Betreff: Transmission on Information on Freedom Commission on Mental Health (Mandatory Mental Health)
Von: "Andrea Ball"
Datum: Sat, 15 Jan 2005 11:10:42 -0500

----- Original Message -----
From: gloria glorious
To: Undisclosed Recipient
Sent: Thursday, January 13, 2005 7:13 PM
Subject: [icmhp] ALERT re transmission on Information on Freedom Commission on Mental Health (Mandatory Mental Health)

PLEASE BE ADVISED:  During the past 2 days I have transmitted to your address information regarding the President's Freedom Commission on Mental Health, along with the recommendations handed down by that Commission.  The outcome of this commission is the formation of a national mental health screening program which has been designed to be put in place first through the public school system, and then across the nation -- whereby all citizens will be required to submit to mental health testing/screening & evaluations.  Jacob expressed great surprise when I told him of this plan & requested I submit this information for posting on this site, believing the membership would be very interested in this.
Since posting this information I have run into considerable computer trouble -- including having a very difficult time getting the original email with attachments to send.  When done incrementally (as follow-up to these difficulties) I encountered the same problem & noted so to Jacob.  Thus I sent the info on to him & awaited seeing all of it appear on this site -- to no avail!  (It is a sizeable amount of info when all transmitted.)  This morning I noted a notice from Postmaster whereby I was advised the following pertaining to the transmission I refer to: 
Symantec Mail Security detected prohibited content in a message sent from your address
Please know that every bit of info I transmitted consisted of public documents.  What is of great concern to many I work in advocacy with is that this very, very important matter has not been picked up by national media & the national public remains uninformed, unaware, & unprepared for what lies ahead for the entire U.S. population! 
I am of course concerned that this very transmission will not make it to your site.  Nonetheless, I sense it is imperative I send all this out to inform you that I am very concerned that public information that pertains to the lives of human beings/citizenry of this nation is considered "prohibited content", and believe you should be informed of this action regarding my emails & evidently my knowledge!  I look forward to hearing from any of you in reference to this matter.
Regards to all --
Gloria Wright
NC Vice President,
Executive Board
National Coalition of Grandparents for Children's Rights

International Information Programs
Disability Awareness 29 April 2002

Executive Order President's New Freedom Commission on Mental Health

By the authority vested in me as President by the Constitution and the laws of the United States of America, and to improve America's mental health service delivery system for individuals with serious mental illness and children with serious emotional disturbances, it is hereby ordered as follows:

Section 1. Establishment. There is hereby established the President's New Freedom Commission on Mental Health (Commission).

Sec. 2. Membership. (a) The Commission's membership shall be composed of:

(i) Not more than fifteen members appointed by the President, including providers, payers, administrators, and consumers of mental health services and family members of consumers; and

(ii) Not more than seven ex officio members, four of whom shall be designated by the Secretary of Health and Human Services, and the remaining three of whom shall be designated -- one each -- by the Secretaries of the Departments of Labor, Education, and Veterans Affairs.

(b) The President shall designate a Chair from among the fifteen members of the Commission appointed by the President.

Sec. 3. Mission. The mission of the Commission shall be to conduct a comprehensive study of the United States mental health service delivery system, including public and private sector providers, and to advise the President on methods of improving the system. The Commission's goal shall be to recommend improvements to enable adults with serious mental illness and children with serious emotional disturbances to live, work, learn, and participate fully in their communities. In carrying out its mission, the Commission shall, at a minimum:

(a) Review the current quality and effectiveness of public and private providers and Federal, State, and local government involvement in the delivery of services to individuals with serious mental illnesses and children with serious emotional disturbances, and identify unmet needs and barriers to services.

(b) Identify innovative mental health treatments, services, and technologies that are demonstrably effective and can be widely replicated in different settings.

(c) Formulate policy options that could be implemented by public and private providers, and Federal, State, and local governments to integrate the use of effective treatments and services, improve coordination among service providers, and improve community integration for adults with serious mental illnesses and children with serious emotional disturbances.

