Health care providerws still owe $1.4 million -Elizabeth City (NC) Daily Advance

By BOB MONTGOMERY

While one local health care provider has satisfied its nearly $500,000 Medicaid debt with the state, four others with area offices still owe nearly $1.4 million, according to the N.C. Department of Health and Human Services.

The four private providers with offices in Elizabeth City are: Life Inc., 405 W. Main Street; Pride in North Carolina Inc., 905 Halstead Boulevard; Innovative Programming Associates (IPA), 1023 U.S. Highway 17 South; and Health Services Personnel, 905 Halstead Boulevard.

Those four firms owed a total of $1.8 million and have repaid through withholding of payments $438,082 to date — or about 24 percent of the debt, according to data from the state DHHS.

DHHS spokesman Brad Deen estimates that 500 community service providers statewide owe a total of nearly $60 million in Medicaid repayments that were used for non-qualified services. The federal government announced in mid-April that it was withholding at least $138 million from North Carolina in Medicaid funding until it submits an acceptable plan to deal with the misspent funds.

All of the firms, which are paid to provide counseling and other services to mental health patients, were ordered to repay the monies DHHS said had been misspent. To speed up the recoupment, DHHS began withholding 10 percent of the firms' Medicaid reimbursements.

One local firm that owed $483,041, American Health and Human Services, has satisfied all its debt, Deen said.

Meanwhile, the other four with offices in Elizabeth City have satisfied roughly one-quarter of their debt through withholdings. According to DHHS records:

— Life Inc., which owed $1.1 million, has repaid $315,643.

— Pride in North Carolina Inc., which owed $459,051.12, has repaid $112,989.71.

— Health Services Personnel, which owed $137,784.84, has repaid $60,104.57.

— Innovative Programming Associates (IPA), which owed $129,159, has repaid $49,345.15.

When contacted, the local providers referred questions to their corporate offices.

Life Inc. executive vice president Sammy King referred questions to Sharon Raynor, president, who could not be reached.

Health Services Personnel executive Jim Southern declined to comment and referred questions to Todd Key, state director, who could not be reached.

IPA 's Tonya Boyce in Elizabeth City could not be reached for comment.

Meanwhile, Pride in North Carolina Inc.'s president, Deanna Janus, said she has appealed the state's action, although the state is still continuing to withhold 10 percent.

She said some of the funds the state wants to collect are for services that providers were told to continue providing for existing patients — then later told not to.

"The division was very clear not to reduce services," Janus said. "We were told to continue (treating them) as community service providers."

Janus said her business has tried hard to follow all the rules, many of which were unclear and provided "little guidance" from the outset.

"They set up a system destined to be abused by providers without integrity," she said. Read more!

Mentally ill Michigan inmates not being treated, expert says - Grand Rapids Press

By Pat Shellenbarger

GRAND RAPIDS -- The 31-year-old man came into prison with a long history of mental illness, including a diagnosis of bipolar disorder, depression and a couple of suicide attempts. He complained of hearing voices telling him to assault others.

Yet a prison psychologist doubted the inmate was mentally ill and suggested he stop taking the medications intended to control his mood swings and quiet the voices in his head.

Such instances of mentally ill inmates being misdiagnosed or undiagnosed are fairly common, an independent psychiatrist testified Tuesday during a hearing on a long-running federal lawsuit over conditions in a Jackson prison complex.

Only about 6 percent of inmates in the three facilities -- known as the Reception and Guidance Center, Duane Waters Health Center and the C Unit -- are treated for serious mental illnesses, well below the national average of 15 percent to 30 percent, testified Dr. Terry Kupers, a California psychiatrist who specializes in prison mental health issues.

"That is way below what other states are doing," he said.

The reason is not that Michigan's inmates have fewer mental problems, Kupers said, but their mental illnesses are going undiagnosed.

"This creates a problem," he said. "The biggest problem is people who need psychiatric treatment aren't getting it."

Kupers, called as an expert witness by attorneys representing inmates in the class-action lawsuit, spoke the day after another psychiatrist, Dr. Jeffrey Metzner, testified the state Department of Corrections is doing an adequate job of identifying mentally ill inmates.

Kupers testified some inmates told him they were advised by prison psychologists not to seek treatment for their mental illnesses, because it could hurt their ability to get into some prison programs and might discourage the parole board from releasing them.

He traced the problem to the 1980s, when the state closed most of its mental hospitals, releasing patients into the community. While funding for mental health programs was cut, many mental patients ended up homeless, and some were convicted of crimes.

"So the number of people with mental health problems in the prisons has increased massively," Kupers said, adding that the number of mental health workers in the prisons "has not kept pace with the rising population of mentally ill inmates."

Last July, he interviewed 37 inmates who had been diagnosed as not needing treatment and concluded several had serious mental illnesses. Many mentally ill inmates end up in segregation, sometimes known as solitary confinement, which only aggravates their illness, Kupers said. Some decline treatment for their mental illness, he said, because it could mark them as weak, making them a target for other inmates.

"They know they're mentally ill," he said. "They isolate themselves, which makes their mental illness worse. Prisoners tell me if you show weakness, you will be assaulted. It's dangerous to be slight, to be gay, to be weak."

American Civil Liberties Union attorney Elizabeth Alexander, representing the inmates, claimed the mental health care in the prisons is unconstitutionally inferior. Assistant Attorney General Peter Govorchin, representing the Department of Corrections, disagreed and wants U.S. District Judge Robert Jonker to dismiss that portion of the long-running lawsuit.

"You'd have thought we were talking about two different places," Govorchin said during a break in the hearing.

Send e-mail to the author: pshellenbarger@grpress.com

Read more!

Teen's dark dreams raise 'mental issues' -The Columbia (SC) State

By LEE HIGGINS
lhiggins@thestate.com

FLORENCE — The Chesterfield County 18-year-old accused of plotting to blow up his high school reportedly told a sheriff’s investigator that “once he got to heaven, he was gonna kill Jesus,” an ATF agent testified Tuesday in federal court.

Magistrate Thomas E. Rogers III is weighing whether Ryan A. Schallenberger needs a mental evaluation and is expected to decide in a day or two.

“Given the complexion of this case, I think it’s impossible that there will not be mental issues raised in the trial,” assistant U.S. attorney Buddy Bethea said.

Schallenberger faces federal charges of:

• Attempting to use a weapon of mass destruction

• Attempting to damage, by means of an explosive, property of an institution receiving federal funds

• And receiving an explosive in interstate commerce with the intent to kill, injure and intimidate any person and unlawfully damage property.

If convicted, the straight-A Chesterfield High School senior could spend the rest of his life in prison.

Schallenberger also faces state charges of making bomb threats and possession of explosive materials.

Craig Townsend, an agent with the federal Bureau of Alcohol, Tobacco, Firearms and Explosives, testified Tuesday that Schallenberger told a Chesterfield County sheriff’s investigator “once he got to heaven, he was gonna kill Jesus or something like that.”

Townsend also said Schallenberger waived his Miranda rights and told officers he wanted to kill himself.

“Ryan began (becoming) upset, stating that he wanted to die. Death was better than his life. He only wanted to kill himself,” Townsend said, reading an investigator’s report.

Federal prosecutors have said they were concerned Schallenberger might be suicidal, and he initially was on 24-hour suicide watch last week at the Chesterfield County jail. Schallenberger is now in the jail’s general population.

In court, Schallenberger’s attorney, William Nettles, questioned the prosecution’s urgency in seeking the mental exam. “I think it’s completely premature at this point to order any type of evaluation.”

Nettles said he had only received Schallenberger’s journal and had not had time to review other evidence.

Schallenberger’s 50-page journal — in which police say he detailed plans to blow up Chesterfield High — is temporarily sealed until at least midafternoon Friday, at which point Nettles would have to persuade Rogers to keep it off-limits.

Also Tuesday, the court heard a 911 tape in which the teen’s mother, Laurie Sittley, could be heard asking police to come pick up her son two days before Schallenberger’s arrest.

The dispatcher asked Sittley why.

She replied: “He just smashed his head through the wall, and if the police come here, he’s going to shoot them.”

Police say they found bags of matchstick heads and canisters of carbon dioxide and ammunition in Schallenberger’s room. According to authorities, Schallenberger told investigators he had two cans of gunpowder but couldn’t remember where he had hidden them.

The ATF turned over to the FBI several audiotapes found in Schallenberger’s room. Assistant U.S. attorney Rose Mary Parham, who also is prosecuting the case, said she doesn’t know what is on the tapes.

According to a State Law Enforcement Division analysis of Schallenberger’s computer, it appears that several hundred pages of documents, some detailing bomb-making, were deleted, said Townsend, the ATF agent.

Schallenberger told investigators that he never took explosive materials to Chesterfield High School and that no one else was involved in the plot, Townsend testified.

Over the past year, police say, Schallenberger planned to bomb the school.

His parents called police April 19 when they intercepted a delivery of ammonium nitrate — a fertilizer that, when combined with diesel fuel, can be used to make a bomb.

Schallenberger’s parents were in court Tuesday but declined to comment.

The man who reportedly sold Schallenberger the fertilizer on eBay was a gun enthusiast advertising the product as a substitute for tannerite, which is used in explosive targets, Townsend said.

Investigators later found a yearlong journal Schallenberger had kept and DVDs of two of the most tragic days in American history — the 1995 bombing of the Oklahoma City federal building and the 1999 Columbine High School shootings in Colorado.

Schallenberger had about 20 pounds of ammonium nitrate his parents turned over to law enforcement, federal court documents say.

He admitted he already made two to four pipe bombs, documents say.

Reach Higgins at (803) 771-8570.
Read more!

Deputies shoot, kill man with knives at Calif. court -Associated Press

FRESNO, Calif. (AP) — A man with a history of mental illness burst into a packed courtroom Monday wielding two carving knives and was shot to death as he threatened a judge he may have blamed for his misfortune, authorities said.

Robert Eaton, 40, had an extensive arrest record and last year, rammed his car into the Merced County courthouse out of anger that he was refused treatment by a mental health facility, Merced County Sheriff Mark Pazin said. Merced is about 50 miles northwest of Fresno.

On Monday, Eaton drove back there in a Toyota Camry he hijacked from someone who was hired to take him to a doctor's appointment, Pazin said. He ran past guards and through a set of metal detectors at the front door holding a knife in each hand, he said.

As attorneys and witnesses cried out, Eaton charged through the doors of Courtroom 2 and into the well where lawyers were standing in the midst of court proceedings, Chief Deputy District Attorney Harold Nutt said.

"As soon as he hit the inside doors, I was behind him and I started yelling that he had a knife," said Nutt, who saw Eaton approach as he stood in the hallway talking with a colleague. "The officers started yelling at him, and yelling at everybody else to get down, and at that point it was rather chaotic. People started screaming, people started heading for the door, and I just ran back outside."

As Judge Brian McCabe tried to hurry his court clerks out of the courtroom through his chambers, Eaton held the knives aloft in a stabbing position about 30 feet away, Nutt said.

When Eaton refused to drop the weapons, several officers fired directly at him, and the man died on the courtroom floor, in front of a few dozen witnesses, law enforcement officers and others doing business in the court, Pazin said.

"There is a likelihood that he and Judge McCabe may have crossed paths in his courtroom," Pazin said Monday. "He had the knives in tow and literally left the vehicle running and came straight over to the courthouse."

Nutt said a public defender told him he recognized the suspect as a previous client with a history of mental illness.

Eaton had an arrest record dating back nearly two decades for car theft, vandalism and other charges, Pazin said.

No other injuries were immediately reported, but the courthouse was locked down for hours as investigators interviewed witnesses and officers involved in the incident, said sheriff's spokesman Tom MacKenzie. Read more!

N.J. Gov's Medicaid co-pay plan troubling, human services chief concedes - Assoiated Press

The state human services commissioner Monday said it was a "valid concern" that poor people would avoid medical care if Gov. Corzine's proposal to charge them new fees for prescription drugs and some hospital visits is approved.

Corzine proposed co-payments for Medicaid recipients to raise $7.55 million for the cash-strapped state budget.

Legislators fear the payments could prompt poor people to forego health care, especially senior citizens, the disabled and mentally ill.

"I do think it's a valid concern," Jennifer Velez, the state human services chief, told senators during a Monday hearing. "I couldn't tell you that it's not."

New Jersey is among eight states that doesn't charge Medicaid co-payments for prescription drugs.

Corzine proposes a $6 co-payment on emergency room visits that aren't a true emergency to raise $550,000, and a $2 co-payment on prescription drugs to raise $7 million. The prescription drug co-payment would be capped at $10 per month per person.

Corzine proposes spending $33 billion next fiscal year, but legislators and advocates for the poor fear the co-payments, even if small, could be too painful for people with little margin for extra expenses but serious medical problems.

"They obviously will make a choice, whether it's food, clothing or shelter, as opposed to pursuing their meds," said Sen. Dana Redd, D-Camden.

Velez said the state has little choice. Corzine has proposed $2.7 billion in cuts amid chronic budget woes.

"There are very few, if any, really good options," Velez said. "This is not a particularly good option, but the reason why it's in the budget this year is the dire situation."

Mary Lynne Reynolds, executive director of The Mental Health Association in Southwestern New Jersey, said 5,000 New Jerseyans with mental illnesses live in boarding homes.

She said most of those people receive Medicaid and Social Security insurance that pays for room and board and a $50 per month personal allowance to buy personal effects and amenities such as snacks and newspapers.

Legislators and Corzine must adopt a budget by July 1.

This is the third time the Democratic Corzine has proposed Medicaid co-payments since becoming governor in 2006. His fellow Democrats who control the Legislature rejected them the first two times.
Read more!

Former Broward librarian is found dead on Death Row - South Florida Sun Sentinel

By Jon Burstein
April 29, 2008

A former Broward County librarian who killed two ex-girlfriends in attacks almost two decades apart died Monday morning on Florida's Death Row.

William Coday, 51, bled to death in his cell at Union Correctional Institution in Raiford from what are being called self-inflicted wounds, said one of his attorneys, George Reres. Coday had a history of suicidal behavior and had attempted to kill himself while awaiting trial at the Broward County Jail.

"He did have a death wish," Reres said.

The Florida Department of Corrections is investigating Coday's death, but cannot disclose how he died, said Jo Ellyn Rackleff, a department spokeswoman. He was found dead in his cell at 2:42 a.m.

Reres said Coday's death raises serious concerns about security onDeath Row.

"Obviously, having something sharp enough that you can cut yourself is a problem for the Department of Corrections," Reres said. "They are supposed to be watched and monitored hourly. How can he bleed to death without being found? A lot of questions come to mind."

An autopsy was performed on Coday's body Monday at the local Medical Examiner's Office in Gainesville.

Coday was on Death Row for the July 1997 murder of ex-girlfriend Gloria Gomez — a frenzied killing in which he used a hammer to beat her and when that broke, he used a second hammer and a knife. She was stabbed 41 times, cut 46 times and suffered 57 blunt injuries. Gomez was alive for all but the last of the hammer blows and stab wounds, according to forensic evidence at his trial.

The crime occurred almost 20 years after Coday used a shoemaker's hammer to beat to death his ex-girlfriend Lisa Hullinger in Hamburg, Germany, where the two Americans were students. His attorney in that case used an insanity defense and he was sentenced to three years in prison. He was released after 15 months behind bars and sent back to the United States with orders to get psychiatric help. He got some help but dropped out, partly because of the cost, he said.

The bespectacled Coday later got a job as a foreign languages librarian at the Broward County Main Library in Fort Lauderdale. Colleagues described him as mild-mannered and soft-spoken, fluent in five languages. It was at the library that he met Gomez, who had immigrated from Colombia.

They dated for a year until Gomez broke up with him, sending him into an emotional tailspin and causing his colleagues to fear he was suicidal. He begged Gomez to talk to him, luring her to his Victoria Park apartment on July 11, 1997, after concocting a tale that he was dying of cancer.

