Va. Tech shooter had 'some interaction' with counseling center - The Associated Press

By KRISTEN GELINEAU

A mentally ill student who killed 32 people and himself during the April 16 shooting spree at Virginia Tech had 'some interaction' with the campus counseling center, the chairman of a governor's panel studying the killings said Saturday.

But it remains unclear whether Seung-Hui Cho actually received treatment at Virginia Tech's Cook Counseling Center, panel chairman Gerald Massengill said in a telephone interview Saturday.

'We know he had some interaction with the Cook center,' Massengill said. 'The records we got did not have the detail that would tell us the level of counseling _ if any _ so that's something yet to be determined. I think eventually we'll get there.'

Panel members obtained Cho's university mental health records in mid-June after weeks of negotiation with his family.

Cho was involuntarily sent to Carilion St. Albans Behavioral Center near Radford for an overnight stay and mental evaluation in December 2005, after police received a report that he was suicidal. A special justice found him to be a danger to himself, but not to others, and ordered him to receive outpatient treatment.

After a nearly 15-hour stay at St. Albans, Cho made an appointment with the Cook Counseling Center. But whether he underwent counseling at the center is still unclear.

Les Saltzberg, director of the New River Valley Community Services Board _ the agency that delivers mental health services in the Blacksburg area _ said Saturday that he knows Cho was referred to the Cook center, but that he had 'no direct knowledge' of whether Cho was treated there.

'I don't know if he went,' Saltzberg said.

Massengill said the records the panel has received do list when Cho interacted with the counseling center, but patient privacy laws prevent him from publicly releasing such information.

The review panel has one more public meeting scheduled for July 18 in Charlottesville. It is expected to produce a report in August.


Read more!

Bipolar LA inmate charged with cellmate death - The Associated Press

LOS ANGELES (AP) - A mentally ill prisoner accused of strangling a cellmate at the Los Angeles County jail was not placed in solitary even though he was facing trial over a similar slaying in state prison, officials said.

Mental health workers concluded that Kurt Karcher was fit to be in the general jail population instead of placing him in the wing for mentally ill inmates at the downtown Twin Towers jail, the Los Angeles Times reported Saturday.

He is accused of killing Jose Daniel Cruz at the jail on May 22.

Karcher, a convicted killer who has bipolar disorder, was transferred to the jail to face charges of strangling his previous cellmate at the state prison in Lancaster, officials said.

State prison officials acknowledged they did not provide county jailers with reports that Karcher allegedly had killed his former cellmate.

County mental health officials said they were prohibited by state and federal law from discussing their treatment of Karcher, but that diagnosing the mental health of any inmate is difficult because so many are dishonest during screening interviews

"Unfortunately, mental illness doesn't have a blood test," said Robert Fish, clinical manager for treatment at Twin Towers.

Karcher is now in a one-man cell and is awaiting trial on charges of killing two inmates.

Meanwhile, a county grand jury report released Friday recommended developing a program to better train mental health professionals who provide jail services. It also recommended that electronic medical records be made available within the jails.





Read more!

High court says Ark. man mistakenly released from mental hospital - The Associated Press

LITTLE ROCK (AP) - A St. Francis County man in the custody of the State Hospital for killing his father shouldn't have been released from the facility, the Arkansas Supreme Court said.

Carey Lewis Owens, 54, was released from the hospital by Pulaski County Circuit Court Judge Alice Gray in October. Owens was acquitted of killing his father by reason of mental disease in 1991. He was committed to the state facility.

Court files say that Owens stabbed his father in the neck with a meat cleaver before decapitating the 83-year-old, then setting the body on fire. When he was arrested, Owens told authorities that he thought his father was a robot.

Owens was transferred from the State Hospital to a treatment program in 1993 on an order of conditional release. He later returned to the hospital, but was conditionally released two more times. Those releases were later revoked.

Owens' attorney, Rusty Byrne, argued that the court's jurisdiction over his client's case ended in 1998, five years after his first conditional release. Gray agreed and approved a dismissal on Oct. 25.

Byrne said Friday he didn't know where his client was and that he hadn't seen Owens since October.

On Thursday, the Arkansas Supreme Court found the state law "cannot be interpreted to suggest that the court automatically loses jurisdiction over a case five years after an initial conditional-release order."

"Had the Legislature intended for the five years to run only from the initial order of conditional release, it could have easily said so by including such language in the statute," Justice Paul E. Danielson wrote in the decision.

The high court ruled that the five-year limit didn't apply because Owens' 1993 release was later revoked.

To hold that the state law limits a court's jurisdiction to five years from the first order of conditional release "could yield potentially devastating results in these types of cases," Danielson wrote.

"For example, it would potentially allow for the release of an individual who still poses a danger to themselves or others, and even the release of an individual who has been recommitted since the first order of conditional release so long as the five years had run," the ruling said.

Read more!

Mental health parity should be approved - Greensboro News Record

Opinion

The stigma of mental illness can prevent people who need psychiatric help from getting it. They're even less likely to seek treatment if their insurance doesn't pay for care or leaves them in a financial bind.

Legislation requiring equal treatment from insurance companies for mental and physical illness appears headed for approval in the General Assembly. This week, a committee passed on to the full Senate a parity bill. In May, the House, with only one dissenting vote, approved a somewhat different version.

Parity in coverage should encourage more North Carolinians to seek treatment for mental disorders. By getting the help they need, there's a better chance they can return to productive lives. And timely access to private care at home eases the costly drain on a faltering state mental health system.

It comes down to a matter of fairness. Mental health advocates argue convincingly that insurance providers should cover patients with major depression, for example, just as they do someone with heart disease.

The push to erase such inequities is gathering momentum. According to the National Conference of State Legislatures, 34 states already have passed such legislation. A similar bill awaits congressional debate. Not to be overlooked, N.C. state employee health plans already require equal coverage for mental and physical illness.

In the past, insurance companies warned that parity-related higher costs would curtail coverage. However, that hasn't occurred in states with equal treatment laws. Only a few companies dropped coverage, and cost increases were minimal.

With that in mind, insurers now are more open to covering mental health care. In fact, the state's largest private health insurer, Blue Cross and Blue Shield of North Carolina, suggested the version of the bill approved by the Senate committee.

Yet there are shortcomings. There's a glaring lack of coverage for treatment of alcoholism and drug abuse. That should be addressed because those conditions often are associated with mental disorders.

Also unresolved is whether businesses with fewer than 25 employees must comply. The fear is that expanded coverage would be too expensive for small businesses. But where there's parity, that hasn't happened. A stronger case can be made that employees shouldn't be penalized just because they work for smaller companies.

What has emerged isn't perfect, but it is a giant step toward more equitable insurance coverage. For many people, mental health care will become more affordable and accessible. Once it's on the books, there will be plenty of time to fine-tune progressive legislation.
Read more!

Smoking May Interfere With Alcoholics' Neurocognitive Recovery During Abstinence - Medical News Today

Alcoholics frequently smoke. Anywhere from 50 to 90 percent of individuals in North America who seek alcoholism treatment are also chronic smokers. New findings indicate that smoking may interfere with alcoholics' neurocognitive recovery during their first six to nine months of abstinence from alcohol.

Results are published in the July issue of Alcoholism: Clinical & Experimental Research.

"There are several possible explanations for the concurrent use of alcohol and tobacco products," said Timothy C. Durazzo, assistant adjunct professor in the department of radiology at the University of California San Francisco, and corresponding author for the study. "Nicotine and alcohol may enhance each other's rewarding properties; nicotine may decrease some of alcohol's negative effects on cognition and motor incoordination; paired use of nicotine and alcohol may produce a strong association between the two substances such that the use of one leads to cravings for the other; and there may exist a genetic vulnerability for concurrent active cigarette smoking and alcohol dependence."

Durazzo added that previous research had shown that chronically smoking alcoholics demonstrate poorer performance in multiple areas of cognitive functioning than non-smokers when they are still actively drinking or after a short period of sobriety. "However, it was unknown if non-smoking alcoholics and alcoholics who continued to smoke during abstinence would show comparable levels of recovery after a sustained period of sobriety," he said.

Study authors recruited three groups: 13 non-smoking recovering alcoholics (12 males, 1 female), 12 actively smoking recovering alcoholics (11 males, 1 female), and 22 non-smoking light-drinking 'controls' (20 males, 2 females). The researchers examined neurocognitive changes that occurred in the two recovering-alcoholic groups during six to nine months of abstinence from alcohol, comparing their neurocognitive performance with that of the controls.

"Non-smoking alcoholics showed a significantly greater level of recovery than smoking alcoholics in the areas of mental efficiency, higher-level reasoning and problem-solving, visual-spatial processing skills, and working or short-term memory," said Durazzo. "Although smoking alcoholics in the study improved significantly in auditory-verbal memory and processing speed over six to nine months of abstinence from alcohol, the level of their recovery was not greater than the non-smoking alcoholics. It is also of note that in the smoking alcohol group, those with greater nicotine dependence and longer smoking histories showed less recovery in several areas of functioning."

"In short, abstinent alcoholics without a history of cigarette smoking achieved better recovery of critical mental functions during the first six to nine months of sustained sobriety," said Sara Jo Nixon, a professor in the department of psychiatry at the University of Florida. "[These] differential outcomes demonstrate the importance of considering the behavioral impact of continued cigarette smoking among alcoholics on long-term recovery of function."

Durazzo concurred. "Previous research on neurobiological and cognitive recovery from chronic alcoholism has not considered the potential impact of cigarette smoking on recuperation," he said. "Furthermore, most research investigating the health consequences of chronic cigarette smoking has focused on increased risk for various forms of cancer and the cardiovascular, cerebrovascular, pulmonary ramifications. Given that the mortality associated with cigarette smoking is nearly four times greater than the mortality related to alcohol-induced diseases, and given our findings - perhaps chronic smokers entering treatment for substance abuse and alcoholism should consider concurrent participation in a smoking-cessation program."

