Guam § 6700 - Legislative Findings and Intent.

§ 6700. Legislative Findings and Intent.

I Liheslaturan Guåhan finds that:

(a) The use of educational settings to screen children and adolescents for “mental disorders” has

led to parents not being given sufficient information about the purpose of such screenings and the

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ramifications if they consent, such as psychological or psychiatric treatment for their child and family,

thereby violating the recognized requirements and standards regarding “full informed consent”.

(b) Frequently, a system of “passive consent” is used whereby “consent” is considered provided

when the parent does not return the consent form. The onus is, therefore, on the child/adolescent to

transmit the consent form to the parent, and on the parent ensuring that if consent is not given, the

form is signed and returned. However, the onus should rest on both the school and the mental health

professional or agency seeking to conduct the screening, with criminal penalties if consent is not

obtained in writing and the child is subjected to non-consensual screening.

(c) “Passive consent” or other consent forms often:

(1) mislead parents into thinking that what is taking place at the school is just a health

evaluation for their child, not a psychiatric evaluation;

(2) do not include information about the personal and invasive questions their child will be

asked;

(3) do not contain information on the difference between “emotional health concerns”,

mental disorders, or physical diseases, the latter of which can be physically tested for and the

former cannot; and

(4) leave the parent with so little information that he or she cannot make a proper informed

decision to give valid informed consent.

(d) Parents also are not informed that mental health screenings for “mental disorders” are based

on those defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). However, in

the introduction of the DSM-IV it states, “Moreover, although this manual provides a classification of

mental disorders, it must be admitted that no definition adequately specifies precise boundaries for the

concept of ‘mental disorder’”. Further, “...the term ‘mental’ disorders...persists in the title of DSM-IV

because we have not found an appropriate substitute”.

(e) Unlike scientific methods to determine physical diseases like cancer, diabetes or tuberculosis,

a diagnosis of “mental disorder” or “syndrome” is not based on any medical test, such as a brain scan,

a ‘chemical imbalance’ test, x-ray or blood test. The former U.S. Surgeon General, in his 1999 Report

on Mental Health, which became a reference for many countries, stated, “The diagnosis of mental

disorders is often believed to be more difficult than diagnosis of medical disorders since there is no

definitive lesion, laboratory test or abnormality in brain tissue that can identify the illness.”

(f) Harvard Medical School’s Dr. Joseph Glenmullen warns that the checklist rating scales used

to screen people for conditions, such as “depression”, are “designed to fit hand-in-glove with the

effects of drugs, emphasizing the physical symptoms of depression that most respond to antidepressant

medication ...While assigning a number to a patient’s depression may look scientific, when one

examines the questions asked and the scales used, they are utterly subjective measures”. He says, “The

symptoms are subjective emotional states, making the diagnosis extremely vague”.

(g) Based on the subjective nature of the mental health diagnostic system and mental health

screenings, millions of children are prescribed antidepressants or stimulants recognized by leading

drug regulatory agencies as causing suicidal behavior, suicide, violence, hostility and, in the case of

stimulants, the potential for strokes and heart attacks. In October 2004, the U.S. Food and Drug

Administration (FDA) required a “black box” warning of suicide risks for all antidepressants

prescribed to those under eighteen (18) years old. In August 2005, The Commission of the European

Communities that represents twenty-five (25) countries issued the strongest warning yet against child

antidepressant use, warning of the drug’s potential to cause suicide attempts and suicidal ideation,

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aggression, hostility (predominantly aggression, oppositional behavior and anger), and/or related

behavior. According to the U.S. Drug Enforcement Administration, the stimulant drugs being

prescribed to children are scheduled as abusive as opium, morphine and cocaine. In February 2006, an

FDA Advisory Committee recommended a “black box” warning for stimulants, stating that they can

cause heart attacks, strokes, and even death.

(h) As such, Guam’s parents, without explicit protection, will be unable to give informed consent

about whether they want their child to participate in such screening.

It is the intent of I Liheslatura to prohibit the Guam Department of Education from conducting any mental

health screening on school children without the informed consent of parents.