Monday, September 18, 2006

Mental health plan under fire
2005 law mandates testing in children from birth to age 22
Sunday, September 17, 2006

Across Indiana, a rumbling of discontent about a state law passed in 2005 has been gathering momentum for the past several months, in preparation for the Indiana General Assembly to begin its next session.

The controversy centers on Senate Enrolled Act 529 and its mandate regarding children and mental health. The state-directed plan, according to its opponents, effectively sets a precedent for taking away parents’ rights when it comes to mental health care for their children.

While opponents say the most offensive part of the law deals with a mandate to screen children, birth to age 22, for mental health problems as part of routine exams in schools and by health care providers, other parts of the law have enough people upset that some legislators and Indiana parents are calling for a repeal of SEA 529 in its entirety.

So far, state and national privacy and civil rights watchdogs and a host of people from various professions, including doctors, teachers and ministers, have joined the fracas, often pitting themselves against their own peers as they debate the law’s pros and cons.

It is a law with wording that state Rep. Marlin Stutzman, R-Howe, says “was snuck” through, and that state Rep. Matt Bell, R-Avilla, says he will work actively to change. Even its author, state Sen. Connie Lawson, R-Danville, admits it probably needs to be “clarified.”

It is a law that not only has attracted attention across the nation, but also took one Indiana legislator off-guard in a setting several states away.

“I was in Arizona at a women’s legislative conference when I heard some presenters talking about this law — our law, and about how they were watching it, and what it meant to us and other states considering it,” said state Rep. Jackie Walorski, R-Lakeville. “They also were talking about a lawsuit in Indiana with something called TeenScreen, and how this program was labeling kids with different mental illnesses. The lawsuit, I found out, was in my own district, and I didn’t even know it was happening — the first I heard about it or any problems with this law was at that conference.”

The lawsuit was filed by the parents of a high-achieving teenager who took the TeenScreen test in 2004 at Penn High School in Mishawaka, and who, according to the lawsuit, subsequently was told she had two mental health problems — obsessive-compulsive disorder and social anxiety disorder.

TeenScreen controversy

TeenScreen, Walorski learned, is a mental health screening test administered in at least 43 states, mostly through school systems. According to its Web site at, the test is a “simple questionnaire to see if a teen may be suffering from depression or other mental health problem.”

The two-stage screening process, the Web site says, is designed to help identify “teenagers who are at risk for suicide or mental illness and who are in need of a complete mental health evaluation.”

However, Walorski also learned, TeenScreen and its methodology, administration and proscriptive questions — only “yes” or “no” answers are allowed — has stirred a firestorm of controversy all over the U.S.

Walorski came home, did some investigating and started gathering signatures on a petition that she plans to present to Indiana Gov. Mitch Daniels soon. The petition is to recall and repeal SEA 529. She set a goal to collect at least 10,000 signatures. She reached that goal the first week in September and now has nearly 11,000.

History of SEA 529

Signed by Daniels in the spring of 2005, SEA 529 was hailed as ground-breaking legislation that would set new standards of care for children, not only in Indiana, but across the nation.

A key point of the new law was to separate certain children’s services from the Family and Social Services Administration and to set up a stand-alone arm of government charged with the oversight of Indiana’s children. This new cabinet-level agency is called the Department of Child Services.

Another part of SEA 529 took away from counties the responsibility of collecting and distributing child support payments, and redirected that job to the state.

Still another section addressed day care rules and regulations — but left the oversight of day cares in Indiana to the FSSA.

Like any new legislation, SEA 529 and its numerous other changes, additions and deletions to law slid into the books with some kinks that needed smoothing out. Legislators addressed several of those kinks during the spring 2006 “short” session of the assembly.

Daycare providers still have concerns about certain sections of the law. (See related story, “12 steps to change a diaper”). But it is Section 79, IC 20-19-5, the part of the bill that adds a completely new chapter to Indiana law books, that is the hot potato of SEA 529.

Birth to 22

Section 79, Chapter 5, is called the Children’s Social, Emotional and Behavioral Health Plan, and it directs the Indiana Department of Education to devise sweeping reforms regarding mental health care for Indiana children from birth to age 22.

However, the mental health plan itself wasn’t written until after SB 529 became law — meaning that, at the time they voted on it, legislators literally didn’t know what they were voting for, other than that they were assigning the writing of the plan to the DOE. SEA 529 passed the Senate unanimously. Only one person voted against it in the House, Rep. Charlie Brown, D-Gary.

As soon as the governor signed it, the DOE went to work. On June 1, the task force assigned to write the plan made its document public. More than 70 pages long, the plan is prefaced by a letter from the task force’s chair, Kristen Schunk.

The letter’s introduction reads, “In recognition of the one in five Indiana children who may have a diagnosable mental disorder (Surgeon General’s Report on Mental Health, 1999) we are pleased to submit the ‘Children’s Social, Emotional and Behavioral Health Plan’ ... for your review and consideration.”

The letter details who participated in the plan’s creation, and what data and resources the task force tapped to write it. It also mentions that “much of the public comment” the task force gathered when it held public forums on the plan “centered on the (mental health) screening of children.”

Voluntary screening only

“It is important to note that the plan does not recommend screening without parental consent,” Schunk emphasized. ... “Screening must be voluntary, active parental consent must be obtained, and clear procedures must be in place for notifying parents of the screening.”

Proponents of the plan, including the Department of Child Services, along with Schunk’s committee, claim it is an innocuous document that simply delineates the way the state can help identify and treat children with mental health problems.

In no way does it take away any parental rights, supporters insist.

But opponents aren’t convinced. Neither are a growing number of conservative pro-family groups, such as the Indiana American Family Association, the Rutherford Institute and the Eagle Forum. One reason opponents aren’t convinced is because, even though the DOE guidelines say any mental health screening must be voluntary and with active parental consent, the law still mandates it “as a part of routine examinations in schools and by health care providers.”

The issue has become so hot that several groups across the nation, such as Fair Access Coalition on Testing, have put Indiana on their Web site “hot lists,” meaning they are tracking where the state is going with this.

While both Senators Robert Meeks, R-LaGrange, and Dennis Kruse, R-Auburn, said they weren’t aware of any problems with SEA, Kruse did say that “if it is causing extraordinary problems for parents, I think we do need to change it because I have a tendency to side with parents in issues like this.”

In the meantime Walorski has been holding awareness rallies to call attention to SEA 529 and to draw support for its repeal. She’s also working with Bell and Stutzman to lay a plan of attack when the assembly convenes.

“I’ve been following this very closely,” Stutzman said. “And it looks like, from the information I’ve received, they want to go even further with this than they already have. Jackie and I have already been in contact with some lobbying groups — Advance America, for one — and we’re putting our strategy together to get a repeal approved, either in committee or on the floor.

“I feel like this was snuck through, and we were not made aware of all the details in the legislature when we did this. It just blind-sided us, and I’m really, really upset about it because I know people don’t want to go down this path.

“This is just going to get bigger and bigger. Once people find out it’s a mandated test on their children’s mental health, they’re going to be very upset. In my mind this has just stepped over the line,” he said.


TeenScreen is an excellent penetration point to open up discussions on psychiatry: Let er rip!

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