After the killing, Coday fled to Europe and North Africa. He returned in October 1997 to New York City, where he was arrested.

Coday attempted to kill himself at the Broward County Jail in September 2000, slicing his wrist and hand. His attorneys and a psychologist said they didn't learn about the attempt until eight days later.

As a result of his treatment, 11 jail workers were disciplined.

A jury convicted Coday of first-degree murder in 2002, recommending death.

But the Florida Supreme Court tossed out the death sentence in 2006, ruling that the judge shouldn't have disregarded testimony and evidence from six mental health experts who found that Coday suffered from serious mental illnesses. The case went back to the judge, who again sentenced Coday to die.

Gloria Gomez's family, who live in a remote area of Colombia, could not be contacted Monday. Hullinger's parents, Charlotte and Robert Hullinger of Cincinnati, Ohio, eventually founded the national support group Parents of Murdered Children.

In an e-mail Monday, Charlotte Hullinger wrote: "Does the news I received today about Bill's death bring me peace and a sense of justice? No. Does it ease my fears that perhaps there could be a new trial and someday he could be released, possibly to kill for the third time? Yes."

Coday is the subject of an upcoming book by author Stella Sands.

"[His death] surprised me because on Death Row one would have assumed that he was more closely watched," Sands said. "It didn't surprise me because he was a very brilliant man and I don't think he could live with himself. He knew he was highly flawed as a human being."

Jon Burstein can be reached at jburstein@sun-sentinel.com or 954-356-4491.

Copyright © 2008, South Florida Sun-Sentinel Read more!

A prisoner's plea for help -Toronto (Canada) Sun

After admitting guilt 29 times, all he wants is a doctor
By MARK BONOKOSKI
April 29, 2008

Sometime after 9 a.m. today, Don Jail inmate Ronnie Roberts will appear in Courtroom 111 at Old City Hall -- this time via video -- for what will end up being his 29th remand.

He will then be formally told that he will be returned to court from his cell at the Toronto (Don) Jail, this time in cuffs and in person, on May 12.

It's already in the books.

The video remand should take all of two minutes.

Ronnie Roberts' crime, and the reason for his incarceration since last October, basically boils down to the fact that he had a $4.49 (plus tax) beer to wash down a chicken dinner at a Swiss Chalet while on a pass from the Keele Centre federal halfway house -- unquestionably a violation of his long-term offender order to abstain from drugs and alcohol, but nonetheless a rather minor breach on the scale of one to 10.

On his first day in court, 29 appearances ago, Ronnie Roberts attempted to plead guilty to the breach charge.

He was not allowed.

On court appearance No. 25, and still in jail, he finally got his guilty plea read into the court record.

Today he is still waiting to be sentenced, and he will now have to wait until at least May 12 -- if it indeed happens then.

"How many times should anyone have to ask to plead guilty before his guilty plea is finally accepted?" asks Daniel Brodsky, the lawyer now representing Roberts.

"And then, after pleading guilty, how many times should someone have to be hauled back-and-forth to court before he is actually sentenced?

"Is this the good use of taxpayers' money?"

The reason 45-year-old Ronnie Roberts has been left blowing in the judicial wind is because, truth be known, no one wants to deal directly with the fact -- or knows how to deal directly with the fact -- that Roberts has a treatable brain injury that, left untreated, will only see him back in court, somewhere down the line, on some other charge,

So his case keeps getting punted.

What Brodsky wants for his client, in a nutshell, is treatment for the clinically diagnosed brain injury that has been plaguing Roberts since he banged his head on a railway track back when he was an 8-year-old boy.

OUTSIDE PRISON SYSTEM

Otherwise, short-form version, he will be perpetually before the courts through no intentional fault of his own.

Psychiatrists -- and eminent ones -- have already testified to this fact, and they have also testified that the only place Roberts can get treatment that will put him on the straight and narrow is outside the prison system.

It exists nowhere else.

Ronnie Roberts' last court appearance -- and I was there in the gallery -- was on April 9, in Courtroom 112 at Old City Hall, Mr. Justice Peter Harris presiding.

Mr. Justice Hugh Atwood was supposed to have been present to hear the case but, as with Roberts' previous appearance on March 5, which I also attended, Judge Atwood was again waylaid in a Brampton court and unable to attend.

Not that it mattered.

The court exhibits which lawyer Brodsky had previously filed to give Judge Atwood an overview of Roberts' case -- and they added up to a substantial box load -- had not yet made their way to the judge's Brampton office.

Fast forward five weeks to Ronnie Roberts' 28th court appearance on April 9, and those files had still not made it up to Brampton. In fact, as it came out in court, they were still sitting in the Old City Hall office of courtroom exhibits clerk, Mike Rose -- under his desk, no less.

"Being used as a foot stool," as Brodsky later put it.

It was Mr. Justice Peter Harris, in fact, who ordered today's court appearance, and he ordered it solely to ensure that those aforementioned files had finally made it to Judge Atwood's office so that he would be prepared to deal with the case when Ronnie Roberts appears again -- and this will be for the 30th time -- on May 12, supposedly for sentencing.

Two more exhibits were added to that box, and they came in the form of columns written here about the inordinate number of delays in the Ronnie Roberts case.

If Roberts and Brodsky lucked out at all back on April 9, it was in having Mr. Justice Peter Harris sitting on the bench.

Way back at the preliminary stages of Ronnie Roberts' provincial court dealings, Judge Harris was one of the first judges before which Roberts appeared following his arrest.

And he thought, no doubt rightly, that the case belonged in the mental health court.

Once there, however, the Crown prosecutor disagreed and, since the Crown's approval is necessary if a case is to proceed in mental health court, brain-damaged Ronnie Roberts got bounced back into the regular court system that has been kicking him around ever since.

So, today's appearance by Ronnie Roberts -- his 29th thus far -- means absolutely nothing when it comes to closure, which is why he will appear on a TV screen in Courtroom 111, and not in the prisoners' dock.

It will be just another day in court.

And just another remand. Read more!

Man hospitalized for killing father -Baltimore Sun

By Nicole Fuller

April 29, 2008

An Anne Arundel County man with a history of mental health problems was sentenced yesterday to treatment at the state's maximum-security psychiatric hospital for killing his father - a crime prompted by a psychotic episode, according to a court-ordered psychological evaluation.

John Scott Bealefeld, 43, of Linthicum pleaded guilty to one count of second-degree murder for the beating death of his father, Maurice Bealefeld, 74, last summer at the home they shared.

Though he pleaded guilty, he was found 'not criminally responsible,' akin under Maryland law to an insanity plea.

John Bealefeld apologized in court yesterday,

'I truly had mental problems going back to even before 1991,' when he was committed to a mental health facility, he said. 'I just feel I won't be able to hurt anyone else where I'm going.'

Anne Arundel Circuit Judge Paul F. Harris ordered that Bealefeld, now being held at the county detention center, be transferred to the state-run Clifton T. Perkins Hospital Center.

'This is one of the most tragic, sad cases I've had since being a judge,' Harris said. 'It's a shame the [victim] passed in such a tragic manner, especially at the hands of his son.'

Bealefeld's defense attorney, Heather E. Tierney, told the judge that her client was in the throes of a 'psychotic episode' at the time of the killing.

'He had stopped taking his medicine because voices told him so,' Tierney said. 'He does still hear voices from time to time.'

Twice in recent years, Maurice Bealefeld had petitioned the courts to evaluate his son's mental health and was denied.

Prosecutor Kathleen E. Rogers said, 'hindsight is certainly 20/20,' but she declined to criticize past court decisions.

In 2002, John Bealefeld received probation on a second-degree assault charge alleging he had struck his father.

John Bealefeld's sister, Sharon Brown of Baltimore, called the home on the morning of May 14, 2007, to speak to her father and, according to Rogers, he told his sister in a 'sarcastic' tone, 'I killed Dad. I beat him to death. Is that OK?'

When police arrived at the home where father and son lived in the 400 block of Nancy Ave., they found John Bealefeld smoking a cigar outside.

John Bealefeld told police his father had 'disrespected him' and it was a 'justifiable homicide,' Rogers said.

Brown told the judge of her father: 'All he wanted to do was get help for my brother.'

nicole.fuller@baltsun.com Read more!

Uma Thurman's parents testify at stalking trial - Associated Press

NEW YORK (AP) -- The former mental patient accused of stalking Uma Thurman appeared at her front door repeatedly at odd hours, and he left her a frightening letter, according to testimony Tuesday by two of the actress' employees.

Thurman's housekeeper Dorota Janas testified on the second day of Jack Jordan's trial that he rang the bell at the actress' Greenwich Village town house at least twice a day for at least 10 days last summer.

Jordan, 37, is on trial in Manhattan's state Supreme Court charged with stalking and aggravated harassment. He was arrested in October 2007 after following and trying to contact Thurman from early 2005 until about a month before his arrest. He faces up to a year in jail if convicted.

His lawyer, George Vomvolakis, says Jordan is a former mental patient who has been diagnosed as schizophrenic and bipolar and should be in psychiatric treatment, not in jail.

Janas, testifying through a Polish interpreter, said she saw Jordan sitting on the front stoop a few days before another employee called police. Some time later, she retrieved a letter Jordan had left for Thurman on the stoop.

Samara Koffler, a film producer who was Thurman's former personal assistant, testified that she returned from the Bahamas in August 2007 and saw the letter Janas had found. She read part of it in court.

''Dear Uma,'' Koffler read, ''I love you completely. Unless rousted, I'll spend the night in front of (Thurman's address).''

At another point, she read: ''Ask your assistant to let me wait inside until you return. I feel afraid that if I see you with another man I'll kill myself.''

Koffler said she told Thurman about the letter and called 911 and told police ''an unstable man'' was hanging around the house.

The 38-year-old Thurman -- who has starred in ''Pulp Fiction,'' ''Kill Bill,'' ''The Producers,'' and ''My Super Ex-Girlfriend,'' among other films -- hired a private detective and allowed installation of surveillance cameras around the house, where she lives with her two children.

Earlier in the day, Thurman's parents testified.

Her father, Robert Thurman, said his reaction after reading e-mails from Jordan was to try to remember the FBI's telephone number. He said in court Tuesday he was seeing Jordan for the first time.

Her mother, Birgitte ''Nena'' Thurman, testified that she believed Jordan ''was someone who would benefit from medical attention.'' She said the first time she spoke to the defendant was in 2005 when he called her home in Woodstock, N.Y., and told her that he ''and my daughter had a predestination to be together.'' She said he asked her to relay that message.

''I tried to assure him in no uncertain terms that this was just a fantasy and he was projecting,'' Thurman said, and that her daughter had no interest in him.


Read more!

Quieting the Demons and Giving Art a Voice New York Times

Madness: A Bipolar Life
By Marya Hornbacher. Houghton Mifflin. 299 pages. $25.

Poets on Prozac: Mental Illness, Treatment and the Creative Process.
Edited by Richard M. Berlin, M.D. Johns Hopkins Press. 200 pages. $21.95
Marya Hornbacher is a virtuoso writer: humorous, articulate and self-aware. She is also, as she has now documented in two books, incurably mentally ill.

Even on the best possible treatment, Ms. Hornbacher tiptoes along the same high wire as Plath, Lowell, Woolf and the rest of the unbalanced artistes. Off medication, she reliably falls into a turmoil of confused self-destruction, which, as she would be the first to acknowledge, means heartbreak and worry for her friends and relatives, challenges for her doctors, and, in the age-old contradiction, new fodder for her muse.

For scientists trying to parse the mystery of brain and mind, she is one more case of the possible link between mental illness and artistic creativity. With all our scans and neurotransmitters, we are not much closer to figuring out that relationship than was Lord Byron, who announced that poets are “all crazy” and left it at that. But effective drugs make the question more urgent now: would Virginia Woolf, medicated, have survived to write her final masterpiece, or would she have spent her extra years happily shopping?


Ms. Hornbacher brings to the discussion more than the usual pairing of disturbed brain and talented mind. Her talent has created a third self, an appealing, rueful narrator who can look back on three decades of manic-depressive illness, much of it untreated, and spin a story that is almost impossible to put down. In the same way that the psychiatrist Kay Redfield Jamison experienced, recorded and then analyzed her own case in the 1995 classic “An Unquiet Mind,” Ms. Hornbacher provides the perfect trifecta of perspectives.

Readers of her well-received book “Wasted,” published in 1998 when Ms. Hornbacher was 24, left her in a state of tenuous recovery from a long struggle with anorexia. The first pages of “Madness” describe how illusory that recovery was. Prescribed an antidepressant, the common treatment for anorexia, she took a slow-motion swan dive into the full-blown anxiety, agitation and despair of bipolar disease made worse by exactly the wrong medication. Her plunge went unrecognized by her attendant mental health professionals, including one who suggested a regimen of candles, baths and aromatherapy.

Hot water did nothing to help; neither did alcohol, lots of it. Ms. Hornbacher finally picked a psychiatrist at random from the Minneapolis phone book and happened onto a good one. Her illness was accurately diagnosed and properly medicated in short order.

On television, that encounter would cue the credits, but the book has barely begun. What follows is an unsparing saga of severe refractory manic-depressive illness, with treatment often undermined by Ms. Hornbacher herself. “For years after I was diagnosed, I didn’t take it seriously. I just didn’t feel like thinking about it. I let it run rampant, and these are the results” — a jagged decade of health and productive work alternating with relapses, hospitalizations, electroshock treatments and slow climbs back to tenuous health.

The self-absorption of mental illness can be off-putting, or just plain dull. It is a testament to Ms. Hornbacher’s talent that her book is neither. She writes in a fluid staccato well suited to her stuttering reality, with a wicked ear for dialogue and a baseline common sense that contrasts with the immense senselessness of her worst manic episodes.

As for the central question of whether treating the illness impairs the creativity, Ms. Hornbacher weighs in firmly on the side of her meds, imperfect though they may be. “For me, the first sign of oncoming madness is that I’m unable to write.” Depression silences her; mania may flood her mind with glittering words, but they scatter before she can get them down. Only the prosaic morning meds (21 pills, at last count) will let her trap the words on the page.

More reflections on the same subject can be found in “Poets on Prozac,” a collection of essays solicited from published poets with psychiatric illness. Most of the 16 contributors are decades older than Ms. Hornbacher, but while they may lack her vivid prose style, they do supply a long-term perspective on the terrain.

With problems ranging from mild unmedicated depression to schizophrenia treated with an unorthodox megavitamin technique, these writers also focus on trapping the words — and all agree that the sick brain often spells catastrophe for the creative mind. While mental illness may form a part of the creative cycle, if untreated its own cycles invariably take over. “Depression steals the voice,” writes Liza Porter. “Silence breeds depression. Depression breeds silence.”

Meanwhile, the actual hard work of editing a mass of thoughts into a finished product is purely linear. It requires detachment and perspective, what Andrew Hudgins calls the “chemical Zen” of Paxil. “I have no idea if the drug has changed my work at any fundamental level,” writes Mr. Hudgins, a professor at Ohio State University, “but I doubt that it did, which is a great comfort.”

Even the poet’s reliable liquid elixir of inspiration is given short shrift here. Dylan Thomas be damned: it is the first national poet of Wales, Gwyneth Lewis, who writes: “I used to keep notes of my altered states of mind under the influence of drink in the hope that they would offer startling new images for poems. They didn’t. It was impossible to decipher my handwriting, and I kept throwing up. Another poetic myth bites the dust.”


Read more!

Cut loose - Raleigh (NC) News & Observer

Editorial:

Some patients leave state mental hospitals with skimpy follow-up plans that leave them at risk -- another tangle in 'reform.'

