THE TRUTH AND RESPONSIBILITY IN
MENTAL HEALTH PRACTICES ACT
R. Chris Barden, Ph.D., J.D.
The current epidemic of fraud and abuse in the mental health system can and must be stopped. All forms of medical, surgical, pharmacological, psychiatric and psychological therapies must be proven safe and effective before such therapies are offered to the public. All mental health patients must be fully informed regarding the reasonably predictable risks and dangers of proposed therapies. All mental health patients must be fully informed regarding alternative treatments. To prevent patient abuse, carefully constructed and limited rights to civil legal action for third party victims of reckless and fraudulent forms of psychotherapy should be carefully considered. Legislation to create these reforms are so powerfully supported by scientific research, legal argument, economic rationales and simple logic that no responsible legislator will dare vote against it. Finally, mandatory guidelines for social science expert witnesses must be enforced to stem the tide of pseudoscientific nonsense that pollutes our legal system on a daily basis.
The simple fact of the matter is that large numbers of American citizens are exposed every year to experimental and potentially harmful versions of "psychotherapy" without being fully and fairly informed of the risks and dangers involved. It is increasing apparent that psychotherapy patients are almost never fully and fairly informed as to alternative treatments including potentially safer and more effective treatments. In addition, experimental and potentially hazardous forms of "psychotherapy" are routinely funded by federal, state and private tax (or tax exempt) dollars. Such a system makes no scientific, economic, moral or legal sense and must be reformed immediately.
Together we can improve the mental health system for our children and their children. Together we can help to protect the legal system from irrational ideas and dangerous, unsubstantiated testimony. This is an area in which we may be able to help more people at one time by doing one thing that we will ever be able to do for the rest of our lives. Let us turn this tragedy into an opportunity for us to be involved in the ongoing battle for truth meaning the battle between the rational and the irrational which has characterized history for centuries. In this battle for reform we have an opportunity to be on the side of justice, the side of the American legal system, on the side of free will, on the side of informed consent and liberty and to grasp this opportunity to serve such important goals. Don't lose this opportunity. Now is the moment.
The opposition forces are grounded in ignorance, hate and simple greed. We are faced with groups and theories that believe in irrational ideas that are inconsistent with the ideals of Western civilization, American society and the American legal system. I hope that we will dedicate ourselves to making sure that this ongoing tragedy, this abuse of families will not continue and will not be repeated. Let us vow to protect innocent children, expose and punish real child abusers, protect innocent families from reckless therapists, avoid philosophies based on hate and protect vulnerable and suggestible mental patients. Let us oppose the pernicious influence of unsubstantiated and hate-based pseudoscientific, political myths and thus reform, preserve, protect and defend the legal and health care systems of America.
An Overview of the STATE VERSION OF THE TRUTH AND RESPONSIBILITY IN MENTAL HEALTH PRACTICES ACT - DRAFT OF 1/14/1995
Despite recent advances in the development of effective treatments, the current mental health system has become overly burdened by the widespread use of unproven, ineffective and dangerous practices. Responsible mental health practitioners and researchers across America are increasingly alarmed by the role of indiscriminate government spending in generating these problems.
Much of the rapid growth in the use of untested and hazardous mental health practices is the result of inappropriate financial reimbursements by state, federal and private insurance systems. In sum, the current reimbursement systems do not even attempt to distinguish between effective, scientifically valid treatments and untested, hazardous and unethical mental health practices. As a result, too many American citizens and families have suffered needlessly at taxpayer expense.
Similarly, the unprofessional practices that have become all too frequent in the mental health system have seriously contaminated the American legal system. In the civil, family and criminal justice systems unscientific testimony by mental health practitioners has reached epidemic proportions. Such deceptive, "junk science" testimony is an increasing danger to individual and family liberty and a growing stain upon the integrity of the American legal system.