"This study did not include a group of alcoholics who had quit smoking at the time of discontinuing alcohol use," noted Nixon, "but these data suggest this would be an important study. It is [also] important that the current study was almost exclusively male. Given the growing literature regarding female smokers, additional studies including women should be conducted. Finally, as the authors note, the observed differences are not likely associated with nicotine, per se. Rather, they are associated with exposure to the many toxins in smoke. This distinction is critical in considering individual options for nicotine cessation."

"Even though our results should be considered preliminary," said Durazzo, "they suggest that consideration of smoking status is relevant to the assessment of cognitive recovery. More generally, chronic smoking may impact neurocognition in other conditions where is it a prevalent behavior, such as schizophrenia-spectrum and mood disorders. Further research is imperative


Read more!

It can happen to anyone - Lowell Sun

Many people have a stereotypical view of drug addicts -- homeless, dirty criminals who deserve the desperate lives they are leading, who would never have amounted to much anyway.

In most cases, that perception couldn't be more wrong.

"Problems of addiction can happen to anyone -- and I mean it -- anyone," says Dr. Wayne Pasanen, vice president for Medical Affairs at Lowell General Hospital and president of the Massachusetts Society of Addictive Medicine.

He believes addiction is, and should be treated as, a social issue. We agree.

"My patients who are addicted are some of the most admirable, talented people I've ever met," says Dr. Edward J. Khantzian, associate chief of psychiatry at Tewksbury Hospital and a professor at Harvard Medical School.

Some people become addicted after suffering a severe injury or illness that requires the use of prescribed opiates. Others start using illegal drugs as a form of self-medication, to ease the pain of anxiety, depression or other mental-health problem.

There is also research that strongly suggests addiction can be a problem that starts at birth. Some people may be born with addictive personalities, genetic leanings that make it more likely they will become addicted to something -- marijuana, cocaine, food, exercise, opiates. For others it is a learned behavior, they grew up watching parents, siblings and friends use alcohol and drugs for comfort and recreation.

Addiction is not just a scourge of inner-cities. It crosses all socio-economic lines. In fact, heroin use -- and teenage heroin use, in particular -- is New England's dirty little secret, according to Dr. June Stansbury, special agent in charge of the U.S. Drug Enforcement Administration's New England Field Division.

At a recent conference on methamphetamine use at Middlesex Community College in Bedford, Stansbury said teens and young adults tend to view Oxycontin and opiates as clean and safe recreational drugs because they are prescription medicine and come as a pill that can be swallowed. Sadly, it doesn't take long for them to become addicted and to move on to even harsher drugs.

Oxycontin currently sells for between $40 and $80 a tablet on the streets. It's not unusual for an addict -- including teens -- to develop habits that require eight to 10 tablets a day. That's a hefty price-tag for anyone, so it's no surprise that most addicts soon turn to a much less expensive drug -- heroin -- which can be bought for $10 a bag.

"It takes an average of three weeks to go from using Oxycontin to mainlining heroin," says Stansbury.

It can take as little as a month for an honor-roll student to progress from drinking and smoking marijuana at an occasional party, to becoming a heroin addict. For some people, foolishly taking an opiate once or twice is all it takes to become hooked. They don't realize it at the time, of course.

Teens and young adults are particularly vulnerable, Stansbury says, because their brains don't process the risks as well as adult brains.

That is why it is crucial that parents, teachers, doctors, coaches, anyone who spends time with teens and young adults, pay close attention to any changes in behavior, grades, weight, health, friends and appearance. It may not be typical teen angst.

We must all work together to fight drug abuse before more youths fall victim to a deadly addiction.



Read more!

Appeals court backs dismissal of suit on mental-health system - Arkansas Democrat

BY LINDA SATTER

An 87-page ruling last summer dismissing a lawsuit accusing the state of discriminating against its mentally ill was “correct, thorough and well-reasoned,” a three-judge panel of the 8 th U. S. Circuit Court of Appeals said Friday.

In the ruling, U. S. District Judge G. Thomas Eisele stopped short of declaring the state’s mental-health system unconstitutional, but warned that lawmakers needed to address serious problems with the system before another legal challenge could crop up and lead to a costly court-order remedy.

In affirming the ruling that stoked some legislative changes earlier this year that affect the mentally ill, the appellate panel agreed that the state’s failures didn’t rise to the level of being unconstitutional.

The lawsuit was filed by Darin Winters, son of Donald Winters of Bella Vista. The elder man died on Jan. 1, 2003, in the Benton County jail, where he was being held until a bed became available for him at the State Hospital.

He had been arrested on Dec. 28, 2002, on a charge of criminal trespass, and his son had sought a mental-health commitment order, which was granted but could not be enforced until bed space became available in Little Rock.

The lawsuit took issue with the state’s failure to ensure that when mentally ill people pose a danger to themselves or the public, an appropriate place is immediately available to hold them until they can be properly treated or admitted on a more long-term basis to the State Hospital or another institution.

Donald Winters, who was 59, died of peritonitis, an inflammation in his abdomen, that a pathologist testified likely stemmed from an ulcer that perforated after his arrest. The ulcer had gone undetected by jailers who were not experienced in dealing with the mentally ill and could not communicate with Winters during his jail stay.

“Absent accurate information from the patient, the medical personnel [at the jail ] were denied information that might have aided in their ability to timely diagnose the perforated ulcer,” the appellate court said.

Winters also had head and trunk injuries, and fractured ribs, as a result of banging his head and upper body against a metal toilet in his holding cell, and struggling against restraints, although those injuries were found not to have contributed to his death.

The appellate court agreed with Eisele that the Benton County sheriff’s office had done everything it could to protect Winters and was not deliberately indifferent to his medical needs. The court also agreed that the state couldn’t be held liable under the Americans with Disabilities Act or the Rehabilitation Act because there was no evidence that Winters had been denied medical care.

The sheriff ’s office took Winters on more than one occasion to the local Bates Medical Center, but the hospital’s psychiatric ward refused to accept him because it wasn’t equipped to handle violent or aggressive patients.

So far, to address problems related to the mentally ill, the Legislature has directed the state Department of Behavioral Health to create a system of standard protocols statewide for dealing with jail inmates whose behavior indicates mental-health problems, and has authorized training for law-enforcement officials on the handling of people with mental illness.

Legislators also set aside about $ 3. 1 million for developing a new psychiatric unit in Northwest Arkansas, created the Children’s Behavioral Health Care Commission and added beds for juvenile sex offenders at the State Hospital


Read more!

Accused killer called fit to share jail cell - LA Times

By Stuart Pfeifer

A mentally disturbed state prison inmate being transferred into a Los Angeles County jail last month was examined by mental health workers, who declared him fit to be placed in the general jail population.

That finding caused Kurt Karcher, a convicted killer with a bipolar disorder, to be moved into a cell with inmate Jose Daniel Cruz.

Karcher is accused of strangling Cruz a few days later, while awaiting trial on charges that he had strangled his previous cellmate at the state prison in Lancaster.

The May 22 assault has sparked internal investigations and raised questions about how well state prison and county jail officials communicate when transferring prisoners, as they do thousands of times each year.

State prison officials acknowledge that they did not provide county jailers with reports that Karcher had killed his former cellmate when they placed him in the custody of Los Angeles County Sheriff's deputies so he could be closer to the downtown courthouse while awaiting trial.

Had Karcher been housed in the mental illness floor at the Twin Towers Correctional Facility, it's unlikely he would have been able to harm another inmate, said Melinda Bird, who monitors the county jails as a lawyer with the American Civil Liberties Union of Southern California.

"From what we understand, inmate Karcher did not receive adequate mental health care, and this is part of a larger pattern of inadequate treatment," Bird said. "In particular, this failure to coordinate with an inmate's previous treatment is absolutely widespread.

"I'm sick at heart that another inmate has died," she said, "but I'm not surprised."

County mental health officials said they were prohibited by state and federal law from discussing their treatment of Karcher. They said properly diagnosing the mental health of any inmate is difficult because so many are dishonest during screening interviews.

"The challenge for my staff is that some inmates who don't have mental illness will say they do. And some of our most severely disturbed inmates with mental illness deny they have problems and refuse treatment," said Robert Fish, a psychologist and clinical manager for treatment at the Twin Towers facility.

"Unfortunately, mental illness doesn't have a blood test that will definitively say this person has this or this person has that."

After his first cellmate was killed in Lancaster, Karcher was housed in a one-inmate cell and prescribed medication to control his mood, according to court records. However, according to several people familiar with the case, he did not receive medication at the county jail until after Cruz was attacked.

Karcher is now housed in a one-man cell and is awaiting trial on charges of killing two inmates, which could make him subject to a death sentence.

Bird said most complaints the ACLU receives from county jail inmates are about a lack of access to mental health care and medication for psychiatric conditions.

"We are very concerned about the persistent pattern of denial of psychiatric medication to inmates throughout the jail," Bird said. "We were actively pursuing this issue, even before we learned of this murder. We're pursuing it even more intensely now."

In addition to raising concerns about Karcher's mental health care in county jail, Cruz's death highlighted communication lapses between state prison and county jail officials. State prisons typically do not pass along inmates' disciplinary files — which would have included the allegation that Karcher killed a prison cellmate — to local jail officials.

Officials with the state Department of Corrections and Rehabilitation said prison officials will often tell jail officials orally if an inmate has been violent or is an escape risk. But they couldn't say whether that happened when Karcher was transferred to sheriff's custody.

