Since I became a psychologist 20 years ago, I have been involved in various efforts to change mental health policy in this country, by writing, by speaking, by networking with other activists, and by efforts at legislative reform. In the last several years, I have become especially focused on helping with the effort to change the way psychiatry (and its attendant supporters in the schools and state social service agencies) is treating children. This essay is a story of a particular effort here in my home state of Texas, led by the citizens group I direct, Texans For Safe Education. My intention here is to describe a little of what we have done here in Texas, but also to share a few principles of action that may apply to other similar efforts. I hope it will serve to support and inspire others who are doing this work.
Two new laws will take effect on September 1, 2003 as a result of legislation passed in the 2003 Texas legislative session. House Bill 1406 makes in unlawful for school employees to recommend a psychotropic drug or suggest a particular diagnosis to a parent for a child. It also makes it illegal to exclude a child from any school activity because a parent refuses a psychiatric evaluation, treatment or drug for a child. House Bill 320 makes it clear that a parent's refusal to consent to a psychiatric evaluation, treatment or drug for a child does not constitute medical neglect; hence no grounds for a Child Protective Services (CPS) investigation. This is a little of the story of how we accomplished this.
Establish a Clear Vision
I think the first step in an effort to make intentional change is to get really clear about what it is you want to accomplish. This requires really understanding two separate but related phenomena: the issue that you want to confront, and the dynamics of the system that you want to influence. In the case of how psychiatry deals with children in this country, our specific concern is with the fact that child psychiatry's prime directive is to drug children with psychoactive substances.
In 1971, when Ritalin prescription use was approaching 200,000, our country was alarmed enough that the United States Congress convened an investigation, and the Drug Enforcement Administration classified Ritalin and other amphetamines as Schedule II drugs, a category that indicates significant risk of abuse. Since that time, the explosion in use of psychiatric drugs with children in this country has been phenomenal. According to the Drug Enforcement Agency, there was a 700% increase in the production of Ritalin between 1990 and 1997, 90% of which is consumed in the United States, mostly by children diagnosed with the controversial label of Attention Deficit Hyperactivity disorder (ADHD). Today we have an estimated 8,000,000 school-age children in this country on psychiatric drugs (Breeding, 2000).
We roughly know the numbers; we definitely know the trends. We know how it works, the key point being SELECTION (Breeding, 2003). We have figured out, thanks especially to Thomas Szasz, that psychiatric diagnosis is not descriptive, but prescriptive. Once an individual is selected out based on somebody's opinion of their behavior, the evaluation and diagnosis proceed apace, leading to the ubiquitous treatment of choice, which is a drug. We know that psychiatry is guided by a pseudoscientific belief system and that the science is just not there to validate any of their "mental illnesses." And we know that the treatments are dangerous on all levels.
Perhaps more importantly, we also know that these drugs are unnecessary, that there are reasons for disturbed or disturbing behaviors, and that humans respond well to thoughtful, compassionate care. We know that it is safe to trust in human nature, and that young people develop very well when their needs are well met (Breeding, 2002). We are very confident that we can support our young people to grow and develop in a good way. We consider the psychiatric drugging of children not only to be a shame and a disgrace, but probably the most clear and present danger to young people in our country today.
The Issue of Coercion
We also know that the primary conduit of children into psychiatry is through the schools. Not only are school employees affected by psychiatric propaganda just like anyone else in this country, but also they are also specifically trained to look for "diseases" like ADHD. They select children out, pressure parents to get a psychiatric evaluation and get their child on a psychoactive drug. We have also seen a growing incidence of parents being threatened with accusations of medical neglect when they resist or refuse psychiatric intervention, and we have seen what happens when Child Protective Services is called in and violates a family's life. We know that psychiatry is coercive at its root, and it is this coercion of parents by the schools and by Child Protective Services that is the focus for the initiative described in this essay. We were not taking on psychiatry directly (as in challenging the doctors who prescribe toxic drugs to children). Instead, we were taking on the pressure and coercion of parents.
The Legislative Process
The second area of needed clarity is in how the system works that you intend to influence. Inspired by the 1999 Colorado State Board of Education resolution on psychotropic drugs in the schools, we formed Texans For Safe Education, to see if we could accomplish a similar task with the State Board of Education in Texas. That process makes for its own good story. Months of lobbying the Board led to an all day hearing on November 1, 2000 on psychiatry in the schools, and 2 days later we got the 8 votes needed to pass a strong resolution, offered by Board member Judy Strickland, expressing serious concern about psychiatric drugs in the schools and encouraging educators to focus on education. This was good, but it was also non-binding, having no enforcement power. We then went back and forth with David Anderson, the Texas Education Agency legal counsel; the end result was that while he acknowledged that it was unlawful to require psychotropic drugs as a condition of attending school, he would not address issues of school personnel pressuring parents. We then failed in our efforts to get an opinion from the attorney general, and from the Office of Civil Rights. So we decided to take it to the legislature. Seeking redress with the Texas legislature was not an original idea. Connecticut and Minnesota had passed laws addressing the role of schools in psychiatry, and there was a beginning wave of activity in other states, which has now grown considerably (see www.ablechild.org, for a listing of state activities).
