Keeping doors open - Charlotte Observer

EDITORIALS

State can't afford another mental health reform fiasco

If we've learned anything from the six-year effort to reform North Carolina's mental health system, it's how dangerous it is to stop providing some services without making sure new programs that replace them are not just available, but working right as well.

The same thing goes for adequate facilities. That's why the state would be wise to keep the doors open at Dorothea Dix hospital in Raleigh after the new Central Regional Hospital opens in Butner next year. The sad story of the state's mental health reform efforts has centered on the inability of existing mental health hospitals to serve many patients for longer than a brief stay.

The new hospital, which is intended to replace both Dix and John Umstead hospital in Butner, is supposed to have adequate space for current daily demand of more than 500. It also will have access to a patient overflow facility operating on the Umstead campus that can handle 117 patients. But state legislators are wise to make sure the new hospital can handle the patient load before it opens and the old hospitals close.

In addition, officials in Wake County, the state's second most populous, are interested in keeping Dix's doors open for at least several years longer. They want to make sure local mental health patients have a place to go and that local mental health services have a place to operate. The need includes short-term care such as substance abuse treatment programs and therapists to work with patients.

Keeping Dix open longer may get in the way for local groups hoping to turn the remaining 306-acre Dix Hill property into a new local or state park to attract and accommodate Capital City visitors. But there's no reason the hospital cannot continue to operate as a mental health facility while the campus makes a transition to a formal park. Its shady green grounds already serve many local residents in a park-like setting, and a shared arrangement may serve everyone's needs.

But local and state policymakers must get it right this time. The reforms instituted in 2001 were intended to shift responsibility for mental health services to local communities, boosting local service givers as well as private treatment options. But too often those services have not been in place to treat patients. Some programs have engaged untrained workers and provided shoddy or nonexistent services. It's an embarrassing mess.

Budget problems have also contributed to the troubles, but money alone won't fix what's wrong. This time the state must make sure that providers are lined up, services are set to go and that the system is ready to work for the patients who need help and for the taxpayers who pay the freight.
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Cherry Hospital won't face federal payment suspension - Associated Press

GOLDSBORO, N.C. - The federal government won't cut off funding to treat patients at a state mental hospital after officials there addressed concerns about the quality of patient care, a state spokesman said Friday.

Inspectors from the Centers for Medicare and Medicaid Services told officials at Cherry Hospital in Goldsboro they would recommend lifting its "immediate jeopardy" status, according to the state Department of Health and Human Services.

The center told the department earlier this month that it was considering a halt to reimbursing expenses for Medicaid and Medicare patients effective Sunday because of incidents at the hospital.

One involved a patient escape, while another involved failing to provide timely emergency care to a patient. None of the incidents resulted in injuries.

State mental health officials presented a plan to correct problems that were uncovered, but the inspectors visited the hospital again Friday before making the decision, said Mark Van Sciver, a spokesman with the Department of Health and Human Services.

"The staff of Cherry Hospital worked diligently to correct the deficiencies ... and we remain committed to providing the finest mental health care to the people we serve here in the eastern region of the state," said Dr. Jack St. Clair, the hospital's director.

Meanwhile, the state mental health division is trying to restore Medicaid and Medicare patient payments to Broughton Hospital in Morganton after a patient death and fall. The state said this week that hospital staff would be reorganized to improve clinical staff supervision.

The state announced on Aug. 31 the payment suspension at Broughton, which could cost the state $1 million per month.


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Dix dilemma - Raleigh News and Observer

County officials need for the Dorothea Dix mental hospital to stay open. At this point, that is the logical alternative

The plan to close Dorothea Dix Hospital, the historic treatment center for the mentally ill near downtown Raleigh, early next year made sense on one level. Treatment for some patients would be moved to care options closer to their homes. Others who still needed hospitalization would be accommodated in a new, smaller facility in Butner.

Unfortunately, for the plan to work, many things needed to fall into place, and they haven't. Other care options have been hard to find and coordinate. Jails still handle way too many people who should be in mental hospitals under intense care, and in many counties, there are shortages of other services. In Wake County, which has sent more people to Dix than any other, the situation amounts to a crisis, which is why county officials have called upon the state to keep Dix open after the scheduled opening of the Butner hospital.

Wake needs the space to provide local services for people who need short-term treatment. So keeping the hospital open, at least on a limited basis, is a logical option for now, and the state should grant the request. "If Dix is going to close, it certainly can't close under the current conditions," said state Rep. Deborah Ross of Raleigh -- an entirely reasonable view.

Good intentions surround the plans to localize care. But the task of finding help for people, particularly for those who can't pay for it, has proved burdensome. Dempsey Benton, former Raleigh city manager and now state secretary of the Department of Health and Human Services, acknowledges as much. He seems inclined to face the reality of adjusting schedules and the like in order to make the state's mental health care system more effective, and that's good.

State reports on the status of hospitals and community care options suggest the problems by omission. Legislators who have been working on the transition to local care and the closing of Dix, along with the opening of the new hospital, rightly point out that the state hasn't met its obligation to offer adequate information about what counties are doing to attract mental health care providers close to home. If that isn't done, then by law the state isn't supposed to close Dix hospital.

Wake County, and others too, must continue to be vigilant in looking for those providers, anticipating the closing of Dix even if it doesn't happen on schedule. And the legislature will have to be realistic, too, understanding that the transition to localized care may require more state help than lawmakers first thought.

The mentally ill deserve to have good-quality care, just as the physically ill do. And proper treatment can help many of them who otherwise might be institutionalized instead lead productive and independent lives.

In that sense, ensuring they have good care is an investment by the state, not just an expense. The goal of reaching that point is thus in the interest of local and state officials, as well as the mentally ill and their families, and must not be hindered by deadlines or bureaucracy.


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Eating disorders will be focus of one-woman play - Charlotte Observer

Church, 2 high schools will host performances

By CELESTE SMITH

The topic of eating disorders will take center stage in October at two area high schools and a church.

The Providence High School PTSA and Teen Health Connection -- the Mecklenburg County medical practice that specializes in the medical and mental health needs of adolescents -- are teaming to bring "The Thin Line" to town Oct. 9-10.

Performances of the one-woman play will be Oct. 9 at Myers Park High School for those students only and at Myers Park Baptist Church for the general public.

Providence High School students and parents can see the play at that school Oct. 10.

Leaders at Teen Health Connection wanted different groups to see the play and approached the Providence High School PTSA about showing the play there, PTSA president DeeAnn Guthrie said.

As it turns out, the topic fits in with the group's goal of providing informational seminars to its school community, Guthrie said. Other PTSA-sponsored talks planned this year include Internet safety and communicating with your teenager.

"I think our populations tend to mirror a large part of the eating disorder population," Guthrie said of the schools' audiences.

Research suggests about one out of 100 young women between the ages of 10 and 20 have anorexia nervosa, where fear of weight gain leads to sparse eating habits and excessive weight loss, according to Anorexia Nervosa and Related Eating Disorders, a national nonprofit.

About four out of 100 college-age women have bulimia -- binge eating followed by purging.

In the play, an actress portrays four characters: a girl who is struggling; her internal negative voice; her mother; and a friend.

A 30-minute panel discussion after each show will feature local health professionals answering questions from the audience, the questions submitted anonymously via index cards.

Panelists also will stay later at the two high schools so students can ask more questions, said Dr. Kristin Rager, medical director for Teen Health Connection.

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State plans improvements at Broughton Hospital - Charlotte Observer

The state will improve supervision, communication and training at Broughton Hospital to prevent the kinds of problems that led the federal government to cut its Medicaid and Medicare funding in August.A Department of Health and Human Services team that evaluated Broughton this month found problems that may have contributed to the death of one patient, who died after being restrained by a staff member, and an injury to another.

The team found that top medical personnel had grown distant from the healing process and the clinical staff was not being properly supervised or getting enough training.

"We need to put more emphasis on training and supervising staff to therapeutically communicate with patients," said Jim Osberg, chief of state-operated services with the Division of Mental Health. "That should help to prevent some of the needs for restraint."

Division directors, who are among the top-level employees at the hospital, must be more accountable and responsible for patient care and staff, said Dr. Michael Lancaster, the state's chief of clinical policy, who led the evaluation team. -- marcie young

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New health secretary to take on system ills - Asheville Citizen Times

By Leslie Boyd

No more surprises.

That’s one of the first announcements from Dempsey Benton, the new secretary of the N.C. Department of Health and Human Services.

“I want to collaborate with people across the state,” Benton said in a telephone interview last week. “I’m going to listen to ideas.”

Benton replaces Carmen Hooker Odom, who left at the end of the 2007 legislative season to head a nonprofit foundation in New York. One of the main criticisms of Odom was that she made major changes in the mental health system without consulting anyone.


Benton presides over the largest department in state government. Its 30 divisions include the Division of Mental Health, Developmental Disabilities and Substance Abuse Services, the Division of Public Health, the Division of Social Services and the Division of Medical Assistance. It has 19,000 employees and a $14 billion budget.

Reforming mental health care
Benton has promised to focus on the failing mental health system, which has been in a state of almost constant change since the N.C. General Assembly mandated system reform in 2001.

“One of the things we’ve been hearing is that we need stability in the system,” Benton said. “We don’t want to have any more surprises than are absolutely necessary. We’ve had too many already.”

Benton’s first priority will be to build an adequate crisis services system across the state. Patients in crisis often have to spend hours in a hospital emergency room, or they land in jail.

Plans for collaboration
Benton said he plans to work closely with the 25 local management entities, which manage the network of private service providers, on building such a system.

“We need to re-engage,” Benton said.

Benton is meeting with the leaders of each of the management agencies in the coming weeks.

“He spoke with us for three-and-a-half hours, and he listened to our concerns and ideas,” said Arthur Carder, CEO of Western Highlands Network, the local management entity for Buncombe, Henderson, Transylvania, Polk, Rutherford, Yancey, Mitchell and Madison counties. “He kept asking how we (all) could fix this.”

Benton, 62, was the Raleigh city manager for 17 years before taking the No. 2 post in the Department of Environment and Natural Resources in 2001.

“We’re very fortunate that the governor has appointed someone with extensive management experience, and who is open, collaborative and inclusive,” Carder said. “Part of turning the system around will be a willingness on the part of everyone in it to work on it together.”

Two hours’ paperwork, one hour of service
Sen. Martin Nesbitt, D-Buncombe, head of the legislative committee that oversees the mental health system, said Benton attended the most recent meeting of the committee and was open to ideas and suggestions.

“I was impressed,” he said. “It was one of the best meetings we’ve had.”

But Benton is charged with piecing together a mental health system that has crumbled from mismanagement and lack of funding. Providers are burdened with mountains of paperwork – at least two hours’ worth for every hour of service.


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Study's aim: psychosis detection -Ann Arbor (MI) News

BY MARJORIE KAUTH-KARJALA

Dr. Karen Milner is program director of a new research project designed to prevent the onset of psychosis. The program, run by the University of Michigan Department of Psychiatry and the Washtenaw Community Health Organization, received a $2 million grant from the Robert Wood Johnson Foundation to replicate a research program in Portland, Maine. The program began last spring and is now taking referrals.Q. What is psychosis?

A. It refers to changes in the brain that result in an alteration of an individual's perception of reality. Characteristic symptoms include things like hallucinations, which are seeing and hearing things that others don't see or hear, delusions - which are fixed false beliefs, or marked irrational suspicions of others. You can also see confused or disordered thinking, jumbled thoughts, difficulty concentrating. ... Psychosis is a symptom of multiple illnesses. Psychosis may occur as a result of a medical illness, or a treatment for medical illness, it may occur as result of intoxication of a substance or overdose. It may also occur as a result of mental illness such as schizophrenia, or a psychotic mood disorder. ... Being psychotic is not necessarily dangerous, and luckily that's true only for a small portion (of people). ...Disorder of sleep and appetite, mood swings, anxiety, suicidal and homicidal (thoughts) can all be part of it.

Q. Can you briefly describe the research program?

A. It's designed to identify young people in Washtenaw County between the ages of 12 and 25 who are at risk for psychosis. There are a couple of major components to the program. One is community outreach. ... to schools, community organizations ... to educate them about mental illness, specifically about prodromal (pre-illness) symptoms ... that might be suggestive of severe mental illness.

If we can identify the signs and symptoms early enough, we can prevent the progression into an acute phase of a psychotic episode. So we're quite excited about it. ... (The second element) is family psychoeducation (and case management) ... . The third element is low-dose anti-psychotic medication.''

Q. What early symptoms would teenagers exhibit?

A. Not wanting to talk with mom and dad is not enough. ... (Symptoms would include) social withdrawal, a marked drop in functioning. You've got a kid who's doing very well in school, involved in after-school sports, has close friends. What you see is his grades drop precipitously, he's no longer interested in going out and spending time with friends. They just want to sit in their rooms and be by themselves. ... One of the cardinal things is a heightened sensitivity to sights, sound, smells or touch ... suspiciousness of others, unusual or exaggerated beliefs about personal powers, sort of magical beliefs ... an exaggerated sense of what they can do. Those may occur days to weeks to months prior to the acute manifestation of psychosis where you see frank hallucinations, frank delusions or extremely disorganized thinking. That's the period of time where we can intervene and prevent the acute onset and the disability that subsequently might result.

Q. How will the students be identified as candidates for the program?

A. The students themselves may self-identify; they can call. Concerned parents can call, concerned teachers might call, church members, coaches, family docs. The biggest barrier is the stigma (of mental illness.). ... The community outreach programs will help fight that stigma. We know the earlier we treat these illnesses, the less disability will occur, the less impact on personality and cognitive function.

Q. What is the treatment for early signs of psychosis and how effective is it in preventing the illness from getting worse?

A. The first is the family psychoeducation, group meetings with families and individuals that occur every couple weeks designed to deal with specific issues, whether it's education about the illness or resources to help. ... Then there's assertive community treatment with case management. We go out into the community and work with people where they live, educate employers, deliver medication. ... The third component is low-dose anti-psychotic medication.

Q. What types of medication are used and what are the risks of these medications to adolescents and young people?

A. (Well-known) side effects of anti-psychotic medications such as Haldol include weight gain and (involuntary movements). But ... anti-psychotic medications (typically used in the program) have fewer side effects. ... We use the medication that is the most effective for the symptoms the child is presenting at the lowest possible dose and lowest level of side effects.

For more information on the program, call Michigan Prevents Prodromal Progression (M3P) at 734-434-2630 or visit http://preventmentalillnessmi.org.

Marjorie Kauth-Karjala can be reached at 734-482-2961 or mkarjala@annarbornews.com. Read more!

Friends ease stigma of mental illness -Corning (NY) Star-Gazette

By Salle E. Richards
srichards@stargazette.com
Star-Gazette

Scott McDaniels spent much of his childhood in the Elmira Psychiatric Center. When he wasn't there, he was bouncing around in foster homes. Some of those homes were good to him, while others were unable to cope with his behavior.

"In one, they tied me to a chair in the cellar," he said, demonstrating by placing his hands behind a chair he was sitting on. "That was not a good time."

But the worst pain stems from words -- that still come.

"They call us ugly. Retards. They call this a nut house," he said one day last week before having lunch with friends at the Community Services Support Center, run by Family Services of Chemung County on Walnut Street. "There's a lot of intolerance toward the mentally ill. We need to quit labeling someone."

McDaniels grimaces momentarily and then recovers his sunny demeanor.

"It makes me mad," the Elmira resident said. "I want to yell back in their faces."

But McDaniels has come a long way from being a unruly child. As an adult, he has become an advocate for the mentally ill.

"I know. I've been in the system since I was a little kid," he said.

He's a staunch supporter of the Elmira Psychiatric Center and starts to name people, but then stops.

"Can't do that," he says with a knowing smile. "HIPA laws. I can't tell you where I live either."

He can talk about his life, his passions and his friends. In one of his foster homes, he learned to draw. He opens a spiral notebook and shows a series of pencil drawings of a lighthouse by the sea, although he's never been to the ocean.

"I see it in my head," he says.

1 in 4 adults suffers from a mental disorder
McDaniels' story is about one man's recovery. He's willing to share it because he hopes it might not only help those facing a diagnosis of mental illness, but also might enlighten others.

According to statistics from the National Institute of Mental Health, 57.7 million U.S. adults -- about one in four -- suffer from a diagnosable mental disorder each year. Out of the total population, an estimated 6 percent of adults suffer from severe mental disorders.

"Mental illness is shockingly common," says Pat Breux, community advocacy and prevention coordinator at Chemung County Children's Integrated Services.

Even more shocking is that most of those with mental illness don't seek treatment because they fear the stigma of being labeled, she said.

"A huge issue is the effect on employment, losing a job," she said.

Elmira man focuses on diploma, future
McDaniels, 38, has worked in food service part time since he was a teenager. He isn't working now because of a back injury. However, he hasn't wasted his time off from work. He acquired a bicycle and also walks frequently.

"I did weigh 260 pounds," he said. "Now I'm a perfect 200."

His most recent accomplishment is completing the requirements for his high school equivalency diploma.

"I'll be done in two weeks," he said of his classes at Greater Southern Tier Board of Cooperative Educational Services in Horseheads.

Earning his diploma has been a longtime goal. When McDaniels was in school, he was in special education classes.

An avid newspaper reader, he has followed the Star-Gazette's tolerance series this year and is glad to see mental illness is receiving its turn in the spotlight. He goes to Albany every year with a local group, Social Connections, to speak out on issues that concern those with mental illness.

"I'm not a diagnosis," McDaniels says. "I'm a recovery in action."

A nearly lifelong resident of Elmira, McDaniels is enthusiastic about his community and the people in it.

"I love Elmira. We all need to stand up for Elmira," he says.

He is already looking forward to his 40th birthday because it will occur on Election Day 2008, a date that has significance beyond his birthday. McDaniels is a dedicated voter.

McDaniels said that what has sustained him through the bad times are the friends he has made, the people who have let him know they cared.

Compeer program offers help, connections
A program McDaniels credits with greatly helping him is Compeer.

The local Compeer program is part of a national organization that matches volunteers to be friends with people with mental illness.

"I did the same sort of thing in college and really enjoyed it," said Charlie Burke, vice president of Swift Glass in Elmira and a Compeer volunteer who has had a long- running connection with McDaniels.

The formal program structures the time that trained volunteers spend with Compeer friends. However, the structured friendships often become real friendships, Burke said.

"I've been with Scott for 12 years," Burke said of McDaniels, his Compeer friend. "I lose track that it's a program and forget to send in the paperwork. It's more like an everyday friendship."

Burke said he and McDaniels do the ordinary kinds of things that friends do: go to lunches, the movies and sometimes events with tickets furnished through Compeer.

"And we go fishing," McDaniels added later.

The rewards are similar to any other friendship, too, Burke said.

He has enjoyed watching McDaniels' confidence grow as he has become more involved in the community.

That confidence inspired McDaniels to contact his birth family. He has become reunited with his father after a 30-year separation. Next, he hopes to find his sister, who is a year younger. He hasn't seen her since he was 6 years old.

He has already had the thrill of receiving a 2 a.m. telephone call from his grandmother.

"She said, 'Welcome back to the family, grandson,'" McDaniels said, breaking into his trademark smile.

McDaniels is but one of many people coping with mental illness, which is why there are programs like Compeer.

Compeer seeks volunteers, understanding
The need for volunteers as well as understanding is huge, said Caryl Cavalier, director of the local Compeer program. "It allows a person to get out into the community and have a sense of belonging," she said.

The local Compeer oversees more than 200 matches, including its program that sends volunteers into schools to be a special friend, but Cavalier is always looking for more.

Both volunteers and clients of Compeer are carefully screened and have background checks. The volunteers receive the training they need to understand how they can best relate, and volunteers can choose the client they wish to befriend.

After 15 years of watching the interactions among volunteers and their Compeer friends, Cavalier believes friendship is a powerful force on the road to recovery.

She's not about to claim that friends will make you completely free of what ails you:

"There are all points of recovery," she said. "It's a very broad word. Recovery doesn't mean 'all better.' It means advancing. Sometimes there are relapses."

But going on, regaining equilibrium and getting better remains the constant goal.

"We're always proud of everyone," she said.
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Autism Allstars band together to help fund research - Newburyport (MA) Daily News

MERRIMAC - When a pediatrician told Stephanie Ross that her 15-month-old son was showing red flags for autism, the new mother's mind started reeling.

Ross' son Brady had lost the 10 words that had once been in his vocabulary. He wasn't walking, pointing at objects or making eye contact with other people, Ross said. At that point, Brady didn't even respond to his name when he was called, she said.

"I didn't hear another word he said. It was heart-wrenching. I thought of 'The Rainman,'" Ross said. "I knew something was wrong, but it was the first time somebody had put a word to it."

She would quickly find out her family was not alone.

According to the Center for Disease Control and Prevention, one in 150 American children are diagnosed with autism, a neurological disorder that affects social skills and communication. Some of the behavior includes unusual, repetitive activities and a disinterest in human interaction, according to CDC Web site. A delay in any of the basic developmental milestones - such as having a social smile at 3 months old or sitting up without assistance as a 1-year-old or sorting objects by shape and color at 3 years old - could be a cause for concern, according to the CDC's Web page 'Learn the Signs, Act Early.'

This summer, Ross, along with parents, friends and family members of autistic children, formed Autism Allstars - a group of people that plans to participate in Walk for Autism Now, to be held in Boston on Oct. 14. Through a series of fundraisers, the walk team has already raised $15,015 toward autism research, Ross said.

"It's a chance to do something positive about autism," she said. "This lets us feel like we're doing something more for our children."

Ross said the group originally had hoped to raise about $2,000. The Autism Allstars' new goal is $17,000, an amount Ross hopes to reach prior to next month's three-mile jaunt at Suffolk Downs in Boston.

As part of the walk team, Groveland resident Joette Garcia said she has discovered valuable camaraderie and a voice to break the stereotype people have of autism.

"I like the support network," Garcia said. "You meet so many other parents. They are an amazing group of individuals who want to share knowledge and stories and help anyway they can.



"For me, it's important to be raising money for finding a cause and to help with therapy. It's also been about raising more awareness about autism. This has been an opportunity to educate family and strangers, too."

Most importantly, she stresses that, like any individual, autistic children don't have the exact same symptoms.

Her son, Ely, received early intervention at 15 months old when Garcia's primary concern was that he wasn't chewing his food. However, Ely, Garcia's only child, had no problem with eye contact and had a substantial vocabulary, which was derived from repeating phrases he heard, she said.

This month, Ely started attending a preschool at Sweetsir Elementary geared toward autistic children.

The government-funded therapy program, Building Blocks, which is specifically designed for autism, is only applicable after an official diagnosis and ends once the child turns 3, Garcia said. Although she had initiated early intervention, Garcia's son wasn't diagnosed until a few months before his third birthday, allowing for only three weeks of Building Blocks, she said.

The author of the book "Could It be Autism?", Nancy Wiseman advocates early diagnosis and the importance in post-diagnosis therapy to improve the development of autistic children.

Both Garcia and Ross said the wait-list to have children properly diagnosed is long, but agree the early intervention has been helpful.

"People say: 'That must have been really hard getting the diagnosis that my son was autistic,'" Garcia said. "And I say: 'It was much harder not knowing what was going on with my son.'"

On Wednesday, Brady, a blond toddler with big blue eyes, celebrated his third birthday. After a year and a half of one-on-one therapy, he is able to use words to express his needs, his facial expressions have become more animated, and he is able to play with other children with a little direction from adults, Ross said.

The previous weekend, the Ross family entertained the dozen therapists who've been part of Brady's early intervention for the past 18 months. Not only did the party honor the therapists' work, but it also marked the point in Brady's life when he transitions from at-home therapy to the Sweetsir preschool class designed for autistic students.

Despite the improvements in Brady's behavior, autism is still foremost on Ross' mind every single day.

"Once you have a child diagnosed with autism, you're always thinking about it," Ross said. "I would wake up in the morning and ask myself 'what time the therapist is going to be at my house, what appointments do I have and how can I be implementing something a doctor recommended.'" Read more!

Prison does not help a drug addict -Oklahoma City (OK) Oklahoman

By Josh Rabe

TAHLEQUAH — Miller Ballard leaned over to kiss his girlfriend one last time, told her he loved her, and then fired a .38 caliber hollow point into his brain.

The shot wasn't fatal, but it blew a hole in the side of his face and left one eye hanging out of its socket. Ballard said he was so high on methamphetamine, the wound didn't even render him unconscious.

Ballard describes that as the lowest point of a decade of his life spent in a drug-induced blur. His addiction was so strong he thought nothing could stop it — that death was the only way out.

He drove himself to the hospital. When he was well enough, he was transferred to a mental health facility. As soon as Ballard found out his stay there was voluntary, he checked himself out.

He started using again the same day.

Ballard is one of thousands of Oklahomans to be arrested for drug crimes and sentenced to prison, sometimes multiple times, only to return to the same habits after their release.

"Prison does not help a drug addict,” Ballard said.

Whether prison time helps or not, drug and alcohol offenders make up nearly half of Oklahoma's 25,000 prison inmates, according to figures from the Oklahoma Criminal Justice Resource Center.

‘A lot more treatment'
"If we can get things the way I would like, people would get a lot more treatment and a lot less time in prison,” said Marci Sims, who spent a year in a prison boot camp, then started using meth again after her release.

Both Ballard and Sims found an alternative to traditional punishment they say helped them get off drugs for good. Judges and prosecutors agreed to sentence them to in-patient treatment programs rather than prison.

It's an option most courts have had since 2000, when Oklahoma passed the Community Sentencing Act, which allows state funding to be spent on treatment programs before resorting to prison time.

The program isn't as well known as other forms of alternative sentencing like drug and mental health courts that have seen more attention and more funding in recent years, but a recent report shows community sentencing is proving effective, said Sharon Neumann, deputy director of community sentencing.

Almost 90 percent of participants in the program haven't committed another offense within three years of completing a community sentence, Neumann said.

That rate is far better than the recidivism rate for prison inmates. Oklahoma's prison system has a three-year recidivism rate of about 25 percent, said Jerry Massie, spokesman for the Department of Corrections.

The offender treatment cost under the program averages about $1,700. Sending someone to prison costs more than $17,000 per year, Massie said.

"Any type of alternative sentencing is going to have a better rate of non-recidivism than incarceration,” said Bob Ravitz, chief public defender for Oklahoma County.

An attitude change
Ravitz said the attitude toward nonviolent criminals has changed in Oklahoma County since David Prater became district attorney earlier this year. Prosecutors seem more willing to get criminals into programs that can reform their behavior instead of trying to get them locked up, he said.

"If it's a person who could be a risk to the community, we won't do it,” Ravitz said. "I think we are coming to the realization we can't keep incarcerating all the people we are incarcerating.”

Sims turned to meth in 1998 after her 17-year-old son was killed in a traffic accident and she fell into a deep depression.

"It was a way of self-medicating myself, and I didn't really know where I was headed at the time,” Sims said.

"Meth is such a hard addiction it's hard to stop, but I think they got it pretty much stomped out of me.”

Ballard turned to meth after a bitter divorce, and he soon discovered making the drug could be lucrative, but almost impossible to quit.

Ballard has been off drugs for more than four years after being treated through community sentencing. He and his wife, who also went through the program, married in June, and Ballard regained custody of his children. He is currently taking carpentry classes and hopes one day to own his own business.

"I was glad to see this legislation come about,” said Cathy Stocker, an Enid-based district attorney. "It was the first time in all the years I've been a prosecutor that money was made available through the state to address some of the problems these offenders have.”

People with assault and theft charges also have also participated in the program. Almost 3,000 people are participating now in 61 counties. Read more!

Poor families grasp for calm amid the chaos -Ft. Worth (TX) Star-Telegram

When her husband's paycheck didn't arrive with the afternoon mail, Edwina Lockwood went into a tailspin.

It was Friday, and she worried that there wasn't enough food in the house to feed the family through the weekend. She knew the car needed gas so her husband, Bobby, could get to work the next day.

Like many low-income families, the Lockwoods live paycheck to paycheck. It's a precarious existence that compounds the daily stresses that every family faces. Between 10 percent and 13 percent of poor parents reported having symptoms of depression between 1998 and 2003, according to the nonprofit, nonpartisan Child Trends DataBank. That compares with 3 percent to 4 percent for parents earning more than the federal poverty rate.

"If there is a disruption of the secure and stable bond with a parent that is due to parental stress, children's mental health could be affected," said Annie Georges, a senior scientist at Columbia University's Center for Children and Families.

To cope, some working-poor families turn to counselors, support groups or extended family members. Others rely on self-help and prayer.

Edwina, 34, knows that she's under stress. She's not always as patient with her three boys as she'd like to be, raising her voice and regretting it. Bobby, 37, is more low-key, though sometimes he needs a cigarette to calm his nerves.

They got through the recent weekend because relatives gave them a few dollars and invited them over for meals; Bobby didn't buy cigarettes.

Counseling and self-help

The Lena Pope Home provides counseling to about 10,000 low-income adults and children each year. The nonprofit agency tries to get clients in as quickly as possible, but waits for nonemergencies can stretch up to six weeks, Executive Director Ted Blevins said.

Catholic Charities Diocese of Fort Worth, which serves 1,600 families a year, has a four-week waiting list, particularly for people who need Spanish-speaking counselors.

"There is a huge need for counseling," said Heather Reynolds, Catholic Charities executive director.

Michael McKinsey, 12, Edwina Lockwood's oldest son, was having trouble focusing in school. He takes medication for attention deficit hyperactivity disorder, or ADHD.

His biological father, whom Michael hadn't seen since he was 4, had recently died, and he needed help dealing with his grief. Edwina needed to work out the guilt she felt that her son would never have a relationship with his biological father.

In February, Edwina and Michael began weekly visits with a counselor through a program run by the Arlington Life Shelter.

The counseling and medication helped. Michael was calmer and looked forward to sharing his feelings with the counselor. But in August, the family completed the Arlington Life Shelter's two-year transitional housing program and no longer qualified for the counseling program.

Edwina hopes to find some free services, but she's waiting until the family gets a second running car. With only one vehicle -- the family lives on about $30,000 a year -- Edwina sometimes has no transportation when Bobby takes their car to work. So Michael's therapy is on hold.

"It really did help him, so I want him to go," Edwina said.

It took Vedat Lika, 52, six weeks to get counseling for his daughter, Madison. The girl, now 5, had been acting out, hitting her brother and having outbursts -- a result, Lika believes, of the abuse she suffered before he gained custody.

Because he was unemployed at the time, Lika had to rely on Medicare to pay for counseling at the Parenting Center in Fort Worth. In July, he filed for bankruptcy. His annual salary of $40,000 from a job he got May 1 could not cover all the $27,000 in debts he had accumulated from eight months of little to no income.

The Lika family is no longer eligible for Medicare. But the state's Crime Victims Assistance Program is paying for Madison's counseling sessions because she was abused by a man while living with her mother.

Adding to that stress was finding out that his son, Arman, 5, has Asperger's syndrome, a mild form of autism. Arman was so withdrawn that Lika knew something was wrong, but he didn't know what until the boy's condition was diagnosed this summer by the Child Study Center in Fort Worth.

Arman now receives special-education services at the East Fort Worth Montessori School, where he attends kindergarten.

When Lika needs to talk, he said he turns to family, friends, neighbors and his girlfriend, Beverly Demoise.

"I talk to everyone," he said. "I don't have time to see a counselor, but I'm working things out."

He also relieves stress by practicing yoga with his children.

"Yoga strengthens you in ways you never thought about. I never feel tired when I'm finished," Lika said.

He snaps up self-help books and videos at secondhand stores and garage sales. Among his favorites are Don't Sweat the Small Stuff and Soul Food.

He often just collapses in a chair after putting the children to bed and listens to jazz or rock music while reading a book. He might drink a glass of wine or smoke a cigarette.

"A lot has happened to me in this last year," Lika said. "I didn't say, 'God is going to help me,' or, 'Allah is going to help me.' These practical things from other religions say you have to help yourself and believe in yourself. God can only do so much."

Support groups

Terri Rushing sometimes gets so overwhelmed that she suffers panic attacks. Other times she cries in the shower or after her three children go to sleep.

She's constantly worried about car repairs and whether she'll be able to afford groceries or make her rent on an annual income of $27,600. It's not that she isn't working hard to pay her bills -- sometimes she's too tired to stand up and give her kids hugs and kisses when she gets home from her job as a trainer at the Gaylord Texan Resort & Conference Center. It's just that Rushing never sees herself getting ahead.

"You never feel like you are doing anything well," Rushing said. "Everything is always hanging over my head."

That is a common feeling among low-income families, said Blevins of the Lena Pope Home.

"They're fragile. They're hurting," he said. "They're feeling very disappointed in themselves, so it doesn't take much to discourage them."

To cope, Rushing, 49, turns to Saturday single parents night at her church, Gateway Church in Southlake. There, people from across the Metroplex gather weekly to talk, share horror stories and encourage one another to press on.

Rushing also attends a Monday night singles group at the church for adults to meet others with similar faith.

At the events, Rushing has "grown-up" conversations while her children interact in groups with other youngsters and listen to stories about respect, acceptance and friendship. That eliminates the guilt Rushing said she usually has when taking time out for herself.

"I don't have to talk a certain way, do certain things, and I walk out feeling better," Rushing said. "My children have fairly positive self-esteems compared to what they could have had. I believe it is the positive influence I receive that helps me be a better mom and have more patience."