Two days before a North Carolina man, called only "TC" by the advocacy group Disability Rights North Carolina, shot himself to death, he was discharged from an involuntary commitment at the Broughton state mental hospital in Morganton. Doctors sent the dangerously ill man home with an "aftercare plan" that consisted only of his promise to call his family doctor, and despite knowing the following, according to Disability Rights:

"At the time of his release, TC's hospital records contained information that TC had a family history of mental illness; that he was being treated with medication for bi-polar disorder; that he had been involuntarily committed once before following a suicide threat; that the current hospitalization had followed a standoff with police who had to taser TC in order to take him into custody; that he had threatened to shoot any officers who tried to intervene; that he told his family he took 100 Valium; that in talking with family his speech was slurred and he was 'drifting in and out'; that he was intelligent and would try to minimize the event so he would be discharged; that he lost his job the day of the event; that he and his long-time girlfriend, who had a tumultuous relationship, had recently broken up; that he did not have any local support system; that he had anger management issues; that he had been treated for depression with medications for seven years; that he had access to weapons; and that he was aggressive and combative toward hospital staff."

TC is one of three patients profiled in a Disability Rights report who ended up dead after spending just a few days, or hours, in state mental hospitals and with little attention to how they would be cared for on the outside. (TC is Carl Wayne Tournear, identified in a recent series of articles in The N&O about the state's mental health care system. He killed himself on Aug. 3.)

A second patient was a 17-year-old Orange County youth. The third was released to a homeless shelter that actually had been shuttered a few days earlier. According to the report, 1,182 people were released from mental hospitals to homeless shelters last year. That is a disgrace, but not surprising as shelters, jails and prisons increasingly become way stations for the mentally fragile.

The report comes as the state tries to right a seven-year-old reform effort that was to provide more space in the big state hospitals for seriously ill residents but more services in local communities for those whose illnesses were stabilized.

Disability Rights makes sensible suggestions, including hiring more local and hospital staff to coordinate after-care services and setting a statewide policy for local mental health offices. Earlier this month, before the report was released, the state decided on its own to place county liaisons in hospitals to help identify appropriate services for patients returning home -- a welcome step.

Disability Rights has uncovered another hole in the state system that needs to be patched. Until the agency responsible for carrying out reform, the Department of Health and Human Services, gets better control of local and statewide services, troubled North Carolinians are likely to continue falling through the local-state cracks. Read more!

Detainees’ Mental Health Is Latest Legal Battle - New York Times

Saturday, April 26, 2008

Next month, Salim Ahmed Hamdan, a Yemeni who was once a driver for Osama bin Laden, could become the first detainee to be tried for war crimes in Guantánamo Bay, Cuba. By now, he should be busily working on his defense.

But his lawyers say he cannot. They say Mr. Hamdan has essentially been driven crazy by solitary confinement in an 8-foot-by-12-foot cell where he spends at least 22 hours a day, goes to the bathroom and eats all his meals.His defense team says he is suicidal, hears voices, has flashbacks, talks to himself and says the restrictions of Guantánamo “boil his mind.”

“He will shout at us,” said his military defense lawyer, Lt. Cmdr. Brian L. Mizer. “He will bang his fists on the table.”

His lawyers have asked a military judge to stop his case until Mr. Hamdan is placed in less restrictive conditions at Guantánamo, saying he cannot get a fair trial if he cannot focus on defending himself. The judge is to hear arguments as soon as Monday on whether he has the power to consider the claim.

Critics have long asserted that Guantánamo’s climate-controlled isolation is a breeding ground for madness. But turning that into a legal claim marks a new stage for the military commissions at Guantánamo. As military prosecutors push to get trials under way, they are being met with challenges not just to the charges, but to Guantánamo itself.

Pentagon officials say that Guantánamo holds dangerous men humanely and that there is no unusual quantity of mental illness there. Guantánamo, a military spokeswoman said, does not have solitary confinement, only “single-occupancy cells.”

In response to questions, Cmdr. Pauline A. Storum, the spokeswoman for Guantánamo, asserted that detainees were much healthier psychologically than the population in American prisons. Commander Storum said about 10 percent could be found mentally ill, compared, she said with data showing that more than half of inmates in American correctional institutions had mental health problems.

With their filings, Mr. Hamdan’s lawyers are setting the stage for similar challenges to the procedures of Guantánamo in some 80 expected war crimes cases, lawyers for other detainees say. “The issue of mistreatment of prisoners, the miserable lives they live in these cells, will come up in every case,” said Clive Stafford Smith, a lawyer for 35 detainees.

The case of Salim Hamdan is already a landmark because the Supreme Court used an earlier case against him to strike down the Bush administration’s first military commission system in 2006. But that case, like most of the legal battles over Guantánamo, did not affect conditions there.

Detainees lawyers argue that the effects of intense isolation have gradually turned the prison camp into something of a highly fortified mental ward. Mr. Hamdan’s lawyers say his place as one of the best-known detainees has not spared him.

In more than six years of detention, Mr. Hamdan has had two phone calls to his family and no visits. He has been disciplined, legal filings say, for having a Snickers bar that was given to him by his lawyers and for possessing too many socks.

“Conditions are asphalt, excrement and worse,” he wrote his lawyers in February. “Why, why, why?”

At Guantánamo, there are no family visits, no televisions and no radios. A new policy will for the first time permit one telephone call a year.

In the cells where Mr. Hamdan and more than 200 of Guantánamo’s 280 detainees are held, communication with other detainees is generally by shouting through the slit in the door used for the delivery of meals. Mail is late and often censored, lawyers say.

Conditions are more isolating than many death rows and maximum-security prisons in the United States, said Jules Lobel, a law professor at the University of Pittsburgh who is an expert on American prison conditions.

The military prosecutors declined to comment on the claims about Mr. Hamdan’s condition. As is common at Guantánamo, their legal filings were not made public before the scheduled court date. But defense filings released by Mr. Hamdan’s lawyers recited some prosecution arguments.

The prosecutors argued that the way that Mr. Hamdan was being held did not constitute solitary confinement in part because “detainees can communicate through the walls.” They said that Mr. Hamdan had denied having mental problems and that he was no model detainee, spitting at guards, threatening assault and throwing urine.

Speaking generally, Commander Storum said, detainees are enemy combatants held safely. “We are holding the right people,” she added, “in the right place, for the right reasons, and doing it the right way.”

Prosecutors have said Mr. Hamdan, now about 39, helped Mr. bin Laden elude capture after the 2001 terror attacks. He is charged with transporting weapons for Al Qaeda and being a bin Laden bodyguard and driver.

In recent weeks, his case has drawn wide notice because the defense asserted that senior Pentagon officials exerted improper influence over military prosecutors and pressed cases for political reasons. Hearings on that issue, also scheduled for next week, may expose the internal workings of the military commissions. The former chief Guantánamo prosecutor, Col. Morris D. Davis, who has become a critic of the way the war crimes system is run, is slated to testify for Mr. Hamdan.

But the claim about Mr. Hamdan’s mental health could expose the workings of Guantánamo. According to military statistics, three-quarters of the detainees have been held recently in two “camps” that look much like American prisons. Camp 5 and Camp 6, heavily guarded concrete buildings, hold men who have yet to face trial. Behind a heavy door, each cell has a handful of sanctioned items including a cup and a Koran.

Officials concede that the daily two hours of recreation in a chain-link pen is sometimes offered in the dark. From inside their cells, detainees cannot see the outdoors. From the exercise pens they sometimes can see only a sliver of sky.

Michael E. Mone Jr., a Boston lawyer, visited a client last month in Camp 5, where Mr. Hamdan is held. Mr. Mone said his client, an Uzbek detainee, asked why he could not be held in a place where he could see the sun.

This winter, lawyers for Abdulghappar Turkistani, a detainee in Camp 6, received a letter describing life there. “Losing any contact with anyone,” he wrote, “also being forbidden from the natural sunlight, natural air, being surrounded with a metal box all around is not suitable for a human being.”

Reporters are not permitted to interview detainees, and some international groups, like Amnesty International, have been denied access to detainees.

In leaked reports in 2004 investigators for the International Committee of the Red Cross, who do see detainees, said their treatment, including solitary confinement, amounted to torture. But the Red Cross usually keeps its conclusions private.

As a result, much of what is known about current conditions at Guantánamo comes from lawyers, who visit regularly under tight restrictions. Many describe the men as depressed or delusional. Some, they say, show obvious signs of what some of them call Guantánamo psychosis.

Four detainees are believed to have committed suicide in 2006 and 2007, but the military has never released the official details.

Some of the men are increasingly paranoid and some are losing touch with reality, said Rebecca P. Dick, a Washington lawyer who visited two Afghan detainees in March. “One client said, ‘I’m talking to the ceiling now,’ ” Ms. Dick recalled.

Six detainees, according to military officials, are now on hunger strikes. They are fed liquid nutrition through tubes inserted in their nostrils daily.

Mr. Stafford Smith said one of his clients, a hunger striker, was fixated on a mathematical formula that he believed proves that he will be the next to die.

Another detainee, Mr. Stafford Smith said, has smeared feces on his cell walls. “When I asked him why he was doing it, he told me he had no idea,” Mr. Stafford Smith said.

Last month a lawyer for nine detainees who are members of China’s Uighur ethnic minority told a Congressional committee that one of them, Huzaifa Parhat, said that life at Guantánamo was like having already died. The lawyer, P. Sabin Willett, said Mr. Parhat asked the lawyers to pass on a message. He told them to tell his wife to remarry.

Military officials often dismiss such descriptions as accounts by gullible lawyers manipulated by terrorists trained to make false claims of mistreatment.

Detainees’ lawyers say the military methodically understates the mental illness at Guantánamo for public relations reasons.

In military commission proceedings in recent weeks, there have been hints that some of the men facing charges may be deteriorating psychologically.

A military lawyer for a Sudanese detainee said her client appeared frantic and asked that he be evaluated.

When a judge asked a Saudi detainee the name of a lawyer, the detainee’s answer was: “I have been here for six years. Thank God I can even still remember the names of my own family.”

But Mr. Hamdan’s case is the first in the current system to try to air fully the claim that Guantánamo is warping the minds of the men held there.

Commander Mizer said Mr. Hamdan talked unendingly about his desire to moved to Camp 4, the only place at Guantánamo where detainees are permitted to live communally. Camp 4 is believed to house 50 or fewer detainees who officials classify as highly compliant. Mr. Hamdan blames his lawyers for failing to get him out of Camp 5, Commander Mizer said, and will talk only about that. “He refuses to talk about his case,” he said.

The trial is now set to begin on May 28. But twice in recent months, Commander Mizer said, Mr. Hamdan has said he was dismissing Commander Mizer from the case. “He said, ‘I don’t ever want to see you again,’ ” Commander Mizer said.

There is only one subject, he said, that Mr. Hamdan discusses: Getting out of his cell in Camp 5 at Guantánamo Bay.
Read more!

Facility for mentally ill is under fire -Tulsa (OK) World

by: SARA PLUMMER
4/27/2008

FAIRLAND -- Police Chief Woody Greenfeather estimates that more than half of the calls his department receives have something to do with a local residential care facility for mentally ill clients.

"If we wrote a report for every call we got, we'd need a new file cabinet," Greenfeather said.

Green Country Residential opened two years ago in a renovated motel that sits along the main road in Fairland. It recently was under investigation by the Oklahoma Department of Health after complaints surfaced about care at the center.

Dorya Huser, chief of long-term care with the Oklahoma Department of Health, said the center is not a 24-hour nursing facility and its 26 residents can come and go, although they do have assistance with medication and meal preparation.

The recent investigation found several deficiencies at the Ottawa County facility.

Green Country administrator Cindy Bedford referred all questions to her attorneys, David Jones and Mike Torrone with Logan & Lowry law firm in Grove.

Torrone would not comment.

Green Country Residential is owned by Bedford Enterprises LLC, and Cindy Bedford is listed as a stockholder and partner.

Day care across the street

Residents, police and business owners have raised concerns about the facility and its residents since it opened.

"Fairland used to be a place you could keep your door unlocked, your car unlocked. Not anymore," said Rachel Greer, an employee at Growing in Grace Day Care, just across the street from Green Country Residential.

Several incidents at the day care have involved Green Country residents, including residents coming in and demanding ?cqtrash, trying to get in the back door and following an employee.

The latest incident occurred March 13 when a resident jumped the fence into the playground area while children were outside.

"It scared the children tremendously. He jumped the fence like it was nothing," Greer said. "One parent said if it happened again, he was going to file child endangerment charges. Quite a few parents are upset."

Greer said one solution is similar to the day-care's procedures.

"We have activities and lesson plans to keep our kids entertained," she said, and perhaps Green Country needs an activities director to give residents something to do other than wander around town.

"That's all they do is roam," said day-care employee Kari Woods.

Police

The police chief said many of the people in Fairland who call in are worried, not just about their families, but the Green Country residents.

"It's not that they dislike them, but that they need better supervision," Greenfeather said.

Calls have included residents walking in the middle of the street, walking into people's yards, going through trash, attempting to get into vehicles and threatening suicide. Greenfeather said when he was an officer, he witnessed Bedford, the center's administrator, give a resident 15 minutes to evacuate the center. When the resident was escorted off the grounds and he came back to the center, Bedford reported the person was trespassing, he said.

Greenfeather said Bedford no longer does this, but arranges for the resident's transfer.

The whole situation puts a strain on his department, Greenfeather said.

In addition to responding to calls, the police department also is responsible for transporting Green Country residents when there is an incident, he said.

When the department receives an Emergency Detention Order, an officer has to take the resident to the hospital in Miami, Okla., then to a judge in Claremore to rule whether the resident needs further evaluation. If the judge rules for further evaluation, the officer takes the resident to Wagoner, then the officer returns to Fairland.

The whole trip can take four to eight hours, Greenfeather said, and Fairland has a three-person department with two full-time officers, a part-time officer and a reserve officer.

"If we have to take one, we can leave the town uncovered for four hours," he said.

Documents

Responding to complaints about resident care, the state Department of Health started an investigation on April 2, and it concluded Thursday.

In the report, the Health Department cites several deficiencies including failing to provide supervision for residents diagnosed with mental illness, failing to administer mood-stabilizing medications ordered by doctors and failing to protect residents from harm and unreasonable risk of harm.

On Feb. 14, a resident walked away from Green Country and was walking along the side of the road when he was hit by a truck and killed. The same resident was missing from the facility seven times in 37 days.

Green Country failed to report all of the resident's disappearances to the Health Department. The center also did not report to the Health Department when a resident jumped into a day-care's play area and when residents were involved in verbal and physical assaults with each other.

One of the center's rules is if a resident wishes to leave the facility, the resident must notify the staff on duty. In the report, a clipboard was found outside the laundry room that residents were supposed to sign, date and explain where they were going, what time they left and when they would be back.

The report also cites the center's daily journal records that document incidents of resident altercations, residents going through trash cans at local businesses and knocking on nearby Fairland residents' doors asking for cigarettes.

Another deficiency listed on the investigation report is that the center did not comply with a 10-day notice when a resident is involuntarily transferred or discharged and did not include explanations for the transfers or discharges.

Green Country has 30 days to submit a plan of correction for the deficiencies.

According to a letter addressed to Bedford, investigators are recommending a fine of up to $10,000. Read more!

Critics slam treatment as jails deal with mentally ill - Daytona Beach News Journal

By DEBORAH CIRCELLI
Staff Writer

Gas masks over their faces and clad in armor, four correctional officers storm Ciara-Paige Green's cell, then push the naked young woman onto her bunk.

In the video, Green gags from a chemical agent sprayed in her cell and repeatedly yells to the male and female officers, "I can't breathe," as one officer holds her head and others appear to pin her on the bed for a few minutes.

The New Smyrna Beach woman was 19 and at the Volusia County Branch Jail on charges of striking police and corrections officers when the video was recorded last year. She has several mental illnesses and has struggled with cocaine addiction.

Wearing only handcuffs and leg irons, Green, in the video, is lifted off the bed by two female officers, then walked out of her cell. Another officer, aiming a handheld video camera, records the cell "extraction" while a supervisor looks on. Seconds later, Green is pushed against the wall for pulling away, according to jail reports. As the camera keeps rolling, the officers struggle to get Green, still fighting, up stairs. She's then strapped into a restraint chair and a bed sheet placed over her.

