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Monday 31 October 2011

VIDEO - CREATING BOGUS MENTAL HEALTH DISORDERS IN CHILDREN WITH DSM5

JUVENILE BI-POLAR DISORDER? LET THE CHILDREN CHOOSE THEIR OWN POSITIVE LABELS FOR THEIR LIFE.
http://youtu.be/Wv49RFo1ckQ

CLICK ON THE LINK ABOVE TO WATCH THIS CHALLENGING VIDEO

PAEDIATRIC BIPOLAR DISORDER THE NEW EPIDEMIC COUTESY OF THE INFAMOUS PROFESSOR BIEDERMAN AND HIS TEAM - DO YOU BELIEVE THE SPIEL OF THIS RESEARCHER? DOES SHE CONVINCE YOU IT IS A BIOLOGICALLY BASED CONDITION?



http://youtu.be/X4zG2KLBX68


TO SEE THIS VIDEO WITH DR LYNDSAY SCHENCKEL CLICK ON LINK ABOVE COMPLETE WITH POWER POINT SLIDES

DSM5 - A CRITICAL REVIEW PART 1 - Dr Jock McClaren - Australian Psychiatrist

Dr Jock McClaren - CRITIQUE OF DSM5


http://youtu.be/eeEx1MqqE7M

JOCK MCCLAREN OUTLINES CRITICISMS OF DSM5 AS BEING UNSCIENTIFIC AND NOT WORTHY OF MERIT IN THIS RESPECT.

LOUIS THEROUX VIDEO( 4 OF 4 )-" AMERICA'S MEDICATED KIDS." - MUST WATCH



http://youtu.be/t8U4ARVaLvg

WATCH LOUIS'S LAST EPISODE OF THIS AMAZINGLY REVEALING BBC DOCUMENTARY .

LOUIS THEROUX VIDEO (3 0F 4) -"AMERICA'S MEDICATED KIDS" - STARTLING STUFF



http://youtu.be/87nGRHWUr3A

EPISODE 3 OUT OF 4 OF LOUIS'S DOCUMENTARY ON THE USE OF DRUGS INSTEAD OF GOOD PARENTING IN THE U.S. - CRAZY STUFF!

Sunday 30 October 2011

LOUIS THEROUX - VIDEO (2 OF 4) - "AMERICA'S MEDICATED KIDS."

LOUIS THEROUX'S ENGAGING STYLE WITH YOUNG PEOPLE UNCOVERS SOME EXCELLENT EXAMPLES OF QUESTIONABLE PRACTICE BY MEDICS, SCHOOLS AND PARENTS.


http://youtu.be/ILPDEYJl9xA

TO SEE 2ND EPISODE CLICK ABOVE

DO WE WANT THE SAME APPROACHES HERE??

Louis Theroux - YOUTUBE VIDEO (1 OF 4) " AMERICA'S MEDICATED KIDS."- A MUST WATCH IN FOUR PARTS.

LOUIS THEROUX
 SEE LOUIS'S INTERESTING REPORT THAT WAS ON THE BBC - VERY POWERFUL - CLICK BELOW:

http://www.youtube.com/watch?v=-yjo8OkpUIg&feature=relatedhttp://

DSM5 - PSYCHIATRY'S GREATEST SCAM SO FAR ! ?



http://youtu.be/Qn0mgisVhgM

CLICK ON LINK ABOVE TO WATCH GREAT YOUTUBE VIDEO ON THE EXPLOSION OF MENTAL HEALTH DIAGNOSES WITH THE PROPOSED DSM5 IN 2013 SIGN THE PETITION AGAINST IT'S RELEASE AND QUESTION THE 'BAD SCIENCE' IT IS BASED ON.

THE SOCIAL COST OF GLOBALISATION - IN PARTICULAR RELATION TO THE PROFITABILITY OF PSYCHOTROPIC DRUGS FOR KIDS

THIS IS A POLITICO- ECO SOCIAL - PSYCHOLOGICAL PHENOMENON


Social Costs of Globalisation
Written by Helena Norberg-Hodge and Steven Gorelick.


"... America is a new kind of society that produces a new kind of human being. That human being - confident, self-reliant, tolerant, generous, future-oriented - is a vast improvement over the wretched, servile, fatalistic and intolerant human being that traditional societies have always produced."- Dinesh D'Souza, What's So Great About America

Implicit in all the rhetoric our leaders spout about globalisation is the idea that the rest of the world should eventually be brought up to the standard of living of the West, and America in particular. Read between the lines of the 'sustainable development' argument and you'll find the American Dream lurking: it is globalisation's touchstone, its apparent endpoint.

But if this is the direction globalisation is taking us, it is worth examining where America itself is headed. A good way to do so is to take a hard look at America's children, since so many features of the global monoculture have been in place their whole lives. They are like canaries in a mineshaft: if the American Dream isn't working for them, why should anyone, anywhere, believe it would work better for their own children?

As it turns out, children in the US are far from "confident, self-reliant, tolerant, generous, and future-oriented". One indication of this is that an estimated five million of them are being given at least one psychiatric drug. This disturbing trend is growing rapidly. The number of children ages 2-4 for whom stimulant and anti-depressant drugs have been prescribed increased 50 percent between 1991 and 1995. In the following four years, prescriptions for anti-depression drugs rose even more steeply, climbing 151 percent for children in the 7-12 age group, and 580 percent for children six and under.

For most people in the less 'developed' world it is impossible to imagine 2-year old children so depressed that they need prescription drugs. Equally hard to fathom are many other symptoms of social breakdown among America's children. Eating disorders, for example. The number of pre-pubescent children with eating disorders is on the rise, with girls as young as four showing signs of anorexia. Cosmetic surgery, another symptom of insecurity and poor self-image, is also on the increase, with the number of teen-age girls having their breasts augmented quadrupling, and liposuction procedures tripling, in just the past five years.

What about violence, which is a more common symptom of breakdown for boys? Consider the fact that there have been at least 25 school shootings in the US since 1996, claiming the lives of 35 students. The youngest killer? A six-year old boy.

What has made America's children so insecure and troubled? A number of causes are surely involved, all of which can be traced back to the global economy. As corporations scour the world for bigger subsidies and lower costs, jobs move with them, and families as well: the typical American moves eleven times during their life, constantly severing connections between relatives, neighbours and friends.

Within almost every family, the economic pressures on parents systematically rob them of time with even their own children. Americans put in longer hours at work than people in any other industrialised country, and the trend is ever upward: Americans work the equivalent of one week longer per year than they did a decade ago, more than five weeks longer than in 1970. As a consequence more and more young children are relegated to the care of strangers in crowded day-care centres. Older children are often left in the company of violent video games or the corporate sponsors of their favourite television shows. Time spent in nature - fundamentally important to our psychological well being - is increasingly rare.

