Asheville House Transitional Living Program Offered for Sale - Prime Newswire

Editor's Note: Although the following is a press release, not normally run on this blog, it is listed here because of its interest in Western North Carolina. Certainly if the local press would ask if cuts in funding were the reason for closure, it would hold more interest.

August 30, 2007

ASHEVILLE, N.C., Aug. 30, 2007 (PRIME NEWSWIRE) -- Asheville House, a short term transitional living program for adolescents in their latter years of high school and young adults, announced today that the program, along with its campus of residential and educational facilities in Asheville, North Carolina is being offered for sale.

Asheville House opened to residents this spring and was filled through the summer months. The program offered a unique combination of transitional living and therapeutic support focused on participants with drug and alcohol addiction. It also featured a strong educational component to support students finishing high school requirements and taking early college classes through its on site education center.

``We firmly believe in the concept of Asheville House and are anxious to locate a new owner who will be a strong steward of the work we've begun here,'' said Carolyn Bradfield, founder of Asheville House. ``We suspended operations of the facility this month when our last group of residents graduated. Our goal is to work with a new owner to re-establish the program within the coming months.''

Asheville House is located in the historic Montford District of Asheville. The campus includes two restored Victorian homes, serving as residences capable of housing up to 28 residents. They can be used for single gender or mixed gender populations. The main house includes executive offices, a commercial kitchen, laundry and dining facilities. There is a 2-story educational center for online classes and large storage building with added refrigeration capacity.

``Asheville is an ideal location for a therapeutic program,'' added Bradfield. ``It is rated one of the top 10 places to live in the country, has a tremendous labor pool of mental health professionals, a wide variety of recreational opportunities and a community that is very supportive of therapeutic programs. For those in recovery, Asheville boasts a large and diverse young people's community in recovery.''

The campus has all of the necessary permits and inspections for city occupancy. It is recognized by the city of Asheville as a commercial property and zoned as a group home. The facility is license-eligible as a residential program by the NC Department of Health and Human Services having been licensed recently by the previous owners.

The property is fully furnished, with technology and supplies necessary to open a fully functioning program immediately. Additionally, there are two passenger vans that come with the program.

About Asheville House

Asheville House was founded as a 3 to 6 month transitional living program for adolescents in their latter years of high school or early years of college. The program worked with individuals who have been in drug and alcohol treatment, wilderness therapy, residential treatment programs, or therapeutic boarding schools.

A structured and supportive home environment helped participants reintegrate with the community, learn how to live a substance-free life, and better prepare to rejoin their families and friends. To see the program website visit http://www.ashevillehouse.com. To view the renovation process and the facility in detail, visit http://www.ashevillehouse.net. Call Carolyn Bradfield at 770-480-7807 or email her at cbradfield@ashevillehouse.com for more information.

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Stokes officials hope to create mental-healthcoordinator job - Winston-Salem (NC) Journal

By Lisa Boone-Wood

Stokes County officials are working to create a local go-between position for providers of mental-health services and residents who have developmental disabilities, substance-abuse problems and mental illness.

Mental-health advocates in the county urged commissioners in July to consider a mental-health coordinator position as a solution to what they called a failing mental-health system in North Carolina.

As a result, County Manager Bryan Steen is planning the position with the county’s social-services department.

They are meeting with area hospitals and emergency responders, and working with the state to determine a salary and classification for the job, Steen said.

Under a mental-health overhaul, public agencies manage mental-health services in specific areas. CenterPoint Human Services, based in Winston-Salem, serves Forsyth, Stokes and Davie counties.

The system has too many holes, especially in rural counties, said Doris Hill, a volunteer with the Stokes County Mental Health Association who has been pushing for the position.

Hill said that Stokes residents need someone in the county, whom they know, to call on for help.

“If we have a person on top of it, we can see where the problems are from our county. “ she said. “When someone has a chronic or acute mental illness, it is hard to navigate getting treatment and medications.”

CenterPoint officials have said that the position would help improve communication.

A rush for mental-health reform has resulted in “instability and insecurity about the future,” according to a report published recently by Alice Lin, a health and human-services consultant to the N.C. Division of Mental Health, Developmental Disabilities, and Substance Abuse Services.

Stokes officials say they are taking steps to avoid further instability by having a plan in place.

Jimmy Walker, the vice chairman of the Stokes County Board of Commissioners, said that the commissioners recognize the need for the position, but they haven’t ironed out details.

“It’s important because it would be our connection between the people who have the need and those who have the resources to help with the need,” Walker said.

“I want to see the position set up in whatever way will be most effective.

“We had some people do some good work to come up with that concept. I think it’s a very positive solution.”

■ Lisa Boone-Wood can be reached at 727-7232 or at lboone@wsjournal.com.
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Report: N.C. system struggling - Winston-Salem (NC) Journal

Mental-health care changing too fast for providers, it says

By M. Paul Jackson

North Carolina’s mental-health system is changing too fast for its providers to keep up.

That was the finding from a consultant’s report analyzing the state’s mental-health system. According to the report, some mental-health patients have found it tough to get appropriate care because smaller mental-health agencies are struggling to manage within the system.

The 91-page report was released Wednesday. The N.C. Department of Mental Health, Developmental Disabilities and Substance Abuse Services commissioned it in the spring. It was written by Alice Lin, a consultant to the state’s mental-health division.

According to the report, the state has not effectively communicated the system’s changes to its Local Management Entities, the 25 regional agencies that oversee mental-health care in North Carolina.

“In the rush to complete structural changes, the public partners have lost sight of the effect on consumers,” the report read. “There has been insufficient joint effort at resolving consumer access problems.”

The report reviewed seven of the 25 regional agencies that oversee mental-health care. It said that the agencies have problems consistently managing state money and have not received enough help to improve access to care for patients.

The report comes six years after the state made sweeping changes to its mental-health system. In 2001, it shifted care from state mental-health hospitals to local agencies to help keep patients within their communities.

The overhaul did not meet with success. The Winston-Salem Journal published a series of articles two years ago showing how the changes were based on incorrect assumptions about government payments for mental-health programs.

As a result, admissions to the state’s mental hospitals have risen and smaller community agencies have been unable to effectively provide care.

State health officials said they planned to meet with some regional agencies next week to discuss the report.

“This will certainly give us a good discussion point,” said Leza Wainwright, the deputy director of the state’s division of mental health. “We think that Alice has definitely identified some issues, some that we were aware of and some, I think, she has helped bring into focus.”

The report also noted that some agencies made positive changes since the mental-health overhaul.

CenterPoint Human Services, the Winston-Salem agency that oversees the region’s mental-health services, received state approval in May to create a 24-hour crisis program for patients, for example.

CenterPoint’s crisis program includes creating short-term hospital beds for patients in crisis. CenterPoint officials declined to comment on the report.

State mental-health advocates said that the report could help spur improvements to the system.

“We welcome any objective look at the system,” said Yvonne Copeland, the executive director of the N.C. Council of Community Programs, an advocacy group for mental-health agencies.

The report recommended that the state communicate clearly about its changes to the mental-health system and said that the regional agencies should consolidate more business and information-technology services.

“As the LME implementation experience has demonstrated, trust among public partners is fragile and needs to be earned continuously,” the report said. “Six years later, the mutual trust and confidence has not kept pace with the demand of the reform tasks.”

■ M. Paul Jackson can be reached at 727-7473 or at mjackson@wsjournal.com.
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Changes won't be easy or cheap -Newport News (VA) Daily News

BY HUGH LESSIG

RICHMOND -- The governor's Virginia Tech review panel has outlined a course of action that will spark debate over guns on campus and whether taxpayers should dig deeper to help the mentally ill.

In a state still haunted by the image of gunman Seung-Hui Cho, the panel's report will create new questions about how authorities should share information about troubled students. And ultimately, the report and its 70 recommendations will create a ripple effect beyond Virginia, as other states consider ways to strengthen the social safety net and improve campus safety.

The report, formally released Thursday, presents a detailed look at the events of April 16, when Cho gunned down 32 people before killing himself, the worst school shooting in U.S. history.

It tells of a student whose behavior frightened many, but says "no one knew all the information and no one connected the dots."

And its recommendations are potentially controversial and costly for Gov. Timothy M. Kaine and the state legislature, which convenes in January.

MENTAL HEALTH

In December 2005, Cho was temporarily committed to a hospital after writing disturbing messages to one student and telling a roommate he might commit suicide. He was directed to get help as an outpatient. He kept one appointment at a counseling center, but did not return.

The panel says Cho's experience calls into question the procedures of the mental health system and the resources devoted to it.

It recommends a longer evaluation period for the mentally ill who are temporarily detained as potentially dangerous. Currently people can be detained for 48 hours, one of the shortest detention periods in the nation.

The standard for committing someone deemed an "imminent danger" to self or others is not clearly understood, the report says. The report recommends a broader standard that there is a "substantial likelihood" or "significant risk" that the person is dangerous.

It recommends additional secure beds for people temporarily detained against their will.

A leading advocate for the mentally ill in Virginia said she hopes lawmakers seriously consider funding several areas, including more secure beds in the form of crisis stabilization centers.

"You invest in the front end, or you just go back later and you invest in the back end, which ends up being more expensive," said Mira Signer, executive director of NAMI-Virginia. The acronym stands for the National Alliance for the Mentally Ill.

Del. Phil Hamilton, R-Newport News, heads the House of Delegates committee that considers mental health legislation. He has held hearings on Tech-related issues and has monitored meetings of the Virginia Supreme Court mental health commission.

