Screening kids poses risk of harm
October 3, 2007
YOUR OCT. 1 editorial "Better mental health for kids" correctly noted US District Judge Michael Ponsor's point that children's mental health problems are "often exacerbated by external traumas arising from poverty, family chaos or violence, drug abuse, separation from loved ones, and institutionalization." However, screening Medicaid-covered children for mental illness is not the answer. In fact, this approach has been rejected by Congress. A superficial screening by overworked pediatricians would likely result in many false positives with devastating consequences for the children and their families. These quick-fix screening tests invariably end up with quick fixes of kids by labeling them and placing them on medication, without a comprehensive psychosocial evaluation and assistance to the children and their interpersonal environment. As a psychiatrist who has evaluated children in schools, I know that myriad factors can cause what appear to be symptoms of mental illness. Though you state that parents can opt out of the state's screening program, often parents' custody is threatened if they do not comply with mental health treatment. I hope that Posner and the Legislature reconsider screening as an approach to children's mental health and adopt a more comprehensive plan.
Dr. DANIEL B. FISHER
The writer is a member of the federal New Freedom Commission on Mental Health.