Globalisation and the spreading consumer culture thus work to displace the flesh-and-blood role models - parents and grandparents, aunts and uncles, friends and neighbours - that children once looked up to, replacing them with media and advertising images: rakish movie and rock stars, steroid-enhanced athletes and airbrushed supermodels. Children who strive to emulate these manufactured 'perfect' idols are left feeling insecure and inadequate.

In this sense, what is often seen as American 'culture' is not a product of the American people. It is, in fact, an artificial consumer culture being foisted on people through advertising and the media. This consumer culture is fundamentally different from all those cultures which for millennia were shaped by climate and topography - by a dialogue between humans and the natural world. This is a new phenomenon, something that has never happened before: a culture determined by technological and economic forces, rather than human and ecological needs. It is not surprising that American children, many of whom seem to 'have everything', are so unhappy: like their parents, their teachers at school and even their television heroes, they have been put on a treadmill that is ever more stressful and competitive, ever more meaningless and lonely.

America's children are among the first victims of a culture shaped by commercial interests and media moguls, and an increasing number of Americans are waking up to this fact. There is a growing trend towards turning the television off, towards consciously seeking nature and community instead. These are incredibly important and hopeful signs.

Nevertheless, as the globalisation juggernaut steamrolls along the number of victims worldwide is growing exponentially. Today millions of children from Mongolia to Patagonia are targets of a fanatical and fundamentalist campaign to bring them into the consumer culture. The cost is massive in terms of self-rejection, psychological breakdown and violence. These children are just as vulnerable as their American counterparts to the sales pitches of corporate advertisers, who tell them that this brand of make-up will inch them closer to perfection, or that wearing that brand of sneakers will make them more like their sports hero. Sales of dangerous bleach for skin and hair, and contact lenses advertised as 'the colour of eyes you wish you were born with', are skyrocketing in the South.

This psychological impoverishment is accompanied by a massive rise in material poverty. Even in America a decade-long economic 'boom' could not lift an estimated 35 million people above the poverty line. And what about the millions drawn into rapidly growing Third World slums every year, with little hope of escape? What about the factory workers in sweatshops and maquiladoras, and the small farmers in their dying rural communities? What about the indigenous peoples being driven to extinction, and those whose ways of life are so threatened by the forces of globalisation that they turn to fundamentalism, even terrorism?

The central hope of the American Dream - that our children will have a better life than we do - seems to have vanished. Many people, in fact, no longer believe that our children really have any future at all.

Nonetheless policymakers insist that globalisation is bringing a better world for everyone. How can there be such a gap between the cheerleading rhetoric and the lives of real people? Part of the disconnect results from the way globalisation's promoters measure 'progress'. It is all too easy to compare America's consumer cornucopia today with what was available 50 or 150 years ago. More often, the baseline from which comparisons are made is rooted in the Dickensian period of the early industrial revolution, when exploitation and deprivation, pollution and squalor were rampant. From this starting point, our child-labour laws and 40-hour workweek look like real progress.

Similarly, the baseline in the Third World is the immediate post-colonial period, with its uprooted cultures, poverty, over-population and political instability. Based on the misery of these starting points, political leaders can argue that our technologies and our economic system have brought a far better world into being, and that globalisation will bring benefits to the "wretched, servile, fatalistic and intolerant human beings" in the remaining 'undeveloped' parts of the world.

In reality, however, globalisation is a continuation of a broad process that started with the age of conquest and colonialism in the South and the Enclosures and the Industrial Revolution in the North; from then on a single culture and economic system has relentlessly expanded, taking over other cultures, other peoples' resources and labour. Far from delivering us from poverty, the globalising industrial system continually creates it.

Today, on the eve of the Johannesburg summit, it is vital that we connect growing physical and emotional poverty - whether inside or outside the US - to the whole industrial system, to a history that included robbing people from all over the world of their natural resources, labour and self-respect. Our leaders simply fail to connect the dots between 'progress' and poverty.

Erasing other cultures, replacing them with an artificial culture created by corporations and the media can only lead to an increase in social breakdown and poverty. Even in the narrowest economic terms, globalisation means continuing to rob, rather than enrich, the majority. In 1960, the income of the richest fifth of the global population was 30 times that of the poorest fifth; by 1997 the gap more than doubled, with the richest fifth receiving 74 times more than the poorest fifth. This is globalisation at work.

By forcing everyone on the planet to rely on the same, narrow range of resources, globalisation is creating artificial scarcity, thereby adding to real poverty and exacerbating violent conflict. Contrary to the often-repeated claim that global trade is making conflict less likely, a recent World Bank study has found that countries whose economies are highly specialised - precisely what the free traders prescribe - are 20 times more likely to find themselves in civil war than countries whose economies are diversified.

With those in the industrialised world using ten times their share of the earth's resources, it is a criminal hoax to promise that everyone in the 'undeveloped' world can do the same. The global spread of this fantasy has been profoundly destructive to people's ability to survive in their own cultures, in their own place on the earth. It has even been destructive to its most privileged beneficiaries. America's children are telling us we need a very different dream - one shaped by culture and nature, not by corporate greed.

Originally published as "Have a Nice Day" in the September 2002 issue of The Ecologist.



Wednesday 26 October 2011

BRITISH PSYCHOLOGICAL SOCIETY QUOTED IN ADJOURNMENT DEBATE ON ADHD ON 25TH OCTOBER 2011



The Society’s response to a consultation on the proposed fifth edition of the American Psychiatric Society’s Diagnostic and Statistical Manual (DSM5) was quoted at Westminster yesterday.

Pat McFadden, the Labour MP for Wolverhampton South East, had obtained a Westminster Hall debate on the prescription of Ritalin for children diagnosed with Attention deficit hyperactivity disorder (ADHD).

Mr McFadden said he supported the Association of Educational Psychologists’ call for a re view of the prescription of Ritalin and similar medication to children (as the Society itself has done) because of the growth in the number of prescriptions, the evidence that they are being given to very young children, the wide regional variations in their use, and the lack of evidence about the long-term effects of combining these drugs with others.

He also called on the Department of Health to carry out a proper research project into the use of the drugs, including the age of the children receiving them.

In making these calls he quoted the Society’s response to the consultation on DSM5:

"The Society is concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.

"Diagnostic systems such as these therefore fall short of the criteria for legitimate medical diagnoses. They certainly identify troubling or troubled people, but do not meet the criteria for categorisation demanded for a field of science or medicine."

The debate, which also featured brief contributions from the senior MPs Paul Flynn and Frank Field, was replied to by the health minister Simon Burns.

Mr Burns said it is for the National Institute of Health and Clinical Excellence (NICE) and not the Department of Health to review the evidence and to provide national clinical guidance. NICE will soon be announcing the outcome of a review of whether it should update its 2008 guidelines on the treatment of ADHD.

He did not agree to either of the reviews proposed by Mr McFadden, but did say that the DH is investigating whether further helpful information can be derived from prescribing research databases.

Mr Burns also said that "the chief medical officer and the NHS medical director plan to write to clinicians to remind them of the full range of NICE guidelines on conditions - including ADHD - that affect children's mental health. They will highlight the opportunities to support rigorous use of evidence-based treatment through the improving access to psychological therapies programme."