This example from October is one of nearly three straight days where officers held video cameras to record Green naked on and off for more than two hours in what inmates and attorneys call the "buck naked cell," for people on suicide watch. She was put in mental health lockdown or disciplinary confinement all but three days of her more than six-month jail stay and put in restraint chairs for hours at a time for threatening to harm herself and assault staff, officials say.

Her attorney and family say if the jail's psychiatrist had prescribed proper medications for her mental problems, she wouldn't have been a danger. Her appointed lawyer says some of the methods used on Green were malicious, unnecessary and meant to degrade.

"That's not a way to treat an animal much less a human being," said her attorney, Assistant Public Defender Jay Crocker.

Her case, according to the Public Defender's Office, is not isolated and a prime example of the need for change in how inmates with mental illnesses are treated in the county jail. Other groups statewide want more services to divert people with mental illnesses from jails.

Public Defender James Purdy and a local faith-based group are calling for the Volusia County Council not to renew its contract in October with a private health care company unless safeguards are in place for inmates to receive medication.

Local officials are also seeking more community services.

"There certainly are a lot of inmates in the Branch Jail that we would agree would be better off in other circumstances," said Volusia County spokesman Dave Byron. "We are sort of the repository."

FAMILIES WAIT FOR CHANGE

Meanwhile, family members like Green's mother, Debi Green, 52, watch loved ones revolve in and out of jail, crisis units and hospitals -- many for charges such as resisting arrest, battery on an officer or lesser crimes.

Green, now 20, sits in a state mental hospital in Chattahoochee after being sent in February from the jail to a local crisis unit.

She was found incompetent to stand trial for possession of drug paraphernalia, resisting arrest with violence and a probation violation for battery on a correctional officer.

"God, the cruelty," Debi Green cried recently in her New Smyrna Beach kitchen, with her hand against her heart, as she watched the October video of her daughter. "They've stripped her of her dignity."

About 1 a.m., after being video recorded naked in her cell over almost three days, Green rips her mattress with her teeth. Out of the material from the mattress cover, she makes a skirt and a top to cover her breasts. She is then placed in a restraint chair for fear of hurting herself with the material.

Court reports from psychiatrists show Green's mental illnesses, which include post traumatic stress from abuse, bipolar, schizo-affective and borderline personality disorders cause impaired judgment, erratic behavior and poorly controlled anger.

MAKING THINGS WORSE?

Her attorney says the way she was treated in jail only aggravated her condition.

"They were doing things to tweak her and try to set her off," said Crocker, who is a board member for the Mental Health Association of Volusia County. "You don't have to invade somebody's privacy especially when they are naked. It's pretty outrageous."

County officials said Green was given the standard paper gown and blanket, but damaged or refused to use them.

Green wrote in letters to her mom that the jail wouldn't give her a paper gown. One video confirms that officers did not give her a paper gown after making her remove her jail-issue orange pants and shirt.

She asked for a blanket and was shown naked. They replied they would return with one.

Corrections officers also testified that Green's problems were behavioral, not mental. They said she'd kick and cuss at officers, pull hair and threaten to kill them and their families. She was in jail for battery on a law enforcement officer and a new charge of battery on a corrections officer.

Her mom was not allowed to visit throughout her more than 180-day stay. Jail documents stated if Green improved her behavior, she could have recreation and visitation. But that never happened.

COUNTY'S SIDE

"This was a very troublesome inmate. This woman was a handful," Byron said.

He spoke for the county-run jail system after the jail's director, Marilyn Chandler Ford, would only respond in writing for this story, and after her responses were reviewed by Byron. "Whether she was a danger because of her mental illness or whatever factor," Byron said, "it doesn't change the fact that this was a dangerous person. It's not the Mayo Clinic out there. We have a fiduciary responsibility to the taxpayers to balance humane care and cost of care."

County officials also said Ciara-Paige Green wouldn't take medicine prescribed.

The inmate, in written complaints and in court, said she wasn't getting psychotropic medication that stabilized her prior to going to jail and the jail psychiatrist kept switching her medications.

Dr. Stephen Young, forensic psychiatrist for the 7th Judicial Circuit, who found Green incompetent to stand trial in March, defended jail psychiatrist Dr. David Hager, saying he cares about inmates. He said Green was a "complicated case" and had a large volume of medical records.

USE OF RESTRAINTS

Dr. Henry C. Weinstein, a psychiatrist and chairman of the American Psychiatric Association's Committee on the Mentally Ill in the Criminal Justice System, calls practices such as restraint chairs "primitive." He says solitary cells and isolation only worsen an inmate's mental condition.

Byron said the restraint chair is used frequently for dangerous inmates. Video cameras are used when inmates have to be forced from their cells. But in Green's case, Ford said the videos also were to document her behavior so mental health staff could conduct a thorough evaluation. But they also said some of the video recording of Green naked went on "longer than preferred."

"Our point of view is this was handled in a professional manner," Byron said. "Was it a pleasant occurrence? No. Was it the way you would hope these situations work out? No. Is it common for people to be video taped naked? No."

Ford also said in written responses, "Inmate Green was not injured during her incarceration -- but our officers were," including an officer who jail officials said had some of her hair pulled out.

"The general public, including the Public Defender's Office, cannot even imagine what the correctional officer has to handle," Ford said.

DOZENS COMPLAIN

Public Defender James Purdy and several other attorneys report dozens of local cases of inmates being kept naked and not given psychotropic medications. Green is one of 84 inmates defense attorneys documented during a two-year period ending in October who complained the jail took them off the psychotropic medications they were on before incarceration, which Purdy said interferes with their defense. More complaints are coming in, and the American Civil Liberties Union also is collecting information.

"My concern is there are other ways to deal with people who are suicidal besides putting then in a cell nude and leaving them there," Purdy said.

The jail health provider, Prison Health Services, also has faced criticism locally and nationally in lawsuits regarding inmates not receiving psychotropic medication. The county is also being sued. Hager would not comment and is resigning at the end of May to seek a job out of state. But company officials said inmates who need them receive psychotropic medications.

"We are taking care of the mentally ill," said Rita Jorgensen, who oversees mental health services at the county jail for Prison Health. The company is open, officials said, to subcontracting out the mental health portion of the contract with Act Corp. County officials, meanwhile, say Prison Health Services is doing an "excellent" job and saving the county money.

Circuit Judge Joseph Will, who handled Ciara-Paige Green's case, said the numerous reports he's heard from inmates about the suicide cell are "horrible," and "alarming," including being strapped for extended periods of time in a bed without clothing.

"Are the reports true? I don't know," Will said. "I know if it happened to me or one of my children, I'd be very angry -- so it causes me great concern," he said.

Act's crisis unit uses two cloth hospital gowns for people on high-risk watch, and they are allowed to wear their underwear. Cameras are mounted discretely in ceiling corners. In state prisons, wrap-around garments for suicidal inmates are being phased out in favor of an over-the-head smock made of tear resistant fabric, not paper.

County Chairman Frank Bruno said he plans to look into Green's case and others that are brought to him.

"We have got to treat people with all due humanity," he said.

TOO LITTLE TOO LATE?

For Ciara-Paige Green, her mom fears, it may be too late because experts say with each mental breakdown there is more brain damage.

Debi Green has been fighting for several years to get her daughter into substance abuse and mental health treatment since a judge ordered her daughter into a program in 2004, but bed space was never available.

"She needs mental health help, not punishment," her mother said. "I've been fighting for a long time and it hasn't done any good. All I can do now is hope my fighting helps somebody else."

When Ciara-Paige Green finally got sent to a substance abuse treatment program this past January, she walked out after just two days. When police caught her three days later, she was charged with possession of drug paraphernalia, resisting arrest with violence and a probation violation and sent back to jail.

Court and jail documents said she was "extremely regressed" back at the jail, refusing to eat or drink and threatening suicide. Her attorney was able to get her transferred out of the jail at the end of February to Act Corp.'s crisis unit and March 20 to Florida State Hospital.

Her mom wishes the jail had sent her daughter to the crisis unit or hospital earlier.

Ciara-Paige Green has a history in and out of juvenile detention centers and a troubled childhood, including a turbulent custody battle between her parents and abuse as a child and adult, records show. She even had altercations with her mother.

In a Daytona Beach News-Journal interview with Ciara-Paige Green two years ago, when she was at home stable for three months on medication, she said she wished she could "be normal" and not take medicine. She hoped to go to college, but was having problems concentrating to take the placement exam.

She later stopped taking her medicine and ended up in jail last July for twice elbowing an officer, police said, while trying to flee Halifax Health Medical Center. She was taken there by police to be examined for excessive use of cocaine.

WHAT'S NEXT FOR CIARA?

Green is at Florida State Hospital until doctors and a judge say she's competent to stand trial. She likely will then be sent back to jail to face criminal charges. But her mom and attorney fear the cycle will start over again and she won't receive the same medications.

Crocker said Green could face 11 years in prison for various charges that he said are "attributable directly to her mental illnesses."

Last weekend, Debi Green drove to the state hospital for Parents Day. Ciara-Paige Green is back on medication she took prior to her jail stay, her mom said. During the visit, at times she was delusional, talking about people who don't exist, Debi Green said. But at other times she was in good spirits, visiting with other clients and their families. It was a big change, her mom said, from her daughter talking in the third person and not making sense more than a month ago.

She said she's still holding out hope for her daughter to lead some semblance of a normal life.

Ciara-Paige Green wrote in a Jan. 6, 2008, letter to her mom while in jail that she's optimistic.

"I am in need of God's help and I'm tired of being locked away," she wrote. "I've spent most of my life in lock up -- so many family days I missed, years never to be able to be celebrated again, but like you wrote me a while back. There is light ahead."

-- Staff Writer Jay Stapleton contributed to this report. Read more!

Getting HELP: Special court designed to helpmentally ill - Gainesville (GA) Times

By Stephen Gurr
sgurr@gainesvilletimes.com

It took an armed standoff with police to finally get Ron the help he needed for his depression.

Suicidal and waving a loaded .357 Magnum in a public place, the bankrupt 46-year-old was certain he would be shot by officers.

"I had lost my faith," he said, after losing his home and watching his marriage slide toward failure. "I saw everything disintegrating around me."

Police did not shoot Ron, though he says he "fully expected" to be shot. They talked him into putting the gun down, handcuffed him, and took him to a mental health facility, where he spent six days. Afterward, his thoughts still fixated on suicide, Ron was booked into the Hall County jail on a pair of misdemeanor weapons charges. It was there that he was given the option of applying for entry into Hall County HELP Court, a treatment court for people whose criminal acts are rooted in mental illness.

Nearly a year after entering HELP (an acronym for Health, Empowerment, Linkage and Possibilities), after attending court-ordered counseling, taking two anti-depressant medications daily and being monitored by a case manager who made home visits, Ron stood proudly in the well of a courtroom on the fourth floor of the Hall County courthouse, where Superior Court Judge Kathlene Gosselin presented him with a graduation certificate.

"He came in with major depression and had us all worried," Gosselin told the courtroom, where more than 30 active HELP court participants looked on. "He has worked really hard with lots and lots of problems. He's kept on track the whole time."

Ron's wife, standing by his side at the ceremony, managed to say through tears of joy, "he's a lot better, and I'm very thankful."

Said Ron, "The Lord puts people in our lives to help us get through these things. We are all in this program because we made some poor choices. If we stay on track, we can make correct choices."


"Everyone ... has a lot to deal with"

Hall County HELP Court started in December 2004 as one of four accountability courts in the local judicial system, with the focus on people suffering from mental illnesses.

Many of its participants are referred to the court by detention officers or medical workers at the Hall County jail, followed by a clinical interview conducted by a psychologist to determine a diagnosis.
Those diagnosis have ranged from depression to bipolar disorder, schizophrenia and post-traumatic stress disorder.

Prosecutors work with defense attorneys to decide which candidates are right for the program. Offenders who have committed serious violent felonies such as sexual assaults, armed robberies or attacks on police officers are denied entry. More often the charges involve disorderly conduct, domestic violence, drugs, shoplifting, DUIs and other misdemeanors.

Like Hall County's drug court, some HELP participants may have their charges dismissed with successful completion of the program, though not all will. Some may see reduced jail sentences. There are no guarantees, though there is the hope of a healthier, more productive life.

Some will come out of the program with vastly different lifestyles, new jobs and new outlooks on life. In other cases, graduates may never be able to hold down a job or even acknowledge their mental illnesses, but just convincing them to take their medication regularly will be regarded as a success.

Like other accountibility courts, the prosecutors, defense attorneys, case managers, treatment providers and judge work as a team in reviewing each case in weekly meetings, determining who has made progress and who has taken a step backward.

In addition to getting treatment and medication through AVITA Community Partners, the local state-affiliated mental health treatment provider, participants must get jobs, if they are able, secure steady living arrangements, and are encouraged to earn General Equivalency Diplomas. Finding meaningful, worthwhile jobs and housing for participants is a huge challenge for people who "live on the margins financially," Gosselin notes.

Like other accountibility courts, the judge can impose sanctions if certain requirements aren't met.
During one recent court session, a woman who missed a doctor's appointment and a group therapy session had to face the judge. "I have to believe you're not taking this seriously," Gosselin said.

The woman broke into tears, telling the judge, "I'm human. There's a lot on my plate I have to deal with by myself."

"Everyone in the courtroom has a lot to deal with," Gosselin responded. "And while you were in (jail) work-release, you were managing OK."

The judge gave the woman 24 hours in jail. Some get community service, or more time in court. Others have spent days or weeks in jail for not fulfilling their obligations to the court.

Many never will. The graduation rate for HELP court is under 50 percent. Court officials say most drop out or are terminated from the program not because of mental health issues, but because of drug addictions.

More than half the participants are "co-occurring," meaning they struggle daily with drug and mental health problems.

Gosselin hopes HELP's graduation rate will improve after the court recently put co-occurring participants on one treatment track and those with mental health issues only on another.

"I think a lot of people we've lost just couldn't get a handle on their drug problems," she said.


"Not just a job"

Some who come before the judge can hardly hold their heads up or speak during their first day in HELP Court, known as enrollment.

During a recent enrollment session, a young woman was led into court wearing the customary jail attire of jumpsuit, leg chains and shower shoes, took a seat at the defense table and answered the judge's questions tearfully. "We all know you can do this," Gosselin told her.

Later the judge recalled another young woman, this one just 17, who came to the program after a drug arrest, suffering from a severe mood disorder and habitually cutting herself. "You had to almost force her to talk to you the first few months in the program," Gosselin said.

Now, the same young woman is held up as one of the court's successes. Her words of hope are quoted on the back of the HELP graduation program: "I used to hate thinking about the future because I thought that I had nothing to look forward to, but now I know that I have a lot to look forward to," she wrote. "I can be successful in life. I am so glad I have changed. I love the new me."

Ron can remember the turning point for him, while in counseling at AVITA, when he reflected on all the problems he and his wife had endured. "I looked at my depression and realized that no matter what was happening in our lives, we were basically OK," he said. "The structure and support of the HELP system was important as far as keeping me on that track."

Ron has high praise for Gosselin. "Her patience, to me, is just astounding," he said. "She realizes that people are struggling with medical changes and when you're in this state of mind, you're not always the most happy, friendly person."

He also praised his court case workers, who made home visits or checked in by phone to get a feel for how his life was going. "The people in this program really care about the people who are in it," Ron said. "My sense is that this is not just a job for these people, it's a calling."

Rachel Ayers, the clinical case manager for HELP Court, believes it offers community-wide benefits.
"It's so much greater than the one client," Ayers said. "When they get healthier, their family is healthier, their workplace is healthier. It's so far-reaching, the effect that mental fitness can have as opposed to mental illness."

Gosselin said she could point to the statistics that show diverting these offenders from jail saves taxpayer dollars. But in the end, she said, "it's the right thing to do for somebody who's sick.

