoms”
    Recovery Inc.founded in 1937 by Dr. Abraham Low teaches a method of will training to identify and avoid the working up process.
    Alot of people especialy parents tend to avoid this realization.It does put the sufferer on notice that they can get well if they recognize the deeply seated habits of temper(fear and anger).
    Young people would be helped so much because their habits of fear and anger are young and not so set in older people.

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  30. 30. reishi9154 7:00 pm 10/21/2011

    I think the problem is not the screening system in its entirety, but that the screening system needs to be improved. I understand your concerns about overmedicated children. But there is also a lot more mental illness in teens these days, whether it be because of toxins in our environment, changing family structures and arrangements, changing societal practices or what have you. I have read too many stories about teen mental illness to want to do a way with a screening system altogether.

    However it is also important to make sure that teens are not given medication they don’t need. So instead of using a computer, try using a human being, or someone who can more accurately decide if medication is needed or not – have more checks and balances in the system.

    I take Celexa and some anti anxiety medications for the symptoms of Asperger’s I have. There’s something that should be diagnosed more! If I had been diagnosed earlier, my life would have been a lot better. If you want more information on what Asperger’s is, go to

    Thanks for a thought provoking article, at any rate.

    Link to this
  31. 31. nemasa 10:44 pm 01/15/2012

    I love this article, I can relate to it as one who suffers with schizoaffective disorder and depression the schizoaffective disorder was treated before the depression and had I had the opportunity to be treated as a child I think I would have gone further in life and excelled when I should have this give me a wonderful idea to discuss the disparities of mental illness left untreated as a child. If you catch it early it is better for the young person and the family. I am so glad that schoools are intervening now it makes perfect sense to me and as an author of My Battle With Mental Illness Personified I can see the point of those who desire for the young people to live better lives instead of possibly committing suicide.

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