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TWO SIMPLE QUESTIONS



Published: Thu, May 30, 2002 @ 12:00 a.m.



Philadelphia Inquirer: Over the last two weeks, have you ever felt down, depressed or hopeless?

Over the last two weeks, have you felt little interest or pleasure in doing things?

Two simple questions with big implications. Answer yes, and you may be suffering from depression. At the least, "yes" may indicate a need for more evaluation to determine if depression exists.

Seems like a good and simple diagnostic technique. But the fact is that most people never get asked the questions and most depression never gets diagnosed.

That's an enormous national problem, considering that America has an estimated 19 million depressed adults (two-thirds of whom don't get treatment). The personal and social costs are steep: Suicides and violence, torn families and neglected children, lost jobs and lowered productivity.

Two simple questions

So here's a thank-you note to the U.S. Preventive Services Task Force, which last week brought both clarity and urgency to the issue by recommending that primary care physicians pose those two simple questions to all of their adult patients. The hunch is that much of the time, depression may be masquerading as a physical ailment. Just two little questions could open the door to early diagnosis and intervention.

Of course, this widely applied screening device will do no good if those answering "yes" aren't channeled toward further evaluation or treatment. Another potential downside is that patients only mildly or temporarily depressed might be prescribed antidepressant drugs unnecessarily.

Still, the task force -- a respected independent panel that rates screening tests of all kinds -- has found a good way to break through the "don't ask, don't tell" barrier that stands in the way of mental-health treatment.

The recommendation is part of a growing national trend recognizing that mental illness must not be draped in shame but instead treated like any other illness. Congressional passage of the mental-health parity health insurance act will be the next critical step.

MINING INDUSTRY NEEDS A CLEANUP

St. Petersburg Times: When the law regulating hard rock mining was written, Ulysses S. Grant was in the White House and the nation wanted to encourage expansion into the Wild West. Now, mining companies seeking gold, copper and silver have devastated much of the West, releasing more toxic material into the environment than any other industry, yet the law has not changed since 1872. Year after year, decade after decade, mining interests have been able to defeat reform efforts in Congress.

That could be changing. Not only is a bipartisan group of House members pushing for a new law, but support for reform is coming from two unlikely sources: the mining industry and Interior Secretary Gale Norton.

Mining is no longer practiced by crusty characters with mules and pickaxes. Multinational companies leech gold and copper out of the earth with poisonous materials such as cyanide and sulfuric acid that end up in the environment. Forty percent of Western waterways have been polluted by mining. Yet the law gives federal officials little discretion to reject a mining claim.

Under the mining act, companies are able to take ownership of public land for decades and pay less than $5 an acre. They can extract valuable minerals and leave behind an unsightly, toxic mess. Taxpayers are left to pay for the cleanup. In return, they get not even a penny back from the mining companies.

Royalties

Even the generous laws regulating coal mining and oil drilling on public land are more demanding. Those industries must pay royalties of 8 percent to 12.5 percent for what they take. In 2000, $982 million worth of hard rock minerals were extracted from public land, so even an 8 percent royalty would have returned $78 million to taxpayers.

Instead of getting a return on their land, taxpayers must pick up the tab for the destruction mining does. More than 500,000 abandoned mines exist at an estimated cost of more than $32 billion to reclaim. The law allows such abuses because it exempts miners from some environmental laws and essentially forces federal land managers to ignore environmental damage when a claim is sought.

For decades, the mining industry has fought off reform. Now, a bill filed by Democratic Reps. Nick Rahall, W.Va., and Jay Inslee, Wash., and Republican Rep. Christopher Shays, Conn., would plug gaping holes in the law. Its commonsense measures would allow public land to be mined only if that use is suitable, and it would put environmentally significant land off limits. It would establish mining standards to limit environmental damage and require mining companies to clean up their own messes. Miners wouldn't get a free ride, either. They would be required to pay an 8 percent royalty on the minerals they extract.

For the sake of American taxpayers and the environment, Congress should not let this opportunity pass.




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