The power of prayer

Ofelia Luevano knows the power of prayer. She relies on it when she worries about a bill that needs to be paid, or feels she can't provide for the couple's seven children, four of whom they took in from a stranger more than two years ago. She says her husband, Antonio, 38, reads the Bible almost nightly before going to bed.

"With our faith, that's what gets us through," Ofelia Luevano said.

Evidence of their faith is everywhere in their home. A picture of the Virgin of Guadalupe -- an important religious symbol for Mexican Catholics -- hangs on the living room wall.

Throughout the room is an assortment of religious figurines, from angels to Jesus. An open Bible rests on a nearby sofa table.

Luevano, 40, said she used to have a wallpaper border of angels around her living room.

"Everyone has an angel," she said.

People often turn to religion to cope with stress, depression and illness, said Harold G. Koenig, a professor of psychiatry and behavioral sciences and an associate professor of medicine at Duke University. He is also co-director of the Center for Spirituality, Theology, and Health at Duke University Medical Center.

"Studies that we have done at Duke show that people who rely heavily on their religious faith recover more quickly from depression and deal with stress better," Koenig said. "Praying gives people a sense of hope and control over their difficult life circumstances and makes them feel that life has meaning and purpose no matter what they are struggling with."

Life wasn't always based on prayer in the Luevano household.

"I used to get upset about everything," Ofelia Luevano said. "I would want to scream."

Nearly two years ago, Luevano said she suffered from back problems that caused her pain daily and prevented her from being a full-time mom and wife. She could barely stand at times, and her abdomen would swell as if she were eight months pregnant, she said. Doctors couldn't explain it.

"I would feel like my back was going to come apart and break into pieces," she said. "I was taking a lot of pain medication."

Around the time she was suffering with back problems, Ofelia said, a Child Protective Services worker asked the couple whether they would permanently take in Juan, Juliette, Fabian and Victor Martinez. The children, who now range in age from 5 to 8, had moved in with the Luevanos after their grandfather said he could not care for them.

"The day before Ash Wednesday I came home and sat there in that chair and turned on the TV," she said. "I looked at them and turned off the TV and started praying.

"I said, 'Lord, you know my situation. I want to adopt these children, but there's no way because of my health.' I said, 'Lord, if you think these children need me for their permanent future, then heal me.'"

She put her faith to the test and promised God that she would walk five miles from her Haltom City home to Our Lady of Guadalupe church on Blue Mound Road in Fort Worth. After she completed the walk, her back pains slowly went away.

If she had the money, Ofelia said, she would consider visiting a psychiatrist. But with an annual family income of about $31,000, she can't afford it. Sometimes a hot bath or weekend outing with her family helps, she said.

"I sit and think about things and how I can do it, but then I know how. It's from upstairs," she says, pointing to the sky.

Contact the reporters

Today's report was written by Adrienne Nettles, anettles@star-telegram.com, 817-685-3820; Elizabeth Campbell, liz@star-telegram.com, 817-390-7696; Traci Shurley, tshurley@star-telegram.com, 817-548-5494; and Melissa Vargas, msanchez@star-telegram.com, 817-685-3888. Readers' suggestions and comments are welcome. Read more!

Guidance center offers telepsychiatry service - Indiana (PA) Gazette

by John Como

A computer-to-computer system enables students in Greene County to receive psychiatric services without leaving their schools.

The Community Guidance Center in Indiana plans to provide similar services for students in Indiana and Armstrong counties by December 2008. The guidance center has received a grant of $100,000 from the state Office of Mental Health and Substance Abuse Services to purchase the equipment and to establish a dedicated computer transmission line to start a telepsychiatry service project in the Marion Center Area School District.

Dr. Ralph May, a psychologist and chief clinical officer at the guidance center, said the service would be provided in cooperation with the Indiana-Armstrong MHMR (Mental Health and Mental Retardation) and Value Behavioral Health of Pennsylvania. He said Value Behavioral Health administers the state's Medical Assistance behavioral benefit programs.

"A computer with a camera and a secure data line, separate from the school district's computer system, makes it possible for a psychiatrist and a student to see and hear each other," May said. "The visit is done in a secure room in the school and only the doctor, the student and whoever else is in the room with the student can hear what is being said. It is like going to the doctor's office, but students do not have to leave the school for a visit that usually takes from 20 to 30 minutes."

May said the doctor can zoom in the camera lens to see the pupils of the eyes and the heart rate can be checked by having the student place a finger on a sensor on the computer. A therapist or a caseworker from the guidance center and a family member would be in the room with a student.

He said the computer would be locked in a cabinet and the information on each case is encrypted to protect the confidentiality of each student.

"Initially, the services will be provided for four to six students in the Marion Center district that have agreed to participate in the program," May said. "We hope to have services in place in four districts this year and in all participating districts in Indiana and Armstrong counties by December 2008."

May said Dr. Peter Hauber will provide the services.

"The telepsychiatry services have been in Greene County for three years and the kids love it," May said. "Kids are more comfortable interacting with a doctor on the computer than adults. And they are more likely to make the doctor appointments on the computer because the visits are more convenient. They also spend less time out of the classrooms."

He said it can be a hardship for students and their families to make it for visits in the center because of weather conditions and the distance they have to travel from the rural school districts.

"We are trying to make it easier for the people to make the appointments," May said. Read more!

Doctor says disorder must be seen 'as a medical illness' - The Ottawa (Canada) Citizen

By Roger Collier

When her son, Patrick, was diagnosed with autism more than four years ago, Wendy Edwards, a southern Ontario pediatrician, reviewed the science about the disorder, which seemed to indicate there was no treatment. Patrick, then three years old, would stare at toys for hours, ignoring the people around him, and sometimes flap his arms or walk in circles. At first, Dr. Edwards felt there was nothing she could do to help him.

"Then I let the mother in me take over," she said.

Dr. Edwards, along with Derrick MacFabe, director of an autism research group at the University of Western Ontario, and Martha Herbert, a professor of neurology at Harvard Medical School, were the featured speakers at "Autism: A Medical Condition," a conference presented by the Autism Canada Foundation at the University of Ottawa yesterday. Their message: autism is a full-body condition, and not limited to the brain.

"The paradigm of autism is changing," said Dr. Edwards. "This needs to be viewed as a medical illness."

In additional to the popular behaviour therapies, such as IBI (intensive behaviour intervention), Dr. Edwards says people should consider biomedical treatments. When parents ask her to help their autistic children, Dr. Edwards' advice sometimes catches them by surprise.

"I insist that parents work on helping the gut first," she said.

Autistic children have "skewed" immune systems, Dr. Edwards said, which means that viruses and fungi in the stomach cannot be handled properly. This leads to inflammation in the digestive tract. As a result, the immune system releases chemicals called cytokines, which reach the brain and can affect mood, sleep, appetite, memory, learning and social interaction.

A gluten- and casein-free diet, said Dr. Edwards, may reduce immune system reactions that lead to inflammation. She also recommended ridding the digestive tract of unwanted bacteria, fungi and viruses by using supplements such as garlic, cranberry, oregano oil, grapefruit seed extract and olive leaf extract.

Dr. Edwards admitted that her approach to treating autism does not yet have solid scientific backing. But sometimes, she said, waiting for a conclusive study is not the best approach.

"Why not do what we feel is working while we wait for the study to prove or disprove it ... if we're not out there doing all these things and telling the researchers, 'What about this?' the research won't get done."

Dr. Edwards also recommended ridding the body of toxins with antioxidants like Vitamin C, taurine and carnosine. Parents of autistic children should also avoid using toxic cleaners in their homes, she said.

Autistic children also have trouble sleeping, said Dr. Edwards, which may be hurting their overall health. She recommended parents try melatonin to help their children sleep better and said that it may have other biochemical benefits, as it is also an antioxidant.

Dr. Edwards said her son, who is now seven, has improved remarkably since she adopted these practices. His verbal skills are excellent, he makes eye contact and last June he graduate at the top of his Grade 1 class.

"Not all children will recover all the way, but many, and in fact most, will improve to some degree with this treatment."
© The Ottawa Citizen 2007 Read more!

Drawing strength from hope -Cincinnati (OH) Enquirer

BY PEGGY O'FARRELL | POFARRELL@ENQUIRER.COM

It's not always easy for Linda Zachary to describe in words what living with schizophrenia is like.

But she can draw it, capturing in colored pencil strokes the feelings of isolation, fear and even hope that the disease engenders.

The 52-year-old Walnut Hills woman's drawings will be among the works displayed Oct. 9-Nov. 19 at the Main Library, 800 Vine St., downtown.

The Mental Health Arts Consortium is sponsoring "Hope and Strength Through Art: Talking About Mental Illness," an art exhibit and educational program aimed at raising awareness about mental illness and recovery.

Too often, people associate mental illness with violent behavior and crime, said John Hawkins, a psychiatrist and member of NAMI-Hamilton County's board.

But most mental illnesses are brain disorders and can be successfully managed with a combination of medication and ongoing therapy.

About one in five American families is affected by a mental illness, national statistics show.

The exhibit "is a real positive way to communicate issues of resilience and hope and recovery for people who are struggling with and getting better from their mental illness," he said.

Zachary recalls feeling isolated because of her illness, and losing contact with family and friends because of it.

One of her drawings, called "Girl in Cage" sums up "how I felt when I was hospitalized and how I felt society treated me," she said. "As you look at the picture, the bars are very close, and that represents society closing me in. But looking at the picture closely, the bars don't go all the way around the cage, and the girl is sitting on the key. That's how I felt, having society against me and having a mental illness."

Zachary struggled with schizophrenia for years, cycling in and out of therapy and going off and on medications.

She was 19 the first time she was hospitalized, but she'd been hearing voices for years that terrified and confused her.

Now in recovery, she's a client at the Recovery Center of Hamilton County in Mount Auburn, where she takes wellness classes and learns to how to best manage her illness.

She still hears the voices, "but I know they're not real, and I know not to act on them."

"Hope and Strength Through Art" will also include several educational events about living with mental illness.

Consortium members include Art Beyond Boundaries, the Cincinnati Art Museum, Cincinnati Children's Hospital Medical Center, Greater Cincinnati Behavioral Health Services, the Kenton County Public Library, MindPeace, the National Alliance on Mental Illness of Hamilton County, NorthKey Community Care, St. Joseph Orphanage, the Recovery Center of Hamilton County, Visionaries and Voices and the Public Library of Cincinnati and Hamilton County.

Learn more at www.cincinnatipubliclibrary.org. Read more!

Family of slain man outraged by deal -Contra Costa (CA) Times

By Bruce Gerstman
September 29, 2007

After friends and family members of a man who was stabbed to death expressed their outrage about a possible plea bargain for the defendant in the case, a Superior Court judge said Friday she will review nearly 300 pages of evidence before deciding whether to authorize the deal.

"The court has some serious concerns about this case," Judge Theresa Canepa said in Superior Court in Martinez.

More than a dozen family members and friends of 37-year-old Stephen Hauser, who was killed March 22, 2006, asked Canepa to reject a plea agreement proposed by the district attorney's office for the alleged killer, 27-year-old Nathan Gideon.

Prosecutors originally charged Gideon with murder but offered him the opportunity to plead guilty to the lesser crime of voluntary manslaughter and accept a 13-year state prison sentence.

If convicted of murder, Gideon could face a life sentence in prison.

The hearing in Canepa's court offered a glimpse of the difficulties that prosecutors face when determining what kind of charge they can prove to a jury, as well as how they can be at odds with the families of victims.

Concord police responded to a 911 call on March 22 made by Gideon at the home he shared with several housemates, including Hauser. He told the operator that he stabbed Hauser while defending himself.

Investigators determined that he stabbed Hauser in the chest, neck and back. Gideon was unscathed, except for a cut on his finger.

Prosecutors say a jury might believe the theory of "imperfect self-defense," where a defendant has an honest, but unreasonable, belief that he must use deadly force to defend himself.

This could lead to a manslaughter conviction, for which a judge could sentence Gideon to three to seven years in state prison. The plea bargain guarantees the longer 13-year sentence.

Both men had a history of mental illness. They originally met while living at a private mental health facility. Witnesses testified at a preliminary hearing that Gideon has schizophrenia.

Hauser's family and friends spoke directly to the judge, saying that they believed enough evidence exists for a jury to convict Gideon of murder and that the district attorney's office is making a mistake.

They said Hauser feared Gideon, who had threatened him after Hauser alerted police that Gideon was beating his girlfriend.

"This is a man looking for a fight, trying to kill," said Alexandra Childs, the family's pastor, who also counsels inmates on death row.

Gideon stood behind what sheriff's deputies call, "the box" -- an area of the courtroom secured by bars and thick glass. He watched each person speak. Sometimes he looked down to the ground.

Deputy district attorney Brian Haynes said a plea bargain is the best way to ensure that Gideon spends the longest time behind bars on a manslaughter conviction. Jurors would learn that the evidence at the crime scene suggested a struggle, and another housemate heard thuds and yelling that sounded like a fight or that Gideon thought his life was in danger.

"In the overall sense of justice, is this just? Probably not," Haynes said after the hearing. "This is a reasonable disposition that would put him away for as long as possible for a voluntary manslaughter."

Gideon's attorney, Ellen McConnell, said at a previous hearing that the killing was not premeditated. "There was nothing presented by the prosecution to show planning ... on the part of Mr. Gideon," she said.

Canepa is set to rule at 3 p.m. on Oct. 11.

Reach Bruce Gerstman at 925-952-2670 or bgerstman@bayareanewsgroup.com. Read more!

Support for those left behind by suicide-Vail (CO) Daily

By Pam Boyd

EAGLE COUNTY — When Edie Lengel lost her brother to suicide, a family friend offered some priceless advice.

“No matter how someone dies, you still love them just the same,” the friend advised.

As a community and as a culture, we generally know how to react when someone dies as a result of accident or disease. Suicide throws us all for a loop. Family and friends must grapple with both grief and guilt while others tiptoe around their pain, unsure of what to say or do. And in the midst of all their sorrow, the loved ones of suicide victims also feel isolated at a time when they most need the care and comfort that comes from sharing their grief.

“I never knew anyone who had committed suicide until it happened to us,” Lengel says. “People just don’t talk about it.”

A stalwart group of local residents is breaking the silence. Six months ago, with the assistance of the Eagle County Sheriff’s Office, Eagle River Youth Coalition and Colorado West Mental Health Center, the small group decided to launch a local chapter of Heartbeat — a support group for people who have lost a loved one to suicide. They meet monthly in Edwards and have sponsored their first community event — a recent balloon launch to remember loved ones lost to suicide.

Jill Baron, a sheriff’s deputy who lost her brother-in-law to suicide, is one of the local Heartbeat chapter’s founders. “Suicide is such a sensitive topic,” she says. “With Heartbeat, the message we can give to each other is what we care.”

Suicide statistics
• 7th leading cause of death in 2006
• 724 suicides in 2006
• 2nd leading cause of death for youth
• 2,800 people hospitalized annually for suicide attempts or threats
• 6,700 people seek treatment annually for suicide-related thoughts or actions
• 71 Eagle County high school age kids (9 percent) have considered suicide
• 30 of those students (42 percent) sought help from a counselor, minister, or other professional

Grieving and guilt
The grief that follows suicide is devastating. It can be tinged with anger and compounded by remorse.

Living with guilt is a common thread for people coping with the aftermath of suicide. Lengel talks of the weeks leading up to her brother’s death, knowing he was depressed and trying hard to help him. Baron says her brother-in law didn’t communicate any problems, leaving family members stunned by his suicide.

“It’s hard to accept the fact you couldn’t have prevented what happened ... that it got to that point,” says MaryAnn McIlveen of Gypsum. “You always wonder what you could have done, or should have done.”

McIlveen’s 35-year-old son, David, committed suicide five years ago. She has learned that coping with her loss is a long-term struggle. “We try to think about all the good times, but we just always miss him,” McIlveen says.

Ann McNeil of Eagle lost her 22-year-old son, Luke, to suicide earlier this year. She knew her son suffered from debilitating depression and she tried to find him help.
“We found there was really no place in Eagle County you could go to (for a mental health hold) unless you wanted to take your kid to jail,” she explains. At one point Luke did agree to visit a mental health facility in Denver, but then rebelled from being admitted once he got there. McNeil will always wonder if admittance, or if the presence of a closer facility, would have saved her son.

“Luke had a disease. If we could have gotten him help, maybe he would have survived,” McNeil says. “But you can’t blame yourself. That moment happened to Luke.”

Eagle County Heartbeat
What: Support group for people who have lost a loved one through suicide
When: Meets on the first Tuesday of the month
Time: 7 p.m.
Where: Miller Ranch Community Center
Contact: Eagle County Heartbeat, 471-1833
Next meeting: Tuesday, Oct. 2
Moving through the moment
“It was the hardest thing I ever had to do, to tell my daughter about it,” says a local woman who asked to remain anonymous. Her ex-husband died by suicide more than a year ago, and she worries that her teenage daughter hasn’t come to terms with his death. The girl likes to believe that her father’s death was accidental.

“She feels guilt. One of these days she is going to feel anger, too.” She continues, “When if first happened, I was just so worried about helping my daughter. Because of that, I haven’t really helped myself.”

The woman also talked about the confusion that suicide leaves behind. “There were 60 people, from all over the country, who came to my ex-husband’s memorial service — old friends from all over. They couldn’t believe he would do something like that. They all asked, ‘Why didn’t I know?’”

Heartbeat organizers recognize that feelings of responsibility, self doubt, failure, rejection, stigma, shame, anger, hostility and religious fear loom for loved ones of suicide victims. People may find themselves in a life-long search for answers that won’t ever be found.

What the group can do is help survivors navigate through a difficult grieving process.

By reaching out to others, Lengel says grieving families find solace. At her brother’s memorial service, Lengel said a woman she had casually known for years approached her. This woman’s husband had committed suicide and her willingness to talk and to share in that moment of sorrow deeply touched Lengel. In the weeks and months that followed, Lengel longed for that kind of support.

“I would have loved to have someone to talk to at midnight, when I needed to talk,” she said. With Heartbeat, she hopes other families have that kind of support. “It is a way of healing myself, by helping others,” Lengel says.

“My son hung himself. It’s not like any good came out of it,” she says. “I believe that the community really needs to be more educated about suicide. If telling my story helps even one person, at least that’s something.”

Suicide education and prevention is a common cause for Heartbeat members. Barron said it’s a natural progression for the support group to move toward suicide education and prevention.

“Eagle County is a resort area. Everyone thinks it’s all skiing and hiking and all that,” notes McNeil. “But suicide needs to be talked about.”

And in the end, many families devastated by suicide know that they are the ones who need to talk — both for themselves, and for others.

Baron sees it as something good coming from something really tragic.

“Otherwise, you just remain trapped in that terrible day,” she says.

This story first appeared in the Eagle Valley Enterprise.

Common predictors of suicide
• Major depressive illness

• Alcoholism, drug abuse

• Suicide talk, preparation

• Prior suicide attempts

• Isolation, living alone, loss of support

• Hopelessness

• Being an older, white male

• History of suicide in the family

• Work problems, unemployment

• Marital problems

• Stress, negative life events

• Anger, aggression, impulsive behavior

• Physical illness

Help is available by calling the national suicide hotline a 1-800-SUICIDE. Read more!

Hurdles still for treating mental illness -Nashville Tennessean

By KAREN H. RHEA, M.D.
Tennessee Voices

For the past 17 years, Mental Illness Awareness Week has facilitated public discussion about the mental illnesses that touch the lives of many Americans each year. This year's observance takes place Oct. 7-13.

Given the prevalence of mental illness in our nation, it is surprising there remains a need for an awareness week at all.Upon scanning the news, the serious effects of mental illness are apparent — more children with bipolar disorder, increases in the teen suicide rate and a growing number of people with untreated mental illness who are incarcerated or homeless.

Our society continues to consider mental illness a problem experienced only by unlucky strangers. But, in truth, 25 percent of Americans suffer from a treatable mental illness each year.

Unfortunately, many suffer in silence. Fewer than half of those with mental illnesses seek help; they fear being seen as weak or are unsure of what treatment options are available. Also, many cannot afford treatment or do not have access to the care they need.

This lack of treatment leads to increased morbidity and mortality across our nation. Research has shown that depression creates more disability than chronic diseases such as arthritis and diabetes. Also, serious mental illness, which has increased risk of heart disease, diabetes and other physical conditions, can shorten a person's lifespan by up to 25 years.

Understanding of disease

The fact that so many mental illnesses go untreated is unacceptable in our nation today — particularly when so many effective treatments are available. Between 70 and 90 percent of those who receive treatment experience significant symptom reduction and improved quality of life. With consistent treatment, even individuals with severe mental illnesses can lead productive lives.

We must begin by treating mental illnesses as we do other diseases. Neuroscience research has identified biological causes of mental illness; we cannot hold onto beliefs that mental illness is the fault of the person with the disease or that those with mental illnesses are weak, undeserving of care or uniformly dangerous.

Mental illness cannot be prevented or overcome by force of will. These chronic mental health disorders, such as severe depression, bipolar disorder and schizophrenia, must be treated just as we treat cancer, asthma and diabetes, which are chronic medical diseases. The economic cost of untreated mental illness in our nation is more than $100 billion annually.

To this end, it is important that equality exist between insurance coverage of mental health treatment and the treatment for medical and surgical services. We can support our congressmen in adopting the Mental Health Parity Act of 2007 that passed the U.S. Senate in mid-September.

During Mental Illness Awareness Week, please consider taking a few minutes to learn more about mental illness and the treatments that work. As we connect neuroscience research, adequate funding and devoted behavioral health-care providers, we can foster recovery and hope in partnership with our most vulnerable citizens. Read more!

Bristol-Myers Squibb to pay $515 million to settle fraud chargesBristol-Myers Squibb to pay $515 million to settle fraud charges - Associated Press

By Denise Lavoie
September 28, 2007

BOSTON --Bristol-Myers Squibb Co. and a former subsidiary have agreed to pay more than $515 million to settle federal and state investigations into their drug marketing and pricing practices, U.S. Attorney Michael Sullivan announced Friday.

The civil settlement resolves a broad array of allegations against Bristol-Myers Squibb, dating from 1994 through 2005, including a charge that the New York-based pharmaceutical company illegally promoted the sale of Abilify, an anti-psychotic drug, for pediatric use and to treat dementia-related psychoses. Neither use is approved by the U.S. Food and Drug Administration.

In the second quarter, the company reported $412 million in sales of Abilify, approved to treat bipolar disorder and schizophrenia, a 27 percent increase from the same period a year ago.

Although physicians are permitted to prescribe drugs for off-label uses, drug companies are prohibited from marketing them for uses that have not been approved by the FDA.

Sullivan said whenever pharmaceutical companies market drugs for unapproved uses there is a potential risk that patients could be harmed, because the drugs have not gone through the kind of study and rigorous testing they do during the FDA approval process.

Prosecutors have no evidence that specific patients were harmed by Bristol-Myers Squibb's actions in promoting Abilify for unapproved uses, he said.

"People depend on this industry, thus the industry has an obligation to ensure that all rules, regulations and laws are complied with," Sullivan said.

The government also alleged the company paid illegal inducements in the form of consulting fees and trips to luxury resorts to influence doctors and other health care providers to buy and prescribe the company's drugs. The company's former generic drug subsidiary, Apothecon Inc., also was accused of giving illegal enticements to induce retail pharmacy and wholesale customers to buy its products.

Bristol-Myers Squibb misreported its best price for the anti-depression drug Serzone, violating a law that requires drug companies to report their lowest price to Medicaid, prosecutors said. The company was selling Serzone to Kaiser, a larger commercial purchaser, at a lower price, prosecutors said.

Bristol-Myers Squibb and Apothecon also inflated prices for an assortment of oncology and generic drugs knowing that federal health care programs established reimbursement rates based on those prices, Sullivan said.

In a statement, Bristol-Myers Squibb said the settlement would not affect the company's ongoing business with any customers, including the government.

"Bristol-Myers Squibb is pleased to have resolved these matters from the past and is proud of its commitment to conduct business with the highest standards of integrity in its mission to extend and enhance human life," the company said in a prepared statement.

Bristol-Myers Squibb announced in December that it had reached a tentative agreement to pay $499 million to settle the investigation. Sullivan said the $515 million settlement includes interest accrued since January.

The company does not face any criminal charges. Sullivan said the company cooperated in aspects of the investigation, which was sparked by allegations made by six whistleblowers who filed lawsuits and reported the activity to authorities. Under the federal False Claims Act, citizens may file a lawsuit on behalf of the government and later may receive a share of any settlement.

In this case, the six whistleblowers will receive a total of about $50 million as their share of the $328 million federal settlement. They will also receive an additional share of the $187 million state settlement.

Bristol-Myers shares fell 19 cents to $28.82 Friday.

The agreement is the latest in a series of settlements the Justice Department has reached with pharmaceutical companies over illegal marketing and pricing of their drugs. Sullivan's office has been particularly aggressive in prosecuting health care fraud cases.

Earlier this year, Schering Sales Corp. and its parent company, Schering-Plough Corp., agreed to pay $435 million to settle allegations it lied to the government about drug prices and illegal promoted the drugs Temodar and Intron A for the treatment of cancers they were not approved for by the FDA.

In 2001, TAP Pharmaceutical Products paid $875 million to settle allegations it inflated prices and bribed doctors to prescribe its prostate cancer drug Lupron. Read more!

The problem neighbor - Boston Globe

Every town seems to have a fellow like him: someone who makes people want to cross the street when they see him coming, the man store owners have forbidden to enter. Such troubled citizens pose a special dilemma for their families as well as for town officials, who often have no idea how to deal with them.

By Milton J. Valencia, Globe Staff

Locals have long favored the Minot neighborhood of Scituate, where beachfront homes have names like Sea Spray and Bar Rock, and neighbors enjoy barbecues and bonfires against a panoramic ocean backdrop. Until Frank Loring comes along.

Loring lives in the neighborhood, but is not always welcome in it. He is the man, residents say, who crashes parties, floods septic systems with hoses, harasses children at the ice cream truck, and threatens to kill those who question him.

Many in Scituate feel sympathy for Loring, who, a family member said, suffers from bipolar disorder. They say he would hurt himself before he followed through on threats to hurt others. Few want to see him in jail.

But something must be done, they say, about the 62-year-old man who has fallen into a crack between the mental health and criminal justice systems.

"This neighborhood has been his hostage for years," said Michael J. Clifford, who lives across the road from Loring and who has become a target of his harassment.

Every town seems to have someone like Frank Loring - the guy who makes people want to cross the street when they see him coming, the man whom storeowners have forbidden to enter. The presence of such troubled citizens can shade the quality of life in a neighborhood in the same way as, say, potholes or schools or taxes. These people also pose a special dilemma for town officials, who often have no idea how to deal with them, and no laws at their disposal to do so.

"The Commonwealth as a whole needs to realize there's a larger mental health issue here," said police Lieutenant John Rooney. "It's all over - it's not just Scituate."

Says Loring's brother Michael, an established lawyer in town who tries to help his troubled sibling: "It's the system. Is it the court, the mental health system? Is it the Legislature? It falls into that vast nothingness."

A downward spiral

Loring, with a slim build, is 5 feet 10 when he stands up straight, but most of the time neighbors see him hunched over with his hand out, asking for money or a cigarette. Or, he's asleep on a lawn chair outside the home on Glades Road that he and his brothers inherited when his mother died six years ago.

Known around town as just Frank, Loring is no stranger to the courts. He's been arrested multiple times on nuisance-related charges, and has at least three open court cases. He's been in jail since Sept. 10, unable to post the $1,000 bail set on the third criminal charge he's faced this summer: intimidating his neighbor.

Probation officials are now seeking to keep him jailed for violating terms of plea agreements he made in Quincy District Court in 2006. In one of those cases, he pleaded guilty to slapping a teenager at Shaw's Supermarket in Cohasset for refusing to cash his check. In another, he was charged with threatening to kill his neighbor Clifford and Clifford's 13-year-old son.

It hasn't always been like this. There was a time when Loring was friendly with Clifford, a time when he spent his days caring for his mother, Gertrude Loring, until she died in 2001. She was lovely, neighbors said, and seemed to keep her son Frank in order. They lived together in the cottage at 79 Glades Road for more than two decades, after selling the home the Loring family owned on Gannett Road.

Loring has a drinking problem and was diagnosed with bipolar disorder long before his mother died, his brother said, but in earlier years he tended to seek treatment. Family members would take him in for evaluations, and he didn't drink as much as he does now.

But things have grown worse since his mother died. And for the past several years, he has come to be seen by many on the beach as a nuisance, or worse.

Police have responded to calls about Loring in recent months, neighbors said, but in most cases he is taken into custody for his own protection, only to be released a day later. As part of his probation terms, he is supposed to stay away from alcohol and submit to random testing, but he has done neither, according to court records.

Loring likes to, as neighbors put it, get in their face. Sometimes he asks them for money, or offers beachgoers a chance to rent his lawn chairs for $1 an hour.

The rest of the time, neighbors say, he prowls the neighborhood, throwing sand through windows or interrupting bonfires and dinners on porches. Typically, he wears jogging pants with three shirts, or a suit. Sometimes he carries a knife.

"I can't imagine living near him," said Dan Weiner, of The Weinery wine shop on Gannett Road, in the North Scituate plaza. Loring has come in before, trying to pass bad checks for wine, says Weiner. Or he stands outside and stares in through the window. Weiner tries not to acknowledge him.

For others, it's more difficult. Amanda Prouty, of the Wilbur's North ice cream shop, said Loring is banned from the store, to keep him from bothering the children who come in during the day and the teenage girls who work at night.

"It's just a comfort thing, a nuisance thing," she said. During the winter, he sometimes shovels the sidewalk and then asks for money. In the summer, he'll try selling flowers.

"He's just a danger to himself," Prouty said. "I don't think he was a bad guy his whole life."

Attempts to talk to Frank Loring, who is being held in the Plymouth County Jail, were not successful.

Michael Loring is well aware of his older brother's problems, but said that they've lost their connection, and that Frank won't speak to him.

In a way, Michael Loring said, he feels a sense of indebtedness toward his brother for caring for their mother. When Frank is in jail, Michael will send crews to the house to clean up the trash that's been thrown about. He has also fixed windows at the home, which was left in a trust that allows all four of the brothers to live there.

Another brother, Robert, is also a well-known lawyer in town. The oldest brother is Kevin, also known as "Kicka," who has his own criminal record. He once made the news when he was found naked in a Boston church that had been vandalized.

But Frank is the Loring who poses the biggest difficulty in town.

"He has destroyed my summer the last two years and he knows it," Clifford said.

"Everything he does is planned."

Frustration all around

Michael Loring can predict his brother's moods like a textbook: how he's angry in the morning and lashes out at neighbors, and how in the afternoon he's more confused, almost schizophrenic.

He says he feels a responsibility toward his brother - Cohasset police asked him in 2006 to have his brother committed for alcohol treatment - but he also says civil rights are at issue. He has seen his brother taken to mental health hospitals, only to sign himself out. And, as a lawyer, he knows the courts are overwhelmed. Christian Putnam, 43, moved to Minot's beach last year. He never expected he'd join a neighborhood struggling to cope with mental illness. That was the kind of issue he had expected in New York, but not here.

But soon after moving, he became one of Loring's targets, he says.

Loring would flood his septic system with the hose, or throw trash in his yard, he said. Loring has also posted pornographic material on his home, in plain view of children who walk to the beach, according to Putnam. Other times, he'd keep him up all night, shoveling sand on the street.

"You want to have your windows open, and be outside, but then you've got to wonder if he's around the corner," Putnam said. "He's everywhere."

"People fall through the cracks," Putnam said, "and this is a guy who has fallen through the cracks, but everyone just throws up their hands and says, 'What can you do?' "


Read more!

Many soldiers get boot for pre-existing mental illness - St. Louis Post Dispatch

By Philip Dine

WASHINGTON — Thousands of U.S. soldiers in Iraq — as many as 10 a day — are
being discharged by the military for mental health reasons. But the Pentagon
isn't blaming the war. It says the soldiers had "pre-existing" conditions that
disqualify them for treatment by the government.

Many soldiers and Marines being discharged on this basis actually suffer from
combat-related problems, experts say. But by classifying them as having a
condition unrelated to the war, the Defense Department is able to quickly get
rid of troops having trouble doing their work while also saving the expense of
caring for them.

The result appears to be that many actually suffering from combat-related
problems such as post-traumatic stress disorder or traumatic brain injuries
don't get the help they need.

Working behind the scenes, Sens. Christopher "Kit" Bond, R-Mo., and Barack
Obama, D-Ill., have written and inserted into the defense authorization bill a
provision that would make it harder for the Pentagon to discharge thousands of
troops. The Post-Dispatch has learned that the measure has been accepted into
the Senate defense bill and will probably become part of the Senate-House bill
to be voted on this week.

The legislation sets a higher bar for the Pentagon to use the
personality-disorder discharge, and also mandates a review of the policies by
the Government Accountability Office. Bond said it also would "force the
Pentagon to stop using this discharge until we can fix the problem."

Bond said he learned of the practice from returning Iraq veterans. He called it
an "abuse" of the system and "inexcusable."