As an experiment we covered the debate as it took place on the Society’s Twitter account. If you followed this please leave a comment to say whether you found it useful.

PAT McFADDEN, MP, WOLVERHAMPTON SE - PARLIAMENTARY ADJOURNMENT DEBATE ON ADHD ON 25TH OCTOBER 2011 AND CALLING FOR A NATIONAL REVIEW OF PSYCHOTROPIC DRUGS FOR KIDS ON BEHALF OF THE ASSOCIATION OF EDUCATIONAL PSYCHOLOGISTS AND VULNERABLE CHILDREN IN THE U.K. - WELL DONE PAT FOR SECURING £32 MILLION FOR PSYCHOLOGICAL INTERVENTIONS SUCH AS COUNSELLING PRIOR TO MEDICATION



GOOD ON YOU PAT! A GREAT RESULT

CLICK ON LINK ABOVE TO SEE FULL TRANSCRIPT

£32 million released by Minister for Counselling and Psychological interventions to avoid drugs.
A letter to all doctors reminding them of NICE Guidelines for
ADHD MEDICATIONS :

-NOT TO USE WITH PRESCHOOLERS i.e. under the age of 6

-TO WEIGH EVERY SIX MONTHS TO AVOID RISK

-TO GIVE DRUG HOLIDAYS EVERY TWO YEARS

-NOT TO PRESCRIBE FOR ANXIETY = CONTRAINDICATOR

-TO MONITOR BP AND PULSE TO AVOID 
'SUDDEN HEART FAILURE.'

-NOT TO USE AS 'FIRST RESORT' ONLY AFTER
PSYCHOLOGICAL INTERVENTIONS.
e.g. COUNSELLING , COACHING, BEHAVIOURAL PROGRAMMES, C.B.T., OR PARENT TRAINING

ALL OF THESE NICE GUIDELINES ARE BEING REGULARLY BREACHED IN THE WEST MIDLANDS WHERE THE AEP HAS CONDUCTED INFORMAL SURVEYS OF IT'S MEMBERS


McFadden (Wolverhampton South East) (Lab): It is a pleasure to see you chairing the debate, Mr Howarth. I secured the debate because I want to talk about how we treat behavioural problems such as attention deficit hyperactivity disorder in children, and, in particular, about the increasing use of drugs to treat those problems.



I have been tabling questions on this issue for some months. I am sure that it is a complete coincidence that this morning, just a few hours before the debate, the Government announced an extra £32 million for children’s mental health therapy, including talking therapies. That news will be welcomed by parents and professionals, because it is important—a point that I want to stress—to have a range of treatments available for young children who suffer from this condition. Will the Minister confirm whether that is new money, or whether it is part of the wider £400 million announcement, made in February, on mental health? If it genuinely represents extra resources for mental health therapy for children, that is of course welcome. I also welcome its happy coincidence with this debate today.


My main focus is on the use of drugs to treat ADHD and similar conditions. The main drug that we usually talk about in this field is Ritalin. Ritalin is a brand name for methylphenidate hydrochloride, and it is this whole family of drugs that I want to talk about. I want to set out the trend of increasing use of these psychotropic drugs to treat ADHD, and the growth in their use for very young children—sometimes in breach of National Institute for Health and Clinical Excellence guidelines. I want to spell out why many in the field believe that this trend is likely to continue. Finally, I will issue a plea to the Minister to carry out a proper, comprehensive review of the use of these drugs involving professionals from the medical, psychology and teaching fields, as well as the families of those who have been prescribed the drugs.


Paul Flynn (Newport West) (Lab): Had the young Mozart been on Ritalin and the young Beethoven been on anti-depressants, we would probably never have heard of them. Does my right hon. Friend agree that trying to drug children into conformity and uniformity is the enemy of creativity?


Mr McFadden: My hon. Friend makes an eloquent point. I do not take the view that the drugs cannot work. I am not qualified to say that, but there are serious questions to be asked about the growth in their use.


The increasing use of these drugs has not just happened in the period since last year’s general election. I am not here to make a party political point. This has been going on for many years and is part of an international picture, so it is not the responsibility of a single party or a single set of politicians. Some professionals and parents believe that these kinds of drugs can be effective and have a role to play where ADHD is correctly identified, although it is also true that some psychologists believe that there is significant over-identification and diagnosis of ADHD in children. The real question is whether the drugs are considered alongside other appropriate treatments,and are used as a first option, or only after alternatives have been properly explored and considered. Let us look at the trend in the number of prescriptions in England in recent years.


A written answer in July showed that between 1997 and 2009 there was a more than sixfold increase in the number of prescriptions for methylphenidate to the point where, in 2009, 610,000 prescriptions were issued. The number had almost doubled in five years. There is no doubt that there is an increasing reliance on these drugs to treat behavioural problems in children. Methylphenidate is not always used on its own. It can often be combined with other drugs, so that the child ends up taking a cocktail of powerful drugs to control their behaviour in different ways during the course of the day.


What lies behind this trend towards the medicalisation of child behaviour problems? Why are we prescribing more and more drugs to treat such problems? Do we really believe that there has been a sixfold increase in the occurrence of ADHD and similar disorders in recent years, or are these drugs being used to treat behavioural patterns that were dealt with in different ways by parents and teachers in the past? Is the increasing labelling and categorisation of behavioural problems increasing the tendency to treat children with drugs?


Sue Morris, director of professional training and educational psychology at the University of Birmingham, recently said:


“It’s not uncommon for the diagnosis of ADHD to be based on parental reports - without observation of the child in a home or school environment. The prescription of drugs certainly shouldn’t be the first step in treating the disorder. Sometimes drugs are being used in the absence of talking therapy and psychological assistance, and that is wrong.”


There is clear guidance from NICE on the use of these drugs:


“Drug treatment should only be initiated by an appropriately qualified healthcare professional with expertise in ADHD and should be based on a comprehensive assessment and diagnosis.”


NICE also makes it clear that methylphenidate


“is not currently licensed for use in children less than 6 years old”.


NICE makes it clear that it should be discontinued if there is no response after one month, and that treatment should be suspended periodically to assess the patient’s condition. What evidence does the Minister have that this guidance is being adhered to? Are these drugs always used as part of a comprehensive assessment and diagnosis? Are they used as the first option, or only after alternatives are considered? Are they given only to children aged six and over? Are children routinely taken off them after one month if they are not effective? Is their use periodically suspended to assess the patient’s condition?


I suspect that the Minister does not know the answers to many of these questions. In fact, when it comes to the number of children under the age of six being prescribed the drugs, I know that he does not know because the Department of Health has already told me. That is not a reflection on him personally, but it exposes a gap in our knowledge that must be filled. Why is it, despite the clear guidance from the Department of Health about the appropriate age for use of these drugs, that the Department does not know how many children under the age of six are being prescribed the drugs?


