Former Romanian priest jailed for exorcism murder of nun - CNN.com

Former priest jailed for seven years for murdering a young nun during an exorcism. Cornici, once treated for schizophrenia, believed she had heard the devil talk to her.

BUCHAREST, Romania (AP) -- A former priest began a seven-year jail term Wednesday for murdering a young nun during an exorcism ritual when she was bound, chained to a cross and denied food and water for days.

Irina Cornici, 23, died from dehydration, exhaustion and suffocation during an ordeal that stunned Romania and prompted the Orthodox Church to promise reforms and psychological tests to screen potential clergy.

The former priest, Daniel Corogeanu, and four nuns were all convicted and sentenced in September but Corogeanu was freed pending an appeal, which he lost Tuesday. He was picked up by police in the remote northeast Wednesday and sent to jail.

Cornici, who had previously been treated for schizophrenia, had believed she heard the devil talking to her. Corogeanu and the four nuns decided to try an exorcism ritual in June 2005 using techniques that the Romanian Orthodox Church condemned as "abominable".

The church, which has benefited from a religious revival in recent years, defrocked Corogeanu and excommunicated the four nuns, who in September were handed five- and six-year jail terms.

When arrested Wednesday, Corogeanu said he would serve his term if that was God's will, the national news agency Rompres reported.

Corogeanu, a Romanian, dropped out halfway through training for the priesthood, but still served as a priest for the secluded Holy Trinity convent in northeast Romania because of a shortage of suitable candidates for convents and monasteries.

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Britney Spears taken away in ambulance - AP

ASSOCIATED PRESS

LOS ANGELES — Britney Spears was taken from her home by ambulance early Thursday and escorted to a hospital by more than a dozen police officers.

A Los Angeles police officer, who spoke on condition of anonymity because he was not authorized to speak on the matter, said the 26-year-old pop star was being taken to “get help” but did not give the ambulance’s destination.

The Los Angeles Times, citing unidentified authorities, said Spears was taken to UCLA Medical Center to be placed on a “mental evaluation hold.” Center spokesman Mark Wheeler declined to comment to The Associated Press, citing privacy laws.

Spears’ police escort included motorcycles, two cruisers, and two helicopters.

On Jan. 3, police were called to her home when she refused to return her two young sons, Sean Preston, 2, and Jayden James, 1, to ex-husband Kevin Federline, who has custody.

Officers had paramedics haul Spears to a hospital for undisclosed reasons. She was released after a day and a half in Cedars-Sinai Medical Center.

Police also went to the home Monday night after someone reported a swarm of paparazzi trespassing in the singer’s gated community. When officers arrived, they didn’t see anyone trespassing, police said, but citations were issued for several illegally parked cars.

Spears has been in a highly public downward spiral since filing for divorce from Federline in November 2006.

Her bizarre antics include shaving her head bald, attacking a car with an umbrella and bringing along a paparazzo pal on trips to a courthouse in her child custody case.
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Murder-suicide initiator was AWOL -Billings (MT) Gazette

By RUFFIN PREVOST

CODY, WYO. - An active-duty sergeant in the U.S. Army had often threatened suicide in the days before killing his estranged wife and himself, according to witness statements in police reports.

The Lovell Police Department provided reports on its investigation of the Nov. 5 incident in which Sgt. Steven D. Lopez, 23, shot Brenda Lee Davila, 22, three times before turning the gun on himself outside Davila's Carmon Avenue residence.

Lovell Police Chief Nick Lewis declined to comment on the case.

The reports include accounts from those close to Lopez who say he was struggling with depression and had worried that he might kill Davila and himself.

Dispatch logs detail three phone calls to police over 11 days in October by Sgt. Clinton Ham, who was stationed with Lopez at Fort Bragg, N.C. Ham told police he had received text messages from Lopez stating that he was suicidal.

The Army's Criminal Investigation Division, an independent unit that investigates felony crimes involving Army personnel, is looking into the incident.

Chris Grey, CID public affairs chief, said he could not comment on the ongoing investigation.

Grey said the division conducts investigations "to get to the truth, whatever the circumstances, and to ensure we know exactly what transpired."

In mid-September, Davila left Fort Bragg, where the couple lived with their two young children. She returned to Lovell with the children, planning to seek a divorce, according to a police report.

It was a dispute over custody of the children that may have set Lopez off immediately before the incident, according to eyewitness accounts of the shooting.

Lopez was due Oct. 18 at Fort Leonard Wood, Mo., for basic noncommissioned-officer training, a course required for promotion to the rank of staff sergeant. He never showed up, and he returned later to Lovell instead.

Around Oct. 15, Lopez called Chelsea Wardell, a former girlfriend, and told her he was considering leaving the Army to return to Lovell, according to a statement Wardell gave Lewis on Nov. 7, two days after the shooting.

Wardell and Lopez were previously engaged, but after Lopez returned from a deployment to Afghanistan in 2003, they split. Lopez kept in touch with Wardell in the days before his death, speaking with her almost daily, she told Lewis.

On Oct. 19, the day the Army first listed Lopez as absent without leave, Ham contacted Lovell police inquiring if Lopez was in town. Ham called again on Oct. 20, asking police to help locate Lopez.

"I'm just trying to cover my ground to say, 'Hey, he's there with his wife, 'cause I know they got a little problem, or whatever the case may be,' " Ham said, according to a police log of the conversation.

Ham called again the afternoon of Oct. 29, requesting a welfare check of Lopez, who had sent text messages to Ham that he was suicidal. A log of that conversation between Ham and police was not available.

Later that afternoon, Lovell Police Officer Robert Bifano located Lopez and met briefly with him at the police station.

Lewis states in a report that he "never received any information that Steven Lopez was to be arrested on charges of being AWOL." Lewis has said that Lopez was not listed as missing or wanted in a national crime database.

A subsequent check of the database by the Federal Bureau of Investigation shows that Lopez was not entered in the system while AWOL, Lewis wrote in his report.

Because Lopez had not been missing for more than 30 days, he was listed as AWOL but not classified as a deserter, a status assigned after a month.

The Army typically does not actively search for soldiers listed as AWOL or deserters, said Lt. Col. George Wright, a public-affairs specialist at the Pentagon.

He said such soldiers could be arrested by local law enforcement and returned to military custody, but that an arrest often was dependent on a judgment call by local police.

Lewis said the day after the shooting that he was unaware of any meeting between Lovell police and Lopez. He later discussed with Bifano the Oct. 29 meeting.

"During our conversation about this incident, Officer Bifano told me that it appeared to him Steven Lopez was AWOL, but at the time of Officer Bifano's contact with Steven Lopez, he was not told to arrest and hold Steven Lopez for Sgt. Ham," Lewis wrote.

Saw counselor twice
Wardell told Lewis that she had urged Lopez to get mental-health counseling while he was still at Fort Bragg. She said he met twice with a counselor while there, but quit going, and did not discuss his suicidal feelings with Army doctors.

"Steven told her that if he were to admit he was suicidal to the Army counselors, he would be treated like 'trash,' " Lewis wrote.

Lopez also struggled with anger he felt toward Davila, Wardell told Lewis.

She told Lewis that Lopez "wanted to come back to Lovell and try and work things out between he and Brenda, but was afraid that he would kill Brenda," the report states.

The report details Wardell's account of an incident around Oct. 27 when she visited Lopez at his sister's apartment, where he was staying.

Wardell saw a pistol on a couch and was concerned that Lopez would use it to kill himself, so she tried to take it. A confrontation followed, during which Lopez again threatened suicide, even holding the gun to his head, the report states.

Wardell took the gun and gave it to Daniel Lopez, Steven's father, who later returned it to his son, according to statements in the report by Wardell and Amy Lopez, Steven's sister.

Preliminary information indicates the gun belonged to Steven Lopez, according to police reports.

Wardell also described Lopez as "taking any and as many prescription drugs that he could find," including seven Xanax anti-anxiety pills and eight OxyContin narcotic pain pills on one day the week before the shooting.

Witnesses to the shooting described Lopez as acting drowsy, and a police report lists a plastic bag containing four pills that match the description for generic Xanax as being recovered from the scene.

Big Horn County Coroner Del Atwood said in a letter that the final autopsy report on the case, including toxicology results, is not yet complete.

Atwood and Army investigators have declined to say when they will conclude their inquiries.

It is unclear whether Lewis has concluded his investigation, stating in a letter to Lovell City Attorney Sandra Kitchen that "the final investigative report is included in this packet" of documents requested by The Gazette.

But the report provided by Lewis concludes: "The investigation is in its preliminary stage and is not complete. This is a draft report."

Contact Ruffin Prevost at rprevost@billingsgazette.com or 307-527-7250.
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A tale of two deaths: Lives of two mental ill vets end tragically - Plano (TX) Star

By Lynn Proctor Windle, Staff Writer

In the hours leading up to Pat Ahrens’ death, he waged a desperate attempt to draw attention to what he described as the indifferent way the Veterans Administration treats veterans with mental issues.

Ahrens died Saturday night at a Plano hospital from a heart attack, family members said Monday. Details leading up to Ahrens’ heart attack were not released.

His crusade against the Veteran Affairs hospital began immediately after the death of another veteran, a man whom he had met only days before at the Dallas VA Medical Center where they were both patients in the hospital’s psychiatric ward. Ahrens had found the body of Christopher Nicholas Demopoulos hanging from the second story balcony of a local hotel.

“Would it be a bigger story if something happened to another one of us?” he asked in an interview on Friday afternoon with the Plano Star Courier.

During the interview, Ahrens admitted that he had stopped taking his medication for his bipolar disorder.

“I’m not going to be a zombie. I’m not going to be locked up behind doors and cameras,” he said. “I’m intelligent and complex, and I’m not going to be treated like an animal.”

Ahrens also admitted that in the hours following Demopoulos’ death, he had been drinking heavily.

During the three-hour interview with the Star Courier, Ahrens refused to answer whether he himself was still suicidal even though he had been released from the VA Medical Center just days before. “If I say yes, you’ll call the authorities. So no, I’m not suicidal. But I am at peace with God. I have no regrets,” he said.

Ahrens said that he was released from the Dallas VA on Jan. 22. He was committed to the hospital’s psychiatric unit the previous weekend.