"They've kicked out about 22,000 troops who they say have pre-existing
personality disorders. I don't believe that," Bond said in an interview Friday.
"And when you kick them out, they don't get the assistance they need, they
aren't entitled to DOD or Veterans Administration care for those problems."

Obama said the practice is "deeply disturbing" because "it means that those who
have served this country aren't getting the care they need. …"

Pentagon spokesman Lt. Col. Todd Vician declined Friday to discuss the matter
because it was related to current legislation.

Defense Department records show that 22,500 cases of personality-disorder
discharges have been processed over the last six years.

Jon Soltz, an Iraq war combat veteran who founded the group VoteVets.org, said
untreated psychological problems were contributing to the highest military
suicide rate in a quarter-century and to growing homelessness among veterans,
he said.

If such widespread mental problems really existed before people joined the
military and saw combat, they would have been uncovered when the recruits were
enlisting, Soltz said.

STRESS FACTORS

The issue of personality-disorder discharges is a window into the broader
problem of psychological damage to Iraq veterans, which experts say has three
main causes:

— Multiple and longer deployments.

— The stress of fighting an insurgency with no breaks and everyone always on
the front line.

— Better and faster medical care that helps troops survive horrific physical
injuries that often leave psychological scars.

"You land in Iraq, and you're on the battlefield, whether you're a
quartermaster or a medic or a cook," said David Segal, director of the Center
for Research on Military Organizations at the University of Maryland. "All you
have to do is get on the highway to go somewhere from the airport."

The military and lawmakers are only slowly coming to grips with the
consequences, Segal said.

"I think we have failed to recognize the extent of the problem," he said.
"We've produced a problem that's going to be plaguing us for generations."

Past wars, through the Persian Gulf war, produced three casualties for every
fatality, while now in Iraq "we're up to about 16-to-1," Segal said. Those
killed are "really the tip of the iceberg" as far as the toll on soldiers, he
added.

One Republican congressional staff member who works on military issues said the
rationale behind the Pentagon's practice was: "We didn't break you, you were
already broken. You're not our responsibility."

"One soldier I know received a diagnosis for a personality disorder after a
45-minute talk," said the staffer, who spoke on condition of anonymity. "He'd
been in the military 10 years, had made it his career, and then he was told he
was being shuffled out in a couple of weeks. We keep getting these stories."

In the House, Rep. Phil Hare, D-Ill., is leading the effort to get similar
legislation approved.

"It defies logic to think that tens of thousands of our servicemen and women
slipped through the cracks during the pre-screening process," Hare said. "We
have a moral obligation to review the discharge process and ensure we are
getting it right."
Read more!

Dad, daughter, daffy quest -Philadelphia Inquirer

By Carrie Rickey
Inquirer Movie Critic

In the Los Angeles exurb of Santa Clarita there lived, not long ago, Charlie, a manic/depressive who kept meds in the kitchen, ancient treasure maps under his pillow, and his teenage daughter on tenterhooks.

Charlie lives in a house with a sagging porch and graying paint (suggestive of its owner's belly and temples), a dilapidated Victorian, an anachronism drowning in the rising stucco tide of development.

His adventures, a picaresque tale of madness, buried treasure and daddy/daughter love, are told in King of California, a delightful shaggy-dude story that, despite its allusions to Shakespeare's The Tempest, unfolds like Don Quixote Goes to Costco.

Charlie (Michael Douglas), magnificently wild-eyed and woolly-haired, is released from a mental institution after two years. This prompts Miranda (Evan Rachel Wood), his supremely self-reliant 16-year-old, to get back on "the bipolar pony," as she calls riding Dad's mood swings.

An unreconstructed beatnik and onetime jazzman, Charlie sees that they have paved the orange groves he remembers to put up big-box stores.

And while the antiestablishment figure is proud that Miranda has outwitted child welfare by saying that she lives with her mom (who decamped when she was 7), he's horrified that she works - gasp! - for McDonald's. And that she craves - how's that? - a dishwasher, that establishment status symbol.

The nicely detailed, resonant film written and directed by newcomer Mike Cahill sets us up to expect that the physics of comedy will involve a levelheaded caretaker helping her seesawing father achieve some kind of balance.

But what if the slightly square Miranda (imaginative enough to fool the social workers, pragmatic enough to work two shifts) plays two for the seesaw? What if she rides along with her father's crackpot theory, developed while he read California history in the institution, that a 17th-century conquistador buried a cache of doubloons near a ravine where a Costco now stands? What if she declines to parent her parent and instead rides shotgun to a scheme that most health-care diagnosticians would call delusional?

Charlie's quest dovetails with Miranda's hunger for parental connection. As Cahill gently depicts it, Charlie builds a castle in the air, Miranda furnishes it, and the audience gets a privileged visit. To the credit of Douglas, who does his most poignant work since Wonder Boys, and Wood, an ingenue of startling emotional resources, we suspend disbelief.

Whether Charlie and Miranda get the gold is insignificant. The treasure of the film is the unearthing of the family bond, magically played by Douglas and Wood.

King of California *** (out of four stars)

Written and directed by Mike Cahill. With Michael Douglas and Evan Rachel Wood. Distributed by First Look Pictures.

Running time: 1 hour, 33 mins.

Parent's guide: PG-13 (profanity, mature themes, drug references) Read more!

Mental health reform still a work in progress - Gaston Gazette

By Michael Barrett

At the turn of the millennium, more than 700 people were on the payroll at Pathways.
The agency now has about 65 positions.

It’s a stark example of how privatization has changed mental health services in North Carolina. Pathways at one time directly provided mental health, developmental disability and substance abuse services to people in Gaston, Cleveland and Lincoln counties.

Since 2004, Pathways has merely managed the system for the state, setting clients up with private companies that provide counseling and various types of therapy.

The change was designed to use public funds more efficiently and give consumers more choice. It has succeeded in some areas, but not all, said Pathways director Rhett Melton.

“Mental health reform has certainly created a lot of problems,” he said. “There have been issues with people accessing services, and getting those services for the length of time they need.”

Pathways sets up new clients with private case managers, who pinpoint programs that individuals may be eligible for.

Of the incoming clients Pathways sees, about 75 percent end up receiving federal financial help through programs such as Medicaid. The other 25 percent rely on state funding, Melton said.

In recent years, state funding has been more unstable, he said.

Funding shortages

“If you look back over the last five years, there have been several occasions of decreases in state funding,” Melton said.

The state allocated almost $19 million to serve mental health needs of indigent residents here last year. That total is expected to drop by more than $4 million when Pathways gets its new allocation in October, Melton said.

A vast majority of those cuts will affect children and adults who receive developmental therapy, Melton said. The rising demand for services and limited funds have largely kept Pathways from approving any new developmental therapy services since March 2006, he said.
“I’d like to say we’ll receive more money, but we can’t plan on that at this time,” Melton said. “There’s not enough money in the system right now to fund what the identified need is.”

An uncertain future

Mental health agencies and providers are restricted from responding to specific complaints about service due to privacy issues, Melton said.

In many cases, officials are doing their best to help consumers with the available resources, even if it may not seem so, he said.

“The answers we provide aren’t always the ones individuals want to hear,” Melton said. “But that doesn’t mean they’re not being helped.”

Despite legitimate problems in the system, Melton said the state is taking steps to address them.

“I think Pathways has done a very good job in trying to help consumers navigate an extremely complex system,” he said. “Are there opportunities to improve that? Absolutely there are.”

The state deserves credit for trying to fix problems that have come up, said Doug Sea, an attorney for Legal Services of Southern Piedmont, a non-profit law firm in Charlotte serving people with low incomes.

He and other advocates for improving the system have been working with state officials on such efforts, such as trying to get more Medicaid access for children under the age of 21.
“There are just so many complexities in the system that get in the way of serving people, especially kids,” Sea said.
Read more!

Funding keeping mental health care from people who need it - Gaston Gazette

By Michael Barrett

Deborah Barnette’s desperation radiates less in the things she says than in the way she says them.

When she speaks of her daugh-ter, Stephanie, the tone of her voice and strain in her eyes are a subtle roadmap into her 20-year battle for her oldest child’s well-being.

Stephanie’s struggle began in 1987 when she was born with a brain injury. It continued as be-havioral tendencies emerged that required special attention every day she went to school.

As an adult seeking a fulfilling life, her physical and mental hur-dles are steep enough. But rising financial walls have made it harder to receive care.Debbie Barnette relies on a complicated web of state and federal funding to help Stephanie. Her frustration has escalated as North Carolina adjusts to an overhaul of its mental health system six years ago.

But the Barnettes are not alone. Their experience is typical of more and more clients who are losing faith in the system’s ability to help people most in need of it.

“There are so many things Stephanie needs right now that I just can’t provide for her,” said Debbie Barnette, who is raising her daughter and 16-year-old son in Gastonia. “All I want is for her to get the help she needs.”

One family’s mountain

In the years after her birth, Stephanie Barnette went through a series of 14 operations that in-cluded brain surgeries and cranial reconstructions.

“(Doctors) told us there’s a good chance she’d never walk or talk,” said Debbie Barnette. “They said they didn’t know how she would develop.”

Stephanie’s developmental de-lays were more apparent as she grew and her behavior became more erratic. Her occasional tantrums made getting through school a challenge, and required her mother to stay close as much as possible.

Stephanie has always been bright — able to read and compre-hend things well. She has grown up not only walking and talking, but developing a love of swimming and camping. One of her strongest outlets is a love for animals.

She dreams of someday getting a driver’s license. So her mom lets her practice on a golf cart in their yard and on camping trips.

“I haven’t been able to teach her to dodge the trees,” Debbie Bar-nette said with a laugh. “But it gives her a feeling of independ-ence.”

But Stephanie’s adaptive skills are a work in progress. She is still learning how to build self-esteem and find her future in a world that can frustrate her at times.

“She doesn’t always know how to act appropriately around peo-ple,” said Debbie Barnette, who has been unable to work because of Stephanie’s condition. “She needs direction and structure to help her be a role model in the community and help her deal with situations.
“Some things she can improve, with the right kind of guidance.”

Service spurs frustration

When Stephanie started 12th grade in 2005, Pathways began cutting back the hours of service she could receive. Her case has taken a number of turns since then, but various obstacles con-tinue to keep her from getting the help she needs, said her mother.

In some cases, Stephanie has been approved for a certain num-ber of hours of service each week. But finding therapists and other professionals to fill those hours has been difficult.
That’s likely tied in some degree to the state’s 2006 adjustment of compensation rates for providers, said Doug Sea, an attorney for Legal Services of Southern Piedmont, a non-profit law firm in Charlotte serving people with low incomes.

When the state changed the re-imbursement levels, the hourly rates for providing services such as case management and devel-opmental therapy became less attractive to many providers, Sea said.

“They don’t pay well at all,” said Sea, who represents a number of clients pursuing mental health services in the Charlotte metro region. “It’s definitely a problem finding and retaining staff in these provider agencies.”

A therapist’s perspective

Carmella Crews has worked as Stephanie Barnette’s mental health therapist for several years. While she is legally bound from discussing specific details of Stephanie’s case, she said she knows Stephanie isn’t getting all the help she needs.

Stephanie isn’t the only one, said Crews, who has worked with a number of clients over the years.

“I guess the main issue I see is a lack of funding and a lack of knowledge,” Crews said.
Stephanie Barnette and others are being penalized for mistakes made in the system before the mental health restructuring, Crews said.

“My belief is that a parent should not have to provide for their family because they have a child who is developmentally ill or disabled,” she said. “I don’t under-stand how this can be allowed to happen.”

A resolve to keep fighting

Debbie Barnette has a long list of criticisms with the mental health system. She is exasperated not just for her daughter, she said, but for others out there who feel the same way.

Barnette said she would not stop fighting for the help Stephanie needs and deserves.

“It’s not anyone’s fault that Stephanie was born with her chal-lenges,” she said. “But if we have a mental health system that’s sup-posed to be helping people, it needs to be working.



Read more!

$2.3 million, 14 years and still no trial - Charlotte Observer

EMILY S. ACHENBAUM

The detention of Floyd Brown, who has spent 14 years locked up despite not being convicted of a crime, has cost state taxpayers more than $2.3 million, according to state records requested by the Observer.

The state Department of Health and Human Services says the bill for holding Brown in Dorothea Dix mental hospital in 2006 alone was $689 a day -- the same for any of the hospital's patients -- or $251,485 for the year.

Doctors there have said it's unlikely Brown, who is retarded and has an IQ of 50, will ever have the mental capacity to go to court. That means the 43-year-old could stay in Dix for the rest of his life.

During Brown's stay, records show, Dix officials have asked Anson County District Attorney Michael Parker at least a half-dozen times to allow Brown to be moved to a less expensive group-care facility near his home.

Parker refused. His reasoning: If Brown is well enough to be transferred from Dix, he's well enough to stand trial.

"The district attorney has resisted any efforts to resolve the situation, apparently being quite content to leave Mr. Brown in his present setting ad infinitum," Dix psychiatrist Dr. Freerk Wouters noted in 1995.

The hospital's rates have tripled since 1993, when Brown was charged with killing 80-year-old Katherine Lynch of Wadesboro. The daily rate then was $215.

By comparison, the N.C. Department of Correction spends an average of $68.45 a day per inmate, or about $24,986 a year. A death-penalty inmate costs taxpayers about $29,000 a year, the state says.

The jail in Brown's home county of Anson, about 55 miles southeast of Charlotte, spends far less, $41.80 a day per inmate.

The cost of staying at Dix, in Raleigh, is so much higher because it's a hospital, not just a detention facility.

Records also indicate Parker has sought to limit Brown's privileges, despite documentation of his good behavior. Parker denied a doctor's request to take Brown to the state fair, and he objected to the hospital allowing Brown to have lunch off-grounds with his sister. Parker has declined to comment.

The state pays the bill for Brown's incarceration. Even so, some county leaders have strong opinions about the case. Anna Baucom, chairwoman of the Anson County Board of Commissioners, calls it "a mess" that has embarrassed the county.

"This has gone on entirely too long," she said. "It's very uncomfortable for all of us to know things can go so awry."

Detectives said Brown confessed to beating Lynch with her walking stick in 1993. Lynch was found dead in her home by a neighbor. Brown lived about a mile away. Detectives said a description of a suspect led them to Brown, even though he did not match the description.

The only Anson official with direct power over Brown's status is Parker, who has said in court that he thinks Brown is guilty and will not drop the case. That means Brown's best hope for release is a hearing in Durham on Oct. 8, when a judge will hear claims from Brown's attorneys that he is held unconstitutionally.

Brown's attorneys have argued that holding him violates his rights to due process. In legal filings, they detail other issues with the case: corrupt detectives who served federal prison time; lost evidence; and a confession they said was "falsified."

Last month, the N.C. Department of Justice said it was examining allegations of wrongdoing in the case. It has declined further comment.

State Sen. Robert Pittenger, R-Mecklenburg, said the big bill in Brown's case is an example of poor government management.

"There has to be some type of alternate facility that would be available for cases like this, that wouldn't cost $250,000 a year." Read more!

‘Milestone’ reached in mental health care -San Luis Obispo (CA) Tribune

By Sarah Arnquist

Nearly 300 mental health and substance abuse professionals from San Luis Obispo County gathered Friday to learn how they could integrate their treatment systems to better serve their clients.

“This is a milestone,” said Joyce Heddleson, chairwoman of the county’s Mental Health Board, an advisory group to the Board of Supervisors.

Heddleson is also a member of the Drug and Alcohol Advisory Board. The two oversight boards are beginning to work together to shape the county’s vision for integrated substance abuse and mental health treatment.

“It will become the norm,” Heddleson said.

Adopting integrated treatment programs, however, requires dramatic system transformation. Friday’s workshop was a sign that the momentum is swinging that direction, attendees said.

When California voters passed Proposition 63 in 2004, they taxed millionaires to increase mental health funding and adopted a mandate to transform the state’s mental health system.

The landmark legislation required counties to rethink how they serve people with mental illnesses, particularly those who suffer simultaneously from other disorders, such as substance abuse.

People with these co-occurring, or simultaneous, disorders often fare the worst in treatment, experts say, because, though their problems are intertwined, their treatments are not.

Studies show dually diagnosed people represent about half the people using the mental health or substance abuse systems nationally. Those numbers increase to up to 80 percent in the criminal justice and inpatient psychiatric patient populations.

In 2000, San Luis Obispo County combined the mental health and substance abuse programs under one umbrella called behavioral health. While administratively the programs were combined, most of the treatment remains separate.

That is beginning to change, and Friday’s workshop was a step toward the goal of having every program and every professional capable of helping people with simultaneous disorders, said Karen Baylor, director of the county’s Behavioral Health Department.

“I think we’re turning a corner in terms of putting these tools into the hands of clinicians,” Baylor said.

Dr. Kenneth Minkoff, a Harvard Medical School professor and national expert in integrated treatment, led Friday’s workshop. He is leading eight other California counties through similar system changes.

Minkoff told the audience that research from the past two decades shows people “dually diagnosed” with men-tal illness and addiction disorders are the most complicated, expensive and tragic cases.

“We should design the systems so these people are the priority,” he said, “but historically the opposite is true.”

Minkoff spent the next eight hours explaining how to reorganize the system so integrated treatment is the exception and not the rule.

Norma Hoffman, vice chairwoman of the Mental Health Board, said she hopes people will finally be treated for their mental illness and substance abuse at the same time.

“For those of us who have lived it with our loved ones, it’s like: ‘Why has this taken so long?’ ” she said.
Read more!

Grants to help drug users' children - Denver Post

By Tom McGhee

A state task force fighting methamphetamine abuse will use $375,000 in new grant money to help children of meth users and fund a program to treat addicts and ease them back into the community.


The Daniels Fund provided $200,000 to the Colorado Alliance for Drug Endangered Children, and $175,000 that will go to a meth treatment pilot program in Delta County.

The Alliance worked closely with the state Methamphetamine Task Force to create a program for communities to use when tackling meth abuse and its effects on children, said Attorney General John Suthers, who chairs the task force.

Children who are removed from homes where meth is used or manufactured need the attention of child welfare services and assessment by medical and mental health professionals, said Lori Moriarty, commander, Thornton Police Department and a vice chair of the task force.

The Alliance will bring together personnel from law enforcement, courts, probation, social services, treatment, mental health and other agencies to work on~ the problem in an integrated way, Moriarty said.

"If we can help those using the drug and also treat the children we can try to break the cycle," of addiction, she said.

The Delta Community Based Methamphetamine Community Based Treatment Project provides treatment but also helps meth users work their way back into the community, said Nicolas Taylor, a licensed psychologist who helped develop the program.

Meth addicts become enmeshed in a world of illegal drugs, and frequently commit crimes in order to pay for their habit.

Getting the community to accept them when they are weaned from the drug isn't easy, Taylor said. "We are dealing with a population of people who are not the most popular members of the community. These are not people you welcome to your kids' soccer game. We have to figure out ways to get them back into the community," Taylor said.

Both programs will serve as models for communities throughout Colorado, and in other states, Suthers said.

The Daniels Fund grants follow a $50,000 grant from the El Pomar Foundation to fund the task force, formed one year ago, for two years.

When the state Legislature set up the State Methamphetamine Task Force last year, "We were told that we should be looking for private funding and government grants," said Suthers.

Tom McGhee: 303-954-1671 or tmcghee@denverpost.com


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Judge Orders Psychiatric Test for Suspect in St. John’s Gun Case - New York Times

By ELIAS E. LOPEZ

Omesh Hiraman, the St. John’s University student accused of bringing a loaded rifle onto the college’s campus in Queens this week, was ordered by a judge yesterday to submit to a psychiatric examination to assess his fitness to stand trial.

The judge, Deborah Stevens Modica of Queens Criminal Court, gave the order during an arraignment conducted via a closed-circuit video link between the courtroom in Kew Gardens and Bellevue Hospital Center in Manhattan, where Mr. Hiraman has been confined since Wednesday. Mr. Hiraman, 22, was arrested that afternoon as he strode across campus wearing a mask and carrying a .50-caliber rifle loaded with a single round, according to the police, prompting a three-hour campuswide lockdown.

Mr. Hiraman, a freshman, has been charged with two counts of fourth-degree criminal possession of a weapon, a misdemeanor, and several other violations, including possession of a firearm on the grounds of an academic facility and possession without a permit, prosecutors said yesterday. If convicted of the most serious charge, he faces up to a year in jail, they said.

On a screen in the courtroom, he could be seen sitting next to one of his lawyers as a uniformed police officer stood in the background. Mr. Hiraman looked frail in blue pajamas, but his voice was firm as he answered all questions from the judge and from his principal lawyer, Anthony J. Colleluori, who was in court. His parents, Pat and Vejai Hiraman, were in the front row of the courtroom.

Mr. Colleluori has said that Mr. Hiraman was diagnosed with schizophrenia in 2003 while attending Cornell University and was treated at Mount Sinai Medical Center in Manhattan.

Mr. Hiraman’s mental condition was aggravated in recent weeks after he had surgery to treat scoliosis, Mr. Colleluori said yesterday at a news conference after the arraignment. Mr. Hiraman had an adverse reaction to the pain medication he had been given, the lawyer said, which made it hard for him to digest his psychiatric medication.

“My client is innocent,” Mr. Colleluori said. “The issue becomes, was he competent to form an intent? What was his mental state that day? Was he cognizant enough?”

The events leading up to Mr. Hiraman’s arrival on campus were included in a police report released yesterday.

At noon, hours before arriving on the campus in Jamaica, Mr. Hiraman took the subway to Lower Manhattan in search of a Halloween mask, the report said.

After he made the purchase, Mr. Hiraman hailed a cab and told the driver to take him back to the house in East Elmhurst, Queens, where he lives with his parents. There, he picked up the gun, a single-shot “black powder” rifle, and loaded it with a single round, according to the report.

At the news conference, Mr. Colleluori disputed the report, saying his client did not keep the gun inside the house. He would not elaborate. Mr. Hiraman then took another cab to school. About 2:30 p.m., wearing the mask and holding the rifle in a plastic bag, according to the police and witnesses, he was subdued by a fellow student and a school security guard, who held him until his arrest.

The police report also said he told officers that “he felt that he needed to bring a gun to school that day,” but that he did not know why he had been wearing a mask.

Judge Modica ordered a hearing on Oct. 9 to discuss the results of the psychiatric test and to possibly set bail for Mr. Hiraman.


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Schizophrenic man faces 7-year-old cocaine charges - Pittsfield (MA) Berkshire Eagle

By Tony Dobrowolski, Berkshire Eagle Staff

PITTSFIELD — A 32-year-old Pittsfield man who acknowledged being treated for schizophrenia received a two-year jail sentence yesterday after pleading guilty in Berkshire Superior Court to a 7-year-old drug case.

Mark P. Lesniak, of no known address, pleaded guilty to two counts of distribution of cocaine and to two counts of a drug violation within a drug-free school zone for selling crack cocaine twice to undercover police officers in Pittsfield on March 16, 2000.

Second Assistant District Attorney Joan M. McMenemy said Lesniak was not arrested until Jan. 5, 2007, when he was picked up in New Hampshire on unrelated charges.

Concurrent sentences

He has been held in the Berkshire County Jail & House of Correction on the outstanding warrant related to his Pittsfield case since that time, she said. McMenemy said that New Hampshire authorities intend to pursue charges against Lesniak after he completes his sentence in Massachusetts.

Superior Court Judge John A. Agostini ordered Lesniak to serve concurrent two-year jail sentences on the school-zone charges, and concurrent one-day sentences on the distribution counts. The First Street apartment where Lesniak sold crack cocaine is within 1,000 feet of St. Joseph's High School, McMenemy said.

At Lesniak's request, Agostini recommended that he serve his sentence at the Hampshire County House of Correction in Northampton.

Lesniak told the court that he takes various medications for schizophrenia. "I hear voices," he said.

'I know what I'm doing'

He acknowledged hearing the voices yesterday — "they direct me to hurt myself" — but understood that he was changing his plea.

"I know what I'm doing," Lesniak said.

His attorney, Lori Levenson, said that a competency evaluation conducted on Lesniak by court clinician Dean Zarvis was "a little bit equivocal," but that she and fellow attorney Leonard H. Cohen believed that her client understood the proceedings.

"We're confident that he understands he's pleading guilty," Levenson said.

McMenemy said the court evaluation indicated that Lesniak was competent to plead guilty but not competent to stand trial.

To reach Tony Dobrowolski: tdobrowolski@berkshireeagle.com; (413) 496-6224. Read more!

15% of Women Struggle With Pregnancy-Related Depression - Health Day

By Steven Reinberg

FRIDAY, Sept. 28 (HealthDay News) -- One in seven women suffers from depression before, during or after pregnancy, a new study finds.

The consequences of depression can be devastating to the mother, her baby and her entire family, according to the report in the October issue of The American Journal of Psychiatry.

"The prevalence of women diagnosed with depression before, during and after pregnancy was pretty similar," said lead author Patricia Dietz, an epidemiologist at the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health.

"There are a lot of women who are becoming pregnant with depression, and that's really important for people providing prenatal care to be aware of," she said.

Screening for depression needs to occur during pregnancy and right afterward, Dietz said.

The consequences of postpartum depression, which affects 400,000 women in the United States, can be significant. It can inhibit a woman's ability to bond with her baby, relate to the child's father, and perform daily activities, according to background information for the study.

For the study, sponsored by Kaiser Permanente, Dietz's team collected data on 4,398 women who gave birth between 1998 and 2001. They found that 8.7 percent of the women experienced depression in the nine months before pregnancy, 6.9 percent during pregnancy, and 10.4 percent in the nine months following childbirth.

Some 15.4 percent of the women were depressed during at least one of these periods. Almost 75 percent of women with postpartum depression also suffered from depression before pregnancy. And more than 50 percent of women who were depressed before pregnancy were depressed during pregnancy, Dietz said.

"For many women, it's a chronic condition," she said.

In addition, 93.4 percent of the women who were diagnosed with depression before, during or after pregnancy had seen a mental health professional or were taking antidepressants.

Among women with depression, 75 percent had taken antidepressants -- 77 percent before pregnancy, 67 percent during pregnancy and 82 percent after delivery, the researchers found.

Women should report any signs of depression to their doctor, Dietz said.

"There is effective treatment out there for women. You are supposed to be elated when you've had a baby. It is sometimes difficult to even bring depression up," she said. "But doctors should ask."

Dr. David L. Katz, director of Yale University School of Medicine's Prevention Research Center, said the finding that depression is very common before and after, as well as during, pregnancy is of clear importance.

"There are two potential explanations. Either the challenges of pregnancy -- from hormonal changes to psychological adjustment -- induce depression, or the medical monitoring that occurs around the time of pregnancy identifies depression that otherwise would have gone undiagnosed. Of course, both factors may be in play," he said.

There are opportunities for prevention if pregnancy is causing depression, Katz said. "If pregnancy is merely unmasking depression in the population at large, it highlights the need to screen more effectively. Finding depression is prerequisite to treating it," he said.

Dietz thinks that before a woman starts a program of antidepressants, she should discuss the risks and benefits with her doctor.

According to the March of Dimes, a woman who is depressed feels sad or "blue" for two weeks or longer. Other symptoms of depression include:

* Trouble sleeping.
* Sleeping too much.
* Lack of interest.
* Feelings of guilt.
* Loss of energy.
* Difficulty concentrating.
* Changes in appetite.
* Restlessness, agitation or slowed movement.
* Thoughts or ideas about suicide.

More information

To learn more about depression and pregnancy, visit the March of Dimes. Read more!

Mental health system needs infusion of common sense - Asheville (NC) Citizen-Times

Editorial:

The horror stories that continue to emerge from the state’s failed mental health system would almost be laughable if they were not so tragic.

Constant rule and rate changes, inadequate reimbursement, interminable paperwork and frequent audits continue to drive providers from the field. They leave behind desperate patients who can’t get timely appointments, run out of medications, lack stability in their treatment and sometimes sink into crisis. They then end up in hospital emergency rooms or in jails ill equipped to cope with their needs.

As a result, taxpayers foot the bill for the most expensive possible care. Instead of providing for the management of mental illness and allowing those who suffer from it to be contributing members of society, taxpayers end up paying for inefficient crisis care that overburdens and disrupts the medical community, law enforcement, schools and the courts.

Still groping for answers

State lawmakers did a number of things during the 2007 legislative session to shore up the state’s battered mental health system. But Sen. Martin Nesbitt, D-Buncombe, who co-chairs a legislative oversight committee charged with figuring out how to fix the mental health mess, admitted that lawmakers don’t know enough at this point to get a handle on how to fix it. While that may be true, there are actions the Department of Health and Human Services should be able to take immediately to make things better for those who work in the field and their patients.

A report produced by a consultant hired to determine what needs to be done, using numbers provided by the Department of Health and Human Services, was “totally flawed,” Nesbitt said in August.

To get some basis for comparison, Nesbitt said legislative staffers were asked to compare North Carolina’s expenditures on mental health to those in other states.

They found that in every category except developmental disabilities, North Carolina is near the bottom.

But without a better idea about where money needs to be spent and how it should be distributed, lawmakers chose not to infuse a lot of new money into the system.

Instead, they asked for better tracking, set up several pilot programs and directed funding at areas where specific problems could be identified.

That’s all well and good, but the alarming stories coming from the field involve more than a lack of money.

Excessive paperwork

In the past nine months, the N.C. Division of Mental Health Developmental Disabilities and Substance Abuse Services sent out 15 “implementation updates” (rules or rate changes), some with four or five topics. More than 80 “communications bulletins” also have been sent out, most reflecting smaller changes. And these changes don’t include Medicaid rules, which come out in a monthly bulletin.

In one of the most outrageous examples, the state in April cut the $60-per-hour rate for community-based services to $40 and made the cut retroactive to six weeks before the announcement. Several weeks later the rate was changed again to about $51.

When changes are retroactive, providers must go back and change paperwork. Paperwork plagues therapists, who can bill $90 an hour for time spent with the patient, but must spend two hours or more completing paperwork, time for which they cannot bill. In fact, what appears to be excessive paperwork dogs the system from the minute a patient enrolls. Victor Clark, a therapist with Parkway Behavioral Health Services in Asheville, told a Citizen-Times reporter that he has to process 18 pages of forms to get one person into the system.

“And the forms change all the time,” he said. “If you get anything wrong on any of the forms, you don’t get paid. And you have to put the same information on form after form after form.”

Audits and red tape

Then there are the audits. Providers are undergoing audits almost constantly by the state, the federal government and the local management entities.

Combine the hassle with the low reimbursement and it’s easy to understand why providers are being forced to cut back or leave the profession.

Even the most efficient agencies have to reduce expenses, said Dan Zorn, CEO of Families Together.

The oversight committee Nesbitt co-chairs had its first meeting with the state’s new secretary of DHHS, Dempsey Benton, earlier this week. Benton replaced Carmen Hooker Odom, who at times seemed almost bent on sabotaging an already abysmally dysfunctional system.

Benton is “really attentive to mental health,” Nesbitt said, but the system is so broken, it will take a long time to fix.

It may well be that better data are needed to address funding and other problems. But DHHS could begin to address the constant rule changes and the excessive amount of paperwork.

“It would be fine if we could go for six months with no major changes in the system, but that hasn’t happened yet,” said Sandra Layton, cofounder of Parkway Behavioral Health Services.

Benton has promised to be more collaborative. Nesbitt and other local lawmakers would do well to urge him to stabilize the system to the extent possible while the data needed to make other improvements is gathered.
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Arrested St. John's Student Dreamed of Navy -New York Sun

BY SARAH GARLAND

A police ballistics test has shown that a rifle carried by a St. John's University student was loaded and ready to fire when he was arrested this week on the Queens campus. His lawyer said yesterday he meant no harm.

A fellow student and university security officers tackled the student, Omesh Hiraman, 22, Wednesday afternoon after he was noticed striding through campus wearing a Halloween mask and carrying a muzzle-loading rifle wrapped in a black bag.

Mr. Hiraman's attorney, Anthony Colleluori, said a combination of physical pain from recent back surgery, depression, and a diagnosis of schizophrenia led to the incident.

"My client is suffering badly from health issues — both mental and physical," Mr. Colleluori said.

"His big dream was to join the Navy and become an astronaut, and his dream was crushed," he added.

Mr. Hiraman has suffered from scoliosis since childhood, the lawyer said, which forced him to drop his plan to enter the Navy. He then became depressed, left Cornell University, and was diagnosed with schizophrenia, Mr. Colleluori said. After a year off, Mr. Hiraman was trying to restart his academic career at St. John's this fall.

"The pain, I don't think he was up for it," Mr. Colleluori said, adding about his purchase of a gun last week: "My thinking on that is it was a protective action, but I can't rule out suicide."

Mr. Hiraman was moved to a psychiatric ward at Bellevue Hospital yesterday as he awaits his arraignment today on charges of criminal possession of a weapon. It is illegal to have a gun, even of the old-fashioned black powder sort, in the city without a permit or NYPD registration.

Police fired his weapon yesterday afternoon in front of attorneys to determine whether it had been operable. They found that the gun, a Wolf rifle that breaks in the middle and is charged with black gunpowder, had been loaded with a powerful .50 caliber ball.

"It would have worked," a police spokesman, Deputy Commissioner Paul Browne, said.

Police officials said Mr. Hiraman had bought the gun on September 21 at Dick's Sporting Goods in Poughkeepsie at a pre-tax price of $179.99, along with some accessories. He paid cash and didn't show identification, police said.