"All over the country, jails and prisons are dealing with the mentally ill, because we are not dealing with them in other ways," she said. "If it is indeed your mental illness that's causing you to enter the criminal justice system, keeping you in and out of jail instead of getting the treatment you need ... then we should be providing that." Read more!

Volunteer helps kin of the mentally ill -San Francisco Chronicle

Shelah Moody, Chronicle Staff Writer

For 24 years, Luisa Perez, 79, has helped Spanish-speaking families of mentally ill people as a volunteer with the National Alliance on Mental Illness of Santa Clara County. The alliance offers support, education and practical advice, including treatment options, to anyone concerned about mental illness, primarily schizophrenia, bipolar disorder, clinical depression and obsessive compulsive disorder.

Perez herself was referred to the alliance for help when two of her six children were diagnosed with schizophrenia in the '80s."I had never heard about what schizophrenia was about; it was just some weird word," said Perez, who grew up in San Jose. "When Connie started behaving badly and doing a lot of weird things, I couldn't figure out what was the matter with her. I thought maybe she was on drugs. She was a good student in school, and then her grades started failing."

Perez began attending support groups at NAMI Santa Clara, where she met other people in her situation. She began learning as much as she could about schizophrenia, and attended state conferences on mental illness.

"I noticed that there weren't any Spanish-speaking people, people who looked like myself," said Perez. "I thought, 'This information should be getting into the Spanish-speaking community.' "

For 15 years starting in 1984, she organized and taught more than a dozen De Familia a Familia (Family to Family) classes, providing the families with up-to-date medical information and advice about how to assist and advocate for their ill relatives. From 2003 to 2008, Perez served as vice president of NAMI Santa Clara's Latino Outreach program. She has also spoken at NAMI conferences about her work.

Although she had no formal education beyond high school, Perez can explain complex concepts and medical and psychological terms for her clients.

"We're in there to help people come forward and gain some of the resources that are available," said Perez.

Perez's daughter Connie, 42, is in a locked mental health facility in Fremont, where she ended up after she was arrested for assaulting her mother. Perez's son Mark, who also had schizophrenia, died in undetermined circumstances in February. He was 37. Perez's goal is to help Connie, who once had a job and her own apartment, overcome the disease so that she can begin living independently again.

Perez works with NAMI from her Campbell home, providing telephone and one-on-one peer support. She said some of her Spanish speaking clients feel more comfortable speaking with her at her home than in the offices of the alliance.

"People trust me, and they feel that I can help them protect their families," said Perez. "I have a little office here at my house, and I have all this information. I know that a lot of these mothers - all they want to do is just talk. I also have a hot line, (408) 378-6988, here at my house where I answer questions or just talk on a friendly basis to people who call in."

Last year, Perez received the Junior League Award from Santa Clara County for her outstanding volunteer work. In 2006, she was honored at the 12th Annual Behavioral Institute Conference in Universal City (Los Angeles County).

On June 16, Perez will travel to Orlando, Fla., where she will be presented with the NAMI Multicultural Award for 2008. This year she also organized an all-day seminar in Spanish at the NAMI California Conference in Burlingame, where activist Dolores Huerta of the United Farm Workers was one of the guest speakers.

Perez has found a high incidence of mental health problems among immigrants from Mexico and other Latin countries.

"I think there is depression among many ethnic groups, especially now, when a lot of people are losing their homes and their jobs," said Perez. "People are overextending themselves, and there are higher expectations. People feel that this is a country where you can fulfill your dreams, and right now, it's a lot more difficult to achieve. People come in and they are working in the fields and in the restaurants where they pay the lowest wages. Rents are so high and everyone wants a car. People need two incomes to pay a $1,500 rent.

"It's pretty sad for people who come to the U.S. from foreign countries and are faced with all of these obstacles that are a lot bigger than what the established person here in this country can understand. I think that causes a lot of depression."

For information on the National Alliance on Mental Illness of Santa Clara County, go to www.namisantaclara.org.

Each week, The Chronicle features a Bay Area resident who has won a Jefferson Award for making a difference in his or her community. The awards are administered by the American Institute for Public Service, a national foundation that honors community service. Bay Area residents profiled in The Chronicle are also featured on CBS 5-TV and KCBS-AM, which are Jefferson Award media partners, along with The Chronicle.

E-mail Shelah Moody at smoody@sfchronicle.com. Read more!

Explaining bipolar disorder -Austin American Statesman

By Eric Dexheimer
Sunday, April 27, 2008

With his mood disorder diagnoses, Billy represents a growing issue for the Texas Youth Commission. Ten years ago, a quarter of the youth sent to the agency were identified as having a mental illness. Today, it is closer to half.

One reason, advocates say, is that communities often are ill-prepared to meet the needs of delinquent teenagers who also struggle with mental illness. The Texas Juvenile Probation Commission estimates that about 60 percent of Texas youth who need mental health help don't get it.

Critics say finding psychiatric help for clients without insurance, in particular, can be an uphill battle. Billy is such a client.

Indeed, because of shortages of treatment opportunities, mentally ill children have landed in lockup without even committing crimes. A 2003 U.S. General Accounting Office study estimated that in 2001, 9,000 youth with psychiatric diagnoses were funneled into the juvenile justice system simply because there was nowhere else for them to go.

Many, however, are sentenced for criminal or disruptive behavior related to their illness. Successful treatment is elusive. Three-quarters of juveniles with a mental illness diagnosis will be re-arrested within three years of being released from the Youth Commission.

Billy's condition is a particular concern. The number of young people treated for bipolar disorder increased 40-fold in the United States between 1994 and 2003, according to a September 2007 report.

The reasons for the dramatic increase are unclear. Yet juvenile justice experts say they consider bipolar disorder, along with depression and schizophrenia, one of their biggest current challenges.

Bipolar disorder, which is characterized by dramatic mood swings, depression and impulsive behavior, can be treated with drugs. But because there is no single therapy, it requires diligence and persistence as dosages and drug combinations are tweaked. Children with unstable lives can struggle with the regimen.

And, experts say, if patients fail to stay on top of their treatment, those very qualities can evaporate, causing a downward spiral.

edexheimer@statesman.com; 445-1774 Read more!

Survey answers on NC mental healthquestions - The Associated Press

By The Associated Press

Here are three questions posed by The Associated Press to the eight major-party candidates for governor on the topic of mental health, followed by their unabridged responses. The responses were edited for AP style:

1. In 2001, lawmakers began to overhaul the state's mental health treatment system by shifting more patients from institutional care to community-based treatment by private doctors and services. The reforms have stalled and are widely regarded by critics and advocates of the mentally ill as a failure. As governor, what will you do in your first two years in office to improve the state's mental health care system?

2. Do you support a law - as proposed by a campus safety task force led by Attorney General Roy Cooper - to bar handgun sales to people who have been involuntarily committed to mental hospitals?

DEMOCRATS

RICHARD MOORE

When reading The News & Observer's series on mental health I was struck by Professor Joseph Morrissey's summary of the problem: "Solving these systemic problems will require the capacity to analyze proposed solutions, check out their costs and benefits in advance, monitor policy and program implementation, and assess outcomes on an ongoing basis. No multibillion-dollar enterprise in corporate America operates without this type of intelligence function."

As the only candidate for governor that has run two state agencies, I am very familiar with the challenges of operating vast bureaucracies with silo-funding streams and have experience in breaking down those barriers to change and improvement. I will bring a decade of public managerial experience to bear on our mental health system.

First, I will finish any of the outstanding initiatives Secretary Benton began, but remain incomplete, in order to ensure a smooth transition. This includes gaining approval from Centers for Medicaid and Medicare Services to end the blended payment rates. My budget will include funding for an internal inspection team to ensure we do not forfeit millions in Medicaid/Medicare payments because our hospitals are not in compliance with federal rules. And I will ensure we are filling key positions related to our mental health system with the most highly qualified individuals by offering sufficient salaries to attract them.

Concurrently, I will begin my own improvements starting in our institutions. I will develop an interagency team that will be dispatched immediately to investigate all deaths that occur in our mental hospitals. The team will include investigative personnel from the Department of Crime Control and Public Safety and will be required to file timely reports with the hospital, the DHHS Secretary, the medical examiner/pathologists, and the family. It will also be forwarded to the district attorney if there is any suspicion of wrong doing by anyone in the facility.

Second, to increase the quality of care our patients are receiving in state hospitals, we will seek to institute a career ladder of sorts for the medical and patient technicians working directly with patients in our hospitals. To advance on the ladder and earn a higher salary, the staff will achieve more advanced levels of certification. We will ask the community colleges, universities, and medical hospitals to design continuing education courses that will be offered during the work day. Much like we have done in our schools and in child care, we will raise the wages of our employees by raising the quality of care they provide.

Because more than 20 percent of the patients admitted to our mental hospitals last year were dependent on alcohol or drugs and because our psychiatric hospitals admitted more drug addicts than schizophrenics last year, I will commit more resources to substance abuse treatment programs.

As governor I will seek to further our knowledge base on mental health issues and develop improvements by working with our research institutions to convene regular task forces of experts to study these complex mental health issues and develop workable solutions on an ongoing basis. Currently, Secretary Benton has a number of working groups meeting regularly to develop solutions, but I want to institutionalize the dialogue and grow the state's knowledge base on mental health issues.

From those groups we will 1) seek to create meaningful, clear objective criteria for the local management entities, 2) design effective clinical and fiscal competencies with incentives for those exceeding the criteria and penalties for those who fail, 3) develop standard protocols for mental health care to ensure consistency of treatment between providers, 4) develop a system of statewide case management through health care community networks, or a "medical home" system and 5) develop a funding mechanism to ensure our low wealth counties have the resources they need to attract high quality providers so all patients can have access to high quality care.

2. Yes.

---

DENNIS NIELSEN

1. We must first define the exact problem and then work towards real solutions. Hoping will not work we need real definitions of problems and then together set real goals and milestones to implement the fixes. This is a complex issue and one that requires strong leadership to define and fix. We also need to separate those that need help; citizens with mental illnesses, disabilities and those with substance abuse need different programs, we must do away with a one size fits all approach.

2. Handgun sales: I don't like a law that is so broad so I would have to see the actual legislation to see if I would or would not support it.

---

BEVERLY PERDUE

We need to get serious about the goal of quality health care for all North Carolinians - and that must include mental health care.

My background in health care tells me that it makes no sense to separate mental from physical health care. The best research confirms that many patients have mixed mental and physical health issues. Thus I am proud that my plans for expanding health care coverage to all children and more low-wage working parents have been praised by such leading advocates as Adam Searing of the North Carolina Health Access Coalition for containing "the most significant changes in health care access in North Carolina in, quite literally, decades." To read more, go to http://bevperdue.com/healthcare.

As North Carolina's next governor, I also want to establish the national model for an integrated approach to behavioral and primary health services for patients with mental health, development disability, and substance abuse problems. It will be one of my top goals to break down the barriers to the coordination of mental and physical health care.

North Carolina's Medicaid program has recently moved to the forefront in emphasizing the importance of a "medical home" for the primary care of adults and children. Our Community Care of North Carolina has developed a very cost-effective and quality-driven model of statewide case management through health care community networks. We need to extend this kind of collaboration and community network to the delivery of mental health services.

In my view, the concept of a medical home should play a major role in helping to revitalize our badly tattered mental health system within and outside of Medicaid. Patients with severe mental illness need the security of a medical home as well as strong inpatient professional service. We should also strive to define a basic level of mental health services to which needy patients should have access.

Recent events have made us all too painfully aware of what can happen to those who fall through the gaping holes in our mental health care system. While in the long-term my focus is on closing those holes, it would be irresponsible not to take what steps we can in the short-term to avert tragedy. The Campus Safety Task Force led by Attorney General Cooper has proposed a law to bar handgun sales to people involuntarily committed to mental hospitals. We should take such a sensible step in the interests of the safety of our students and of our communities.

I know that improving our mental health system is easier said than done. Yet we cannot stop until we have a system where the local and state levels work in a coordinated fashion to assure access to appropriate services for all North Carolinians. We will need to adopt a disciplined approach with lots of two-way learning between government officials and the mental health community.

That will require sound leadership and coordination throughout state government. We need stability, a shared vision, and a focus on quality outcomes for all those who depend on our mental health, developmental disability, and substance abuse services. I will be the kind of dedicated, hands-on governor who can provide this needed leadership on health care generally and mental health in particular.

---

REPUBLICANS

BILL GRAHAM

1. The first step I will take is to bring all interested parties involved to the table to discuss the failure of our current system as well as any successes. We have some of our nation's premier experts on mental health in our state, yet we have failed to use them. Our mental health professionals understand what needs to be done, we need a governor who will listen to them. I would immediately increase funding for our mental hospitals and for other programs that offer treatment to those who are considered high risk or critical.

After the initial steps, I will work with our mental health professionals and experts to devise a plan that will meet the needs of our mentally ill citizens. We will begin with pilot programs so that we can quickly identify any problems. Once I am satisfied that we have a workable system that will fully meet our needs, I will then launch the new mental health system statewide.

2. Yes.

---

PAT MCCRORY

1. It is no secret that North Carolina has people who suffer some form of mental illness and need state help. It is also no secret that the last eight years have seen escalating waste, fraud, institutional ineptitude, bureaucratic bungling, and now, finger pointing as to who is to blame for this sorry state of affairs. Responsibility for mental health care falls under the broad mandate of the governor and his secretary of Health and Human Services. Now the governor is trying to "pass the buck" to the Legislature, which approved privatizing many mental health care services without, apparently, having appropriate service levels defined and without having clear guidelines of responsibility and supervision in place. Such lapses could explain other puzzling proposals as the one recently where HHS planned to close two mental health hospitals without having enough beds in place to replace them.

Parceling out treatments to private sector facilities located closer to the patients themselves makes sense. The existing plan needs considerable redrafting in terms of quality, costs, patient care, oversight, and state follow up but can be salvaged. The new governor first needs to take responsibility for fixing the problem and actually begin fixing it ... putting policies and procedures in place to make sure the patients who are depending on the state for help get the help they need. Those actions will be my starting point for mental health reform. The governor's office is responsible and accountable for mental health in North Carolina. If the legislature is making that job harder, the governor needs to let us know and then he needs to step up to the plate and do his job.

2. Yes.

---

BOB ORR

1. We must have leadership, the right concept of care, the appropriate resources, and a rigorous oversight process. Administration officials have admitted that they have been aware of the problems in mental health, yet have taken no action to fix them. The next governor must be ready to take on the challenge of addressing our broken mental health care system from the first day in office. Among the reforms needed, we must determine where privatization is a viable business model, implement a fair and efficient reimbursement process that pays for actual care, fully fund the Mental Health Trust Fund, and ensure that the state has a secure, long term supply of mental health care providers. Please visit my web site at http://www.Orr2008.com for my full proposal.

2. Yes.

---

ELBIE POWERS

1. Apparently, lawmakers may not have the best answers or solutions. I will replace some agency directors with knowledgeable and efficient people in their proper fields, removing ones placed by favoritism or the buddy-buddy system. Who are these inefficient agency directors? To find out, I go down the ladder in each department to the working people. The following statement from an individual who is a worker within the mental health system. "The state passed the buck to private providers. Now the private providers are collecting money for services that they are not necessarily providing. Also, they appear as they don't care about the individual. All they are worried about is collecting the money. The dollar has become what's important. Also there are approximately 800 private providers now that are fighting to offer services. Another issue that concerns me is that we have had individuals that have worked on their own for years, now all of a sudden they need a one on one worker. What this means is the facility draws down huge dollars for this individual to have a baby sitter for several hours a day."

2. Definitely, yes on this question unless a unique situation reveals it to show otherwise.

---

FRED SMITH

1. It is important that we move forward with reform that creates a structure of clarity, certainty, and confidence, providing appropriate leadership and a plan that more clearly identifies the roles and responsibilities of the State, the Local Management Entities (LME's), and the care providers. To accomplish this we must:

- place clear responsibility on the state for providing care for the long-term and more difficult chronic cases of mental illness and disabilities that cannot be appropriately served in the community and require the expertise and services provided through our state psychiatric hospitals and facilities for the developmentally disabled.

