TeenScreen National Center for Mental Health Checkups

(Formerly known as the Columbia University TeenScreen Program)

Drummond Rennie, professor of medicine at the University of California, and deputy editor of the Journal of the American Medical Association, said that the word he uses to describe advocacy organizations fronting for pharmaceutical companies is “astroturf.” According to New Science, “astroturfing is the practice of disguising an orchestrated campaign as a spontaneous upwelling of public opinion.”[1]

TeenScreen is prime example. It is “just a way to put more people on prescription drugs,” said Marcia Angell, a medical ethics lecturer at Harvard Medical School and author of The Truth About Drug Companies.

In 1991, David Shaffer, Professor of Child Psychiatry Columbia University and New York State Psychiatric Institute’s Division of Child & Adolescent Psychiatry invented the TeenScreen program for Columbia University to screen large numbers of high-school students to identify them at risk for suicide and refer them for “treatment”—usually antidepressants.[2]

A report on the pilot lists 11 psychiatric and psychological associations and 13 psycho-pharmaceutical front groups that supported the program.[3] More than 1,700 students throughout the New York metropolitan area were screened between 1991 and 1994. The public screening project began in 1995 and a national screening pilot was launched in 1999.

In 2003, the President’s New Freedom Commission on Mental Health (NFC)’s report recommended TeenScreen as a program to be implemented and for all 52 million American school children and adolescents to be screen.[4] At least 14 of the 22 NFC members had drug industry ties.[5]

By 2004, $92 million in federal funds had been allocated for mental health screening.[6] Psychotropic drug prescription for teenagers skyrocketed 250% between 1994 and 2001 but as a study determined the rapid acceleration occurred after 1999”—the same year the national pilot was initiated.[7]

Since 1991, the Columbia University Division of Child and Adolescent Psychiatry has invested nearly $19 million in the research and development of the Columbia TeenScreen Program and provided “free screening materials and technical assistance for up to 400 sites across the US.”[8]

Shaffer has long-term ties to drug companies and is a consultant for Hoffman La Roche, Wyeth and GlaxoSmithKline (GSK).[9] He has been a member of a consensus panel discussing child and adolescent “bipolar” by: Abbott, Bristol-Myers Squibb, GSK, Janssen, Johnson & Johnson, Eli Lilly, Novartis, Pfizer, and Solvay.[10]

While pushing for every teen to be screened based on his subjective questionnaire, Shaffer also asserts that antidepressants “do not increase the risk of suicidal thinking or attempts in youth despite FDA warnings about this serious risk.[11]

In fact at the request of Pfizer, Shaffer wrote the British Medicines and Healthcare Products Regulatory Agency in 2003, urging them not to ban the use of SSRI antidepressant drugs (like Pfizer’s Zoloft) for adolescents.[12]

Shaffer is also the executive director of the DISC (“Diagnostic Interview Schedule for Children”) Development Group at Columbia University, Division of Child and Adolescent Psychiatry. Apart from TeenScreen, DISC also spawned BSAD (Brief Screen for Adolescent Depression)—an 8-item questionnaire completed in 5 minutes and now used during the drug company-funded National Depression Screening Days.[13]

Pharmaceutical company grants for DISC are funneled through the New York State Psychiatric Institute Research Foundation of Mental Hygiene and private foundations.[14]

TeenScreen refuses to divulge the source of its funding. The website says they are funded by private family foundations, corporations and individuals. The national office of TeenScreen says it does not control its local chapters seeking pharmaceutical company funding.[15] In Tennessee, for example, Eli Lilly funded the program, which determined that over 50% of the 170 students surveyed ended up at a therapist’s office.[16]

Columbia University is known for its collaboration with pharmaceutical companies. Its medical center has collaborated with AstraZeneca, GlaxoSmithKline, Janssen, Pharmaceutica, Merck, Novartis, and Pfizer.[17] Shaffer has also built up research grants for Columbia University to $30 million per annum.[18]

Every member of the faculty of Columbia University’s Department of Child and Adolescent Psychiatry has financial ties to drug companies as a consultant, receiving honoraria, or research funds, including psychiatrists:

  • Gabrielle A. Carlson: Chair (Bristol-Meyers Squibb Company, Eli Lilly and Company, Otsuka America Pharmaceutical, GlaxoSmithKline and H. Lundbeck).
  • Laurence L. Greenhill: (McNeil Pediatrics, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., Pfizer, Forest Labs, Johnson & Johnson, and Otsuka America Pharmaceutical.
  • Boris Birmaher: (Jazz Pharmaceuticals, Solvay, NIMH; John T. Walkup, GlaxoSmithKline, Abbott Laboratories [free drug], Eli Lilly [free drug and placebo], Pfizer [free drug and placebo]).
  • Barbara J. Coffey: (Eli Lilly, Jazz Pharmaceuticals, Novartis, Boehringer Ingelheim, Bristol-Meyers Squibb).
  • Christoph U. Correll: (AstraZeneca, Bristol-Meyers Squibb, Eli Lilly, Otsuka America Pharmaceutical, Pfizer, Solvay, Supernus Pharmaceuticals, Vanda Pharmaceuticals and Otsuka America Pharmaceutical).[19]
  • AACAP Institutes Subcommittee includes Melissa P. DelBello, (Chair) and Timothy Wilens, M.D., two psychiatrists under Senate Finance Committee investigation for their failure to disclose pharmaceutical company funding.[20]
  • TeenScreen’s PR firm, Rabin Strategic Partners has long standing ties to the drug industry­. Among its 13 clients are 7 pharmaceutical companies, including Janssen, Johnson & Johnson, McNeil, Merck, as well as Columbia University.[21] In 2005, Rabin hired a former Bristol-Meyers executive and the communications director for Columbia University’s Division of Child and Adolescent Psychiatry.[22]
  • Rabin works with other major PR firms, Nelson Communications and Widmeyer Communications, whose clients also include Big Pharma companies. Widmeyer also lists American Psychological Society, Allendale Pharmaceuticals, Pfizer, and “Columbia University Department of Psychiatry / TeenScreen.[23]
  • Dr. Richard Gosden, an independent researcher and writer and Prof. Sharon Beder, (School of Social Sciences, Media and Communication) wrote: “The public relations industry often refers to front groups euphemistically as ‘partners.’ Steve Rabin, a former executive vice president/general manager of Porter/Novelli, is an expert on the art of forming advocacy partnerships.” [24]
  • Over the years, in addition to Columbia University, his client list has also included Abbott, AstraZeneca, Bayer, Bristol-Myers Squibb, Eli Lilly, Glaxo Wellcome, Hoffman-La Roche, Janssen-Cilag, Lundbeck, Novartis, Pfizer, SmithKline Beecham, Wyeth-Ayerst and the National Alliance of the Mentally Ill (NAMI).[25]
  • The director of TeenScreen is Laurie Flynn, former executive director of NAMI for 16 years.[26] TeenScreen’s National Advisory Council includes Michael F. Hogan, chairman of the 2003 New Freedom Commission on Mental Health that recommended nationwide mental health screening of Americans and the use of a highly controversial expensive psychotropic medication program called TMAP.[27] Hogan got five county mental health boards in Ohio to fork out $15,000 a piece to set up TeenScreen.[28]
  • Rabin Strategic Partners put together a key publication called, “Catch Them Before They Fall; How to Implement Mental Health Screening Programs for Youth as Recommended by the President’s New Freedom Commission on Mental Health.” Flynn was quoted at that 2004 meeting as saying they mailed a copy of the report to 50 states with a model resolution to implement screening.[29]
  • In 2003, TeenScreen was responsible for screening approximately 14,200 teens. Among those students, 3,500 youth were targeted as having mental health problems and were “linked with treatment.” A year later, it was estimated to be 10,000 teens—a 300% increase.[30] By 2006 TeenScreen was reportedly used in 460 communities in 42 states.[31]
  • TeenScreen utilizes a “passive consent form” which requires no written parental approval. If the form is not signed, that constitutes “consent.” TeenScreen officials favor passive consent because they say it boosts their chances of screening kids to 95%.[32]
  • Even more troubling, according to Shaffer, the test can falsely identify kids as being suicide risks at least 84% of the time.[33] This astounding level of inaccuracy apparently doesn’t trouble Dr. Shaffer, who concluded with the other authors of the study referenced above that “many of these so-called false-positive cases…are likely to benefit from treatment.”[34]
  • A 2002 study found that every 9 out of 10 children who see a child psychiatrist are prescribed a psychotropic drug, so the TeenScreen program could result in hundreds of thousands more children prescribed mind altering antidepressants.[35]
  • Based on estimates given by TeenScreen on the numbers of students screened, identified and that could be potentially prescribed drugs to “prevent suicide,” the pharmaceutical industry could make an additional $30 billion a year in drug sales.[36]
  • In November 2009, it had more marketing ammunition to its promotion of Adult ADHD with a “free, online patient support program for adults taking once-daily Vyvanse,” a site called FOCUS with the trade marked slogan, “Shire…your ADHD Support Company.”[37] The press release announcing it spuriously promotes that it is “the only online, branded personalized patient support program providing tips and tools for adults diagnosed with ADHD taking a prescription medication. FOCUS is designed for the individual needs of adults with ADHD who are taking Vyvanse by letting them choose the tips and tools in the areas that most impact their life.”[38]
  • There’s also a McNeil site for Concerta that is for doctors called concerta360.com, “Your complete ADHD resource.”[39]