Understanding the legislative process is a lifelong task, and not my personal favorite. We do have some experience here in Texas, however, as we have successfully passed a number of psychiatry-related bills over the last 10 years, regarding electroshock, restraint, psychiatric drugs in nursing homes, and others. The Texas Citizens Commission on Human Rights has been especially active and effective in the legislature, and has established many good relationships there. The director, Andy Prough, was my best ally on this particular effort. There are many steps that must be accomplished to make a new law; it is way easier to kill a bill than to get one passed into law. First you have to have a bill authored by a legislator in the House or the Senate. Both our bills (and a third, Representative Charley Howard's HB 1070, which ended up being amended onto House Bill 320) started in the House; HB 1406 was authored by Representative Betty Brown, HB 320 by Chairman Kent Grusendorf. The next step was to get a committee hearing in the House, then to get it passed out of committee. Then it goes to Calendars, which schedules bills for a vote by the full House, and in which a good many bills die. Then it goes to the Senate, where you have to get a sponsor; Senator Troy Fraser took HB 320, Senator Todd Staples took HB 1406. Then follows a Senate committee hearing, then a vote by the Senate. Then it is doneÉmaybe. In Utah last year, a great bill by Assemblywoman Kathy Bryson passed, and was vetoed by the governor! So the governor has to sign the bill.
There are many other subtleties. There were many delays in the Texas legislature this session. You may have heard about the controversial legislative tussles, or the flight of the so-called Killer Ds to Oklahoma for a week. In any event, many bills died for lack of time. We got HB 1406 passed on the very last day it could be passed by the Senate. That was in the "local and consent" calendar, as opposed to the general calendar where the Senate debates and votes on the bill. Local and consent is usually reserved for resolutions and non-controversial bills, which are rubber-stamped on through the morning they are scheduled with only two senators in the room (a 31-0 vote is recorded). Sometimes, however, a bill is scheduled there because time is running out, and the referring committee has presumably worked out the conflicts. There were many on 1406 with school districts and the Texas Education Agency and schoolteacher groups, and, of course, the psychiatric lobby weighing in. So we needed local and consent after many delays, and it looks good. The huge catch is that a dissenting Senator can show up and "drop a card," and the bill is dead. Although we had double billed it to the general calendar as well, the odds of getting it heard there in the last day crush were not good. We counted on no senator being willing to pay the price of angering colleagues after a consensus had been reached. I was very nervous as I watched that morning. A doctor Senator was reading the bills, and our main antagonist on our other bill was standing by. Fortunately, they took no negative action, and the bill passed.
Give Your Best Effort
I shared some of the details above to give you a feel for how much is involved in getting legislation passed. You really do have to know how it works. Even then, of course, you may still lose; an opponent in a key committee chair position can doom your bill no matter how hard you work. Without knowing how it works, however, you are guaranteed to lose. We did very well in the House, thanks to the fact that we lucked into and cultivated alliance with very influential legislators. The Senate was a bear, however, probably mainly due to the fact that the psychiatric association sent a very smooth, well-connected lobbyist against us. He could do in minutes what took us days (or maybe never) because he had direct access to the Senators. That one on a key committee apparently owed him a favor almost killed HB 320. With a week to go, we took a terrible shot. He got it amended from all psychotropic drugs to stimulant drugs for ADHD. One way we fought back was to bring parents down and talk to the Senators. But we also hired our own professional to help bring these two bills home. Since the Senate version of HB 320 was not acceptable, the bill author (Grusendorf) did not concur. So this bill went to a conference committee, meaning many more steps to be done in very quick order. Our lobbyist shepherded us through this process, and the corrected bill passed at about 9pm Sunday night, 3 hours before sine die.
Like so many worthy endeavors, legislative action is very hard work. We began two years ago with a series of educational letters and a few visits to legislators. We worked hard in advance, and we showed up almost every day during the session. We had 6 hearings to orchestrate with 3 different committees to educate and influence. When the psychiatry lobbyist demonstrated his prowess in the Senate, we were thrown for a loop with two weeks to go. He almost orchestrated a coup on Friday, and we were in trouble on HB 320. We went home tired and upset, but we decided to give ti our very best and go down fighting if we were going down. We called on our best parent allies, and all four of them showed up Monday morning. We pulled Senators off the floor and told them hurried stories of dead children and school coercion. I played the fool as I grabbed a Representative not once but twice who I mistook for a Senator on the Education committee. We lost the vote on the amendment that day, but we are convinced that our effort shifted the energy, as the Committee chair said it was still a "work in progress," and the Senator who carried the Psychiatrists' amendment did not look too happy about it. In the end, he told Senator Fraser that he would stay out of it as we went to conference. Also that weekend, I called a very well-respected insurance lobbyist who had been one of our positive votes back in 2000 when he was on the State Board of Education. I implored him to help us; he was too busy, but he referred us to another lobbyist who we called and met Monday morning and hired on the spot for the last two weeks. He made all the difference as we handled all the details and communications to pull this off.