Sheriff's personnel at the jail may not have been aware that Karcher was believed to have killed a cellmate even though sheriff's detectives conducted that homicide investigation, officials said.

State Sen. Gloria Romero (D-Los Angeles) said she believes the prisons should share information about dangerous inmates with county jails and is considering introducing legislation to require them to do so.

"It is the responsibility of the Department of Corrections to make sure that there is communication as to the risk and behavior that has occurred within the state system," said Romero, who oversees state prisons as chairwoman of the Senate Public Safety Committee.

"He was being transferred to jail because he committed something while incarcerated. That information has to be shared. To say 'we didn't need to tell you because you investigated it,' that's not good enough."

Sheriff's officials have declined to discuss details of their handling of Karcher because of an internal affairs investigation. Fifteen inmates have been slain in county jails since 2000. Sheriff Lee Baca said through a spokesman that he would support any effort to improve communication between state and local jail officials.

Read more!

Rehab in prison can cut costs, report says - LA Times

By Nancy Vogel

SACRAMENTO — Until California eases prison overcrowding, it can't slow the revolving prison doors that return roughly 70% of freed inmates within a year, national experts reported to the Legislature on Friday.

Their analysis of why California is among the worst in the nation at keeping ex-convicts out of prison concludes that jam-packed conditions prevent prison officials from offering drug and alcohol addiction treatment, anger management classes and job training — steps to help keep felons from committing more crimes.

The Legislature requested the report last year. It comes days after two federal judges blamed overcrowding for abysmal medical and mental healthcare in the state's prisons and indicated they were willing to move toward capping the inmate population.

The 16-member panel of rehabilitation experts faults California for giving prisoners and parolees little incentive to behave.

They recommend that wardens subtract time from the sentences of compliant inmates. They also suggest using nominal payments — such as the 8 cents to 95 cents an hour inmates can earn for working — to encourage people to complete classes, as well as offering expanded family visiting privileges, long-distance phone calls and vouchers at prison stores as rewards.

Parolees could get an early discharge for repaying victims, holding jobs or staying off drugs, they suggest.

"There are very few incentives, so inmates and parolees who participate in programs don't necessarily get out earlier or get off parole earlier, and that's unlike many other states," said panel co-chairperson Joan Petersilia, director of the Center for Evidence-Based Corrections at UC Irvine.

Harriet Salarno, president of Crime Victims United of California, agreed that prisoners should have rehabilitation programs. But she took umbrage at the notion of letting inmates out early for completing them.

"They still have to serve their time," she said. Otherwise, "you're allowing them to manipulate the system."

If California were to follow all of the report's recommendations, according to the authors, the state could eventually save between $561 million and $684 million a year on a reduced inmate population.

California Department of Corrections and Rehabilitation Director James Tilton embraced the report. He says that he doesn't have the money in his budget to do all it suggests but that he intends to launch pilot programs in a few prisons to prove that targeted rehabilitation programs work.

The public assumes, Tilton said, that "inmates go to prison, they sit on a bunk out in the desert somewhere and never come back."

"That's not the facts," he said. "People come back. Over 90% of these inmates come back to communities…. And we can do a better job."

The report's authors portray the state's $7-billion prison system as a lousy investment for taxpayers, with one of the highest rates of criminals returning to prison. They blame lawmakers and voters who for the last 30 years have passed laws that locked up more people for longer terms without helping criminals change their behavior.

They point to recent data showing that of the $43,287 that the state spends on each inmate each year, almost 50% is spent on security while 5% goes toward such efforts as teaching them to read or get a job.

According to the department, nearly half of all California prisoners released last year were not assigned to any rehabilitation programs or given jobs.

The authors of the report include current and former officials of prison systems in Ohio, Arizona, Pennsylvania and Washington state; James Gomez, who oversaw California prisons in the 1990s; Mark Carey, president of the American Probation and Parole Assn.; and several academic researchers. Marisela Montes, a chief deputy secretary with the prisons department, chaired the panel.

The report's top recommendation was to ease overcrowding. There are more than 170,000 inmates in California prisons designed for 100,000, with roughly 17,000 of them housed in classrooms, gyms and other spaces that could be used for rehabilitation efforts. Overcrowding also hinders education by triggering frequent lockdowns, in which prisoners are confined to their beds and classes are canceled.

At a news conference Friday, panel members said the quickest way to ease overcrowding would be to revamp parole policies that send thousands back to prison for brief stays for technical parole violations such as failing a drug test or missing an appointment with a parole officer.

"It's bad policy," said panel member Joseph Lehman, a retired director of prison systems in Maine, Washington state and Pennsylvania. It's better to see if there's a connection between a parole violation and past criminal behavior, he said, and decide whether an inmate should return to prison or get help finding housing or drug treatment.

Sen. Michael Machado (D-Linden) requested the analysis of California's rehabilitation programs last year as part of the state's annual spending bill. On Friday he said an independent analysis of sentencing laws was needed.

"Many states have done this and done it successfully without putting the public in danger," Machado said. "I think it's something we need to embrace posthaste
Read more!

Fraudulent Disabilities A Concern To NCAA - Washington Post

By Josh Barr

Recent rules passed by the NCAA to crack down on academic fraud by student-athletes allow significant latitude to students with diagnosed learning disabilities, and college administrators expect that some academically struggling athletes may seek to attain their athletic eligibility by obtaining fraudulent diagnoses.

In late April, the NCAA took aim at fraudulent prep schools, or "diploma mills," by ruling that, beginning with the high school senior class of 2008, incoming student-athletes must have completed 16 core courses, two more than previously required, at least 15 of which must be completed in their first four years after enrolling in high school. The rule ostensibly prohibits the practice of "fixing" an academically deficient high school transcript by fulfilling all missing requirements during a year in prep school.

However, students with diagnosed learning disabilities are allowed to take core coursework up until they enroll in college, with no time limitations -- essentially an exemption from the rule.

"There's no question it's out there," said Gary Roberts, the faculty athletic representative at Tulane and a member of the NCAA's Academics/Eligibility/Compliance Cabinet. "Anytime you have a program designed to give some sort of special accommodation for any class of people, there are going to be people who fraudulently try to become a member of that class so they can get benefits they're not entitled to."

Learning disabilities "will be the next area our committee will have to address," said Kim Callicoatte, chairman of an NCAA subcommittee on initial eligibility issues. "It's a floodgate where we're stopping up holes and there are always going to be additional holes some people will try to get through."

The first step toward receiving this accommodation is obtaining a diagnosis. According to NCAA spokesman Erik Christianson, the organization will accept a diagnosis from "a licensed or otherwise properly credentialed professional who has undergone appropriate and comprehensive training and has relevant experience."

"We receive LD diagnoses from psychiatrists, psychologists, pediatricians, neurologists and social workers," Christianson wrote in an e-mail.

The most common learning disorder in childhood is Attention Deficit Hyperactivity Disorder, which occurs in an estimated 3 to 5 percent of school-age children, according to the National Institute of Mental Health. ADHD usually becomes evident during childhood, and the median age for onset is 7, although ADHD can persist in later years and sometimes into adulthood, according to the NIMH.

Various forms of dyslexia and other disorders associated with reading comprehension also are common for those seeking to obtain the LD designation.

Before granting a student-athlete learning disabled consideration, the NCAA requires a signed copy of the most recent diagnosis, diagnostic test results and an individual education plan (IEP) designed by the school district for the student. For students attending private school, the IEP can be replaced by a statement of accommodations on school letterhead. The NCAA then notifies the Clearinghouse, which is responsible for certifying initial eligibility, that the student is learning disabled and allowed to receive the special considerations afforded to such students.

Said Bridget Niland, an assistant professor at Daemen College in Amherst, N.Y., and a former associate director of membership services for the NCAA: "There has always been a question about whether [diagnoses] have been legitimate or not. But when someone gives you a diagnosis, it's a diagnosis and you can't really refute that."

While obtaining a learning-disability diagnosis in the latter stages of high school might raise a red flag for some -- one local college athletic administrator dubbed the disorder "NBA DD" -- the diagnosis also could be legitimate, cautioned Diane Dickman, the NCAA's managing director of membership services. Dickman suggested that a student could be hindered by a undiagnosed learning disability throughout his or her schooling.

"Late diagnosis requires a clear explanation of why the diagnosis was not previously detected, which is a component of the clinical interview and reflected in the test summary by the clinician," Christianson said.

In recent years, the number of students receiving accommodations for a learning disability has remained relatively stagnant. There was a significant jump, from 203 to 338 students from the 2003-04 school year to 2004-05, with 335 cases in 2005-06 and 302 in 2006-07, according to the NCAA.

The Clearinghouse certifies 77,000 students for initial eligibility each year.

"The numbers wouldn't suggest that there is some mounting evidence of fraud," Dickman said. "We're going to monitor any kind of academic fraud. If, as we go forward, we see something that is of concern to us or leads us to believe there is something going on that relates to fraud, we certainly would [address] that."

High school and college coaches anticipate the NCAA will be busy. An assistant coach for a team that advanced to the round of 16 in this past season's NCAA men's basketball tournament said he was aware of one player who plans to try for an LD waiver. The coach spoke on the condition of anonymity because he did not want to identify the player or his potential disability in case the coach successfully recruits the player. "I don't think he's ever been tested before," the coach said, noting that he had seen the player's transcript and spoken with the player over the course of the past year. "There's definitely going to be some abuses, no question about that."

One area high school coach acknowledged that some may attach a stigma to being labeled LD, but didn't believe that would stop players from seeking such a diagnosis.