He said common threads are emerging: the need for more caseworkers, more crisis centers and more money. Kaine will set the tone when he introduces a two-year budget in December.

"None of this is going to come without a hefty price tag," Hamilton said.

Kaine has vowed to make mental health a priority, but he did not discuss specifics during a press conference where the report was formally released.

GUNS ON CAMPUS

Cho killed 32 people with a pair of handguns. He bought them in defiance of federal law, since at one point he was judged to be a danger to himself, the report says.

The report recommends requiring background checks for all firearm sales, including private sales at gun shows. Kaine supports this measure.

It says the legislature should pass a law that clearly establishes the right of every Virginia college and university to regulate the possession of firearms if it so desires. Governing boards can set those policies now, but the report says education officials "do not seem to be adequately versed" in what they can do.

However, the panel recommends that guns be banned on campus unless required by law.

It also recommends that Attorney General Bob McDonnell clarify an opinion from a previous attorney general regarding the authority of colleges and universities to ban guns. It says universities have developed various interpretations, adding to the confusion.

McDonnell spokesman Tucker Martin said the two-page opinion from former Attorney General Judith Williams Jadgmann is clear. It reads in part, "It is my opinion that colleges and universities may regulate the conduct of students and employees to prohibit them from carrying concealed weapons on campus."

The Virginia Citizens' Defense League, a gun-rights group, opposes each school setting its own policy. In an e-mail sent to supporters Thursday, it says the state should allow gun permit holders, whether they are students, employees or visitors, to carry guns anywhere on campus.

And the league has long argued that fears about private sales at gun shows are overblown.

Bob Ricker, a former legislative advocate for Virginians for Public Safety, said he had not seen the report. But generally speaking, "for students at least, guns are not appropriate," he said.

PRIVACY ISSUES

The report cites "widespread confusion about what state and federal privacy laws allow." This was important in Cho's case because his parents were never told he had been involuntary committed or judged to be a danger to himself. They did not know about his troubling encounters with students and professors.

Often, the report says, people with sensitive information will not disclose it out of ignorance or because they want to hide behind a statute. It calls upon McDonnell to develop guidelines regarding how privacy laws apply to troubled students.

In a statement, McDonnell noted the report's "apt conclusion" that state and federal privacy laws "are too complex and confusing."

Kaine agreed, saying, "It is imperative that these laws be explored to give clear instruction to people working in the field."

At a separate press conference Thursday, Virginia Tech President Charles Steger said he also recognized the importance of sharing information when needed.

"If we look at a question of the balance between protecting privacy rights and the need to protect the broader society, we will certainly become advocates for a change of the laws," he said.



Staff writer Cathy Grimes contributed to this report.

Copyright © 2007, Read more!

Mental health program faces bleak future -San Gabriel (CA) Tribune

By Will Bigham Staff Writer
08/31/2007

POMONA - A local program that provides housing, employment and other services for mentally ill homeless people is in jeopardy of folding because its funding was cut from the state budget last week by Gov. Arnold Schwarzenegger.

The program, administered by the Tri-City Mental Health Center, serves about 100 people in Pomona, Claremont and La Verne, said Mary Baron, the organization's interim deputy director.

It's annual budget of $900,000 depends entirely on state funding, and with all of that money being lost, officials are now scrambling to come up with a backup plan to fund the program.

"There are no answers right now. This just happened," said Margaret Harris, chief financial officer at Tri-City. "And I believe it will be several months before any answers are known, and at that point in time Tri-City, along with all the other counties, will have to decide on whether they can afford to continue the program."

About $55 million allotted for the program was cut statewide, part of $700 million in cuts made by the governor.

The budget cuts were necessary "so we can have a significant budget reserve, because of the uncertainties that are out there about the economy," said H.D. Palmer,
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a spokesman for the state Department of Finance.

The program was established in 2000 by Assembly Bill 2034. Baron said the program "has been one of the most effective mental health programs ever."

"For Tri-City, it has been an incredibly successful program," Baron said. "The focus is on housing, on education, and on work. Our averages, as far as results, have always met or exceeded the state averages."

Baron said that in June, 25 percent of the people enrolled in the program were employed, and 96 percent were now off the streets.

"It absolutely keeps people off the street, out of jail, and out of psychiatric facilities," Baron said.

State officials suggest that money for the program is available through alternate sources, such as federal and county governments, and through money raised by Proposition 63, which established a 1 percent income tax on millionaires for services for the mentally ill.

Proposition 63 money can go only toward newly established programs, but if programs such as Tri-City's are restructured sufficiently they could qualify for the funding, Palmer said.

"We were hopeful that the governor would not have blue-lined it, so right now all the counties are working with the state to find how other financing can be received to continue these programs," Harris said.

Tri-City's program remains operational, though officials aren't sure when it may have to be shut down if funding is not secured, Baron said.

will.bigham@dailybulletin.com

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Residents Blast Plan to Relocate 16 Mentally Ill Patients - KHNL, Honolulu

Video report here.

By: Mari-Ela David

AIKAHI (KHNL) - Outrage spreads throughout a tight knit Oahu community over a plan to house mentally ill patients.

Under the plan, more than a dozen patients would live under one roof in Aikahi and they would be right next to homes and an elementary school.

More than 60 residents showed up at a meeting Thursday night to voice their concerns. Many were frustrated with the state for not telling them until the last minute about a plan they fear could bring danger right in their backyards.

The proposed site is at a home on Kaneohe Bay Drive. A for-profit organization called CARE Hawaii wants to use the Aikahi home as a care facility for 16 mentally ill patients.

"It isn't fair to the neighborhood because they're mentally ill, but they don't state what kind of illness and what offenses in the past," says Lawrence Wilcox Smith Jr., a resident who lives next door to the home.

The patients would come from Hawaii State Hospital which is plagued with problems such as overcrowding and has a history of patients assaulting staff.

"When you go to that hospital you've been sent there by the criminal justice system," says Rep. Cynthia Thielen.

The primary concern is the home is nestled in the middle of a neighborhood and is only a one-block walking distance from Aikahi Elementary School.

Thielen spearheaded a neighborhood meeting at the school cafeteria where residents demanded answers from CARE.

"Has the company decided how they're going to take care of runners? Escapees? All of these come into mind because you do have children living next door," says Claudine Tomasa, a Kailua resident.

Thielen says it's not just the safety of kids at stake, but also the patients housed there.

"Don't shove people in like cattle into just this crowded situation, that doesn't help anyone," says Thielen.

The ultimate fate of the house lies in the hands of the State Health Planning and Development Agency. Residents say they can only hope their voices will be a factor in the state's final decision.

The Department of Health was at the meeting, saying the court will determine if the patients are stable enough to live in the community.

CARE says it has adequate staff to watch over the patients at the home. The agency has applied for a permit to convert the home into a care facility.

The state will hold a public hearing on the issue Tuesday. No word yet on when SHPDA will make decision.
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Hostage taker wanted to die, sister says -Louisville (KY) Courier-Journal

By Jessie Halladay
jhalladay@courier-journal.com

Guy Ray III left police no choice but to shoot him when he came out of a bank Monday and threatened them with a firearm, his sister said yesterday.

"We feel that these officers were forced to take the action they did," said Nancy Littlefield of California. "He is responsible for what he did," she said of her brother.

Ray, 44, died Monday of multiple gunshot wounds after he came out of a National City bank branch brandishing what turned out to be an air rifle and jogged toward SWAT officers who had surrounded the building.

Eight SWAT officers have been placed on routine paid administrative leave pending an internal investigation into the shooting, said Alicia Smiley, a Louisville Metro Police spokeswoman.

The officers involved are James Kaufling, John Seymour, Jeffrey Hancock, Andrew Eichberger, Andrew Holden, Charles Newman, Bradley Harris and Donald Meredith.

Before the shooting, Ray held four female employees hostage inside the bank at 3603 Bardstown Road. He released the women shortly after police provided White Castle hamburgers to him at his request.

Within a half hour of releasing the hostages, Ray came out of the bank carrying a rifle that was later determined to fire pellets or BBs.

Littlefield said she and her parents believe that her brother, known to family and friends as Nick, went to the bank and took the hostages knowing that it would draw a large response from police.

"Nicky was there to make it happen," Littlefield said. "He had a goal. He was going to force them to shoot him."

Before Ray came out of the bank, he told hostage negotiators that he was bringing out a gun and they warned him not to do that, Chief Robert White said.

All hostage negotiation team members are trained in how to handle mentally ill suspects through the police department's crisis intervention team, Smiley said.

Littlefield said her brother struggled with mental illness since he was a teenager. Over the years he had tried several medications, but his sister said he often didn't like the side effects and would stop taking them. She said she doesn't know if he was on any medication recently.

Littlefield said her brother visited their parents a couple of days before the shooting and gave no indication that he was in a troubled state or suicidal.

While he had never made a plea for help with suicidal thoughts, Littlefield said her family had often worried that he would try to end his life.

"We knew he had always felt lost and unable to function in the world," she said. "We never expected that he would choose such a violent route."

Because he chose to end his life in such a public way, Littlefield said, she and her parents are struggling to deal with the incident. "I feel really sad for the people who were involved. … I'm horrified that these people have this pain they have to live with."

A spokeswoman for National City said none of the employees would comment. The branch, at 3603 Bardstown Road, was closed yesterday to give employees a chance to recuperate, Terri Wilson said.

