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THE PRESIDENT’S NEW FREEDOM COMMISSION ON MENTAL HEALTH

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George Stone
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Since Michael Moore's film Fahrenheit 911 and the publication of Kevin Phillips Dynasty, many American's are aware of the strong ties between the Saudi Royal family and the Bush family around oil. However, not as many know that there are also strong ties between the Pharmaceutical industry and the Bush family as well. George H.W. Bush sat on Lilly's board of directors. Lilly gave $1.6 million dollars in campaign contributions during the 2000 election. 82 percent of this money went to Republicans and George W. Bush. And, Mr. Bush, or his advisor and brain Karl Rove, appointed one active and one former Lilly employee to important public positions. Sidney Taurel, Lilly's CEO, was appointed to the Homeland Security Council (HSC), while Robert N. Postlehwait was appointed to the NFC. (Whitehead 2005)

TMAP
Here's how the TMAP scheme works: administrative changes in Texas government made the University of Texas Medical Center (UTMC) a key mental health player in the state. UTMC was placed in charge of all public mental health, including the mental health of all state prisoners. The drug companies recognized this change and began to court the University, as well as mental health and correction personnel. They donated money to create TMAP and "educate" state providers about its benefits. There are also two or three drug lobbyists for every legislator in the state of Texas. So, in addition to influencing the university, mental health and corrections systems, the drug companies influenced the Texas legislature. When TMAP was officially adopted, Texas Medicaid, which insures public mental health patients, picked up the bill. It was nearly driven into bankruptcy by the expensive TMAP drugs.

Again we see a Pharma pattern: relatively modest investments pay high returns: Pfizer contributed $232,000 to TMAP start up and, in return, Texas paid Pfizer $233 million in tax dollars for drugs like Zoloft. Johnson & Johnson (Janssen Pharmaceuticals) contributed $224,000 and collected $272 million for Risperdal. Eli Lilly had the biggest jackpot; it gave only $109,000 and collected $328 million for Zyprexa. As the Governor of Texas, George W. Bush had oversight on this process. (Pringle 2005)

The drugs on the TMAP list are hundreds of times more expensive than the older typical antipsychotics and antidepressants, which are now "generic" drugs because their patents have expired. For example, the typical antipsychotic Haldol, which is off patent, costs around 8 cents per pill, or about $2.40 per month, while the atypical Zyprexa, which is still under patent to Eli Lilly, costs $8 per pill or about $240 per month. (Whitehead 2005)

Texas Medicaid picked up the huge tab for TMAP drugs in that state because the expert consensus process presented itself as "scientific." But it was pseudo-science. In fact, the CATIE studies recently completed by NIMH show that the older drugs are as effective, cheaper, and safer than the new drugs on TMAP. It is interesting to note that every drug on TMAP now bears a "black box' warning label mandated by the FDA.

Hey ho, nobody home! With Governor Bush supporting the TMAP, and with key experts and the legislature in its pocket, there was virtually no oversight for the project. (Whitehead 2005) The scheme worked so well that drug companies began exporting it to other states and even other countries.

PENNMAP
Charles Currie's name is not a household word, but it should be. He was in charge of the Pennsylvania mental health system at the time TMAP was brought into that state from Texas. He gave final approval for adoption of TMAP in Pennsylvania, where it is known as PennMap; and he supervised the people who set up illegal "off book" accounts for the drug industry bribes to Pennsylvania officials that lubricated the process. Soon thereafter, President Bush (or Karl Rove) appointed Currie head of Substance Abuse and Mental Health Services Administration (SAMHSA) - - perhaps as a reward for his good work on PennMap. Once at SAMHSA, Currie began vigorously promoting TMAP, TeenScreen, and other NFC recommendations. (Whitehead 2005) For example, in July 2005, a SAMHSA press release announced its sponsorship of the Federal Mental Health Action Agenda (FMHAA). FMHAA is a coalition of six cabinet level departments, including Health and Human Services, Justice, Housing and Urban Development, and represents a major effort to fast track implementation of NFC recommendations, including TeenScreen and TMAP. FMHAA adds the authority and prestige of SAMHSA and six cabinet level departments to the already prestigious NFC. This unprecedented cabinet level coalition was launched in the face of growing evidence that the screening and medicating recommendations are neither safe nor effective.

The creators of TMAP claim they used scientific evidence to establish the safety and effectiveness of the drugs on their list. However, Allen Jones a former investigator for the Pennsylvania Office of the Investigator General (OIG) disputes this claim, "It has been revealed that TMAP personnel may have tampered with the research results through a process known as 'Retrospective Analysis.' Patients who had previously been treated with the new medications were researched, and files showing positive results were selected [out] and reported on. Unsurprisingly, TMAP research 'confirmed' that the new drugs were safer and more effective than the older treatments. Ignoring contrary findings, TMAP employees referred to their algorithm as being 'Evidence-Based Best Practices.' [But] Dr. Peter J. Weiden, a member of the project's expert consensus, stated that the guidelines promoted by the program are based on 'opinions, not data' and that 'most of the guideline's authors have received [financial] support from the pharmaceutical industry." (Whitehead 2005) TMAP drugs were selected by an "expert consensus process;' a process that, as we have already seen, can easily be rigged to promote special interests. "A project management team tied to the [drug] industry selected other doctors whose opinions were then analyzed or accessed by TMAP. They determined from that process that these drugs were safer and more effective, and that became their mantra. But they used pseudo-science. And of the 55 doctors pooled for the first schizophrenia consensus, 27 had [financial] ties to the pharmaceutical industry." (Whitehead 2005) NFC later named TMAP a "model program" despite its lack of scientific rigor. Let's examine the safety and efficacy of the TMAP drugs in more detail.