“I came within one hour of committing suicide. My daughter saved my life,” he said.

Ahrens was released after the state’s three-day mandatory observation period.

“He shouldn’t have been out. They [the VA] don’t care,” Dawn Ahrens, Ahrens’ former wife, said via a phone interview also on Friday.

In a written statement, VA spokeswoman Susan Poff said, “We at VA North Texas Health Care System are deeply saddened by these families’ losses. Following these tragedies, we have been in contact with the family members to offer our support. We are also providing support for the VANTHCS staff that provided care to these veterans and are affected by their deaths.”

Ahrens said he was diagnosed with bipolar disorder five years ago. He had voluntarily checked himself into the VA hospital on several previous occasions.

Mrs. Ahrens, a registered nurse, blamed the couple’s breakup last year on the VA’s inability to adequately treat the disorder.

Two lost souls

During his most recent stay at the Dallas VA Medical Center, Ahrens made friends with three other vets. One in particular was Demopoulos, a 58-year-old former Marine from Hillsboro.

Cordelia Demopoulos said her husband was a Vietnam veteran who suffered from posttraumatic stress disorder. He had been in and out of the VA mental health care system for years.

Demopoulos’ latest ordeal began Dec. 14 when he was admitted to the VA facility in Waco. He was released a week later.

By Jan. 7, he was suicidal again, his wife said.

In a journal entry dated Jan. 3, Demopoulos wrote,” I could have used more sleep…I think I blew up very badly today. Must think. Must break through.”

Reading from his journal, Mrs. Demopoulos said her husband described racing thoughts and panic attacks. He also admitted to not taking his medication.

On the advice of her husband’s psychiatrist, she called the police to pick him up for involuntary commitment. He was admitted to the Dallas VA hospital, and again, released a week later, Mrs. Demopoulos said.

After an incident on Jan. 16, Mrs. Demopoulos again called police. When she left the room for a minute, Demopoulos stripped the wires from an electrical appliance and tried to electrocute himself, she said. Again, he was taken to the VA Center in Dallas.

Within a week, on Jan. 23, the hospital called saying he was ready to be released again.

Mrs. Demopoulos said she had no transportation and pleaded with the hospital to hold him for another 48 hours, but was told no. At the very least, she wonders why her son wasn’t called.

Ahrens said Demopoulos called him that morning asking for a ride back to his Hillsboro home.

“He was very depressed. He talked and listened to me,” Ahrens said. “He kept saying he was scared of his wife.”

Mrs. Demopoulos said she’s not surprised her husband would say that.

“It’s OK that he said he was afraid of me. He was afraid of his own dog. That’s part of the paranoia. He couldn’t separate reality from the demons inside of his mind,” she said.

Mrs. Demopoulos believes he was afraid she’d call the police again.

“No more chances. Got to figure out what’s wrong. I am wrong. She is right,” Mrs. Demopoulos said reading from his journal. In another entry he wrote, “I need to stop messing up,” she said.

Demopoulos called Ahrens a second time, around 3:15 p.m. and Ahrens said he picked him up about 45 minutes later.

“I told him I had good news and bad news. I told him that I had to go to confessional at St. Marks at 7 p.m. on Wednesday, and I couldn’t get to Hillsboro and back in time,” Ahrens said. “I told him that I had got him a room and some clothes.”

Ahrens said he gave the man some money for food and left him at the La Quinta Inn located in the 1800 block of U.S. 75.

“I had to make mass, but I called and checked on him afterward. I asked him if he’d eaten, and he said he went to Denny’s to eat.”

Ahrens said he called Demopoulos between 4:45 a.m. and 5 a.m. the following day. Demopoulos did not answer.

“I wanted to get an early start to Hillsboro because I didn’t want to be driving in rush hour traffic. “I went over there, and I saw the door to the room open about six inches, and then I saw him hanging from the balcony. I’m surprised no one else saw it.”

Ahrens said he first called a friend and then called 9-1-1.

Initially Mrs. Demopoulos said she did not believe Ahrens’ story. In the past when she couldn’t be reached, her husband would call other family members. She wonders why her husband was taken to a Plano hotel instead of to family members in Murphy, just 20 minutes away.

“Was Nicholas so disoriented that he couldn’t call my son? Was he so medicated that he didn’t know what was going on around him? He was so paranoid. Was he already so far gone that he couldn’t think straight? It doesn’t make sense how he ended up where he ended up. Why did he end up at a La Quinta? He knew he could go there [to family in Murphy.] This does not make sense,” she said.

“I think Patrick was scared. He tried to do what he thought was best, but he just got into something he didn’t know how to handle,” she said. “I don’t blame Patrick now. This was one veteran trying to help another. They were living with such demons and such nightmares. Two veterans are dead because the paranoia was too strong. I blame the Dallas VA. There are just too many questions. He’s as big a victim as Nicholas.”

Plano Police said they are awaiting a report from the Collin County Medical Examiner’s Office determining Demopoulos’ cause of death, and the case is still under investigation.

VA explains

Both Ahrens and Mrs. Demopoulos blamed the VA for its revolving door treatment of vets with mental issues.

Mrs. Demopoulos said her husband’s condition was ignored because the long-term in-patient treatment he needed was too expensive. She said the VA refused to give her husband 100 percent disability because that meant he would have received more benefits and treatment.

“He wasn’t worth the government’s money. Now he’s dead,” she said.

Poff said that isn’t the case at all. Citing federal patient privacy laws, she declined to discuss the specifics in either case, but said the VA system follows a standardized approach for suicide risk assessment.

“Level of treatment and/or treatment plan is not based upon a veteran’s disability rating. All patients with a primary diagnosis or presenting complaint of an emotional or behavioral problem are assessed for suicide risk,” she wrote.

The assessment includes evaluation and documentation of factors such as the patient’s intent and plan to commit suicide. Other considerations include risk factors, protective factors, the clinician’s overall impression, the patient’s immediate safety needs, and the most appropriate setting for treatment.

Ahrens complained that the VA would cancel appointments at the last minute and that appointments with psychiatrists had to be scheduled months in advance.

Poff disputed Ahrens claims. She said crisis cases are handled immediately.

“All patients and available family members are provided with instructions regarding crisis numbers and resources,” she wrote. “In the event of a mental health emergency, veterans are seen by a mental health provider and immediately admitted to the inpatient unit if indicated. All other veterans can be seen on the same day of their request for an appointment or will be given an appointment within 30 days if that is preferred by the veteran.”

Patients admitted to the Dallas facility for acute inpatient psychiatric care generally are suffering from “exacerbation of mental or substance abuse disorders that place them at high immediate risk of suicide, aggression, or dangerous withdrawal. Disorganized thinking or impaired judgment posing a substantial risk of harm may also constitute appropriate criteria for admission,” the statement said.

Patients stay an average of eight days. “However that varies from patient to patient, depending on the individual treatment plan. Criteria for discharge from the acute inpatient psychiatric care unit are stabilization of symptoms, and the patient is no longer at an immediate risk of suicide, aggression or dangerous withdrawal.”

Ahrens said that, medication was the only treatment option he was offered, but Poff said the VA offers many treatment options while inpatient.

“While under inpatient care, they participate in community meetings, medication, education, stress management and other groups,” she said.

Ahrens said he didn’t know what else would have helped him, but in his desperate hours, he only wanted to help others avoid the same fate.

In the wake of these twin tragedies, both families are left wondering why.

Mrs. Demopoulos said her husband’s death as left her heart broken, but hopes in the end something good will come of it.

“I don’t want him to be remembered just as the man found hanging at a local hotel,” she said.
Read more!

Officer’s Slaying Leaves New Orleans Asking Why - New York Times

By LESLIE EATON

NEW ORLEANS — On Monday morning, in a bleak shopping strip almost under the Pontchartrain Expressway, Bernel P. Johnson wrestled the gun away from a young police officer and shot her dead. When backup officers arrived, he handed them the weapon.

But Mr. Johnson, 44, who had a long history of psychiatric problems, was not supposed to be anywhere near that street or any other. Just three weeks earlier, on Jan. 4, the police “observed him to be mentally ill and dangerous to others,” said Dr. Jeffrey Rouse, the chief deputy coroner, who signed the papers committing Mr. Johnson to involuntary treatment.

He was sent to a state mental institution, to be confined until he was no longer a danger to himself or others. Somehow, for reasons that remain unclear, the institution released him before the shooting. Because of privacy laws, state officials are not saying which institution it was, or how the decision was made.

But the mental health system has been in chaos since Hurricane Katrina, and questions over these kinds of releases are adding to waves of grief, anger and fear that have swept over many in the city, even as it celebrates Mardi Gras.

James Arey, a psychologist and the commander of the Police Department’s crisis negotiation team, worked closely with the slain officer, Nicola Cotton, 24. He said Mr. Johnson appeared to have been improperly released from state care, even though he had allegedly threatened to kill police officers.

“The State of Louisiana had ample time to figure out this guy,” he said. “And because they weren’t doing their job, this officer, my friend, is dead.”

Police officers are furious over what they see as a shortage of acute-care psychiatric beds at the remaining public hospital in the city and a lack of follow-up treatment. A prominent judge says the parish jail has become a de-facto replacement for closed psychiatric wards, and the sheriff who runs the prison agrees.

State officials contend that they are struggling to rebuild the system, even as more people here are uninsured and so do not have access to other treatment. Doctors warn that the stress of living in a deeply damaged city, often without family and friends, is pushing people over the edge.

And some also say that since Hurricane Katrina, the city has been attracting transients with mental health problems, who end up homeless and troubled on the streets. Or, as Dr. Rouse puts it, “It’s almost as if New Orleans has become a magnet for chaos.”

In 2004, a mental patient shot LaToya Johnson, the first female officer to be killed here. Since then, Dr. Arey said, there have been seven deaths directly involving deranged people, “where there were gunfights with the police and we had to kill them, or they killed other people.”

He said he did not think that, proportionately, there had been an increase in the number of dangerous mentally ill people on the streets, but others, including Dr. Rouse, disagree.

Certainly, the number of mentally ill jail inmates has risen, said Marlin N. Gusman, the criminal sheriff for Orleans Parish.

He said that after the flooding shut down Charity Hospital and other treatment alternatives, families who were worried about disturbed relatives would end up calling the police. “The lack of alternatives makes us the provider of first resort,” he said.

