So says a news article in the British Medical Journal on-line 19 June (BMJ, 1458).
A sweeping mental health initiative will be unveiled by President George W Bush in July. The plan promises to integrate mentally ill patients fully into the community by providing “services in the community, rather than institutions,” according to a March 2004 progress report titled Freedom Initiative (http://www.whitehouse.gov/newfreedom/toc-2004.html). While some praise the plan’s goals, others say it protects the profits of drug companies at the expense of the public.
Bush established a mental health commission in 2002 that issued the Freedom Initiative report last July (President’s New Freedom Commission on Mental Health, Final Report). One of the commission’s findings is that schools are in a key position to screen 52 million students and 6 million adults who work in the schools (Final Report, p. 66). The commission also recommended linkage between the screening and state of the art treatment using the Texas Medication Algorithm Project (TMAP) as a model for the treatment plan (Final Report, pp. 76 and 77).
However the Texas Project achieved some notoriety outside of Texas when Allen Jones, an employee of the Pennsylvania Office of the Inspector General, revealed that individuals who had influence over the medication plan received perks and money from drug companies with a stake in the plan. Jones, told by superiors to ignore his finding, was fired for going public to the British Medical Journal and the New York Times (BMJ, 1153).
This quote is from the second BMJ new item.
The Pennsylvania formulary is based on the Texas Medication Algorithm Project that has been exported to about 12 states and was recently commended as a model program by President Bush’s New Freedom Commission.
However, Dr Peter J Weiden, who was a member of the project’s expert consensus panel, charges that the guidelines are based on “opinions, not data” and that bias due to funding sources undermines the credibility of the guidelines since “most of the guidelines authors have received support from the pharmaceutical industry”
Not surprisingly, the TMAP methodology leads to guidelines that recommend new and expensive antipsychotic drugs, such as Eli Lilly’s Olanzapine. However, according to the BMJ article (1458), studies indicate that “using older drugs first makes sense. There’s nothing in the labeling of the newer atypical anti-psychotic that suggests they are superior in efficacy to haloperidol [an older “typical” antipsychotic].There has to be an enormous amount of unnecessary expenditures for newer drugs.”
The TMAP project began in the mid 90s as an alliance between the pharmaceutical industry, the University of Texas, mental health organizations, and the Texas corrections system. The project published its guidelines in 1995. The pharmaceutical companies who funded the scheme include Janssen Pharmaceutica, Johnson & Johnson, Eli Lilly, Astrazeneca, Pfizer, Novartis, Janssen-Ortho-McNeil, GlaxoSmithKline, Abbott, Bristol Myers Squibb, Wyeth-Ayerst and Forrest Laboratories. The drugs recommended as “first line treatment”, many of them with potentially deadly side effects, are patented expensive drugs produced by the sponsors of the guidelines: Risperdal, Zyprexa, Seroqual, Geodone, Depakote, Paxil, Zoloft, Celexa, Wellbutron, Zyban, Remeron, Serzone, Effexor, Buspar, Adderall and Prozac.
On the surface, Bush’s approach to dealing with mental illness appears to differ from Reagan’s. If you recall, the great communicator threw them out on the street. However, my very brief review of the Final Report indicates that Bush’s program is a major new initiative. If it runs true to form for new government programs, it will be underfunded. That will, inevitably, take money away from such things as shelter programs. So, there is some similarity after all.
Let’s see about the old boy network. Bush Sr. was a member of Lilly’s board of directors. Bush Jr. appointed Lilly’s CEO, Sidney Taurel, to a seat on the Homeland Security Council. Rumsfeld worked for Lilly before being selected to go visit Saddam. Lilly and the other pharmaceutical companies are, of course, campaign contributers. (About 65:35 Republican to Democrat this year.) Prozac anyone?
Source—the The Randi Rhoads Show
In addition to a more extensive quote of the Jones report than I found in the BMJ news items, the discussion at Randi’s URL covers a number of additional issues:
—Juvenile detention facilities as a source of potential customers,
—Re-definition of environmental illness—a debilitating condition with varying, symptoms due to environmental causes—as a purely psychological phenomenon,
—Flaws in the TMAP methodology and generalizing from research on adults to a different population, children,
—Vastly increased costs for psychiatric medication in Texas,
—Some state governments going after psychiatric drug companies, and
—Petrochemical vs biological treatment models.