Evidence from the Association of Educational Psychologists suggests an increase in the use of methylphenidate for very young children. An informal survey of their members in the west midlands suggests that more than 100 children under the age of six in that region alone are on some form of psycho-stimulant medication. As we do not ask for someone’s age when a prescription is written, the Department of Health has told me that it cannot say whether its own guidance is being adhered to. I am sure the Minister would agree that that is an unsatisfactory situation. We have clear guidance from the Government, but no clear knowledge about whether that guidance is being breached on a regular basis. That is not an acceptable situation and the Government must establish a clear picture of what is going on.


I am not asking the Minister to ask the age of every person issued with a prescription, but it would be possible, through a proper survey of practitioners, to establish how much prescribing involves very young children. Will the Minister commit today to carrying out a proper research survey of professionals in the field to establish the degree to which the guidance from NICE is being adhered to and to establishing a clearer picture, particularly with regard to the use of these drugs by children under the age of six?


The question of age is not only about the youngest children. The sharp increase in the use of these drugs in recent years means that we now have a generation of teenagers who have taken psychotropic drugs for years. What happens when they reach adulthood? What are the long-term effects and what is the appropriate alternative treatment for people trying to come off these drugs after a number of years? In its review, NICE concluded:


“Given that ADHD is a chronic condition which may require long-term treatment, there is a need for further data on long-term outcomes of drug treatments.”


There is significant regional variation in prescribing patterns, with the BBC reporting a few years ago that the highest prescribing area prescribed 23 times more than the lowest. I can understand that in any health system in which people are asked to use their judgment prescribing patterns will not be uniform, but 23 times more is a very large difference, and there is similar variation abroad. In the United States, for example, the closer someone lives to the east coast the more likely they are to be diagnosed with ADHD and prescribed these kinds of drugs.


An important feature of the growth in the use of methylphenidate to treat behavioural disorders is the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition”—DSM-IV. The manual breaks down and categorises various psychological and behavioural disorders and has significant international influence. In 2013 it will be replaced by DSM-V.


Some people believe that such publications exacerbate a trend towards the over-medicalisation of behavioural problems. The British Psychological Society, for example, has expressed serious concerns about DSM-V. Its response to the impending introduction of the fifth edition states:


“The Society is concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation. 


It goes on:


“Diagnostic systems such as these therefore fall short of the criteria for legitimate medical diagnoses. They certainly identify troubling or troubled people, but do not meet the criteria for categorisation demanded for a field of science or medicine”.


What is the Department of Health’s response to those serious concerns? How does the Department intend to work with the professions on the introduction of DSM-V, and does the Minister share the concerns of the Association of Educational Psychologists and the British Psychological Society that it might exacerbate the trend towards the medicalisation of behavioural problems?


It is for all those reasons—the growth in the number of prescriptions, the evidence that they are being given to very young children, the wide regional variations in their use, and the lack of firm data and evidence about the long-term effects of combining these drugs with others—that the Association of Educational Psychologists has called for a review of the use of the drugs. The review should involve paediatricians, child psychiatrists, GPs, teachers, parents and other relevant voices. We must get to the bottom of what lies behind the increased use of the drugs, and establish whether we are dealing with childhood behavioural problems as best we can.


The association’s call for a review is a call I echo today, and I hope that the Minister can confirm that the Government will undertake such a review, before the introduction of DSM-V in 2013. I hope also that he will be open-minded about my questions. I welcome the money for children’s mental health therapy that has been announced today, but it does not mean that we should ignore the questions raised in this debate. If recent trends of growth in the use of the drugs were to continue, we could end up with more than 1 million prescriptions for them, each year in England. Would the Minister be comfortable with such an outcome?


Having highlighted the growth in the use of the drugs and raised concerns about their being taken by very young children in particular, I am essentially asking the Minister to do two things. First, will he commit his Department to carry out a proper research project into the use of the drugs, including the age of the children receiving them? Secondly, in the light of the huge growth in prescriptions, will the Government carry out a proper review of practice in the field, as called for by the Association of Educational Psychologists, before the new guidance comes into effect in 2013? Those requests are moderate and measured, and I look forward to a positive response.


1.45 pm


Mr Frank Field (Birkenhead) (Lab): I am grateful to my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) for securing this debate and for allowing me to address a simple question to the Minister.


Like my right hon. Friend, I am not qualified to say whether people should be on treatments or not, but I am struck by the increasing number of children in Birkenhead who are given what a group of teachers has referred to as “medical coshes” to keep them quiet. In some instances the drugs are no doubt necessary, and they work, but along with my right hon. Friend I question the growth in the number of prescriptions.


Will the Minister work with his colleagues in the Department for Work and Pensions to consider the moral hazard of someone ensuring that their child is on Ritalin so that the prescription gives them access to disability benefits? Clearly, that was never the Government’s intention, but we now have a system in which, if someone can prove that their child is ill, and keep them ill, the likelihood of the child being passported on to disability benefits increases. I know that this is not in the Minister’s sphere of influence, but in his response to my right hon. Friend’s most detailed points will he tell us whether he will co-ordinate with the relevant Minister in the Department for Work and Pensions to look at the moral hazard of someone proving their child needs to be on Ritalin to increase their chances of getting disability living allowance for that child?


1.47 pm


The Minister of State, Department of Health (Mr Simon Burns): I congratulate the right hon. Member for Wolverhampton South East (Mr McFadden) on introducing a particularly interesting and sensitive subject. He made his points very fairly and very well. In passing, I should, I suppose, declare an interest because a member of my family has for a number of years been on Ritalin and, contrary to the observations of the hon. Member for Newport West (Paul Flynn), the benefits to that person’s education have been immense—the decision was taken on clinical advice, not on the advice of parents.


I am pleased that the right hon. Gentleman has welcomed the announcement by the Minister with responsibility for social care, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), of £32 million to help with children’s mental health. The right hon. Gentleman asked whether that was new money. It comes from within the £400 million that was identified by the Treasury in the spending review last year.


The right hon. Member for Birkenhead (Mr Field) asked about the link between disability allowance, and other entitlements, and children on Ritalin. The entitlement is based not on having a specific health condition diagnosis or treatment, but on what help is needed with personal care as a result of the disability. Nevertheless, I will certainly draw his comments to the attention of my right hon. Friend the Secretary of State for Work and Pensions, whose Department will hopefully get back to him.


Let me set out some of the background to this issue. According to NICE, between 3% and 9% of school-aged children and young people in the UK meet the broad criteria for mild to moderate attention deficit and hyperactivity disorder, and between 1% and 2% suffer from severe ADHD. Methylphenidate, commonly known as Ritalin, and similar drugs are used to treat a range of mental health conditions, including ADHD. The NICE guidelines, published in 2008, recommend that medication should always form part of a holistic package of care, which might include talking therapies. I fully appreciate the concerns raised by the right hon. Member for Wolverhampton South East about the increase in the number of prescriptions for Ritalin and similar drugs. We need better to understand the reason for that. It is

always wrong for doctors to prescribe medication inappropriately, and medication should not be the sole response to an individual’s condition.