Even before Katrina hit, mental health services for the poor in New Orleans were often criticized as inadequate — as they are in many big cities with large indigent populations. The police brought obviously disturbed people to the main public hospital, known as Big Charity, which had a floor devoted to short-term and long-term psychiatric care, including 97 acute-care beds.

According to the state, there were 555 public and private inpatient psychiatric beds in and around the city, as well as out-patient clinics and supervised living programs.

Louisiana State University, which ran Charity, contends that it was too badly damaged to reopen. The university did open an emergency room in nearby University Hospital and has been slowly adding beds for seriously ill patients, along with the state, bringing the total to 268.

The state has added 133 beds elsewhere in Louisiana to help, said Dr. Kathleen Crapanzano, medical director of the state Office of Mental Health.

But beds are not the only issue, Dr. Crapanzano said. Clinics are opening, but not necessarily full time. None of the private psychiatric facilities has returned. Insurance coverage is down, and stress is up. “We are slowly but surely rebuilding and adding services,” she said. “But the need is still great.”

The family of Bernel Johnson could not be reached for comment Wednesday. But a brother and sister told The Times-Picayune of New Orleans this week that he was a paranoid schizophrenic who had threatened to harm people and once shot himself in the chest. The family’s efforts to have him treated or confined had all failed, they said.

“This is a dangerous situation,” said Judge Arthur Hunter Jr., a former police officer who now presides over a special court dealing with mentally ill nonviolent people. “Citizens need to know how dangerous it is. They don’t.” Read more!

Study shows vaccine-autism link unlikely - LA Times

By Thomas H. Maugh II

New studies in infants show that the mercury used as a preservative in vaccines is cleared from the body at least 10 times faster than researchers had previously believed, a finding that casts further doubt on the theory that the preservative causes autism.

Researchers had believed that the ethyl mercury in the preservative thimerosal is metabolized in much the same way as the methyl mercury found in fish and other sources.

But the first study of ethyl mercury in children shows that levels of mercury in the blood are only a tenth as high as expected, and the toxic element is cleared out rapidly, according to a paper to be published Monday in the journal Pediatrics.

There is a "clear relationship" between the amount of mercury that must be in the blood, the length of time it must remain there, and the likelihood of it accumulating in the brain to cause damage, said Dr. Michael E. Pichichero of the University of Rochester in New York, the paper's lead author. "Now it's obvious that ethyl mercury's short half-life prevents toxic buildup from occurring. It's just gone too fast."

The bottom line, said Dr. William Schaffner of Vanderbilt University, who was not involved in the study, is that "this is yet another study added to the increasing stack of studies that are reassuring about thimerosal's safety."

But Isaac Pessah of the UC Davis MIND Institute pointed out that the researchers had only studied healthy children. They didn't address "the key issue of whether a subset of kids with metabolic disorders would handle it differently."

Like the authors, he also noted that they couldn't examine the brain and other organs for mercury accumulation.

Still, the findings should reassure parents of millions of infants around the world who receive vaccines with thimerosal even though it was eliminated from most childhood vaccines in the U.S. in 1999, Pichichero said. Removing thimerosal would raise prices and limit availability in poor countries.

Autism strikes as many as one in 167 children born in the U.S. Many parents link the increase in cases to past use of thimerosal in vaccines. The new study was designed to address those concerns.

It confirms previous findings of Pichichero and his colleagues in studies in rhesus monkeys and in a much smaller group of infants.

In the latest study, they examined 72 newborns, 72 2-month-old infants and 72 6-month-olds at R. Gutierrez Children's Hospital in Buenos Aires, where thimerosal is still used in vaccinations.

They found that blood mercury levels spiked shortly after vaccination -- although they remained much lower than levels of methyl mercury observed in other studies -- then dropped, with a half-life of 3.7 days. The half-life of methyl mercury, in contrast, is 44 days.

They also found that levels of mercury in the blood were about the same at birth, at 2 months and at 6 months.

"That's super-reassuring evidence that you don't accumulate mercury, you get rid of it," Schaffner said.

The researchers found no evidence of mercury in urine, indicating that the toxic metal was not coming into contact with the kidneys. Most of the mercury, they found, was eliminated through the feces.

Dr. Peter Hotez of the Sabin Vaccine Institute, who was not involved in the study, characterized it as "beating a dead horse."

"On the other hand, it is useful to know that ethyl mercury does not have the same metabolism as methyl mercury," he said.

The study was funded by the National Institutes of Health. The researchers said they had in the past been paid for consulting with vaccine manufacturers.

thomas.maugh@latimes.com Read more!

TBI symptoms might really be PTSD,docs say - Associated Press

By Marilynn Marchione

The role of traumatic brain injury — blamed for symptoms plaguing thousands of soldiers returning from Iraq — might be overstated, contends a provocative military study that offers hope for successful treatment.

In many cases, post-traumatic stress and depression may be driving the symptoms, doctors reported Wednesday. And that’s good news because those are treatable.

The study by U.S. military doctors was praised by outside experts who found the conclusions convincing.

Returning soldiers have struggled with memory loss, irritability, trouble sleeping and other problems. Many have suffered mild blast-related concussions, but there is no easy way to separate which symptoms are due to physical damage and which are from mental problems caused by the traumatic stress of war. Imaging of the brain is being tested, but hasn’t yet proven to be helpful.

The new study, based on a survey of 2,525 soldiers, found that brain injury made traumatic stress more likely. The study tied only one symptom — headaches — specifically to brain injury.

“We found that the symptoms and health concerns that we expected to be due to the concussion actually proved to be more strongly related to PTSD,” or post-traumatic stress disorder, and depression, said Dr. Charles Hoge, a colonel and psychiatry chief at Walter Reed Army Institute of Research who led the study. “There isn’t a clear delineation between a psychological and a physical problem.”

Other doctors were optimistic about treatment efforts.

“It gives us hope because we’ve got good treatments for PTSD,” said Barbara Rothbaum, a psychologist who heads a trauma recovery program at Emory University in Atlanta. “If we can relieve the PTSD and depression, I’m hoping we’ll see alleviation of a lot of these physical symptoms.”

Hoge reported on the survey Wednesday at a military health conference in Washington. Results also were published in Thursday’s New England Journal of Medicine.

The journal’s editor-in-chief, Dr. Jeffrey Drazen, said editors initially were skeptical of the findings, which depart from the gloom-and-doom picture some have painted for soldiers with brain injuries.

However, the solid research methods and the “strong and robust” data linking stress and concussion symptoms persuaded them, said Drazen, who is a scientific adviser to the Veterans Administration.

The case of Eric O’Brien, a 33-year-old Army staff sergeant from Iowa’s Quad Cities, suggests the researchers may be right.

After an explosion in Baghdad in 2006, O’Brien was treated at Vanderbilt University’s brain injury rehabilitation program and at Fort Campbell, Ky., for post-traumatic stress. Now he is preparing to redeploy, this time to Afghanistan.

“I retested on a lot of the tests and they showed a pretty decent increase,” he said of his mental function tests. As for stress, “I don’t know if it’s something you just learn to deal with or if it just gets a little bit better over time,” he said. “It’s not as bad as it was.”

The vast majority of brain injuries, or concussions, are mild, but the military previously estimated that one-fifth cause symptoms lasting a year or more.

The new study tried to pin down the potential long-term effects of mild brain injury, through an anonymous survey of two Army combat brigades — one active and one Reserve — in 2006, several months after they returned home from Iraq.

Fifteen percent of soldiers reported a mild brain injury — having been knocked unconscious or left confused or “seeing stars” after a blast. They were more likely than other soldiers to report health problems, missing work, and symptoms such as trouble concentrating.

The worst symptoms were in soldiers who lost consciousness. About 44 percent of them met the criteria for post-traumatic stress, compared with 16 percent of soldiers with non-head injuries, and only 9 percent of those with no injuries.

“The same incident might have triggered both processes,” Rothbaum said, noting that after World War I, “they thought that shell shock was a neurological disorder and it turned out to have a lot of overlap with the psychological disorder.”

However, Dr. Greg O’Shanick, a psychiatrist and medical director for the advocacy group Brain Injury Association of America, said it would be over-simplifying to think that treating PTSD alone would be enough.

“It’s like having fleas and ticks,” he said. Getting rid of one may not make you stop itching, “and if you’ve got one, it makes it harder to handle the other.”

Concussions may compound stress by damaging brain areas that tamp down responses to fear, Richard Bryant, a psychologist at the University of New South Wales in Sydney, Australia, writes in an editorial in the journal.

“PTSD and depression may be the primary problem,” he writes. “Soldiers should not be led to believe that they have a brain injury that will result in permanent change.”

The military recently started screening all returning troops for concussions. Any soldiers who saw intense combat should be similarly checked for stress disorder, said Anthony Stringer, director of Emory University’s neuropsychology rehabilitation program.

The new study can be viewed as positive “if the results are used to make sure that soldiers have the care they need when they return,” he said.
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Defense: Fisher-Riza bipolar on day of chase -Cleburne (TX) Times-Review

By Leia Jobe/reporter2@trcle.com

An attorney for the woman accused of leading police on a high-speed chase in April that resulted in the death of her 9-month-old child argued the woman ran from police because she was bipolar.

Opening arguments for Aimee Andrea Fisher-Riza’s murder trial were heard Tuesday in Judge William C. Bosworth’s 413th District Court in Cleburne.

Prosecutors said she ran because she stole money from the department store where she worked.

Fisher-Riza, 36, faces charges of evading arrest and felony murder. She led Somervell and Johnson County officers on a 40 minute chase April 6 that ended in a crash in Alvarado. Her 9-month old daughter, Alexxus, was ejected and died.

“On April 6, 2007, Aimee Fisher was in a severe manic state of her bipolar disorder,” her attorney, Bill Mason, said in his opening argument. “She was psychotic, delusional and became paranoid, which are symptoms of psychosis.”

Mason said she thought the police were going to kill her. Fisher-Riza could not see what was going on behind her because the mirrors in her new black sport-utility vehicle had not yet been adjusted from the position the dealer put them in, he said.

Assistant District Attorney Martin Strahan said Fisher-Riza stole money from the Goody’s department store in Brownwood, which she managed, and that her reckless driving caused Alexxus’ death, who was sitting unrestrained in the front seat.