Sec. 4. Principles. In conducting its mission, the Commission shall adhere to the following principles:

(a) The Commission shall focus on the desired outcomes of mental health care, which are to attain each individual's maximum level of employment, self-care, interpersonal relationships, and community participation;

(b) The Commission shall focus on community-level models of care that efficiently coordinate the multiple health and human service providers and public and private payers involved in mental health treatment and delivery of services;

(c) The Commission shall focus on those policies that maximize the utility of existing resources by increasing cost effectiveness and reducing unnecessary and burdensome regulatory barriers;

(d) The Commission shall consider how mental health research findings can be used most effectively to influence the delivery of services; and

(e) The Commission shall follow the principles of Federalism, and ensure that its recommendations promote innovation, flexibility, and accountability at all levels of government and respect the constitutional role of the States and Indian tribes.

Sec. 5. Administration.

(a) The Department of Health and Human Services, to the extent permitted by law, shall provide funding and administrative support for the Commission.

(b) To the extent funds are available and as authorized by law for persons serving intermittently in Government service (5 U.S.C. 5701-5707), members of the Commission appointed from among private citizens of the United States may be allowed travel expenses while engaged in the work of the Commission, including per diem in lieu of subsistence. All members of the Commission who are officers or employees of the United States shall serve without compensation in addition to that received for their services as officers or employees of the United States.

(c) The Commission shall have a staff headed by an Executive Director, who shall be selected by the President. To the extent permitted by law, office space, analytical support, and additional staff support for the Commission shall be provided by executive branch departments and agencies.

(d) Insofar as the Federal Advisory Committee Act, as amended, may apply to the Commission, any functions of the President under that Act, except for those in section 6 of that Act, shall be performed by the Department of Health and Human Services, in accordance with the guidelines that have been issued by the Administrator of General Services.

Sec. 6. Reports. The Commission shall submit reports to the President as follows:

(a) Interim Report. Within 6 months from the date of this order, an interim report shall describe the extent of unmet needs and barriers to care within the mental health system and provide examples of community-based care models with success in coordination of services and providing desired outcomes.

(b) Final Report. The final report will set forth the Commission's recommendations, in accordance with its mission as stated in section 3 of this order. The submission date shall be determined by the Chair in consultation with the President.

Sec. 7. Termination. The Commission shall terminate 1 year from the date of this order, unless extended by the President prior to that date.


April 29, 2002.

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Our Mission About the Commission Return to the Home Page Background Information Contact Information Presidential Address New Freedom Commission on Mental Health


President's New Freedom
Commission on Mental Health

Achieving the Promise: Transforming Mental Health Care in America

Goal 4: Early Mental Health Screening, Assessment, and Referral to Services Are Common Practice


    4.1 Promote the mental health of young children.

    4.2 Improve and expand school mental health programs.

    4.3 Screen for co-occurring mental and substance use disorders and link with integrated treatment strategies.

    4.4 Screen for mental disorders in primary health care, across the life span, and connect to treatment and supports.

Understanding the Goal

Early Assessment and Treatment Are Critical Across the Life Span

If Untreated, Childhood Disorders Can Lead to a Downward Spiral

Schools Can Help Address Mental Health Problems

People with Co-occurring Disorders Are Inadequately Served

Mental Health Problems Are Not Adequately Addressed in Primary Care Settings

While effective treatments exist for most common mental disorders, studies have shown that many consumers seen in primary care settings do not receive them.7; 134 Even in the 1990s, most adults with depression, anxiety, and other common mental disorders did not receive appropriate care in primary care settings.7; 134 Older adults, children and adolescents, individuals from ethnic minority groups, and uninsured or low-income patients seen in the public sector are particularly unlikely to receive care for mental disorders.5; 16

Achieving the Goal


    4.1 Promote the mental health of young children.

Early Detection Can Reduce Mental Health Problems

Figure 4.1. Model Program: Intervening Early to Prevent Mental Health Problems


Nurse-Family Partnership


To improve pregnancy outcomes by helping mothers adopt healthy behavior, improve child health and development, reduce child abuse and neglect, and improve families' economic self-sufficiency.


A nurse visits the homes of high-risk women when pregnancy begins and continues for the first year of the child's life. The nurse adheres to visit-by-visit protocols to help women adopt healthy behaviors and to responsibly care for their children. In many states, Nurse-Family Partnership programs are funded as special projects or through State appropriations.