"They were very, very brave," Wilson said.

Littlefield described her brother as an extremely intelligent man who earned the nickname "The Professor" in high school. She said he was mostly self-taught after dropping out of college because of his mental illness.

But she said he had an aptitude for things, such as taking apart a computer and putting it back together.

Over the years, Littlefield said, her brother would have episodes in which he was consumed by his mental illness. At other times, he would be functioning rather normally.

"There were people who really cared for him," she said.
Two have shot others

Detectives with the department's Public Integrity Unit continued to investigate Monday's shooting.

All of the eight officers involved in the incident were members of the SWAT team. They will be on restricted duty until the case can be reviewed for any potential criminal wrongdoing.

Two of the officers on leave have been involved in previous shootings.

Newman wounded Thomas R. Miller in the knee, ankle and finger during another SWAT incident June 6.

That incident followed a robbery at a McDonald's that led to Miller hiding behind a home near the robbery site. Newman attempted to subdue Miller with a Taser, but then Miller pulled a gun, prompting Newman to fire two shots, police said.

Newman was cleared of any criminal wrongdoing in that case on June 28 by Commonwealth's Attorney Dave Stengel and has been back to work since, said Maj. David Ray, head of the integrity unit.

Officer Kaufling was involved in the fatal shooting of Marshall E. Marbly in August 2002. Marbly, who was mentally ill, barricaded himself in his car and brandished a knife at officers who were called about a man standing in the street directing traffic.

Police used several less lethal options, but when an officer shouted that Marbly had a gun and he raised it, Kaufling and another officer shot him. The gun was later found to be an air rifle.

Stengel determined in April 2003 that Kaufling acted appropriately.

Reporter Jessie Halladay can be reached at (502) 582-4081. Read more!

Montana's most vulnerable citizens well-served by 2007 Legislature - Great Falls (MT) Tribune

By ROSE HUGHES

Children, elderly, and families coping with physical and mental illnesses, abuse, and disabilities, and the people who care for them, are better off today because of the work of the 2007 Legislature.

The Human Services Appropriations Subcommittee — three Republicans and three Democrats — showed us how caring people, working together, can accomplish good things.

They deserve our thanks. Reps. Edith Clark, Joey Jayne and Penny Morgan, and Sens. Dan Weinberg, John Cobb and Greg Lind worked tirelessly on the human services budget.

Their proposals passed both houses with bipartisan support and were signed into law by Gov. Schweitzer. The people of Montana should be proud of these efforts. How we treat our most vulnerable is a reflection on all of us.
Caregivers and service providers...

This Legislature helped thousands of workers across the state who provide hands-on services and care to those who need help — children, the elderly, the disabled, those with mental illness. These people do work that is physically and emotionally draining for low pay and inadequate benefits, in large part because those they care for are on Medicaid.

The Legislature provided funding to assure that these workers make at least $8.50 per hour and additional funding for wage increases beyond $8.50 per hour.

Caregivers will also benefit from a pilot program to provide health-care insurance for low-paid workers who provide personal assistance to disabled and elderly individuals in their homes.

Service providers across all human services programs received modest rate increases each year of the biennium to allow them to keep up with inflation.

These increases help ensure that needed services will be available and of high quality.
Children and families...

The Legislature increased funding for child protective services, foster care, subsidized adoption, children's mental health and flexible funding sustainability for the Children's System of Care.

The funding means better services for our abused, mentally ill and other at-risk children. The funding supports foster parents and those who adopt difficult-to-place children, attempts to keep children in their homes, and allows development of new and creative services.

Property and liability insurance coverage for foster parents and therapeutic foster parents who care for seriously emotionally disturbed youth was also funded.

The Children's Health Insurance Program was expanded to serve more children, and increased access to dental care within Medicaid and CHIP was funded.

Access to quality child care was improved, including a program to assist working caretaker relatives in paying for child care. Montana's neediest families received a modest increase in their monthly financial assistance payment.

Public health and other prevention-focused programs also received attention.

This includes expanded screening for genetic and metabolic conditions, additional funds for public health home visits, start-up funding for Community Health Centers and full funding for the tobacco use prevention program, which distinguishes Montana as one of only five states to fully implement Centers for Disease Control recommendations.

These efforts translate into families having access to more services, including preventive services, lowering future costs for more expensive services.
Developmentally disabled...

The funding system for developmental disability services underwent a major overhaul including significant funding increases, to assure the quality and availability of services.

Funding to address the adult and child waiting lists means more individuals waiting for services can get the help they need.

Funding was approved for a new Vocational Rehabilitation counselor, VR client tuition increases, and the Montana Youth Leadership Forum, which helps train youth with disabilities transitioning into adulthood.

Other legislation addressed the problems governing commitment proceedings for people with developmental disabilities, making community treatment an option, and assuring appropriate handling of court records in cases of commitment to a residential facility.

Additional legislation will make it easier for people with disabilities to testify in cases of alleged abuse and neglect.
Elderly...

The Legislature provided increased funding for services to the elderly in our nursing homes and assisted living facilities as well as those who are still living at home.

Home and community based waiver slots were increased to enable more individuals to be served in their homes and communities.

Aging Services programs which provide meals on wheels, transportation and an array of other services to the elderly also received a substantial boost in funding to expand their services.

Appropriately funding all senior services means that individuals can be served in the setting that best meets their needs.

Other important legislation for seniors included establishment and startup funding for an Older Montanans Trust Fund, designed to meet future needs of an aging population and continued funding of the Big Sky Rx program to assist those on Medicare with prescription drug costs.
Mentally ill...

The pleas of mental health advocates, providers, consumers, family members and law enforcement for desperately needed mental health care close to home were heard.

There is new funding for crisis services for uninsured seriously mentally ill Montanans, including limited funding for new community crisis beds and funding for expanded tele-medicine so that rural communities have better access to psychiatric expertise.

Legislators funded a statewide suicide prevention coordinator, a statewide suicide prevention hot line, new community drop-in programs (such as The Hub in Billings) and more money for the Mental Health Services Plan, which pays for limited mental health services and medications for people with no other insurance or ability to pay.

People with mental illness who are on probation or parole will have improved access to needed community mental health services and prescription medications.

The focus of the human services budget was to put things in place now that will reduce costs in the future.

The Legislature focused on prevention, early intervention and access to care.

It focused on providing services in our communities and stabilizing and lowering the populations of institutions, including the state prison. It increased funding for workers and providers in communities throughout the state to assure that care would be available for those who need it, now and in the future.

The human services budget is about people, and when the 2007 legislative session ended, the people won.
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Jail Savings - Bangor (ME) Daily News

Editorial
August 30, 2007

Gov. John Baldacci’s county jail consolidation plan is a welcome move to try to save tax dollars. It’s too soon to say whether the plan would work or save the amount of money promised, but lawmakers should be eager to start going through its details and testing its ideas.

The governor would have the state take over Maine’s 15 county jails, close four — in Oxford, Franklin, Piscataquis and Waldo counties — and consolidate administration. As with Baldacci’s school-district administration consolidation, more savings would come through greater efficiencies in central offices, through purchases — in the jails’ case, medical costs and pharmaceutical contracts are big — and more effective use of bed space throughout the system.

For instance, while jails in Knox or Penobscot counties are overcrowded, those in Cumberland and York are operating under capacity. Yet because counties set their own rates, according to Corrections Commissioner Martin Magnusson, York might have a per-day cost of $45 per prisoner but charge $105. That’s an added tax burden on the sending county.

Maine county jails have additional burdens that raise costs but need to be met: better service for the mentally ill, treatment for substance abuse, and services for women. Over the last three years, county jail budgets have cumulatively risen more than 12 percent annually, as the state prison costs have risen at less than half that rate. New county jail construction — even as some jails have enough space —will keep that rate high.

The governor says the first year projected savings from administrative efficiencies at the jails is conservatively $10 million. He says he believes more consolidation opportunities will push that number higher in future years. Under the governor’s plan, property tax rates would be frozen at their current levels, with added costs picked up by the state in subsequent years. That’s an attractive idea, but the public should be given a better sense of how that would work in both the short and long terms. As more details of the savings are released, this is a good place for legislators and the public to examine the potential of this plan.

The governor says he wants to build public support for this consolidation — a task that should be considerably easier than the one he launched for school-district administration. One way he could do that is to encourage money-saving suggestions from jail personnel, local taxpayers and even county officials who, after all, have been looking at county-level savings possibilities for years.

By raising this issue, Gov. Baldacci offers Maine the chance to save substantially over the long term and to create a higher-quality jail system simultaneously. The desire for this reform should be applauded by the public, but its details should be examined closely over the next couple of months. Done right, property taxpayers, as well as people in jail, could end up better off. Read more!

ValueOptions eliminates 500 jobs -Phoenix (AZ) Republic

By Ken Alltucker
Aug. 30, 2007

About 500 ValueOptions administrative positions will be eliminated this week as a competing provider takes over Arizona's $1.5 billion contract to manage Maricopa County's public mental health system.

Another 1,400 therapists and other ValueOptions clinic workers will become Magellan Health Services employees beginning Saturday when the new provider officially assumes control of the county's mental health services. Magellan hired the clinic employees to ensure a smooth transition for patients.

Yet managers, finance, information technology and other administrative jobs are no longer needed as ValueOptions exits Maricopa County. The Norfolk, Va.-based provider will retain a small staff of claims specialists and other administrative positions to tie up loose ends.