"Some of the kids [seeking an LD diagnosis], they don't have a learning disability. There is a moral dilemma there," the coach said, speaking on the condition of anonymity because of the sensitive nature of the topic. "Do you go to get something you know you're not and then you're labeled from that point on as a kid who is learning disabled?"

Roberts compared the situation to those who falsify documents to qualify for welfare or other governmentassistance.

"I'm sure there are some doctors out there who are big fans of college athletics or their local university and would be willing to bend their ethical standard," Roberts said. "When athletes run up against a brick wall, there are coaches and people out there helping them get over that wall."


Read more!

East Texas Woman Talks About Life With Mental Disorder - KLTV

Video of the story here.

It's an illness that affects one in every four Americans. Today, almost everyone knows someone suffering from a diagnosable mental disorder. One very brave East Texan knows the impact mental illness has on both a person and society. She is now sharing her life with Bipolar in a book, in hopes society will better understand the illness.

For more than 25 years, Melody Stroud of Chandler has been living with Bipolar Disorder.

"I was under a lot of stress at the time," said Stroud. "I began not to sleep. I had paranoia that people were watching me, following me. I had extreme energy, and then I became to where I had thoughts that were not real and basically lived out of reality." After admitting herself into a mental health facility, Melody learned she was bipolar, something that has taken her years to accept.

"For years I denied that I had a mental illness, so it's been a process up until the last two years where I have really come to terms with my illness and not ashamed to talk about it." Two years ago, Melody began writing a book about her life with Bipolar called In My Head, giving details that are not often talked about.

"The details of the thoughts, of your behavior, of the treatment that is available," said Stroud. "A lot of those thoughts like I said were so horrific, it's hard to even get it out of your mouth." Melody says she wants her book to be a resource for families because it was her family that has helped her live a more stable life.

"My family was so very supportive," said Stroud. "If it hadn't been for them, truly I wouldn't know where I would be." It's a success story, Melody says she hopes will encourage others suffering, or know someone suffering from the illness.

"There is hope," said Stroud. "There is hope." Melody says she hopes to have her book finished within the year.

Molly Reuter, Reporting. mreuter@kltv.com Read more!

Mental health services move to Rocky Mount -Wilson Daily Times

By Rochelle Moore
June 28, 2007

The Wilson-Greene Mental Health Center will close its doors Friday after operating from a building next to Wilson Medical Center for decades.

Public mental health centers operating in Wilson, Greene, Nash and Edgecombe counties will completely merge Sunday and become The Beacon Center. The administrative offices will be in Rocky Mount, located in the former Edgecombe-Nash Mental Health Center on the Nash General Hospital campus.

"People need to understand that even though the (local management entity) is moving to Rocky Mount, the people doing the services — the private providers — are still doing the services in Wilson," said Karen Salacki, director of the Beacon Center.

"Private providers that are in Wilson County will continue providing the services."

The closing of the mental health center in Wilson County is the final step of the four-county merger, which has been occurring in stages during the past several years. The change is a result of the state Mental Health Reform Act of 2001.

Prior to mental health reform, clients were able to receive mental health services onsite at the Wilson-Greene Mental Health Center.

But that role started changing and the mental health center started turning over services to the private sector.

The mental health center has become a manager of services and contracts with many area providers, some which receive state and local tax dollars for indigent care. Providers also receive payment through insurance, Medicaid and Medicare.

"I am not concerned about the closing of the Wilson-Greene Mental Health Center because most of the services have been divested to private providers," said Gail Boswell, a mental health advocate and consumer in Wilson. "The statistics show that more consumers are being served now than were being served by the Wilson-Greene Mental Health Center."

Wilson residents needing service, including emergency help, now have a toll-free number they can call for service referrals. Someone will be available to answer the call and assess the level of need by a caller. Immediate assistance will be given to people experiencing an emergency situation.

The number — 1-888-893-8640 — is open 24 hours, seven days a week, including holidays. Rocky Mount-area callers may also dial 407-2474 for the same service.

"If they have a question about services or they need a referral into services, they can call that number," Salacki said. "They don't have to go to Rocky Mount for services."

The remaining 10 staffers from the Wilson-Greene Mental Health Center will all move to The Beacon Center, except for some temporary office staff. Some of the agency staff have moved to Rocky Mount during the past 18 months.

The Beacon Center will have a board of 20 people, consisting of five from each of the four counties. Each county will need to have a county commissioner on the board. The four counties will also continue to provide money to the Beacon Center through county budgets.

Services provided through the Beacon Center will include telephone screening services, provider enrollment, quality assessment, quality assurance and utilization management, which assesses the type and level of services a client needs.

Jennifer Hancock, executive director of the Mental Health Association in Wilson County, expects to see an increase in calls into the nonprofit agency when the center closes.

"The phone for the center will automatically roll over to Rocky Mount for a while. However, our office anticipates we will field a lot of calls once there is no longer a number in the local phone book, other than ours, that says, 'mental health,'" she said.

The closing of the center will remove a sense of security from some consumers, Hancock said.

"It was like their safety net and possibly the only people they knew in their lives that they felt cared about how they are doing," she said.

rochelle@wilsontimes.com | 265-7818
Read more!

Speaker: Study mental health, too -Richmond (VA) Times-Dispatch

By CARLOS SANTOS
June 28, 2007

CHARLOTTESVILLE -- College mental-health advocate Alison Malmon, whose brother committed suicide while on leave from Columbia University, wants college students to look out for one another if mental illness strikes.

"Look at [Seung-Hui]Cho's roommates" in his senior year, said Malmon, speaking Monday at a forum at the Miller Center of Public Affairs at the University of Virginia.

"They knew he was off. They knew things were weird, but they left him alone. . . . Students see the changes in friends more than anybody. We can use what happened at Tech to open up the lines of communication.

"We need to educate students so they know who to go to," Malmon said. "We need to educate them so they know what to look for [in mental illness] in themselves and in others."

Cho, a mentally unbalanced Virginia Tech student, killed 32 students and faculty members at the school on April 16 before killing himself.

The forum was held to discuss mental-health issues on college campuses in the wake of the Tech killings.

Malmon founded Active Minds Inc. in 2001 to teach college students -- some 1,100 of whom kill themselves each year -- about mental health and its symptoms. The nonprofit group has spread to some 69 campuses.

Many college students face depression and other mental problems but are ashamed or afraid to seek help, Malmon said.

Her brother Brian, 22, was an extremely successful student with a 3.8 GPA and an active social life that included being head of a student a cappella group and sports editor of the newspaper. But Brian heard voices and fought depression.

"He did it all in secret. He was ashamed," Malmon said. "Students are living in this silence at campuses all over the country."

Unlike Cho, she said, most are much more likely to harm themselves than others.

Richard J. Bonnie, the director of the Institute of Law, Psychiatry and Public Policy at U.Va. and head of the Virginia Commission on Mental Health Law Reform, said one of the main issues is how to "redesign the system so people can get help quickly when they need it. . . . The goal is to provide timely access to high-quality care without stigma."

As for college students with mental-health issues, Bonnie said administrators are confused about what course of action to take.

"College and university administrators are uncertain and even ambiguous in assisting students with mental-health problems. How aggressive should they be?"
Contact Carlos Santos at (434) 295-9542 or csantos@timesdispatch.com.

Read more!

Coordination is important in addressing child mental health - Nashville Tennessean

Opinion: By CHARLOTTE BRYSON
June 28, 2007

Last month, more than 10,000 Tennesseans celebrated National Children's Mental Health Week to create awareness about children's mental health and to advocate for a coordinated system of care to meet the needs of children with mental health problems and their families.

Mental health problems seriously affect the thoughts, body, feelings and behavior of one out of 10 children, or about 140,000 children in Tennessee. Children and youth from low-income households are at increased risk for mental health problems. Mental health problems can be severe and lead to school failure, loss of friends, family problems and disruptions, out-of-home placements, and involvement in the juvenile justice system.

Youths with mental health problems are more likely to be absent from school, suspended or expelled, or drop out of school. In Tennessee, half the youths in custody and a vast majority in juvenile facilities have mental health problems; nearly half have substance abuse problems. Suicide is the third-leading cause of death ages 15-25. Two out of three children with serious mental health problems are not getting the services and supports needed to recover.

Tennessee's public service delivery system for children's mental health is fragmented, too often inaccessible and inadequate. The system especially fails young adults transitioning to the adult system.

Through the efforts of the state Department of Mental Health and Developmental Disabilities, Centerstone, Vanderbilt and Tennessee Voices for Children, system-of-care projects have shown that providing a comprehensive, coordinated system of care that is family-driven and youth-guided results in positive outcomes for children and families.

Culturally competent services provided include parent education and support, leadership training, parent support groups, in-home behavioral support, evaluations and assessments, interagency services for children, peer mentoring, child-care resources, special-education advocacy and respite care.

With this system, the goals of successfully keeping children with serious emotional disturbance in the homes, their communities and in their local schools have been met for hundreds of Tennessee kids. However, this represents only a fraction of children needing this interagency coordination, family support and individualized services.

Senate Joint Resolution 799, passed unanimously by the House and Senate and signed by the governor, directs the Select Committee on Children and Youth to study the children's mental health system and develop recommendations by April 1, 2008. Core partners include legislators, the state Mental Health Department, Tennessee Commission on Children and Youth, Governor's Office of Children's Care Coordination, state departments of Children's Services and Education, TVC, families, providers, advocates and the state Comptroller's Office.

Families are again hopeful we, as a state, will do the right thing and put in place a coordinated system for children with mental-health problems. Read more!

Mental health, on hold for 9 months? -Minneapolis-St Paul Star Tribune

For women with depression, the question of meds during pregnancy is complicated and personal.