Enough is enough. The TRUTH AND RESPONSIBILITY IN MENTAL HEALTH PRACTICES ACT (the "ACT") provides concrete steps to improve the safety, efficiency and effectiveness of the American mental health system by:
I. Requiring All Psychotherapists to Tell the Truth To Patients About the Safety and Effectiveness of Proposed and Alternative Treatments
Few patients would agree to untested, unsafe, experimental or known-to-be-dangerous forms of mental health practices if they were truthfully informed of the scientific status of such pseudo-"treatments" and the existence of demonstrably safe and effective alternative treatments. Under this ACT, in order to receive insurance reimbursements from state, federal or private insurance systems, providers must simply document that each mental health consumer was truthfully informed of 1- the proven benefits (if any) and proven or reasonably foreseeable risks and hazards of the proposed treatment and 2- the proven benefits (if any) and reasonably foreseeable risks and hazards of alternative treatments -- before treatment begins. This rule provides a simple and powerful financial incentive for mental health practitioners to comply with universally accepted professional codes of ethics in force since the Nuremberg Trials and Conventions following World War II. Health care providers should never again be reimbursed with public or tax exempt private insurance funds for using experimental, untested and potentially dangerous forms of mental health treatment on unwarned and unsuspecting patients. Citizens are currently entitled by law to receive accurate and truthful information regarding the cars and T.V. sets they purchase -- certainly it would be a rare legislator who could vote to deny mental health consumers similar protections from consumer fraud and abuse.
II. Requiring All Psychotherapists to Tell the Truth to State, Federal and Private Insurance Systems About the Safety and Effectiveness of the Treatments Offered to Patients
The mental health professions have made documented progress in the creation of reasonably safe and effective mental health treatments. Using universally accepted and easily performed methods of scientific research (See, Daubert v. Merrell Dow Pharmaceuticals, Inc., 113 SCt 2786 (1993) where the U.S. Supreme Court has defined such rules), a growing number of mental health treatment procedures have been proven reasonably safe and effective compared to no treatment or alternative treatment groups. Under this ACT, in order to receive insurance reimbursements from state, federal or private insurance systems, providers must simply verify and ensure that each mental health consumer was treated using methods and procedures demonstrated reasonably safe and effective by universally accepted scientific research. Methods that are "too vague and abstract to be scientifically tested" are simply too vague and abstract to be paid for with taxpayer dollars. Experimental treatments -- those lacking scientific validation -- must be labeled experimental and must be conducted at reputable and accredited medical schools, research institutes and psychology departments at accredited institutions of higher learning. This portion of the ACT will create powerful financial incentives for the mental health professions to conduct responsible and scientifically valid research on the benefits, risks and hazards of mental health practices. Certainly every American taxpayer objects to tax or tax exempt (private health insurance) funds being expended on experimental mental health treatments that have never been scientifically validated as safe and effective. Again, treatments that are "too vague and abstract for reputable scientific research" -- treatments supported by nothing more than "clinical judgment" -- are simply too vague and abstract to be paid for with taxpayer dollars.
III. Requiring All Psychotherapists and Social Scientists To Tell the Truth in American Courts of Law
Junk science has become a serious threat to the integrity of the American legal system. In the civil, family and criminal justice systems, irresponsible and unethical testimony by mental health practitioners has reached epidemic proportions. "Experts" using psychological "tests" known to be worthless for decades have decimated families with "clinical" opinions regarding parental fitness. Similarly, bogus "experts" using tests such as "doll play", "interpretations of drawings" and "facilitated communication" have sent scores of innocent citizens to prison while defrauding judges and juries into believing that such procedures were uncontroversial and based upon responsible, scientific research. This ongoing and growing attack on the integrity of the legal system must stop. This ACT requires states to enact and enforce model legislation mandating an affirmative duty for expert witnesses to tell the truth including full disclosure of limitations on the validity or reliability of the witnesses' methods and conclusions. This wise rule also requires witnesses to truthfully disclose to the court and attorneys the nature of any relevant scientific controversies regarding the methods, procedures or "tests" used by the witness. Finally, law schools and judicial training programs are encouraged to teach legal professionals how to distinguish inappropriate junk science from reputable and reliable research methods thus reducing the dangers of fraudulent or reckless testimony.
THIS LAW SHOULD PASS WITH UNANIMOUS SUPPORT --
WHO COULD VOTE AGAINST REQUIRING MENTAL HEALTH
PRACTITIONERS TO TELL THE TRUTH?
Contact author R. C. Barden, Ph.D., J.D., LP 888-947-6281 for copies.