The big switch stems from Arizona's decision this year to award Magellan a three-year, $1.5 billion contract to manage behavioral health services for more than 60,000 low-income and mentally ill patients. ValueOptions held the contract since 1998, but the company was the target of many complaints about its patient care and case management.

Magellan spokeswoman Erin Somers said the incoming provider's top priority is caring for patients.

"We want to make sure the clinics are up and running Sept. 1," Somers said. "Once we get that underway and make sure we are servicing the needs of the consumers, we can take a look at gaps we have in our staffing."

She said that Magellan expects to study its case management staffing levels and decide whether additional managers are needed to ensure quality patient care.

ValueOptions has attempted to keep employees with the company through the end of this month by offering retention bonuses. Some have accepted new jobs at ValueOptions locations in other states. Other employees have already taken new jobs or returned to school.

Ortiz said about 286 administrative employees remained with ValueOptions through this week, mostly workers in the provider's quality management and evaluation departments. The other administrative workers whose jobs were eliminated already moved on.
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Killer's Parents Describe Attempts Over the Years to Help Isolated Son - Washington Post

By Brigid Schulte

Sometimes, Hyang Im Cho would become so frustrated with her son, Seung Hui Cho, that she would shake him. He rarely spoke. And when he did, it was just a few words, barely above a whisper. He never looked anyone in the eye. It was as if he lived walled off in a world of his own. Try as she might -- with countless visits to counselors and psychologists, treatment with antidepressants or art therapy, and attempts to find him friends at basketball camp or taekwondo or church -- no one could break through.

Like any mother, she wanted her son to fit in. Like any immigrant, she felt that no sacrifice was too great to make sure he found a place for himself in this new country, even if it meant overcoming the deeply ingrained stigma in Korean culture of admitting mental illness.

She knew he was troubled and isolated. But it wasn't until her son killed 32 students and teachers at Virginia Tech on April 16 that she knew just how twisted his private world had become.

And how little she knew him.

Hyang Im Cho, along with her husband, Sung Tae Cho, and daughter, Sun Kyung, spoke about Seung Hui Cho to the panel appointed by Gov. Timothy M. Kaine (D) to investigate the Virginia Tech shootings. The panel's report, formally released yesterday, paints the most complete portrait to date of Cho's frail and sickly childhood; his hopeful middle and high school years bolstered by intensive psychological therapy, medication and a supportive school environment; his misplaced aspirations to become a famous writer; and, as that dream slipped away, his descent into madness.

The report also provides for the first time some perspective from Cho's family. They were shocked when they learned of his violent writings. Cho had always been so secretive, typing away on his computer but refusing to share what he wrote. They had no idea that he had been briefly hospitalized at a psychiatric institution during his junior year at Virginia Tech and had been declared mentally ill. The son, the hospital and the court never told them.

"We would have taken him home and made him miss a semester to get this looked at," the Chos told the panel. "But we just did not know . . . about anything being wrong."

Until now, the family's only public comment had been a statement of deep remorse in the days after the tragedy. "We never could have envisioned that he was capable of so much violence," they wrote at the time. The Chos, who own a townhouse in Centreville, have been in seclusion since April. Cho's sister, a graduate of Princeton University, has been on leave from her job as a contractor with the State Department. Wade Smith, the Chos' attorney, who released the statement, did not return repeated phone calls yesterday. Smith arranged for the Chos to meet with the panel for a three-hour interview. Sun Kyung translated, as she had for many of her brother's conferences.

Although the panel said neither it nor the police had uncovered a motive for Cho's rampage, his sister provided a key piece of the puzzle. Cho began his college career as a business information technology major but, by the time he was a sophomore, decided to switch to English, which was one of his weakest subjects. Nevertheless, he was convinced that he could be a great writer. He had written a novel, which he described to teachers as "sort of like Tom Sawyer except that it's really silly and pathetic," the report said.

Later that year, after his sister found a rejection letter from a New York publishing house, she noticed that he became increasingly depressed and detached. His English grades ranged from B's to D's, and his rage grew as he felt no one understood him or his talent.

Life had always been difficult for Cho. As an infant in South Korea, he developed whooping cough and was hospitalized with pneumonia. Doctors told the family that he had heart troubles and, when he was 3, they performed an invasive procedure to examine him. From then on, Cho did not like to be touched.

In Korea, Cho had a few friends he played with. But once the family moved to the United States in 1992 to provide a better education for the children, Cho became more withdrawn. If he talked to anyone at all, it was to his sister. Even then, he would never tell her what he was thinking or feeling. She knew he was being taunted for his accent and inability to speak English, as was she. But whenever she'd ask him about it, he would always say he was "okay."

Even that limited communication disappeared when a visitor came to the home. The family noticed that Cho's palms would become sweaty, he would freeze, would sometimes cry and was able only to nod yes or no. His parents, by then working six days a week at dry cleaners, pressured him to talk. His mother urged him to "have more courage," the report said.

When Cho was still in elementary school, the family decided to "let him be the way he is," the report said.

In 1997, the summer before he entered middle school and on the school's recommendation, the family took Cho to the Center for Multicultural Human Services, where he saw an art therapist and a psychiatrist who diagnosed a severe social anxiety disorder. "It was painful to see," one of the psychiatrists told the panel. The Chos took turns leaving work early to get their son to his sessions every week. In art therapy, Cho made houses out of clay that had no windows or doors. Sometimes, when the therapist explained that his artwork showed how inadequate he must feel, Cho's eyes would fill with tears.

In 1999, during the spring of eighth grade, the clay houses morphed into disturbing caves and tunnels. Cho wrote in a school assignment about wanting to "repeat Columbine." A psychiatrist diagnosed selective mutism -- the inability to speak in certain circumstances because of profound social anxiety -- and prescribed paroxetine, an antidepressant. The drug treatment was discontinued after one year because Cho seemed much improved.

When Cho was at Westfield High School in Chantilly, his inability to communicate and lack of social skills landed him in a special education program designed to help him succeed in school. He was excused from participating in class discussions and received language therapy once a week. The plan enabled him to graduate with a 3.52 grade-point average in a demanding honors program. As a junior, he resisted further therapy. "There is nothing wrong with me," he complained to his parents, according to the panel report. "Why do I have to go?"

When Cho was a senior, his guidance counselor strongly encouraged him to attend a small college close to home. But Cho had his sights set on Virginia Tech, where he was accepted on the strength of his grades and SAT scores. When his school records were sent, as is common practice, there was no mention of the special education provisions or his condition.

At Virginia Tech, he became increasingly isolated and behaved in a bizarre manner, stabbing a carpet with a knife at a party and yelling at a teacher who told him to drop a class. His writing likewise became increasingly violent.

The night before their once-invisible son would become infamous for the worst mass shooting by a lone gunman in U.S. history, the Chos had their weekly Sunday evening phone call with him. It was typical. He was fine. No, he didn't need money. His parents ended with, "I love you."

The report does not say whether Cho answered


Read more!

Filling mental health void a top priority -Gray's Harbor (WA) Daily World

By Steven Friederich
August 30, 2007

A spokesperson for Behavioral Health Resources, an Olympia-based mental health organization, said they stand ready to “cover the needs” of some 900 Evergreen Counseling Center clients, but “whether that will be in the interim or permanently is up in the air.”

In the wake of Evergreen’s decision to close its doors, Grays Harbor County Health Department officials and administrators at Evergreen are exploring options with the CEO of Behavioral Health Resources and the management of another health center.

Evergreen’s volunteer board decided Monday to pull the plug after 39 years on the Harbor, concluding that a funding contract offer from the county would mean laying off 16 staff members — too big a hit for the center “to provide mental health services in accordance with ethical and professional standards.”

Evergreen, which employs 58 people and serves 937 clients, will close on Sept. 30.

Maryann Welch, the county’s director of public health, says she and three staff members will work with the center’s administrators to find alternative mental health counseling providers.

Welch planned to meet today with John Masterson, CEO of Behavioral Health Resources, which has an office in Elma. She said she will also talk with officials at Sea Mar Community Health Centers, a low-income health care provider that has a clinic in Aberdeen.

Behavioral Health Resources already sees 2,000 patients per month and has more than 350 staff members, including several psychiatrists and nurse practitioners. It operates an in-patient hospital and already manages a lot of the services that Evergreen has provided in the past.

Most of its facilities are in Olympia and one question that will have to be resolved if Behavioral Health Resources takes over the bulk of Evergreen’s load is where those services will be provided, on Grays Harbor or in Olympia or some combination of the two. That’s the kind of thing that the health care providers and county officials will be working on.

“This will not be easy, given the short time frame we’ve been provided,” Welch said. “We really need to get a response from both of them (Sea Mar and Behavioral Health Resources) on what they think they can do. And then they have to sit down with their organization and their management.”

Judith Hoefling, the community relations director with Behavioral Health Resources, said her organization already provides some mental health services to East Grays Harbor as well as to Thurston and Mason counties.

“We are the closest, major mental health provider and we will take whatever steps necessary to prepare for an influx of people who need our help,” Hoefling said.

Hoefling said her agency learned of Evergreen’s imminent closure Tuesday morning and immediately started working with county officials and Evergreen management.

Rogelio Riojas, a spokesman at Sea Mar, said he was just hearing about the closure on Wednesday.

“This is very surprising to us that they are closing their doors,” Riojas said. “We will help in whatever way we can, that’s for sure.”

