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Bush plans to screen whole US population for mental illness
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     The responses sparked by Lenzer's news item on US president George W Bush's plans to screen the whole US population for mental illness overwhelmingly opposes such plans.1 Some correspondents, however, see some positive elements in the plans as an attempt to improve the United States' "very diseased" mental health system, or as ambitious yet commendable. Under different labelling such a programme could even be a valid public health measure designed to prevent or delay the onset of acquired neurodegenerative disorders or diseases of ageing.

    Several correspondents write from their own experience with mental illness in the shape of depression or autism. Acknowledging that mental illness is like any other disease may be a good thing. Equally, so is taking an active part in conveying the needs of people who have a mental illness but cannot express themselves. Many correspondents, on either side of the argument, seem to think that if this happens in the United States, the United Kingdom will follow suit.

    On the contra side, correspondents recommend that any such screening programme has to start at the very top of public service (and not all of them are joking) and warn that the president may be perceived as pushing drugs. While screening and the treatment of mentally ill people can certainly be improved, attention has to be paid to a possible hidden agenda, when "unpatriotic" means "mentally ill" or when the goals of such a programme are not entirely clear. Comparisons with totalitarian regimes with fascist agendas are inevitable.

    The dangers of denying people, especially children, their emotional experience by giving drugs to control them is highlighted by several correspondents. The role that other factors, such as homelessness, poverty, violence, unemployment, etc, play in children's mental problems or behaviours is being ignored. So is the child's own viewpoint. The question is what the US government's priorities are, and why other ways of treating children's behavioural problems are not being considered. Urgency because of the forthcoming US elections is suggested as a possible motive for the one-sidedness of the proposal.

    Much worry is expressed about the erosion of personal freedoms, not only in the United States, and about the fact that the current US government has done more to restrict the rights of disabled and mentally ill people than any in recent history. Furthermore, such a screening programme would be entirely subjective and reduce people's mental health to a mere number.

    The warning that we could become completely beholden to the pharmaceutical industry is serious. The simple question posed, "Who stands to gain if this passes?" for most correspondents logically leads into the next simple question: "What next?"

    Birte Twisselmann, technical editor

    BMJ

    Competing interests: None declared.

    References

    Electronic responses. Bush plans to screen whole US population for mental illness http://bmj.bmjjournals.com/cgi/eletters/328/7454/1458 (accessed 21 Jul 2004).