BACKGROUND
On May 17, the Centers for Disease Control and Prevention (CDC) issued a report titled Mental Health Surveillance Among Children – United States, 2005-2011. The CDC is based in Atlanta, Georgia and is a part of the US Department of Health and Human Services.
The CDC’s report runs to 40 pages, including tables and references. It received a fair amount of media coverage, and will likely inform legislation and other government action for several years.
REPORT’S FINDINGS
The report provides estimates of prevalence among children aged 3-17 of the following “diagnoses”: ADHD; ODD and conduct disorder combined; autism spectrum disorder; depression; anxiety; alcohol use disorder; illicit drug use disorder; cigarette dependency; and Tourette’s syndrome. For illustrative purposes, I will discuss only the ADHD results here, but similar observations can be made on most of the other “diagnoses.”
ADHD
The report presents data from four different surveys: National Health Interview Survey (NHIS) 2007-2008; NHIS 2009-2010; NHIS 2011; National Survey of Children’s Health NSCH) 2007.
The prevalence data for ADHD is shown below:
NHIS 2007-2008 7.6% (ever)
NHIS 2009-2010 8.5% (ever)
NHIS 2011 8.4% (ever)
NHIS 2007 8.9% (ever)
NSCH 2007 6.8% (current)
Similar data is provided for the other “disorders,” and in their press release issued on May 16, the CDC stated that: “In the United States, 1 in 5 children have mental disorders and estimates are increasing.”
DISCUSSION
The CDC is a very prestigious and highly quoted agency. Their pronouncements on general medical matters are afforded a high level of credibility, and this report is likely to be taken very seriously.
What’s of particular concern, however, is their unquestioned acceptance of the concept of mental illness/mental disorder as defined in the DSM.
It seems likely to me that government officials, at all levels, reading this report will form the view that there is an epidemic of “mental illness” sweeping the country rather like influenza or, in former years, polio.
But if we read the APA’s “diagnostic” criteria for ADHD, for instance, we realize that there is no underlying illness. ADHD is simply the name that the APA gives to a loosely defined collection of problem behaviors in order to legitimize the prescribing of drugs.
In practice, here’s how it works. A child (usually a boy) is giving trouble at school. So his teacher fills in a behavior checklist. The items on the list are lifted straight from the DSM. There are lots of these checklists on the Internet. You can see one at: Vanderbilt ADHD Diagnostic Teacher Rating Scale. Examples of items are: “leaves seat in classroom…,” “talks excessively,” “loses temper,” etc… The teacher rates the child 0, 1, 2, or 3 on each item. The scores are tallied and collated, and if the score exceeds a certain threshold, then the teacher asks the parents to take the child to a physician to see if he “has ADHD.” The physician looks at the completed checklist, asks the parents a few questions, looks at the child, makes a “diagnosis” of ADHD, and writes a prescription for methylphenidate (Ritalin) or another drug.
Now – perhaps a few years later – enter the CDC surveyors.
“Household adults who have knowledge of the child’s health status (usually parents) who participated in NHIS were asked whether a doctor or other health-care provider ever told them that the sampled child has ADD or ADHD.” (p 8)
Similar questions were asked for the other disorders, and it was on this data that the 1 in 5 prevalence rate was based.
So what’s actually being measured is parental reports of healthcare provider endorsement of teacher-completed behavioral checklists. And now, these tallies, through the influence of pharma money and psychiatric venality, have been integrated by the CDC into American epidemiology.
By generating this report, the CDC has put its stamp of approval onto the APA’s spurious medicalization of virtually all problematic behavior/feelings in children. After all, it is the Center for Disease Control.
Although the report is simply a prevalence study, an accompanying document titled Children’s Mental Health Surveillance, which I think may have been their press release, contains the following:
“Mental disorders are chronic health conditions that can continue through the lifespan.”
Tony Pugh, a reporter with The McClatchy Company, wrote an article which ran in several mainstream papers. I’ve checked the copies in the Washington Post, the Wichita Eagle, and the Sacramento Bee. They’re titled: “Child mental health disorders rising, cost society $247 billion annually.” Here’s an interesting quote:
“While the prevalence, early onset and impact on society make childhood mental problems a major public health issue, only 21 percent of affected children actually get treatment because of a national shortage of pediatric subspecialists and child and adolescent psychiatrists, according to the American Academy of Child & Adolescent Psychiatry.”
Reading between the lines: we need more psychiatrists so all these “untreated” children can be given drugs.
CONCLUSION
The point I’m making is that although we’ve made considerable gains in recent years, the notion that problematic behavior and feelings are caused by these putative mental illnesses is still firmly entrenched in our laws, in our public agencies, and in our mainstream media.
We need to keep writing; keep drawing attention to the damage, the disempowerment, and the stigmatization. There are no mental illnesses!