Further Conflicts of Interest

In 1995, CHADD awarded Dr. Joseph Biederman, who is also on CHADD’s medical advisory board, its “Hall of Fame” award.[40] Biederman, professor of psychiatry and chief of the Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital and Harvard Medical School in Boston, has been under Senate investigation for failing to disclose $1.6 million in consulting payments from drug makers. Biederman is a consultant and serves on the advisory board of Shire and receives research funds from the company.[41] He has also received research from other ADHD drug manufacturers, Janssen, Novartis, McNeil, and Eli Lilly.[42]

When the FDA issued warnings about stimulants causing heart risks and sudden death in 2006, Biederman and two other psychiatrists under Senate investigation, Timothy Wilens and Thomas J. Spencer conducted a study, down playing the risks and stating: “There does not seem to be higher risk of sudden death in stimulant-treated individuals compared with the general population.” Shire cites the study on its website. All three psychiatrists reported they received research funds Shire, among other stimulant makers.[43] Wilens is listed as a past member of CHADD’s Professional Advisory Board.[44]

[1] http://www.lawyersandsettlements.com/articles/00436/ssri.html.

[2] http://www.teenscreentruth.com/teenscreen_key_players.html.

[3] http://fccmh.org/images/uploads/Teen_Screen_Presentation_8.5_.05_.pdf.

[4] Jeanne Lenzer, “Bush plans to screen whole US population for mental illness,” British Medical Journal, Vol. 328, No. 7454, 19 June 2004, p. 1458.

[5] http://medfascism.blogspot.com/.

[6] http://fccmh.org/images/uploads/Teen_Screen_Presentation_8.5_.05_.pdf.

[7] Cindy Parks Thomas, Ph.D, Peter Conrad ,PhD, Rosemary Casler, MA, and Elizabeth Goodman, MD, “Trends in the Use of Psychotropic Medications Among Adolescents 1994-2001” Psychiatric Services, 57:pp 63-69 Jan. 2006; “Psychotropic Drug Prescriptions For Teens Surge 250% Over a 7 Year Period,” Science Daily, 4 Jan. 2006; http://www.sprc.org/grantees/pdf/SAMHSAPresentation_McGuire.pdf.

[8] http://suicideandmentalhealthassociationinternational.org/natint.html.

[9] “TeenScreen ‘Under Intense Criticism Nationally’, http://www.ahrp.org/cms/content/view/106/31, 11 Mar. 2008.

[10] http://www.ahrp.org/cms/content/view/26/55/.

[11] JJ Mann, et al., “ACNP Task Force Report on SSRIs and Suicidal Behavior in Youth,” Neuropsychopharmacology, 2005, pp. 1-20.

[12] Goode, E., Timmons, H., “British Warning on Antidepressant Use for Youth,” New York Times, Dec. 11, 2003.