Both Sea Mar and Behavioral Health Resources had been planning to enhance their presence on the Harbor in terms of mental health care, even before Evergreen’s announcement.

Sea Mar had asked the county for funds for two staff people at its Aberdeen clinic. Behavioral Health Resources had asked for money to start a new office in Aberdeen for “consumers who need intense services, which is something Evergreen didn’t provide,” Welch said. (The Daily World incorrectly reported Wednesday that Sea Mar would be providing those services.)

Behavioral Health Resources was offered a $1.3 million contract over a nine-month period starting in October. It is receiving $620,000 for the current nine-month period.

Sea Mar was offered a $160,000 contract starting in October.

Some of that money, routed from state and federal sources, had been going to Evergreen. The re-allocation was done under the watch of county-appointed citizen advisory boards, Welch said.

Hoefling said Behavioral Health Resources had not yet signed its contract. Riojas said Sea Mar would never have applied for the funding, had it known it would be taken away from Evergreen and contribute to the local agency’s closure.

The allocated budget for Evergreen went from about $386,000 per month in 2005 to around $325,000 per month in the most recent contract. The new contract offer was about $293,000 per month or $2.6 million over nine months, starting in October.

Riojas said, “If we had something to do with their closure, we feel bad about it.”

Some wondered yesterday whether anything can be done to keep Evergreen afloat.

Welch said none of the conversations she’s had so far have focused on anything the county could do to save Evergreen. Rather, “we’ve been working with BHR on the issues of transition.”

But if both of the other agencies are willing to take less money to make sure Evergreen stays at their current level of service, would the county go for that?

“Evergreen did not provide us with any information on what it might take to keep them open,” Welch said. “We don’t even know that from them. We gave them the information on what their contract would be, and they responded several days later that they would be closing their door.”

Melissa Fox, interim executive director for Evergreen, said, “Without the funding we had been receiving … if we were to remain open, we would have to reduce by a minimum of 16 direct service providers.”

That wasn’t acceptable to her or the board, she said, noting the local agency was in a “Catch-22” scenario since by cutting funding, that would mean cutting staff and not being able to live up to the county’s contract to provide adequate mental health services.

Welch said the details of Evergreen’s new contracts weren’t yet set up, “We would have expected any reduction in funding would have resulted in a reduction of staff to some extent but we expected there would be a staff increase at BHR and Sea Mar. They would offer different services and BHR, in particular, would increase their services by opening an Aberdeen office.”

Is that better than having a local agency provide mental health coverage?

“I wouldn’t characterize it quite that way,” Welch replied. “We were looking at any mental health agency that meets the requirements to operate under our funding, whether they’re based in Olympia or locally is beside the point. BHR’s services in East Grays Harbor have been very well received and we have been happy with their services.”

Hoefling said Behavioral Health Resources’s new office would be an adult out-patient facility, which could be used by persons with any kind of mental illness, but would likely specialize in helping those with bipolar disease as well as schizophrenia.

“We are very distressed for Grays Harbor and Aberdeen, but we will do what we can to help,” Hoefling said.

Riojas said that at Sea Mar’s clinics, “We try to provide as many services as possible because our patient needs are so high and they need so many services. One of the areas we try to combine is mental health and medicine. … We had no idea that our request for funding was going to impact Evergreen Counseling Services in such a way.”

Does Evergreen’s closure impact you? The Daily World would like to know. Please e-mail sfriederich@thedailyworld.com or call (360) 532-4000 ext. 134. Read more!

A True Madhouse - Princeton (NJ) Packet

By: Susan Van Dongen

A new book details the insanity of the practices performed on patients at Trenton State Hospital in the early 20th century.
image

Even more chilling than the thought of being incarcerated when innocent is the idea of being committed to a psychiatric hospital against one's will. Certainly, these are places where genuine healing can take place, especially now with the breakthroughs in medications. However, the "lunatic asylum" or "bughouse" of the past still conjures a special kind of horror deep down in the gut.

If you've shrugged off those archetypal fears, reading author Andrew Scull's soon-to-be-published Madhouse: A Tragic Tale of Megalomania and Modern Medicine (Yale University Press, $18) will bring you back to full blown disquietude. The meticulously researched book tells the story of Henry Cotton, superintendent of Trenton State Hospital in the early 20th century, whose radical ideas about healing mental illness led to countless deaths and unspeakable anguish among the patients.

Madhouse reveals a long-suppressed medical scandal, shocking in its brutality and sobering in its implications. Convinced that he had uncovered the single source of psychosis, Dr. Cotton launched a ruthless campaign to "eliminate the perils of pus infection." Teeth were pulled, tonsils were excised and stomachs, spleens, uteruses and colons were all sacrificed in the assault on "focal sepsis."

Randall McMurphy and the fictional One Flew Over the Cuckoo Nest crew had it 100 times better than the poor souls at Trenton State.

Warnings of Dr. Cotton's macabre practices fell on deaf ears for years until a legislative committee, led by Sen. William Bright, focused its investigations of waste in state government on the hospital's affairs. That's when a profusion of gothic horrors came into light.

"Ex-patients, their families and disaffected former nurses and attendants had surfaced and a litany of lurid tales had filled the pages of the state's newspapers," Mr. Scull writes. "The scandal had even begun to draw the attention of the august 'New York Times.' Stories of patients being beaten, kicked and dragged screaming into the operating room, of trolleys filled with body parts and not a few corpses streaming in the opposite direction, had aroused the archetypal fears of the horrors of the madhouse that always linger just below the surface in our collective unconscious."

Mr. Scull has written numerous books about the history of treating mental illness, and was working on a tome about "managing lunacy" in Victorian England when he stumbled on a small item about therapeutic practices in the first part of the 20th
century.

"Most of the treatments from those times were ill-conceived and have now been abandoned," Mr. Scull says, speaking from his home in San Diego. "I've (written about methods) such as electric shock therapy, lobotomies and insulin comas. Scientists have wondered where the origins of these illnesses came from and tried all sorts of things. Unfortunately, patients' rights were (weak) up until World War II.

"I came upon a reference or two to Henry Cotton, and over the years collected a number of materials," he adds. "Some of my Princeton contacts happened to know people in the New Jersey mental health bureaucracy and that got me access to a lot of hospital records."

With training at the University of Maryland and Johns Hopkins, Dr. Cotton apprenticed in psychiatry at the Sheppard and Enoch Pratt Hospital in Baltimore under the eminent Princetonian Stewart "Felix" Paton. He later obtained an even more prestigious post at the Worcester State Hospital (Worcester, Mass.) under Swiss neuropsychiatrist Adolph Meyer, himself educated in Zurich, Paris and London. Indeed, Trenton State, which had been mismanaged for years, was fortunate to get someone with such excellent scientific credentials.

Dr. Cotton began as a reformer and a progressive, with at least a few humane ideas about treating patients, for example, abolishing restraints.

"He wanted to solve the riddle of psychosis, but he was also in despair about the state of mental hospitals he encountered and wanted to find a way forward," Mr. Scull says. "Some of the reforms included doing away with restraints and re-training his doctors. Then he happens upon this idea of focal infections, poisons in the bloodstream that are affecting the brain.


"Once he's become convinced of something, he blinds himself to anyone else's theories," Mr. Scull continues. "If you're pulling out their teeth and they get better, well that's OK. If they don't get better, (the infection) must be somewhere else in the body, or he thought, 'it was too late, that's why this person didn't get better.' (For scientists like Dr. Cotton) you can find ways to explain why the treatment didn't work. The danger always was therapeutic enthusiasm."


One of the most disturbing facts that comes to light in Madhouse is the disproportionate number of women who were operated on.


"Cotton had three well-equipped operating services, two for women and one for men, which are busy most of the time," Mr. Scull writes.


One good — or terrible — example is former patient Mrs. Georgiana Phillips. During Dr. Cotton's trial, she appeared, stating that she had been committed on the grounds of "immorality, indigency and moral insanity" — in other words, prostitution.

Claiming that she had been sane when shut away and in direct violation of her wishes — and a court order — Mrs. Phillips had been "compelled to undergo a delicate operation while a patient at the state hospital."

"He removed her ovaries," Mr. Scull says. "This was also a pattern when you look at lobotomies. This is conscious gender bias at work. It's not that men were exempt from this, but among women patients 60 to 65 percent had their colons removed. Even with gender neutral parts of the body like the colon, women seemed to fall into (Dr. Cotton's) clutches."

You might wonder how one would digest and eliminate food without a colon, and Mr. Scull remarks that a patient would simply be left incontinent.

"This accounts for many of the deaths," he says. "This was murderous. There was nearly a one in two chance for death."

Dr. Cotton had almost a fetish about pulling teeth. He removed the teeth of his two sons — both of whom would go on to commit suicide — and even had his own removed.

"This is someone who genuinely believes in what he's doing," Mr. Scull says, adding that a visitor to Trenton State, who came from Johns Hopkins, observed room after room of patients with no teeth, but also no dentures. "Because they couldn't chew their food, they were malnourished. In fact, during those times, in New Jersey, if you didn't have any teeth, people suspected you had been at Trenton State."

Mr. Scull is a professor of sociology and science studies at the University of California in San Diego. He is the author or co-author of nine books, the most recent (before Madhouse) being Customers and Patrons of the Mad Trade: The Management of Lunacy in Eighteenth Century London (University of California Press, 2003), which he co-wrote with Jonathan Andrews. He earned his doctorate in sociology from Princeton University in 1974.