By Maura Lerner, Star Tribune
June 28, 2007

Since she was a teenager, Linda had struggled with major depression. As a married woman in her 30s, she thought about having a baby, and on her obstetrician's advice, stopped her medication.

And she started spiralling down fast.

Within two months, she said, "I was so depressed that I didn't even want a baby anymore."

For many women like Linda, who asked that her last name not be used, the combination of depression and pregnancy can create a delicate balancing act. Many worry that taking antidepressants may harm their fetus. Yet untreated depression also can pose a danger to both mother and fetus.

So far, medical science has offered no clearcut answers. And two new studies being released today are unlikely to end the debate.

The studies, published in the New England Journal of Medicine, found that taking antidepressants during the first trimester of pregnancy may slightly increase the risk of some rare birth defects, including deformities of the skull and brain.

At the same time, the authors concluded that the risks were quite small, and might be explained by chance. Experts caution women against stopping treatment, because the risks of depression may outweigh those of the medication.

"If you do the math ... the absolute risk of even these rare defects is quite low," said Dr. Helen Kim, director of the Women's Mental Health Program at Hennepin County Medical Center in Minneapolis.

The two national studies were designed to find out if a class of drugs, known as SSRIs (selective serotonin-reuptake inhibitors) poses a risk to developing fetuses early in pregnancy. They were prompted, in part, by a 2005 study suggesting that one such drug, Paxil, increased the rate of heart defects from about 1 percent to 2 percent.

Researchers in Atlanta and Boston reviewed the records of thousands of infants, including those whose mothers took antidepressants early in pregnancy. They found no clear pattern of birth defects associated with SSRIs as a whole.

Yet one study found slight increases in three types of birth defects, affecting development of the skull, brain and intestines. The other study found a small rise in heart and intestinal problems with specific drugs. Both said more study is needed.

A fine balance

To some, the results were good news.

"I think this data is reassuring," said Dr. Katherine Moore, a psychiatrist at the Mayo Clinic in Rochester. She said Mayo's own studies have found no increase in heart defects among babies born to women on antidepressants.

But to some women, even small risks are unbearable. "The patients are always concerned about it," said Dr. Andrea Flom, an Edina obstetrician and vice chair of the state chapter of the American College of OBGYNs. "Some people won't even take Tylenol during pregnancy."

For doctors, too, what seems acceptable has shifted over time. At one point, they generally shied away from giving antidepressants to pregnant women, said Kim, a psychiatrist who specializes in treating depression during pregnancy. But in the last five years that's changed, she said, because of growing concerns that "depression itself carries risk during pregnancy."

Kim said about 10 to 15 percent of pregnant women experience depression, and many of those will go on to experience postpartum depression.

Experts say depressed women are less likely to take care of themselves, get prenatal care, sleep well or exercise; and more likely to engage in reckless behavior, such as illicit drug use. The mother's stress hormones can affect the developing fetus as well. And of course, there's the ultimate danger of suicide.

"The belief used to be 'We'll take them off meds, they'll be fine during pregnancy,' but in fact that's not true," said Deb Rich, a psychologist at Fairview Health Services in Minneapolis. "I have women who, a month into being off medications, are hardly functioning."

Flom, as an obstetrician, says she'd be reluctant to recommend stopping antidepressants, especially in a woman with a long history of depression. But if a woman has mild symptoms, and hasn't started on antidepressants, she said she might encourage alternatives such as psychotherapy. "I will probably try to hold them off if I can until the end of the first trimester," she said.

Sometimes, the women themselves insist on toughing it out until the baby is born.

Linda, who lives in a Twin Cities suburb, wasn't one of them.

After her depression returned, she decided to go back on antidepressants. And she switched to another doctor who supported her decision. Now she and her husband have a healthy son, born just over a year ago. And she has no regrets about taking the medication during her pregnancy.

"If you're so depressed that you're not taking care of yourself, then that's going to hurt the baby," she said. "And it's probably going to hurt the baby more than if you were on an SSRI."

Maura Lerner • 612-673-7384 • mlerner@startribune.com Read more!

Report details recommendation on children's health in Rockland -Westchester (NY) Journal News

By JANE LERNER
June 27, 2007

NEW CITY - Lack of services for children with psychiatric conditions is one of the most glaring gaps in health care for Rockland youngsters, according to a report by a local lawmaker yesterday.

"While the state of New York is a national leader in the delivery of services to children with mental retardation and developmental disabilities, it is ironic that services for children with depression, diagnosed psychoses, behavioral problems, addictions and other mental impairments are sorely lacking," the report said. "A significant contributing factor for this shortfall is the general lack of coordination between agencies in the state that provide mental health services for children."

The report, titled "A Vision for the Children of New York State," was done by Harriet Cornell, chairwoman of the Rockland Legislature.

Cornell held three public hearings last year during which she solicited opinions and information about issues related to the physical and mental health of children in Rockland. She also looked at services offered by state and local agencies to Rockland residents.

The hearings focused on such topics as prenatal and postnatal care, mental and behavioral health and nutrition and physical activity.

"The single most important conclusion of our report is that children are not small adults and face health-care issues that are unique and complex," Cornell said.

One of the most striking issues to come out of the hearings is the lack of mental-health services for children, Cornell said.

Many of the problems experienced by Rockland parents stem from lack of coordination of services.

New City resident Marlene Becker agreed.

She recalled spending years trying to get help for a child with mental illness.

"The most difficult thing at the time was that there was no single point of access," she recalled. "If you heard through word-of-mouth where to go, you were lucky. If not, you were left in the lurch."

Grass-roots organizations and parent support groups have made it easier to share information, but much more could be done to improve the quality of care that mentally ill children and their families receive, she said.

Many people who spoke at a meeting called by Cornell yesterday at the county office building said they agreed that more needed to be done to address mental health needs of children.

"Mental disorders in children are real and common and treatable," said Karen Oates, president of the Mental Health Association of Rockland.

Some services are available, but county and state agencies need to do a better job of working together, said Mary Ann Walsh-Tozer, Rockland County commissioner of mental health.

"There has to be a transformation in our system of care," she said. "We must put an end to the fragmented care of individuals."

Mary Jean Marsico, assistant superintendent for special student services at the Rockland Board of Cooperative Educational Services, said research into brain function was helping to improve treatment.

"Neuroscience has opened the door," she said.

The report highlights other areas where improvements to children's health could be made:

- Removing barriers for high-risk women who need prenatal care by making it easier for them to enroll in health insurance programs.

- Improving health-promotion and disease-prevention programs and using community education to promote better nutrition and more physical activity.

- Focusing on dental care for children. Rockland obstetricians and pediatricians should speak with families about dental health in children.

- Mandating better coordination among the offices of Mental Retardation and Developmental Disabilities; Mental Health; and Alcohol and Substance Abuse. The Inter-Office Coordinating Council should meet regularly.

Cornell presented a copy of the report to Lori Hall Armstrong, one of Gov. Eliot Spitzer's representatives. Armstrong said she would share the report with the governor.
Reach Jane Lerner at jlerner@lohud.com or 845-578-2458.
Read more!

Here's the truth about EMTs handling mental health patients -Barre Montpelier (VT) Times Argus

Letter: June 27, 2007

By Anne Donahue

The comments (letter of June 19) of the local EMT regarding emergency care of those with mental illness was a sad reflection of inadequate training. Fortunately, I know directly of many other emergency personnel who share in recognizing that mental illness in its acute phases is an illness that needs the expertise of medical personnel, including EMTs, and that individuals suffering from them should not be transported by sheriffs as though they were criminals unless it is necessary for safety.

The writer has his direct facts wrong.

He alleges that dangerous patients are now being dumped on local ambulance services without regard to safety of the EMTs, a subversive change from what he sees as appropriate shackling of ill persons.

Statutory changes were made in 2004, and refined in 2006, based upon recognition that some involuntary patients were not a safety risk to transport in a less traumatic ways than the use of leg irons, waist chains and handcuffs that traditional sheriff transport required.

Those changes, however, do not remotely resemble what the writer alleges.

First, the statute requires that while the transportation to inpatient settings use the least restrictive method of transportation that is necessary for the safety of the patient, it also requires that transportation protocols be "reasonable and appropriate measures consistent with public safety" (18 VSA 7511.) Patients at risk of injuring others, or themselves (by jumping out the ambulance door, the writer suggests, when strapped to a gurney and under the direct care of the treating EMT, as every type of patient already is?) are still always transported by sheriff.

In fact, the protocols established by the Department of Health in 2006 establish three options, depending on the level of safety needs: a) transport by a mental health staff person; b) transport by ambulance accompanied by a mental health specialist; or c) transport by sheriff. None of those options resemble the alleged "duping" of EMTs to have them unknowingly transport potentially violent ill patients. The protocols require an extensive assessment of any risk factors.

Statistics are maintained of all such transports. The fact is that last year, 100 percent of the nine transports from Central Vermont Medical Center to another hospital, and 25 of the 29 transports from the community to a hospital were done by a sheriff, a similar figure to 2004, when 32 persons from Washington County were transported by sheriff. The four other patients in 2006 are the total number that represent the "change from the past," and they include those transported by Washington County Mental Health staff; only one was by ambulance.

Interestingly, this is an area in which Washington County and most of Vermont is backward compared to many other states. Massachusetts uses ambulance only for all emergency mental health transportation; in Pennsylvania the law bans the use of metal restraints for such transports; in Florida, most transports are done by civilians with ambulance or law enforcement if needed as back-up; in New Hampshire, law enforcement is available as "back-up."

Most telling is what happens in Bennington County. Perhaps the air is different there.

