WASHINGTON — Once again, teenage boys make the cover of a national newsmagazine for killing their classmates. This time, the focus of the coverage isn't school bullying. It's adolescent rage.
Recent reports about raging videos produced by Columbine High School shooters Eric Harris and Dylan Klebold highlight the importance of schools coming to terms with the anger of students. But there are sharp differences in the strategies parents and schools are being encouraged to take.
Some experts argue that the problem is clinical: Mental illness is a "no-fault" disease of a disordered brain. It is not related to inadequate parenting, abuse, or childhood trauma. And schools should protect themselves from violence by intervening more aggressively to diagnose and medicate it.
Others caution that there's a great danger of overprescribing psychiatric drugs for children, especially boys. They urge addressing the quality of school and home life, especially the influence of a caustic culture that exposes kids to everything from hate Web sites to nihilistic music and videos.
The tack parents and educators take on this issue could dramatically affect how kids are evaluated and counseled in and out of school. It could also influence how students experience the climate of learning in schools.
A White House conference on mental health convened soon after the Littleton, Colo., shootings strongly emphasized medical intervention as a strategy for helping "more than 2 million children" who experts say suffer from depression.
"It's hard to believe that until 20 years ago we still believed that inadequate parenting and bad childhood traumas were the cause of psychiatric illness in children," said Harold Koplewicz, director of the Division of Child and Adolescent Psychiatry at the New York University Medical Center. "These are no-fault brain disorders ... they respond to medicine."
Commenting on his remarks "with the tragedy at Littleton in mind," Hillary Rodham Clinton observed that "part of what we've got to do, though, is reflect how we can both identify and get help to children who need it, whether or not they want it or are willing to accept it."
A Dec. 9 report by the surgeon general targets primary care and schools as "major settings for the potential recognition of mental disorders in children and adolescents." Some schools are beginning to screen their students for signs of depression, and a new national program to train schools to "identify troubled children" is expected early next year.
But critics say that parents are jumping too quickly to medicate angry youths, and thereby missing opportunities to connect with kids more effectively. The emphasis on drugs also obscures what could be important social sources of childhood anger. "By locating our children's problems in their supposedly flawed brains rather than in our obviously flawed society, the White House Conference took adults off the proverbial hook, while dangling our children on its point," writes Peter Breggin, director of the International Center for the Study of Psychiatry and Psychology, in a new book, "Reclaiming Our Children: A Healing Plan for a Nation in Crisis" (Perseus Books).
"What we really need to do is improve the quality of parenting and appeal to the ethical spirit of our children," he adds in an interview. "We do just the opposite when we drug. You can't drug the spiritual energy of the child and at the same time have a full appreciation of their moral power."
Dr. Breggin argues that press coverage has also overlooked the extent to which the side effects of psychiatric drugs may be implicated in recent incidents of school violence. Several of the shooters had been taking psychiatric medication, a fact that is generally not picked up in press reports, he says.
With such concerns in mind, the Colorado Board of Education passed a resolution last month urging schools to use discipline and instruction to overcome troublesome behavior in the classroom, rather than to encourage parents to put children on psychiatric drugs. The Nov. 11 resolution is not binding.
"The resolution does not stop teachers from communicating with parents. What it does do is stop teachers from giving parents an ultimatum: 'Put your kid on a drug or we're not going to teach them.' That can't happen anymore. It's wrong," said Patti Johnson, a member of the Colorado school board, in a comment reported in the Portland Oregonian.
The controversy strikes deep into assumptions in both the medical and therapeutic professions. New research reported in last week's edition of The Lancet medical journal signals that it may be possible to reduce the number of children mistakenly put on drug treatment for attention deficit disorder by referring to brain scans.
"We need to distinguish between that small group of people who are sick and need medication and the vast majority of our boys, who are normal. Our therapeutic profession and our culture right now do not know how to figure it out," says Michael Gurian, a family therapist in Spokane, Wash., and author of "The Good Son: The Moral Development of Our Boys & Young Men" (Tarcher/Putnam). "Some 60 to 70 percent of our males on Ritalin don't need Ritalin, they need a change in their family system and school system. Therapy works far better for girls than boys. And when the talk doesn't work, we jump to meds."
Other activists urge a closer look at the "toxic" cultural influences that may enhance student anger. Researchers at the Simon Wiesenthal Center in Los Angeles track the spread of hate Web sites over the Internet. They were the first to discover the link between Eric Harris's Web site and a bombmaking site. They also reported that he had reconfigured the Doom game to massacre mode based on the floor plan at Columbine High School.
In response to the urging of the Wiesenthal Center and others, some Internet providers are beginning to enforce policies against hate Web sites.
"The Internet creates an environment where kids like this can get validation for their hatred. Hate groups are getting much more sophisticated in using the Internet.... If you're looking for it, the World Wide Web can become your terrorism tutor," says Rabbi Abraham Cooper, associate dean of the Simon Wiesenthal Center.
Parents need to convey values to their kids, and "teach the worth of another human life. That's not being promoted," says Mr. Cooper. "Kids are are looking for something to believe in. If parents, schools, and the community won't provide it, someone else will."
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