Police were seeking a warrant to search Mr. Hiraman's computer yesterday afternoon after he reportedly sent an e-mail message to a local lawyer asking about which government agencies would be notified if he were to buy a gun, police officials said.

The police commissioner, Raymond Kelly, said he could not comment on Mr. Hiraman's mental state, but said St. John's had not been made aware of any "red flags" in Mr. Hiraman's behavior before the incident.

Mr. Kelly praised the university's new emergency text messaging system, which he said "worked like a charm."

The commissioner also honored the student who helped security guards arrest Mr. Hiraman, Christopher Benson, 21, a police cadet. "At one point I was afraid he would turn into the crowd and start shooting," Mr. Benson said at an afternoon news conference with Mr. Kelly. "I was pretty relieved that it didn't go off." Read more!

Warning System Draws Wide Praise at St. John’s -New York Times

By ELLEN BARRY and WINTER MILLER

Five months ago, James Pellow, the chief operating officer of St. John’s University, numbly watched the panic at Virginia Tech. Students were dropping from upper-story windows, cowering under desks, scrambling for cover or freezing where they stood.

The sight appalled him, bringing painful reminders of Sept. 11, when the St. John’s campus in Lower Manhattan was chaotically evacuated.

So this summer, when St. John’s carried out its annual review of security procedures, Dr. Pellow lobbied for a change he had long been considering: a text-messaging system that could send information about an unfolding crisis to individual cellphones.

That system underwent the ultimate dry run on Wednesday when a gunman in a mask strode onto the St. John’s campus in Jamaica, Queens. Though no one was hurt, the incident showed that large, dispersed crowds — at least 10,000 students were on the campus at the time — could respond calmly in the face of alarming information.

Yesterday the technique was praised by everyone from Gov. Eliot Spitzer to Assemblyman Rory I. Lancman of Queens, who presented legislation requiring text-messaging systems at college and university campuses across the state.

After the crisis at Virginia Tech, “everything from bullhorns to texting was considered,” said Dr. Pellow, who is also the university’s executive vice president. “How do you communicate instantly? Because the expectation now is instant communication.”

The campus yesterday was suffused with relief, a rare celebration of something that did not happen. A lawyer for the gunman, Omesh Hiraman, said his client had suffered a psychotic episode because he was unable to digest medication prescribed for schizophrenia. He will be arraigned today at his bedside at Bellevue Hospital Center on charges including fourth-degree criminal possession of a weapon, said Richard A. Brown, the Queens district attorney.

St. John’s president, the Rev. Donald J. Harrington, said Mass under glowing stained-glass windows as students stood in rows two deep at the back of the packed chapel. He prayed for Mr. Hiraman, and praised the actions of “ordinary people in extraordinary times.”

“In yesterday’s incident, we observed, I believe, God’s gentle hand protecting and preserving our university,” he said. “God can work in our midst, and when he does so, he does it through other people.”

The emergency messaging initiative is so new that administrators were debating whether to send a sample message out as a test when Mr. Hiraman, 22, strode onto the campus, wearing a mask and carrying a rifle.

That was at 2:20 p.m. At 2:30, Mr. Hiraman had been apprehended, but there were reports of a second gunman. Within minutes, Thomas Lawrence, the university’s vice president for public safety, had dictated this message: “From public safety. Male was found on campus with a rifle. Please stay in your buildings until further notice. He is in custody, but please wait until the all-clear.” An information technology specialist pressed the “send” button at 2:38.

“We didn’t sugar-coat it,” said Mr. Lawrence, who said his years as a police officer — he is a former deputy chief of New York Police Department’s Brooklyn South Patrol Bureau — convinced him that issuing complete information to the public is “the safest way to go.”

Though only 2,100 students were signed up for the program, the text message, and two more that followed, spread within seconds, which Dr. Pellow said “allowed us to manage this mini-city of 20,000 people.”

Students and faculty waited for three hours while police determined there were no additional gunmen, and were released just after 5:30.

By yesterday afternoon, administrators said the number of subscribers had reached 6,542.

Jonathan Azara, 18, who was helping enroll students in the program yesterday, said many of his peers had initially hesitated because they were afraid of receiving spam. Others thought the system would convey more ordinary information, like snow days.

But those ideas were swept away by Wednesday’s incident, said Tanesha Wright, 19, who was helping Mr. Azara. If students at Virginia Tech had received similar bulletins, she said, “lives would have been saved.”

The growing popularity of cellphone text-messaging, which once seemed to be the exclusive domain of teenagers, has opened up new possibilities for mass notification, said Amir Moussavian, president and chief executive of MIR3, the San Diego company that designed St. John’s system.

Similar systems have long been used in government agencies and large-scale logistics operations, but they were cumbersome and difficult to use. To receive a text message, by contrast, a person does not even have to answer the phone, Mr. Moussavian said.

The April murders at Virginia Tech vastly increased interest in Mr. Moussavian’s technology. He said it is now in use at 70 universities, 10 times as many as before the attacks in Virginia. MIR3 sends messages via pager, fax, e-mail and satellite phone, as well as text.

Mass notification systems bring with them their own risks, chief among them the spread of rumors or bad information, said security officials at several area universities. James F. McShane, associate vice president for public safety at Columbia University, said it can be difficult to “craft a message in the heat of the moment.”

“You don’t know who’s out there,” he said. “If you tell people to run, you’re telling people to abandon secure cover without really knowing what the risks are.”

John Carroll, the director of safety and security at Fordham University, said he would always consult with the police before issuing instructions to students. “This message is not going to go out in the first two minutes.”

Columbia is developing a system similar to the one used by St. John’s.

Administrators at Fordham can send 40,000 text or voice messages within 10 to 30 minutes of an incident, Mr. Carroll said.

Meanwhile, authorities at St. John’s are so satisfied with their notification system that they may decide to make participation mandatory, Father Harrington said after yesterday’s Mass.

Added Dr. Pellow: “To have 18-year-olds react very responsibly and very calmly was very pleasing to us. It’s consistent with our plan, but that’s one of the elements we can’t control.”
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Colorado urging businesses to hire people with disabilities - Colorado Springs Gazette

By PERRY SWANSON

The state government is encouraging businesses to hire people with disabilities such as Down syndrome and bipolar disorder.

Nine people dispatched throughout Colorado since July are telling businesses about the capabilities of people with disabilities and programs providing incentives to hire them.

Many people with disabilities have a hard time getting work. In Colorado Springs, an estimated 29,299 people age 16 to 64 are disabled. About half of them were unemployed last year, according to the U.S. Census Bureau. The statistics don’t reveal how many people with disabilities sought employment.

“The biggest barrier is attitudes and stereotypes,” said Larry Gehring, business outreach coordinator for the Division of Vocational Rehabilitation. The division is part of the Colorado Department of Human Services, the state welfare department.

Hiring officials sometimes don’t realize people with disabilities are capable of performing many jobs, and the changes necessary to accommodate a disability are often minimal, Gehring said. The state set aside about $200,000 for marketing efforts to tell companies about disabled workers, he said.

In Colorado Springs, Business Outreach Specialist Melody Babbitt said she identifies businesses that might hire people with disabilities through networking groups, cold calls and other means. Among Babbitt’s arsenal of reasons for hiring someone with a disability is one argument that’s highly personal. Babbitt has dyslexia, an impairment of the ability to read.

“I’ve got one, and I’ve been working all my life,” she said. “The more people we have working in our community, the better it is for all of us.”

Other arguments are on the practical side. For some employers, the state gives a temporary reimbursement of the salary for a disabled person. The government also sometimes covers the cost of changing a work space to accommodate a worker’s disability.

Colorado Springs resident Robert Troy Caron, a shift leader at a Quiznos restaurant, got his job about a year ago with help from Babbitt. Caron, 49, has several barriers to getting a job, including attention deficit hyperactivity disorder, bipolar disorder and a criminal record that includes felony convictions.

The store manager, Marge Carl, said she’s hired several people with disabilities through the Division of Vocational Rehabilitation program and now has two on staff.

Caron wrapped sandwiches at the restaurant until he got a promotion a few weeks ago. He said he enjoys the new position.

“I guess I got more responsibilities to myself, so it makes me feel better to myself,” he said.

CONTACT THE WRITER: 636-0187 or perry.swanson@gazette.com Read more!

Mom: Daughter was reclaiming life -Wilkes Barre (PA) Times-Leader

By Terrie Morgan-Beseckert
morgan@timesleader.com
September 27, 2007


WILKES-BARRE – Plagued by problems with drugs, Kelli Fasulka appeared to be getting her life in order in the weeks before she died, her mother, Sharon, said.

Intent on regaining custody of her children, Kelli had submitted to weekly drug testing and had been clean up until five days before her death, Sharon said.

But something happened in the week before Aug. 15, 2006. Kelli decided to use cocaine again. It was a decision, police say, that helped lead to her murder.

Now, her mother is left wondering what went wrong as she raises Kelli’s three children, ages 15, 12 and 4.

Sharon, who asked that her last name be withheld to protect the privacy of the children, said Kelli’s problems with drugs stemmed from her battle with bipolar disorder. Kelli would be fine when she took her medication, but when she went off it, she would self-medicate with alcohol and drugs.

“She had used drugs in the past but was on the right track. She was going to church every Sunday and had just gotten accepted into a church,” she said.

Sharon said Kelli had been dating a man for awhile, but they had broken up and she began dating Daniel Lock, a man who was a fellow patron at a tavern she frequented, the New Pot Belly bar in Duryea.

The evening of Aug. 15, 2006, Lock brought the owner of that bar, William Rohland, to Kelli’s trailer home in Avoca. Police say Lock had arranged for Rohland to purchase $500 worth of cocaine from Joey Hernandez and Fred O’Shea.

But something went terribly wrong. Rohland, police said, stabbed Kelli 18 times, then fired a shotgun into her head. Hernandez was also fatally shot after arriving at the home with O’Shea, who along with Lock escaped the carnage.

Sharon sat through all seven days of Rohland’s trial. A rosary clutched in her hands, she frequently fought back tears as she listened to the sometimes graphic testimony describing her daughter’s last moments. She bolted from the courtroom in disgust several times during Rohland’s testimony on Wednesday.

“I can’t stand the lies,” she said after returning the courtroom on Wednesday. “I don’t think anyone will believe it. There are too many holes.”

Her prediction proved correct on Thursday, when a jury convicted Rohland of two counts of first-degree murder. On Monday the panel will reconvene for a sentencing hearing to determine whether Rohland should be sentenced to death or life in prison.

Sharon said Thursday she doesn’t know if she will be called to testify at the sentencing hearing.

For now she’s concentrating on helping Kelli’s children get through the ordeal. Her daughter’s been painted in a negative light during the trial. She wants the public to know there was another side to her.

“She had the best heart in the world. Her girls adored her,” she said.

Terrie Morgan-Besecker, a Times Leader staff writer, may be reached at 570-829-7179 Read more!

Adolescent angst or something else - USA Today

By Sharon Jayson, USA TODAY
September 27, 2007

Adolescent behavior has baffled parents for generations, but today's culture is especially rife with potential pitfalls that can trip up even the best of teens.

"They're often forced to be adults way before their time," says Deborah Tackmann, who teaches health at North High School in Eau Claire, Wis. She has been teaching middle and high school students for more than 20 years and estimates 10% to 15% of students in a given school year are what she would call "troubled," with a wide range of ills from suicidal thoughts to self-mutilation to pregnancy, family stress, sexual orientation, death or divorce of a parent to substance abuse.

Are all teens moody? Do they clam up and head to their bedrooms and close the door? How can you tell if your teen is abusing substances? These are questions the experts have heard time and time again as parents try to decipher whether their teen's behavior is "just a phase" or whether an adolescent is really headed for trouble.

NATURE OR NUTURE?: Teens driven to distraction

Lisa Boesky, a child and adolescent psychologist from San Diego, says she wrote When to Worry, published in July, to help parents with those weighty questions.
FIND MORE STORIES IN: Adolescent | North High School | John Townsend

"One of the big things to keep in mind is that all teenagers are moody. It doesn't mean they have bipolar disorder. They may have a difficult time focusing. They don't all have ADHD," she says.

Boesky says when kids hit 13 or 14, parents will begin to see new behaviors that usually are normal. Besides moodiness, she says, they sleep more, may be rebellious and just don't want to talk to you.

Experts say signs of real difficulty emerge if the behavior interferes with the way teens function at school, at home or with friends. If grades slip, if conflict at home escalates, or if teens are isolated or bullied, those are signals that trouble is brewing.

But Norman Hoffman, a licensed mental-health counselor from Ormond Beach, Fla., and author of Bad Children Can Happen to Good Parents, advises parents not to worry about a child who appears to be a loner. "Being a loner is not in itself pathological," he says. "Many loners can be very successful individuals when they grow up."

But what about kids who spend hours alone in their rooms playing video games, watching TV or surfing the Internet? How much is too much?

Richard Lerner, director of the Institute for Applied Research in Youth Development at Tufts University in Medford, Mass., says such behavior is a problem when that's almost all they're doing except for school.

"Parents need to exercise control over what they think is a healthy dose of anything," he says. "Without a doubt, too much of any one activity is not going to be good for a well-rounded child."

Lerner says children who don't have enough supervision "get into trouble by finding inappropriate materials. They are left aimlessly to float by on their own decisions when they need parent support."

John Townsend, author of the 2006 book Boundaries With Teens, says the level of connection to or detachment from parents is important. "If they're talking about their life and you know how they're doing, it's a good sign. If you have no idea what's going on in their life, that's not a good sign.

"I don't believe that every problem requires a therapist," Townsend says. "Part of the job of parenting is helping kids succeed with problems. Help them come up with solutions."

For those who do need professional help, some type of substance abuse may be involved.

Mike Linderman, a licensed professional counselor, works with teens at the Elk Mountain Academy, a therapeutic boarding school primarily serving drug- and alcohol-addicted kids in Clark Fork, Idaho.

"Parents' gut instincts are right on the money," says Linderman, author of the new book The Teen Whisperer: How to Break Through the Silence and Secrecy of Teenage Life. "They say they knew it. They could feel it, but they didn't want to admit it. They need to remove that denial. They need to see the reality of what's going on."

Stanton Peele, a psychologist, attorney and addiction expert from Chatham, N.J., is familiar with parents in denial. He says many parents are not realistic about expectations. "We think that drugs and alcohol are two bad things out there and we need to beat them back. We figure if we just warn and scare kids enough, everything will be all right. But we know that doesn't work."

Peele's Addiction-Proof Your Child discusses how parents can help their children overcome such problems. "The majority of kids who experiment or sample substances don't become problematic users of those substances. Most of those who develop a problem don't continue the problem later in life."

Parents often overreact, the experts say.

"Either they're too strict, which brings about more rebellion, or they're too hands-off, and the child gets into trouble because of lack of supervision," Boesky says. "Parents need assistance to find that balance — to monitor and supervise without being too strict." Read more!

Wake County hopes to keep hospital open - AP

The Associated Press
September 27

RALEIGH, N.C. - Wake County officials are interested in using a state psychiatric hospital in Raleigh after a new facility opens in Granville County early next year so they can provide short-term treatment to local patients.

Dorothea Dix Hospital is slated to close as the state prepares to open a new Central Regional Hospital that legislators approved for construction four years ago.

But county officials and mental health advocates are worried there aren't enough alternatives in and around Raleigh for immediate short-term care, such as drug detoxification centers and therapists. These services have been slow to develop as sweeping changes have been made to the state mental health system since 2001.

Keeping Dix open could fill in the gaps while space for short-term treatment in Wake County expands through 2010, said Joe Durham, Wake County deputy county manager. County administrators want to offer a plan for Wake commissioners to consider this fall.

"We can't sit idle while this facility closes," Durham said.

Wake County's interest in Dix comes as state legislators wanted more answers Tuesday about whether enough community treatment options are available in central North Carolina as Dix and John Umstead Hospital, also in Butner, are replaced by the new hospital.

State health officials told a legislative mental health oversight committee that they want to open the new hospital by March.

"Somebody's going to have to assure me that we will take care of everybody before we open it," said Sen. Martin Nesbitt, D-Buncombe, the committee's co-chairman. "The good news is we've got a little bit of time."

The new hospital will have enough beds to care for the more than 500 patients that on average have been treated daily at Dix and Umstead during the past fiscal year, said Dr. Jim Osberg, who supervises the state's mental hospitals. The capacity includes a 117-bed overflow unit on the Umstead campus that will become part of the new hospital nearby.

The overflow unit will remain until treatment options improve in the counties and the number of patients needing institutional care decreases, state Department of Health and Human Services spokesman Mark Van Sciver said Wednesday.

Wake County lawmakers at the meeting said they want more assurances that the department has assembled enough outpatient services and private treatment options before the transition to the new hospital is complete.

Without such services, the patients will have to be hospitalized, leading to overcrowding or waiting lists for treatment that will damage patient health, according to critics. Other lawmakers wanted the state's patient projections at the new Central Regional Hospital for the next five to 10 years.

State law says new department Secretary Dempsey Benton can't close the two old hospitals without presenting to the committee detailed information about the outpatient treatment. Members were unhappy with what they received Tuesday.

Mike Moseley, head of the state division that oversees mental health, said his office would provide a better review soon.

The hospital transfer highlights a six-year effort to reform the state's mental health system from one centered on institutional care to community-based mental health and drug and alcohol treatment programs.

The movement has been harmed by budget shortfalls earlier this decade and uneven community care as some private programs assembled to treat patients where they lived went under financially. Most recently, Broughton Hospital in Morganton stopped receiving Medicaid and Medicare reimbursements following the death of a patient and the fall of another.

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'Kid Nation' drawing controversy - USA Today

By MARILYN ELIAS

"Kid Nation", the TV reality show airing on CBS, is igniting a firestorm of criticism from children's mental health and media experts, even as some parents of participants say the show made their kids better people.

The premise of the program is to plunk down 40 kids, ages 8 to 15, in a New Mexico ghost town for 40 days. Producers challenge the children to make a viable society in the primitive wilderness.

Controversy has surrounded the show for weeks. The New Mexico attorney general is investigating whether child labor laws were violated and inspectors illegally kept from checking out the set. One mother complained to authorities that her daughter's face was burned by spattered cooking grease, and four other children accidentally drank bleach.

CBS has said the injuries were immediately treated by professionals.

But there may be lasting emotional injuries to some children involved and bad after-effects for viewers, say experts on media and kids.

"Kid Nation "emphasizes some of the worst aspects of society, such as group inequalities and fighting for limited resources, says Joseph Al- len, an adolescent psychologist at the University of Virginia. "They re-create these bad things on purpose and then subject kids to them. The children are manipulated to an unconscionable degree."

It's not really a "kid nation" at all because adults quickly move in to structure the society and set rules, adds Michael Brody, a Washington, D.C., child psychiatrist who teaches about kids and media at the University of Maryland.

Left alone, the kids quickly flounder until a host sets up a contest that divides them into four classes . The rich can buy abundant candy and fun things without working; merchants, second in affluence, run the stores; cooks, paid less, prepare the meals; and laborers do all the grunt work and make the least money.

With one outhouse for 40 kids, many assigned to cook but unsure how, 15-year-olds bullies getting in the face of delicate 8-year-olds and hard sleeping conditions, it's no surprise that the camera soon shows children crying. Viewers see 8-year-old Jimmy saying softly: "I'm really homesick. It's scary. I'm too young for this."

He is the only child who leaves. "What's it going to be like for him to go back to school after crying and being homesick on national TV?" Brody says. "He's going to be perceived as a wimp."

And though show spokesmen say that kids can leave, there's intense pressure not to, says Jana Martin, a child psychologist in Long Beach, Calif. "The host tells them, "You can decide if you want to give up If you can't handle all of this, you can go home.' It's portrayed as a personal failure."

Children soon find out the four-member town council (kids chosen by show producers) award $20,000 every week to one deserving child. "We don't know how this would put pressure on kids who come from poor families," Martin says.

They learn "they'll have to impress "the management' to get that money - just like adults," says Donald Shifrin, a Seattle pediatrician and spokesman for the American Academy of Pediatrics. "It's all about materialism and consumerism."

CBS declined to respond to specific criticisms, but spokesman Mitch Graham said children had been prescreened to make sure they were emotionally and physically healthy.

While she deplored the show's intense rivalries, "there are some nice portraits of empathy and caring," says Jane Brown, an expert on media and adolescence at the University of North Carolina-Chapel Hill. Kids care for one boy with a muscle spasm, others comfort the weeping.

Some parents think the show did wonderful things for their children. (Parents signed waivers in advance that subject them to a potential $5 million penalty if they comment on the show, so the only parents who have spoken publicly are preapproved by the network.)

Hunter Jeffers, 13, has been much more appreciative of comforts such as running water and more helpful around the house since he left "Kid Nation", says his mom, Dawn Jeffers, of Augusta, Ga. "He also realized he doesn't know much about world politics, because some of the kids talked about it while he was out there, so he's watching more news on TV." He also wants to learn to cook, she says.

Jeffers says she and her husband prayed hard about whether to let Hunter participate. The contract waives CBS responsibility even if a child dies on set. "God was giving us signs that we were supposed to do this. God wanted Hunter for His kingdom out there," she says.

The show's competitive edge was healthy, says Isa Goenaga, whose 13-year-old daughter Natasha loved being on the show. "Competition made it more fun for them. That's what life is about. It's an accurate depiction of our society. You have to work hard, and you have to work harder than the next guy to move up in life," she says.

Natasha came home concerned about global warming and recycling old clothes, Goenaga says. "She didn't even want to come home. It made her a stronger person."

Some viewers, seeing the feats on "Kid Nation", might push their children to be even more independent when many already are pressured to be "little adults" too soon, Martin says. It's good to see that children are resilient, but she shudders at the response of one boy in a focus group that saw the program. "He said, "This shows we can do things better ourselves, and we should have more power!' That attitude could create trouble for parents."

Still, many parents don't see it that way. Casting for "Kid Nation 2 "has begun, says CBS' Graham, and more than 2,000 applications have been submitted. Read more!

Author Speaks on Flawed Mental Health System - Southern Pines (NC) Pilot

BY MARY GRIFFIN: STAFF WRITER

The National Alliance on Mental Illness of Moore County's Pathway to Awareness weekend will feature renowned investigative journalist Pete Earley as its special guest speaker at 7:30 p.m. Saturday, Sept. 29 at Sandhills Community College's Owens Auditorium.

When Earley's son Mike was diagnosed with bipolar disorder, Earley saw firsthand what it was like navigating through this country's sadly neglected mental health care system. While it was a horrendous experience for Earley as well as his son, there is a small blessing. Earley did what he does best: He delved into the system, exposed the flaws, and wrote a book about it.

"Crazy, A Father's Search Through America's Mental Health Madness," documents not only Mike's experiences with a devastating mental illness, but also those countless others who fared worse, as well as the system that handles them as a result of deinstitutionalization.

"All of a sudden, that guy who was psychotic on the street corner took on my son's face," says Earley.
Laws have been
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passed to protect the civil rights of the mentally ill. However, they've often left family members and loved ones without any means to help those who are suffering.

When Mike had his first psychotic episode, Earley took him to the emergency room in his hometown, only to be told by the physician that he couldn't treat Mike unless he was likely to hurt someone or himself. Mike said he wasn't planning to hurt anyone, and refused medications because he thought they were poison. He was released with no treatment.

"The ironic thing is, after all the fighting they did to free someone, they walk out the door, and it's the parent or loved one who is left there facing reality," says Earley. "We have to deal with the loved one with a mental illness."

Deinstitutionalization Issue

Through deinstitutionalization, "everyone was thrown out overnight. And in most states, the imminent danger standards are really high," says Earley. "Those safeguards came out of reason, but unfortunately, the federal government, through Medicaid, has taken over the process. Doctors are cut further and further out, and civil rights activities are fighting really hard for the wrong reasons."

Just a few days after his first trip to the hospital, Mike broke into a home, took a bubble bath, and did extensive damage while there. And that was the father and son's introduction to how the mentally ill are treated in this country: Through the criminal justice system, often involving long stays in jail.

Mike was ultimately given two years' probation with a promise to undergo treatment with medication. Many more mentally ill receive jail sentences instead of treatment.

Private corporations that have assumed the management of mental health facilities have made finance the top priority, while shuffling patients in and out without much care, according to Earley. As he discovered, an empty bed makes more money from subsidies than an occupied bed does.

Earley says that his home state, Virginia, has one of the highest imminent danger criteria.

"And if you do meet it, the average time you'll spend in an institution is just six days," he says. "Institutions or hospitals don't have the funds, and they don't have the beds available.

"The problem gets to be vast. We look in Virginia and see such a shortage of hospital beds that 2,400 people will not be admitted, and of those people, most will just sit in jail cells with no treatment. We think 400 will simply be turned loose."

North Carolina doesn't fare much better. NAMI's Web site grades America's health care system by state. North Carolina's grade is a D+, spending just $50.26 per capita on mental health care and ranking 43rd in the nation. Although the state was building a new state hospital to replace two antiquated facilities as of 2006, NAMI identifies the urgent need to build more crisis services and alternatives to hospitalization.

Earley states that as many as 16 percent of the people in jail suffer from a mental illness.

"No one wants to deal with them," he says. "It's really tough. Who wants a dirty psychotic person coming into a community center? They'd rather have someone like my son. As horrible as what we'd gone through, there are much more horrible stories."

Earley found this out when he traveled to Miami-Dade County Jail, where he regularly visited the ninth floor, or its psych ward.

Patchwork System

The result of America's patchwork system of mental health care became glaringly obvious when he followed the lives of several of the inmates who had been in and out of the jail system for years. When one of its inmates, Freddie Gilbert, who had been very nearly catatonic, did receive the proper treatment and medication, he responded well. He even thanked his doctor later. As soon as he was freed, and the law continued to bar further treatment, Gilbert wound up back in jail.

A patient in a Florida state hospital who had been warehoused for 20 years, was finally discharged into a badly run boarding home, or assisted living facility. She had family who cared for her, but were limited in what they could do to help her by the law. Her condition only worsened until she died.

As heartbreaking as that is, it's a cold reality. And those who do get the help they need are never cured.

During Mike's probation, he got a job, was taking his medication, and everything was fine, according to his father. But when his probation ended, he stopped taking his medication.

"And I had to watch him deteriorate all over again," says Earley. "In Fairfax we have a mobile crisis team to help evaluate the person. We ran right into the same thing. He wasn't dangerous yet, so we had to call them back when he did become dangerous."

When that happened, Mike was shot with a Taser twice and hog-tied.

"If I couldn't get help for my son after spending three years with my connections, my knowledge and money, what chance does someone else have without those advantages?" Earley asks.

That was exactly one year ago, and Mike's been taking his medication and doing fine since.

Some Solutions

After his exhaustive research for "Crazy," Earley offers some simple solutions.

"We have to educate people so they understand that mental illness is not something people choose to get, or that they've done something to deserve it," he says. "We stigmatize the mentally ill because we're so afraid it can happen to us".

It's a tough stigma to fight. Even with a college degree that said he was qualified to do the work he chooses, Mike had a difficult time getting hired.

"If you're in human resources, would you want to hire someone who could have a breakdown? Would you want to fly with a pilot who has bipolar disorder?" asks Earley. "The main thing is, we have to recognize we need to put money where our hearts are, and begin financing mental health services. We need to take another look at laws. Eighty percent can recover, manage their disease, and live productive lives."

Earley says drop-in centers, assertive community treatment teams and more beds at hospitals are urgently needed.

"Not everyone will get better, but that doesn't mean we should abandon these people to the streets," he says. "Getting them help needs to be the least coercive as possible, so we don't infringe on their civil rights. So far, we've been too cavalier about it because it's more important to protect their civil rights."

In a perfect world, protection would be put into place to prevent what happened to the mentally ill before, when state hospitals were nothing more than dumping grounds. Hearings would be held before a person is committed to a mental health facility, and advocacy groups would be in place to monitor those facilities.

Earley will speak about his book and his personal experiences at NAMI of Moore County's Pathway to Awareness Weekend. He'll also conduct a book signing from 12:30 to 2 p.m. Sunday, Sept. 30, at Pinehurst Village Assembly Hall Complex.

Contact Mary Griffin at 693-2482 or by e-mail: mgriffin@thepilot.com.
Read more!

State OKs funds for distressed hospitals -Springfield (MA) Republican

September 27, 2007
By DAN RING
dring@repub.com

BOSTON - Deluged by requests for money from hospitals, state legislators today quickly approved an additional $9.5 million in grants for health care providers.

The approval by the House and the Senate gives the state $37.5 million for grants to financially pinched hospitals such as Providence Behavioral Health Hospital in Holyoke and Holyoke Hospital. The state budget for this fiscal year contains $28 million for the grants for providers that serve needy people.

Mark M. Fulco, a vice president at the Sisters of Providence Health System, said he is even more optimistic the group will receive $5 million grant to keep open the 124-bed Behavioral Health Hospital in Holyoke, at least for another year.

Fulco said he was "extremely grateful" for the work of Western Massachusetts state legislators.

In May, officials with the Sisters of Providence Health System warned that the Behavioral Health Hospital was facing possible closure because of a lack of financing from the state.

In a short speech on the Senate floor, Sen. Gale D. Candaras, D-Wilbraham, yesterday emphasized the need for keeping it open.

"If that hospital were to close, there would be hundreds and hundreds of jobs lost and hundreds and hundreds of patients with nowhere to go, and hundreds of methadone patients out looking for heroin on the street," Candaras said.

The hospital offers the only inpatient mental health program for children and adolescents west of Route 128 and the only psychiatric unit in Western Massachusetts that specializes in treatment for the elderly. It also operates a methadone clinic.

According to a spokeswoman for the state Executive Office of Health and Human Services, 83 providers submitted applications for grants that totaled $110 million, about three times the money available.

Many hospitals that serve the poor are squeezed by Medicaid reimbursements that don't meet their costs of providing the care.

Jennifer L. Kritz, spokeswoman for health and human services, said the grants will be awarded within a week.

Holyoke Medical Center, Noble Hospital in Westfield, Cooley Dickinson Hospital in Northampton and several community health centers in Western Massachusetts received grants last year from the fund.

Gov. Deval L. Patrick sought the additional $9.5 million in $132 million spending bill he filed in May.

The House and the Senate yesterday approved the $9.5 million separately from the rest of the $132 million bill. Patrick is expected to approve the $9.5 million.
Read more!

Hayes to remain at Dorothea Dix - Associated Press

The Associated Press
September 27, 2007

A judge has ruled that a man who has spent almost 20 years in a state psychiatric hospital for killing four people and wounding five others in a 1988 shooting spree in Forsyth County will remain in the hospital.

Judge Steve Balog ruled Thursday that Michael Hayes will stay at Dorothea Dix Hospital in Raleigh for another year.

His attorney, Karl Knudsen, said Hayes would appeal the ruling.

Hayes, 43, has been housed at Dorothea Dix since a jury found him not guilty by reason of insanity in 1989. The hearing was to determine whether Hayes can be released from the hospital.

Several experts testified that Hayes was past the point in which many experts would consider patients ready for release.

Balog ruled that Hayes did not meet one of two conditions for release: that he's no longer mentally ill or no longer a danger to others.

The judge also ruled that Hayes should stay at Dorothea Dix at his last hearing in 2001. Read more!

11-year-old overcomes autism to lead fellow students - Stockton (CA) Record

By Keith Reid

STOCKTON - Donnie Hunyh is not your ordinary politician.

Sure, he's a self-proclaimed conservative Republican holding Christian values (he wears a bracelet reminding him to "fear not"); he supports President Bush because "I like the way he talks"; and after giving his spirited campaign speech early this month - from memory - he held up two fingers, Nixon-esque, as a the peace sign.

But, no, this 11-year-old Manlio Silva Elementary School class president is anything but a gimmicky, fast-talking politician with an agenda aimed at slashing student fees, increasing recess minutes or placing restrictions on teachers with stringent homework schedules.

"I want our school to recycle and use the money for a pizza party," said Donnie, a sixth-grader.

His ascendency to the presidency was anything but assured when he was diagnosed with autism at age 2. In the intervening years, Donnie and his family worked at achieving despite his disability.

Donnie overcame his tendencies to be shy, quiet and aloof to persuade his classmates to elect him as their school leader. In that capacity, he runs the student council and makes daily announcements over the loudspeaker.

"It just popped in his head one day, that he wanted to do it," sixth-grade teacher Phillip Jay said. "He said he wanted to run for president. Sometimes with special-needs students the first instinct is to think, 'No, don't let them go through it.' But we decided that if he met the requirements, he could run."

The requirements included getting good grades and filing a petition with signatures from parents, teachers and classmates in a timely fashion. He also had to give a campaign speech in front of 300 students.

"I wish half the students I have could give a speech like he did," Jay said. "He was genuine, delivered it with charisma, and he kept eye contact with the audience. And he was the only (candidate) that memorized his speech."

Donnie's mother, Candy Hunyh, said she has worked diligently to help mainstream her son, who attended a special-needs school before enrolling at Silva Elementary. As a toddler, he spoke rarely and as he grew older had a hard time performing household chores. But a lot of time and patience have allowed Donnie's parents help him learn and overcome his disability.

