Bush unveils mental health action plan
http://www.100md.com
《英国医生杂志》
President George Bush signs the Garrett Lee Smith Memorial Act, designed to reduce youth suicide, in O ctober 2004. His new mental health plan also makes reducing suicide a priority
RON EDMONDS/AP
President Bush has unveiled a federal action agenda for mental health in the United States, aimed at helping more patients to live in the community and removing some of the stigma of mental illness.
The agenda, which is based on the earlier recommendations of the New Freedom Commission on Mental Health ( BMJ 2003;327: 248), has been praised by a number of organisations, including the American Psychiatric Association and the National Alliance for the Mentally Ill. But critics say the agenda includes the promotion of unproved screening examinations and a controversial treatment algorithm, known as the Texas medication algorithm project (TMAP) ( BMJ 2004;328: 1458).
The federal plan is being coordinated by the Substance Abuse and Mental Health Services Administration, which is part of the Department of Health and Human Services in Rockville, Maryland.
Mark Weber, spokesman for the administration's Center for Mental Health Services, said that roughly $24bn (￡13bn; 20bn) would be made available annually for the reforms. The cash is not all new money but includes funds for existing projects, which will be brought into the federal plan.
One of the projects endorsed by the commission and incorporated into the plan is the TMAP. Mr Weber said the algorithm is a plan for best practice. But Stefan Kruszewski, a psychiatrist who exposed the overprescribing of psychotropic drugs to young people in state custody in Pennsylvania ( BMJ 2004;329: 69), criticised the federal action agenda for adopting the TMAP.
He said, "TMAP was marketed as a guide to safer and more effective drugs than the cheaper, existing medications." But he said that the drugs promoted by the algorithm are neither safer nor more effective. "The newer atypical antipsychotics and SSRIs have positive features, but these are often overshadowed by their negative effects, such as obesity, diabetes, and suicidality."(Jeanne Lenzer)
RON EDMONDS/AP
President Bush has unveiled a federal action agenda for mental health in the United States, aimed at helping more patients to live in the community and removing some of the stigma of mental illness.
The agenda, which is based on the earlier recommendations of the New Freedom Commission on Mental Health ( BMJ 2003;327: 248), has been praised by a number of organisations, including the American Psychiatric Association and the National Alliance for the Mentally Ill. But critics say the agenda includes the promotion of unproved screening examinations and a controversial treatment algorithm, known as the Texas medication algorithm project (TMAP) ( BMJ 2004;328: 1458).
The federal plan is being coordinated by the Substance Abuse and Mental Health Services Administration, which is part of the Department of Health and Human Services in Rockville, Maryland.
Mark Weber, spokesman for the administration's Center for Mental Health Services, said that roughly $24bn (￡13bn; 20bn) would be made available annually for the reforms. The cash is not all new money but includes funds for existing projects, which will be brought into the federal plan.
One of the projects endorsed by the commission and incorporated into the plan is the TMAP. Mr Weber said the algorithm is a plan for best practice. But Stefan Kruszewski, a psychiatrist who exposed the overprescribing of psychotropic drugs to young people in state custody in Pennsylvania ( BMJ 2004;329: 69), criticised the federal action agenda for adopting the TMAP.
He said, "TMAP was marketed as a guide to safer and more effective drugs than the cheaper, existing medications." But he said that the drugs promoted by the algorithm are neither safer nor more effective. "The newer atypical antipsychotics and SSRIs have positive features, but these are often overshadowed by their negative effects, such as obesity, diabetes, and suicidality."(Jeanne Lenzer)