Chuck Currie has an entry up about the ongoing assault on mental health treatment by the Cult (I refuse to call it a church) of Scientology. I don't have anything to add to Chuck's remarks, which you should definitely read, about Tom Cruise and his brainwashed buddies, but I wanted to take a personal diversion into his comments section, where one "RandiHeisterWoman" says:

... The overall number of proscriptions [sic] of mental medications, particularly among children, is way, way out of control. As a teacher, you should see the length of the line of students lined up outside of the office at lunch time every day, just so they can get their ritalin. I know these kids. They're normal. They were normal before ritalin and they're a sedated form of normal after ritalin. You can't look at the numbers and say that drugs aren't replacing discipline in many (not all) cases. There is a real problem here. [...]

The other legitimate problem is the fact that psichiatric [sic] medicines are prescribed primarily based on symptoms, not causes. Have you ever actually read the DSM (diagnostic and statistical manual for mental disorders)? Every definition of every mental health illness is so vague, they could apply to anybody! ... who would want a medical doctor to prescribe heart medication simply because someone reported chest pains, without doing any tests to investigate the cause? No one. Yet psychiatrists do that every single day.

If this person really is a teacher, I despair.

Have you ever actually read the DSM (diagnostic and statistical manual for mental disorders)?

Yes, I have.

Every definition of every mental health illness is so vague, they could apply to anybody!

No, they are not. This is utter nonsense.

I am not a clinician, but I have major depressive disorder, so I have a certain stake in understanding mental illness. (I also have a PhD in molecular biology, which gives me a bit of a head start on reading the literature.)

A fairly common analogy is to diabetes: no one claims that insulin is overprescribed, or that diabetics should just "pull themselves together" -- a la "I know these kids, they're not really diabetic". You don't hear those things because the physiological basis of diabetes is not disputed, because the primary symptoms are in large part physical. Popular misunderstanding of an inherently flawed concept, "mind/body duality", seems to have something to do with this: behavioural and emotional symptoms stem from the mind, which is somehow not physical, so the "cure" must be somehow non-physical as well. This is nonsense, and commenter #2, "a social worker", is exactly correct:

Mental illness consists of chemical differences in the brain which are prompted by heredity and environment. Symptoms are behaviors and feelings that differ from the norm and are similar across cultures. "Sheer will" does not eliminate depression, just as will alone does not eliminate blindness. Medication can be an important piece of therapy by helping to balance chemicals in the brain.

Mental illness has a physiological basis regardless of trigger or treatment. That such treatments as cognitive behaviour therapy have real efficacy only reinforces the observation that mind is part of body, and the two can exert mutual influence. It does not make psychotropic drugs somehow illegitimate as a treatment modality.

In fact, the current standard of care in depression (for obvious reasons, the section of the mental illness spectrum with which I am most familiar) is to stabilise patients with chemotherapy and move on to explore the utility of counseling, CBT and so on. A further analogy is perhaps useful: if you have an infection, it is likely that your own immune system can take care of it, but this can be a long and painful course of recovery and it can fail catastrophically. For these reasons, we use antibiotics to bolster the body's innate defenses. Similarly, psychotropic medication can be a way of restoring equilibrium (like antibiotics) or a permanent fix for a damaged system (like insulin for diabetes).

Unsupported claims that psychotropic medication prescription is "out of control", or that "drugs are replacing discipline", are irresponsible at best. The contention that psych meds are prescribed for "symptoms not causes" reflects a fundamental misunderstanding of clinical practice in, and the nature of, mental illness. I expect better of teachers.

(Update: comments off, discuss at Chuck's.)