All transports from the emergency room at Southwestern Medical Center (which has no psychiatric inpatient service) are by ambulance. All of them. One hundred percent. If security is an issue, a sheriff rides along.

The introductory training for ambulance service staff from the Office of Emergency Services is 120 hours. Three of those hours address mental health. A 2004 report from the Division of Mental Health noted a need to increase the mental health component. The slow move to a society that recognizes that mental health is a part of health requires more comprehensive training.

The numbers are similar in training of corrections staff and for law enforcement. Police officer training has traditionally included one day on mental health response out of six weeks of training, despite the fact that police are the most frequent "first responders" to such crises. There is now an excellent initiative through the law enforcement Training Council to enhance training opportunities.

It is often inadequate training that leads to comments such as those in the June 19 letter, or to debates such as in Montpelier, where police argue that Taser guns are necessary tools, often to de-escalate mental health crises that could be "talked through" with the right training. Tasers, a risky and painful alternative, is a "quick fix" substitute that reflects sadly on our social priorities.

In 2001, in an earlier phase of my recovery from my own mental illness, I was the subject of a 911 response in Barre, but took off on foot. Somewhere around 12:30 a.m., a local police officer spotted me. He took advantage of my confused and distraught condition to convince me that the only way he could help me make a phone call was to offer me a ride to Central Vermont Medical Center, which I accepted. Once there, I agreed to voluntary hospitalization. If hospitalization had been presented as the true reason for the ride, I would have refused it.

I am forever grateful to that officer's sensitivity and skill; without it, I, too, may have ended up temporarily committed against my will and therefore transported — as the June 19 letter writer would have preferred — by local sheriff in shackles. That outcome would not have been helpful either for my mental health, for the long-term costs to our medical system for my medical care and recovery, or for society as a whole.

Rep. Anne Donahue is a Republican who represents the town of Northfield.
Read more!

Mental health makes the switch - Morganton News Herald

By Heather Sanders
June 28, 2007

After today, Burke County will have officially switched from the Foothills Area Program to the Mental Health Services of Catawba County.

The switch has gone relatively smoothly, with no real obstacles beyond the amount of work going into it, said Catawba Area Director John Hardy.

“I feel very encouraged about the response from Burke County,” Hardy said.
He said the program has tried to anticipate issues, but fully expects unforeseen problems to come up in the switch.

The program has already made contact with the service providers in Burke County, many of whom people saw under Foothills.
“I really don’t see any change here at all,” Hardy said.
He said they are setting up a connection for emergency services with Grace Hospital and the 911 system.

For other issues, Hardy said the program will compromise between Catawba and Burke counties.

For instance, the Consumer Family Advisory board will meet in Valdese because it works as a midpoint between Morganton and Hickory, Hardy said.

County Commissioner Maynard Taylor will sit on Catawba’s board, along with two residents of Burke County, appointed by the commissioners.

Taylor said the county will be part of both Foothills and Catawba for a period of time during the switch before moving completely to Catawba.
He said Burke County residents shouldn’t worry about their services, and if they do have concerns, to contact him or the other commissioners.
“All the ones who need service in Burke County will be tended to,” Taylor said. “The reason (for the switch) was to offer better service. I wouldn’t have voted for it otherwise.”

Read more!

Mental health parity should be approved - Greensboro News-Record

The stigma of mental illness can prevent people who need psychiatric help from getting it. They're even less likely to seek treatment if their insurance doesn't pay for care or leaves them in a financial bind.

Legislation requiring equal treatment from insurance companies for mental and physical illness appears headed for approval in the General Assembly. This week, a committee passed on to the full Senate a parity bill. In May, the House, with only one dissenting vote, approved a somewhat different version.

Parity in coverage should encourage more North Carolinians to seek treatment for mental disorders. By getting the help they need, there's a better chance they can return to productive lives. And timely access to private care at home eases the costly drain on a faltering state mental health system.

It comes down to a matter of fairness. Mental health advocates argue convincingly that insurance providers should cover patients with major depression, for example, just as they do someone with heart disease.

The push to erase such inequities is gathering momentum. According to the National Conference of State Legislatures, 34 states already have passed such legislation. A similar bill awaits congressional debate. Not to be overlooked, N.C. state employee health plans already require equal coverage for mental and physical illness.

In the past, insurance companies warned that parity-related higher costs would curtail coverage. However, that hasn't occurred in states with equal treatment laws. Only a few companies dropped coverage, and cost increases were minimal.

With that in mind, insurers now are more open to covering mental health care. In fact, the state's largest private health insurer, Blue Cross and Blue Shield of North Carolina, suggested the version of the bill approved by the Senate committee.

Yet there are shortcomings. There's a glaring lack of coverage for treatment of alcoholism and drug abuse. That should be addressed because those conditions often are associated with mental disorders.

Also unresolved is whether businesses with fewer than 25 employees must comply. The fear is that expanded coverage would be too expensive for small businesses. But where there's parity, that hasn't happened. A stronger case can be made that employees shouldn't be penalized just because they work for smaller companies.

What has emerged isn't perfect, but it is a giant step toward more equitable insurance coverage. For many people, mental health care will become more affordable and accessible. Once it's on the books, there will be plenty of time to fine-tune progressive legislation.
Read more!

One More Snag - Winston-Salem Journal

June 28, 2007

Clients of a major provider of mental-health care in Winston-Salem got a break last week with the news that the provider, which had been planning to shut its doors, found a way to stay open. But the troubles with this state's mental-health system are far from over, and it's past time for North Carolina to get serious about fixing the system.

Disability Advocacy and Information Services (DAIS), which opened just five years ago, was planning to shut down until a Cumberland County mental-health agency said that it's buying DAIS. That ended several days of what must have been high anxiety for the clients of DAIS and for its employees. But that, unfortunately, is the topsy-turvy nature of this state's flawed mental-health system.

Many of the current problems were caused by the state's misguided overhaul of its mental-health system. The plan to move thousands of patients from state psychiatric hospitals to private community programs failed because the state didn't provide enough money for the switch and moved too fast in its reform efforts.

"One of the main problems you have in the system right now is a lack of providers," Sen. Martin Nesbitt of Buncombe County told the Journal's M. Paul Jackson. "We have run them off."

Indeed. And such agencies as DAIS are crucial. DAIS is a private company that provides community-support and other services to more than 400 patients. Its shutdown would have left families of those with mental-health problems scrambling to find help. DAIS's patients would have strained already overloaded social-service agencies.

And it would have been the second major mental-health care provider in the area to shut down in the last two years. HopeRidge Centers for Behavioral Health closed because of financial troubles in 2005.

Officials at CenterPoint Human Services, which oversees DAIS and other area mental-health agencies, told the Journal's M. Paul Jackson that "unpredictable mental-health system changes," delayed state reimbursements and a recent cut in Medicaid payments were behind the DAIS decision to close. The N.C. Department of Health and Human Services cut the Medicaid reimbursement rate to community-support services by 13 percent in April because some agencies over-billed.

DAIS, which was purchased by Mid-State Health Systems and will be renamed for that company, is spared, at least for now, as are its staff and patients. But DAIS, just as other mental-health-care providers, must continue to struggle with a flawed system as the state "reforms its reform."

It needs to move a lot faster at that job


Read more!

Psychiatrists Top List in Drug Maker Gifts The New York Times

By GARDINER HARRIS
June 27, 2007

As states begin to require that drug companies disclose their payments to doctors for lectures and other services, a pattern has emerged: psychiatrists earn more money from drug makers than doctors in any other specialty.

How this money may be influencing psychiatrists and other doctors has become one of the most contentious issues in health care. For instance, the more psychiatrists have earned from drug makers, the more they have prescribed a new class of powerful medicines known as atypical antipsychotics to children, for whom the drugs are especially risky and mostly unapproved.

Vermont officials disclosed Tuesday that drug company payments to psychiatrists in the state more than doubled last year, to an average of $45,692 each from $20,835 in 2005. Antipsychotic medicines are among the largest expenses for the state’s Medicaid program.

Over all last year, drug makers spent $2.25 million on marketing payments, fees and travel expenses to Vermont doctors, hospitals and universities, a 2.3 percent increase over the prior year, the state said.

The number most likely represents a small fraction of drug makers’ total marketing expenditures to doctors since it does not include the costs of free drug samples or the salaries of sales representatives and their staff members. According to their income statements, drug makers generally spend twice as much to market drugs as they do to research them.

“For the fourth year in a row, our analysis shows that there is a great deal of money being spent in our small state on marketing pharmaceutical products,” said William H. Sorrell, the Vermont attorney general.

Endocrinologists received the second largest amount, according to the Vermont analysis, earning an average of $33,730. Since the state identified the specialties of only the top 100 earners, these averages represent the money earned by only some of the state’s specialists. There were 11 psychiatrists and 5 endocrinologists in that top group of 100.

Still, a similar pattern was evident in a Minnesota database that was the subject of a series of articles in The New York Times this year. As in Vermont, psychiatrists earned on aggregate the most in Minnesota, with payments ranging from $51 to $689,000. The Times found that psychiatrists who took the most money from makers of antipsychotic drugs tended to prescribe the drugs to children the most often.

These and other stories have helped to fuel a growing interest among state and federal officials to document and restrict payments to doctors from drug makers. At a gathering last month at Columbia Law School in New York, state attorneys general from across the country discussed ways to get similar data for their states.

And today, the Senate Special Committee on Aging, which is led by Senator Herb Kohl, Democrat of Wisconsin, will hold the first of a series of hearings on the issue, which could lead to legislative proposals to restrict and require disclosure of payments and gifts to doctors from drug companies nationwide.