- develop the community capacity for short-term acute psychiatric care by working with our LME's, community hospitals, and other providers to establish and reinforce our abilities to serve consumers in crisis, providing a hub around which to build community services while reducing dependency on the State's psychiatric hospitals.

- develop the community capacity to provide individuals with mental illness, developmental disabilities, and substance abuse with appropriate ongoing assistance and services necessary to provide the greatest opportunity to live a productive and quality life.

Building a strong system of community based mental health services is not going to happen as a result of increased and constantly changing state rules and regulations coupled with poorly developed and sometimes inadequate provider reimbursement policies. Building community access and choice is going to require leadership focused on understanding the needs and identifying and addressing the barriers to success. This requires a willingness and devotion to working closely with our community hospitals and other care providers, the LME's and local governments, consumers, families, and advocates to find solutions.

2. Yes.

END

Read more!

Teen's death still under investigation -Greely (CO) Tribune

Mike Peters
mpeters@greeleytribune.com
April 24, 2008

The case of a teenager who was picked up on a mental hold and died at North Colorado Medical Center earlier this month is still under investigation by the Weld County Coroner's office.

The cause of Ian Wittner's death hasn't been determined yet, and Chief Deputy Coroner Tom Shimp said his is awaiting toxicology reports to see if medications contributed to his death. Wittner was 18 and listed as a resident of Commerce City.

According to Greeley police reports, Wittner was contacted in the parking lot of JBS Swift packing plant about 6 p.m. on April 4. He had recently been fired from his job at the plant and a security guard said he was in the lot next to his van, shouting threats that he was going to blow up or burn the plant.

"He was talking of gas and chemicals and guns," said Greeley police spokesman Sgt. Joe Tymkowych.

Police reports state the officers contacted Wittner and said he had a rambling conversation and made threats against the packing plant, and tried to walk away from the officers.

Police took him into custody and took him to the Emergency Room of NCMC, where they left him on an "M-1" hold, meaning he could be a threat to himself or others.

Although hospital officials said they can't discuss what happened because of national privacy regulations, Wittner died April 9 in the Intensive Care Unit of the hospital.

NCMC spokesman Gene Haffner said he couldn't discuss anything further on the case, and officials there also await autopsy results.

Wittner's organs were removed for organ donations, and his body was cremated in his home town of Commerce City. Aspen Mortuaries handled the services.

Wittner's mother has not been available for comment, and his father was recently arrested in Greeley for parole violation and is currently being held at the state prison unit in Colorado Springs.
Read more!

Fixing our criminal sentencing system -Boston Globe

Commentary: By David W. White Jr.
April 26, 2008

A NUMBER of news stories this spring have shown us that the criminal sentencing system is out of line - both in Massachusetts and in the nation as a whole. The United States has not just the highest rate of incarceration in the world, but also one-fourth of all of the prisoners in the world.

What has led us to this? And what is it about our priorities that has us spending more on incarceration than higher education?

In Massachusetts, we have over 25,000 inmates serving time in county jails or state prisons. Governor Deval Patrick's proposed 2009 budget seeks $1.4 billion for the sheriffs' departments and the Department of Correction. This money is primarily for incarceration. The same budget proposes $963 million for higher education.

The prisons and jails are seriously overcrowded, not just with convicts but also with hundreds of additional pre-trial detainees who either cannot make bail or are being held without bail pending their trials. A federal lawsuit has forced one county sheriff, in Worcester, to choose which inmates will be released before their sentences are completed. Some detainees are left in local lock-ups because of space shortages.

Incarceration rates increased dramatically when the "War on Drugs" was launched in the 1980s. In Massachusetts and elsewhere, strict mandatory minimum sentences were enacted for drug dealing. One of those sentences, for selling any type or quantity of drug within 1,000 feet of a school, annually sends more than 300 people to jail for a mandatory minimum of two years.

These convictions are usually known as status crimes. The offenders in question generally weren't dealing drugs to children; rather, they were selling in dense urban areas where a school is rarely more than 1,000 feet away. The application of the school zone offense may vary widely from county to county.

When you look across the vast spectrum of crimes committed each year, so many of them can be traced back to drug and alcohol abuse and addiction. This is no secret, nor is the fact that more than 20 years of get-tough policies have not made a difference in drug-related crimes.

Two other factors are relevant. At the front end of the trial process, the courts are cluttered with the smallest of crimes, such as disturbing the peace or passing a bad check. Because these crimes carry the threat of incarceration, if the defendant is indigent the court must appoint a lawyer at taxpayer expense. If treated instead as civil infractions, with only the risk of fines, the dockets could be cleared, and the legal help could be reserved for more serious matters.

Bigger problems lie at the back end of whatever sentences are imposed. Massachusetts must find a better way to deal with ex-prisoners returning to society. Most released prisoners lack job skills, education, family support, money and, most importantly, supervision. Recidivism is more than likely. A high percentage of Massachusetts inmates complete their sentences by "wrapping up" - or serving out their time - and therefore have absolutely no supervision by a probation department or the Parole Board upon their release. With supervision, however, the likelihood of reoffense drops by one-third.

So what can we do this year, while the budget and the laws are still being written, and before our legislators recess for a season of campaigning?

This is a simple, cost-saving, and effective wish list:

Eliminate mandatory minimums for drug crimes to allow for parole eligibility.

Ensure meaningful post-incarceration supervision through parole or probation.

Resist calls for new mandatory minimum sentences that tie the hands of prosecutors, judges, and corrections officials.

Support policies that provide and promote drug treatment instead of incarceration.

Fully fund prison programs for treatment of mental illness, substance abuse, and training.

None of these ideas suggest that we should be soft on crime. Rather, they represent measures that are smart on crime in ways that Massachusetts can afford - and will be more effective in reducing future crime than the status quo.

David W. White Jr. is president of the Massachusetts Bar Association. Read more!

DA: Autistic son forced to drink a dozenjuice boxes - San Mateo (CA) Daily Journal

By Michelle Durand

A Burlingame father forced his 13-year-old autistic and developmentally disabled son to drink juice until he threw up and beat him with a belt because the boy was sent home from school for stealing a juice box, according to prosecutors who could seek a third-strike sentence if he is convicted of child abuse.

Jason Todd McGlown, 34, pleaded not guilty in Superior Court yesterday to two alternative counts of child abuse. McGlown was ordered back to court May 19 for a pretrial conference and June 9 for jury trial.

On Feb. 13, according to prosecutors, McGlown was called by his estranged wife to pick up their 13-year-old son from school in San Bruno after the child was sent home for swiping a juice box. McGlown allegedly brought the boy to the Burlingame home he shares with his parents and made him drink a dozen juice boxes until he vomited. McGlown then whipped the boy on the buttocks and back with a belt, according to the District Attorney’s Office.

On Feb. 14, the boy’s teachers discovered bruises after he told them it hurt too much to sit, said Chief Deputy District Attorney Steve Wagstaffe.

The underlying question, said defense attorney Bill Johnston, is if his client went beyond the legal standard of “reasonable punishment.” Those standards are fluid dependent upon circumstances such as the child’s age, size and mental capacity, he added.

The child gave various accounts to authorities including discrepancies in the number of juice boxes, Johnston said.

“This is not an instance of an angry father who lashes out at a child because he is keeping him from a favorite TV show but a situation of a father who spends every day working with the child on homework and imposes discipline to make sure the child learns appropriately,” Johnston said.

Johnston acknowledges his client has a criminal past but said it doesn’t necessarily pertain to the current situation.

McGlown has two felony assault convictions dating from 1996 and 1998. The latter included a domestic violence conviction which, taken with the assault charge, brought McGlown a 14-year prison sentence of which he served 50 percent, Wagstaffe said.

A conviction in this case could count as a third-strike and bring a mandatory sentence of 25 years to life in prison.

“This is a case where we will be looking very closely at that,” Wagstaffe said.

McGlown remains in custody in lieu of $100,000 bail.


Michelle Durand can be reached by e-mail: michelle@smdailyjournal.com or by phone: (650) 344-5200 ext. 102. Read more!

Expert: Man mulled killing others -Detroit News

April 25, 2008
Mike Martindale / The Detroit News

PONTIAC -- A Troy man charged in a 2007 office shooting in which one person was killed and two others wounded told a psychiatrist he had considered killing other people, including random victims at the Somerset Mall and a party store clerk, as well as bothersome motorists or shoppers.

Anthony LaCalamita, 39, is charged with first-degree premeditated murder in the death of Madeline Kafoury and assault with intent to murder Paul Riva and Alan Steinberg, all employees at Gordon Advisors, a Troy accounting firm where LaCalamita had been fired four days earlier because of poor job performance.

"They unfortunately picked the wrong time in their lives to let me go," LaCalamita told defense witness Dr. Norman Miller, a psychiatrist who believes LaCalamita is delusional, hears demons and has a history of mental illness that fits the legal description of insanity.

"'I got up and decided it was a good day to go to Gordon's,' " Miller said he was told by LaCalamita during one of three sessions at the county jail. "The partners became a target -- he was in battle mode and on a mission to kill or be killed. Destroy or be destroyed. ... But it was all a delusion. I don't think he went there for revenge."

Defense attorneys are attempting to show jurors in the Oakland Circuit Court trial that LaCalamita acted impulsively in the shooting. But during examinations by state psychologists after his arrest, LaCalamita spoke of his dislike for one firm partner, Kevin Klein, and intended to put "a shell right in his chest, right in his gut. I called to see if he was there."

Yet witnesses have testified of face-to-face meetings with LaCalamita as he walked through the building with a 12-gauge shotgun but never attacked them.

Miller said LaCalamita also considered killing a clerk at a convenience store where he stopped for a drink after the shooting but decided "it wouldn't do any good."

LaCalamita was disappointed when he was turned down for a handgun permit and told Miller in a November 2007 interview he wanted the weapon so he could kill "pimps, prostitutes or anyone who cuts him off in traffic."

A person can be mentally ill but not insane, which is a legal term. To be considered insane, a person must be unable to distinguish right from wrong, not have control of his or her actions or be unable to conform actions to the law.

Assistant prosecutor Rob Novy peppered Miller with questions regarding Miller's 12 hours with LaCalamita and Miller's review of medical records dating to the mid-1990s, when LaCalamita attended a seminary in hopes of becoming a priest. Read more!

Bravo to legislators’ defiance of Medicaid cost-cutting - Asheville (NC) Citizen-Times

North Carolinians owe U.S. Rep. John Dingell, D-Mich., their gratitude for leading the fight against Bush administration regulations that would cut Medicaid funds totaling $2.7 billion to the state and $50 billion nationwide over the next five years.

A bill sponsored by Dingell to put the regulations on hold for a year passed the House Wednesday with strong bipartisan support and a veto-proof vote of 349-62.

The legislation has yet to be taken up by the Senate

The ripple effect from the regulations, which were issued by the administration without congressional review, would have cost North Carolina 11,700 jobs and $415 million in lost wages during the first year alone, according to a report issued by Families USA.

U.S. Rep. David Price, D-N.C., who was among 220 House co-sponsors, helped lead the fight to pass the House bill. Other North Carolina co-sponsors included Reps. George Butterfield and Bob Etheridge.

Rep. Heath Shuler, D-Waynesville, wasn’t a co-sponsor, but did vote for the bill.

‘Morally bankrupt’

“This is just an incredibly morally bankrupt policy,” Price said. “And this is exactly the wrong time to do this. (The regulations are) like a $50 billion anti-stimulus bill for the economy.”

The regulations represent yet one more manifestation of skewed priorities that leave vulnerable Americans to suffer and undermine the nation’s future by failing to care for its most precious resource — its children.

They would affect case management and rehabilitation services for people with developmental and other disabilities and mental illnesses, school outreach programs that help eligible children get Medicaid, medical education and funding for public hospitals.

The new rules would limit payments to safety net institutions including hospitals and nursing homes that treat indigent patients, severely impacting the institutions’ viability, according to a spokesman for Price.

The result would be that states would either have to pick up the payments or risk bankrupting the medical facilities in question, which the state could not allow to happen.

Shifting burden to states

“The problem here is not that the federal government is telling us what to do or not to do,” said Dan Gerlach, senior policy adviser to Gov. Mike Easley for fiscal affairs. “The problem is they’re just shifting the cost.”

The Bush administration wants to extend tax cuts for the wealthy and to continue indefinitely a costly occupation of Iraq and profligate military spending. Meanwhile, it wants to cut or shift domestic spending to states, which will be forced to raise taxes to maintain essential services.

The regulations affecting Medicaid payments to hospitals go into effect May 25, a spokesman for Price said Thursday, so Senate action on the bill is needed before the end of May.

Get on board, senators

President Bush has threatened to veto the bill if it gets to his desk.
We urge our North Carolina Sens. Richard Burr and Elizabeth Dole to support the legislation. The vote in their chamber needs to be veto-proof like it was in the House. Read more!

SPECIAL REPORT: Keeping guns from the mentally ill -WSBT-TV South Bend (IN)

Video report and other content available here.

by Troy Kehoe (tkehoe@wsbt.com)
Apr 24, 2008 at 10:05 PM EDT

SOUTH BEND — One year after the fatal shooting of Corporal Nick Polizzotto, South Bend paused to remember the life and legacy of a local hero. But for some, it was a frustrating pause because questions about how the mentally ill man who shot him was able to obtain the gun remain unanswered

They were questions Indiana lawmakers began asking in the wake of Polizzotto's shooting. At the time, some worried that "a lapse in information sharing" may have helped put the gun in 45-year-old Scott Barnaby's hands.

Barnaby shot Patrolman Mike Norby and killed Polizzotto on April 24 at the Wooden Indian Motel. Barnaby was also killed in the shoot-out.

But one year later, many of those same questions about "information sharing" remain unanswered, because of concerns about privacy. Some lawmakers still aren't sure where to draw the line between protected information and protecting innocent lives.

THE WORDS THAT CHANGED IT ALL

It was a simple phrase, but one year ago, when Chris Barnaby confirmed his brother Scott had wrestled with what he called "the demons in his head," WSBT began to dig deeper into Barnaby's past.

What that investigation uncovered was shocking.

"We had him forcibly committed," Barnaby said in April of 2007. "Yes. He's been in a mental institution."

And the symptoms, Chris said, were obvious when Scott Barnaby was off his medication. Paranoia, schizophrenia and delusions, just to name a few.

Barnaby had a history of treatment, too, at four different institutions, including one in Grand Rapids, where Chris Barnaby said Scott was forcibly committed.

They were the words that meant the system had failed.

A CLOSER LOOK AT THE LAW

It's been 40 years since Congress banned the sale of firearms to anyone deemed "mentally defective" by a judge, and today, answering "yes" to "question 11-F" on a federal background check means an automatic disqualification for a handgun permit or purchase.

It reads, simply: "Have you ever been adjudicated mentally defective or involuntarily committed to a mental institution?"

It's aimed at preventing scenes like the one that played out on the campus of Virginia Tech just over one year ago. The gunman there, Sung Hui Cho, was responsible for the worst massacre on a college campus in U.S. history.

Court records show Cho was also ordered to receive mental health treatment by a judge who also declared him "dangerously mentally ill."

But he never went.

Even so, his background check came back clean.

So did Barnaby's, the day after the gun he bought illegally was used to kill Polizzotto.

Former Bristol firearms dealer Ronald Wedge was sentenced to serve prison time for falsifying information on Barnaby's application, and allowing him to buy the gun before his background check cleared.

But the fact remains, it did clear.

The question for lawmakers in both Indiana and Virginia one year ago, was why?

SEARCHING FOR ANSWERS

They quickly found that the answers lie in the mental health records kept by each state in the nation. Just over 30 states share some, or all of those records with the federal government. In our area, Illinois recently began sharing many of their records, and Michigan is one of the few states in the country that shares nearly all their records.