Both Candy Hunyh and her husband, Tim Hunyh, a land developer, are natives of Vietnam, and Vietnamese is their primary language. Their first son, 14, is bilingual. On a doctor's advice that learning two languages could stunt Donnie's language development, the Hunyhs decided to teach their second son only English. Candy Hunyh, who did not know how to read English, learned to read as she taught Donnie.

Tim Huynh came home from work every day to help Donnie practice making eye contact and help him complete chores.

"It has really helped," Candy Hunyh said. "He is now very responsible."

After working on some basketball skills during physical education class last week, Donnie hung around with Jay, teaching aide Joelle Silver, who works with him throughout the day, and his two best friends, Tianna Spurell and Danyelle Dwyer, both sixth-graders, to discuss his political victory.

According to Jay, students at the school didn't understand that Donnie had autism or what it meant to have autism. Some students poked fun at some of the habits that stem from his disability; some still do. But in the past year, Donnie has gained acceptance among his peers. Silva, a school with a diverse student body (16 primary languages), might be the ideal situation for a student with differences to fit right in.

"I voted for him because he's full of spirit, and he's smart - really smart," Tianna said. "He was easily the best candidate."

Silver applauds his ability to draw and uses that to help keep him on task. Keeping autistic students focused is often the key to helping them progress and learn, Silver said, as she pulls out three sheets of paper with detailed comic strips that Donnie created on his own titled "Spy Penguin vs. Goldfeather," which chronicle an undercover penguin's quest to thwart the evil plans of a gold-feathered bird.

Donnie has come out of his shell since starting at Silva last year as a fifth-grader, Jay says, but he notes that Donnie still struggles a bit with occasional outbursts or crying when he can't have Tianna or Danyelle as his class study partners.

"He has a hard time with some of his social cues, like understanding body language - he takes it very personally and might cry if he's picked last," Jay said.

But those tears are fleeting, and friends and faculty will describe Donnie as upbeat. As Principal Dan Faith walks past the youngster in the hallway and asks, "How's it going?" there's only one answer from Donnie:

"Well, everything is going just great, of course."

"Of course it is," Faith answers. "Why wouldn't it be?"

Contact reporter Keith Reid at (209) 367-7428 or kreid@recordnet.com. Read more!

Autism affects far more than brain, experts say -Ottawa (Canada) Citizen

Research opens potential for new treatments

By Tony Lofaro

It's time to look at autism as a whole-body disorder and not just as a brain problem, researchers from Canada and the U.S. said at a news conference on Parliament Hill yesterday.

"I think what we're looking at is a transition from just a behaviour and brain disorder to a whole-body condition," said Martha Herbert, a pediatric neurologist from Harvard Medical School.

"We're looking at a transition from it just being (considered) genetic to being genetic and environmental," said Ms. Herbert, "and moving from being incurable to being something that we can treat in various ways to make the quality of life better and to have more options."

She said looking at autism as a whole-child, whole-body condition is not a particularly new theory, but researchers are advocating that it be put more into the spotlight to have the public better understand the disease.

Researchers have discovered there are often other systemic problems alongside autism, she said.

"We're finding immune abnormalities in probably the majority and gastro-intestinal abnormalities. And when you study children for gastro-intestinal abnormalities directly instead of just looking at old medical records, you find the majority have problems of this kind.

"These problems affect more than one organ system and they travel around the body and affect everything," she added.

A research study done last year by Derrick MacFabe, an assistant professor from the department of psychology and psychiatry at the University of Western Ontario, along with other researchers, found that when a compound known as propionic acid was administered into the brains of rats, it produced behaviours and brain changes similar to autism in people.

Mr. MacFabe, who is also a director of the Kilee Patchell Evans Autism Research Group, said they hear about the problems of autistic children from their parents.

"These children are sick. A lot of these children have gastro-intestinal symptoms, very strange behaviours with eating certain foods," said Mr. MacFabe.

"Families are telling us that some of these children have regressed. Some have had apparent normal development in the first few years of their life and (then) something happens.

"These children lose some or all of their behavioural social inter-connections with the world and retreat into a ritualistic world filled with self-injury, a lack of language and extreme behavioural abnormalities that puts a tremendous strain on families and (on) society as well."

The researchers will be speaking about autism at a conference tomorrow at the University of Ottawa, Roger Guindon Building, 451 Smyth Rd. Read more!

Law gives hope to mentally ill people and families - Fox Valley Villages (IL) Sun

September 27, 2007
BY DENISE CROSBY Managing Editor

One of the most tragic -- and courageous -- victims I've interviewed in my long career as a journalist was a gentle, soft-spoken woman named Norma Piazza.

I met her not long after her 41-year-old son shot and killed his brother and father on a beautiful summer afternoon in June of 1996.

Few around at the time will never forget that very public police standoff. Certainly I won't, for I was among the throng of media outside that home in unincorporated Aurora as Gerald Piazza held law enforcement officers at gunpoint for more than three hours while his mother, summoned to the scene, waited to learn the fate of the three men inside.

I got to know Norma better a few weeks later when I wrote a lengthy story about how she and husband Eugene tried so desperately for years to get help for Gerald, who suffered from schizophrenia.

"No matter where we turned for help," she told me a few weeks after the tragedy, "we always found something blocking us."

Even back then, as Norma struggled with such loss -- a husband and son now dead, a second son languishing in a comatose state in a county jail -- she vowed to become an advocate to change laws that would make it easier for family members to get help for those suffering from severe mental illness.

Today, we celebrate her decade-long battle.

This month, Gov. Rod Blagojevich signed a bill that will do just that -- a law that can be directly attributed to this tragedy and Norma Piazza's tireless efforts. And for that reason, there's a local campaign to name Bill HB646 "Norma's Law."

Sadly, she's not around to enjoy the victory. Friday was the fourth anniversary of her death to lung cancer.

But there are many other local people who are celebrating, including Jim McNish, president of the Kane County Chapter of the National Alliance for the Mentally Ill; as well as State Rep. Patricia Reid Lindner, a Sugar Grove Republican, who introduced a similar bill in 1999 and co-sponsored the new one.

Both Lindner and McNish say it was the Piazzas' tragedy that triggered the local NAMI group to begin the arduous task of making significant changes. In 1998, the group hosted a statewide forum on the legal right to treatment, and lobbying for a bill that would make it possible for those suffering from severe mental illness to be committed involuntarily.

It was an uphill battle, but a couple years later, a bill was passed that McNish described as "baby steps." A short time later, the Kane County Mental Health Protocol, which serves as a road map for how law enforcement deals with the mentally ill, was dedicated to Norma.

In spite of these successes, it took another seven years to get a bill passed that had real teeth to it. The battle was contentious, said Lindner, because groups like the American Civil Liberties Union believed such a law would chip away at the rights of the mentally ill, who for years had been warehoused in atrocious conditions throughout this country.

But the pendulum had swung too far the other way, and NAMI saw families suffering horrendous tragedies because people with schizophrenia and manic depressive disorder often fall into a crisis mode that makes them unable to judge just how sick they are.

"There was such opposition in the beginning," said Lindner. "But I think there is more understanding of mental illness now."

Certainly it took the efforts of many people to get this law passed that "significantly lowers barriers to treatment," says McNish.

But it was Norma's voice, Norma's pain that served as the catalyst. And now both sides understand that, with the right medication and support, those suffering can become stabilized in six days -- with a recovery rate that is much greater than if they were battling heart disease or cancer.

A few years after killing his father and brother, Gerald Piazza was found not guilty by reason of insanity. He is living at Elgin Mental Health Center where he is "doing well," said his sister, Janet Piazza of Aurora. "He is involved in horticulture there, he is interested in salt water fishing ... he really looks good."

Her mother, she added, would be proud, not only of Gerry, but of this bill that hopefully will carry her name.

"She was very kind and very devoted to her cause," said Janet. "All she really wanted to do was help others."

dcrosby@scn1.com Read more!

Learning to push past stereotypes -South Bend (IN) Tribune

ANITA MUNSON

CULVER -- Ross Szabo is a young man whose passion about changing young people's minds about mental illness has also changed his own life.

The director of youth outreach for the National Mental Health Awareness Campaign easily won over students at Culver Academies Wednesday afternoon with his machine-gun delivery, his ability to reach the audience in its own youthful language, and his call to "change these stereotypes in your own life."

Szabo spoke to the all-school assembly in Eppley Auditorium from the perspective of "been there, done that." Using his own battle in achieving sound mental health, he said he came not to preach but to provide options.

Admitting he's a motivational speaker, Szabo said that when he thinks of the term, "I think Chris Farley (in his role of Matt Foley)," and not the staid, traditional type of how-I-found-success speaker.

"I think, what would Dave Chappelle do if he had my job," Szabo said, launching into an impression that left students laughing out loud.Making the transition to the serious topic, Szabo said one in five high school students suffers from some form of mental disorder, and seven out of 10 high-school-aged drug or alcohol abusers have mental health issues.

He asked students if they knew anyone who participated in binge drinking, use of drugs, or even cutting themselves. Raised hands filled the auditorium.

"Here's the interactive part," Szabo continued. "About 70 percent of all people don't talk about it. Why?"

Students responded quickly: Embarrassment; difficulty with talking about emotions; they don't want to be judged by their peers; it's nobody's business but their own; societal pressures; and more.

American society places "a huge focus on external things" such as money, clothes, status and power, he said."But if you have problems inside, it doesn't matter ...," Szabo added.

Szabo, who has appeared on CNN, MTV and CBS, then said if the students saw someone whose "shin bone" was sticking out through his leg, they wouldn't hesitate to get him to the hospital. And, he said, the brain is every bit as important to heal as any other part of the body.

"But we're deathly afraid to talk about our emotions ... when we don't understand them," he explained. "But they're still there ... so the earlier you find a way to deal with them, the better off you are."

Szabo said another reason to find help is that 80 percent to 90 percent of people seeking such help today and receive it are able to return to functioning and living "normal" lives.

He said that all America sees are the people like those who commit killings on college campuses.Szabo said he and his older brother were both diagnosed with bipolar disorder. The brother was in college and was hospitalized, but later returned to complete a degree in physics. He's now working on a doctorate in astrophysics.

Szabo said he was diagnosed at age 16, and was hospitalized during his senior year in high school for wanting to take his own life. He went on to college, relapsed, recuperated and graduated cum laude in psychology from American University in 2002.

He pleaded with his audience to take time to do something positive for themselves, to seek help if needed.

He warned that the road would be rough, and it would take strength to travel it.

"It takes more strength to be different than to hide what you're going through," he continued. "But you don't have to be afraid.
Read more!

Shutdown may devastate mentally ill -Jackson (MI) Citizen-Patriot

Thursday, September 27, 2007
By Christina Hildreth
childreth@citpat.com -- 768-4924

A shutdown of state government could put many of Jackson County's mentally ill in danger.

Some of the neediest -- residents of adult foster homes who require assistance eating, dressing and bathing -- might be left unattended as the agencies responsible for them scramble to develop shutdown plans.

Nancy Miller, who leads LifeWays, the main community mental-health agency in Jackson and Hillsdale counties, said the state has given her no direction on which services to maintain in the event of a government shutdown.

Miller said her agency would do everything in its power to maintain emergency and inpatient services if the state closes shop. But it's unclear whether anyone will be able to pay for some vital services.

"The services I'm most concerned about -- because it's a huge amount of money -- are all of the people we have that live in group homes," she said. "In some instances, we have people that need assistance being fed. Literally, they've got feeding tubes or they need somebody to put food in their mouth. And so far it's not clear that those are going to be considered 'essential.'"

Her agency provides services to more than 6,000 clients with serious mental illness, substance-abuse disorders or developmental disabilities in Hillsdale and Jackson counties.

"As far as our services right now, they've basically said we're not going to pay you for anything," she said.

State officials have informed Miller and her counterparts in other counties to rely on their own cash reserves to continue operations if lawmakers can't come to a budget deal by the end of Friday. In some counties, that's fine -- cash reserves could last up to a month. But Miller said LifeWays only has enough in the bank to operate for about two weeks without state payment. And she's not comfortable with the thought of breaking the bank.

"At the end of two weeks, we wouldn't even have enough to provide emergency services," she said. "I'm going to be a little bit more conservative. I sent an e-mail out to my staff, saying I may be sending some of you home without pay."

In a letter to lawmakers, Miller said a shutdown would jeopardize crucial services -- such as the Mental Health Prisoner Re-Entry Program, a 400-person statewide program that supports parolees.

Read more!

Cherry director: Hospital will meet state deadline - Goldsboro (NC) News-Argus

Sept. 27, 2007

Cherry Hospital has complied with recommendations toward lifting "immediate jeopardy" status imposed by the state earlier this month, its director says.

And hospital director Dr. Jack St. Clair said he is optimistic that a survey team will lift the sanction.

St. Clair talked Wednesday about the nearly three-week effort to introduce a plan that will satisfy officials.

Survey teams from the Division of Health Services Regulations and the Joint Commission visited the hospital Sept. 4-7 to investigate complaints that had been lodged against Cherry. Three areas of concern were listed -- patient safety, nursing services and its governing body -- and prompted the state's sanctions, giving Cherry until Sept. 30 to comply with recommendations.

The ruling placed Cherry in jeopardy of losing federal funding for patients. On Sept. 21, a public notice was published from the Centers for Medicare and Medicaid Ser-vices in Atlanta, announcing the voluntarily termination of a Medicare/Medicaid provider agreement between Cherry Hospital and the Secretary of Health and Human Services if conditions were not met by Sept. 30.

St. Clair said he is guardedly hopeful the sanction will be lifted.

"I feel confident that we're going to come out from under the immediate jeopardy because our staff has worked very hard since Sept. 7 when (CMS) left with their findings," he said. "We have modified some policies and procedures. We have done a lot of training for staff in a lot of areas to address those three issues."

Cherry staff has worked steadily to produce an acceptable plan, culminating with conversations by phone this past weekend with officials in Atlanta and a document being sent to them by overnight mail on Saturday, St. Clair said.

"They called Monday with some questions to clarify some things. That conversation continued into (Tuesday). At this point, the Atlanta office approved our plan of correction," he said.

A return visit by the state survey team is expected any day now, the scope of which is unknown, St. Clair said.

"The survey may be focused on those three issues, or it may be a full survey," he said.

St. Clair said he stands behind his staff and efforts being made, choosing to view the situation as a chance to improve on services at Cherry Hospital.

"We're not taking this matter lightly. Patient safety and the care and treatment of patients is our No. 1 priority," he said. "(This has) given us an opportunity to put additional measures in place and to enhance the quality of care to our patient population.

"If we're truly all about not just good but exemplary care to our patients, we should always be receptive to scrutiny. We can always do better, and that's the way to look at this thing, because it's all about patients. That's what we're here for."

As one of the largest employers in Wayne County, with an estimated 1,100 staff members, the 284-bed facility has a rich history and St. Clair said it is one he works hard to protect.

"Regardless of how this thing plays out, I think it's an opportunity for us to raise the bar, to affect better care. That's the intent of every organization that's affiliated with Cherry Hospital," he said.

Instead of viewing recent findings as a black mark on the hospital, he said he plans to move forward with a positive approach to change. At the same time, he said he is keenly aware of the difficulties that come with caring for the mentally ill.

"This population is a very challenging group of folks to work with," he said. "(The staff) has dealt with people with all kinds of addiction disorders ... many of these people are aggressive as in violent, which poses a challenge every day to the staff. We get patients and staff hurt at times. I think it's important for folks to know because some folks don't know that.

"We're trying to be forthright with the public about our situation and to recognize that we're not perfect but also to say that we view this as an opportunity to improve over the status quo." Read more!

Grant Files Lawsuit Against County -Columbia (KY) Adair County Progress

By Paul B. Hayes and Lawrence Har
September 27,2007

Wellie Paul Grant, the Glensfork man who shot and killed Columbia businessman Rex Coffey in June of last year and was later determined incompetent to stand trial on the charge following an evaluation at the Kentucky Correctional Psychiatric Center, has filed a lawsuit the county, Jailer William “Bug” Knight and Judge/Executive Ann Melton, alleging in part that he has received inadequate medical care while incarcerated at the Adair County Jail.

The lawsuit was filed Tuesday in U.S. District Court for the Western District of Kentucky in Bowling Green by Grant’s attorney Robert Bertram.

Grant has been lodged in the jail since his arrest for shooting Rex Coffey on June 10, 2006 on the grounds of the Beech Grove Church on KY 900 near Glensfork.

In May of this year, an evaluation conducted at the KCPC stated that Grant was incompetent to stand trial due to deteriorating mental functioning.

Circuit Judge James Weddle must hold a hearing to rule on Grant’s competency, but no date for the hearing has been set and some of Grant’s medical records requested by Commonwealth Attorney Brian Wright so he could review them have not yet been received. As a result, Grant has remained lodged in jail.

In the lawsuit filed by Bertram, Grant alleges that Knight as jailer failed to enact sufficient policies or procedures or employed a custom of violating his own polices and procedures and failed to properly equip staff, hire, train, re-train and supervise competent admin-istrators, officers and health care providers to confine, segregate, supervise and care for and provide medical services to Grant during pretrial incarceration.

The suit specifically states that the county, Melton and Knight were under a duty to provide health care services to inmates including Grant.

The suit also states that Knight and Melton were informed of problems in delivering medical care at the jail knowing that those problems to create a substantial risk of physical injury or death to some pretrial inmates including; low staff levels, lack of basic medical supplies and working equipment, provision of treatment by unqualified personnel and a delay in treatment and transfer to outside facilities.
The suit also alleges that Knight and the jail failed to provide Grant with his proper and necessary prescription medications from his booking date until he left the facility.

The suit states that Grant is seeking damages for physical pain and suffering and emotional trauma and suffering, loss of his enjoyment of life and extra related medical expenses as well as incurring legal fees.

The suit also states a violation of civil rights for deliberate indifference to Grant against his civil rights for the alleged charges listed above.
Contacted yesterday afternoon both Jailer Knight and Judge-Executive Melton, said they could not comment on the suit as they have not yet received a copy of it. Read more!

Deficient care for mentally ill puts KMC at risk - Bakersfield (CA) Californian

BY EMILY HAGEDORN

Crisis had to be averted — and was — after Kern Medical Center’s treatment of mentally ill patients almost cost the county hospital 75 percent of its income. The Centers for Medicare and Medicaid Services recently threatened to pull all Medicare and Medi-Cal funding from KMC after an Aug. 30 inspection showed mentally disturbed patients were bottlenecking in the waiting room of the hospital’s emergency room, said Kern County Supervisor Michael Rubio.

The loss of funding could have forced shutdown of the entire hospital, KMC’s chief recently wrote to county supervisors.

Toni Smith, hospital director of patient care services, said psychiatric patients are held in a separate area of the ER. Problems arise when KMC’s 25 psychiatric inpatient beds fill up, requiring patients there to wait for more than a day for a bed.

“When those beds were full, there is no other place for them to go in the county,” she said.

KMC treats six to seven psychiatric patients a day, Rubio said.

The federal Centers for Medicare and Medicaid cited KMC after the inspection. It “centered on issues of patient privacy, patient overcrowding due to patients being held in the department in excess of 24 hours while awaiting inpatient placement” and patients leaving without notification and staffing, according to a memo from KMC CEO Paul Hensler to county supervisors.

The Kern County Department of Mental Health first reported the problem to the feds, prompting the inspection and violation notice, the memo said. The complaints came out of the patient rights office, which is housed in the Mental Health Department but operates independently, said Diane Koditek, mental health director. Koditek did not know how many people complained or the specifics of the complaints.

After the inspection, KMC was placed on “immediate jeopardy” status and a “fast track” to termination of the hospital’s Medicare and Medi-Cal provider status, the memo said. “Immediate jeopardy” means there’s some systemic problem in the hospital jeopardizing patients’ health, said Jack Cheevers, California spokesman for the Centers for Medicare and Medicaid Services.

It’s not rare for hospitals to be placed on “jeopardy” status but it’s not to be taken lightly either, he said. “Fast track” means the hospital has 23 days to correct the problems. “It’s very serious, and we take it very seriously,” Cheevers said. “It’s just a way of putting more pressure on the hospital to resolve the issue.” He said he can’t comment on investigations and did not know the specifics of KMC’s case anyway.

Hensler wrote that KMC submitted a formal plan of correction with more than three dozen actions.

The Centers for Medicare and Medicaid Services has OK’d the plan, Smith said, removing KMC’s “immediate jeopardy” designation. Rubio said there’s already a solution to the problem.

Last Tuesday, supervisors approved a $776,085 contract with Good Samaritan Hospital in Bakersfield to take up to 10 psychiatric patients from KMC at a time. Patients will still come to KMC for medical clearance before being routed to Good Samaritan, Rubio said.

It is a short-term solution, he said, but it gives Kern County time to craft a permanent fix.

Koditek, who submitted Good Samaritan’s contract to the supervisors, said Good Samaritan can take patients as long as need be.

In the memo, Hensler also requested that supervisors hold a hearing to discuss reducing psychiatric services at KMC and approve the reduction. Smith said he will tell supervisors Tuesday he no longer needs this.

KMC and county mental health are also working on a needs assessment of psychiatric services in the county, which is expected to be done in the next two months, Koditek said. “There has been recognition that the capacity at KMC has not gotten any larger,” Koditek said. “We were aware that there was a need for additional resources.”

— Staff writer James Burger contributed to this report


Read more!

Senseless violence won't be tolerated in our community - Reno (NV) Gazette-Journal

Editorial
September 27, 2007

Reports from homeless people and homeless advocates regarding the latest rash of hatred and violence, which ended in injuries and a death since Labor Day, show that a segment of the community doesn't understand about homelessness or about the damage to be done by victimizing a specific group.

Those who senselessly target homeless people and other groups exhibit a special brand of inhumanity and fear. There is no place for such brutality in our community. This is the lesson that the Cardboard Box City campout on Friday night expects to convey.

Homelessness is a social blemish, certainly. And no one would wish to see it perpetuated. Most people do not choose to live it. It is a fact of life, however, that many people have no recourse but to live out of doors and at the largesse of those who can do better. Many are physically and mentally ill, many are just weak and unable to sustain themselves. Homelessness gains perspective when it is understood that our closest friends could be a paycheck, an illness or a family crisis away from the street. People who are homeless do not deserve to be victimized.

Witnesses report that teens are responsible for the recent beatings with sticks, bats and tree branches. The hate speech found written, graffiti-style, on downtown benches is related. It's been suggested the victimization is for sport. There is nothing sporting about it. It is serious when people, who often distrust caregivers too much to accept care, seek the safety of the city shelter because they fear attacks as they sleep. It is disturbing if youth are so callous.

The charitable groups and agencies that work to help those who are unable to help themselves (and the new homeless complex that was so long in development) point to the compassion that is alive and well here.

The Cardboard Box City, sponsored by Family Promise of Reno-Sparks and planned for Wingfield Park, offers another opportunity to demonstrate how humanness works. It is a chance to teach about homelessness and vulnerability and to say that senseless violence and brutality will not be tolerated.

Read more!

Mental Illness Cited in NYC Gun Incident - Associated Press

By TOM HAYS

A masked college student arrested on charges of carrying a loaded rifle to campus is schizophrenic and recent back surgery worsened his condition, his lawyer said.

Omesh Hiraman, 22, became convinced he needed the rubber Halloween mask and rifle to deal with the pain, attorney Anthony Collelouri said Thursday, a day after Hiraman was taken into custody at St. John's University. A police cadet studying at the university helped apprehend Hiraman.

Hospitalized after his arrest, Hiraman was to be arraigned Friday in his hospital bed on weapons possession charges, prosecutors said. He could face up to a year in jail if convicted.

Hiraman "was wearing a mask so that whatever was going to hurt him could not find him," Collelouri said, adding that Hiraman wanted to attend a business class "so badly that he took a chance on leaving his home."

Hiraman bought the rifle legally last week for about $180 at a shopping mall in upstate Poughkeepsie before bringing it into the city, where he failed to get a permit to possess it, police said.

Police Commissioner Raymond Kelly said Thursday that investigators had obtained a warrant to search Hiraman's computer for clues to why he took the single-shot firearm to the university's Queens campus on Wednesday. He said there was no evidence Hiraman "had a problem with a fellow student or anyone else," but he declined further comment about possible motives.

The cadet who helped capture Hiraman, Christopher Benson, got a special award from Kelly for his "quick thinking and quick action." No one at the Catholic school of about 20,000 was harmed.

Students, including Benson, first reported seeing an armed man walking around campus at about 2:20 p.m. Wednesday. He was carrying a plastic bag with the gun barrel protruding and was wearing the mask, its mouth cut out, police said.

Benson, 21, started following Hiraman and joined in when unarmed campus security officers approached and tried to grab the gun minutes later. Benson and the officers subdued Hiraman after a brief struggle, he said.

Students were told to stay inside classrooms and buildings for about three hours during an extensive search of the campus. Classes were canceled Wednesday evening but resumed Thursday.

Copyright © 2007, The Associated Press


Read more!

Campus Suspect Showed No Warnings of Violence - New York Times

by THOMAS J. LUECK

The 22-year-old student who strode across the Queens campus of St. John’s University on Wednesday wearing a mask and carrying a loaded rifle suffers from severe mental illness and had no intention of harming anyone, his lawyer said yesterday.

The student, Omesh Hiraman, was confined yesterday at Bellevue Hospital Center in Manhattan. He will be arraigned today at his bedside on charges including fourth-degree criminal possession of a weapon, Richard A. Brown, the Queens district attorney, said in a news release.

Mr. Hiraman was subdued and arrested on the St. John’s campus at 2:30 p.m. Wednesday after students and faculty had been instructed in cellphone text messages to remain indoors, effectively bringing the campus to a standstill.

Anthony J. Colleluori, the lawyer, who spoke at a news conference, said Mr. Hiraman was diagnosed with schizophrenia in 2003 while attending Cornell University and was treated at Mount Sinai Medical Center in Manhattan. According to Cornell, Mr. Hiraman left without graduating in the spring of 2005. Simeon Moss, a spokesman for Cornell, said the university was bound by federal privacy laws not to comment on why Mr. Hiraman left.

Mr. Moss said Cornell “will do everything within the bounds of the law to cooperate with another institution” when a student who intends to transfer is believed to have severe mental problems and could become violent. In the case of Mr. Hiraman, there was no communication between Cornell and St. John’s. Mr. Hiraman did not ask to transfer his academic credits from Cornell, and began anew as a St. John’s freshman this year.

Dominic Scianna, a spokesman for St. John’s, said, “We were not aware of any behavior problems.”

The description of Mr. Hiraman’s mental state came as the police and university officials yesterday sought signs that might have predicted his bizarre behavior on campus. The officials, and people who knew Mr. Hiraman, provided a portrait of a studious, introverted young man who had suffered academic setbacks but showed little inclination toward violence.

Mr. Hiraman, who has been living his with parents in Elmhurst, grew up in a competitive environment in which academic success was demanded, according to acquaintances. He has two older brothers, a physician and an engineer, and a younger sister who is still living at home.

But after graduating from Stuyvesant High School, Mr. Hiraman faltered after he entered Cornell to study engineering in 2002.

“There is nothing we can identify at this point that happened at St. John’s that should have raised a red flag,” said Police Commissioner Raymond W. Kelly. He said detectives had found no notes or recordings in which Mr. Hiraman warned of his behavior in advance, and no evidence that he had argued with fellow students or faculty members.

Mr. Kelly said that detectives were seeking a search warrant for Mr. Hiraman’s computer, but that they had not yet obtained the warrant late yesterday.

Mr. Hiraman’s mental condition was aggravated in recent weeks after he had back surgery, Mr. Colleluori said. In an adverse reaction to pain medication, he said, Mr. Hiraman vomited repeatedly, and had difficulty digesting the medication that he needs to control the symptoms of his mental illness.

“I believe he has been undermedicated for the schizophrenia,” said Mr. Colleluori, who was joined at the news conference by Mr. Hiraman’s parents, Pat and Vejai Hiraman.

One thing Mr. Hiraman may have signaled was his intention to acquire a gun, if not to use it. In June — several weeks before his back surgery — he walked unannounced into a lawyer’s office in Jackson Heights, introduced himself as a student doing research on gun control, and asked what procedures he must follow to obtain a gun.

“He seemed like a normal student, but a little more assertive than most,” said Michael Paul, the lawyer, who ultimately exchanged e-mail messages with Mr. Hiraman, but said yesterday that he did not offer advice on how Mr. Hiraman might get a gun. “He came walking right into the inner office.”

Investigators said yesterday that the gun Mr. Hiraman ultimately purchased about a week ago for $175 at Dick’s Sporting Goods in Poughkeepsie was an uncommon, single-shot, .50-caliber “black powder” rifle that he was able to buy without showing a New York City gun permit.

Bruce Lambert contributed reporting.


Read more!

Son intentionally leaves mentally ill mom at pier - Northwest Florida Daily News

Staff Reports
September 26th, 2007

A Pensacola man may be charged with felony neglect after he dropped his mentally ill mother off at a fishing pier on Okaloosa Island and left.

The 62-year-old woman ended up at the Wal-Mart on Beal Parkway after she took a transit bus, and she appeared confused and disoriented, according to an Okaloosa County Sheriff’s Office report.

Wal-Mart employees contacted the son by cell phone, and he said his mother wandered away from the pier and when he couldn’t find her, he returned to his home in Pensacola.

He also stated that his mother has a mental condition that he is “tired of dealing with” and that they should “just call the police because he wasn’t driving back to Fort Walton Beach to get her,” according to the report.

The woman has been prescribed medication and the son was supposed to take her to pick them up but had not.

The woman was treated at Fort Walton Beach Medical Center and Baker Acted.

Her son is being investigated due to “the nature of the conversation” and the fact that he left her at the pier.

He could be charged under a state statute that for “a person who willfully or by culpable negligence neglects an elderly person or disabled adult without causing great bodily harm, permanent disability, or permanent disfigurement to the elderly person or disabled adult.” It is a third-degree felony. Read more!

Wyoming Parent Wants School District to Ban Book - Associated Press

September 26, 2007

GILLETTE, Wyo. — School officials are assembling a committee of community members to review a book that a woman wants removed from the libraries at two junior high schools.

Sarah Forster has asked the district to pull the book, "The Shell Lady's Daughter," from library shelves, and the book was pulled from one elementary school. The book remains at two junior high libraries.

"The teenagers in the book show such a lack of moral integrity," said Forster, a parent of three.

The 144-page book by C.S. Adler received the American Library Association's Best Young Adult Book of the Year award in 1983.

The book is about a girl who learns how to cope with her mentally ill mother. In her formal request to have the book pulled, Forster listed several "objectionable subjects" she said appear in the book, including sexual relations between teenagers, sexual thoughts, promiscuity, masturbation, deceiving parents, suicide and self-inflicted pain.

Most of those subjects appear briefly in the book, but Forster believes the references are inappropriate nonetheless.

"We need to teach girls to treasure their purity and that's going in the total opposite direction," she said.

Forster submitted a book challenge form in April after her then fourth-grade daughter found the book on a teacher's shelf and read it during independent reading time.

When Forster's daughter told her about some of the scenes, she read the book and requested that it be removed from elementary schools. The request was granted.

Now, Forster wants the book removed from libraries at Gillette's two junior high schools. The committee being assembled by Campbell County School District officials is expected to review the request in coming weeks.

Wagonwheel Elementary School's library/media specialist Mary Wegher stood behind the book as appropriate for junior high students.

"It's a good coming-of-age story about a girl who is dealing with a lot of issues that girls deal with at that age," she said. "We can't shelter our kids from reality. These are things that they are going to deal with in their life."

Wegher said the more familiar kids are with those issues, the more prepared they'll be to handle them appropriately.
Read more!

Family Wins Suit for Autistic Son's Health Care - NPR

Listen to story here.

by Larry Abramson

Two years ago, Jacob Micheletti was diagnosed with autism.

His parents say Applied Behavior Analysis (ABA) has transformed their son from a boy who was retreating into darkness into a precocious, gregarious kid.

Jake's father, Joe Micheletti, who works for the state of New Jersey, assumed the family's insurance company would cover the treatment costs. They were not, which came as a shock, Micheletti said. So he took the case to the state's highest court — facing off with fellow co-workers along the way — and won.

The Treatment

When autism therapist Kerrie Pawlikoski first met Jake, she says his language skills were limited.

"He would say 'Hello,' and you might say 'What's your name,' and sometimes he would say 'Jake,'" Pawlikoski says of Jake's first days in treatment. "Sometimes he'd say 'What's your name, Jake.' So, you know, a lot of repeating what the other person said."

Pawlikoski runs Child's Play, a therapy center in Branchburg, N.J. During the school year, Jake spends 5 1/2 hours a week working with her and therapist Daniella Simon. They work with Jake on skills he can only learn through intense repetition. Among other things, they spend hours practicing how to answer a question with an appropriate answer.

But despite the potential of the treatment, the insurance company said they would not cover the costs.

"What they said when they rejected me was that treatment was not restorative. It didn't restore a previously existing function," Micheletti says. "Jake was three and a half. He had never spoken before. [The insurance company thought], 'Why should we give him verbal behavior therapy to make him speak now.'"

The insurance company may not have known who they were tangling with.

The Battle Ahead

Micheletti is a deputy in the state attorney general's office. If he was to sue the state health plan, he knew he would have to fight his own boss in court.

