Congress and President Bush apparently think that a lot of children have a "mental health" problem. Or that enough of them do to justify taking millions of dollars from taxpayers to fund a universal "mental health screening" for children, and eventually for everyone.
Personally, I think - from the perspective of a person who never had any - that almost all children act crazy. Those who don't are, by definition, abnormal, because they don't act like the others.
The main problem with about half of them is that they are boys. Such children are obviously made of snips and snails and puppy dog tails. On the farm there is a solution for that: a procedure for turning boy lambs into non-ram lambs. After a quick little operation, they act like peaceful little lambs instead of aggressive, disruptive rams.
We don't do surgery like that on little boys, of course, but we do have our methods: such as behavioral therapy and chemicals.
There are those who argue with some passion that society has to do something. Bad, disruptive, antisocial or depressed little kids make lots of trouble for parents and schoolteachers. Worse, they can grow up into dysfunctional, unhappy or troublemaking adults. That snotty little boy might become a dissenting nonconformist or even a rebellious man, who could throw a monkey wrench into our smoothly functioning society. We have to catch them early - for their own good.
Teams of experts are awaiting the infusion of cash. They'll be ensconced in your child's school before you even know it. A bonus is that your little darlings will probably give them quite a bit of information about you also, and then you too can receive therapy you didn't know you needed.
Do you sometimes raise your voice? Ever spank them? Hug them inappropriately? Have politically incorrect attitudes? Use forbidden words? Own a gun? Smoke cigarettes, especially indoors? Read extremist literature? Refuse to recycle? Prepare for a knock on the door.
There are many tools at the disposal of the mental health squad. Counseling sessions. Drugs (Ritalin, antidepressants, tranquilizers, maybe some new ones that need to be tested on some experimental subjects of your child's age). Group therapy. Removing the child from the home. (This may be a "last resort," but often the mere threat can accomplish wonders.)
If an interview with a child raises concerns, the next step might be a home visit. This could discover poor parenting skills, inadequate housekeeping, harmful literature, or a baby who is crying or has a bruise (signs of abuse?).
It is true that some interventions have potential side effects, say drug dependence or suicide, but to assure the health of the population some shared sacrifice and risk are needed. We will have excellent means of tracking outcomes to improve future therapies. The mental health workers' impressions will all be recorded in the school records. An added benefit could accrue to would-be employers or college recruiters.
Some cautions are in order. Democrats might think that potential future Republicans are crazy. Republicans might think the opposite. Should an extremist Christian be one of the screeners, he might think that nonbelievers are possessed by the devil. And an extremist secular humanist (if such exist) might think that an overly religious child is at risk for mental illness if not already impaired.
In fact, parents ought to be asking some very serious questions before the government experts interview the first child.
What are the credentials of the screeners? Most importantly, how many children have they raised to adulthood, and with what outcome?
What are the criteria for possible abnormality? What is the scientific validation? How often do different observers agree? Have any long-term studies shown a solid correlation with adult performance in life? Do today's oddball children fail, or might they turn into our greatest achievers?
Will you be allowed to get a second opinion? Can you see the record and enter corrections if indicated? Will the record at any point be destroyed, or will the stigma of a diagnosis such as "personality disorder" follow the child throughout life?
What will happen if your child fails the screen? What sort of treatment will be given? Who will supervise it? What if you don't approve of it?
What's the very worst thing that the program will have the power to do to you or your child, say if your worst enemy were to gain control of it?
Who might profit from the program (perhaps discoverable by asking who lobbied for it)? Do drug companies expect to have a large number of new consumers of their psychoactive drugs?
What are the results of studies of long-term use of drugs like Ritalin, which has effects on the brain similar to those of cocaine? Have there even been any such studies?
Can you refuse to participate in the program? If you do refuse, what are the repercussions?
What is the evidence that the program, at best, will be anything other than a waste of millions of dollars? Miraculously, throughout human history most of those crazy children have become stable, productive adults without federally mandated psychiatric treatment. Still more amazingly, their parents have managed also.
Psychiatry in the hands of government, instead of independent physicians who are working for patients, reeks of Orwell's 1984 or the Soviet era. The very need to ask the questions should tell us the right answer for this program: It's crazy.
Dr. Jane M. Orient is an internist practicing in Tucson, AZ and executive director of the Association of American Physicians and Surgeons. Copyright 2004 United Press International. Reprinted with permission.