Several lawmakers on Capitol Hill have expressed interest in such legislation, including Senator Charles E. Grassley, Republican of Iowa. “A federal law requiring public disclosure of payments to doctors could be very effective if it was carefully monitored and consistently applied,” Mr. Grassley said.

Efforts to require disclosure of payments to doctors began almost by happenstance in 1993, when The Minnesota Legislature passed a law that restricts drug companies from giving doctors gifts valued at more than $100 in any given year. The legislation also required companies to report and make public any consulting fees paid to doctors.

Lee Greenfield, a former state representative in Minnesota and one of the law’s authors, said it passed with little fanfare or debate after legislators heard stories about doctors accepting gifts of great value from drug makers.

“Why do we want them bribing doctors to use what may not be the best or most cost-effective drug for the patient purely to get some hand-held TV, we all asked,” Mr. Greenfield said.

Still, compliance with the law has been spotty. Some companies never responded to the board’s requests for disclosures. Others did so fitfully. A few sent letters saying they did not collect that information and thus could not provide it.

Minnesota officials never cracked down. Such reports were put in file drawers and largely forgotten until this past year, said Cody Wiberg, executive director of the Minnesota Board of Pharmacy. Mr. Wiberg said he planned this year to pursue companies that fail to report.

Besides Vermont and Maine, more than a dozen other states have or are now considering similar legislation, said Sharon Anglin Treat, executive director of the National Legislative Association on Prescription Drug Prices.

Officials in Maine and Vermont said they would try to compare reports of payments to doctors with Medicaid records to explore how marketing practices might influence prescribing by doctors in ways that increased costs to taxpayers.

“What we want to be able to do is overlay the prescribing information that we have with the drug detailing information,” said Jude Walsh, special assistant to the governor of Maine, John E. Baldacci. “If we see that doctors in a certain southern county in the state are prescribing a lot of a drug and getting a lot of detailing for that drug, that could lead to some record reviews to see what’s happening.”

Read more!

New Survey Links Mental Health Issues in the Workplace to Higher Indirect Company Costs - PRweb.com

A new national survey is underscoring the growing concern over mental health issues in the workplace and the critical need for employee assistance programs, or EAPs, and other services that address mental health head-on. Based on a recent May 31st survey of more than 500 company representatives across the United States, mental health ranked as the number one health issue requiring the highest indirect costs among employers, beating the second-ranked concern of back problems by more than two to one.

Industry experts say the survey results, released by the Partnership for Workplace Mental Health and Employee Benefit News, reflect the growing awareness that unresolved mental health problems can sour working relations, dampen productivity and increase absenteeism among a company's most valuable resource - its employees.

"An unresolved mental health problem that affects an employee's job performance can quickly become everyone's problem and ultimately hurt a company's bottom line," said Dr. Robert Mines, CEO of the national employee assistance provider MINES and Associates (http://www.minesandassociates.com). Dr. Mines, a licensed psychologist, added, "Fortunately, more and more employers are now recognizing the importance of early and effective intervention and the long-term dividends of employee assistance programs and other on-the-job mental health services."

For industry leaders such as MINES and Associates, such intervention means an easily accessible EAP that features conflict resolution, short-term counseling or referral, crisis intervention, a 24-hour emergency service and after-care follow-up. In addition, MINES' managed mental health care service includes all assessments, referrals, authorizations and treatment monitoring, whereas its behavioral risk management can identify and address behavioral risks before they boil over and become disruptive physical or mental health problems.

With an extensive array of services available to employers and their employees, Dr. Mines stressed that education and sensitivity remain key parts of the equation. "Employees who are experiencing mental health problems need to know what their options are," he said. "Educating them and allaying their fears of being stigmatized or having their privacy invaded can do wonders for getting early and effective help to those who need it most." According to the survey results, for example, 80 percent of employers said they believe their workers don't seek help for mental health problems because of the associated shame and stigma of a diagnosis, while many cited privacy concerns and a lack of awareness about the seriousness of the issue or about treatment options as other deterrents.

When accessed, however, such services can dramatically lower the indirect costs of diminished employee productivity and increased absenteeism, a result in line with recent studies that suggest productivity rises as the stress levels and health problems of employees go down. Through an EAP, in fact, organizations can realize returns on their investments ranging from $8 to $20 for every dollar spent. Early intervention that helps solve employee or member problems reduces additional long-term costs by providing savings in the recruitment, training and retention of valued employees.

In February, MINES introduced telephonic coaching and consultation to its already extensive list of employee assistance programs and services, allowing employees and families belonging to any of MINES' client organizations to access EAP for confidential, one-on-one coaching sessions over the telephone. Trained professionals can help employees deal with topics ranging from conflict resolution and relationships to stress and even personal goals such as weight loss or smoking cessation. Together, the comprehensive array of tools focusing on the mental health and overall wellbeing of company employees can help people move forward with their lives, develop additional skills and enhance working relationships - positive steps for the continued health of any company.

The conclusions of this new survey suggests that as the list of success stories and new corporate strategies, such as EAP, continue to grow "companies large and small will recognize the value of investing in their employees' mental health." For more information on employee assistance programs and any of the other health and organizational psychology programs that MINES and Associates has to offer please log on to http://www.minesandassociates.com or contact Judy Braun at 1-800-873-7138 extension 4980.





Read more!

Coroner's Report: Jeni Was Mentally Ill - The Associated Press

LOS ANGELES (AP) -- Comedian Richard Jeni, who shot himself to death in March, had a history of mental illness and was hospitalized late last year for suicidal depression, according to a coroner's report obtained Thursday. Jeni, 49, died at a hospital after shooting himself in the head at his Hollywood home on March 10, authorities have said.

His girlfriend heard him talking to himself about a week earlier, saying '''just squeeze the trigger,''' according to a police report cited by the Los Angeles County coroner's office.

She was making breakfast downstairs when Jeni shot himself in the mouth with a .38-caliber Colt Detective Special handgun, according to the report.

Jeni, whose birth name was Richard John Colangelo, had not made any previous suicide attempts and left no note, the report said.

However, the report said Jeni was involuntarily hospitalized on Dec. 28 after he showed up in a hospital emergency room with suicidal depression and indicated he would jump off of a building.

Days after his death, Jeni's family disclosed the comic was mentally ill and said in a statement that he had been diagnosed earlier this year with ''severe clinical depression coupled with bouts of psychotic paranoia.''

According to the coroner's report, Jeni's girlfriend said he had problems with ''insomnia, paranoia and high blood pressure due to stresses of his work schedule.''

He also had a history of schizophrenia and had taken several antidepressants and a sleeping aid, the coroner's report said.


Read more!

Execution of Schizophrenic Killer Blocked By High Court - Washington Post

By Charles Lane

The Supreme Court yesterday blocked the execution of a schizophrenic Texas death-row inmate in a ruling that may allow more mentally ill condemned prisoners to contest their death sentences.

The court ruled in 1976 that it is unconstitutional to execute an insane prisoner, but since then no death-row inmate has succeeded in overturning a death sentence based on mental illness. Yesterday's ruling removed one obstacle to such claims: the fact that a prisoner's disorder might not become evident until after the deadline for raising constitutional appeals has passed.

By a vote of 5 to 4, the court said the law does not bar consideration of convicted murderer Scott Louis Panetti's claim that he is too delusional to understand the state's reasons for planning to put him to death, even though Panetti waited until his execution date was set in 2003 to raise it.

Requiring prisoners to meet the deadline would effectively require every inmate to lodge an "unripe" insanity claim just to preserve the option, Justice Anthony M. Kennedy wrote for the majority.

The court also held that the U.S. Court of Appeals for the 5th Circuit, the New Orleans-based federal court that regulates capital punishment in Texas, used an overly restrictive definition of mental incompetence when it rejected Panetti's claim. Panetti, who has a history of hospitalizations, says he knows that the state says it wants him to die for the 1992 murder of his mother-in-law and father-in-law. But he insists that the real reason is to prevent him from preaching the gospel.

The State of Texas suggested that Panetti met the requirement of the court's 1976 ruling, derived from then-Justice Lewis F. Powell's opinion that only those mentally sound enough to be "aware" of the reasons for their execution may be put to death.

But Kennedy ordered the case sent back to a federal district court to determine whether Panetti has no "rational understanding" of the connection between his acts and his execution

Read more!

Governor, show a little care for the mentally ill - The Los Angeles Times

By Steve Lopez

Hey, Gov. Schwarzenegger, it's been too long since our last cigar. You busy the next few days?

Yeah, I know. You're always busy in budget season.

But that's all the more reason for us to get together. If you can squeeze it in, I'd like to introduce you to a few people who have caught some tragically tough breaks in life and now face the possibility of another: a $55-million budget cut by you.

Sure, you've got a tough job and can't keep everybody happy, especially with your own party leaders yapping and barking for even deeper cuts. But the cut I'm talking about is heartless and idiotic, with all due respect. I'm talking about your proposed strangulation of the AB 2034 program, which provides 5,000 Californians with everything from lunch to counseling to housing.

Who are they?

They're castoffs who have lived under bridges and on sidewalks; people who have been beaten down, locked up and, finally, rescued. The thing they have in common is that they were struck down through no fault of their own. They're all mentally ill.

Before we light our smokes, I'll take you to meet Alan Guthrie, 48, who was once stabbed at 5th and San Pedro on skid row in L.A. Now he lives in supportive housing at the Lamp Community and says he has never had the combination of housing, counseling and other services he gets under AB 2034. He hopes he doesn't end up back out on the street because of a certain governor's knife work.

Then there's Charles Jordan, 51, another Lamp client whose AB 2034 benefits include an apartment at the Ballington on Wall Street. And by the way, governor, Jordan said he'd be happy to show you his apartment, share the story of all his hard knocks on the streets and tell you about the comfort he finally found when he was steered inside by Lamp outreach workers.