But some states share none of their mental health records. That means all records of treatment, including treatment ordered by a court, is not included in the FBI's NICS database used to check the backgrounds of potential gun buyers.

In other words, in many cases, the FBI has no way of knowing whether or not that buyer has ever had any sign of mental illness.

One year ago, as Scott Barnaby pulled the trigger, Indiana was one of those states.

Today, it still is, and Nick's brother Tony Polizzotto calls that unacceptable.

"It seems like a no brainer to me," he said. "Half the states [still] don't have this law in action. And it's something that really needs to be brought to the forefront."

In the wake of Polizzotto's shooting and the campus shootings at Virginia Tech and Northern Illinois University, it has been brought to the forefront in the Hoosier state.

"Indiana is working to develop a mechanism for transfer of information to the background check system," said Jane Jankowski, a spokeswoman for Indiana Governor Mitch Daniels. "We know the state is not in full compliance. So, we're doing what nearly every other state is doing: looking for solutions."

At Gov. Daniels' direction, a panel that includes representatives from the Indiana State Police, Indiana Department of Homeland Security and the Indiana Supreme Court and others, has been meeting for the last nine months to formulate a plan on how the records might be shared.

But so far, there's been little movement.

SEARCHING FOR SOLUTIONS

Indiana State Representative Ryan Dvorak (D-Granger) says there's a simple reason why.

"No one wants to see a violent criminal with a history of violent mental problems have a handgun permit," he said. "But we do have to be careful to balance out privacy concerns."

Rep. Dvorak says there are still too many unanswered questions.

"What are mental health records? What qualifies as something that needs to be reported? What would be some sort of incident that would disqualify somebody from getting a permit?" he asked.

Former Mayor of Fort Wayne Paul Helmke, who is now the president of the Washington, D.C. based Brady Campaign to Prevent Gun Violence, says it's clear at least 30 other states have already answered those questions with a simple definition.

"We're not talking about people who have gone in for counseling," he said. "[We're not talking about] people who have had treatment or people taking medication. We're talking about people who a court has found to be a danger to themselves or others because of mental illness."

Because of that, Helmke says the "privacy argument" no longer holds up.

"The gun dealer doesn't know the reasons for denial. They just get the signal that they're denied. So there really shouldn't be privacy concerns here," he said.

Indiana State Representative Jackie Walorski (R-Lakeville) doesn't buy it.

"We say, 'Oh, it's only going to go to the FBI. It's only going to their database.' Oh, really? Do we know that for sure? Hmm. I don't know if we know that for sure," she said.

Until she's assured the system would work the way Helmke describes it would, she says she'll refrain from calling for passage of a bill, or an executive order from the governor to begin sharing the state's records with the NICS.

Still, she does believe the issue needs further study.

But some aren't even convinced of that.

"From the perspective of the crimes that are brought to us, we don't really see the problem," said St. Joseph County Prosecutor Michael Dvorak. "As far as the tragedy with Corporal Polizzotto, whether or not a change in laws may have prevented that is speculative."

But despite the concerns and lack of movement, Helmke and others remain convinced change will come and soon.

MOVING FORWARD

Shortly after the shootings at Virginia Tech, Virginia Governor Tim Kaine signed an executive order mandating that his state's mental health records be shared with the NICS database. So far, Gov. Daniels hasn't followed suit. But Helmke says he, and state legislators may soon have no choice.

Three months ago, President Bush signed a bill passed overwhelmingly by Congress that allocates more than $1 billion to help states cover the costs of sharing the records.

And if they don't?

"There will eventually be monetary penalties if the state doesn't fix it," said Helmke. "So, I'm hopeful that with the money and the concern about losing other dollars that the state is going to take some action."

It's a battle Tony Polizzotto never wanted to be a part of, but, like it or not, it's one he now feels he has to fight. And after 40 years of battles that have now hit all too close to home, he now wants to win the war by changing laws and changing minds.

"I don't know what they're going to do or how they're going to do it, but something has to happen," Polizzotto said.

Many are convinced something will happen. Both Representative Dvorak and Indiana Statehouse Speaker B. Patrick Bauer (D-South Bend) say it's likely some sort of bill on information sharing will move forward at the state capitol this fall.

And it's likely the pressure on lawmakers will only increase until it does.

It's coming from a number of different groups, including a group called Mayors Against Illegal Guns. South Bend Mayor Steve Luecke is a member of that group, and at a meeting earlier this month, helped draft a letter to state and federal leaders demanding a change in policy.

For those like Tony Polizzotto, it's a sign that real change will eventually come. His hope now, that it doesn't take another tragedy before it does.
Read more!

Man gets 20 years for killing mother -Philadelphia (PA) Intelligencer

04/25/08
By LAURIE MASON

Patrick Hughes-Bygott, the 22-year-old Abington man who fatally stabbed his mother more than 60 times in her Bensalem home last year, was sentenced Thursday to 20 to 40 years of incarceration.

In imposing the maximum sentence allowed by law for third-degree murder, Bucks County Judge John Rufe said that his paramount concern was the safety of the community.

Rufe cited the “ferocity” and “suddenness” of the stabbing, noting that two of the three hunting knives Hughes-Bygott plunged into his mother’s face, neck and chest broke during the attack.

Hughes-Bygott didn’t react as Rufe announced the sentence at a hearing in Doylestown. His attorneys, Wallace Bateman and Robert Adshead, said their client was “happy” with the sentence.

“The sentence was more than fair,” Bateman said. “This case was a tragedy for everyone involved.”

Hughes-Bygott pleaded guilty, but mentally ill, last month to a general charge of homicide and allowed Rufe to determine his degree of guilt. The judge rejected prosecutors’ arguments that the slaying was premeditated first-degree murder, which carries a life sentence, but also refused a defense request to find Hughes-Bygott guilty on a lesser charge of manslaughter.

Two mental health experts testified at that hearing that Hughes-Bygott was paranoid and delusional when he killed his mother.

The slaying occurred Aug. 16 in the Wildman Avenue home Ellen Hughes-Bygott shared with her mother. Police who responded to a 911 call were met by Patrick Hughes-Bygott, who immediately confessed to the crime.

Officers who testified at the plea hearing said Hughes-Bygott told them his mother was suffering from anorexia, that she was a “stick figure,” and that he had to stab her to put her out of her misery.

Later, he told investigators his mother physically and sexually abused him as a child and that he harbored a deep anger toward her.

In court Thursday, Hughes-Bygott’s father, James Bygott, said his son’s stories about his mother being anorexic and abusing him were the “ramblings of a sick mind.”

He described Hughes-Bygott as a loving child who had a mostly normal life until the last few years, when his mental health problems began to surface. Bygott described a phone call from his son when Hughes-Bygott was in college, in which his son berated him with foul language and demanded money to hire a prostitute.


“It was like I was talking to a stranger. I was crying so hard, I had to pull over,” he said.

Bygott said he and his wife tried to get Hughes-Bygott to see a therapist, but he wouldn’t cooperate. Bygott said he truly believes his son wouldn’t have turned violent if not for his mental health condition.

“In my heart I know he was ill. He was not my son Patrick,” he said. “I want him to get the medical help he needs, so that someday he will have a chance at a normal life.”

Bygott said his wife wasn’t anorexic, but acknowledged she’d been treated for bipolar disorder in the past.

He said Ellen Hughes-Bygott, a registered nurse, couldn’t keep a job when her illness flared up. He said she was once forcibly removed by police from her post as a school nurse in the Central Bucks School District, after refusing to leave the school building when she was fired.

Bateman read a letter from Hughes-Bygott’s grandmother, Margaret Hughes, who witnessed the slaying. She also asked the judge for leniency.

“I know he was not in his right mind when he killed his mother,” the 91-year-old Bensalem woman wrote. “He loved his mother and she loved him. None of us knew how sick he was.”

Hughes-Bygott will begin his sentence in a state prison, where he will be tested to determine the level of his mental illness. Depending on the outcome of the tests, he will then be sent to a locked mental health hospital or the therapeutic wing of a state correctional facility.

If prison officials determine at a later date that he has been cured of his mental illness, Hughes-Bygott will serve the balance of his sentence in a regular state prison.

Before Rufe handed down the sentence, Hughes-Bygott apologized, but continued to blame his mother for his actions.

“I thought I was helping her,” he said. “I loved my mother very much, even though it seems I had a lot of anger toward her. She was often very mean to me but I loved her anyway.”

First Assistant District Attorney David Zellis, who prosecuted the case, said he believed that Hughes-Bygott embellished his story of having a bad childhood in hopes it would help his case.

Zellis said he was pleased that Rufe gave Hughes-Bygott the maximum sentence possible.

“Ultimately, the most important consideration was the protection of the community,” Zellis said.

Read more!

Psychiatrist: LaCalamita thought he was a soldier -Rochester (MI) Daily Tribune

04/24/08
By Ann Zaniewski
Journal Register News Service

A psychiatrist testified Thursday that Anthony LaCalamita III spiraled deeply into mental illness and was delusional and legally insane when he shot one person and injured two others at a Troy accounting firm.

Dr. Norman Miller said LaCalamita believed he was a soldier influenced by demons who was out to "kill or be killed."

"He really believed that he was on a mission ... A battle mission, and the battle was between good and evil," Miller said. "He really was acting out of evil thoughts, and they were controlling him."

LaCalamita, 39, is on trial for killing 63-year-old office receptionist Madeline Kafoury, of Warren, and injuring two company partners -- Paul Riva and Alan Steinberg -- during an April 9, 2007 shooting at Gordon Advisors in Troy. LaCalamita had worked at the firm as an accountant but had been fired days earlier.

LaCalamita's defense attorneys have argued that LaCalamita was legally insane. Assistant Oakland County Prosecutor Robert Novy has said LaCalamita's actions were premeditated and deliberate.

Miller, the sole defense witness, interviewed LaCalamita a few times starting in October and reviewed his mental health history. Miller said LaCalamita seemed normal from childhood through young adulthood and first saw a counselor in the mid-1990s at the urging of his superiors at a seminary where he was studying. In the years leading up to April 2007, LaCalamita attempted suicide three times and was diagnosed by various doctors as having major depression and bipolar disorder.

Miller said LaCalamita visited with prostitutes during his time in the seminary and continued to do so off-and-on after he left in 1997. His first suicide attempt happened in 2001 after his wife learned about the prostitutes, Miller said.

Over the next years, LaCalamita spent time in various hospitals, took mental health medications and saw several different mental health professionals. Previous evidence and testimony have indicated sexual addiction. A pimp and prostitute came to Gordon Advisors in October 2006 to collect $200 from LaCalamita. Soon after, LaCalamita assaulted the pimp with a tire iron or crow bar, Miller said.

Miller said LaCalamita had violent thoughts, including thoughts of killing pimps and prostitutes.

"He feels hopeless, helpless, worthless," Miller said.

Miller said LaCalamita stopped taking his medications in March 2007. His wife began to fear for her safety and asked him to move out that same month, Miller said.

"Things have been escalating for months. He was very out of control," Miller said.

Miller said the partners at Gordon Advisors were incorporated into LaCalamita's delusions and became targets, though LaCalamita had no set plan. LaCalamita never intended to shoot Kafoury, Miller said.

"I don't think he went there for revenge," Miller said.

LaCalamita told Miller -- who has billed LaCalamita's family about $30,000 for his work on this case -- that he thought about going to the Somerset Collection with a shotgun and killing random people.

During cross-examination, Novy highlighted some of LaCalamita's statements that suggested planning. LaCalamita told another mental health professional that, "I wanted to put a shell right in his chest," referring to a Gordon Advisors partner.

LaCalamita fled after the shootings and was arrested after a high-speed police chase. Miller said LaCalamita said he had heard that snow had fallen in a town in the Upper Peninsula, so he planned to go there to see snow one last time before killing himself.

The trial before Oakland Circuit Judge Rudy Nichols will continue today. A mental health professional from the state's center for forensic psychiatry is expected to testify.


Click here to return to story:
http://www.dailytribune.com/stories/042508/loc_localn03.shtml Read more!

Grieving the loss -Odessa (TX)

April 24, 2008
BY DANIEL SKOLFIELD

Funeral services have passed, but the siblings of Noel Richard Lopez plan to keep the memory of the slain man strong.

Adelita and Gabriel Lopez said Thursday that they want to start a foundation for research of bipolar disorder - a condition of manic highs and depressive lows that Noel Lopez suffered with for years.

"We chose to honor his life by raising awareness about mental illness," Adelita Lopez, Noel's sister, said. "Join us as we work to increase access to better treatment and research."

Gabriel Lopez, Noel's brother, said he saw the danger of his brother's mental state and erratic behavior just months before his death - a distorted reality that he has personally experienced in his own life as well.

"Before I was diagnosed (with bipolar disorder), it was really tough - I had really intense thoughts and moods that I couldn't explain," Gabriel Lopez said.

The siblings, speaking with members of the media Thursday, said Noel Lopez had been admitted to a hospital in Big Spring, but he was later released and couldn't get further treatment without declaring an intention to commit suicide - something he wouldn't do.

Gabriel Lopez said his brother should be remembered for his humorous personality, peacemaker attitude and brilliant abilities, and hopes his death will lead others to get help for bipolar disorder.

"It's often something that people who suffer with it are ashamed of, but they need to talk about it," he said.

In addition to honoring the poet, painter, actor, athlete, musician and student who was their brother, the two siblings also wanted to clear up details about his death.

Workers in Seattle found Lopez's body at a construction site on April 14, but Gabriel and Adelita Lopez said Noel wasn't killed in front of a large crowd over a span of several hours, like previously reported.

Marcus D. Dennis, 20, and Steven D. Bauder, 22, have been charged in Noel Lopez's beating death. Gabriel and Adelita Lopez said a crowd had gathered to watch Noel Lopez wrestle Bauder in the street.

The fatal beating happened later, away from the crowd gathered to watch the two wrestle.

The victim's family said they would not ask that the death penalty be sought for the men.

Noel Lopez was a 2001 graduate of Odessa High and heavily involved in the community before moving away.

Adelita Lopez said rosary and funeral services on Sunday and Monday were packed with family and friends who had been touched by her brother's life.

"The outpouring from the Odessa-Midland community has been nothing short of miraculous," she said. "We thank all of you deeply - you have been a true comfort." Read more!

'Shock" of therapy horror - New York Post

April 27, 2008 -- You'd immediately notice something odd about Staten Island homemaker Felicia Vitale if you simply said goodbye to her.

"Alive, 100, good, 100, good," is a phrase people must use to end any conversation with the 50-year-old mother of two.

Forget the nonsensical ritual, and Vitale, who has obsessive-compulsive disorder, freaks out. She can't rest until you repeat it.

"I fixate on certain words," said the former real-estate broker.

She also washes her hands repeatedly. And she can't say or hear numbers without them being consecutive.

Still, with medication, she had managed to control her illness, along with her ongoing battle with severe depression.

That is, until 2006, when her husband, Louis, heard a radio ad for the Carrier Clinic, a private facility that claimed it could cure certain mental illnesses, especially depression.

They went for a consultation at the Belle Mead, NJ, private psychiatric center, where doctors suggested a dozen electroshock therapy sessions over a three-week period.

After nine visits, Vitale's memories of precious moments - her wedding day, her daughter's performance at the Apollo Theatre and many more - had been wiped away.

"I can't remember anything," Vitale said recently, "I always start my sentences, 'I may have told you this already.' "

Electroshock therapy - a method of curing the so-called mentally incurable by running electric currents through the brain - was banned by many hospitals in the '60s and '70s after it was deemed barbaric and abusive.

But it remains legal and has, in fact, seen a resurgence since the 1990s. About 30,000 Americans were treated with electroshock last year.

Each of Vitale's $1,000 sessions would take about four hours, including 15 minutes of zap time.

It was like a scene out of the 1975 movie, "One Flew Over the Cuckoo's Nest." Vitale was sedated to keep her from body from jerking, and she wore a rubber mouth guard to keep her from swallowing her tongue. But Vitale wasn't getting any better.