"The office was very mixed. There are people there who have worked with me for a long time — career deputies — who were very supportive," Micheletti says. "There were administration officials who were not that supportive. They did not appreciate one of their own challenging them."

Micheletti lives with his wife and three kids in Milford, N.J., about an hour away from his Trenton office.

Elizabeth Micheletti, Jake's mother, is a stay-at-home mom who used to work as an attorney, too. When the family decided to launch the lawsuit, the couple turned into a crack legal team, and their writing styles and legal approaches meshed.

"Joe is so good with strategy, but I don't think he's as eloquent as I am," Elizabeth says, laughing.

The case dragged on. Even after the family won in the lower courts, the insurance company refused to pay. So before the New Jersey Supreme Court, Micheletti argued against one of his colleagues in the AG's office.

The court's justices were clearly peeved that the state-run insurance system continued to refuse to pay for Jake's therapy, even after a mandate from a lower court.

Assistant Attorney General Lewis A. Scheindlin told the court that the insurers just wanted to ensure that the therapy was legitimate.

"[That concern] is consistent with this general practice of checking who is providing therapies," Scheindlin told the court. "Give us your therapy notes, so we can check the patient's progress, [and] we can ensure that appropriate utilization and medical services is being provided."

When a decision came down earlier in September, the state Supreme Court ruled in favor of the Michelettis. The judges ordered the insurance company to pay in full for all of Jake's therapy.

Growing Demands for Coverage

Many insurance companies say they will not cover ABA because they view it as experimental and unproven. The New Jersey State Health Benefits Commission declined to speak to NPR. NPR contacted a number of private insurance companies, such as CIGNA and AETNA. Those companies declined to be interviewed, but they did send regulations that state that they won't cover therapies considered experimental — including ABA.

Pamela Greenberg of the Association for Behavioral Health and Wellness says there just is not enough data on the effectiveness of ABA therapy.

"Yes, there are examples of where ABA has been very effective. And there are other examples of situations where it has been very harmful," Greenberg says. "Coverage decisions need to be made based on the best possible medical evidence and not just on the experience of a few cases."

The Michelettis' victory comes as parents of autistic children across the country are pushing for better coverage of this disorder. But better coverage for some families may mean higher premiums for everyone. That presents a dilemma for insurance companies, according to Mohit Ghose of America's Health Insurance Plans.

"The question then becomes: do you provide that through the healthcare setting, or do you provide that through the educational setting as many states have traditionally done?" Ghose says.

South Carolina and Texas have passed laws this year requiring some insurers to cover autism therapy, and the Pennsylvania House recently passed its own bill. When South Carolina's governor tried to veto his state's bill, he said one reason was that it would raise premiums by an estimated $48 a year. That veto was overturned. There's currently a bill before the New Jersey legislature that would mandate coverage for ABA. A state analysis concluded the bill would raise premium costs by less than 0.5 percent.

Jake's Progress with Therapy

Joe and Elizabeth Micheletti are overjoyed watching Jake play with his siblings. A year ago, they say, Jake largely ignored his brothers. Even though this affectionate five-year-old is making great progress, he still gets confused about how to phrase a question.

"What you can hug mommy," Jake asks his mother Elizabeth.

She quickly corrects him, "When can you hug mommy."

Like a lot of parents, the Michelettis desperately want Jake to succeed, not simply to get by. The Michelettis felt like they got adequate services from their school system. Jake has an aide in his kindergarten class. But their neurologist says Jacob would benefit from more intensive therapy. Elizabeth says her son has a right to thrive.

"The standard for a school to teach autistic children is … that they are making some progress," she says. "So their goal is not to recover or cure your child. Their goal is to show some educational progress."

"And schools are not medical professionals," Jake's father adds. "They are not doctors; they are not there to cure your child."

Therapists concede that some children won't flourish the way Jacob has — no matter how much therapy they get. So while the Michelettis' adventure is dramatic, it doesn't answer the toughest questions: What are these children entitled to? How much therapy should they get? And who should pay?

Read more!

High schooler’s death affirms importance of prevention efforts - Colorado Springs Gazette

By BILL REED
September 27, 2007

Shannon Anthony and Kassie Miskho pulled into Memorial Gardens Cemetery as the sun set Sept. 12. Coming from volleyball practice, the two high school girls were in shorts and baby-blue T-shirts that bore the name “Krissy.”

Baby blue was Krissy’s favorite color, and this day would have been her 17th birthday.

Shannon thought her friends were joking when they called her Nov. 29, 2005, to tell her that Krissy Baumann had killed herself. The girls, then 15, had attended elementary and junior high school together and were sophomores at Liberty High School.

“It’s weird to see your friend in a coffin,” Shannon, 17, said. “You go through your little mood swings, but you never think anybody is going to make that final decision and actually complete suicide.”

Suicide does happen, and historically it has happened in El Paso County more often than in most places. From 2000 to 2005, El Paso County’s suicide rate for people ages 10-19 was 8 per 100,000, higher than statewide rates — which are way above the national average.

However, recent statistics suggest that communitywide suicide-prevention efforts, many created in response to the high numbers, are paying off. The number of suicide deaths in the county dropped by nearly half from 2004 to 2006, from 121 to 69.

“The 2006 numbers blew us away. The rate is the lowest we’ve had in this county in 16 years,” said Susan Golden, interim executive director of the Suicide Prevention Partnership of the Pikes Peak Region.

She credits the local suicide hotline, programs to provide mental-health treatment to the uninsured, “and the fact that the community is becoming more aware.”

Still, local teens are nearly as likely to die from suicide as car crashes. While middleaged and older men are the most likely to commit suicide, teen suicides are perhaps the most jarring to the community because an entire lifetime is lost.

“Our hallways were silent that day,” Shannon said of the day after Krissy’s death.

“It just devastated our whole community,” said Art Mannon, a counselor at Liberty whose brother killed himself. “She was a wonderful kid. She affected people so much because she was a real high-profile kid.”

Besides having a large group of friends, Krissy was active in soccer, theater and her church.

“It drove home to everybody that everybody is at risk. We need to be there for each other,” Mannon said. “It brought us together, and it made people get involved and say ‘Let’s do something about it.’”

VOICES OF CHANGE

That effort started with Krissy’s circle of friends.

“All my friends and I have changed, because if one of us says something we aren’t comfortable with, we immediately act and we talk about it,” Shannon said. “Saying something and having a friend be mad at you for a while is better than saying nothing . . . saying nothing can be the worst thing.”

Shannon took her efforts a step further. As a project for her Girl Scout Gold Award, she created a 30-second public-service announcement on suicide called “Break the Silence” (see it on gazette.com). In it, a group of people who have relatives or friends who killed themselves talk about statistics, signs to watch for and how to react.

Her goal is to get the film on YouTube, as well as on the Channel One Network, which is broadcast to 6 million students across the country. Her fondest wish is to get it on TV.

“I never want people to go through what all my friends go through,” Shannon said. “I know that if I knew the signs, I maybe could have had some effect.”

Shannon received funding and support for her project from the El Paso County Department of Health and Environment.

“I remember being that age and wanting to do something larger than yourself, and not knowing where to start,” said Ali Nagel, the county’s injury- and violenceprevention specialist.

Nagel and Lindsey Myers administer the SAFE:TEEN program for suicide education at local middle and high schools. The program debuted in 2002 and started slowly.

“There was a lot of resistance at first,” Myers said. “(Schools) wanted to do what was right for the students; they were just scared.”

But Myers said she’s seen the attitude in the community shift from fear and secrecy, which can be fatal, to a willingness to openly address suicide.

“Talking about suicide is the best way to prevent it,” she said. “It’s been very exciting just to watch how the community changes. Not only schools, but businesses and nonprofits are more willing to talk about this.”

Recently, the growth of SAFE:TEEN has been exponential, they said: The program is now in 25 schools in the county, and organizers can barely keep up with demand from schools.

Liberty High School is among the latest schools to adopt the program, thanks not only to administrators but to the efforts of Shannon as well as Arlene Baumann, Krissy’s mom.

“We’ve been wounded already, so we know it’s time to get (SAFE:TEEN) in here,” Mannon said. “Who knows how many lives we’ll be able to save.”

He said the school is on a mission to obliterate the secrecy and stigma that surround suicide.

“The biggest myth of all is that by asking them (about suicide) you will put ideas in their head,” he said. “Ask the question. Just ask the question.”

BIRTHDAY MEMORIAL

Shannon and Kassie stepped into one of the mausoleums at the cemetery. They walked to Krissy’s resting place, a familiar journey. Once there, they stared at their friend’s picture, hugged, and cried for a while.

Then they gave her a silly, singing balloon that rapped a hip-hop version of “Happy Birthday.”

The girls giggled as they wiped away tears. They were two young women full of life — celebrating a rare volleyball victory over rival Rampart High School the night before, thinking about college applications and majors, still trying to forget thoughts of what they could have said or done, and wishing happy birthday to a longtime friend who will forever be a 15-year-old with her future waiting to welcome her.

SUICIDE PREVENTION

Signs to watch for:

- Depression (crying, insomnia or excessive sleep, appetite loss, hopelessness)
- Isolation from friends, and pushing people away
- Comments that sound final such as “I’m sorry for everything I’ve ever done”
- Giving away possessions
- Mood swings
- Loss of interest in favorite activities
- Impulsive or aggressive behavior
- Alcohol or drug use
- Saying “I want to die,” or threats of suicide

How to ACT:

A: Acknowledge you are seeing signs of suicide and you take it seriously. Be open, honest and direct.
C: Care. Ask questions, listen, and let the person know you are there for him.
T: Tell a parent or a professional, either with the suicidal person or on his behalf.
- Don’t be afraid to ask whether the person is considering suicide. Typically, a detailed plan indicates greater risk.
- Don’t allow the person to be alone while at a crisis point. Remove weapons, alcohol and drugs.
- Don’t hesitate to seek professional help, and don’t be sworn to secrecy.
- Don’t dismiss the threat, even if the person brushes it off as a joke.
- Don’t act shocked or judgmental.
- Don’t tell the person how much better off he is than others; it may increase feelings of guilt/worthlessness.

STATISTICS

- Colorado is consistently among the 10 states with the highest suicide rates, and often among the three states with the highest rates of teen suicide. In 2004 (the latest available national figures), Colorado was 36 percent above the national average for suicide per capita, with the sixth-highest rate among the states.
- Adolescent boys are three to four times more likely than girls to complete suicide, but girls are more likely to be hospitalized for an attempt.
- White men have the highest rates of suicide, particularly men 65 and older.

SOURCE: Suicide Prevention Partnership of the Pikes Peak Region; American Association of Suicidology; El Paso County Department of Health and Environment

ONE WAY TO HELP

WHAT: 2007 Mayor’s Cup Challenge to benefit the Suicide Prevention Partnership of the Pikes Peak Region, with a 5K run, 3K walk and kids fun run

WHEN: Saturday; 8 a.m. registration begins, 9 a.m. 5K run, 9:45 a.m. kids fun run, 10:15 a.m. 3K walk

WHERE: America the Beautiful Park, Colorado Avenue and Cimino Drive

COST: $5 kids fun run, $20 in advance or $25 on race morning for the run or the walk (family rate is $45 in advance or $50 on race day)

ADVANCE REGISTRATION: At The Colorado Running Company, 833 N. Tejon St. (deadline 6 p.m. Friday), or online at www.sppppr.org (deadline midnight today).

RESOURCES

- Suicide Prevention Partnership of the Pikes Peak Region, 573-7447, www.sppppr.org. The umbrella organization that combats suicide in the area. It’s the contact for the SAFE:SENIOR and SAFE:TEEN programs.
- The local suicide-prevention hotline is 596-LIFE (596-5433). National hotlines: 1-800-SUICIDE (784-2433), 1-800-273-TALK (273-8255).
- LOSS Assistance Team, to help relatives and friends in the immediate aftermath of a suicide. Call 573-7447.
- Heartbeat, for those who have lost a loved one through suicide. Call Mary King at 593-8680 or LaRita Archibald at 596-2575.
- Teen Heartbeat, for teens who have lost a loved one through suicide. Call LaRita Archibald at 596-2575.

You can read all of today's articles from The Gazette if you subscribe to the electronic edition. Click here for details or go straight to the login page if you are already a subscriber.
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Woman tries to sell 'white trash' life on eBay - AP

9/27/07

BENTON, Ill. (AP) - A woman who offered two days in her "white trash dream" of a life for sale on eBay - including her two young daughters and depression medications - was reaching out for help, authorities said Thursday.

Benton Police Chief Michael O'Neill would not identify the woman, but said she is a 31-year-old resident of the town, about 90 miles southeast of St. Louis.

Authorities have asked the Illinois Department of Children and Family Services to make sure the woman gets the services she needs to properly care for her daughters, ages 8 and 4, O'Neill said.

The woman used the name "givemeanewlife" in the posting on the eBay auction site earlier this week, urging readers to "please bid on my life so I can have some peace."

"I'm on the verge of a complete breakdown," she wrote. "What you get is to put up with these two crazy, unruly kids, and a white trash dream for two days. I get to take the money you bid with and do something nice for myself like sit in a roach motel for a day or two and sleep peacefully."

The woman wrote that she suffers from bipolar disorder, depression and borderline personality disorder. She said the winning bidder also could have her medications: "Although they don't seem to be working for me, they may work for you."

The auction violated eBay policy and was taken down Wednesday, within 24 hours of its posting, said company spokeswoman Kim Rubey. She said an internal investigator was assigned to help law enforcement acquire any necessary information.

O'Neill said he was alerted to the posting by television station KTVI of St. Louis. Because he has a small police department, O'Neill said he asked the Illinois State Police for help.

The woman told State Police she had put the description on eBay to find someone to talk to and that she had no intention of selling her children or allowing them to spend time with the highest bidder, O'Neill said.

"It was a reach out," O'Neill said, "a reach out for someone to talk to, a reach out for help."

State Police on Thursday referred all questions back to O'Neill's department. A spokesman for DCFS said he could neither confirm not deny the agency is investigating the case without having the family's name.

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How do you treat ADHD? - Kankakee (IL) Daily Journal

09/26/2007
By the faculty of Harvard Medical School

Q: My 4-year-old boy is very rambunctious and hard to control. Friends have suggested that he may have ADHD. Can it be diagnosed at this early age? I'm reluctant to give him medications, but what else can I do?

A: Kids like yours are often suspected of having attention-deficit/hyperactivity disorder (ADHD). The main symptoms of the condition include hyperactivity, impulsiveness and inattentiveness. However, many normal children may have these symptoms at a low level, especially during the preschool years. And the symptoms may be caused by another disorder. That's why it's important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional. To show that something more is involved than just kids being kids, clinicians and researchers compare a child with others the same age to determine whether the symptoms are severe, frequent, persistent and outside the range of behaviors seen in normal development.

Diagnosing ADHD

Studies have found that ADHD symptoms under age 6 are strikingly similar to those found in older children. Depression and defiant behavior are also common. These children are not just rambunctious. They seem unable to wait their turn or think before acting. They may jump off playground slides, play with matches despite repeated warnings, climb into medicine cabinets, rush into traffic and pull down objects from the shelves of stores. They are noisy and constantly interrupt other children and adults. They can sow chaos at home or in day care. For a diagnosis of ADHD, the American Academy of Child and Adolescent Psychiatry recommends a general psychiatric evaluation. The process also includes interviews with parents, information from teachers and monitoring of the child in several settings.

Medications

A stimulant drug, such as methylphenidate (Ritalin and others), is the standard treatment for school-age children. Theses medications are increasingly prescribed for younger children as well. An estimated 1 percent of preschool children have been given stimulants, although the Food and Drug Administration has not approved them for children under age 6.

Because of concern about long-term effects of these medications on the developing brain, there are misgivings about prescribing drugs for very young children. The most popular alternative, parent training, aims to reduce difficult behavior by changing the way parents respond to it. Parents are shown how to set appropriate limits and use moderate rewards and punishments.

Parent training might be especially helpful for preschool children. Because they are still young, the children's behavior may be reshaped. If that doesn't happen, the expectation of failure becomes self-fulfilling for the child, for parents and eventually for teachers and others.

In one study, behavioral parent training was combined with an effort to encourage more constructive interactions between parents and children with ADHD. Children ages 4 to 6 who received this treatment for two months had a better outcome than those who received only general counseling. The training was about as effective as methylphenidate. But it worked only when conducted by specialists with experience in behavior therapy. And we don't know how long the improvement lasts.

A controversial subject

ADHD has always been a controversial diagnosis. Critics believe that the diagnosis is overused and drugs are oversold as a solution. The growth of preschool programs and day care might be making excessive demands on young children for self-control and obedience to rules. But others say that ADHD is not diagnosed as often as it should be. The only two studies done in pediatric clinics found that it was not identified in preschool children even when their parents were worried about the child's behavior. One study found that only 23 percent of preschool children with possible ADHD had been referred for mental-health evaluation.

Given the doubts and disputes, it is probably best to follow the recommendations of the American Academy of Child and Adolescent Psychiatry. Make the diagnosis slowly, they advise. And consider parent training and specialized day care before resorting to stimulant drugs.

It's hard to raise a rambunctious child, whether or not he has ADHD. Consider getting an expert evaluation to see if your child might benefit from professional treatment, with or without medication.



Submit questions to harvard_adviser@hms.harvard.edu. Visit the Web site at www.health.harvard.edu/
adviser.
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At least there's one upside to being hospitalized - Ottawa (Canada) City Guide

Matthew Good's New Album Came Out Of Last Year's Mental Breakdown

By Heather Adler
Dose.ca

Making Hospital Music just about killed Matthew Good.

Prior to recording the album, the opinionated art provocateur suffered through the worst year of his life: His lifelong struggle with mental illness climaxed after Good's marriage fell apart; he became crippled by a dangerous addiction to anti-anxiety medication Ativan; he suffered from extreme episodes that would often leave him unconscious or vomiting for hours; and it all came to a head one night when he swallowed 40 pills, overdosed and ended up begging paramedics to let him die as he was rushed to hospital. The singer-songwriter then willingly checked himself into the psychiatric ward, where he finally dealt with the demon that had been tormenting him his entire life: He was diagnosed with Type 2 bipolar disorder.

This type of bipolarity is a mood disturbance characterized by rapid cycling between debilitating depression and unbridled mania. Good had sought treatment prior to the breakdown that left him hospitalized, but he had never been properly diagnosed, resulting in him taking anti-depressants that actually increased his mania and anti-anxiety drugs that he grew tragically dependent on. Inevitably, that resulted in a near tragedy.

"Bipolarity does come with a significant suicide rate, but what people misconstrue about it is that you're not really looking at taking your own life to make a point. You know, some people kill themselves to make a point. In my case, you get divorced, so you try to kill yourself to make a point," Good candidly explains of his attempted suicide. "That's not really the case with people who suffer from this illness. We just want it to stop. It has nothing to do with anyone else. We just want it all to stop. Sometimes, at the end of the line, the only way for it to stop, is for you to stop."

After overdosing, Good purged his feelings while in the psychiatric ward by writing and drawing, two things he has relied on since he was a child to cope with himself -- and from those scrawlings, much of the material on Hospital Music was born. On the record, he speaks of his drug dependence, such as on 99% of Us Is Failure, in which he writes about a kind of bad that "they can't operate on," and "bag drugs that never work enough." Elsewhere, he reveals even more intimate details, such as on the first single Born Losers, which speaks to his marriage's destruction, the daughter his wife never had, "cocaine cons" and "trailer-trash pedigree." It's shockingly honest, tragic and somehow inspiring in its frank confessions.

Good also posted a lengthy blog about his time in the hospital, including extremely personal drawings he did at the time, in which he depicts himself as a man with a crack in his head, filling up with little, pink pills. The singer-songwriter says it wasn't a conscious decision for him to open up to the world this way -- making art was simply what he had to do to survive.

"It's not a choice. It's not a choice like you get up one day and go, 'Oooh, you know what? I'm going to do this writing,'" Good explains. "It's more like 'I've got to find a way to deal with getting this shit out of my head.' I need to find a way so I can find calm. And if I can find calm for a certain amount of time, while the well is filling back up, then I've found at least a little bit of a rest."

Throughout his life, Good has been driven to create, often to his own detriment; it meant staying up for days with only a few hours of sleep or chain-smoking while exhaustively pacing in his apartment with clenched fists, gritted teeth and an inability to find calm. As much of a burden as it has been, Good admits his bipolar nature might have had an effect on the artist he is today, following the old adage that the most gifted among us are often the most troubled.

"A lot of people who suffer from bipolarity, they tend to be very creative people and, usually, it has to do with creativity and intelligence and the inability to shut your mind off," he relates.

Now, Good is gearing up to take Hospital Music on the road. The last time he toured, he admits it was "basically an experiment of pushing my personal endurance, both physically and mentally." The experiment wasn't a good one. Already in the throes of Ativan addiction, he spent his mornings throwing up, his afternoons numbing up and his evenings struggling through shows that he no longer remembers playing. Now on the proper medication for his disorder, Good's hopeful this time around will go much better.

"The last couple of days, I've been thinking 'How am I going to do this?' Because the last time I did it, I was unconscious," he says. "This time, I will know what I'm doing. ? But it's really fun, and I really like playing by myself because it's an experience where people feel they're involved in something, rather than just going and seeing something."

- Matthew Good plays the Bronson Centre Oct. 17-18. Both shows are sold out. Read more!

Mentally ill man receives 45-year sentence for killing mother - South Bend (IN) Tribune

By PABLO ROS
Sept. 26, 2007

SOUTH BEND — A judge sentenced a 27-year-old, mentally ill man to 45 years in prison this morning after the defendant pleaded guilty but mentally ill to killing his mother in 2005.Judge Roland W. Chamblee Jr. ordered Donald Zwolinski to serve time and receive mental health treatment at the Indiana Department of Correction.

According to Zwolinski’s attorney, Mark S. Lenyo, Zwolinski had no criminal history and suffered from “all kinds” of mental illness since he was a child. The judge’s 45-year-sentence was part of a binding plea agreement signed with prosecutors.

Chamblee heard testimony from the victim’s sister, Marcia Evans, before sentencing Zwolinski.

“My whole family was affected,” Evans told the judge. “It’s been a very painful experience.

“I don’t hate Donald for this, but I really do think he needs to have supervision and medicine,” she continued. “I hope he will learn to deal with his problems in a way that is much more appropriate. I hope he will learn to use words instead of violence, kindness instead of murder.”

Evans owned the home in the 100 block of East 6th Street in Mishawaka where Zwolinski and his mother, Patricia Garcin, lived together. He killed her on July 21, 2005, by hitting her with a hammer.

Evans’ daughter, Julie Evans, found the body. Zwolinski later confessed to the crime.
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Mental health advocates seek safe houses for crises - Belen (NM) Valencia County New-Bulletin

By Sandy Battin News-Bulletin Staff Writer; sbattin@news-bulletin.com

Los Lunas There has to be a better way than having folks in a mental health crisis winding up in jail, members of a local behavioral health collaborative say.

"A lot of problems happen when families call 911 when a family member is in a mental health crisis," said Julie Medina, an advocate for Parents for Behaviorally Different Children. "More often than not, he ends up in jail. He's committed what's considered an act of domestic violence or is in a paranoid delusional state."

Because police now have limited options, one of two things will probably occur. "The system takes away your right to choose. He needs to go to the hospital, but they can't guarantee he will stay in the hospital. He goes to jail, and he'll call you and say they're not letting him take his meds.

"It's a bad experience that makes things considerably worse."

Sometimes, if police have been called often enough, their mere presence can escalate things, Medina said. It can be dangerous for the individual, the family and the police officer.

Local Collaborative 13-Valencia County held a Behavioral Health Day at Daniel Fernandez Park in Los Lunas on Saturday to discuss what it sees as possible options in this oft-repeated scenario and to pass out information to the community about the alternatives that are available to those coping with mental health issues.

The collaborative, made up of agencies and individuals in Valencia, Cibola and Sandoval counties, works to "discuss and act on issues of behavioral health services, treatment and care. (It) is a community voice to the state's Behavioral Health Purchasing Collaborative, educator of the public, and advocate to the Governor's Planning Council."

Medina said that agencies are advocating the establishment of quick response teams for crisis situations throughout the state. "They would know how to talk people down," she said.

The teams would include two recovered peer specialists or community health workers, a licensed behavioral health clinician and a paramedic, according to information released by the group.

The team members would be trained in:

# Non-violent and non-coercive de-escalation techniques.

# Techniques for fostering reconciliation between people in crisis and their families and friends.

# In-depth and comprehensive understanding of serious mental and behavioral disorders such as schizophrenia and brain injury.

# Knowledge of health, social service and emergency resources in the area and how to access them.

The second component of the initiative would be establishment of safe houses that would serve as an alternative to hospitalization or jail, the release said. People in need of help could stay there for the short-term, perhaps a few weeks. Treatment and services would be voluntary and could include "peer counseling, employability skills, adaptive living skills, the Wellness Recovery Action Plan program, various expressive activities as well as traditional psychotherapy and medication," the release said.

The house would be staffed at all times by a licensed clinician and others. The quick response team would be headquartered in the safe house.

Medina says there are problems in securing help for those in need of behavioral help. "Very little money is available in recurring funds," she said. "But we've seen enough stories about the dangers that exist that something needs to be done."

Smaller counties such as Valencia "could have people on call. They could also create safe houses where people can choose to go ... and take a few days to get out of crisis," she said.

The agencies have estimated that $3,525,800 would pay for five houses — to be established in rural communities where fewer resources are available. That money would pay for the purchase of a home in each region, remodeling it to accommodate five adults, staff it for the first year and operate it.

Jill Dougherty of the collaborative says more people need to be involved, from schools to churches, to groups working with teens.

Jails are not the right place for people who need help such as psychological evaluation and medication, she said.

The local group said it has been getting help from members of the legislature, and it singled out two Valencia County officials — Sen. Michael Sanchez and Rep. Elias Barela — for praise, presenting them awards Saturday for "fighting for the rights of the mentally ill," said Bobbie Taylor of the collaborative.

Barela was honored for his stand against Kendra's Law. According to the Albuquerque Journal, the proposal was patterned after a New York law named for a woman who died after being pushed onto subway tracks by a mentally ill man. The New Mexico bill would have allowed petitions in district court for orders of assisted outpatient treatment when a mentally ill person isn't taking medications and doesn't recognize the need for treatment.

"It seemed like a way out-of-balance way of infringing on your constitutional rights," Barela said.

"The bill didn't pass, and that's because of you folks coming out. I intuitively thought it was a bad bill."

Barela encouraged the volunteers to continue to work for solutions for "more mental health services."

Taylor said she's spoken to Sanchez and he was "helpful and concerned for the rights of the mentally ill in Valencia County and the state."

Sanchez said he worked with Barela and Rep. Andrew Barreras and the effort "will continue to make headway." He said that the issue affects everyone and has "been ignored way too long, and it's time to bring it to the forefront and make sure it's one of the top priorities."

Mike Wirts of Los Lunas, co-chairperson of the local chapter of the National Alliance for the Mentally Ill and who is active in Collaborative 13, said it was his brainchild to hold the event in the park and bring to the public information about services available and problems that need solutions.

"We've got problems and hospitals closing right and left in this state," he said. "We need to fix what we've got before building something new. ... We're trying to get the word out to the public and let everyone know there are people out here who are willing to stand up and speak out for you."

Collaborative 13 has set down its own legislative priorities for 2008. The No. 1 goal is to establish a pilot program for a consumer-operated transportation company. Wirts said it is extremely difficult for individuals living in rural communities such as Valencia County to access services that are available because they can't get to them.

The group will ask for three vans to help solve the transportation issue plus drivers and other essentials, at a cost of $900,000.

Its other priorities will be:

# Identifying and strengthening consumer and family initiatives, activities and networks such as a consumer-operated drop-in center in Valencia County, with peer specialists among the staff members.

# Providing psychiatric emergency medical treatment teams — the quick response teams.

# Providing early-intervention psychiatric crisis treatment centers — the safe houses — with Los Lunas getting a pilot project.

# A mental health court in the 13th Judicial District to divert people with serious mental illnesses from incarceration with court support staff, housing and counseling.

# Increasing the reimbursement rates for services at all levels of treatment and care.

# Providing pre-release public benefits assistance for people in custody or at risk of incarceration.

# Increasing the number of School-Based Health Centers in the Bernalillo School District. Belen already has a center in operation at its high school.

Leslie Wirts, who co-chairs the NMMI with her husband, said money is always a problem in addressing the needs of the mentally ill. "Individuals I know of are facing problems paying for medications. Some can't afford them and go without their meds. It's hard to see them," she said.

"People go through mood swings and have problems, ... I've seen a lot of things that make me just cry."

But she said that the issues are being discussed more openly now. "If people are afraid about what's going on, they shut themselves in, they don't want to be around people to see and help. That's why I joined this group. I like to help, to be there for people, to take a chance. I don't like to see people hurt, to see them all bottled up."

She was happy that people were attending the event in the park, sharing lunch and reading the material. "I'm glad we could do this to let people be aware of what's going on and let people know we're out there," Wirts said.


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Improving Montana's mental health system discussed in Helena - Great Falls (MT) KRTV

Sep 26, 2007

State lawmakers are looking to bring in an outside source to try and improve the mental healthcare system in Montana. They've been meeting at the State Capitol in Helena to discus how an out-of-state expert could provide help.

Republican Representative Edith Clark of Sweetgrass says Montana's mental health care system is outdated. During the 2007 special session lawmakers approved a $200,000 budget to study the state's needs and Clark says guidelines must be set.

"We have to work towards ways of improvement. This is one way."

The Legislative Council has the authority to set the guidelines for the study which would bring in an out-of-state mental health expert.

Supporters say Montana needs a new perspective to help increase efficiency while continuing to provide quality services but opponents say the study is too broad and the topic should be limited.

By a majority vote members of the Legislative Council agreed the study should assess gaps in the system and find efficient ways to reach more Montanans. Lawmakers say they anticipate an out-of-state expert will also help state and local programs gather new data to apply for federal grants.

The guidelines for the Mental Health Study will now go to the Children, Families, and Health and Human Services Interim Committee which is in charge of hiring the out-of-state mental health expert.

- Kay Rossi reporting from KRTV in Great Falls Read more!

Report On Hospital Faulted - Hartford Courant

Officials Dispute Some Key Findings

By JOSH KOVNER

State officials have answered a highly critical federal report on Connecticut Valley Hospital by disputing a number of the key findings while vowing to work with the Department of Justice to avoid a civil rights lawsuit and resolve cited problems.

The officials also outlined a series of improvements they have made or are planning to make. Their response to the Justice Department's scathing August report was posted Tuesday afternoon on the website of the state Department of Mental Health and Addiction Services.

Mental health officials said they were obligated to correct what they saw as errors or misinterpretations in the Justice Department report. For example, they cited one instance in which, they said, federal investigators mistook a patient's escape attempt from an upper story window as a suicide attempt, and they called several other assertions in the report "puzzling."

But a patient advocacy group said the stewards of the state's largest public psychiatric hospital are spending too much time protesting and not enough time fixing fundamental problems with the safety and treatment of patients. The hospital since 2003 has dealt with four suicides of patients, a multimillion-dollar settlement in the restraint-related death of a patient, the 20-month Justice Department probe, and separate findings earlier this month by the state Department of Public Health that could threaten the hospital's federal funding.

"If only a portion of the Department of Justice's report is true, it raises grave concerns," said Kate Mattias, executive director of the state branch of the National Alliance on Mental Illness.

She called on Gov. M. Jodi Rell and the state legislature to appoint an independent monitor to oversee reforms at CVH.

A Justice Department spokesman in Washington said Tuesday that typically in these cases a consent decree is filed in federal court that spells out the corrective plan, and a neutral monitor is appointed to keep tabs on the progress and report any problems to the court.

The Justice Department's civil division probed CVH under the Civil Rights for Institutionalized Persons Act, which gives the unit authority to review hospitals, prisons, nursing homes, and other facilities.

Also Tuesday, Michael Piscopiello, a social worker at CVH, said that Local 1199 of the New England Health Care Workers Union had within the last week signed formal agreements with the state that increase worker training and establish overlapping shifts at the hospital's Whiting Forensic Division. That will allow Whiting staff members to communicate better about high-risk patients, something workers have wanted for a decade, Piscopiello said.

To read DMHAS's response to the Department of Justice report, go to web address http://www.ct.gov/dmhas/site/default.asp and look under What's New.



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Genes Might Predispose Antidepressant Users to Suicidal Thoughts - Washington Post

By Amanda Gardner
HealthDay Reporter

Variations in two genes may help spur suicidal thinking in individuals taking a commonly prescribed antidepressant, research suggests.

Although preliminary, the findings could pave the way for genetic testing to determine which patients with depression are likely to have this unusual but dangerous side effect.

"These findings, if replicated, would provide a way to have a genetic test that would tell us who is at a higher risk of developing suicidal ideation when taking antidepressants," said Dr. Gonzalo Laje, lead author of the study and associate clinical investigator at the U.S. National Institute of Mental Health. "Our long-term goal is to make sure that people with depression can take antidepressants, because treating depression is the best way to avoid suicide," he said.

Other experts stressed the need for more studies before getting too excited about the finding.