Yes, I know your argument for cutting the program. You say some of the same services are provided by Proposition 63, which was approved by voters in 2004 and taxes the wealthy to pay for mental health services.

But that's nonsense, and you know it. That money wasn't meant to give the state license to slash existing programs. It was for expanded services and for all the urgent needs unmet after decades of shameful under-funding, beginning with the shutdown of state hospitals.

"It would be plainly illegal" to eliminate AB 2034 funding because Prop. 63 is in place, says state Sen. Darrell Steinberg, who is fighting to keep the funding in the budget legislators hope to send to the governor any day now. Steinberg, of Sacramento, said a cut would subvert the will of the people who voted for Prop. 63, and he predicts legal challenges.

Do you want that, governor? Do you want to get sued for eliminating a program that has rescued so many lives and been imitated around the country?

Lamp Director Casey Horan calls AB 2034 "hands down the most effective" program for bringing people in off the streets and restoring their dignity. She says the program has led to huge reductions in incarceration and hospitalization. So AB 2034 reduces other expenses, and it also makes it possible to leverage private and nonprofit investment in more housing.

There's a great example of how it all works at a place called the Village, in Long Beach, which happens to be just a few blocks from the joint where you and I had our last cigar. Bring Maria too. I know she'll love what she sees. I'm happy to set up a tour, and this time the stogies are on me.


Read more!

High court spares mentally ill killer - The Los Angeles Times

By Henry Weinstein

The Supreme Court ruled Thursday that Texas could not execute a severely mentally ill man because he could not comprehend why he was going to be put to death.

The 5 to 4 ruling, written by Justice Anthony M. Kennedy, spared the life of Scott Louis Panetti, 49, who murdered his former in-laws in 1992 after battling mental health problems for years.

Panetti has been on death row in Texas since 1995 and has been diagnosed as schizophrenic.

Both Panetti's lawyers and attorneys for the state said he was mentally disturbed. The question was whether he was sufficiently mentally ill that his execution would violate the 8th Amendment's bar against cruel and unusual punishment.

Panetti was hospitalized for mental illness 14 times in the decade before using a shotgun to kill his former in-laws in the Texas hill country town of Fredericksburg, as his estranged wife Sonja and her child watched.

During Panetti's trial, he exhibited bizarre behavior, wearing a purple cowboy suit and 10-gallon hat and subpoenaing President Kennedy, Pope John Paul II and Jesus Christ as witnesses.

Panetti was ruled mentally competent to stand trial, mentally competent to represent himself and mentally competent to be executed. Before Thursday's decision, four courts, including the U.S. 5th Circuit Court of Appeals, rejected Panetti's lawyers' pleas to spare his life.

The Supreme Court sent the case back to a federal judge in Austin to reassess Panetti's mental health in light of the decision issued Thursday. Ted Cruz, the Texas solicitor general, said he would continue to press for Panetti's execution.

The case presented a particularly thorny question because evidence was introduced that Panetti was aware that he had killed Amanda and Joe Alvarado. But expert testimony was presented that Panetti, known as "the preacher" on Texas' death row, believed he was going to be executed because Texas was conspiring with the devil to block him from preaching the Gospel to fellow inmates — not because he murdered the Alvarados.

At an oral argument in April, Cruz asserted that Panetti was capable of understanding the connection between his crime and his punishment and was exaggerating his delusions.

But defense lawyer Gregory Wiercioch, of the Texas Defender Service, told the justices that Panetti did not rationally understand why he was to be executed. Consequently, Wiercioch said, killing Panetti would serve no legitimate retributive purpose.

That view eventually prevailed. The high court majority ruled that the 5th Circuit's standard for determining incompetence was too restrictive to provide Panetti the protections he was entitled to under the 8th Amendment.

Writing for the majority, Kennedy rejected the position taken by Cruz and the 5th Circuit, that Panetti's delusions were irrelevant as long as he was aware that Texas had made a link between his crime and the punishment.

"This test ignores the possibility that even if such awareness exists, gross delusions stemming from a severe mental disorder may put that awareness in a context so far removed from reality that the punishment can serve no purpose," Kennedy wrote.

Kennedy also found that execution would be inconsistent with a 1986 Supreme Court decision, Ford vs. Wainwright, which ruled that a person may not be put to death if he cannot perceive "the connection between his crime and his punishment."

Kennedy was joined by the court's moderate and liberal justices — John Paul Stevens, David H. Souter, Ruth Bader Ginsburg and Stephen G. Breyer.

Dissenting was Justice Clarence Thomas, joined by Chief Justice John G. Roberts Jr. and justices Antonin Scalia and Samuel A. Alito Jr.

Thomas' opinion illustrated the deep divide on the high court in death penalty cases. He said that the court should not even have considered the case because Panetti did not meet the standards set by a 1996 law to have his petition considered.

"Ignoring this clear statutory mandate, the court bends over backward to allow Panetti to bring" his mental illness claim "despite no evidence that his condition has worsened — or even changed — since 1995. Along the way, the court improperly refuses to defer" to a state court finding that Panetti was competent to be executed "even though Panetti had the opportunity to submit evidence and to respond to" a courtappointed experts' report on his condition.

Kennedy countered that the procedures the state court provided to Panetti "were so deficient that they cannot be reconciled with any reasonable interpretation of the Ford rule."

Still, Kennedy acknowledged that "a concept like rational understanding is difficult to define" and made it clear that not all condemned inmates with irrational thoughts would become the beneficiaries of the ruling.

"Someone who is condemned to death for an atrocious murder may be so callous as to be unrepentant; so self-centered and devoid of compassion as to lack all sense of guilt; so adept in transferring blame to others as to be considered … to be out of touch with reality," Kennedy wrote describing the types of individuals who could not utilize the decision.

The Supreme Court decision was hailed by the National Alliance on Mental Illness, which submitted a friend-of-the-court brief, along with the American Psychological Assn. and the American Psychiatric Assn.

"For once, law has caught up with medical science," said Ronald S. Honberg, NAMI's director of policy and legal affairs.

"The circumstances of this case are tragic, and no one minimizes the gravity of the crime or the suffering of the victims. However, execution of someone who is profoundly ill would only compound the original tragedy and represent a profound injustice for us all."


Read more!

Antidepressant-birth defect risk small - Associated Press

June 27, 2007

BOSTON, Massachusetts (AP) -- Newborns face little risk of birth defects from antidepressants taken by many women early in pregnancy, say the reassuring findings of the two biggest studies of this controversial link.

The research focuses on the class of drugs chosen most often for depression and anxiety, including the brands Prozac, Paxil and Zoloft.

Paxil carries a warning of possible heart defects in newborns, and experts don't expect the new research to change that. However, they find the new studies comforting for women struggling with depression.

The possibility of birth defects from antidepressants has put doctors and patients in a tricky quandary. Birth defects obviously hurt newborns, but depressed mothers who can't give proper care also endanger their babies.

Confusing matters, researchers have wondered whether the concern about birth defects should extend beyond Paxil to this entire class of drugs, known as selective serotonin-reuptake inhibitors, or SSRIs. The two latest studies, appearing Thursday in The New England Journal of Medicine, relieve some of that worry, say birth specialists.

"Yeah, there's a risk, but the risk overall is probably pretty small," said Dr. Susan Ramin, obstetrics chairman at the University of Texas Medical School in Houston, who was familiar with the findings.

The two studies -- one from the federal Centers for Disease Control and the other from Boston University -- use more cases of birth defects than previous research to consider links between the abnormalities and SSRIs. The Boston University study was funded partly by the National Institutes of Health and Paxil maker GlaxoSmithKline PLC.

Together, the two studies looked at 19,471 newborns with birth defects and 9,952 without them. Then they considered what SSRIs the mothers in both groups took during the first three months of pregnancy and mapped the patterns of birth defects.

Neither study was able to tie SSRIs as a group to either heart defects or most other defects. That reassurance is especially welcome because depressed women fret even more than other mothers about the health of their newborns, said Dr. Stephan Quentzel, a psychiatrist who treats pregnant women at Beth Israel Medical Center in New York City.

Also, a mother's untreated depression can lead to poor care or turmoil at home, a weaker maternal bond, and other problems for a newborn. "The fetus and the newborn are almost always worse off if the mom is depressed than if ... exposed to the vast majority of antidepressants," Quentzel said.

However, doctors and mothers have been very wary about medications and birth defects since Europe's thalidomide scandal of deformed babies in the 1960s. Defects from all causes are expected in about 3 percent of births, enough to make many mothers nervous.

The concern about SSRIs grew out of GlaxoSmithKline's own alert in 2005 about possible heart defects in newborns whose mothers took Paxil early in pregnancy. The U.S. Food and Drug Administration added its own warning. Last year, a separate study linked SSRIs taken late in pregnancy to a lung disorder in newborns.

The latest studies do not consider that disorder, known as persistent pulmonary hypertension. But they suggest that the risk of other defects from an SSRI -- even if confirmed -- would add only a fraction of 1 percent to the overall danger, researchers said.

Paxil did appear to triple the risk of a defect in blood flow from the heart, both studies found. But that additional danger would still be modest, experts said.

The studies further hinted at possible ties between other SSRIs and a handful of other defects, but researchers said the numbers of newborns with specific defects were too small to draw strong conclusions.

"Based on these studies, it's correct to say: no major risk," said Carol Louik, a public health expert who led the Boston study. "I wouldn't say, 'No risk."'

Researchers said women should talk over the potential risks and benefits with their doctors, preferably before pregnancy.



Read more!