Last May, the Church of Scientology's Citizens Commission on Human Rights (CCHR) distributed 50,000 copies of a new booklet entitled Psychiatry--Education's Ruin, complete with a cover photo of drugged-looking school kids at desks. The CCHR logo on the cover resembles a federal government seal, with a hand holding up scales of justice. Beneath the logo are the words: "Published as a public service by the Citizens Commission on Human RightsTM."
On its World Wide Web site (http:/www.cchr.org/morals/wit-cchr.htm), CCHR describes itself as a "nonprofit, tax-exempt 501(c)(3) public benefit corporation" and as an "international organization with 118 chapters in 27 nations...CCHR was established by the Church of Scientology in 1969. Our mandate is to investigate and expose psychiatric abuses of human rights."
In past years, CCHR has undertaken campaigns against fluoxetine (Prozac), electroconvulsive therapy, methylphenidate (Ritalin) and the inclusion of psychiatric care in health care reform, among others. But in recent months, it has made psychiatry itself the direct target, with the publication of Psychiatry--the Ultimate Betrayal by Bruce Wiseman, CCHR U.S. president, and the publication of the Psychiatry- Education's Ruin booklet.
Asked about the American Psychiatric Association's stance on the booklet, Lynn Schultz-Writsel, associate director in the Division of Public Affairs, said: "We have not responded in any way, shape or form. There has not been a hue and cry from members to respond. And anyway, the publication speaks for itself."
The booklet blames psychiatrists for the purported erosion of America's educational system, growing drug abuse and the rise of crime and violence.
"We--the taxpaying public--have hired just such an expert. He is psychiatry. And he claimed to be the expert who would take care of society's drug problem, crime and violence problem and education problem. He also said he would take care of our mentally ill and cure them. And we have paid him not millions but billions upon billions of dollars to perform these functions. His results? In the United States, there has been a more than 370 percent increase in violent crime since 1960...Today, drug abuse is ravaging society, particularly our young...There has been a drop of almost 80 points in SAT scores...as for mental illness, according to census takers, last century one in a thousand people were mentally ill...now some psychiatrists say that 50 percent of us are suffering from 'mental illness.' "
The booklet goes on to discuss suicides and drug abuse among psychiatrists and instances of psychiatrists and psychologists sexually assaulting patients, students and their own children.
Seeking to answer the question, "Do psychiatrists manufacture madness?" the booklet asserts that psychiatrists have "invented criteria," such as attention-deficit disorder, learning disability, impulse disorder or conduct disorder, "and based on these criteria, millions of children around the world are placed on powerful, mind-altering drugs."
Last July Rep. Christopher Shays (R-Conn.), chairman of the House Subcommittee on Human Resources and Intergovernmental Affairs, held hearings on attention-deficit/hyperactivity disorder (ADHD). Shays cited Department of Education estimates that up to two and one-half million school-aged children have ADHD. Some Washington observers wondered whether the CCHR was behind the hearings (see Washington Report in September Psychiatric Times). That suspicion was heightened because some originally thought Shays was a Scientologist. He is not. He is a Christian Scientist.
Chris Allred, the staffer on the House subcommittee who arranged the hearings, said the Scientologists had no role in the scheduling of the hearings. Allred and other staffers came up with the idea after perusing newspaper clippings. Of course, the Psychiatry booklet could have stimulated some of those articles, Allred conceded.
Allred explained he probably saw references to the church's campaign in those clips. But he, and ultimately Rep. Shays, declined to invite the Scientologists to testify. "We were looking for more recognized experts," Allred stated.
Allred admitted that in preparing the hearings, he heard from a number of congressional offices who thought ADHD was "very wishy-washy." He added, "One of them gave me a lot of evidence, none of it from the Church of Scientology."
Among those testifying at the subcommittee hearing was Deborah Zarin, M.D., deputy medical director of the American Psychiatric Association and a trained child and adolescent psychiatrist. In her oral testimony, Zarin pointed out that the DSM IV criteria for ADHD are meant to be applied by trained clinicians who can determine whether characteristics are there, whether symptoms are clinically significant and whether the symptoms are better accounted for by normal variant or other disorders. "Both under and overdiagnosis is possible if the assessment is not done by trained clinicians," she said. In recommendations for public policy, Zarin expressed support for possible ADHD sufferers to have access to "fully trained professionals for assessment and diagnosis." She urged support for access to all potentially effective treatments "so that clinical decision-making for an individual can be based on what's best for the individual child, not based on what is covered within the school system or health plan." Finally, she urged public support for ongoing research to better understand etiology of ADHD, develop better medications and better guides for matching particular treatments to particular children.
On behalf of the American Academy of Child and Adolescent Psychiatry and the APA, Zarin also submitted 11 pages of written testimony. Contained in it were discussions of the epidemiology of ADHD, changes in terminology, recognition and diagnosis of ADHD, treatment approaches and outcomes. The testimony pointed out that "there are more than 200 studies showing that a stimulant called Ritalin...works effectively for children with ADHD."
