Is Johnny Mentally Ill?

Now, the Biden administration wants to put more psychologists in American schools. This might mean that childhood mental illness is not being recognized or treated. But it also might mean that America’s institutions of higher learning are producing an abundance of psychologists. And we need to keep them in business, don’t you think?

After all, when America produces too many lawyers, it will rise to the occasion and find more and more aspects of everyday life for which you need legal services. More make work for lawyers. 

Dare I say, the same applies to government bureaucrats. Fair enough, they are not producing wealth or anything resembling wealth, but bureaucrats are in the business of keeping themselves in business. Besides, they belong to labor unions that contribute to political campaigns. Politicians pay back the favor by increasing their bureaucrats' salaries.

Anyway, this feels cynical, and perhaps it is. Studies taken before the pandemic school shutdowns-- an event designed to gin up business for mental health professionals-- show that American children were suffering from declining mental health. And thus were more in need of the services that our psycho professionals were so ready to provide.

Besides, it is no secret that every time the pharmaceutical industry discovers a new mental health treatment, suddenly, psychiatrists are finding that the condition it treats is far more pervasive than they had imagined. Whether ritalin or valium or lithium or thorazine or Prozac, each of these treatments-- which are certainly effective treatments in many cases-- has become wildly overprescribed.

As for the mental health of America’s children, there are other problems beyond the diagnosis problem. Take a look at the number of broken homes, single parent homes, the types of indoctrination that are passing for education in many schools, the neighborhoods that are infested with gang violence and so on. And don't even start on the derangement exhibited by the media and our politicians. Even if, as Crispin Sartwell cogently explains, childhood mental illness is being overdiagnosed, there are good reasons for American children not to be doing very well.

Sartwell looks at a 2019 study-- that is, a pre-covid study-- and concludes that childhood mental illness has been increasing at an alarming rate. This, from the Wall Street Journal:

President Biden’s education plan proposes to double the number of psychologists in U.S. schools. This is partly a response to an apparent crisis in childhood mental health. According to a 2019 study in the Journal of Pediatrics, some 30% of American adolescents with fair or poor physical health have been diagnosed with anxiety, between 13% and 20% with behavior disorders, and almost 15% with mood disorders. The study finds that the reported prevalence of these disorders doubled over the previous decade. According to a Centers for Disease Control and Prevention study, the number of children with attention deficit hyperactivity disorder in 1999 was 7.6%, and in 2018 it rose to 12.9%; that’s an almost 70% increase in 20 years.

Next Sartwell asks how much of this increase derives from the way that certain behaviors are being diagnosed:

The apparent decline in childhood mental health is itself depressing. I suspect, however, that one of the factors driving it is increased diagnosis due precisely to the increasing prevalence of mental-health services. It is one thing to detect diseases with well-established biological bases; early detection of cancer has saved many lives. It is quite another to detect diseases on the basis of a rough group of ill-defined symptoms.

He focuses on ADHD-- a condition that has become more prevalent since psychiatry discovered that ritalin can treat it:

When the DSM-5, the standard manual for psychiatric diagnosis, characterizes ADHD, it does so in a way that doesn’t neatly separate any population into those who have it and those who don’t. It specifies that a child with ADHD displays “six or more” symptoms of “inattention.” Such a child, for instance, may be easily distracted. Psychologists don’t, one might remark, diagnose teachers and curriculums as insufficiently interesting to maintain attention. Before you treat a child with powerful stimulants, you might ask whether education would give you six varieties of inattention, too.

The last point is telling. Consider how much classroom inattention derives from the fact that teachers are incompetent buffoons. One suspects that the children in charter schools do not suffer inattention, because they are obliged to be more disciplined and more focused. And, dare we mention, government policies that make it nearly impossible to discipline unruly children-- bequeathed by the Obama administration-- destroy the learning experience for all children.

According to Sartwell, ADHD symptoms seem strangely to correlate with normal behavior, or better, normal behavior for a child living or being taught in suboptimal circumstances:

The grab bag of supposed symptoms of the disease amounts to a description of the average boy’s behavior in the average classroom before the era of school psychology: “often fidgets” or “squirms,” “often leaves seat,” “often runs about,” “often talks excessively.” These aren’t symptoms of an illness. They are symptoms of being a normal human child.

Biochemical discipline, Sartwell suggests, is taking the place of teachers who can exercise authority in the classroom. Again, the same situation does not pertain in charter schools, like New York’s Success Academies:

The diagnoses provided and medications mobilized by child psychology are devoted largely to getting students to sit quietly and still, goals formerly pursued by the cane or the knuckle-rap. It’s a new form of school discipline, one that leaves parents certain that their children are diseased, and that quickly leads the children to the same conclusion about themselves. The line drawn by the DSM-5 between normal or reasonable worry and diagnosable anxiety, or between appropriate sadness and depression, is just as blurry.

So, schools have turned into treatment facilities. More therapy and less education:

And I’d like to return to thinking about schools as places to learn history and mathematics rather than as wraparound childhood treatment facilities.