Testimony Against SF 2841 - Preschool Socioemotional Screening
Minnesota Senate Early Childhood Finance Division
March 9, 2006
Karen R. Effrem, MD
EdWatch Board of Directors
Alliance for Human Research Protection Board of Directors
ICSPP Board of Directors
Thank you Mr. Chairman and members of the Committee.  My name is Dr. Karen Effrem.  I am a mother of three wonderful children, a pediatrician, and a policy analyst that serves on the boards of several national organizations, including EdWatch, the Alliance for Human Research Protection, and the International Center for the Study of Psychiatry and Psychology.  I am here in vigorous opposition to SF 2841 that would implement mental health screening for three-year-old children entering public school.
Government sponsored and controlled universal mental health screening, no matter how sweetly wrapped in the fig leaf of parental consent, should never, ever be implemented.  It is never, EVER, the proper role of government to set norms for, assess or intervene in the thoughts and emotions of free citizens, much less innocent, vulnerable, and still developing children.  It is our thoughts and emotions that make each of us uniquely and individually human, and we use these thoughts and emotions to understand the world and maintain our inalienable right to liberty.
We are all well aware that the parental consent or opt-out language referred to for this bill is just a way to assuage concerns long enough to put this dangerous system into place.  Once it is passed with parental consent, that language will either be changed by future legislators, not enforced, or side stepped in some other way.  The non-existent enforcement of the federal Protection of Pupil Rights Amendment on invasive surveys is a classic example of this phenomenon. Another is the lack of parental notification of their rights in current Minnesota statute 121A.17 to decline to answer the part of the screening that involves invasive and subjective assessment of family risk factors, or that parents may have their child’s screening administered by private providers, or that no preschool screening is required if it is against the conscientiously held beliefs of the parents.
SF 2841 is proposed as part of the Roadmap for Mental Health System Transformation in Minnesota, which is an outgrowth of the federal New Freedom Commission report and the federal Mental Health Action Agenda. The Minnesota Roadmap clearly states what that plan is for young children.  It proposes to, “…integrate early childhood screening systems to assure that all children ages birth to five are screened early and continuously for the presence of health, socioemotional or developmental needs” and then to implement, among other things, “mental health services and early care and education.”
Members of the New Freedom Commission as well as groups advocating the Minnesota Roadmap plan have inherent financial, professional, and policy conflicts of interest and do not mention any scientific or medical problems with screening or treatment.  For example, Michael Hogan, the chairman of the New Freedom Commission, was paid by the Janssen Pharmaceutica, the manufacturer of one of the drugs advocated in the model psychiatric drug treatment program (TMAP)  in the commission’s report. The National Alliance for the Mentally Ill and the National Mental Health Association, both supporters, of this legislation and the Minnesota Roadmap received tax dollars from the federal mental health agency, SAMHSA, to help implement the New Freedom Commission’s recommendations, including universal screening and TMAP.
Even if mental health screening did not have these fatal policy and philosophical flaws, the medical and scientific justification for this idea is equally lacking.  Proponents tell us that mental illnesses are biological brain disorders due to chemical imbalances of neurotransmitters, and that mental health screening is therefore scientific and objective and fully equivalent to hearing or blood pressure screening.  They also tell us that children who screen positive will merely be sent for further evaluation, that screening does not yield a diagnosis, and that services do not necessarily mean drugs.  Here is but a small sample of facts and statements from experts and the medical literature that contradict that view:  In summary, universal mental health screening and treatment for preschool aged children is far beyond the proper role of government, lacks scientific and medical justification and will have dangerous effects on our youngest citizens.  The premier dictum of medicine is “First, do no harm.” Both the psychiatric profession and policymakers would do well to heed that advice.

For more information, link to these resources:
  Infant mental health (11/23/05)

  Myths and Facts Regarding Mental Health Screening Programs and Psychiatric Drug Treatment for Children (pdf)
 Dangers of Universal Mental Health Screening, Briefing Book (Newly Updated)