In states across the country, advocates of universal mental health screening are increasingly marginalizing parents. Schools are stepping in as the new gatekeepers, turning K-12 campuses into the venue of choice for taxpayer-funded mental health screening. But parents and some pediatric health professionals are crying foul, claiming universal screening usurps parental authority and is a Trojan horse for unprecedented pharmaceutical coercion. This promises to be a battle of epic proportions.
All of the newfound focus on pediatric mental health comes thanks to President Bush’s New Freedom Commission on Mental Health, established in 2002. The commission’s findings, released in 2003, claim schools are in a “key position to identify mental health problems early” through routine and comprehensive screening of the nation’s 52 million public school students. In 2004, Congress appropriated $20 million to fund the commission’s recommendations. Lured by the carrot of federal grant money, states are quickly falling into line.
One of the more popular mental health screening tools employed by schools is TeenScreen, developed by Dr. David Shaffer, chief of the Department of Child Psychiatry at Columbia University. In 2005, TeenScreen’s computer-based, subjective, 10-minute questionnaire was used by schools in 43 states. Interestingly, up to one-third of student test-takers are found to evidence mental health problems.
There’s no question that children and teens afflicted with mental illness need help. The consequences of undiagnosed, untreated mental health problems are sobering, sometimes fatal. But mandatory screening, especially without parental consent, is fraught with its own ethical and long-lasting ramifications.
In addition to abrogating parental rights, mandatory evaluations and their subsequent diagnoses are often followed by recommendations to use powerful pharmaceutical drugs. U.S. Rep. Ron Paul, a physician for more than 30 years, is an outspoken critic of school-based screening and its link to increased drugging. “Federally funded universal or mandatory mental-health screening in schools without parental consent could lead to labeling more children as ‘ADD’ or ‘hyperactive,’ and thus force more children to take psychotropic drugs like Ritalin against their parents’ wishes,” Paul said.
What’s a parent to do? Above all, learn the facts. The Protection of Pupil Rights Act safeguards the rights of parents to inspect instructional materials used in conjunction with surveys. The act also requires schools to obtain written parental consent before conducting evaluations assessing mental health or other privileged information.
Parents would also do well to monitor schools closely. Even in states (like North Carolina) that do not yet have mandatory mental health screening, schools still sometimes conduct their own evaluations. Schools may also circumvent the standard written permission process, sending home “passive consent” forms instead. Passive consent forms specify that a school will screen all students unless parents return forms saying they do not want their child to participate. During my tenure with the Mecklenburg Board of Education, a local elementary school used passive consent to screen students for mental health problems. This continued unabated until angry parents notified the Board of Education.
Debate on this issue is sure to rage on. In the meantime, here’s what we know for sure: Pediatric mental illness is a matter for serious concern. But in our zeal to alleviate children’s suffering, we dare not trample on the rights of those who care most. Parents, not schools, are best equipped to navigate the often murky and uncharted waters of a child’s mental illness. No law will ever change that.
Lindalyn Kakadelis is director of the North Carolina Education Alliance.