"The real key is, does it replicate in another data set? . . . [because] replicating results is rare," said Dr. Michael Slifer, assistant professor of medicine at the University of Miami Institute for Human Genomics. "It's a very important topic," said Slifer, who was not involved in the study. "Nobody has really looked into what might be different about the background of these folks that have such a difficult time in treatment and get suicidal thoughts. This is a first step, but it's only a first step."

There is some evidence that people starting antidepressant medication can develop suicidal ideation, or suicidal thoughts and ideas, although this notion remains controversial.

In 2004, the U.S. Food and Drug Administration (FDA) recommended that the class of drugs known as selective serotonin reuptake inhibitors (SSRIs) carry a strong "black box" warning on the label outlining the possibility of an increase in suicidal ideation. SSRIs include widely used drugs such as Celexa, Paxil, Prozac and Zoloft.

The black box warning was based on studies that found that 4 percent of the group taking SSRIs had suicidal ideation, compared with 2 percent of the group taking a placebo.

"It is a severe side effect, but it is unusual," Laje stated. "Given the warnings by regulatory agencies, we thought this would be a very important side effect to look at."

The current study was part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, the largest trial to date to look at depression in real-world settings. Participants in STAR*D were treated with the SSRI citalopram (Celexa) for up to 14 weeks.

For this study, Laje and colleagues analyzed DNA samples from 1,915 participants, looking for associations between reports of suicidal ideation at 768 sites in 68 genes.

Versions of two genes involved with cellular glutamate receptors, which have been implicated in depression, were more prevalent in participants reporting suicidal thinking.

While overall about 6 percent of the patients reported suicidal thoughts when taking Celexa, 36 percent of patients who carried both of the gene variations reported suicidation. Overall, 59 percent of those who reported suicidal ideation had at least one of the suspect gene types.

One percent of the participants had a version of the kainate receptor gene (GRIK2) that increased the risk of suicidal thinking more than eightfold.

Forty-one percent had a version of the AMPA receptor gene (GRIA3) that almost doubled the odds.

Eleven participants, or one-half of one percent, had both versions which resulted in a 15-fold increase in risk.

Since the researchers only looked at Celexa, it's unknown if the findings extend to other antidepressants, even those in the same class of SSRIs.

This study, which is published in the October issue of theAmerican Journal of Psychiatry, is the first to find a significant association between a genetic marker and suicidal ideation.

Researchers elsewhere are working to further clarify the links, if any, between antidepressant use and suicide ideation.

On Thursday, scientists led by Dr. John March, chief of child and adolescent psychiatry at Duke University Medical Center, announced the launch of a large-scale safety registry tracking antidepressant use by children and youth.

In its first study, the Child and Adolescent Psychiatry Trials Network (CAPTN) hopes to follow the outcomes of 2,420 children and adolescents prescribed either an SSRI or another type of drug, a serontonin-norepinephrine reuptake inhibitor (SNRI) to help treat depression, anxiety disorders, and other psychiatric woes. A subset study will examine gene variants associated with an increase in either the benefits or side effects of psychiatric medicines in young users.

The CAPTN effort is funded by the U.S. National Institute of Mental Health



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Parents seek awareness of suicide signs - Boston Globe

By Laura M. Colarusso, Globe Correspondent | September 27, 2007

For the two dozen observers at the Beth Israel Deaconess suicide awareness lecture in Needham, the discussion was more than a talk about stopping teens from taking their own lives.

It was a chance to learn more about how to talk with their children.

Suicide, which is the third leading cause of death in the United States for those between the ages of 15 and 24, has been an issue with special resonance in Needham. Over the past three years, the town has been struggling to cope with a string of suicides that started just before Thanksgiving in 2004.

No harm has ever come from asking a child or teenager if they are experiencing problems at school or with friends, said Dr. Tomas Lichauco, a Dedham family physician. All too often, parents are afraid to ask about sullen or gloomy behavior because they fear they might alienate their child.

But taking that difficult step might make the difference.

"We are social animals at heart," Lichauco said at the Sept. 19 lecture. "It turns out having connectedness makes you a lot less likely to commit suicide."

The statistics can help identify those who are most at risk, said Larry Berkowitz, a psychologist with Riverside Community Care, a nonprofit mental health organization with offices in Newton and Dedham. In at least 90 percent of completed adolescent suicides, the person had some level of depression or acute psychotic disorder, he said.

Though more die from accidents and homicides, 11 adolescents die of suicide each day, Berkowitz said. Males are more likely to complete the suicide, while females are more likely to make an attempt.

Ninety-five percent of people who die from suicide will talk about it first, Berkowitz added.

Parents need to look out for a variety of signs that could indicate their child - or perhaps one of their children's friends - is in trouble, according to Berkowitz. Has there been a change in appetite or sleeping pattern? Is the child more withdrawn or exhibiting signs of anger and hostility recently? Is the child giving away possessions and saying things like, "There isn't any hope for me?"

Knowing whether these indicators are simply normal teenage angst or a symptom of something more serious is difficult, Berkowitz said. Most teenagers and young adults are pulling away from their parents, trying to establish their independence.

"It's a matter of degree," said Berkowitz, who noted that if all of these changes are taking place at once, that is a clear indicator of problems. Parents should be looking to see whether these changes are interfering with their child's school performance or their interaction with friends, he added.

Other factors to keep in mind are a family history of suicide and whether the child has access to a way to end his or her life.

"There is no one thing that causes a suicide," Berkowitz said, asking, "Are you putting all these things together?"


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Report Says Army Hasn’t Met Goals for Injured Soldiers - Associated Press

WASHINGTON, Sept. 26 (AP) — The Army has yet to fully staff the new teams being put together to improve treatment of wounded soldiers at the Walter Reed Army Medical Center, according to a Congressional report made public on Wednesday.

Under the Army plan, each injured service member is to be assigned three key people — a doctor, a nurse case manager and a squad leader — to manage the member’s care.

Better management of soldiers’ care was one recommendation that emerged after news reports this year revealed serious problems at Walter Reed. As of mid-September over half of these teams had significant shortfalls in one or more of the positions, the Government Accountability Office said in a report presented at a House hearing on treatment of wounded soldiers.

John Pendleton, author of the report, said many of the current workers are borrowed, presumably temporarily, from other offices.

Ultimately, hundreds more nurses, social workers and mental health specialists will be needed to handle issues like traumatic brain injuries and post traumatic stress disorder, Mr. Pendleton said.

The Government Accountability Office also noted that the Pentagon and the Veterans Affairs Department were behind schedule in starting a pilot program under which they would adopt a single medical examination and a single disability rating performed by Veterans Affairs.

“We are seven months into this process, and we are just now getting off the ground,” said Representative John F. Tierney, Democrat of Massachusetts, chairman of the Oversight and Government Reform subcommittee on national security. “Why has it taken so long to get going on that?”

Maj. Gen. Eric Schoomaker, commanding general at Walter Reed, said that staffing of the teams known as “warrior transition units” was now 65 percent, and that they were on “the projected glide path” to full staffing by January.

The Government Accountability Office said that as of mid-September, 17 of the 32 teams created


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Vaccine Compound Is Harmless, Study Says, as Autism Debate Rages - New York Times

By GARDINER HARRIS

Yet another study has found that a controversial vaccine preservative appears to be harmless. But the study is unlikely to end the increasingly charged debate about vaccine safety.

The study examined whether thimerosal — a mercury-containing vaccine preservative that was almost entirely eliminated from childhood vaccines by 2002 — is associated with neurological or certain psychological problems in children ages 7 to 10.

Some parents’ groups and prominent legislators contend that thimerosal has caused an epidemic of childhood autism. Several studies have examined this question and found no evidence that thimerosal is associated with autism.

The most recent study did not assess thimerosal’s association with autism directly. The Centers for Disease Control and Prevention is conducting a separate autism and thimerosal study that is expected to be published next year.

In this study, published yesterday in The New England Journal of Medicine, researchers from the C.D.C. and several managed-care organizations subjected 1,047 children to 42 neurological and psychological exams, which included I.Q. tests, how well children recalled a list of names and whether they could repeat the names backward, their manual dexterity, and whether they stuttered or had tics.

The researchers also took detailed medical histories to determine whether the subjects’ mothers were exposed to thimerosal while pregnant, and how much thimerosal the children were exposed to in their first seven months of life.

After subjecting the data to nearly 400 different statistical measures, researchers found 19 different possible associations between thimerosal and various mental outcomes — most of which suggested that thimerosal was actually beneficial.

Researchers largely dismissed these associations as statistical flukes.

“By chance alone, with that number of tests, we would estimate that 5 percent of the results would be significant,” said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the C.D.C. “And that’s what we found.”

The lone worrisome result was that, among boys, the study found an association between thimerosal and tics, which are involuntary movements or sounds. At least one earlier study had found a similar association.

But Dr. Schuchat said that researchers had made no distinction between transitory tics — those that soon disappear and are not considered clinically important — and permanent, serious or disfiguring tics.

“That particular finding is being evaluated further,” Dr. Schuchat said.

Dr. Jeffrey Baker, a pediatrician and vaccine expert who is director of the history of medicine program at Duke University, said that the study’s findings should be reassuring for parents.

“This study will further strengthen a growing consensus among researchers that there is no real evidence that thimerosal in vaccines led to any actual harm,” Dr. Baker said.

But Sallie Bernard, executive director of SafeMinds, a nonprofit parent organization whose members contend that thimerosal injured their children, said the study was inconclusive. Ms. Bernard served on a board of consultants that helped design and oversee the study, but she withdrew her support for the published version of the study, saying its conclusions were not supported by the underlying data.

“There are some red flags here,” Ms. Bernard said.

Nearly 5,000 families have filed claims with the federal government contending that vaccines caused their children to become autistic. Even if the government dismisses their claims, many families have vowed to continue their fight in the courts.

Since thimerosal’s removal from vaccines, there has been no evidence that autism is on the decline.

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Senate to Hike Health Care Reimbursement - Associated Press

By FREDERIC J. FROMMER

WASHINGTON -- The Senate has voted to allow the Pentagon to raise reimbursement rates for mental health treatment, following reports that soldiers returning from war have had difficulty getting services because of reduced payments to therapists.

Tricare, the military health insurance program, cut its payments to civilian therapists this year because it ties its rates to Medicare, which had dropped its rates. The Associated Press reported in June that the lower payments to therapists were making it harder for veterans to find a therapist who would accept them as a patient.

Some veterans seek treatment from a civilian therapist using the insurance because there is a shortage of military therapists and there are long waits at some military mental health clinics.

Under an amendment by Sen. Norm Coleman, R-Minn., which passed the Senate by unanimous consent Tuesday night, the secretary of defense could change the rates if he determines that access to mental health services is threatened. The amendment also requires the secretary to submit a report to Congress on access to mental health services under Tricare.

Coleman said mental health services have become increasingly important for returning soldiers as they face post-traumatic stress disorder and other psychological difficulties.

"The last thing we should do right now," he said, "is make it more difficult for mental-health professionals to provide treatment for these troops and their families as they deal with the challenges associated with reintegration."

About one-third of returning soldiers seek out mental health counseling in their first year home.

A Tricare spokeswoman said she could not comment on pending legislation.


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Oprah highlights bipolar, depression

Monday's edition of Oprah highlighted mental illness and is worth a look by clicking here. There are related stories at the bottom of the page as well. Read more!

DOD center will monitor mental health services - Stars and Stripes

By Jeff Schogol, Stars and Stripes

ARLINGTON, Va. — The Defense Department plans to open a Center of Excellence to improve the quality of and access to the department’s mental health services.

The move comes in response to a June report by a mental health task force that found the Defense Department was failing to meet troops’ mental health care needs.

The report included 95 recommendations for addressing the reported shortcomings, including hiring more mental health providers.

In response, the department recently gave Congress its plan for implementing all but one of the task force’s recommendations.

One major feature of the Defense Department’s plan calls for creating the Center of Excellence by May. The center would be tasked with developing standards of care, monitoring traumatic brain injuries and measuring how satisfied troops are with mental health care services.

“While focused on research, education and training, and clinical care, the Center of Excellence will also house an information clearinghouse and ombudsman that will serve an advocacy function for servicemembers and family members who have questions, concerns, or need assistance in navigating the system of care,” the plan says.

The plan also says the Defense Department is looking into whether it needs to hire more mental health care providers, but it did not get into specific numbers.

The plan calls for adding 200 professionals from the Public Health Service to military facilities to make it easier for troops to have access to mental health care.

These military mental health professionals will go to U.S. bases worldwide, Defense Department spokeswoman Cynthia Smith said.

Other aspects of the plan include:

Embedding mental health professionals with line units.

Putting more mental health providers into primary care clinics.

Limiting the waiting time for initial mental health visits to seven days.

Looking into new incentives to recruit and retain mental health providers.

The Defense Department’s plan to implement most of the mental health task force’s recommendations drew praise from two prominent Democratic lawmakers who requested the mental health task force study — Sens. Joe Lieberman, I-Conn., and Barbara Boxer, D-Calif.

“We have a responsibility to ensure that our troops are both physically and psychologically healthy and the Department’s decision to implement the recommendations of the Mental Health Task Force is a first step in fulfilling that responsibility,” Lieberman said in a statement.

Boxer called the plan “an urgently needed step forward.”

“By embracing the recommendations made by the Mental Health Task Force, the Pentagon is recognizing and accepting the importance of ensuring our Armed Forces are not just physically healthy, but also in good psychological health,” Boxer said in a statement. “Implementing these recommendations will save lives and help those suffering from mental illness.”


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Fathers suffer postpartum depression in silence - Chicago Tribune

By Karen Pallarito

Postpartum depression has gotten a softer face in recent years as celebrity mothers such as Brooke Shields, who've experienced its devastating symptoms, have begun to share their personal stories.

Still hidden, though, are the identities of new fathers who have suffered in silence all these years.


Almost as many men as women suffer from this type of depression, according to researchers who examined data from more than 5,000 two-parent families. In all, about 14 percent of mothers and 10 percent of fathers showed signs of moderate or severe postpartum depression, according to the study, first reported in the August 2006 issue of the journal Pediatrics.

"The long-standing belief of many people, including physicians, has been that postpartum depression is due to hormone changes in women that take place after childbirth," said study leader James F. Paulson, an assistant professor of pediatrics, behavioral research and community health at Eastern Virginia Medical School's Center for Pediatric Research in Norfolk. "Obviously, fathers wouldn't be susceptible to changes of this nature and, probably because of this, haven't been a focus of study."

Janice Goodman, a psychiatric clinical nurse specialist and assistant professor at the MGH Institute of Health Professions, an affiliate of Massachusetts General Hospital in Boston, agrees that hormonal changes aren't the only plausible explanation.

"In both men and women, the huge life changes that go along with having a baby can contribute to depression," she said.

Postpartum depression can begin any time after childbirth and can last up to a year, according to Mental Health America, formerly the National Mental Health Association. Symptoms often mirror those of any clinical depression, such as sadness, fatigue and hopelessness. A sufferer may experience drastic changes in mood and appetite, excessive preoccupation with a child's health, or intrusive thoughts of harming the baby.

Although research suggests that hormonal changes may contribute to the onset of postpartum depression in women, "no definitive hormonal cause" has been identified, Paulson pointed out. Other factors suspected to play a role include history of depression, fatigue, marital discord, and lack of social support and financial support. "Factors of this nature certainly can affect fathers, and they probably do in many families," he said.

For the study, parents completed questionnaires and were interviewed to determine whether they showed symptoms of depression. Researchers also probed parent-child interactions, such as reading, telling stories and singing songs—acts considered critically important for positive child development. Depression in either parent was associated with reduced interaction, Paulson noted, and "fathers with greater levels of depression interacted with their child less."

Goodman said the research highlights a link between maternal and paternal postpartum depression, "such that men whose partners are distressed are at significantly higher risk of experiencing postpartum depression themselves." Yet paternal postpartum depression typically isn't on clinicians' radar, she conceded, and men often have less contact with health-care providers than women do.

However reluctant they may be to seek help, it's important for new dads who are experiencing symptoms of depression to see their primary-care provider or a mental-health specialist for evaluation and treatment, Goodman said. "One important implication for clinicians is, if a woman is identified as depressed during the postpartum period, to ask the father how he's doing and to screen for depression in him," she said.


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Study: Firms Should Help Unhappy Workers - Associated Press

By LINDSEY TANNER
AP Medical Writer

Investing in depressed employees -- quickly getting them treatment and even offering telephone psychotherapy -- can cut absenteeism while improving workers' health, a study suggests.

Many employers view mental health coverage as a financial black hole, but the study shows that spending money on depression is a smart business move, said researcher Dr. Philip Wang. Wang works for the National Institute of Mental Health, which funded the study.

Employees who got the aggressive intervention worked on average about two weeks more during the yearlong study than those who got the usual care -- advice to see their doctor or seek a mental health specialist.

Also, more workers in the intervention group were still employed by year's end -- 93 percent vs. 88 percent -- savings that helped employers avoid hiring and training costs, the researchers said.

In addition, intervention employees were almost 40 percent more likely to recover from depression during the yearlong study, which is reported in Wednesday's Journal of the American Medical Association.

The researchers haven't finished a formal cost-benefits analysis but early results suggest savings from more hours worked averaged to about $1,800 per employee. That far exceeds the program's initial $100 to $400 per worker cost. The benefits also likely exceed other costs, including drugs and therapy too, the researchers said.

"We knew before that treating depression makes good medical sense. This suggests that it makes good business sense," said Dr. Thomas Insel, director of the institute.

The percentage of workers who improved substantially -- 31 percent -- or who recovered -- 26 percent -- was low even in the intervention group. That was comparable to the rate of improvement in other studies of people with depression.

The results are important because depression takes a hefty toll on the U.S. workplace, affecting about 6 percent of employees each year and costing over $30 billion annually in lost productivity, said study co-author Ronald Kessler, a Harvard Medical School researcher. Kessler has worked as a paid consultant for several drug companies, including makers of antidepressants.

Two other co-authors are employees of United Behavioral Health, the large managed-care company involved in the study, and own stock in UBH's parent company. The research compared UBH's usual mental health coverage with the experimental telephone-based outreach program devised for the research.

Because of the study's results, UBH began offering a similar program after the study ended more than a year ago.

Dr. Ken Duckworth, medical director of the nonprofit National Alliance on Mental Illness, praised the research as "a real advance."

"This study shows employers benefit" from paying attention to depression, Duckworth said. His group supports a bill before Congress that would require employers to offer mental health insurance coverage that is equal to that provided for physical illnesses, when policies cover both.

The study involved 604 white-collar and blue-collar workers at 16 large U.S. companies. Employees included pilots, lawyers, bankers, truckers and janitors.

The study volunteers answered an online screening questionnaire that found signs of depression. Half got the usual care, including a letter suggesting they contact their primary-care doctor or call UBH for referral to a mental health specialist.

The intervention group got repeated telephone calls during non-work hours from UBH case managers trained in mental health treatment. Case managers urged workers to get treatment and called periodically to see how it was going.

When workers resisted seeking help, case managers offered telephone psychotherapy, which many employees viewed as less stigmatizing and more convenient than office visits with a psychiatrist, Kessler said.

About 40 percent of workers in both groups got antidepressants. Intervention group workers were 60 percent more likely to get treatment from a mental health specialist.

More employees in the treatment group stayed employed, a savings for the company.

Among those participating were workers at International Truck and Engine Corp., based in Warrenville, Ill. Dr. William Bunn, the company's medical director, said the results influenced International Truck to enhance its mental health coverage and do more employee depression screening.

"Now we know that purchasing a product such as the intervention is going to be cost-effective," Bunn said. "It's not just the right thing to do, it also saves money for the company."



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Mental health breakthrough - Boston Globe

September 25, 2007

A DECADE AGO, Congress acknowledged the heavy toll of mental illness by passing the 1996 Mental Health Parity Act. The law called for equalized insurance coverage in group health plans, so limits set on mental health benefits could not be stricter than the limits set on other medical care.

It was a start at ensuring that clinical depression, for example, doesn't take a backseat to appendicitis. But as a policy it was "half a loaf," and abused by insurance companies, as Senator Pete Domenici, a New Mexico Republican, said in an interview recently.

Indeed, the current law has loopholes that are easy to exploit. Health plans can still limit the number of mental health visits and increase deductibles without regard for parity.

So Domenici and senators Edward Kennedy and Michael Enzi, a Wyoming Republican, have hosted meetings among businesses, insurance companies, and mental health care providers, to come up with the Mental Health Parity Act of 2007.

Establishing parity in deductibles, copayments, and numbers of clinical visits, the bill passed in the Senate last week. It still has some gaps: It would apply only to companies with 50 or more employees, and it does not cover individuals who buy their own policies. But it could help 113 million people. The Congressional Budget Office estimates that it should increase the cost of employer-sponsored premiums by an average of 0.4 percent.

"Mental illness is just as treatable as physical illness," Kennedy said. Public policy should catch up to the advances in mental health treatments.

Now the challenge is working out differences between the Senate bill and one in the House. A difference is that the House bill - sponsored by Kennedy's son, Rhode Island Democrat Patrick Kennedy - would require coverage for all the mental illnesses that are covered by the insurance plan that members of Congress enjoy.

The Senate bill seems weaker: It would let businesses and insurance companies negotiate which mental illnesses will be covered. But the advantage of this proposal is that it has support from employers and insurance companies who were part of the legislative process. This should make them less likely to try to block passage of the law, or to duck it by simply deciding not to offer any mental health coverage - as they could legally do.

Such a compromise, however, demands vigilance. If the Senate's version, which has the support of the American Psychological Association, becomes law, Congress should monitor its execution to ensure that patients actually get better coverage. If parity remains elusive, Congress should crack down hard.

Healthcare reform remains a work in progress. But for now, it makes sense to enact the Senate bill and bring badly needed treatment to millions of Americans.


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Mental health maze works against patients - Atlanta Journal

By Lorraine Echols
For the Journal-Constitution

Georgia Department of Human Resources director B.J. Walker is right in stating that Joshua Hazelton's illness should have been treated long before his crime and his death ("Mentally ill need treatment on front end —- way before criminal acts," @issue, Sept. 19).

Walker is in charge of the system that should have provided his much needed services.

I consider myself a fairly knowledgeable mental health advocate. However, navigating access to mental health services in this state and knowing what services are available is in some cases extremely difficult. If you have private insurance, it is not going to pay for all necessary services. If you seek services from the state, you have to fall close to poverty level to qualify.

When my son was in elementary school —- continuously suspended for his behavior —- he was seen by psychologists and psychiatrists. He was on several different medications for a mental illness. My health insurance would not cover all his treatment. I did not know anything about an Individualized Education Plan. No one in his elementary school mentioned it. He was just punished for his behavior.

By the time he was in middle school, I reached out to the school administration and teachers —- still with no knowledge of an IEP. The school repeatedly suspended my son for his outrageous, often violent behavior. I tried to reach out to the school system and the truant officer to make my son go to school.

I did seek community services. I sought help from the Clayton County Community Service Board. They could not help because they did not take my insurance, and I wasn't eligible for their sliding-scale fee for services.

I called the police on several occasions when my son stole from me and others, went missing for days, allowed bad characters into my home, and generally risked the safety and security of me and my other son.

I appealed to everyone I came into contact with —- neighbors, employers, co-workers —- anyone who would listen —- trying to get services for my son.

I managed to get a private residential treatment center to accept my son on a two-week scholarship, which is extremely rare. In my desperation, I went to every state agency that I knew of looking for the funds to keep him there. A nonprofit child advocacy organization that, at the time, didn't even serve children in my county paid for my son to stay there for eight months. He was asked to leave because his behavior had not changed.

I ultimately went to the courthouse and pleaded for help from a Clayton County juvenile judge. He ordered my son to Georgia Regional Hospital for three weeks. Georgia Regional diagnosed my son with a serious mental illness and recommended to the judge that he be placed in a 90-day treatment facility for further assessment. At that time the community board refused to pay for the services. The judge did not want my son at home because he was a threat to himself and the community. Therefore, he had to stay in jail until there was some facility to take him. The judge told me that if I were to agree to place my son in the custody of the Department of Juvenile Justice they would pay for his mental health treatment. I reluctantly, regretfully, agreed.

I had to press criminal charges against my son in hopes of getting treatment.

The Department of Juvenile Justice decided that they were not going to pay for mental health services —- one reason being that my son was then too old. He was 16. He was placed in an independent living home, a group home, a drug treatment facility. He was kicked out for his behavior.

I am unable to do anything for my son now because as an 18-year-old, he is considered legally responsible for himself. I see him often wandering my neighborhood, wearing bedroom slippers, walking around wide-eyed and confused. Hopeless.

Gov. Sonny Perdue has since appointed a Mental Health Service Delivery Commission. Its charge is to "undertake a study of the conditions, needs and issues associated with the services to those with mental illness and substance abuse." While I would question the inclusion of the DHR commissioner since it is hard to assess yourself, I hope the members of the commission recognize and correct the system so that our family members can start getting the mental health services they deserve.

> Lorraine Echols of Clayton County is a member of the Georgia Mental Health Planning and Advisory Council

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Suicidal Gunman Reported at U. Wisconsin - Associated Press

MADISON, Wis. (AP) -- Police searched areas of the University of Wisconsin-Madison on Tuesday evening for a suicidal man they said was trying to provoke a shootout with authorities.

The university canceled night classes at the west end of campus, as well as a soccer game. Police urged students to stay home for the evening, and the University of Wisconsin Hospital discouraged visitors.

Police were searching for Jesse Miller, 19, of Madison, who was serving a work-release jail term for armed robbery but who stopped reporting this month, said Dale Burke, assistant UW-Madison police chief.

Miller has a history of mental illness and is a safety concern, Burke said, but police weren't positive Miller was ever on campus or even near the hospital.

''I can assure everyone in the community that all efforts are being exhausted to locate Mr. Miller,'' Burke said.

The Dane County Crisis Center got a call about 4:40 p.m. about a person on top of the hospital's parking ramp who was apparently suicidal. As officers responded, authorities learned the person claimed to have a gun and intended to be killed by police.

Two later calls claiming that shots were fired near the hospital and that a bomb threat had been made to the hospital were hoaxes made by Miller, Burke said.

''The calls appeared to be fictitious and without merit, and this gentleman indicated that he wanted to be killed by the police,'' Burke said. ''It looks like one of those cases where somebody is trying to create a scenario for that to happen.''

Officers had thoroughly searched the west end of campus and were not sure of Miller's whereabouts, Burke said, cautioning that the phone calls might not even been made from Madison.

By 11 p.m., officials determined that Miller was a danger to himself but not to the campus community and that classes and other operations would return to normal Wednesday, campus authorities said.

''This has been an unusual and troubling situation, but we have confidence that UW Police and other police agencies are handling this situation well,'' Provost Pat Farrell said.

The university sent two mass e-mails to students about the search, Burke said. Some still hadn't heard about it by Tuesday evening.

Greg Grube, a senior, said Tuesday night as he walked home on the west end of campus that his flag football game had been canceled that night for unspecified security concerns.

''Wow, jeez, I wish I would have known that. I would have been a little more careful,'' he said.

At the residence halls, students were being warned to stay inside or at least walk with friends if they went out. University employees were also checking student IDs for entrance. The university also offered to pay for cab rides to get students home.

The scare was at least the second security concern on campus in a week. Last week, police arrested a 52-year-old man who had been banned from campus by a judge for harassing female students.

Tuesday's search also came four days after Delaware State administrators ordered a swift shutdown of the Dover campus after two people were shot at a school dining hall. A student was arrested in that shooting Monday.



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House Passes Children’s Insurance Measure - New York Times

By ROBERT PEAR

WASHINGTON, Sept. 25 — The House on Tuesday passed a bill providing health insurance to more than 10 million children, but supporters of the measure fell short of the two-thirds majority they would need to override a veto repeatedly threatened by President Bush.

The bill was approved by a vote of 265 to 159. House Republican leaders strenuously opposed the measure, saying it cost too much, $60 billion over five years. But 45 House Republicans voted for it, along with 220 Democrats. Republican support for the bill was more than expected.

More than two-thirds of senators are expected to vote for the bill when it reaches the floor later this week. Without a fresh infusion of federal cash, a dozen states are expected to run out of money for coverage of children next month.

Speaker Nancy Pelosi, Democrat of California, said supporters would keep fighting for the bill until they overcame the president’s resistance.

“This legislation will haunt him again and again and again,” Ms. Pelosi said. “It’s not going away, because the children are not going away.”

To help override the veto, Ms. Pelosi said: “We are hoping to galvanize support of the American people for this legislation. The president will find himself alone.”

Explaining his objections, Mr. Bush said, “The bill goes too far toward federalizing health care and turns a program meant to help low-income children into one that covers children in some households with incomes of up to $83,000 a year.”

Senator Charles E. Grassley, an Iowa Republican and a co-author of the bill, said the president’s charge was “factually incorrect.” The goal, Mr. Grassley said, is to sign up low-income youngsters who are already eligible but not enrolled in the State Children’s Health Insurance Program.

The White House insisted that, under the bill, it would be “next to impossible” for federal officials to deny a request from a state like New York, which recently adopted a law to increase its income limit to four times the poverty level, or $82,600 for a family of four.

Sponsors of the federal bill said it would cover nearly four million uninsured children, while continuing coverage for 6.6 million youngsters.

Among those lobbying for the program on Tuesday was Bonnie S. Frost of Baltimore. Her daughter, Gemma, now 9, has been in the program for eight years and received treatment for a traumatic brain injury after an auto accident in 2004.

The money provided in the bill is $35 billion more than the current level of spending and $30 billion more than Mr. Bush wanted.

To cover the cost, the bill relies on tobacco taxes, especially the cigarette tax, which would be increased to $1 a pack, from the current 39 cents.

The bill would make the following changes in the children’s insurance program:

¶Dental services would have to be covered. Mental illnesses would generally be covered on a par with physical illnesses.

¶States could cover pregnant women with low incomes. The federal government would reduce payments for coverage of parents and would gradually end coverage of nonpregnant childless adults in the program.

¶Instead of directly providing coverage to children in low-income families, states would have new incentives to subsidize premiums for private health insurance offered by employers.

The bill stipulates that federal money cannot be used to provide health benefits for illegal immigrants. But states could try to verify citizenship by using Social Security numbers, without inspecting documents like birth certificates and passports.

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OCD traps people in obsessions -Jackson (MS) Clarion-Ledger

By Robin Street
Special to The Clarion-Ledger

Shirley Montgomery cannot leave her house without repeatedly checking to be sure her door is locked first.

"Some days it might take me 10 to 15 minutes to get out the door, when somebody else would just walk out," says Montgomery, executive director for the Mississippi branch of the National Alliance on Mental Health in Jackson.

She also requires everything, such as cans in her cabinet, to be in a certain order.

"I can't stand anything out of order," Montgomery says. "All the money in my billfold, all the ones have to be together, all face up, then I do fives and tens, with no corners bent."

For Amanda Clement, order is almost impossible because she has severe anxiety if she throws away papers of any kind.

"I'm very fearful, very afraid that If I throw something away that I might need it later," says Clement of Hattiesburg.

"My whole house is cluttered. There's papers in different rooms that are intertwined with things. It's hard to walk in my bedroom and in the back room."

Although their symptoms differ, these women - like an estimated one in 50 Americans - have obsessive compulsive disorder or OCD.

A person with OCD experiences obsessive thoughts such as if they left the stove on. As a sense of relief, they compulsively check the stove.

Television's Adrian Monk on Monk has OCD, but while Monk makes the disease entertaining, its victims suffer tremendous emotional pain, experts say.

WHAT IS OCD?

"Basically, OCD is an anxiety disorder where the mind expresses anxiety through creating obsessions, which are intrusive, repetitive thoughts or ideas and tries to control or relieve those obsessive thoughts through compulsions, which are repetitious activities that the person often believes will help them prevent whatever the obsessive thought tells them could happen," says Tricia Barrios, a staff counselor at the University of Mississippi Counseling Center.

OCD patients are aware their fears are not logical but remain trapped in the cycle of compulsions, experts say.

"The person cannot stop thinking about these issues," says Dr. Timothy Kelly, an Oxford psychiatrist. "They keep coming back, like torture."

"OCD can simply take over the lives of these patients," says Dr. Allen Cooley, a clinical psychologist of Tupelo. "Many are simply unable to work or are fired because their performance at work is so poor."

People with OCD are at increased risk of alcohol and drug abuse. About two-thirds of OCD patients have suffered major depression in their lives, and many are at risk of suicide.

"It is very common that patients with OCD develop depression," Cooley says. "Their quality of life is often quite poor, and many OCD patients become hopeless about overcoming their condition."

CAUSE OF OCD

OCD is not a personal flaw, experts say. It is a anxiety disorder beyond patients' control. The exact cause is unknown.

"It's not anyone's fault, and it's not a personal weakness," says Dr. Jonathan Abramowitz, associate professor and director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill. "It's something that develops as a result of many factors."

"There have been many studies on the genetics and biology of OCD, and while we have some leads, we are no where close to establishing the definitive cause," Abramowitz says. "Most likely, there are both biological and environmental contributing factors, some nature and some nurture."

OCD often begins in childhood, but it can appear in adults, too.

"Because it is an anxiety disorder, the symptoms may either not show up or not be as obvious until stressful events occur in the person's life, when the OCD may be triggered by the brain as a way to help manage the ensuing anxiety," Barrios says.

HOW IS IT TREATED?

OCD is treated with a combination of medication and therapy.