My friend, Andy, told me about the movie, "Ali," where the former champion is in a fight for his life in Zaire against George Foreman. He is talking to himself on the stool between rounds, saying something like, "Do you have what it takes? Can you keep going with a busted jaw and swollen eyes, and where the next punch might kill you? You better know that you are going to have to kill me to win this fight!" I checked out the film and watched it, and drew inspiration as I had a lot at stake and was not going down without my very best effort.
Keep Communicating and Be Honest
Most people know very little about your issue, and the education process requires time and persistence, clear, simple and frequent communication. Our home stretch lobbyist is a student of politics, and he told us about two kinds of communications. One is strategic, like when a couple of Senators walked out of the room before the key committee vote on HB 320, not to vote for or against, but in effect allowing the amendment to go through. This kind of communication avoids confronting the truth. The other type of communication is content oriented, telling the truth as you see it about the issues. To be effective, you need to know something about strategic communications, but it is telling the truth that really influences policy, and in our work it is the way we should and must go. Over time, truth moves people, and in the meantime, the spirit remains with you. Being honest is crucial for this reason, but also because nothing will get you killed more effectively than being caught in a lie.
Make no Assumptions
Don Miguel Ruiz, author of The Four Agreements, says that by making this one agreement, you can completely transform your life. I found it to be a profound key in our efforts at the legislature. One time, we assumed a key player was against us, and I went to check this out, and found out what we really needed to make it work. The reverse happened, too, where an assumed vote is not necessarily there; maybe it was yesterday, but not today. More than once, our diligence in communication found instances where something was supposed to have been handled but was not. Make no assumptions.
Anyone who has a bit of a shyness pattern like me, or who does not like to be pushy and bother busy people is going to have a hard time with an effort like this. So it was hard for me. The fact is that there is so much noise (busyness) in the legislature that it is hard to be heard. It is very difficult to become and remain a priority, easy to be ignored and forgotten. So we keep communicating on all levels.
Cultivate and Enjoy Relationships
It really is all about relationships. The problem we are confronting is about failed relationshipsÑwith our children, and between adults. The process of successful policy change completely hinges on relationships. Start with your team of close allies and partners who are committed to the initiative. These relationships must be cultivated, and they can be so enjoyable. Working together with meaning and purpose is a fantastic way to be together and get close.
Two sources are necessary in this type of effort and we had both. One is the "experts" like myself, a couple of legal allies, and a couple of school counselor/psychologist types who could speak from experience in the schools. The other, probably even more important, are the individual parents who could tell their true stories about coercion and harm. Connecting with other groups is also a key. As an example, we had Eagle Forum and the Texas Home School Coalition on our team.
Grassroots support is vital. All those relationships, faces and stories are carried forward as you speak with individuals and testify in the halls of power. These people are also needed to communicate to the legislators, and let them know this is a real concern out there. We have been building relationships for a few years, and it makes all the difference. There were a couple of great examples where this grassroots community work really paid off. On one Monday night before a Tuesday hearing, we had lost two of our star witnesses to other commitments, and I was concerned. I got home that night to an email message form a mom who had an incident that day in a local school in which a memo from the school nurse to all school employees singing the praises of Strattera for parents who did not like Ritalin was handed to her and the father, even after years of repeated strong no drug assertions. This memo turned out to be our "smoking gun" as the father testified in the subsequent hearing and others on down the line. Another time, we needed a parent, and a couple showed up at the fourth Saturday public forum my non-profit leads at a local library. The father testified at a hearing that week, and became a key member of our team.
Developing relationships with the legislators, and especially their staff members who must carry the ball and do so much work to get a bill moving, is essential. It is crucial to avoid getting so caught up in the content and righteousness of your cause that you fail to see and recognize, and get in rapport with the real individuals with whom you are or will be working. A little affinity goes a very long way, and the experience becomes so much more enjoyable.
When I was working on the State Board Of Education initiative, I learned a big lesson. We were working so hard, and doing so much. We had a great ally on the Board who was willing to carry our resolution; she was interested and supportive, but still it was our resolution. At some point, perhaps in the face of some testy opposition, perhaps with the help of a personal story or two, this resolution became not just ours, but it was Judy Strickland's resolution. She took leadership, and she got it done. I have seen this dynamic again and again now; people will go a little ways out of duty or out of curiosity. They will go a little further out of regard or affinity for you. To go the distance, however, requires one or both of these two things: a very close, committed relationship, and/or an ownership of the initiative. An effort is successful to the extent that individuals are influenced enough to take a personal stake in making change happen. We were fortunate that Texas legislators and their staff decided that it was important to defend parents' rights to make psychiatric treatment decisions for their children, without coercion.
Breeding, J. (1996, 2003) The Wildest Colts Make The Best Horses. Austin, TX: George Wier & Co.
Breeding, J. (2000) Does ADHD Even Exist? The Ritalin Sham. Mothering, July/August, pp. 43-47.
Breeding, J. True Nature and Great Misunderstandings: How We Care For Our Children According To Our Understanding. Virtual Bookworm, 2002.
www.wildestcolts.com The author's website has a great deal of information on issues related to the subject of this essay.