Strahan said Fisher-Riza stole between $28,000 and $30,000 from Goody’s and at the time of the chase had $9,000 in stolen money with her in the car, which is why she ran after police tried to stop her for speeding.

Strahan said jurors would probably see some video of the chase later and that they should be prepared to see some gruesome images of the crash scene.

“We’re here to ask for justice for Alexxus Riza, who was almost 10 months old at the time of the crash,” Strahan said.

Fisher-Riza cried as Strahan presented his argument to the jurors, but lifted her head as Mason argued in her defense.

Jury selection began at 10 a.m. Monday and lasted until 7 p.m., District Attorney Dale Hanna said.

“It was an unusually long selection process,” he said. Read more!

State hospital cemetery needs repairs -KENS-TV San Antonio

Watch Video Here.
01/30/2008

James Munoz
KENS 5 Eyewitness News

It's been around for a long time but seems to have been forgotten. Now there are calls for an old cemetery off South New Braunfels and I-37 to be cleaned up.

Mount Calm East dates back to 1924. It is the final resting place for hundreds of mentally ill patients who died at the San Antonio State Hospital.

One woman says the state needs to do a better job of maintaining the cemetery.

"It's inappropriate and inexcusable for the state to allow this to happen. It's just not right," Sarah Reveley said.

Finding the cemetery isn't easy. An unpaved dirt road behind a park leads to the locked and gated cemetery.

"My biggest concern is that it's ignored," Reveley said.

Reveley says cemeteries are supposed to be open to the public.

"This lock does not allow that, and this barbed wire is terrible, you feel like they're in prison," she said.

The fence isn't working anyway; there's a hole in the back.

More coverage
KENS video: Watch the broadcast

Reveley is concerned a stack of grave markers is proof the headstones are not being properly replaced.

"Who's buried here, do their families know?" Reveley said.

From 1924 to 1989 everyone buried at the cemetery was only assigned a number.

"And these numbers, these people had names," she said.

Most private cemeteries straighten headstones on a daily basis. Reveley says the San Antonio State Hospital should be able to handle the simple task.

"This is rest in peace? Well this is not the American way," she said.

A spokesperson for the San Antonio State Hospital says restoring the cemetery is a top priority. They're currently looking for community partners to support the project.
Read more!

Soldier Suicides at Record Level - Washington Post

Increase Linked to Long Wars, Lack of Army Resources

By Dana Priest
Washington Post Staff Writer
Thursday, January 31, 2008; A01

Lt. Elizabeth Whiteside, a psychiatric outpatient at Walter Reed Army Medical Center who was waiting for the Army to decide whether to court-martial her for endangering another soldier and turning a gun on herself last year in Iraq, attempted to kill herself Monday evening. In so doing, the 25-year-old Army reservist joined a record number of soldiers who have committed or tried to commit suicide after serving in Iraq or Afghanistan.

"I'm very disappointed with the Army," Whiteside wrote in a note before swallowing dozens of antidepressants and other pills. "Hopefully this will help other soldiers." She was taken to the emergency room early Tuesday. Whiteside, who is now in stable physical condition, learned yesterday that the charges against her had been dismissed.

Whiteside's personal tragedy is part of an alarming phenomenon in the Army's ranks: Suicides among active-duty soldiers in 2007 reached their highest level since the Army began keeping such records in 1980, according to a draft internal study obtained by The Washington Post. Last year, 121 soldiers took their own lives, nearly 20 percent more than in 2006.

At the same time, the number of attempted suicides or self-inflicted injuries in the Army has jumped sixfold since the Iraq war began. Last year, about 2,100 soldiers injured themselves or attempted suicide, compared with about 350 in 2002, according to the U.S. Army Medical Command Suicide Prevention Action Plan.

The Army was unprepared for the high number of suicides and cases of post-traumatic stress disorder among its troops, as the wars in Iraq and Afghanistan have continued far longer than anticipated. Many Army posts still do not offer enough individual counseling and some soldiers suffering psychological problems complain that they are stigmatized by commanders. Over the past year, four high-level commissions have recommended reforms and Congress has given the military hundreds of millions of dollars to improve its mental health care, but critics charge that significant progress has not been made.

The conflicts in Iraq and Afghanistan have placed severe stress on the Army, caused in part by repeated and lengthened deployments. Historically, suicide rates tend to decrease when soldiers are in conflicts overseas, but that trend has reversed in recent years. From a suicide rate of 9.8 per 100,000 active-duty soldiers in 2001 -- the lowest rate on record -- the Army reached an all-time high of 17.5 suicides per 100,000 active-duty soldiers in 2006.

Last year, twice as many soldier suicides occurred in the United States than in Iraq and Afghanistan.

Col. Elspeth Cameron Ritchie, the Army's top psychiatrist and author of the study, said that suicides and attempted suicides "are continuing to rise despite a lot of things we're doing now and have been doing." Ritchie added: "We need to improve training and education. We need to improve our capacity to provide behavioral health care."

Ritchie's team conducted more than 200 interviews in the United States and overseas, and found that the common factors in suicides and attempted suicides include failed personal relationships; legal, financial or occupational problems; and the frequency and length of overseas deployments. She said the Army must do a better job of making sure that soldiers in distress receive mental health services. "We need to know what to do when we're concerned about one of our fellows."

The study, which the Army's top personnel chief ordered six months ago, acknowledges that the Army still does not know how to adequately assess, monitor and treat soldiers with psychological problems. In fact, it says that "the current Army Suicide Prevention Program was not originally designed for a combat/deployment environment."

Staff Sgt. Gladys Santos, an Army medic who attempted suicide after three tours in Iraq, said the Army urgently needs to hire more psychiatrists and psychologists who have an understanding of war. "They gave me an 800 number to call if I needed help," she said. "When I come to feeling overwhelmed, I don't care about the 800 number. I want a one-on-one talk with a trained psychiatrist who's either been to war or understands war."

Santos, who is being treated at Walter Reed, said the only effective therapy she has received there in the past year have been the one-on-one sessions with her psychiatrist, not the group sessions in which soldiers are told "Don't hit your wife, don't hit your kids," or the other groups where they play bingo or learn how to properly set a table.

Over the past year, the Army has reinvigorated its efforts to understand mental health issues and has instituted new assessment surveys and new online videos and questionnaires to help soldiers recognize problems and become more resilient, Ritchie said. It has also hired more mental health providers. The plan calls for attaching more chaplains to deployed units and assigning "battle buddies" to improve peer support and monitoring.

Increasing suicides raise "real questions about whether you can have an Army this size with multiple deployments," said David Rudd, a former Army psychologist and chairman of the psychology department at Texas Tech University.

On Monday night, as President Bush delivered his State of the Union address and asked Congress to "improve the system of care for our wounded warriors and help them build lives of hope and promise and dignity," Whiteside was dozing off from the effects of her drug overdose. Her case highlights the Army's continuing struggles to remove the stigma surrounding mental illness and to make it easier for soldiers and officers to seek psychological help.

Whiteside, the subject of a Post article in December, was a high-achieving University of Virginia graduate, and she earned top scores from her Army raters. But as a medic in charge of a small prison team in Iraq, she was repeatedly harassed by one of her commanders, which disturbed her greatly, according to an Army investigation.

On Jan. 1, 2007, weary from helping to quell riots in the prison after the execution of Saddam Hussein, Whiteside had a mental breakdown, according to an Army sanity board investigation. She pointed a gun at a superior, fired two shots into the ceiling and then turned the weapon on herself, piercing several organs. She has been at Walter Reed ever since.

Whiteside's two immediate commanders brought charges against her, but Maj. Gen. Eric B. Schoomaker, the only physician in her chain of command and then the commander of Walter Reed, recommended that the charges be dropped, citing her "demonstrably severe depression" and "7 years of credible and honorable service."

The case hinged in part on whether her mental illness prompted her actions, as Walter Reed psychiatrists testified last month, or whether it was "an excuse" for her actions, as her company commander wrote when he proffered the original charges in April. Those charges included assault on a superior commissioned officer, aggravated assault, kidnapping, reckless endangerment, wrongful discharge of a firearm, communication of a threat and two attempts of intentional self-injury without intent to avoid service.

An Army hearing officer cited "Army values" and the need to do "what is right, legally and morally" when he recommended last month that Whiteside not face court-martial or other administration punishment, but that she be discharged and receive the medical benefits "she will desperately need for the remainder of her life." Whiteside decided to speak publicly about her case only after a soldier she had befriended at the hospital's psychiatric ward hanged herself after she was discharged without benefits.

But the U.S. Army Military District of Washington, which has ultimate legal jurisdiction over the case, declined for weeks to tell Whiteside whether others in her chain of command have concurred or differed with the hearing officer, said Matthew MacLean, Whiteside's civilian attorney and a former military lawyer.

MacLean and Whiteside's father, Thomas Whiteside, said the uncertainty took its toll on the young officer's mental state. "I've never seen anything like this. It's just so far off the page," said Thomas Whiteside, his voice cracking with emotion. "I told her, 'If you check out of here, you're not going to be able to help other soldiers.' "

Whiteside recently had begun to take prerequisite classes for a nursing degree, and her mental stability seemed to be improving, her father said. Then late last week, she told him she was having trouble sleeping, with a possible court-martial weighing on her. On Monday night, she asked her father to take her back to her room at Walter Reed so she could study.

She swallowed her pills there. A soldier and his wife, who live next door, came to her room and, after a while, noticed that she was becoming groggy, Thomas Whiteside said. When they returned later and she would not open the door, they called hospital authorities.

Yesterday, after having spent two nights in the intensive care unit, he said, his daughter was transferred to the psychiatric ward.

Whiteside left two notes, one titled "Business," in which her top concern was the fate of her dog. "Appointment for the Vetenarian is in my blue book. Additional paperwork on Chewy is in the closet at the apartment in a folder." On her second note, she penned a postscript: "Sorry to do this to my family + friends. I love you."

Read more!

Family torn apart with issues posed by mentally ill child - Oscoda (MI) Press

Jan. 30, 2008
by Holly Nelson

HALE - Living with a handicapped and mentally ill child is challenging, according to a Hale mother, but never more so than now that it has, literally, torn her family apart.