I fully appreciate the concerns of those worried about the growth in prescriptions for Ritalin. We do, however, need to acknowledge the fact that too many young people and their families are not getting the support they need. The NICE clinical guidelines on ADHD said, at the time of their publication in 2008, that a minority—fewer than 50%—of all individuals who should be receiving medication and/or specialist care were in receipt of such care. If left untreated, mental health problems can lead to low attainment in school, antisocial behaviour, drink and drug misuse, worklessness and even criminality in adult life. Getting things right for children and their families—through a broad range of support to promote good mental health from the start of life, through the school years and into adulthood—can make a real difference to young lives.


The costs of doing nothing are simply too great. Across hospital and primary care, the prescribing of drugs for ADHD increased by around 12.5% between 2007 and 2010, the latest four years for which data are available, and by around 6% in 2010 alone. Prescribing in primary care alone increased by 22% in that four-year period, reflecting a significant shift in prescribing activity from a hospital setting and into primary care. Looking back further, one sees that prescribing in primary care has tripled in the past 10 years. Some variation in the prescribing of ADHD drugs around the country must be expected in the light of the distribution of specialist services, which might be more likely both to diagnose children with ADHD and to support GPs in taking responsibility from hospital teams for repeat prescriptions; the different local patterns of prescribing across primary care and specialist settings; and demographic factors, such as deprivation, which might be correlated with ADHD.


We do not, however, have good-quality data on the number of children and young people assessed with ADHD, against which prescribing patterns could be compared. If we had, it would be possible to gain a true measure of variations in clinical practice. Prescribing data are not routinely collected by age, but we do need better to understand the position. In the shorter term, we are investigating whether further helpful information can be derived from prescribing research databases. As a result, the data we do have must be interpreted with care and in the context of all the evidence that suggests under-diagnosis and under-treatment of this distressing behavioural disorder.


Mr McFadden: The point about age is important. The NICE guidelines on children under 6 could not be clearer. The Minister acknowledges that the Government do not know—I will leave aside whether that is a good state of affairs—how many children are prescribed these drugs. His Department has a research budget, so, rather than trawling other research projects, why can it not commit to research to find out from professionals how many children under 6 have been prescribed such drugs?


Mr Burns: The right hon. Gentleman anticipates my remarks on the NICE guidelines, and I hope that once he has heard them the situation will be clearer.



The 2008 NICE clinical guidelines on the treatment of ADHD are clear that medication is an appropriate treatment for severe ADHD, but that it should be initiated only by a specialist and should form part of a holistic care package that may include talking therapies. The guidelines do not recommend drug treatment for pre-school children, and health care professionals are expected to take the guidelines fully into account when exercising their clinical judgment. They do, however, have the right to prescribe the drugs if they feel it is clinically justified and in keeping with specialist consensus, given the individual circumstances of the child and in consultation with the parent or guardian. Such prescribing can include so-called off licence prescriptions, which means a prescription of medication outside its licensed age indications.


The right hon. Gentleman has asked the Department of Health to conduct a review of the prescription of drugs for the treatment of ADHD, working with families, teachers, medical and mental health professionals. It is, however, for NICE, as an independent organisation, and not for the Department of Health, to review the evidence and to provide national clinical guidance. Between 30 August and 12 September, NICE consulted stakeholders on whether to update its 2008 clinical guidelines. The review is a thorough assessment of the ways in which evidence on ADHD, including pharmacological treatments, has since developed. It will announce a final decision on its review shortly.


In June 2007, the UK led a European review of the risks and benefits of Ritalin and sought advice from independent scientific advisory groups on the available evidence. As a result of that review, the prescribing guidance for patients has been updated to ensure that it contains clear, comprehensive information about the effects of Ritalin and the importance of monitoring children and adolescents throughout their treatment. The safety of Ritalin remains under close review. In addition, the findings of research continue to inform the field and a number of bodies may commission such research, including the National Institute for Health Research. The Government are committed to improving mental health outcomes and have laid down important principles for the future in the strategy, “No health without mental health”, published earlier this year.


The emotional well-being and mental health of children and young people are vital to them as individuals, to their families and to wider society. A principle of the Government's mental health outcomes strategy is the importance of prevention and early evidence-based intervention. Half of those with lifelong mental health problems first experience symptoms before the age of 14, and three quarters of them before their mid-20s. Indeed, today, the Minister with responsibility for social care, my hon. Friend the Member for Sutton and Cheam, has announced £32 million of funding to improve access to psychological therapies for children and young people over the next four years.


Psychological therapies can in some cases form part of the holistic package of care that NICE recommended for children and young people with ADHD. It is important that a range of clinicians—paediatricians and GPs as well as child and adolescent mental health service professionals—are well informed on the diagnosis and treatment of mental health problems in children and young people. I am pleased to tell the right hon. Gentleman that the chief medical officer and the NHS medical director plan to write to clinicians to remind them of the full range of NICE guidelines on conditions—including ADHD—that affect children's mental health. They will highlight the opportunities to support rigorous use of evidence-based treatment through the improving access to psychological therapies programme. High-quality, evidence-based treatment is central to our programme to transform mental health services for children.


The right hon. Gentleman referred to DSM-V. This point goes much wider than ADHD alone and touches on the appropriateness of diagnostic categories that are the subject of international professional consensus through the American Psychiatric Association and through the World Health Organisation. The Association of Educational Psychologists and other concerned professional organisations might wish to make their representations on this issue through the American Psychiatric Association and the World Health Organisation.


The right hon. Gentleman asked what the Government’s response would be, but it is not the responsibility of the Department of Health to respond. The professional bodies respond and reach a broad, scientific consensus on the way forward.


I fully appreciate the concerns of those worried by the increasing number of prescriptions for Ritalin and similar drugs. We are investigating whether further helpful information can be derived from prescribing research databases. It is of course for NICE, not the Department, to review the broader evidence and to consider the case for updating the existing clinical guidelines. That is what it has been doing and we await its conclusion. Furthermore, the NICE clinical guidelines on ADHD state that drug treatment for children and young people with ADHD


“should always form part of a comprehensive treatment plan that includes psychological, behavioural and educational advice and interventions.”


The NICE guidelines do not replace the clinical judgment needed to treat individual cases, but health care professionals are expected to consider fully the guidelines alongside professional consensus when exercising their clinical judgment.


2 pm
Mr Pat


DANNY KELLY SHOW ON RADIO WM - 25TH OCTOBER 2011 RE: ADJOURNMENT DEBATE IN PARLIAMENT



Danny Kelly - 25/10/2011 - Google - "BBC Radio WM - Then 'Listen Again' - then Danny Kelly for the 25-10-11 show and slide bar to 9 minutes in to listen to Dave Traxson on today's adjournment debate proposed by Pat McFadden (Wolverhampton SE Labour) and the ongoing issues of over-diagnosis and over-prescription of drugs for school aged children who are clearly behaving within the normal range expected by society.