Robert Whitaker recently published evidence that, at best, antipsychotic drugs temporarily reduce psychiatric symptoms in the short term, but in the long term they shatter the mental and physical health of those persons who take them. Furthermore, he shows that that the death rate of patients on the newer TMAP drugs, the atypical antipsychotics like Eli Lilly's Zyprexa, is double that of patients taking the older, cheaper typical antipsychotics, like Haldol. (Whitaker 2005) The suicide rate for treated schizophrenic persons has increased 20-fold since the introduction of psychiatric drugs. (Healy 2006) Weight gains of 240 pounds or more and a higher incidence of diabetes has been documented with the use of these drugs. (Whitehead 2005) "The uncontrolled movements caused by the older drugs were 'less troubling than the potentially fatal metabolic problems' associated with some of the newer drugs."(Vedantam 2005; emphasis added) David Healy (2002) describes the danger this way, "The rhetoric of modern drug development is powerful enough to blind clinicians to preventable deaths and obscure the fact that the life expectancies of their patients are falling rather than rising." You may remember Healy as the British researcher who blew the whistle on the use of SSRI's in children when the FDA failed to do so.

Let me summarize the situation: 1) the NFC was created as part of Laurie Flynn Pharma agenda. 2) TMAP, created under George W. Bush's tenure as governor of Texas, is a list of expensive, ineffective and dangerous drugs. 3) despite its political/pharmaceutical birth, TMAP is presented as "scientific" and a "model" program and that has the support of President Bush's NFC. 4) TMAP drugs have all been shown to be no more effective than older, cheaper drugs and they are far more dangerous than those older drugs. 5) TeenScreen has no scientific validity (it has high levels of false positives, for example). 6) TeenScreen has a record of flagrantly bypassing parental consent in screening children. 7) Children shown to be at risk by the TeenScreen program would be referred to a standard of treatment that is highly likely to use the dangerous TMAP drugs.

Is this the best US public mental health policy has to offer?

TeenScreen and TMAP represent naked drug company greed. Even before these NFC recommendations were made there were 15 million Americans on Zyprexa (7.4 million) and Risperdal (7.6 million) alone in 2002. Sales of atypical antipsychotic drugs reached $6.4 billion, making them the fourth best selling class of drugs in America. "The combined sales of antidepressants and antipsychotics jumped from around $500 million in 1986 to nearly $20 billion in 2004 - - a 40-fold increase." (Whitaker 2004 & 2005) Yet, apparently this kind of growth is not enough for Pharma. A public mental health policy to screen children and get more of them on atypical antipsychotics is also required.

Gadsden can only be smiling as he looks down from CEO Heaven.

American psychiatry maintains that "schizophrenia" is a chemical imbalance in the brain, despite the fact that there is no scientific evidence to support this theory. It also ignores existing evidence that schizophrenia might have social causes and treatments. For example, WHO research shows that recovery from schizophrenia in industrializing countries, like India and Nigeria, is holding steady at 49-51%, while it is only 11% in industrialized countries, like Denmark and the US. This led WHO researcher Jablensky et al to conclude, "Being in a developed country was a strong predictor of not attaining complete remission." (Richporte-Haley 1998) Furthermore, recovery rates for schizophrenia in Western countries have been falling most sharply since the introduction of antipsychotic drugs fifty years ago. (Richporte-Haley 1998; Whitaker 2002 & 2005a&b)

Allen Jones contends that the TeenScreen program is "designed to diagnose mental illness in teenagers"[but] has been shown to be coercive and unreliable. It serves the same political/pharmaceutical alliance that generated the Texas project [and is] behind the New Freedom Commission." Using TeenScreen, this alliance is "poised to consolidate the TMAP effort into a comprehensive national policy"with expensive, patented medications of questionable benefit and deadly side effects." (Whitehead 2005)

TeenScreen: Introducing Children to Life-Long Use of Psychiatric Drugs
Just as Pharma subsidized bone density tests in osteoporosis, so it is behind the promotion of TeenScreen as the mental health-screening tool of public mental health policy. TeenScreen is a nonprofit organization, housed at Columbia University - - an interesting arrangement that gives TeenScreen an air of academic respectability it does not deserve. Let's follow the money.

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George Stone has a master's degrees in anthropology and social work. He is a licensed clinical social worker with 35 years experience in therapy and supervision specializing in family & brief therapy and has practiced privately and publicly with (more...)
 
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THE PRESIDENT’S NEW FREEDOM COMMISSION ON MENTAL HEALTH

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