For mothers: 80% reduction in abuse of their children, 25% reduction in maternal substance abuse, and 83% increase in employment. For children (15 years later): 54% to 69% reduction in arrests and convictions, less risky behavior, and fewer school suspensions and destructive behaviors. This is the only prevention trial in the field with a randomized, controlled design and 15 years of follow-up. The program began in rural New York 20 years ago and its benefits have been replicated in Denver and in minority populations in Memphis.146-148

Biggest challenge

To preserve the program's core features as it grows nationwide. The key feature is a trained nurse, rather than a paraprofessional, who visits homes. A randomized, controlled trial found paraprofessionals to be ineffective.149

How other organizations can adopt

Modify requirements of Federal programs, where indicated, to facilitate adopting this successful, cost-effective model.


270 communities in 23 states.

For additional information

The Commission suggests a national focus on the mental health needs of young children and their families that includes screening, assessment, early intervention, treatment, training, and financing services. The national focus will:

A coordinated, national approach to these issues will help eliminate social and emotional barriers to learning and will promote success in school and in other community settings for young children. This effort may involve collaborations among parents, mental health providers, and early childhood and child care programs. Other important dimensions of the approach will include:


    4.2 Improve and expand school mental health programs.

Schools Should Have the Ability to Play a Larger Role in Mental Health Care for Children

Figure 4.2. Model Program: Screening Program for Youth


Columbia University TeenScreen® Program


To ensure that all youth are offered a mental health check-up before graduating from high school. TeenScreen® identifies and refers for treatment those who are at risk for suicide or suffer from an untreated mental illness.


All youngsters in a school, with parental consent, are given a computer-based questionnaire that screens them for mental illnesses and suicide risk. At no charge, the Columbia University TeenScreen® Program provides consultation, screening materials, software, training, and technical assistance to qualifying schools and communities. In return, TeenScreen® partners are expected to screen at least 200 youth per year and ensure that a licensed mental health professional is on-site to give immediate counseling and referral services for youth at greatest risk. The Columbia TeenScreen® Program is a not-for-profit organization funded solely by foundations. When the program identifies youth needing treatment, their care is paid for depending on the family's health coverage.


The computer-based questionnaire used by TeenScreen® is a valid and reliable screening instrument.151 The vast majority of youth identified through the program as having already made a suicide attempt, or at risk for depression or suicidal thinking, are not in treatment.152 A follow-up study found that screening in high school identified more than 60% of students who, four to six years later, continued to have long-term, recurrent problems with depression and suicidal attempts.153

Biggest challenge

To bridge the gap between schools and local providers of mental health services. Another challenge is to ensure, in times of fiscal austerity, that schools devote a health professional to screening and referral.

How other organizations can adopt

The Columbia University TeenScreen® Program is pilot-testing a shorter questionnaire, which will be less costly and time-consuming for the school to administer. It is also trying to adapt the program to primary care settings.


Sites where implemented

69 sites (mostly middle schools and high schools) in 27 States

The No Child Left Behind Act of 2001154 is designed to help all children, including those with serious emotional disturbances reach their optimal potential and achievement. To fulfill the promise of this Act, schools must work to remove the emotional, behavioral, and academic barriers that interfere with student success in school. Consequently, it is critical to strengthen mental health programs in schools. This effort may involve:

Since the IDEA requires that a variety of professionals collaborate in the school and in the community, the Commission urges that coordinating services be regarded as a "related service" in the child's Individual Education Plan (IEP). In developing the IEP, there should be a stronger family focus and youth involvement and support. The training and research funds designated in this Act should be considered for use to train teachers, related services professionals, and parents to recognize signs of emotional and behavioral problems in children, make appropriate referrals for assessment and services and classroom accommodations, and implement and evaluate evidence-based school mental health interventions.

On a related topic, the Commission recognizes the particular challenges for youth in transition from adolescence to adulthood. IDEA has transition requirements beginning at age 14, but to date, these requirements have not resulted in acceptable post-school outcomes.

Studies show that approximately 42% of students with serious emotional disturbances graduate from high school as opposed to 57% of students with other disabilities.81 Schools and local mental health agencies could improve their collaboration and use of evidence-based practices to develop transition-to-work services so that children with serious emotional disorders can move successfully from school to employment or to post-secondary education.