"Medication is generally helpful, and SSRIs (serotonin reuptake inhibitors), prescribed by physicians and psychiatrists, are the most common and effective ways to begin medically treating OCD," Barrios says.

SSRI's are anti-depressants such as Prozac, which work on serotonin, a neurotransmitter chemical in the brain that may affect OCD.

Counseling also is critical in treating OCD .

"The gold-standard as far as treatment of OCD is exposure and response prevention, or ERP," Cooley says.

In ERP, the person is exposed to an anxiety-producing situation, such as touching something dirty but prevented from coping through his compulsions such as handwashing.

"The idea is that if one exposes oneself to the anxiety-exposing stimulus, the anxiety will reduce over time if one does not give into it," Kelly says.

People with OCD may not understand their symptoms can be helped.

"OCD is commonly accompanied by a great deal of self-blame, self-distrust and a fear of being crazy," Barrios says. "The fear of being the only ones with these unwanted but unstoppable experiences or thoughts often leads them to try and hide their symptoms or isolate themselves instead of talking about it and seeking help."

But treatment can make all the difference, experts say. It has helped both Montgomery and Clement, who both take medication and have had counseling.

"My OCD is not as bad as it used to be," Clement says. "The medication helps me be able to deal with it."

People with OCD can have hope, Barrios says.

"A person can learn to manage it quite effectively and regain true measures of control over their own lives again," she says.

"The essential thing to remember is that there is help in managing OCD, and it is a sign of true strength and control to get that help from a mental health or medical professional for yourself."

----------------


FACTS AND FIGURES

# One-third to one-half of OCD cases in adults began in childhood.

# In adults, OCD typically begins about age 21.

# People with OCD average seeing three to four doctors and spend nine years seeking treatment before they are correctly diagnosed.

# OCD often runs in families. If one parent has OCD, a child has a 2 percent to 8 percent probability of having it.

Sources: Mental Health America, www.nmha.org; OCD Foundation, www.ocfoundation.org; American Psychiatric Association, www.psych.org;, Mayo clinic, www.mayoclinic.com

CATEGORIES OF OBSESSIONS

Compulsions and obsessions

People with OCD have anxiety-producing obsessive thoughts that typically fall into four major categories:

# Contamination - fear of being contaminated by germs

# Responsibility for harm -fearing they harmed someone or did something that could cause harm. For example, they worry if they left the iron on, thus causing the house to burn down.

# Order/symmetry - obsession with the need for order and alignment.

# Unacceptable thoughts - unwanted thoughts such as harming someone or of blasphemy.


To reduce the anxiety caused by these compulsions, they perform behaviors compulsively. Some typical compulsions include:

# Cleaning and washing - Repeatedly taking showers, washing their hands or cleaning their house.

# Repeating - Repeating a word, phrase or behavior over and over.

# Checking - Repeatedly checking to be sure he/she has not hurt someone or done something that could cause harm such as leaving the iron on or accidentally hitting someone with their car

# Ordering and arranging - Putting things in symmetry or perfect order.

# Hoarding - Keeping large amounts of items that other people would consider useless.

Sources: Dr. Jonathan S. Abramowitz, associate professor and director of the Anxiety and Stress Disorders Clinic at the University of North Carolina at Chapel Hill; Tricia Barrios, staff counselor at the University of Mississippi Counseling Center; American Psychiatric Association at www.psych.org

-----------------

ON THE WEB

Mental Health America: www.nmha.org

OCD Foundation: www.ocfoundation.org

American Psychiatric Association: www.psych.org

Mayo Clinic: www.mayoclinic.com
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Letters from Van Gogh to friend reveal artist's thoughts on sex, food, painting - Associated Press

By Verena Dobnik

NEW YORK - A never-before-exhibited collection of letters from Vincent van Gogh to a colleague reveal the beliefs and mundane challenges of the artistic genius, from his beliefs about sex to keeping his easel steady in the wind.

Van Gogh wrote the letters to Emile Bernard over two years starting in 1887, shortly before the tortured artist committed suicide.

"You see the human being in a body - who gets exhausted, working at his easel, outdoors in the blazing sun, with no food on some days," said Jennifer Tonkovich, curator of "Painted With Words: Vincent van Gogh's Letters to Emile Bernard," on display at The Morgan Library & Museum.

The 20 letters - alternately frank, humorous and profound - relate to 22 paintings, drawings and watercolours in the exhibit that the two artists discussed or exchanged, including a portrait of a French soldier dressed in a bright uniform influenced by the Algerian background of the so-called Zouave regiment.

"It's coloristically brilliant. And it captures the humanity of the moment," Tonkovich said of the face, which the artist describes as "bloody ugly."

Bernard, an artist and poet 15 years younger, became friends with the Dutch-born van Gogh in Paris, and the two often worked side by side. Van Gogh later moved to Arles, in the south of France. He committed suicide in 1890 at age 37, walking into fields outside Paris and shooting himself in the chest.

Months earlier, from Arles, he had written to Bernard: "I am in better health here than in the north - I even work in the wheat fields at midday, in the full heat of the sun, without any shade whatever, and there you are; I revel in it like a cicada."

In the 1920s, the letters ended up in the possession of the Baroness Marianne de Goldschmidt-Rothschild, who kept them in her home in Berlin and passed them on to her descendants in Paris. Nineteen of the letters now belong to collectors Eugene and Clare Thaw of Santa Fe, N.M., who have promised the collection, worth millions, to the museum.

The letters from Bernard to van Gogh have disappeared, perhaps because van Gogh moved around while undergoing psychiatric treatment, Tonkovich said.

The letters debunk the popular conception of the artist as an unknown, naive genius recognized only after his death.

"You have the sense of a well-read person; van Gogh read everything from the Bible to Zola. And his talent was recognized even then," she says.

Van Gogh complains about his eyes getting tired from painting and about the challenge of keeping his easel from being blown away by the wind in the fields.

And he talks about sex.

"Van Gogh adamantly believed that too much sexual activity detracts from your work," the curator said. "He believed sexual activity depletes you."

Van Gogh had left a woman he was living with in Holland to devote himself entirely to painting, Tonkovich said. But when he had the money, van Gogh writes, he tried to visit a brothel about every two weeks.

In the letters, he talks about finances and about his health - and how to maintain his stamina for work by eating well. There is little direct reference to his mental health, "but you're aware that there's this problem. He talks about calming his head," the curator said.

The exhibit opens Friday and runs through Jan. 6. Read more!

NC lawmakers want more answers before mental hospital changes - Associated Press

By GARY D. ROBERTSON

RALEIGH, N.C. - State health officials said Tuesday they want to open a new state psychiatric hospital by March, but lawmakers want more answers before closing two other hospitals.

They also want to know if enough community treatment options are available.

"Somebody's going to have assure me that we will take care of everybody before we open it," said Sen. Martin Nesbitt, D-Buncombe, co-chairman of a legislative mental health oversight committee. "The good news is we've got a little bit of time."

The General Assembly approved in 2003 the construction of a new mental hospital designed to serve central North Carolina patients and replace Dorothea Dix Hospital in Raleigh and John Umstead Hospital in Butner.

The new hospital, also located in Butner, will have more than 500 beds, enough to care for the number of patients that on average have been treated daily at Dix and Umstead during the past fiscal year, said Dr. Jim Osberg, who supervises the state's mental hospitals.

Wake County lawmakers at the meeting said they want more assurances that the Department of Health and Human Services has assembled enough outpatient services and private treatment options before the transition to the new hospital is complete.

Without such services, the patients will have to be hospitalized, leading to overcrowding or waiting lists for treatment that will damage patient health, according to critics. Other lawmakers wanted the state's patient projections at the new Central Regional Hospital for the next five to 10 years.

State law says new department secretary Dempsey Benton can't close the two old hospitals without presenting to the committee detailed information about the outpatient treatment. Members were unhappy with what they received Tuesday.

"This eight-page summary in my opinion no way complies with the statutory requirements," said Sen. Richard Stevens, R-Wake. Mike Moseley, head of the state division that oversees mental health, said his office would provide a better review soon.

The hospital transfer highlights a six-year effort to reform the state's mental health system from one centered on institutional care to community-based mental health and drug and alcohol treatment programs.

The movement has been harmed by budget shortfalls earlier this decade and uneven community care as some private programs assembled to treat patients where they lived went under financially. Most recently, Broughton Hospital in Morganton stopped receiving Medicaid and Medicare reimbursements following the death of a patient and the fall of another.

A consultant's report produced for Moseley's office released last month showed that the broad changes within the mental health system have created insecurities among consumers, leaving some indigents still without care.

The report said 25 regional agencies that work with patients to ensure they receive treatment in their communities should be consolidated to improve services and reduce operating costs. The agencies and state hospitals also must work together better to serve patients, according to the consultant, Alice Lin.

Lin told the committee Tuesday that other states performing similar reforms have had problems, too.

"We should not be too critical of ourselves when we are running into obstacles and barriers," she said.

All rights reserved. This copyrighted material may not be published, broadcast or redistributed in any manner.
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State hospital to ban tobacco -Pueblo (CO) Chieftan

By JOHN NORTON

On June 1 of next year, the Colorado Mental Health Institute at Pueblo will go totally tobacco-free.

Smoking is already banned within 50 feet of the buildings as well as indoors, but that restriction will extend to all the grounds, Superintendent John R. DeQuardo said on Tuesday.

A memo went out earlier this month to all employees, he said, and there will be reminders over the next few months in advance of the new rule taking effect.

Along with that, he said, the hospital will make an effort to help employees quit tobacco with classes and other methods, since the new rule will make it much more difficult to take smoking breaks during the day.

DeQuardo, who quit the habit himself in 1986, said that the ban was the recommendation of a committee representing people from all parts of the CMHIP operation working over the last five months. It will be another eight months before it goes into effect. DeQuardo said that other institutions that have done this have found “the longer you plan for this, the smoother it goes.”

The rule has one goal, he said: better health.

“As a health-care facility,” DeQuardo said, “it goes against our mission to allow tobacco use.”

And it’s a tobacco ban, he adds, not just a smoking ban. That means no dipping or chewing either.

Few of the approximately 450 patients are able to use tobacco now as it is. The state has banned smoking in the buildings and there is no tobacco allowed in the forensic areas, where patients are not able to get outside. Even many of the medium-security areas don’t have any outdoor smoking areas.

One of the biggest challenges will be getting the word out to friends and relatives who visit that smoking won’t be allowed anywhere on the grounds.

Patients who smoke also will be encouraged to quit. “There’s a risk factor involved,” DeQuardo said. “If they continue to smoke, there’s a greater risk to relapse into substance abuse.”

Of the slightly fewer than 1,000 employees at the hospital, there are still a lot of smokers, however. DeQuardo said that an online survey showed 37 percent of the employees responding said they smoked. While not everyone working there took part, that’s still a high number. He said it’s not necessarily high, though, for people in the mental health field. “You find a lot of smokers,” he said, “I guess because of the stress of the job.”

While getting people to quit is not the goal of the program, employees will be encouraged to give it a try.

Workplace smoking bans have led many smokers to get serious about quitting, especially those with strong nicotine addictions that make it difficult to get through the day without lighting up.

“I have no intention of controlling people’s behaviors,” DeQuardo said. “I'm not going to turn this into a tobacco-free police state.”

He said that there will be smoking cessation programs and nicotine patches will be provided to those trying to move away from cigarettes. One of the staffers even offers auricular acupuncture, using the ear lobes, a technique that has been credited with helping some people quit.
He said that Pueblo City-County Health Department officials have met with hospital staff and offered their help. “They’re going to be a huge resource for us,” he said.

He’s also contacting Colorado mental health providers who refer patients to Pueblo from around the state, and letting them know about the rule so that patients will be prepared.

“There’s always a lot of hubbub before you do this,” he said, “but afterward, it goes pretty well."

Some have said that patients will be more agitated but DeQuardo said that’s more likely in areas where they can’t smoke and smell it on the employees.

“People will say that smokers have rights. That’s not true and it’s been established in court.

“They say there will be absenteeism but that actually drops because people have fewer respiratory problems. They call in sick less.”

In studying what’s been done at other locations, he said, “this is most successful when it’s taken as a public health issue.”

After a few years, smokers will feel better and can even reverse some of the damage they’ve done with tobacco, he added.

Last spring, he said, a “biggest loser” contest resulted in about 300 employees shedding “tons” of weight through diet and exercise. Smokers who used to go outside will be encouraged to take “fresh air breaks,” he said.

It will still be possible for workers to go off the grounds although it’s going to be a pretty good hike for a 15-minute break. DeQuardo said that neighboring homes and businesses are going to get letters letting them know about the new rule and asking them to contact the hospital if there is any problem with littering.

He said that on the grounds, the caretaking crews will have less work to do because there won’t be any cigarette butts to clean up. Read more!

Criminal Assault Charge Dismissed Against Autistic Boy - Cincinatti (OH) WCPO-TV

Reported by: Tom McKee
Photographed by: Scott Wegener

A Brooksville, Kentucky, family vowed Tuesday to fight for the rights of children with autism after a criminal charge was dismissed Tuesday against their six-year old autistic son.

"As for our plans we plan to seek the best possible outcome for our son's future," Cathy Darnell wrote in an e-mail to WCPO-TV on behalf of her son, Nathan.

"Sadly, that probably means by civil action," Darnell said in her e-mail. "We understand that may bring a more political aspect to the matter."

Nathan Darnell was charged September 11 with 4th degree assault, a minor misdemeanor, for allegedly knocking a kindergarten aide to the floor at Taylor Elementary School.

The aide, Glenda Schultz, told Bracken County sheriff's deputies that she sustained bruises on an arm and lacerations to a knee in the incident.

The case wound up in the Bracken District courtroom of Judge W. Todd Walton, II, Tuesday afternoon.

Public Defender Amanda Mullins asked that the charge be dismissed because of Nathan's age and autism.

"A child can't participate in their own defense at six-years-old because they're unable to answer questions or give me their version of the story accurately," Mullins said.

The judge agreed.

"I was happy. I was tearful," said Cathy Darnell, outside the courthouse. "It's what I've been waiting for."

Nathan's father, Tony, added, "I'm very happy, but we feel that people still need to be aware of what happened and that people need to learn from it."

The Darnells came to court not knowing what to expect, but with the knowledge that they've received support from around the globe.

"We've got people from the United Kingdom and they're worried that if this stands, its precedent will be that it's against the law to have a disability in this world," Tony Darnell said.

They left breathing an emotional sigh of relief.

"It's our son. I don't know how to say it," said Tony, fighting back tears. "It's our child. Everything that makes him so unique and precious to us is everything that was almost held against us."

Mullins said with the criminal case closed, the matter is now between the Darnell family and Bracken County schools.

"It's not an issue of assault," she said. "It's an issue of a school being unprepared to deal adequately with a child like that."

Tony Darnell says he hopes that can be changed.

"Try to correct the things in society and this region that caused this," he said. "Making people aware. Letting the school know that we don't hate them. It's just that they suffer from the same lack of funding and understanding that we do."

Darnell continued, "We're learning, and learning how to deal with our child and love him. They get paid to do so, so we expect it."

Bracken County Schools Superintendent Tony Johnson issued a statement which read:

"Upon advice of legal counsel, neither I, nor any other representatives of the Bracken County Schools, will comment on this matter due to the Family Education Rights and Privacy Act, (FERPA), which affords a right of privacy to parents and student relative to their educational records."

What likes ahead for Nathan?

His parents say they'll push to try and get the outreach and services he needs.

That might mean transportation to a day care program.

It could mean more funding for training educators about dealing with autistic children.

"We want him to know that his parents did everything they could to give him the kind of life and help he needs," said Tony Darnell.

©2007 The E.W. Scripps Co. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. Read more!

Study: Tourette's provides advantage in some skills - Wilmington (NC) WWAY-TV

25 September 2007

Scientists are finding that people with Tourette's Syndrome may actually have an advantage when it comes to certain skills. Those who suffer from Tourette's learn to get used to the physical and vocal tics that others often view as faux pas, but the sudden or repetitive motions and sounds are involuntary.

Researchers at Georgetown University and the Kennedy Krieger institute tested children with and without Tourette's Syndrome. They found that kids with Tourette's were just as accurate as other kids at certain skills, but quicker.

Fourteen-year-old Andrew Youngen visits classrooms to explain that his sudden or repetitive motions and sounds are involuntary.

Andrew Youngen said, "Don't tease because that just makes it worse, and don't remind me about it because then I'll start thinking about it and then I'll do my tics."

Andrew also participated in a study to find out if the neurological disorder affects the brain in other ways. Researchers at Georgetown University and the Kennedy Krieger Institute tested children with and without Tourette's Syndrome. They designed tasks that use the same brain areas affected by Tourette's, such as applying the rules of grammar.

They wrote in the journal "Neuropsychologia" that kids with Tourette's were just as accurate as other kids at those skills, but quicker. Neuroscientist Michael Ullman hopes their research will change our view of such disorders.

Ullman said, "It seems to me that this finding can be thought of as positive and encouraging in the sense that it's not a disorder, associated just with problems, but also with advantages, potentially."

Ullman says early results in similar studies of autism suggest that disorder may bring advantages in other types of mental skills.

For more information visit www.sciencentral.com.
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Kid Hero Saves Teacher -Poplar Bluff (MO) KFVS-TV

Sep 25, 2007

By: Holly Brantley

POPLAR BLUFF, Mo. - A Heartland kid who loves super heroes got a chance to be one.

Two weeks ago, teacher Madonna Kenser, of Oak Grove Elementary in Poplar Bluff, suddenly had an asthma attack during class. Her hero is one of her students, nine-year-old Brendon Garman.

"I was teaching the class using the projector and little did I know I was allergic to the fumes of my dry erase pen," Kenser said. "My throat began to close."

"I was having an asthma attack," she said. "The students were watching and I knew I had to get to my desk."

Before Kenser could get to her desk and her inhaler, she passed out.

"I was starting to get worried," said Brendon Garman, the young hero.

Brendon quickly came to Kenser's rescue.

"I just ran over when she passed out," said Brendon. He got to her purse and grabbed her inhaler, gave it to his groggy teacher and saved her life. He says he knew what to do from a scene in the movie "Are We There Yet."

"If I didn't see that movie, I wouldn't know what to do," said Brendon.

"After the event he said '‘You know Mrs. Kenser, TV's not so bad huh?'" said Kenser.

Brendon's family is very proud of him. His mother and teachers point out something that makes this young hero even more amazing. Brendon has autism, something that usually affects communication and social skills. Kenser and Brendon's mother hope others will see autistic kids, like Brendon, are full of potential and capable of incredible things like saving a life.

"I went to the doctor and he said 5000 people die from the things that happened that day," said Kenser. "There's a good chance I wouldn't be here."

Kenser says she's very proud of her entire class for their calm reaction. Ironically this is Autism Week. Read more!

New treatment for autism? -Louisville (KY) WHAS-TV

Videos from this report can be found here.

LOUISVILLE, Ky. -- WHAS11 News has learned of a possible groundbreaking treatment for autism here in Louisville.

Kosair Children's Hospital and the University of Louisville are planning a study of that therapy. It comes after a local mom reached out to Kosair for help.

This is not a cure for autism but it is a rare glimmer of hope for parents of autistic kids. The medical director of Kosair Children's Hospital tells me this treatment could be life changing.

“If we find out this is as good as Mrs. Riggle thinks it is, in what we've seen, then it will be a huge impact,” says Dr. Stephen Wright, medical director of Kosair.

The parents of 7-year-old Evan Riggle have been dealing with his autism since he was 1. We have chronicled their search for effective treatments, including rare blood transfusions to boost his immune system.

WHAS11 News

Evan Riggle

But Evan is far more receptive to an IV of glutathione, an amino acid in your body that neutralizes harmful molecules.

“So, by helping boost their own natural glutothione production, it reduces the oxidative stress in their body and they are less combative, they are more calm and therefore generally more cooperative,” says Emlyn Riggle.

As it was, the Riggles didn't know how long they were going to be able to care for Evan.

“Evan was getting bigger and stronger every day, and I wasn't,” Emlyn says.

WHAS11 News

Emlyn Riggle

Glutathione has been talked about for years in alternative medicine. In February of last year, the Riggles brought their research to Kosair.

“I have to tell you, I was very skeptical,” says Dr. Wright.

Even today, Wright is very careful not to give false hope. Parents of autistic children are desperate for any answers. “The problem with that is the patients and families then become susceptible to charlatans and people want to take advantage of them and make a quick buck off of somebody's bad fortune.”

But Evan's experience prompted Kosair to give the glutathione therapy to three other kids. Dr. Wright says two of them have also shown remarkable progress, including an 8-year-old boy.

“After about three or four treatments, I visited him while he was here,” he says. “His mother said he dressed himself for the first time in his life.”

“It has made a life-changing difference,” Emlyn Riggle says. “Is Evan cured? No. Is he better? Yes. And progress is what we need in this area of autism.”

The next step is a study with 50 autistic children.

“Even if we see in half the patients what we've seen in those four, it would be remarkable for hundreds and thousands of families,” Dr. Wright says.

WHAS11 News

Michala Riggle

“I'm a stay at home mom. I'm just a mom that cares about my kids. But, obviously, I feel incredibly humbled that they took me seriously and really looked into the research and that we've gotten to the place where we are,” says Emlyn.

Kosair's phones are likely to ring off the hook once parents of autistic kids hear about this study. But Dr. Wright says they're not ready for that and are still writing the research protocol.

Kosair estimates it will cost about $400,000. Ten-year-old Michala Riggle has seen firsthand the benefits of the glutathione IV that her brother, Evan, has been getting since February of last year. It's not a cure, but early results show it decreases aggression in autistic kids and improves their interpersonal skills, their socialization and verbalization.

“It's hard because when he wants something that we won't let him have, he'll get mad and frustrated,” she says. “And he'll try to find ways to get out of the house to throw things, to drop things, so we have to keep an eye on him.”

When Michala heard that Kosair and UofL needed between $200,000 and $400,000 for this autism research, she began beading bracelets and selling them for the study.

“She walks in and pulls out a baggie with $29 in it, and showed me all these bracelets she's beaded,” says Dr. Wright.

Michala has recruited friends and family to help and sell the bracelets at local events, and has raised about $1,000.

“That's a lot of bracelets. So, she's beading to beat autism,” says Dr. Wright.

Michala will be selling the bracelets at the St. James Court Art Show this weekend.

Web story produced by Jay Ditzer.
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Owner of home charged with fraud - Associated Press

09/25/07

SPRINGFIELD, Mo. (AP) -- The owner of a Missouri group home where 11 people died in a fire was released on a $25,000 bond Tuesday to face a federal charge of Medicaid fraud.

U.S. District Judge James England ruled against prosecutors who wanted to keep Robert DuPont, 62, in jail while he awaits trial.

DuPont was arrested Monday on a federal charge of Medicaid fraud. He is accused of running five residential care homes in southwest Missouri despite an earlier felony conviction that barred him from being in charge of those facilities.

The judge agreed to the bond on conditions including that DuPont surrender his passport and have no role in any health care facilities. Court records show DuPont was released after posting bond.

The criminal charge follows a slew of lawsuits against DuPont and his wife, LaVerne DuPont, since the Anderson Guest House, a home for the mentally ill and handicapped, burned in November.

The DuPonts owned the Anderson home and four others that were operated by a group they had established, Joplin River of Life Ministries Inc.
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LaVerne DuPont was executive director of the ministry, but federal prosecutors allege that Robert DuPont was really in control. Prosecutors allege that violated laws barring Robert DuPont from operating any facility that receives Medicaid money because of a 2002 fraud conviction.

"In day to day operations of the facilities, Dupont makes unilateral hiring decisions, terminates employees, directs staffing levels, and unilaterally decides whether to accept potential residents referred by local hospitals," investigators said in an affidavit filed with the federal charge.

"Dupont has prohibited facility managers from seeking decision making authority from LaVerne Dupont, his wife and the individual listed as executive director of JROL, and threatened to terminate employees who fail to seek his authorization for decisions," the affidavit read.

DuPont has repeatedly said he was just an employee of the ministry and did not run the homes. At Tuesday's hearing, his wife and his attorney both declined to comment to reporters.

Judge England ruled there was enough evidence in the affidavit to send the case to a federal grand jury. If the grand jury indicts Dupont, the next step would be trial.

The maximum sentence could be life in prison, said Assistant U.S. Attorney Richard E. Monroe.

In a filing with the court arguing against bail, Monroe said the sentence could be life because 11 people died in the Anderson home while it was being illegally run by Robert DuPont.

The Missouri Department of Health and Senior Services withdrew all operating licenses from Joplin River of Life in December over Robert DuPont's apparent involvement in operations.

The DuPonts also are the targets of a state lawsuit alleging Medicaid fraud, and nine wrongful death lawsuits filed on behalf of several victims of the Anderson Guest House fire or their relatives. Those suits are pending.

The state lawsuit filed by Attorney General Jay Nixon alleges that Robert DuPont lied to state regulators to conceal that he ran the homes.

Nixon is seeking $689,491 in Medicaid payments made to Joplin River of Life Ministries, plus about $2.1 million in damages and an unspecified civil penalty for each fraudulent Medicaid billing made by the company.
Read more!

Mental health services limited for delinquents -Toledo (OH) Blade

By ROBIN ERB
BLADE STAFF WRITER

On a police report, Dale looks like any other burglar: “The defendant did trespass into an occupied dwelling … and did steal $522 and a cell phone.”

And he might not stand out among the list of kids this day inside the Lucas County Juvenile Detention Center — a litany of suspected burglars, thieves, and batterers.

But Dale still colors pictures of Scooby-Doo. His brain functions at a kindergarten level.

“He’s a 17-year-old kid in a 10-year-old body, with a 4-year-old mind,” said one court official.

So on this day, no one seems to know what to do with Dale.

In Lucas County, mental health services — especially for adolescents — are limited and costly. And throughout Ohio, a mental illness for a juvenile delinquent can be a get-out-of-jail card, said Doug Messer, administrator for Lorain County Juvenile Court near Cleveland.

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DAY ONE
READ: Felonious juveniles in Lucas County often avoid serious jail time
READ: Inmate now wishes court had been strict earlier
READ: Youth diversion allows judges a range of options

DAY TWO
READ: In certain situations, teen minds are found to be wired for trouble
He and other juvenile justice and mental health officials from around the state have been meeting to establish a mental health statute that would lay out steps to help some of the state’s most mentally ill young criminals.

Unlike Ohio’s adult courts, the juvenile courts have no protocol for identifying youths who may be unable to defend themselves in court.

In adult court, a defense attorney generally asks for a competency evaluation. If a defendant is too cognitively impaired or mentally ill, a judge may order treatment, triggering a detailed process that might “restore” them so they can stand trial.

Finally, if they can’t be restored to competency, a judge can order them to a secure mental health facility.

Juvenile justice doesn’t work like that.

“What happens in most jurisdictions is that the charges are dismissed and the child goes on his way,” Mr. Messer said.

And there’s another issue, he said. Is there a point in which kids are simply too young to defend themselves?
“Can you grow or be educated into competency? Is there an age cutoff?” Mr. Messer asks.

In Lucas County, officials say they use some creative intervention — even turning custody of a child over to Children Services — to get a young offender the help he needs.

Still, it’s not easy.

On a recent morning, Kathleen Baird, chief psychologist for the Lucas County Juvenile Detention Center, had just finished evaluating a 15-year-old felon. Unable to read beyond a second-grade level, it was also unclear if he really understood the gravity of being detained and facing youth prison.

“He can’t tell a story sequentially. How could he tell his attorney what happened? …” She didn’t finish, frowning instead.

According to the Ohio Department of Youth Services, kids in prison are about four grades behind in math and reading. About half are assigned to some special education classes.

About one in three have some type of mental health issue. As many as 80 to 90 percent have been abused, and nearly all have experienced some tragedy, violence, or some other trauma — the sort of event that research suggests interrupts and rewires the brain in critical developmental years.

Not surprisingly, children like Dale pose a real concern for Lucas County where Juvenile Court officials must sort out more than 10,000 delinquency cases each year, ranging from kids sneaking cigarettes to young sociopaths and murderers.

A happy kid who’s eager to please, Dale has been urged by older teens to sneak into homes. He’s 110 pounds and can wiggle through windows and open doors for them.

There are other kids whose brains misfire and they seem like demons and hear voices. Ms. Baird estimates that about 30 percent of juveniles in detention take some kind of psychotropic medication.

There are those whose brain development is so delayed, they can’t appreciate they are in jail.

Some are violent.

A defense attorney’s ethical mandate is to, above all, vigorously defend a client against the criminal charges against him.

But what if evidence in a case is so poor that the attorney knows he can get the charges tossed out yet also realizes that he can get the child into the mental health system only with a finding of guilt?

“Sometimes you can go in and win a case, but lose it for a kid,” said Ken Phillips, a defense attorney who represents many of Lucas County’s substance-abusing youths. “It’s tough.”

Among the suggestions Mr. Messer and others have discussed is enabling a child’s guardian ad litem, a person appointed to represent the best interests of the child, to demand a competency evaluation.

That way, the defense attorney can focus on best defending the child against the criminal case while the guardian ad litem can worry about mental health help.

A disturbing example
Just before Thanksgiving last year, the phone rang at Judge James Ray’s house in the middle of the night. It was a sheriff’s deputy.

A 17-year-old drug addict, suffering from schizophrenia and paranoia, had grown violent. He’d threatened people. And he’d been arrested.

But juvenile detention staff wouldn’t take him. He needed hospitalization, they said.

A local hospital doctor wouldn’t accept him either. He needed to be locked up, they said.

The Lucas County jail couldn’t take him either. It’s for adults.

Exasperated, the judge talked to an emergency room doctor: “I said …What do you want these deputies to do? This young man doesn’t belong in detention. He can’t go to jail. Should they put him in the back of their car and drive him around until he expires and then take him to a coroner’s office?”

Those in juvenile justice say young criminals with serious mental health issues don’t just fall through the cracks, they’re pushed and shoved through.

Medicaid doesn’t cover mental health care inside lockup.

Lockup doesn’t provide long-term treatment anyway.

Insurance companies bristle at being court-ordered to provide treatment.

And mental health providers feel criminals sometimes are unfairly dumped into their system.

“We’re not always in agreement about how we see things,” said Karen Olnhausen, director of child and adolescent behavioral health services at the Mental Health and Recovery Services Board of Lucas County.

These days they’re working to close the gaps in Lucas County, say the leaders of the county’s public mental health agencies and juvenile court.

“There is more open-mindedness that we really do have to work better together on these kinds of kids. We have to stop trying to turf them other places,” said Ms. Baird.

It will take awhile, said Connie Darling, a longtime county juvenile probation officer: “It’s a stressed system, and it’s discouraging.”

Still, everyone agrees on this: Finding the right court sanction — from time behind bars, to counseling, to community service, to a host of other options — is critical to changing criminal behavior and ultimately to making the streets safer.

Inappropriate sanctions aren’t just ineffective, they can backfire, said David Arredondo, a child psychiatrist and leading national expert on juvenile mental health issues.

According to both mental health and juvenile justice experts, the first step is understanding that even in the best circumstances the adolescent brain is undergoing an explosion of neurobiological, psychological, social, and moral development.

Finding what works is even more complicated when it’s a kid who may be simply surviving in chaos, neglect, and fear, and panics rather than being nurtured by routine, expectation, and love.

“Some of these kids, horrible backgrounds, horrible environments. [If a] kid’s mom was doing meth when he was in utero, God knows what’s going on with his brain,” said Dr. Arredondo.

How do you know?
So how do you sort out mental health from sociopathy, from normal teenage angst and obnoxiousness?

“It’s very hard, even for a professional sometimes,” said Dr. Lurley Archambeau, medical director of the Lucas County Mental Health and Recovery Services Board.

“You have a kid that the parents bring in, and they’re misbehaving, or not being truthful, or disobeying. Is this part of a normal teenager emancipatory process and who they’re hanging around with and trying to fit in with the group? Or is this an underlying sign of some kind of nascent mental illness that’s developing?

“To be honest, sometimes only time will give you the answer to this.”

That’s not to say youths shouldn’t be held accountable, but lockup simply isn’t always the best answer, he and others said.

But even in times when community safety is not the overriding issue, it’s often the only option.

Said Thomas Stickrath, director of Ohio Department of Youth Services, which provides some mental health care: “From time to time, courts tell me, judges tell me, ‘I’m sorry I’m sending Johnny to you. He really needs mental health treatment, but we’re not sure the options are there locally.’”

They’re especially limited in Lucas County for those kids whose substance abuse problems are so deep that they need residential treatment.

Two decades ago, several Toledo-area hospitals featured long-term substance abuse and psychiatric wards, and in West Toledo there was St. Anthony Villa, a long-term residential treatment center where staff were specially trained to deal with the complexities of mental health and sometimes violent, criminal behavior.

But as insurance policies changed over the years, many cut back on mental health and substance abuse services. That, in turn, meant some of those services, including St. Anthony Villa, closed down, mental health providers say.

This month a change in state law will mandate that most policies expand certain coverage for the care of biologically based mental illness, like schizophrenia, the same way they do for physical illnesses, said Kelly McGivern, president and CEO of the Ohio Association of Health Plans, which includes about 20 health care companies serving 6 million Ohioans.

Insurance shifts
She said the old one-size-fits-all policies diversified over the years. Th