Even with the gruesome pseudo-science and the growing number of casualties at Trenton State, Mr. Scull writes that until the news spread, families cheerfully sent their kin to be treated.

"There was a belief that mental illness was a biological problem and could be treated," Mr. Scull says. "Very wealthy and intelligent people brought their family members to these centers. Yale professor and economist Irving Fisher brought his daughter to Trenton State for treatment and Cotton killed her."

Mr. Fisher had been an advocate of vegetarianism, exercise, hydrotherapy and paying attention to healthy bowels. In fact, he was good friends with John Harvey Kellogg and took his family to Kellogg's health center in Battle Creek, Mich.

"He only wanted the best for his child," Mr. Scull says. "That case in particular helps us understand how educated people saw the logic in (Dr. Cotton's practices). But patients were so vulnerable and controls were non-existent. Medical treatment has changed some, but even today patients put themselves in the hands and the mercies of doctors. These days, though, there are reviews and we can pull back if we decide we don't want a treatment. (In Dr. Cotton's time), once patients had been certified as mentally ill, they lost their rights as a person, lost their autonomy."

Andrew Scull's Madhouse: A Tragic Tale of Megalomania and Modern Medicine will be available in bookstores and online at www.yalebooks.com beginning Sept. Read more!

Funny, inspiring documentary helps mentally ill battle stigma - Ottawa Canada Citizen

It's hoped that a video link to this documentary will be posted once it is posted on the Canadian Broadcast System website.

Tony Lofaro, Ottawa Citizen
August 29, 2007

A woman dressed in a wedding gown walks up to a microphone. She's clearly nervous as she faces the audience in what appears to be a comedy club.

"Did you ever get the feeling you're supposed to be somewhere else," she deadpans, eliciting chuckles.

This is Eufemia Tantetti, one of the people featured in the new documentary, Cracking Up. She's not a professional comedian. In fact, she is a victim of childhood abuse and has battled clinical depression most of her life. Her mother was schizophrenic.

The fact Ms. Tantetti is able to face strangers speaks highly of her courage and the success of a course she participated in that helped her battle her demons through standup comedy.

Cracking Up follows a year in the life of 11 people who suffer from mental illness and use laughter as therapy. The documentary airs tonight at 9 p.m. on CBC.

The documentary is funny, inspiring and insightful as it shows the progress of these individuals who have no formal training in comedy but, through steady reinforcement and encouragement, take to the stage.

Their success as performers is largely attributed to Vancouver's David Granirer, a standup comic who fought depression for about 15 years and is on medication. In his course, he coaches people with mental illness to confront their disease through standup.

"Part of the healing capacity of the course is that they take incidents they're ashamed of, turn them into standup comedy, tell them to people and then have audiences afterwards tell them how wonderful they were," said Mr. Granirer, 46, in a telephone interview from Vancouver.

"All of a sudden they feel, 'I'm not such a bad person after all and people can relate to me.' It really helps to diffuse a lot of the shame they have."

Mr. Granirer is the founder of Stand Up for Mental Health, a Vancouver-based group with chapters in several Canadian cities, including Ottawa.

He says people in his course have a desire to perform standup, but they also have a commitment to "fight the public stigma" of mental illness. He says the participants in the documentary felt it was part of their "contribution to the mental health community" to bring about a better understanding of the disease.

Some of those in the documentary are Robbie Englequist, a schizophrenic, Michael, who is bi-polar and has attention deficit disorder, and Paul, who suffered a traumatic injury to his brain and spine after he fell from a balcony when he was two years old.

"When I had met Robbie, he had come through years of failure, he was frightened and withdrawn," said Mr. Granirer.

"But as the year progressed, he completely changed. It's like he came back to life. His mom says he has something to live for now and he's changed in his attitude about things."

Mr. Granirer says Robbie has developed a resilience to his personality, he's more confident and feels that he's accomplished something after going through the comedy course.

"And for the first time in his life, he's getting attention for doing something positive, instead of getting attention for getting in trouble, fighting or doing drugs." Read more!

No simple solutions to issues of mental illness-Denver Post

Editorial:
08/29/2007

The University of Colorado needs to walk a careful line between protecting its students and needlessly stigmatizing the mentally ill in the wake of a shocking attack in a student cafeteria outside University Memorial Center.

Indeed, all of society needs to practice the same balancing act between prudence and persecution.

A cashier at the Alferd Packer Grill in the UMC, identified as Kenton Astin, 39, was arrested for using a steak knife Monday to slice the throat of a freshman student. Astin then stabbed himself repeatedly before police subdued him with a stun gun. The victim, Michael George Knorps, 17, is expected to recover. Astin was hospitalized in serious condition.

In the wake of the attack, the university announced it would undertake criminal background checks on all new employees, a prudent move. It also suspended, with pay, all employees who had been recommended by the Mental Health Center of Boulder County - the agency that referred Astin to CU - until they can be checked out.

With the benefit of hindsight, there is much in Astin's background that could have warned the university that he could pose a threat to other people and to himself. Astin was arrested in Longmont in 2001 for a similar, unprovoked knife attack on a citizen. If a further red flag was needed, the fact that he used several aliases during that period - including that of Dylan Klebold, one of the two perpetrators of the mass killings at Columbine High School - would have served nicely.

Astin later was found not guilty of the Longmont stabbing by reason of insanity and sent to the state mental hospital in Pueblo, which released him two years ago to the supervision of the mental health center. CU officials said he had a good work record prior to the attack but would not have been hired if the university had known about the previous attack.

Which, of course, raises a very good question: Why wasn't the university told about that incident and other pertinent parts of Astin's record?

Unfortunately, not all good questions have good answers - let alone easy ones. Mental health experts must continually balance issues of patient privacy and public safety. It's clear, after the fact, that this time they leaned too far toward protecting Astin. But it is equally clear that unless the mentally ill are to be locked away for life, there must be some way of treating them and eventually re-integrating them into society. One of the most important steps is getting recovered patients back to gainful employment.

At this point, the issue of patient privacy stops being merely an ethical issue and assumes a pragmatic dimension. If knowledge of past offenses is too widely disseminated, it may preclude the patient from getting a job. If such knowledge leaks into the general community, it can be damaging.

Clearly, past violent acts should be disclosed to potential employers, along with current diagnoses and treatments. But employers, in turn, must treat such information with the utmost respect and use it to channel the formerly mentally ill into jobs suited to their current behavior, not refusing to hire them at all. Read more!

No simple solutions to issues of mental illness-Denver Post

Editorial:
08/29/2007

The University of Colorado needs to walk a careful line between protecting its students and needlessly stigmatizing the mentally ill in the wake of a shocking attack in a student cafeteria outside University Memorial Center.

Indeed, all of society needs to practice the same balancing act between prudence and persecution.

A cashier at the Alferd Packer Grill in the UMC, identified as Kenton Astin, 39, was arrested for using a steak knife Monday to slice the throat of a freshman student. Astin then stabbed himself repeatedly before police subdued him with a stun gun. The victim, Michael George Knorps, 17, is expected to recover. Astin was hospitalized in serious condition.

In the wake of the attack, the university announced it would undertake criminal background checks on all new employees, a prudent move. It also suspended, with pay, all employees who had been recommended by the Mental Health Center of Boulder County - the agency that referred Astin to CU - until they can be checked out.

With the benefit of hindsight, there is much in Astin's background that could have warned the university that he could pose a threat to other people and to himself. Astin was arrested in Longmont in 2001 for a similar, unprovoked knife attack on a citizen. If a further red flag was needed, the fact that he used several aliases during that period - including that of Dylan Klebold, one of the two perpetrators of the mass killings at Columbine High School - would have served nicely.

Astin later was found not guilty of the Longmont stabbing by reason of insanity and sent to the state mental hospital in Pueblo, which released him two years ago to the supervision of the mental health center. CU officials said he had a good work record prior to the attack but would not have been hired if the university had known about the previous attack.

Which, of course, raises a very good question: Why wasn't the university told about that incident and other pertinent parts of Astin's record?

Unfortunately, not all good questions have good answers - let alone easy ones. Mental health experts must continually balance issues of patient privacy and public safety. It's clear, after the fact, that this time they leaned too far toward protecting Astin. But it is equally clear that unless the mentally ill are to be locked away for life, there must be some way of treating them and eventually re-integrating them into society. One of the most important steps is getting recovered patients back to gainful employment.

At this point, the issue of patient privacy stops being merely an ethical issue and assumes a pragmatic dimension. If knowledge of past offenses is too widely disseminated, it may preclude the patient from getting a job. If such knowledge leaks into the general community, it can be damaging.

Clearly, past violent acts should be disclosed to potential employers, along with current diagnoses and treatments. But employers, in turn, must treat such information with the utmost respect and use it to channel the formerly mentally ill into jobs suited to their current behavior, not refusing to hire them at all. Read more!

Insanity ruling cleared suspect in 2001 assault -Denver (CO) Rocky Mountain News

By Berny Morson, Hector Gutierrez And Justin Coons
August 28, 2007

For Dylan Trembly, Monday's attack on a student at the University of Colorado was a grim and eerie rerun.

Trembly, 27, was stabbed six years ago. His knife-wielding attacker had an evil look in his eye and mouthed words about how everyone was "going to burn in hell."

The man was Kenton Astin, the same man held Monday in the stabbing of CU student Michael Knorps.