Starla Hawley had quite a time the past few weeks, since being given an ultimatum concerning her 18-year-old son, Nathan Pemberton, who suffers from retardation and mental illness.

She is beginning to see daylight, but said she knows the challenges will never be over.

Two different dramas have been unfolding in the single-parent household.

First, Hawley contends, she was told to either turn her son out of the house or lose her three daughters, ages 13, 15 and barely 17.

Then Nathan was arrested for crimes - which may have been the result of others taking advantage of his trusting nature.

Nathan’s intelligence quotient (IQ) is 49, a number shared by less than one percent of the population.

According to Dr. Arthur Jenson, in his book “Straight Talk about Mental Tests”, an IQ of 50 or below is the threshold below which most adults cannot cope outside an institution.

In terms of age, Hawley’s son will always think and learn like a second or third grader.

That’s not his only problem. According to Hawley and as documented by mental health professionals, Nathan has also been diagnosed with schizophrenia, which is an incurable mental illness in which the interpretation of reality is abnormal and can lead to delusions and hallucinations. He suffers from bipolar disorder - which comes with extreme mood swings from mania to depression. And he is diagnosed with attention-deficit/hyperactivity disorder (ADHD), oppositional defiancy disorder, nonverbal learning disorder (NLD) and intermittent explosive disorder - a genetic condition characterized by repeated episodes of aggressive, violent behavior which is grossly out of proportion to the situation.

Nathan has been in the mental health system since he was just five years old. Medication helps control his symptoms, but nothing completely stops the violent outbursts and hallucinations - which have led to plenty of holes in the drywall and can be triggered by something as common as an echo.

His mental health problems have also resulted in Nathan shoving his sisters.

Usually, Nathan said, he can sense when he is becoming angry, “so I go to my bedroom and punch the walls,” he says.

This has been going on for 13 years, but now that Nathan is an adult, at least in the eyes of the law, it led to someone reporting him to the Iosco County Department of Human Services’ Child Protective Services (CPS) division.

The CPS worker told Hawley - remove Nathan or move the girls, also threatening that failure to act would lead to the state taking her daughters, she said.

Hawley has a long list of the agencies she contacted in an effort to find a safe place for Nathan, all without success.

Ultimately, she found temporary housing for her daughters with friends in Bad Axe and Twining.

The girls didn’t want to go, according to Hawley, but she did not want to lose them.

She gave the friends signed consents and powers of attorney to make decisions on her daughters’ behalf, but temporariness of the situation and the documents were not sufficient to enroll the girls in school.

“My girls are being denied an education,” Hawley cried. “It’s hard. They want to come home. And what about truancy laws?”

“The school’s [Hale Area] on my side. They’re making calls and trying to help,” she said.

Hawley said nothing has worked and she is being torn in half.

AuSable Valley Community Mental Health denied her request for emergency placement of Nathan - since there was no imminent danger to him or others.

The agency is, however, working to place him in a group home, where he can also be taught life skills. Hawley has been told this could take another month - 30 more days her girls would miss classes.

So Hawley got back on the phone. This time, she reached a state ombudsman. The advocate, upon learning that the CPS caseworker did not have a court order, told her the girls did not have to leave the house, according to Hawley.

One problem potentially solved, at least temporarily.

The other is not going to be so easy.

Nathan is trusting and easily manipulated, according to his mother and others who have worked with him over the years.

“He’s like a puppy dog. He trusts everybody and pretty much does whatever he’s told, as long as somebody is there to remind him,” Hawley said.

“But you could see him set something on fire and say to him, ‘That’s dangerous, Nathan.’ He agrees with you, but he doesn’t understand. That’s the NLD.”

This trait is evident in meeting Nathan. He is engaging, friendly and cooperative. Ask him anything - no matter how potentially damaging the answer might be - and he will candidly respond.

His memory is good, both regarding his own actions and what he has been told. He also appears articulate, until you realize he is merely repeating what he has heard from others.

His mother blames his current legal woes on people who deliberately use him, one young couple in particular.

Nathan would pay the pair to provide him with transportation, such as taking him to a store. He has also given them money because they needed gas, he said.

It was this couple who, after learning that Nathan receives a monthly government check, took him to the bank where it is directly deposited. There, the female half of the couple aided him in opening a checking account - all without the knowledge of his mother.

Nathan does not know how to add and subtract, Hawley said. He can scarcely read.

They also “helped” Nathan issue an $800 non-sufficient fund check to buy a four-wheeler.

Nathan was arrested on Jan. 15, charged with uttering-and-publishing, forgery and larceny in a building. If convicted of the felonies, he could be sentenced to as much as 14 years in prison.

According to Nathan, he was at a man’s house where kids hang out when he found a checkbook on the floor of a porch. The man was gone, so Nathan put the checks in his pocket.

Later, he said, his friends took one of the checks and the woman wrote it out for $250. The woman then asked Nathan to endorse it and she and her boyfriend took him to a bank. The teller refused to cash it. When he told the waiting pair, they instructed him to go back inside and retrieve the check. He tried, but says the teller refused to give it to him.

Later, a state trooper showed up at the Hawley residence and questioned Nathan about the check. He says he told the trooper that he did endorse it and attempted to cash it, but that he also explained he did not write out the check and named the person who did.

The trooper’s request for a warrant reflects Nathan’s admission, but not his alleged statements about who wrote out the check.

Nathan spent two nights in jail - without his medication - before his mother was able to arrange for his release on bond.

He was assigned a public defender who, according to Hawley, failed to inform the court of Nathan’s mental health status and was proceeding as though the young man were mentally competent.

In fact, Hawley said, the attorney was planning to have Nathan plead guilty to reduced charges.

Hawley subsequently found another attorney who, upon learning of the circumstances, agreed late last week to represent Nathan without charge.

In the interim, the mail brought more bad news - a notice from a Hale store than Nathan must make restitution for two $100 checks.

According to Nathan, this same couple suggested he could get himself and them some cash by signing one of his own checks. He did and the woman took it into a store while he and the man waited in a car outside.

“When [the woman] came out, she said they don’t cash two-party checks and wouldn’t give her any money,” he said. “I asked for my check back, but [she] said she tore it up. I don’t know where she got the other one. Maybe I dropped it.”

The copies of the checks sent him by the store show his signature on one, with the payee’s name and amount in different handwriting. The second check also appears to bear his signature; however, Nathan denies signing it. It was also made payable to the woman, with the name and amount in different handwriting.

Hawley contacted the store and learned that both checks were passed by the woman. She said the store owner agreed not to prosecute if restitution is made.

When he learned of the two checks, Nathan said, he confronted the pair. In doing so, he admitted he became angry, especially after the woman contended that he had given her the checks as payment for something.

“I did no such thing and she knows it. I was rude,” he said. “They told me to leave or they’d have me put in jail for assault and battery, so I left. I shouldn’t have been rude. I shouldn’t have called [the woman] names. I called [the woman] this morning and I told her I was very, very sorry I was rude.”

Nathan’s dog, Buddy, pressed against his master’s knee as he spoke. On Buddy’s white back were Xs drawn with a marker.

“Buddy and I were playing Tic, Tac, Toe,” Nathan explained when asked why.

After contacting the store, Hawley called the state police, seeking to have the pair charged with forgery. There will be no investigation, however, because the trooper told her that, to pursue the case, would mean Nathan would also have to go to jail, she alleges.

So, Hawley said, they are simply going to scrape together the restitution sought by the store.

Hawley has had to fight for Nathan since violent outbursts led to his diagnosis at the age of five.

This has, she said, become a way of life, one which she does not always have the education and knowledge to deal with.

“It’s chaos. I’m doing what I can do. It’s frustrating,” she said.

According to Hawley, it would be much easier if people on all levels develop a better understanding of mental illness, especially within the system.

Meanwhile, she is asking people if they think the CPS caseworker will make good on his threats, given AuSable Valley’s promise to look for a group home placement for Nathan.

She is hoping not, since she plans to bring the girls home and get them back in school yet this week.

“I love my children,” she said. “I shouldn’t have to choose between them.” Read more!

Lilly in Settlement Talks With U.S. - New York Times

By ALEX BERENSON
01/30/08

Eli Lilly and federal prosecutors are discussing a settlement of a civil and criminal investigation into the company’s marketing of the antipsychotic drug Zyprexa that could result in Lilly’s paying more than $1 billion to federal and state governments.

If a deal is reached, the fine would be the largest ever paid by a drug company for breaking the federal laws that govern how drug makers can promote their medicines.

Several people involved in the investigation confirmed the settlement discussions. They insisted on anonymity because they have not been authorized to talk about the negotiations.

Zyprexa has serious side effects and is approved only to treat people with schizophrenia and severe bipolar disorder. But documents from Lilly show that between 2000 and 2003, Lilly encouraged doctors to prescribe Zyprexa to people with age-related dementia, as well as people with mild bipolar disorder who had previously been diagnosed only as depressed.

Although doctors can prescribe drugs for any use once they are on the market, it is illegal for drug makers to promote their medicines any uses not formally approved by the Food and Drug Administration.

Lilly may also plead guilty to a misdemeanor criminal charge as part of the agreement, the people involved with the investigation said. But the company would be allowed to keep selling Zyprexa to Medicare and Medicaid, the government programs that are the biggest customers for the drug. Zyprexa is Lilly’s most profitable product and among the world’s best-selling medicines, with 2007 sales of $4.8 billion, about half in the United States.

Lilly would neither confirm nor deny the settlement talks.

“We have been and are continuing to cooperate in state and federal investigations related to Zyprexa, including providing a broad range of documents and information,” Lilly said in a statement Wednesday afternoon. “As part of that cooperation we regularly have discussions with the government. However, we have no intention of sharing those discussions with the news media and it would be speculative and irresponsible for anyone to do so.”

Lilly also said that it had always followed state and federal laws when promoting Zyprexa.

The Lilly fine would be distributed among federal and state governments, which spend about $1.5 billion on Zyprexa each year through Medicare and Medicaid.

The fine would be in addition to $1.2 billion that Lilly has already paid to settle 30,000 lawsuits from people who claim that Zyprexa caused them to suffer diabetes or other diseases. Zyprexa can cause severe weight gain in many patients and has been linked to diabetes by the American Diabetes Association.