[13] “TeenScreen ‘Under Intense Criticism Nationally’, http://www.ahrp.org/cms/content/view/106/31, 11 Mar. 2008; http://www.promotementalhealth.org/downloads/DISC%20Brochure.pdf.

[14] http://www.ahrp.org/cms/content/view/106/52/.

[15] http://www.teenscreen.org/setting-the-record-straight-about-teenscreen-schools-and-communities#funding.

[16] http://www.opednews.com/pringleEvelyn_041405_teenscreen.htm.

[17] http://www.reuters.com/article/pressRelease/idUS152733+15-Jul-2009+BW20090715.

[18] http://en.wikipedia.org/wiki/David_Shaffer.

[19] http://www.aacap.org/cs/2009_psychopharmacology_update_institute/faculty.

[20] http://www.aacap.org/cs/2009_psychopharmacology_update_institute/faculty; http://blogs.wsj.com/health/2008/04/07/sen-grassley-knocks-psychiatrists-funding-from-astrazeneca/?mod=WSJBlog; http://www.nytimes.com/2008/06/08/us/08conflict.html.

[21] Rabin Strategic Partners website, http://www.rabinpartners.com/clients.html; http://www.widmeyer.com/expertise/practice-areas/health-wellness/.

[22] Announcement in Brandweek, Apr. 11, 2005.

[23] http://www.widmeyer.com/expertise/practice-areas/health-wellness/.

[24] http://www.ahrp.org/cms/content/view/97/29/.

[25] http://www.opednews.com/pringleEvelyn_041405_teenscreen.htm.

[26] Evelyn J. Pringle, “Portrait of Laurie Flynn, TeenScreen’s Top Pill Pusher,” 7 June 2005, http://dissidentvoice.org/June05/Pringle0607.htm.

[27] “TeenScreen ‘Under Intense Criticism Nationally’, http://www.ahrp.org/cms/content/view/106/31, 11 Mar. 2008.

[28] Evelyn J. Pringle, “Portrait of Laurie Flynn, TeenScreen’s Top Pill Pusher,” 7 June 2005, http://dissidentvoice.org/June05/Pringle0607.htm.

[29] http://www.teenscreentruth.com/New_Freedom_Commission.html.

[30] http://www.opednews.com/pringleEvelyn_041405_teenscreen.htm.

[31] “TeenScreen ‘Under Intense Criticism Nationally’, http://www.ahrp.org/cms/content/view/106/31, 11 Mar. 2008.

[32] http://www.psychsearch.net/teenscreen.html.

[33] Shaffer, David MD, “The Columbia SuicideScreen: Validity and Reliability of a Screen for Youth Suicide and Depression,” Journal Amer Acad Child Adoles Psychiatry, Vol. 43, pp. 71-79, 2004.

[34] Shaffer, David MD, “The Columbia SuicideScreen: Validity and Reliability of a Screen for Youth Suicide and Depression,” Journal Amer Acad Child Adoles Psychiatry, Vol. 43, pp. 71-79, 2004.

[35] Stubbe DE, Thomas WJ, “A Survey of Early-Career Child and Adolescent Psychiatrists,” Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 41, pp. 123-130, May 2002.

[36] http://www.abcmedsfree.com/Teen%20Screen.htm.

[37] http://www.vyvansefocus.com/.

[38] http://findarticles.com/p/articles/mi_m4PRN/is_2009_Nov_11/ai_n42079345/?tag=content.

[39] http://www.concerta360.com/mcneilpediatrics360/concerta360/adhd-resources.html.

[40] http://www.chadd.org/AM/Template.cfm?Section=Speakers_and_Presenters; http://www.adhdfraud.org/commentary/2-12-01-1.htm.

[41] http://www.apsard.org/APSARD/APSARD/AboutUs1/BoardofDirectors/JosephBiedermanMD/Default.aspx.

[42] http://pediatrics.aappublications.org/cgi/content/full/118/3/1215.

[43] http://pediatrics.aappublications.org/cgi/content/full/118/3/1215.

[44] http://www.chadd.org/Content/CHADD/AboutCHADD/BoardandStaff/Professional_Advisory_Board/default.htm.