    4.3 Screen for co-occurring mental and substance use disorders and link with integrated treatment strategies.

Treatment for Co-occurring Disorders Must Be Integrated

Integrated treatment often involves other systems as well, because individuals with co-occurring disorders typically have a wide range of health and social service needs. For example, children in the juvenile justice system are at high risk for co-occurring mental and substance abuse disorders.156 Similarly, in the child welfare system, research strongly demonstrates that children in foster care at a high-risk for maladaptive outcomes, including socio-emotional, behavioral, and psychiatric problems warranting mental health treatment and supports.157-159


    4.4 Screen for mental disorders in primary health care, across the life span, and connect to treatment and supports.

Expand Screening and Collaborative Care in Primary Care Settings

Figure 4-3. Model Program: Collaborative Care for Treating Late-Life Depression in Primary Care Settings


IMPACT-Improving Mood: Providing Access to Collaborative Treatment for Late Life Depression


To recognize, treat, and prevent future relapses in older patients with major depression in primary care. About 5% -10% of older patients have major depression, yet most are not properly recognized and treated. Untreated depression causes distress, disability, and, most tragically, suicide.


Uses a team approach to deliver depression care to elderly adults in primary care setting. Older adults are given a choice of medication from a primary care physician or psychotherapy with a mental health provider. If they do not improve, their level of care is increased by adding supervision by a mental health specialist.


The intervention, compared to usual care, leads to higher satisfaction with depression treatment, reduced prevalence and severity of symptoms, or complete remission.163

Biggest challenge

To ensure that the intervention is readily adapted from the research setting into the practice setting.

How other organizations can adopt

Be receptive to organizational changes in primary care and devise new methods of reimbursement.


Study sites in California, Texas, Washington, North Carolina, Indiana

Commission on Mental Health Logo

Mental Health Resources / Home




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Illinois Lounches Compulsory Mental Health Screening
For Children and
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July 28, 2004

Posted 12:56 AM Eastern

This past spring, the Illinois General Assembly passed a new bill requiring compulsory mental health screening for children and pregnant women; it was signed into law by Governor Blagojevich. This program will require all pregnant women and children through the age of 18 be tested for mental health needs.

Public forums are now being held in different locations throughout the state and many alarmed parents are attempting to get the word out: get to those forums and voice your opinion. "We're moving toward social training over academic training with this program," says Larry Trainor, a Mt. Prospect parent of four children and a contact for Citizens Commission on Human Rights.

Trainor went on to state, "Since psychiatric involvement in education, SAT scores have gone down for the past few decades. Evaluating mental conditions is not based on scientific evidence, it's subjective. What if they find a student has a math disorder, a reading disorder? Would that be a mental health disorder, one that would cause the parents to put their children with a drug for a condition they may or may not have?" Trainor asked.

Other concerned parents say they will refuse to participate in such a program they emphatically state has gone way too far with state interference in their lives and the personal lives of their children. Amy Witherspoon said she and her husband will leave the state before they subject their three year old to any mental health screening by the State of Illinois, nor will Amy, now six months pregnant, submit to any state program "invading my privacy under the guise of mental health screening." Amy's husband, Larry, also rang in by saying, "This is just one more step in the state separating the parent from the child via the school system. Compulsory mental health evaluation for my wife against her will? Good-bye, Nazi Illinois."

The Witherspoon's aren't alone in their opinion about health issues in their state. Dom Pagalia, grandfather of six, says the governor and legislature have "gone crazy," passing this new, compulsory mental health law and says the voters of Illinois should "throw out every legislator this November who voted for this forced testing program." Pagalia says his two children, the parents of his grand children, will file a lawsuit to keep the state from any forced mental evaulation of their minor children. Should that fail, Pagalia says they are prepared to leave the state rather than give up their rights as parents.

Under this new, compulsory mental health law, pregnant women will be screened for depression and following her baby's birth, evaluation would continue for up to one year. Follow up treatment will also be provided under this program. All children ages 0-18 years will be provided screening under this mental health program. "Mental health centers" at schools will handle the process to "ensure appropriate and culturally relevant assessment of young children's social and emotional development with the use of standardized tools."

The Illinois State Board of Education is the agency targeted with the responsibility to develop appropriate tests that assess both mental health and academic standards. The current task force hosting these statewide public forums is scheduled to send their recommendations to Governor Blagojevich by the end of the summer in accordance with the Act (HB 2900).

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Other concerned parents say they will refuse to participate in such a program they emphatically state has gone way too far with state interference in their lives and the personal lives of their children.