Screening brings labeling, drugs

Of Interest is this letter to the editor in the Boston Globe by a psychiatrist from the State of New York, regarding the recent start of mental health screening for children under the care of the Medicaid program.

As a psychiatrist since 1947, I am appalled that mental health screening is now being required of Massachusetts children on Medicaid ("Mental screening for young to begin," Page A1, Dec. 27). Such screening greatly exaggerates the significance of the normal variations in psychological state.
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Normal kids will therefore be labeled "sick" and referred for "treatment." That labeling is often harmful in itself; once tagged, how does a kid prove he's not mentally ill?

In some middle-class families, treatment may be individual or family counseling. Whether it helps or is merely wasteful, it usually causes relatively little harm. For Medicaid kids, however, treatment will almost always involve powerful drugs whose serious side effects can include the stunting of growth. Mental health screening is thus a harmful invasion of the privacy of Medicaid youngsters.

Dr. NATHANIEL S. LEHRMAN
Roslyn, N.Y.

See also Our own earlier report