Astin was acquitted by reason of insanity in the 2001 attempted murder of Trembly.

"I couldn't believe it, you know," Trembly said after he learned of Monday's incident. "It blew me away. I haven't thought about it in a while."

Trembly still has scars on his left ankle and right hand from where Astin stabbed him without provocation inside a Salvation Army store in Longmont.

"He was just giving me the evil eye, and I was like, 'whoa,' " Trembly remembered as he juggled his 2-year- old son, Wyatt, on his knees. "Apparently, he was waiting for the perfect person."

Without saying a word, Astin charged Trembly, knocked him to the ground, stabbed him and tried to choke him. Trembly said he managed to wrestle the knife away from Astin, slash his assailant's cheek and gain the upper hand.

"He pulled out a Bible and started saying, 'We're all doomed . . . We're all going to burn in hell.' Apparently he thought I was the devil," Trembly said.

Astin was charged with attempted homicide and was sent to the Colorado Mental Health Institute in Pueblo. In October 2005, he was released to a halfway house at 748 19th St. in Boulder, on the edge of the University Hill neighborhood.

University of Colorado Chancellor Bud Peterson said Astin was employed at the university as a cashier at the Alferd Packer Grill from October 2006 through April. Chinook Clubhouse, a Boulder- based nonprofit that helps find employment for mentally ill men and women, had referred Astin to CU.

Peterson said Astin was not given a background check before starting work and that the school does use such checks, but at different degrees depending on employment. All Chinook-referred employees will be placed on seven-day suspension, pending review of their backgrounds, he said.

Astin had no criminal record while at the halfway house. A Boulder judge in April placed Astin on "conditional release," a status that requires less supervision and indicates that the court agreed he was doing well, said Liz McDonough, spokeswoman for the Colorado Department of Human Services. He had to continue to live at the halfway house and receive treatment at the Boulder Mental Health Center.

Trembly said he holds no animosity toward Astin, but saidthe second attack involving the same culprit is a wake-up call to the mental health profession.

"The poor man needs help," Trembly said.

morsonb@RockyMountainNews.com or 303 954-5209

Read more!

Mental disorders leading cause of homeless hospital visits - Toronto (Cananda) Globe & Mail

By ANNE-MARIE TOBIN
August 30, 2007

TORONTO — More than half of hospital stays by homeless Canadians are a direct result of mental disorders, suggests a study of mental health and homelessness released Thursday.

The report by the Canadian Institute for Health Information describes homelessness as a "harsh reality" for more than 10,000 people staying in shelters on any given night in Canada, and provides an overview of research and interventions for people living on the street and in shelters.

In particular, it pulls together hospital data on admissions in 2005-06, and the reasons behind them.

"This is the first time we're tracking this kind of information," Elizabeth Votta, an author of the report, said from Ottawa.
Internet Links

* CIHI report: Homeless and hospitalization Popup

The Globe and Mail

"It's data that's collected from Vancouver, Calgary and Toronto — primarily Toronto because that's the way the database is set up — but what it's telling us is that 52 per cent of homeless persons that are being hospitalized are being done so for mental disorders ... and that's much higher than the general population, which is coming in at five per cent."

A portion of the report looked at selected emergency rooms, mostly in Ontario, and found that 35 per cent of visits by the homeless were related to a mental disorder. Substance abuse accounted for 54 per cent of those mental disorders, followed by psychotic disorders, such as schizophrenia, at 20 per cent.

The report notes Aboriginal Peoples are over-represented among the homeless in cities across Canada, and men comprise three-quarters of the hospital visits by the homeless.

"One of the things from a stigma point of view that we want to get across is that not everyone who's mentally ill is going to become homeless, and not everyone who's homeless has a mental illness," said Ms. Votta.

"But we do have to recognize that there is that higher prevalence of mental illness and compromised mental health among the homeless."

Bill Wilkerson, co-founder of the Global Business and Economic Roundtable on Addiction and Mental Health, expressed impatience with the report, which noted homelessness is linked to stress, low levels of self-esteem and suicide.

"We have known for 25 years what this report is telling us yet again," he said. "So it's time for action, not time for more study."

Mr. Wilkerson was involved in a task force that scrambled to find housing for mentally ill people who were deinstitutionalized in Ontario in the early 1980s.

"The only difference, I think, is the problem then was new. Now it's old," he said from his home in Port Hope, Ont.

"I think we have studied this problem into the ground ... I think the city of Toronto, the city of Vancouver should both say, as a matter of public policy, living on the street is unacceptable," he added.

"We need a combination of tough love and community support, housing and drug treatment support measures, and a whole ton of compassion to resolve this issue."

Beric German of Street Health, an organization in Toronto that provides health care at shelters and on the streets, said one in five people in Canada will have a mental-health issue in their lifetime.

He noted that many people who are homeless develop mental-health problems after landing on the streets.

"In reality, the extreme stress of being homeless can cause mental-health issues, certainly can lead to depression," he said.

"You don't get enough food. You don't get enough sleep. You're in a worse situation in regard to being possibly assaulted. If you're very, very stressed out, it's very common in this country to reach for a bottle or to reach for some drug to kill the pain. And people do that. And sometimes they kill the pain too much and they end up in an emergency ward."

Homelessness can often be traced to the lack of a job and affordable housing — and German said this is something that any Canadian could face.

"There's a tremendous prejudice out there around mental health. ... They see people sometimes who are in terrible shape, and they think that somehow that person can be dismissed."

He called for a comprehensive health-care system that would provide housing, support, income and nutritious food for those who need it.

Ms. Votta said it's hoped the CIHI report will increase awareness and discussion about homelessness and foster a broader look at interventions, such as providing housing.
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Mental Health Gets Axed -Santa Barbara (CA) Independent

County Scrambles to Find Replacement Funds

Commentary: By Nick Welsh
August 30, 2007

In a case of toxic trickle-down, county mental health officials now find themselves pressed to find $1.4 million to fund a successful program that keeps mentally ill homeless people off the streets. Governor Arnold Schwarzenegger axed funding on August 25 as part of Sacramento’s convoluted and dysfunctional budget dance: In order to get the Republican votes needed to pass his budget, the governor agreed to cut $700 million from the $145-billion budget. Among the most controversial casualties was the $55 million that funded the mentally ill homeless program, created in 1999 by Assembly Bill 2034. It was from that pot of gold that the county’s $1.4 million came, funding services for 120 clients a year. Statewide, 4,700 people benefit from the program.

Given the chronic fiscal woes confronting the county mental health department — a surprise $5-million shortfall was found earlier this year — there’s no obvious substitute funding source. The governor’s aides argue that counties could use funds generated by Prop. 63 — the tax on millionaires benefiting mental health services, which voters approved in 2004 — but the language of Prop. 63 prohibits using its revenues to supplant existing mental health operations. And a statewide coalition of mental health advocates has already threatened legal action. Besides, noted county spokesperson William Boyer, the Prop. 63 money is already allocated for other services.

By all accounts, the programs funded by AB 2034 have been uncommonly successful, providing a wide range of housing, health, and job support services to the mentally ill homeless. In fact, three years ago, Schwarzenegger himself bragged about the program’s effectiveness while on a trip to Washington, D.C. According to the state’s own figures, those now enrolled in the program have experienced 81 percent fewer days locked up, 65 percent fewer in psychiatric institutions, and 76 percent fewer on the streets. In Santa Barbara, the numbers are similarly impressive. According to Roger Heroux — former director of the county Public Health Department, who now administers Santa Barbara’s federally mandated “10-year plan to end chronic homelessness” — the loss of funding would seriously hamper the effort to address the problem. Already, he noted, Santa Barbara County has more animal shelters than homeless shelters and only 12 detox beds. In fact, Heroux discovered that county law enforcement and health agencies spend roughly $40 million a year dealing with homeless people, “with nothing to show for it.” Heroux argued that housing the homeless and helping them become self-sufficient would cost dramatically less than jailing, hospitalizing, or institutionalizing them.

AB 2034 was authored by then Assemblymember Darrell Steinberg. Based on its success, Steinberg — now a state senator — also authored Prop. 63, which included language to make it legally impossible for counties or the state to use its revenues to cover ongoing mental health programs. “The whole idea was we wanted more mental health services, not just a different funding source for existing services,” explained Jim Evans, Steinberg’s spokesperson. Evans noted the state budget preserves a controversial tax shelter on yacht sales that costs the state $45 million a year.

Meanwhile, it remains uncertain how long the county can or will pick up the state’s slack. At an August 28 meeting, Telecare — the private company that provides these services for the county — announced its contract remains intact despite the lack of funding. It was not clear, however, whether Telecare had the funds needed to maintain the housing required by its clients. County mental health officials said they were evaluating their options, but were wary of a suit by advocates if Prop. 63 funds were used to sustain current programs. And there was some indication that mental health advocates might not sue, based on news from the state Department of Mental Health that $50 million in “unallocated administrative reserves” associated with Prop. 63 had just been discovered. While the advocates are confident they would prevail in court, they also recognize such a strategy would last five years. By then, the program would surely be dead. Read more!

Mississippi Supreme Court to allow Thorson to argue mental retardation - Associated Press

By JACK ELLIOTT JR.

JACKSON, Miss. -- Inmate Roger Eric Thorson will be allowed to argue before a Harrison County judge that he is mentally retarded and his death sentence should be tossed out, the Mississippi Supreme Court has ruled.

Thorson was sentenced to death for killing a former girlfriend on the Gulf Coast in 1987.