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Tuesday 25 October 2011

"TRIAL AND ERROR APPROACH TO DIAGNOSIS." RESEARCHER BLOWS WHISTLE ON CURRENT MEDICAL PRACTICE WITH ADHD DIAGNOSIS

FRIDAY, Oct. 21 (HealthDay News) — 

Children with specific gene variants respond better to the drug methylphenidate (Ritalin, Concerta), which is widely used to treat attention-deficit hyperactivity disorder (ADHD), a new study says.

The finding could help improve treatment of ADHD, according to the Cincinnati Children's Hospital Medical Center researchers.

"Physicians don't have a good way of predicting who will experience great improvement in ADHD symptoms with a particular medication, so currently we use a trial-and-error approach. Unfortunately, as a result, finding an effective treatment can take a long time," lead investigator Dr. Tanya Froehlich, a physician in the division of developmental and behavioral pediatrics, said in a medical center news release.

Monday 24 October 2011

ALTERNATIVES TO DRUGS - MENTORING PROGRAMMES - HOW EFFECTIVE ARE THEY?

Mentoring Programs – How Effective Are They?- BY DAVID DUBOIS

Whether it’s parents, teachers, coaches, or family friends, there’s no question that adults serve as powerful role models for youth as they transition from childhood to adolescence to adulthood. Mentoring programs across the United States have tried to harness the power of positive role models in the hopes that relationships with an adult mentor will help to support kids’ socioemotional and cognitive development. But are mentoring programs effective? And do all programs have equally positive effects?

A new report in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, takes a close look at the research that has accumulated over the last decade and identifies the aspects of mentoring programs that seem to help – or hinder – kids’ development across many domains.

It may seem like common sense that kids benefit from having mentors in their lives, and that the kids who are at risk – for poor performance in school, for engaging in risky behaviors, or for negative health outcomes – stand to benefit the most from a mentoring relationship. These assumptions are the reason that mentoring programs are used as an intervention strategy in many different settings, including education, juvenile justice, and public health. But mentoring programs vary along many dimensions and serve diverse populations, so it’s important to establish the aspects of these programs that benefit different groups of kids.

In this report, David DuBois, a professor of Community Health Sciences at the University of Illinois at Chicago, and co-authors review over 70 existing evaluations of mentoring programs and they confirm that mentoring programs do confer many benefits. In general, mentoring programs seem to improve kids’ outcomes across behavioral, social, emotional, and academic domains, and they can help improve outcomes in several of these areas at the same time. And research suggests that it’s never too late to establish an effective mentoring relationship, as mentoring programs seem to make a difference for youth of all ages. DuBois argues that these results “speak to the universal importance of caring relationships for us as social animals, whatever our age.”

Despite the overall benefits of mentoring programs, improvements in youth outcomes tend to be modest and it is not clear how well such gains hold up over time. Furthermore, while mentoring does seem to help boost kids’ academic test scores, there’s little rigorous research on whether it contributes to other policy-relevant outcomes, such as overall educational attainment, juvenile offending, substance use, or obesity prevention.

Mentoring programs appear to be most effective for youth who have some pre-existing difficulties or who are exposed to heightened levels of environmental risk, but most programs probably can’t handle the demands of youth with really serious difficulties. Matching mentors and mentees according to their interests helps to produce greater benefits for kids, probably because this kind of matching helps kids and mentors connect and find activities that they enjoy doing together. The research also finds that kids benefit more when programs help mentors to provide useful guidance and act as an advocate on kids’ behalf. DuBois notes that there are real risks of youth experiencing a mentor as “one more adult telling them what to do” and of mentors “crossing boundaries and become over-involved in a youth’s life.” He adds, though, that many mentoring programs clearly have developed “effective ways to navigate these concerns so that mentors can share their knowledge and life experience and be powerful allies for vulnerable young people.”

Given the number and diversity of mentoring programs in the United States, some programs are undoubtedly more effective than others. In order to achieve the biggest return on investment, DuBois and his co-authors urge policymakers to support the use of evidence-based practices, like mentor screening and training. Policymaker support for mentoring practices that are grounded in scientific evidence will help to create and sustain high-quality mentoring programs for youth.

According to DuBois, finding out what works in mentoring programs is especially important during these tough economic times.  


Mentoring programs allow communities to make strategic use of their own human capital (i.e., through people volunteering their time), thereby amplifying the reach of community programs and supports for your people. “Because of this potential,” says DuBois, “mentoring programs represent a particularly exciting direction for maintaining strong investments in the future of our nation’s youth despite the economic challenges that are currently facing the country.”

For more information about this study, please contact: David L. DuBois at dldubois@uic.edu

PETITION AGAINST DSM5 STARTED BY PSYCHOLOGISTS IN U.S.

SO SIGN THE PETITION NOW

Psychologists Start Petition Against DSM 5
A Users Revolt Should Capture APA Attention
Published on October 24, 2011 by Allen J. Frances, M.D. in DSM5 in Distress




 Several divisions of the American Psychological Association have just written an open letter highly critical of DSM 5. They are inviting mental health professionals and mental health organizations to sign a petition addressed to the DSM5 Task Force of the American Psychiatric Association. You can read the letter and sign up at http://www.ipetitions.com/petition/dsm5/ It is an extremely detailed, thoughtful and well written statement that deserves your attention and support.  

  The letter summarizes the grave dangers of DSM 5 that for some time have seemed patently apparent to everyone except those who are actually working on it. The short list of the most compelling problems includes: reckless expansion of the diagnostic system (through the inclusion of untested new diagnoses and reduced thresholds for old ones); the lack of scientific rigor and independent review; and dimensional proposals that are too impossibly complex ever to be used by clinicians.

  The American Psychiatric Association has no special mandate or ownership rights giving it any sovereignty over psychiatric diagnosis. APA took on the task of preparing DSM's sixty years ago because it then seemed so thankless that no other group was prepared or willing to do it. The DSM franchise has stayed with APA only because its products were credible enough to gain widespread acceptance. People used the manual only because it was useful.

 DSM 5 has strained that credibility to the breaking point and (unless radically changed) will be much more harmful than useful. We have reached a turning point that will soon become a point of no return. A near final version of DSM 5 must be ready by next spring and all final wording will be set in stone within a year. Time is running out if DSM 5 is to be saved from itself.

  Rescue attempts and pushback are coming from numerous directions and are fast gaining in momentum. The American Psychological Association's petition was preceded by an even harsher critique by the British Psychological Society. The Society of Biological Psychiatry has wondered why we need a DSM 5.  Experts in personality disorder have universally decried the proposed revisions in DSM 5. And the American Counseling Association will  soon weigh in with its own statement.

  Meanwhile DSM 5 has lived in a world that seems to be hermetically sealed. Despite the obvious impossibility of many of its proposals, it shows no ability to self correct or learn from outside advice. The current drafts have changed almost not at all from their deeply flawed originals. The DSM 5 field trials ask the wrong questions and will  make no contribution to the endgame.