Prescriptions for Zyprexa have skidded since 2003 over concerns about those side effects. But the drug continues to be widely used, especially among severely mentally ill patients. Many psychiatrists say that it works better than other medicines at calming patients who are psychotic and hallucinating. About four million Zyprexa prescriptions were written in the United States last year.

Federal prosecutors in Philadelphia are leading the settlement talks for the government, in consultation with the Department of Justice headquarters in Washington. State attorneys general’s offices are also involved. Lawyers at Pepper Hamilton, a firm based in Philadelphia, and Sidley Austin, a firm based in Chicago, are negotiating for Lilly.

Nina Gussack, who is representing Lilly at Pepper Hamilton, said she could not comment on the case. Joseph Trautwein, an assistant United States attorney in the Eastern District of Pennsylvania, also declined to comment.

While a settlement has not been concluded and the negotiations could collapse, both sides want to reach an agreement, according to the people involved in the investigation. Besides the escalating pressure of the federal criminal inquiry, Lilly faces a civil trial scheduled for March in Anchorage, Alaska, in a lawsuit brought by the state of Alaska to recover money the state has spent on Zyprexa prescriptions. A loss in that lawsuit would damage Lilly’s bargaining position in the Philadelphia talks.

While expensive for Lilly, the settlement would end a four-year federal investigation and remove a cloud over Zyprexa. While Zyprexa prescriptions are falling, its overall dollar volume of sales is rising because Lilly has raised Zyprexa’s price about 40 percent since 2003.

Federal prosecutors have been investigating Lilly for its marketing of Zyprexa since 2004, and state attorneys general since 2005. The people involved in the investigations said the inquiries gained momentum after December 2006, when The New York Times published articles describing Lilly’s multiyear efforts to play down Zyprexa’s side effects and to promote the drug for conditions other than schizophrenia and severe bipolar disorder — a practice called off-label marketing.

Internal Lilly marketing documents and e-mail messages showed that Lilly wanted to convince doctors to prescribe Zyprexa for patients with age-related dementia or relatively mild bipolar disorder.

In one document, an unidentified Lilly marketing executive wrote that primary care doctors “do treat dementia” but leave schizophrenia and bipolar disorder to psychiatrists. As a result, “dementia should be first message” to primary-care doctors, according to the document, which appears to be part of a larger marketing presentation but is not marked more specifically. Later, the same document says that some primary care doctors “might prescribe outside of label.”

In late 2000, Lilly began a marketing campaign called Viva Zyprexa and told its sales representatives to suggest that doctors prescribe Zyprexa to older patients with symptoms of dementia.

The documents were under federal court seal when The Times published the articles, and Judge Jack B. Weinstein of Federal District Court in Brooklyn rebuked The Times for publishing them.

The settlement negotiations in Philadelphia began several months ago, according to the people involved in the investigation.

Last fall, the two sides were close to a deal in which Lilly would have paid less than $1 billion to settle the case, which at the time consisted only of a civil complaint.

Then Justice Department lawyers in Washington pressed for a grand jury investigation to examine whether Lilly should be charged criminally for its promotional activities, according to the people involved in the negotiations. A few days ago, facing the possibility of both civil and criminal charges, Lilly opened new discussions with the prosecutors in Philadelphia. Read more!

Insanity ruling leaves Lee's Lopez not guilty - Ft. Myers (FL) News Press

January 30, 2008

A Lee County circuit judge decided that a teen who stabbed to death his best friend 145 times in 2002 is not guilty by reason of insanity.

Mario Lopez, now 21, was 15 when he was at his friend Joey Martins’ house in Cape Coral on May 6, 2002. The two got into an argument after playing a video game and Lopez grabbed kitchen knives, breaking several, and stabbed Martins across his body.

Martins’ mother, Darlene, who was upstairs taking a shower, came downstairs to discover her son being killed.

Prosecutors and Lopez’s defense team battled three times in 2006, with all three trials ending in a mistrial. Doctors testified that Lopez is psychotic and suffers from either paranoid schizophrenia or bipolar disorder.

Lee County Circuit Judge Edward Volz ruled in an order, filed Tuesday, that Lopez will be committed to the Department of Children and Families for placement in a facility to cure him of his mental disease. The judge wrote that he wants a report within six months of his status. Read more!

Suspect's life seemed normal just hours before shooting rampage - Monroe (LA) News-Star

By Robbie Evans
revans@thenewsstar.com

COLUMBIA — Raymond G. Hodges seemed like a quiet man who was always happy and smiled a lot.

Even up to a couple of hours before Hodges went on a multi-parish shooting spree — wreaking havoc on a highway between Columbia and Monroe — Hodges' life seemed normal.

He had spent most of the morning hog hunting.

But between 10 a.m. and noon, something changed.

Within a span of less than an hour, Hodges had fired upon four motorists and left one in critical condition with a shotgun wound to the head.

"He always acted normal and fine when I saw him," said David Ester, a clerk at a Columbia convenience store. "He was always real nice and friendly — a little quiet. It's really shocked me."

Hodges, a 40-year-old white man, was charged Tuesday with attempted second-degree murder and a hate crime by Monroe police after shooting a black woman in the face with a shotgun. Before shooting the woman around 1 p.m., Hodges also was believed to have fired at three other motorists as he drove his GMC Yukon into Monroe from Columbia.

He told police he suffered from bipolar disorder. That was not confirmed as of late Tuesday, but Hodges clearly was not considered dangerous in the community.

Ester said Hodges regularly purchased lottery tickets from him and seemed to be an easy-going fellow.

Mariah Freeman said she used to hang out at bars with Hodges who never appeared to act like someone who would hurt other people. Freeman said she recently saw Hodges at a local music concert and recalled that he always drank wine in a bar, which she thought was unusual.

"He was always real happy when I saw him," Freeman said. "He just didn't seem like the type of person that would do something like that."

Hodges lived in a very rural area in Caldwell Parish at his grandmother's modest wood-frame home on McKee Road, a sparsely populated area near the Ouachita River and just a few miles from the Duty Ferry.

Caldwell Parish Sheriff Steve May had the task of going to the home Tuesday afternoon to secure it before Louisiana State Police investigators arrived with a search warrant.

As sheriff's deputies and a relative stood under the carport and anxiously waited on the investigators to arrive, May said Hodges appeared to have been acting normal less than two hours before the shooting spree began.

"He had been killing hogs with his father," said May, who would not release the names of the family members. "When he left (the home) at 10 a.m. he was fine. He told his aunt he loved her and that he would see her later."

Three hours later, Hodges was in police custody.

Read more!

32 percent of Latino students try suicide -Durham (NC) Herald-Sun

By Monica Chen
mchen@heraldsun.com
Jan 30, 2008

DURHAM -- Latino high school students are twice as likely to attempt suicide as their white and black classmates, according to a recent health survey conducted by the Durham County Health Department and Durham Public Schools.

In 2007, about 32 percent of Latino high school students in Durham said they had attempted suicide in the past 12 months, according to the annual Community Health Assessment report.

Fifteen percent of other students in Durham and 13.8 percent of all high school students in central North Carolina tried to take their own lives.

Upon hearing of the findings, those familiar with the Latino immigrant population expressed shock at the high percentage, but said pressures and anxieties caused by immigration could be the cause.

Hannah Gill, a UNC Chapel Hill anthropologist who studies Latin American migrations, said cultural differences are not to blame. Rather, hostility toward immigrants and the isolation of immigrant families contribute to depression and anxiety in Latino teenagers.

"I'm surprised it's that high, but I'm not surprised there's a higher suicide rate because of the pressure placed on immigrant families," she said. "For the children of Latino immigrants, there's separation from their family. ... There's also discrimination and racism that a lot of Latino immigrants face, especially now that we're encountering a much more hostile environment toward immigrants."

The Latino population in Durham jumped 10.7 percent between 2000 and 2006, but that hasn't necessarily made it easier for the immigrants to assimilate.

A recent string of armed robberies targeted Latinos and other people with foreign features, leading to the death of Dolores Benito Gomez, a Honduran immigrant, and Abhijit Mahato, a Duke University graduate student from India.

Luke Smith, executive director of El Futuro, said the Carrboro mental health clinic has treated many Latino youths in recent years for emotional distress coupled with suicidal thoughts or suicidal intent.

Latino youths who are illegal immigrants are also limited in attaining higher education, Smith said. They must to pay out-of-state tuition for state universities in North Carolina.

At UNC, this means $19,353 a year instead of $3,705, the in-state rate.

"And so they settle for dropping out of school and there's just a kind of demoralization that occurs because they don't feel as valued as some other students," Smith said. "They also lose their extended family and ... who do they turn to? They don't have significant weird or strange psychiatric illnesses. They're just really stressed by the environment around them."

The Durham study surveyed 392 anonymous students and separated the results by black, white and Latino teenagers. The survey did not include other ethnicities or immigrant populations.

The survey, funded by the Result-Based Accountability Initiative, was an exact copy of the annual Centers for Disease Control and Prevention's Youth Risk Behavior survey. Durham Public Schools administered the survey.

Officials with DPS could not be reached for comment Tuesday.

Gayle Harris, assistant director of the county Health Department, said the results will be shared with community organizations in Durham.

"We need to understand what's going on," she said. "This isn't an issue related to school. This goes deeper than that." Read more!

Out from under an anxiety disorder, she now helps others - Springfield (MA) Republican

By Pat Cahill

SPRINGFIELD, Mass. — Rita Howie, secretary to the principal of an elementary school, is the picture of efficiency in her high heels and burgundy pantsuit. As she talks, three different people come up to her with school-related questions, and she interrupts herself briefly to give them answers. She is clearly a take-charge person.

No one would guess that in the 1970s this woman was paralyzed by unfounded fears, housebound because she never knew when she would be overcome by panic, dizziness, delusions.

Howie was suffering from an anxiety disorder.

Today, mental-health professionals know how to diagnose such disorders, which include agoraphobia, panic attacks, social anxiety, obsessive-compulsive disorder, post-traumatic stress disorder or a combination of them.

Treatment usually includes cognitive-behavioral therapy and medication.

But back then, nobody seemed to know what to do. "Every two years I wound up in a psych ward," said Howie, of Chicopee, who is now 60.