In answering the question of whether ADHD is being overdiagnosed, the testimony pointed to an effort made 10 to 15 years ago to educate professionals, parents and teachers. "The general opinion is that more cases are being diagnosed because parents and teachers are recognizing the behaviors and referring to physicians and because more physicians are correctly making the diagnosis," it said, noting also that the AACAP, the APA and the American Academy of Pediatrics have developed or are developing guidelines for diagnosing and treating ADHD.
ADHD was not the only "educational" issue considered in the CCHR's booklet. It also discussed psychiatry's alleged "increasing influence" on education through outcome based education (OBE) and ACCESS program funding that enables school districts to receive Medicaid reimbursement for a variety of special education and related services.
"With OBE and now Medicaid, psychiatrists and psychologists have achieved one of their goals: schools as psychiatric clinics," the booklet said.
In the back of the booklet is a discussion of a June 1995 gathering of parents, educators, state legislators and members of grassroots organizations, representing "over 40 million people" and a call for action. Attendees at the 1995 meeting held a press conference to sign a pledge. Among other provisions, signers pledged themselves "to eliminate...all dangerous and invasive psychiatric/psychologically based programs, assessments and tests from our schools and funding thereof." Among the signers, the booklet said, were Congressman Sonny Bono (R-Calif.); California state senator Raymond Hayes, former Oregon legislator Ron Sunseri, representatives of the Family Research Council and the National Parents Commission. The booklet urges others with similar views to contact Parents Involved in Education.
Investigation of some of the statistics and sources cited in the booklet revealed inaccuracies. For example, on page 10, the booklet alludes to the Elementary and Secondary Education Act (ESEA), which was passed in 1965: "The ESEA allocated massive federal funds and opened the school doors to a flood of psychiatrists, psychologists, psychiatric social workers and psychiatric programs and psychological testing that continues to this day." In fact, it was not the ESEA, but the Individuals with Disabilities Education Act (IDEA), passed in 1975, which required schools to provide treatment to children with disabilities, including mental illness.
The booklet also states: "The number of education psychologists in the U.S. increased from 455 in 1969 to 16,146 in 1992. As of 1994, child psychiatrists, psychologists, counselors and special educators in and around the U.S. public schools nearly outnumbered teachers."
To substantiate the number of educational psychologists in the United States in 1969, the booklet references a presentation made by Tom Fagan, Ph.D., to the National Association of School Psychologists (NASP) in 1993. In a telephone interview, Fagan, a professor of psychology at the University of Memphis, said that presentation cited "455" as the number of members of the NASP, which was established in 1969. The number of school psychologists that year was close to 5,000, he said. "They misrepresented my paper," he complained.
According to the Department of Education's 18th Annual Report to Congress on the implementation of the IDEA, there were 1.87 million elementary and secondary classroom teachers in the United States in 1994. Special education teachers numbered 335,000. There were 20,000 school psychologists and 7,500 counselors. There was no category for psychiatrists in the IDEA report. But the American Academy of Child and Adolescent Psychiatrists said it has 6,000 members. So the CCHR's statement about psychologists, psychiatrists, counselors and special educators "nearly outnumbering" teachers is inaccurate.
Equally erroneous is the statement by Fred Baughman Jr., M.D., a pediatric neurologist, quoted with approval on page 27, that "ADHD was invented, in committee, at the American Psychiatric Association in 1980...There is nothing a physician can see to confirm or refute it..."
Actually, it was DSM-III-R, published in 1987, which first used the term attention-deficit/hyperactivity disorder. The term attention-deficit disorder, with and without hyperactivity, appeared in the DSM-III in 1980. But the first time the APA turned its attention to the disease was 1968, in DSM-II, when it was listed as hyperkinetic reaction to childhood.
In exploring why CCHR and Scientologists have made psychiatry and psychology such a target, Kevin Dwyer, assistant executive director in charge of government affairs and professional relations with the National Association of School Psychologists, explained that psychiatrists and psychologists are their competition. "It is a competitive game," Dwyer explained. "They are trying to make sure they don't lose the grip on those people."
Peter Dockx, a CCHR spokesperson, declined to answer questions about the Psychiatry booklet and requested that questions be submitted in writing. Answers were provided in the form of a memo from Jan Eastgate, president of CCHR International, to Dockx.
Eastgate said the brochure proved so popular that "hundreds of thousands" have been printed in seven different languages. Moreover, she argued, "It is ludicrous to think that Scientology is in 'competition' with the incompetence, brutality and lies of psychologists or psychiatrists." Much of her response reiterates antipsychiatry statements cited in the booklet.
Dwyer said he does not worry so much about people taking CCHR's Psychiatry booklet seriously. "What I worry about," he explained, "is people quoting this material secondhand, without the attribution to the Church of Scientology."
Dwyer said his group does not have the time or resources to respond to CCHR's attack, a view echoed by the APA.
(The full text of Psychiatry Education's Ruin can be seen on CCHR's web site (http://www.cchr.org/educate)-Ed.)