  But the DSM 5 deafness may finally be cured by a users' revolt. The APA budget depends heavily on the huge publishing profits that accrue from its DSM sales. APA has ignored the scientific, clinical, and public health reasons it should omit the most dangerous suggestions- but I suspect APA will be more sensitive to the looming risk of a boycott by users.   

  Here are best case and worst case scenarios. Best case: APA opens up DSM 5 to external, independent review and only those suggestions that pass muster are included. DSM 5 becomes safe, usable, and widely used.

  Worst case: DSM 5 stumbles along blindly as it has and includes most or all of its harmful suggestions. DSM 5 loses its status as a useful and standard guide to psychiatric diagnosis, creating an unnecessary and unfortunate babel of diagnostic practice and research habits. And the American Psychiatric goes broke.

  The APA Trustees and Assembly have thus far been almost completely and puzzlingly  passive in exercising their  governance role over DSM 5. I believe they can wait no longer if they are to fulfill their fiduciary responsibility to the public, to the mental health field, and to their own membership. It is pretty much now or never.

Related Articles

    DSM-5 Task Force Extends Deadline for Sending Comments
    DSM-5 Editors Open to Public Comments Until July 18
    The End of Narcissistic Personality Disorder? Say it ain't so!
    Addiction In Society: Blinded by Biochemistry
    Defining Borderline Personality in DSM-V: Does the Shoe Fit?




IDENTIFYING ADHD CHECKLIST - YOUTUBE VIDEO - YOU WILL SEE WHY SO MANY OF US ARE VERY WORRIED FOR THE SAFEGUARDING OF CHILDREN

http://youtu.be/1GIx-JYdLZs
CLICK ON LINK TO WATCH A DUBIOUS AND VERY COMMONLY SHARED APPROACH TO DIAGNOSING ADHD IN CHILDREN.

HELP!HELP!HELP!

THE LACK OF A NATIONAL CONSENSUS AMONGST PSYCHIATRISTS AND PAEDIATRICIANS - MARK VONNEGUT A LEADING PAEDIATICIAN WHO ADVOCATES MEDICATING KIDS STRUGGLES TO EXPLAIN DIAGNOSIS - WORRYING???

http://youtu.be/trD4RtYnm6Q
A DYNAMITE YOUTUBE VIDEO - LEADING PROPONENTS OF ADHD STRUGGLE TO DEFINE WHAT IT IS DESPITE THEIR CONFERENCE BEING CALLED 'THE NATIONAL CONSENSUS ON ADHD.' WELL YOU COULD HAVE FOOLED ME!!!!!

BPS - "WE HAVE MORE CONCERNS THAN PLAUDITS." - GENERAL COMMENTS OF THE BRITISH PSYCHOLOGICAL SOCIETY TO THE AMERICAN PSYCHIATRIC ASSOCIATION ABOUT THEIR CONCERNS ABOUT DSM5


The Society is concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of
their natural and normal responses to their experiences
; responses which undoubtedly have distressing consequences which demand
helping responses, but which do not reflect illnesses so much as normal individual variation.

 

We therefore do welcome the proposal to include a profile of rating the severity of different symptoms over the preceding month. This is
attractive, not only because it focuses on specific problems (see below), but because it introduces the concept of variability more fully
into the system. 


That said, we have more concerns than plaudits.
 

The putative diagnoses presented in DSM-V are clearly based largely on social norms, with 'symptoms' that all rely on subjective
judgements, with little confirmatory physical 'signs' or evidence of biological causation. 


The criteria are not value-free, but rather reflect
current normative social expectations
.

Many researchers have pointed out that psychiatric diagnoses are plagued by problems of
reliability, validity, prognostic value, and co-morbidity.
 

Diagnostic categories do not predict response to medication or other interventions whereas more specific formulations or symptom
clusters might (Moncrieff, 2007).
Finally, disorders categorised as ‘not otherwise specified’ are huge (running at 30% of all personality disorder diagnoses for example).
 

Personality disorder and psychoses are particularly troublesome as they are not adequately normed on the general population, where community surveys regularly report much higher prevalence and incidence than would be expected. This problem – as well as threatening the validity of the approach – has significant implications.

If community samples show high levels of ‘prevalence’, social
factors are minimised, and the continuum with normality is ignored. Then many of the people who describe normal forms of distress like feeling bereaved after three months, or traumatised by military conflict for more than a month, will meet diagnostic criteria.
 

In this context, we have significant concerns over consideration of inclusion of both “at-risk mental state” (prodrome) and “attenuated psychosis syndrome”. We recognise that the first proposal has now been dropped – and we welcome this. But the concept of “attenuated psychosis system” appears very worrying; it could be seen as an opportunity to stigmatize eccentric people, and to lower the threshold for achieving a diagnosis of psychosis.
 

Diagnostic systems such as these therefore fall short of the criteria for legitimate medical diagnoses.

They certainly identify troubling or troubled people, but do not meet the criteria for categorisation demanded for a field of science or medicine (with a very few exceptions
such as dementia.) 


We are also concerned that systems such as this are based on identifying problems as located within individuals.
 

This misses the relational context of problems and the undeniable social causation of many such problems.
 
For psychologists, our wellbeing and mental health stem from our frameworks of understanding of the world, frameworks which are themselves the product of the experiences and learning through our lives.

"AN UNFOLDING PUBLIC HEALTH CARE CATASTROPHE." - WATCH YOUTUBE VIDEO BY DR JOHN BREEDING PhD.

http://youtu.be/XVYv8WoOGTQ

This video  by Dr John Breeding PhD. outlines how drug companies settle out of court to avoid class actions on the misuse of psychotropic medications for children.

KIDS AND PSYCHOTROPIC MEDICATIONS 1 -YOUTUBE VIDEO - USEFUL BACKGROUND

http://youtu.be/iXa4w6fBTHQ

WATCH THIS BACKGROUND VIDEO FROM 'CLARITY' WITH 
THOMAS MATTHEWS,M.D. 
BY CLICKING ON THE LINK ABOVE.

EMPHASISES THE 'OFF LABEL USE'  FOR KIDS AND "ALWAYS USE PSYCHOLOGICAL APPROACHES FIRST."

Sunday 23 October 2011

PSYCHOTROPIC and PRESCRIPTION DRUGS,THE HIDDEN DANGERS - DR GARY KOHLS - YOUTUBE VIDEOS

http://youtu.be/Z5uw9aTCeKE

CLICK ON LINK ABOVE FOR"THE RISKS OF PRESCRIPTION DRUGS" OR THE TITLE FOR "THE DANGERS OF SSRI DRUGS" AND WATCH THESE VIDEOS BY DR GARY KOHLS THEN SHARE THE ISSUES ARISING - THANKS.