She was given inappropriate treatments like shock therapy and put in a therapy group whose other members had mental illnesses like schizophrenia and bipolar disorder.

Then, 26 years ago, Howie read an article in a local newspaper about a man with agoraphobia. He was afraid to leave his house — just as she was.

When Howie realized there was a name for what she had, it gave her hope. That same year, she volunteered for a yearlong research program on anxiety at the National Institutes of Mental Health in Bethesda, Md.

She moved 400 miles away from her home in Springfield — where her husband had tried to make life easier for his housebound wife by building her a swimming pool — and plunged into a year of spinal taps, blood tests, infusions, placebos and double-blind studies.

Howie said she was scared the whole time, but of all the participants from out of state, she was the only one who stayed. "Some people stayed one day and left," she said. "I was too terrified to leave."

By then her marriage had collapsed. But she came away from NIMH with a diagnosis, a prescription and a vow.

"When I left, they told me exactly what part of my brain was affected," said Howie, "and they gave me exactly the medication I would be on for the rest of my life." It worked.

She had told her doctor at NIMH that if he could save her, she would devote the rest of her life to alleviating the suffering of others like her. "If you can help me," she said, "I will never give up. I will help as many people as I can. I will never let it go."

Howie was true to her word. Back in Springfield, she started a Panic Disorders and Anxiety Support Group with four people. "There was a time when Rita was the only thing out there," said Richard Lombardo, of Wilbraham, who attended the group 10 years ago. "And she was magnificent."

Lombardo was 39 and had just quit a stressful job when, lying in bed at night a week later, he was filled with panic.

"It surprised the heck out of me," Lombardo recalled. He said the key to controlling his anxiety was education, and Howie's group provided it. He learned to recognize and manage the physical symptoms of his disorder.

"When you're in the middle of this, you think you're never going to feel good again," said Lombardo.

One symptom of people with an anxiety disorder is their reluctance to take medication — they're scared to do it. They will take it for one day and stop. But Howie knows that medication can work, and she pushed people to take their pills regularly.

Now Howie is retiring from the group she founded. She's handing over the reins to others.

Not many people come anymore, she said. And that's good news, because it tells her that people with anxiety disorders have other resources.

"Now doctors are diagnosing it right away," she said.

Read more!

Therapists frown on long-distance diagnosis of Spears - Associated Press

By JOCELYN NOVECK
Associated Press

You wouldn't think a pop culture diva like Britney Spears would exactly fit into the usual fare of discussions at the annual winter conference of the American Psychoanalytic Association.

But recently, on the sidelines of the gathering of hundreds of analysts from around the country, the topic did indeed arise — specifically those armchair diagnoses of the troubled starlet's mental health, popping up in celebrity magazines and tabloids everywhere.

"Britney's Mental Illness." "Bipolar Britney?" And so on. Under such headlines, articles have quoted psychiatrists or psychologists who've never met Spears, saying she exhibits "classic" signs of one disorder or another.

"I've been very upset about this," says Mark Smaller, a psychoanalyst from Chicago who attended the meetings at Manhattan's Waldorf-Astoria Hotel. "This idea of making a diagnosis of someone they've never met is completely inappropriate, and it gives mental health professionals a bad name."

Not to mention that it's medically wrong. Smaller says that to make any real diagnosis, it can take several thorough consultations with a patient at the very least.

"Trying to make such a diagnosis based purely on someone's behavior" — and worse, their behavior as portrayed selectively by the media — "is scientifically impossible," says Smaller, also director of the Neuropsychoanalysis Foundation.

Afraid of being labeled

But even more, say Smaller and other therapists, it could actually harm Spears by preventing her from getting the real help she needs. And on a broader scale, such therapy-by-media could discourage other troubled people from seeking care as well.

"It's not right to this one person," says Dr. Gail Saltz, a New York psychoanalyst and psychiatrist.

"But on a grander scheme, it also makes people afraid. They're afraid their confidence might be broken. Or they're afraid they'll become labeled. And labels are very frightening to people."

It's hardly a cause for wonder how coverage of Spears has reached the point of quibbling over which mental illness might afflict her. Each development in the Spears story has upped the scandal ante. From her "mommy foibles," to her head-shaving incident to her attacking a car with an umbrella to her painful custody dispute, her story gets so much more dire with each passing month.

But the moment that set headline writers into overdrive came on Jan. 3, when police were called to Spears' home after she refused to turn over her two boys to a representative for ex-husband Kevin Federline, locking herself in a room with one boy. Police, who said she was intoxicated, had to restrain her; paramedics were called and she was whisked away to a hospital, paparazzi in pursuit.

That's when TV's "Dr. Phil" McGraw paid a visit, then made public statements later that she was in dire need of medical and psychological help. Relatives said he'd crossed the line in talking about her publicly, and he later said he regretted making the statements.

But numerous other psychiatrists and mental health professionals have been quoted as well, speculating on what might afflict Spears. And that, says People magazine's deputy managing editor, Peter Castro, was a necessary element of the story.
Read more!

Friends say tragedy destroyed a kind man -Schenectady (NY) Daily Gazette

SCHENECTADY — William “Bob” Pearce, a homeless alcoholic, died alone a week ago in a vacant house without heat, but he was surrounded by friends at his burial Monday in Vale Cemetery.

City police found Pearce’s body on Jan. 22 inside 7581⁄2 State St. The cause of his death is unknown, and he might have been dead for days. Results of an autopsy were unavailable Monday.

The county Department of Social Services paid for Pearce’s funeral. He was buried in a section of Vale reserved for indigent people. Donations will pay for a marker for his grave.

Approximately 25 people attended Pearce’s burial. None were relatives or immediate family, just friends who met him when he sought treatment for his alcoholism, or wanted a hot meal at a local shelter or needed a warm place to sleep.

Many remembered him as a kind man destroyed by a long-lost tragedy. He was from Binghamton and came to Schenectady about 10 years ago, essentially to receive alcohol rehabilitation services, said friend Mark Mahoney. The treatment failed and Mahoney met Pearce 41⁄2 years ago in April as he drank in an alley behind a downtown business.

“He was a good friend and a drinking partner. I got to know him and I got to love him,” Mahoney said.

Pearce loved music, especially music from the 1960s, Mahoney said. “He sang out music as he walked, and he walked as best he could because he had no toes. People thought he was inebriated [even when he wasn’t],” he said.

Pearce lost his toes at least five years ago, Mahoney said, when he got frostbite from sleeping outside. “At one point, he was a strong human being, but when he lost his toes, it destroyed him,” he said.

Despite his ailments, Pearce “always walked tall, he walked straight. He has an honest and good man,” Mahoney said.

Kathy Ghikas remembered Pearce as a man who “had a lot of pain inside. He never shed tears for people to see. The tears were in his heart.”

She spent hours speaking with him, and “I wiped away his tears. He thanked me and told me I was beautiful inside and outside. He told me my heart is so kind and pure.”

At one point, Pearce asked Ghikas to marry him; she declined, saying she was already married.

Jeffrey Demers said Pearce would stop by his house and watch people play horseshoes in his yard. “He couldn’t play himself because of his feet,” he said.

Demers last saw Pearce 10 days ago. “He was all clean shaven and wanted to go to social services to get benefits, to get a place to live and to get out of the cold.”

Margaret Anderton, executive director of Bethesda House, said Pearce was on a waiting list to get into the agency’s special housing program called The Lighthouse. The 10-bed facility is for people with chronic homelessness and a debilitating condition. It provides a stable environment, case management and other services.

Bethesda House is planning to expand Lighthouse when it relocates from Liberty Street into a new facility on State Street. Its proposed $4 million facility will contain a daytime drop-in center for the homeless and mentally ill and 15 bedrooms for the chronically homeless. Read more!

The highs and lows of bipolar disorder present a formidable foe - Denver Post

01/29/08 - METRO EDITORIAL

Everyone has good days and bad days in his or her life. For many people, not letting emotions get too high when the going is good or too low when the going gets tough is a successful approach to managing the ups and downs of everyday lif

However, for many others such an approach is nearly impossible.

According to the National Institute for Mental Health (NIMH), nearly 3 percent of the American population suffers from bipolar disorder.

Known to many as manic-depressive disorder, bipolar disorder is a condition that results in unusual shifts in a person's mood, energy and capacity to function.

Unlike the typical highs and lows many people feel, the symptoms of bipolar disorder are severe — so severe they can eventually lead to suicide.

As drastic as that sounds, it's important to note bipolar disorder can be treated and many who seek and receive treatment live full and meaningful lives.

It's important to note that anyone suffering from the condition is not suffering alone.

In fact, it may help to know that many successful and notable celebrities have admitted to having bipolar disorder or are suspected of having the condition.

These include actor Ben Stiller and actress Carrie Fisher.

However, diagnosis is no easy task and many people quietly suffer for years before finally being diagnosed and getting treatment.

Once the diagnosis is made, treatment is a lifelong commitment, as bipolar disorder needs always to be managed.

Part of what makes diagnosis so difficult is there are typically long periods of "normal" moods when a person's behavior and emotions are no different from someone not suffering from the disorder.

The most obvious sign that there is a problem is when a person experiences what are referred to as "episodes."

These can be episodes of mania which are extreme highs, or depression which are extreme feelings of sadness or hopelessness.

A typical manic episode can feature any of the following symptoms.

— Increased energy or activity

— Feelings of restlessness

— Extreme irritability

— Feelings of euphoria

— Inability to concentrate

— Lack of a need for sleep

— Poor judgment

— Feelings of invincibility

— Increased sex drive

— Denial of any problem

Many people around someone suffering a manic episode can tell a distinct difference in that person. Many of the symptoms can be abrasive and often are not in tune with the person's normal character or behavior.

Diagnosis as a manic episode typically occurs when the elevated mood is accompanied by at least three of the mentioned symptoms each day for a week.

On the opposite end of the spectrum, the depressed episode is often as extreme as the manic episode.

Friends and co-workers might not recognize depression since the symptoms are not as abrasive. Any of these symptoms should raise eyebrows.

— Feelings of sadness, anxiety or emptiness

— Feelings of hopelessness

— Pessimistic outlook on life

— Loss of interest in previously enjoyed activities

— Feelings of fatigue

— Excessive sleeping or an inability to sleep at all

— Difficulty concentrating and making decisions

— Chronic pain not caused by physical injuries

— Unintended and noticeable weight loss or gain

— Feelings of death or suicide

While the precise cause of bipolar disorder is not known, it has been demonstrated that bipolar disorder tends to run in families.

