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I was asked if I would post an opinion piece by someone that had read the previous posts and comments on TeenScreen - Good or Bad?, Mantatory Mental Health Screening for Our Children Part 1 and Mantatory Mental Health Screening for Our Children Part 2. I figured "why not" so here it is:

The Debate Continues by M.R.L.

The debate on manditory mental health screening can be easily brought down to two arguments that are oppositional in nature. Private versus public. Should the government, hospitals, schools, etc. be allowed to intrude on your life, or the lives of your children and family, for what they prescribe is for the better?

One of the main codes of ethics in medicine and mental health is that the individual has a choice through the whole procedure. If they do not want to be treated for cancer, they have a right to refuse. If they do not want to go to counseling, they have a right to refuse. However, one argument that can be lent to this camp is that therapy and counseling can be a preventative measure for developing a more serious disorder or more serious symptoms of a disorder. Therefore, like a vaccine can prevent many diseases, many disorders can be prevented from getting out of control. Not many people twice before getting their child vaccinated, but, they do have a right to refuse.

On the flip side, early signs of suicide and mental disorders that can be harmful to the individual. The earlier they are found, the easier they are to treat. To a certain point, at least. Bad outcomes could also be prevented. There are plenty of stories where the parents of a child who has committed suicide say that they “never saw it coming”. Suicide doesn’t just happen, and there are signs that perhaps a professional would be looking for that a parent wouldn’t be. Also, parents sometimes do not want to think about the possibilities of suicide or mental disorders in their family, and therefore it goes “unnoticed” or “pushed under the rug”. This could have some serious problems.

Mental health affects all facets of life. However, pinpointing particularly dangerous, symptoms, such as conduct disorder in children, which can develop into antisocial personality disorder and psychopathy, (serial killers and the like) does not mean that the disorder will take that path. Mental disorder is a blend of life experiences and genes. So a lot of money would be spent on something that may not actually happen.

To ease this argument, I guess I would have to say that perhaps in the future, when the DSM is more geared to individual dimensions of predicting behavior and not categorical group classifications, that society will be better equipped to pick out those that are really in trouble.

Another issue would be, what do you do if you find a child has the symptoms of severe depression? Force them into therapy? We all know that a person will not be helped unless they want to be helped. I can also get into the issue that in order to really help many disorders that the environment would have to be changed. For example, poverty might be a component of depression. However, this issue is too complicated to predict. Coming from the same environment, one child might become a gang member while another child will become a doctor. Environment is hard to predict and change. If you find that a child does indeed have all the predictor of developing severe depression, for example, low social economic status, mother or father (or both) having depression themselves or another mental illness, no protective factors against depression in their lives, what do you do? Do you take them from their home? Is it hard to even take a child out of a household where physical abuse is seen, imagine how much harder it would be to take a child out of a household which would seem to be proactive factors for mental illness, which is much more abstract.

I guess that I don't have the answer either but the issue is excellent food for thought!