He was convicted of capital murder in 1988 in Harrison County in the death of Gloria McKinney, a Biloxi mall cafeteria co-worker whom he dated. The state Supreme Court overturned Thorson's conviction because prosecutors excluded potential jurors based on their religious preferences.

Thorson was tried again in 2002, convicted and sentenced to death. The state Supreme Court upheld the second conviction in 2004.

The U.S. Supreme Court declined to hear Thorson's appeal in 2005.

Thorson raised the mental retardation issue in a post conviction petition with the Mississippi high court. Inmates use post conviction petitions to argue they have found new evidence that might win them a new trial.

The U.S. Supreme Court ruled in 2002 in a Virginia case that it's illegal to execute people who are mentally retarded. The court said it would be a violation of the Eighth Amendment prohibition of "cruel and unusual punishment" to execute anyone with a combined IQ of 75 or lower.

In dispensing with dozens of mental retardation claims from Mississippi's death row, the state Supreme Court has required the inmates to produce an expert opinion that the defendant possessed an IQ of 75 or below and that further testing showed the inmate was not malingering.

The Mississippi court on Thursday dismissed prosecutors' arguments that Thorson should have raised the mental retardation issue when he appealed his second capital murder conviction.

Justice George C. Carlson Jr., writing Thursday for the state Supreme Court, said the justices did not set out the procedure on how inmates were to pursue mental retardation claims until after Thorson had appealed his conviction. Carlson also said Thorson was convicted before the U.S. Supreme Court ruling in the Virginia case.

Carlson said the Mississippi court had made it clear that a person convicted before the U.S. Supreme Court decision "could not be denied the opportunity to present his mental retardation claim to the trial court where he had demonstrated that his IQ fell within the range of possible mental retardation, and he had presented an affidavit of a mental health care professional that he suffered from 'mild retardation.'"

Carlson said Thorson had met those criteria. Read more!

Vietnam vets ask senators to back mental health funding - Associated Press

By JOHN MILBURN

Associated Press Writer

TOPEKA, Kan. (AP) -- Ray LaFon knows about the mental problems veterans returning from Afghanistan and Iraq may face. He has lived with his own for nearly 40 years.

LaFon, a Vietnam veteran with the 101st Airborne Division, couldn't shake the images of war. His problems cost him a marriage, businesses and countless other relationships.

"My second wife was about to divorce me. I was an absolute wreck, carried a loaded gun around all the time," he said.

The 59-year-old Basehor resident joined other veterans and clergy in urging Republican Sens. Sam Brownback and Pat Roberts to vote for a spending bill in Congress financing mental health programs for veterans and their families.

The veterans spoke of returning from an unpopular war in Vietnam to little support. Because of their experiences, they said, they understand the horrors soldiers face in Iraq, which they called a "quagmire."

LaFon served in a medical evacuation unit and became used to hosing blood out of helicopters and repairing bullet holes after missions.

But one incident scared him. LaFon was calling in a chopper to pick up a wounded soldier, having been told the landing zone was clear. It wasn't; a rocket-propelled grenade hit the chopper. Three of his best friends died, and a fourth was severely wounded.

LaFon had no way of knowing that the enemy had moved in, but for years felt responsible for the three deaths.

"They had to watch me for awhile. I carried all that guilt. I did my job. It could have been a matter of seconds," LaFon said. "The guilt really hurts."

LaFon said he is doing better, having been diagnosed with a full disability for post traumatic stress disorder. He got help from the Veterans Administration and found a support group of fellow veterans to lean on. His second marriage has recovered, and he is retired.

"I cannot have stress in my life whatsoever, because I have PTSD so severe that any stress might cause me to do something stupid," he said. "I still have a lot of problems. I relapsed once, but I have the tools now to deal with it. I came back."

The Senate expects to debate the funding bill after it returns Tuesday from a recess. Calls left with the senators' offices were not returned.

Veterans said they decided to speak out after a recent Army report found its suicide rate is climbing.

The Army had 99 suicides in 2006, the highest rate since it began tracking the statistic. Thirty were by soldiers in Afghanistan or Iraq and about half were soldiers who hadn't hit their 25th birthday. Failed marriages and relationships were blamed in up to 80 percent of the cases.

While numerous programs have been put in place in recent months to help soldiers still in uniform, the veterans said more must be done to help those who are now civilians.

Tim Saknit, leader of Pointman Ministries in Leavenworth, struggled for years with his own PTSD. He was in the Army and spent a year in Vietnam, starting in April 1969. Alcoholism and drug abuse caused him to lose contact with friends and family.

His life changed when he went to the PTSD Center at Topeka Veterans Administration hospital, where he met LaFon. Though he said he still has relapses, support from fellow veterans and his ministry helps him get by, Saknit said.

"If you don't come in and get help with it, it gets worse. Trying to get these young guys to understand that is rough," Saknit said. "I've got my ups and downs. I don't have to drink anymore. I have my medication, breathing exercises, meditation, reading the Bible."

Gary Sanford, a retired Army colonel and chaplain and now pastor of Rock of Ages Chapel in Leavenworth, said increased federal funding for mental health programs is critical to help communities serve veterans of all wars.

"We came home from 'Nam and got no support whatsoever. If we turn down and veto this bill, I'm telling you, we're doing the same thing to our vets now that was done to us 30 some years ago," said Sanford, who served 30 years in the Army, from Vietnam to Desert Storm.

"Every day we're asking for money to fight the war, and I support that 100 percent. But we need to put our money where our mouth is supporting those who are coming back." Read more!

Mental health services lagging -Greensboro (NC) News & Record

By Mark Binker
Aug. 30, 2007


RALEIGH — Some mental health patients find it hard or impossible to get the services they need because government officials and private providers have struggled to keep up with the rapid pace of changes demanded by North Carolina's mental health reform effort, according to a consultants report released Wednesday.

The 91-page document does point to some successes, but is clear that the state needs to move rapidly to fix "gaps" in the system.

Most of its criticism revolves around a central theme: The pace of change has focused state and local governments on remaking the bureaucracy while leaving some mental health consumers unable to find care.

"In the rush to complete structural changes, the public partners have lost sight of the effect on consumers," the report says. "(T)here has been insufficient joint effort at resolving consumer access problems."

The report was drafted by Alice Lin, a consultant for the state Division of Mental Health. She was at one time a staff member at the General Assembly and helped write the original reform law in 2001.

That remaking of the state's mental health system was in part an effort to save money and was aimed at plugging gaps that prevented some people — for example, substance abusers and the very poor — from getting services. The idea was to better target public money to those in need and to allow government agencies to focus on oversight. Private providers, many of them nonprofits, would be leaned upon to provide the actual treatment.

Lin's report points to some things the state has done well, such as providing more money to the mental health system and giving consumers a voice in structuring the system.

"For 85 percent of consumers, things have gone well," said Leza Wainwright, deputy director of the Division of Mental Health.

The report compares North Carolina's efforts to those of other states that have taken on reform. It points out that other states such as Georgia, Ohio, Pennsylvania, and Texas have spent decades to perfect changes in their mental health system.

"It was somewhat comforting to read the pieces about what other states have done and how long it took them to do things," Wainwright said. "That makes me feel a little bit better about where we are."

But, she quickly said, the report's more critical findings also were correct.

"There are some areas where there have been some slippages," Wainwright said. In particular, she acknowledged the pace of change has forced the agency and its county partners to focus more on process and structure and less on how policies have affected individual consumers.

"That is a valid criticism," she said.

There are 25 local management entities, or LMEs, that work with the division throughout the state. They are local agencies responsible for channeling consumers to the right care. Some are made up of several counties while some, like Guilford County's, stand alone.

Because it was released Wednesday, no one at the Guilford Center had a chance to review or comment on it, said Penny Casto, a spokeswoman for the agency.

Guilford County was not one of the seven local agencies studied directly by the report's author, but the findings are thought to hold statewide.

"From our perspective, this report was way, way past due," said John Tote, executive director of the Mental Health Association in North Carolina, an advocacy group. A comprehensive checkup on how mental health reform was going should have been completed one or two years into the process, not six years on, he said.

Tote said that he, too, was still reviewing the report's findings but said at first blush the report was consistent with problems his agency has seen.

"You've got providers that can't keep up with the pace of reform," Tote said.

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Findings
A recent consultant’s report gave an overview of how the state was doing with mental health reform. The summary included things the state was doing well and problems that needed to be addressed:

The good

More funding support has come to the public mental health system

Local agencies have performed well in establishing a consumer voice through the Consumer and Family Advisory Committee

There have been small and incremental improvements to the delivery system; working relationships at the staff level between the Department of Health and Human Services and local management entities, or LMEs, have been constructive

Local mental health agencies have brought new local, innovative practices, in preserving public psychiatry presence in areas with recruitment and retention challenges, and in collaboration with local hospitals

The bad

In the rush to complete structural changes, the public partners have lost sight of the effect on consumers; there has been insufficient joint effort at resolving consumer access problems

The pace and number of changes have been too fast and numerous, especially during the last two years, resulting in instability and insecurity about the future

There are inconsistent practices across the LMEs in management of state funds, and insufficient tools for LMEs to improve consumer access, monitor the provider network, and develop expertise as a management entity.

LMEs need to develop a common agenda so that meaningful dialogue with the public and private partners can take place


Contact Mark Binker at(919) 832-5549 or mbinker@news-record.com Read more!