Thursday 20 October 2011

Wednesday 19 October 2011

WORLD HEALTH ORGANISATION - DATA ON CORRUPTION IN THE PHARMACEUTICAL CHAIN - FACTSHEET COURTESY OF THE WHO WEBSITE



Medicines: corruption and pharmaceuticals
Fact sheet N°335
December 2009


    US$ 4.1 trillion is spent globally on health services every year, with US$ 750 billion spent in the pharmaceutical market.
    10 to 25% of public procurement spending (including on pharmaceuticals) is lost to corrupt practices.
    In developed countries, fraud and abuse in health care has been estimated to cost individual governments as much as US$ 23 billion per year.
    Countries with a higher incidence of corruption have higher child mortality rates.
    Lack of medicines and counterfeit and substandard medicines lead to patient suffering and have direct life or death consequences.
    To reduce corruption, thorough checks and balances are required at each step in the medicine chain. Good governance includes transparency, accountability, promoting institutional integrity and moral leadership.

Access to health care and essential medicines is needed to reduce disease and death, and enhance quality of life. Medicines are only beneficial when they are safe, of high quality, and properly distributed and used by patients.
Unethical practices in the medicines chain

The medicines chain refers to the steps required for the creation, regulation, management and consumption of pharmaceuticals. Corruption in the pharmaceutical sector occurs throughout all stages of the medicines chain, from research and development to dispensing and promotion.1

Unethical practices along the chain can take many forms such as falsification of evidence, mismanagement of conflict of interest, or bribery. The Figure illustrates key steps of the medicines chain and some examples of unethical practices.

Good governance within the medicines chain is one essential means for optimizing public health outcomes. For example, countries with higher incidence of corruption have higher child mortality rates, even after statistically controlling for quality of health-care provision.2
What factors contribute to pharmaceutical corruption?

US$ 4.1 trillion is spent globally on health services each year3 with US$ 750 billion spent in the global pharmaceuticals market.4 However, 10 to 25% of public procurement spending (including on pharmaceuticals) is lost to corrupt practices.5 Medicines change hands several times before reaching patients. The large number of steps in the medicines chain allows numerous opportunities for unethical practices to take place.

While there are reported cases of corruption in the medicines chain, much unethical practice goes unreported. This is due to fear of victimization and retaliation towards whistle-blowers, and a lack of incentives to come forward. Some forms of corruption have become institutionalized to the point where people feel powerless to influence change in their countries.

Countries with weak governance within the medicines chain are more susceptible to being exploited by corruption. These countries lack:

    appropriate legislation or regulation of medicines;
    enforcement mechanisms for laws, regulations and administrative procedures;
    conflict of interest management.

A lack of transparency and accountability within the medicines chain can also contribute to unethical practices and corruption.
Impact of corruption

There are at least three main areas of negative impact from corruption in the medicines chain.

    Negative patient impact. Unethical practices lead to reduced availability of medicines in health facilities due to diversion of medicines, as well as the presence of unsafe or ineffective products on the market. Diverted, counterfeit and substandard medicines have been identified in markets of both rich and poor countries, as well as medicines that are granted unwarranted registration. Such practices lead to patient suffering and have direct life or death consequences.
    Lost resources. Corruption results in enormous amounts of limited public health resources being lost. For example, in developed countries, fraud and abuse in health care has been estimated to cost individual governments as much as US$ 12–23 billion per year.6 In developing countries, up to 89% leakage of procurement and operational costs has been observed.7 Such losses cripple the ability of health-care institutions to provide adequate care.
    Eroding confidence. Corruption also takes a more subtle toll by eroding public and donor confidence in public institutions. In some countries, the public health system is perceived as the most corrupt public service institution.8 Pharmaceutical corruption within ministries of health has also threatened the withdrawal of donor contributions in some low-income countries.9,10,11

WHO response

To ensure accountability and reduce corruption, thorough checks and balances are required at each step in the medicines chain. Good governance, transparency, accountability, promoting institutional integrity and moral leadership are also essential.

WHO is committed to reducing corruption in the medicines chain through its Good Governance for Medicines (GGM) programme, launched in 2004. By applying transparent, accountable administrative procedures and by promoting ethical practices, GGM provides support for countries to curb corruption. The programme assists countries through a three-step process of assessing their vulnerabilities to corruption, and developing and implementing specific programmes to maintain efficient health-care systems that are not undermined by the abuse of corruption.
References

1. Measuring transparency in the public pharmaceutical sector: assessment instrument, WHO/EMP/MAR/2009.4.

2. Gupta S, Davoodi H, et al., (2000). Corruption and the provision of healthcare and education services, International Monetary Fund:11.

    3. WHO Fact Sheet: spending on health: a global overview, 2007.

4. IMS Health lowers 2009 global pharmaceutical market forecast to 2.5–3.5 percent growth, IMS New Releases.

5. Transparency International (2006). Handbook for curbing corruption in public procurement.

6. Becker D, Kessler D, McClellan M. Detecting medicare abuse. Journal of Health Economics, 2005, 24:189–210.

7. Ye, X, Canagarajah, S. (2002). Efficiency of public expenditure distribution and beyond: a report on Ghana's 2000 public expenditure tracking survey in the sectors of primary health and education. Africa Region Working Paper, No. 31.

8. Fidler A, Msisha W, Governance in the pharmaceutical sector, Eurohealth 14, 2008, No. 1:25–29.

9. The Global Fund welcomes Ugandan corruption inquiry report, Global Fund Press Release, June 2006.

10. The K27 billions scandal at the ministry of health, The Lusaka Paper, June 2009.

11. Dutch Government stops aid to Zambia, Africa News, May 2009.

SHORT YOUTUBE VIDEO ON THE RISKS OF PSYCHOSTIMULANT MEDICATION FOR CHILDREN



http://youtu.be/-IAaAHd7cGE

CLICK ON: LINK ABOVE or TITLE 
FOR INFORMATIVE SHORT VIDEO OF THE RISKS OF PSYCHOSTIMULANTS 
FOR CHILDREN

Tuesday 18 October 2011

Gary Null PhD - EXCELLENT FILM (1HR 40 MINS) + MICHAEL MOORE etc. ABOUT THE 6 - 7 MILION CHILDREN TAKING PSYCHOTROPICS EVERY DAY IN THE U.S.AND HOW THEY BECOME A 'CAPTIVE MARKET' FOR FUTURE DRUG SALES BOTH LEGAL AND ILLEGAL.

+



CLICK BELOW ON THIS EXCELLENT VIDEO WITH MICHAEL MOORE, PETER BREGGIN AND MANY MORE PROFESSIONALS AND PARENTS ABOUT THE DANGERS OF PSYCHOTROPIC DRUGS FOR CHILDREN IN U.S. SOCIETY.

IS THERE A LINK TO THE TERRIBLE MASS SHOOTINGS IN U.S. SCHOOLS?

DON'T LET'S FOLLOW THIS DYSFUNCTIONAL APPROACH IN THE U.K.
   
http://video.google.com/videoplay?docid=-3609599239524875493