In addition, a person's living situation could bring on bipolar disorder.

Individual manic episodes can also be brought on by medications, making it extremely important for someone who suffers extreme highs and lows be completely honest with their doctor.

Visit the NIMH Web site at www.nimh.org for more information on bipolar disorder. Read more!

Looking to ease road for disabled - Denver Post

By Jennifer Brown
01/29/2008

Michael Meeks works at a deli filling relish cups. He knows how to cook meatballs and brownies, and he's obsessed with order — to the point that clutter could trigger an anxiety attack.

And if the 23-year-old with mild cerebral palsy and a behavioral disorder wants to keep the state services that help him live, he can never go home again.

The Colorado rule that says people with developmental disabilities cannot live with family and still have access to 24-hour services is among those laws that legislators hope to change this year.

Lawmakers also plan to tackle a waiting list for services that is 12,000 people deep and — in some cases — stretches more than a decade.

"These people are all of our problems, not just the families that have to put them to bed at night," said Christy Blakely, director of the advocacy group Family Voices Colorado.

The cause gathered momentum last fall as a legislative committee heard testimony from dozens of families fed up with Colorado's meager financial commitment to people with autism, Down syndrome, cerebral palsy and other disabilities.

The result is a host of bills to help them get jobs, at-home care and therapy. But it's too soon to tell how the issue can compete with big-ticket items such as health coverage for all Colorado children and billion-dollar plans to fix roads and bridges.

Already, a lawmaker's plan to raise the state sales tax and eliminate the waiting list for services was dropped. Advocacy groups are preparing to put a proposal on November's ballot raising the sales tax from 2.9 percent to 3.1 percent, about 2 cents for every $10.

It would cost $150 million per year to end the waiting list, according to a legislative estimate.

"There's not an extra $150 million in the budget that no one else is using," said Rep. Michael Garcia, D-Aurora. "The answer is very clear — to end the waiting list you need more money."

Garcia dropped his sales tax proposal because "it wasn't ready for prime time," but he is pushing legislation that would let people with developmental disabilities live with their families and still have 24-hour care funded by the state.

A GOP-backed proposal would dedicate 2 percent of new general fund money each year for the next five years to services for the developmentally disabled. That would mean $8.5 million next year.

"We've been sent here to prioritize with the money we've been given," said Rep. Bob Gardner, R-Colorado Springs.

Gardner refuses to identify which programs might lose cash if his bill becomes law. But some Democrats say that's what would happen.

Advocacy groups, including the ARC of Colorado, are hoping their cause can tag along with a potential proposal to insure at least some of the 790,000 Coloradans without health coverage.

A governor's panel is expected to pitch five multibillion-dollar proposals to the legislature this week.

"It's too early in the session to determine if the legislature is going to take bigger steps to end a lot of crises that Colorado has," said Darla Stuart, executive director of the ARC of Aurora.

The state is projected to spend $348 million this year on services for developmentally disabled adults and children, up from $260 million six years ago. In the same period, the waiting list for 24-hour services has gone 453 in 2001 to 1,368 in 2007.

Other legislation up for debate this year would create tax incentives for employers who hire people with disabilities, set up a state employment program and hire a "navigator" to help decide which people on waiting lists have the greatest need.

Meeks had been on the waiting list for years when the state called to offer him comprehensive services. The catch: He had to move away from his mother within three weeks.

Meeks spent a few lonely months with a host family and began to regress emotionally, said his mother, Marian Neely-Carlson. He now lives in an apartment with two roommates, but his family worries about Meeks losing services if he wanted to come home or live with a sibling.

"What happens if Michael's roommates leave, and he needs to come home a little bit?" Neely-Carlson asked. "What happens if I pass away, and he wants to live with his brothers and sisters? It would be crushing."

Jennifer Brown: 303-954-1593 or jenbrown@denverpost.com Read more!

Need for drug abuse treatment grows as budgets shrink - Daytona Beach (FL) News-Journal

By DEBORAH CIRCELLI
Staff Writer

DELAND -- The stomach scars are long and deep when Kevin Cushing lifts his shirt and reveals one of the lowest points in his life.

He's physically healed from three self-inflicted shotgun blasts five years ago but still on the mend from the addictions that drove him to maim himself. The habits he couldn't quit after almost dying are why he'll live for six months at Serenity House's newest treatment facility west of Daytona Beach.

Cushing, an electrician with his own business for 10 years, said he was spiraling out of control on crack cocaine and other drugs and doesn't remember pulling the trigger or the pain that followed.

He woke up days later in intensive care with his family standing over him. He said he lost his spleen, part of his stomach and three ribs. Doctors thought he would die.

"It haunts me -- the misery of knowing I did that kind of thing to myself," Cushing, 48, said this past week while at the new 76-bed facility. "It took me out of the real world, and I didn't even know I did it because of the alcohol and drugs."

Cushing is one of 20 who have moved into the Hugh West building since it opened last month. Clients with substance abuse and mental health problems are treated there.

He counts himself as one of the lucky ones because the agency has a waiting list of 70 people and future funding for indigent clients is in question because of state budget problems.

Serenity House and Stewart-Marchman Center, the area's largest substance abuse treatment providers, are adding more beds but worry who will pay to fill them.

Bill Janes, the assistant secretary of substance abuse and mental health at the state Department of Children & Families, is seeking an extra $10 million for treatment statewide, but with the state's shortfall and local government's struggling, he said services could be cut.

Gov. Charlie Crist is expected to release his budget proposals to legislators by Feb. 4.

Serenity House, which primarily serves uninsured clients such as Cushing, will have 30 beds vacant at other sites in the next month after some current clients are moved into the new facility, which was bought by the county from Act Corp.

Randy Croy, executive director of Serenity House, hopes for state and veterans' funding to fill vacant beds.

Stewart-Marchman Center is requesting $1 million from the Legislature to help fund a new 100-bed Bunnell treatment center expected to open at the end of the year. Half of the beds at the Vince Carter Sanctuary in Bunnell will be for indigent clients and the other for people with insurance or other private funding.

Stewart-Marchman officials said they may look at doing less residential treatment for indigent clients and more outpatient, which is less costly though not as effective.

"This is a big problem for us on the horizon," said Chet Bell, CEO of Stewart-Marchman.

The agency is trying to get businesses and individuals to sponsor rooms and wings to help with funding needs at the new facility.

"One option is always to padlock (part of the facility) until we can afford to operate it," said Ernest Cantley, president of the Stewart-Marchman Center.

The state is dealing with projected tax shortfalls of nearly $2.5 billion over two years because of the troubled housing market and other economic problems.

"It's going to be a very down year ," said Sen. Evelyn Lynn, R-Ormond Beach. "We're going to have to work together to hurt people as little as we can."

Janes, who is also director of the state Office of Drug Control, said he and DCF Secretary Bob Butterworth are doing what they can to "protect critical services."

"We have got to support substance abuse funding," Janes said. "If we don't treat the addiction and give (people) life skills, they will continue to use drugs and commit crimes and the cost to our communities and state are just repeated."

Despite almost dying, Cushing, who also has bipolar disorder, still couldn't stop using crack. He lost his business and $100,000-a-year income, was in and out of jail on various charges and ended up sleeping under bridges and in the woods the past two years.

"Once I met crack cocaine, my life ended," said Cushing, who according to police reports also threatened his former girlfriend before eventually turning the gun on himself.

Kirk Phillips, who is also at the new Serenity House facility, has lived a similar life with cocaine. The Army veteran, also bipolar, came down from New York and ended up in detox in Gainesville at the end of last year. He, too, has been in jail, was shot in the neck and once was in the hospital after injecting "every medication I could get my hands on."

"I'm sick and tired of being sick and tired," Phillips said. "I'm 44. I can't do it again."

For Cushing, this is his fourth substance abuse program, but the father of a teen-ager and a young adult also says things are different. He wants to live and have a productive business again.

"I pray to God I'm one of the ones who make it," he said. "It's the end of the road for me. This is my last chance. I'm not going to mess it up. I want to see my (future) grandchildren and give my daughter away and her be proud of me."

Funding cuts spur merger talks among treatment centers

DAYTONA BEACH -- Some area agencies are combining forces to save money and serve more clients as state and local funds dwindle.

Stewart-Marchman Center and Act Corp. are not only exploring whether to merge but currently combining call centers to handle substance abuse or mental health calls.

Consolidating some services between the area's two largest substance abuse and mental health providers saves administrative costs and will result in more patient screenings, agency officials said, along with getting people connected to services faster.

With the call centers, which already were in the same building, people at Act will be able to schedule clients for services with Stewart-Marchman and vice-versa.

Local agencies are trying to cut costs as the state deals with a budget shortfall and concerns over potential funding cuts.

"We all play pretty well together in the sandbox here in Volusia County, but I think we have to get even more creative. That's the bottom line," said Chet Bell, CEO at Stewart-Marchman Center.

Talks continue about a possible merger, or combining more services. Stewart-Marchman is also looking at whether it can get better prices for its patients by using Act's pharmacy.

The Homeless Assistance Corp., which runs a dining program, shelter and other services on North Street, and the Volusia/Flagler County Coalition for the Homeless were also in talks about whether to combine. But talks have ceased, Brian Willard, executive director of the Homeless Assistance Corp., said Friday.

Willard said his agency can be "self-sufficient" despite recent financial struggles. He said donations and grants will have to carry the agency through this fiscal year.

A DeLand agency, The House Next Door, is opening an additional office next month in Daytona Beach, sharing space at Easter Seals of Volusia & Flagler Counties on Dunn Avenue. Services there will be provided to Medicaid and Healthy Start clients.

The House Next Door provides counseling and substance abuse prevention services. It also rents an office at the Presbyterian Counseling Center on the beachside since closing its office in Port Orange more than a year ago to save on expenses.

"A lot of the people referred to us don't have the transportation to get to Deltona or DeLand," said Steve Sally, executive director of The House Next Door. "People are realizing if we coordinate things we can do better things for our community."

deborah.circelli@news-jrnl.com Read more!