After her fifth session - using low-pulsing voltage - Vitale started complaining about memory loss.

Doctors downplayed it as short-term and temporary. After the ninth session, Vitale said she was walking around like a "zombie." And it was already costing her $4,200 out of pocket that her medical insurance wouldn't cover.

"I finally said no more," her husband recalled.

Now Vitale has to leave Post-It notes around the house, reminding her to pick up her children or call a friend. She ordered nine pairs of Ugg boots online - not remembering she already owned them - before her husband took away her credit card.

The Vitales filed a lawsuit against the clinic on March 1 in Staten Island Supreme Court.

"A health-care professional has to listen to the patient. And they just didn't listen. It was clearly negligent to continue," said the Vitales' lawyer, Alvin Gordon.

The Carrier Clinic did not return calls for comment.

jfanelli@nypost.com

Read more!

Governor candidates have own plans to fix mental health system - Associated Press

By Gary D. Robertson
Friday, April 25, 2008

Raleigh - North Carolina's mental health system has never received so much attention from the public, let alone the major-party candidates for governor.

That's largely due to the widespread failure of a reform effort initiated by the Legislature in 2001 and carried out by Gov. Mike Easley's administration, which tried to create a community-centered method for treating the mentally ill, substance abusers and the mentally disabled.

"Mental health has never been a high priority in a gubernatorial race," said Sally Cameron, executive director of the N.C. Psychological Association. "This is something now on their radar screen."

Some mental health care advocates call the reform a disaster that made things worse. The state also may have wasted hundreds of millions of dollars on unnecessary and overpriced care.

The focus on the state's mental health care system intensified following a series of stories published earlier this year by The News & Observer of Raleigh. While there is optimism about the system's future following the installation of new leadership, the major-party candidates for governor said in surveys and interviews with The Associated Press that fixing the fix is a complicated task.

The proposals they offered varied on the level of detail, depending on their expertise in the field or knowledge of the intricacies of state government. But all pledged to provide leadership to improve care for the roughly 350,000 patients who use the system annually.

"At the end of the day, I'm going to be the chief, I'm going to be the boss," said Democratic Lt. Gov. Beverly Perdue, echoing the feelings of most candidates. "If something's broken ... it's my responsibility to take the blame for it and to get it fixed."

The idea behind the 2001 reform was to shift the state's mental health programs away from institutional care to community-based treatment offered by private providers. The General Assembly set aside money to help local agencies that manage patient services to build up their treatment capacity by adding short-term hospital beds and crisis services.

The intention was to keep patients from ending up in jails or emergency rooms following a breakdown.

Instead, the state's institutions are used more than ever. Replacing government-run psychiatric services at the county level led to no care in some rural areas because private or nonprofit providers either couldn't survive financially or simply left the area. Easley also intercepted tens of millions of dollars earmarked for mental health to plug a budget shortfall.

"The intentions of reform were good, but clearly it was too much change too quickly," said Debra Dihoff, executive director of the state chapter of the National Alliance on Mental Illness, a patient advocacy group.

Federal regulators have also withheld at least $138 million in Medicaid reimbursements for the community services program while they examine questionable expenses. And the Broughton state mental hospital in Morganton hasn't received federal funding since last summer after safety problems surfaced following a patient's death.

Since the reform effort began, citizens "have seen escalating waste, fraud, institutional ineptitude, bureaucratic bungling, and now, finger pointing as to who is to blame for this sorry state of affairs," McCrory said.

Republican candidates blame Easley, who is barred by law from seeking a third term, for signing the reform bill even though - as he's claimed following The News & Observer series - his administration opposed the sweeping changes.

"Mike Easley got put on his desk a bill. He had the duty to either sign that bill and according to law adopt that and support it and execute it," said GOP state Sen. Fred Smith. "If he didn't believe in that bill, he should have vetoed it, and he didn't. That's what courage would have been."

The platforms suggested by Easley's potential successors largely aim to reduce turnover among hospital workers and medical professionals; coordinate better care, offered through local and state mental health offices; and ensure that a minimal level of mental health care services are available at the local level.

"Yes, there were problems with the community based government-run services, but they obviously did a better job than what the new system is doing," said Bob Orr, a Republican and former Supreme Court justice. "In smaller communities where the ability to make a profit is probably pretty limited ... you're going to have to go back to mental health clinics with government workers."

GOP long-shot candidate Elbie Powers said the mental health system has become too political and focused on money. He said he would replace agency directors "with knowledgeable and efficient people in their proper fields, removing ones placed by favoritism."

Bill Graham, a Republican attorney, said he would work to adjust payment rates for services so that more money is invested in patients who need intense treatment or constant monitoring.

He points out how community service agencies charged the state $61 per hour until last year. For the money, some workers did little more than take patients to the movies.

Orr and Democratic State Treasurer Richard Moore both prominently mentioned efforts to attract people into the mental health profession and keep them there.

Moore wants to give higher salaries to mental hospital workers if they earn professional certification in their field, an education program he envisions could be created by the state's community college or university systems. The financial incentives will provide continuity of care for long-term patients.

"If we don't face the reality that the person, the caregiver, the technician, the person that's going to see that same patient everyday, if we don't have some stability in that piece of the puzzle, none of the rest of this stuff is going to work," Moore said.

Perdue and Moore each said their work history qualified them to lead the effort to fix the mental health reform effort.

Moore said he's run two state agencies as treasurer and secretary of the Department of Crime Control and Public Safety.

Perdue, a former hospital administrator and geriatric consultant, said her plan to boost the number of doctors treating both physical and mental conditions among low-income patients is a cost-effective way to improve patient outcomes.

Cameron said she's pleased that the candidates are interested in mental health. The question is whether they will retain their focus after publicity of the state's problems ebbs.

"All the leadership in the world will not make a difference if it's not a priority," Cameron said.

Read more!

Local leaders look for lessonsfrom tragedy - Fresno (CA) Bee

04/26/08
Editorial:

While the community mourns the tragedy at Roosevelt High School in which a special-education student attacked a police officer and then was shot, we've also begun a self-examination of how our inadequate mental health services cost us in every area of our society.

Those who knew Jesus "Jesse" Carrizales, 17, speak openly of his mental-health issues. Fresno Police Chief Jerry Dyer said the boy attacked the officer Junus Perry with a sawed-off baseball bat in an effort to commit "suicide by cop."

This tragedy has caused public officials to step back and suggest that this incident is a symptom of a much larger problem. The chief and Mayor Alan Autry proposed a partnership this week involving the city, county and the school district to share information about mentally ill students.

Their ideas are not yet well-thought through, but we welcome the attention and passion of Autry and Dyer to this vital community issue. It is largely misunderstood, underestimated, underfunded and ignored by most of those in power in the San Joaquin Valley.

Mental illness in children, adolescents and young adults is enmeshed in every segment of the Valley's news coverage today: politics, education, crime, business, health care, housing, sports, entertainment -- even our war coverage.

It also is a source of fierce debate at every level of government in the nation, from local school boards like Fresno Unified to the U.S. Congress.

In microcosm, the news stories are telling us something: We must address the urgency of treating mental illness in context, realizing that it is affecting every segment of our society. As Fresno County Supervisor Henry Perea says, "Mental illness does not prey on the poor or a certain ethnic group. It preys on everyone."

In this season of draconian budget cuts caused by terrible economic conditions, it is folly to butcher care for mental illnesses, which responds as well to treatment as other chronic diseases such as heart disease and diabetes.

Left untreated or ineffectively treated, mental illness in children systemically grows more difficult as the child's body chemistry changes and matures. But mental health programs are among the first to be cut. There isn't a huge lobby on behalf of mental health patients.

"Treatment" also should be considered in broad strokes by our community. It isn't all about drugs, counseling and hospitals. Mental health care also means paying attention to the core issues that contribute to mental illness: unsafe neighborhoods, broken schools, poor role models and lack of medical care and good food.

Deborah J. Nankivell, CEO of the Fresno Business Council, has a special interest in mental health. In an e-mail to members of the mental health cluster of the Human Investment Initiative last week, she acknowledged the need for better treatment, but wrote, "We can treat an ever-increasing number of canaries, or we can clean out the toxic mine and fill it with healthy relationships and tools."

The Valley's residents must resolve to care for our sick little canaries and clean the gold mine, which is our treasured region.

There is a lot we still do not know about the tragedy at Roosevelt High. But at the very least, we must learn as we go from this heartbreak, promising to do all that is in our power to ensure that it never happens again. Read more!

Mental health workers protest - Asheville (NC) Citizen Times

Gathering points to unsafe conditions, scapegoating

Leslie Boyd

About 45 mental health workers gathered on the steps of Dorothea Dix Hospital at noon Friday in Raleigh to protest working conditions at the state’s four psychiatric hospitals.

Understaffing, forced overtime and low wages combine to make conditions unsafe, say workers affiliated with UE 150 of the N.C. Public Service Workers Union.
“People are tired,” said Larsene Taylor, a health care technician at Cherry Hospital and union chairwoman. “People are burning out, and the ones with the most experience are just leaving.”

Eric Davis, a certified nurse assistant at Broughton Hospital, was stabbed in the abdomen in November by a patient he was supervising. The unit was short-staffed and Davis was working a double shift. He was supervising a patient one-on-one when another patient came to ask a question.
“I looked at him to tell him I couldn’t help him and the scissors was in me,” Davis said.
After more than a month out of work from the injury, Davis returned to find he was being disciplined for neglecting a patient.
“It don’t make sense,” Davis said. “We have to write up what’s happening with the patient every 30 minutes, and we can’t have our eye on the patient then. But I get written up for answering another patient’s question.”
Davis and others say they feel like scapegoats, being blamed for the disarray at the state’s psychiatric hospitals when they don’t have enough staff to cover all shifts and people are exhausted.
Safety is a real issue, said Donna Earley, a health care technician at Broughton.
“There have been times I’ve felt unsafe there,” Earley said. “Sometimes there just aren’t enough people.”
People who are tending to patients one-on-one are supposed to be relieved every two hours, but that doesn’t happen, Earley said.
Health care technicians and certified nurse assistants have an average yearly salary of a little more than $20,000, said Laura White, team leader for state hospitals with the N.C. Division of Mental Health, Developmental Disability and Substance Abuse Services.
“We would like to see health care techs make more, but there are a lot of them, and even a small increase would be very expensive,” she said. “We agree we need a certain ratio, and we know we need more staff. But raises and increases in staff have to be approved by the legislature. It would be a multiyear process.”
North Carolina is one of two states where public employees are prohibited by law from collective bargaining, said union organizer Dante Strobino; Virginia is the other. Workers can unionize and hold meetings, but there is no union contract.
“We’re working to get that changed,” Strobino said.
Representatives from the union met with Gov. Mike Easley on Friday. They plan to hold more rallies across the state to raise awareness about the issue.
“I don’t want to run down the mental health system, but the hospitals aren’t safe, and that’s not right,” Earley said.

Read more!

Senate to debate 'Nicola's Law' -New Orleands Times-Piscayne

It requires treatment for some mentally ill

By Jan Moller

BATON ROUGE -- Gov. Bobby Jindal's plan to require outpatient treatment for some mentally ill patients who refuse to comply with their treatment plans cleared its first legislative hurdle Wednesday.

The Senate Health and Welfare Committee unanimously approved Senate Bill 182 by Sen. Cheryl Gray, D-New Orleans, sending it to the full Senate for more debate.

Gray's bill, also known as "Nicola's Law," was inspired by the January killing of New Orleans police officer Nicola Cotton. A mentally ill man who had been in and out of treatment for much of his adult life and often refused to take his medication has been charged with the shooting.

The proposal is based on a similar law in New York that supporters say has led to a decrease in hospitalizations and arrests of the mentally ill.

The bill lays out detailed criteria that must be met before a judge can order a patient into treatment. Among other things, patients must be older than 18 and have either a history of violence or two documented instances within the previous three years where a failure to comply with mental health treatment led to hospitalization or jail.

Courts could order patients into treatment, which could include drug testing, only if a doctor or psychologist agrees that it is necessary.

Patients who refuse to comply after being ordered by a court could be involuntarily committed to a hospital.

Current state laws allows judges to order mentally ill patients be committed to institutions under certain conditions, but it does not have provisions to require patients to get treatment once they are released.

Critics and supporters of the bill said the measure will be effective only if the Legislature provides enough outpatient services.

"If we're really going to make this work, we're going to have to invest more money in community-based services," Gray said.

Jindal's budget request sets aside $89 million in new spending on mental health, part of which would be used for community "crisis teams" of mental health professionals to treat people in acute psychiatric distress.

Such patients often have ended up in emergency rooms or jail in the years since Hurricane Katrina destroyed much of the mental-health infrastructure in New Orleans.

Two other elements of Jindal's mental health package also continued their march through the legislative process Wednesday, clearing the House by overwhelming margins.

House Bill 653 by Rep. John LaBruzzo, R-Metairie, which would let psychiatrists evaluate patients via video conferencing as long as a health-care professional is physically present, was approved 92-4.

House Bill 930 by Rep. Fred Mills Jr., D-St. Martinville, was approved 99-0. The bill would create four new regional districts that would oversee mental-health and substance-abuse programs and would increase state oversight of such districts.

. . . . . . .

Jan Moller can be reached at jmoller@timespicayune.com or (225) 342-5207.


Read more!

Open door lures elopees - Morganton (NC) News Herald

Police found men who walked away from Broughton at fast food restaurant

By Julie N. Chang
jchang@morganton.com

MORGANTON - Broughton Hospital officials remained tight lipped Wednesday evening about two men who fled the grounds earlier in the day.

Even after their capture, hospital staff referred all questions to the state office in Raleigh.

One of the two men police hunted did talk to reporters.

Timothy Jose Fairbanks, 27, of Catawba County said he left the hospital because, "they left the door open."

Fairbanks and Raymond Camp, 23, of Mecklenburg County walked away without permission Wednesday morning, said Brad Deen, the public information officer at the state Department of Health and Human Services in Raleigh.

Deen said when the staff noticed the two were missing they called for help. Broughton has its own police department and called in the Morganton Department of Public Safety and the Burke County Sheriff's Office as backup.

Public Safety Chief Mark Tolbert met with reporters Wednesday morning and said he received a call from Broughton Police Chief Rex Powell around 8:45 a.m.

Tolbert said Fairbanks is a convicted and registered sex offender.

Officers distributed fliers, notified businesses and patrolled the area looking for the two.

Shortly after noon on Wednesday, a plainclothes Morganton officer who was in an unmarked car spotted Fairbanks and Camp at the Burger King on S. Sterling Street, said Maj. Billy Bradshaw with Public Safety.

Officers returned the men to the hospital.

Deen said Broughton is a psychiatric hospital and should not be compared to a jail or prison.

"Some of the patients might be dangerous to themselves, other patients or people on the outside if they walk away. We obviously have to take security very seriously," Deen said.

Dean said an investigation is under way by Broughton to determine how Fairbanks and Camp managed to leave the campus.

With the return of Fairbanks and Camp, those who are responsible for their care will take into consideration their actions, Deen said.

"We see what we can best do to help these people, and to help them not be a danger to themselves," Deen said.

A step toward helping elopees will be the elimination of any opportunities to leave the campus without permission, Deen stated.

While he was talking to reporters, Fairbanks also listed boredom and continuous eating as reasons for leaving the hospital, but did not have an answer for why he stayed in the area.

Fairbanks said he did not consider himself a threat to the community.

When asked if he would attempt to leave Broughton again, Fairbanks said, "If they leave the door open." Read more!

Roosevelt Shooting Prompts Fresno Leaders to Fight Mental Illness -KMPH-TV San Joaquin (CA)

Video Report of this story here.

By: Ashley Ritchie & Charlene Lee

Just one day after a deadly shooting, Fresno Police Chief Jerry Dyer said the investigation led them to believe it was suicide by cop.

17-year-old Jesus Carrizales' family told police the teen had struggled with mental health issues. And it's a lesson local leaders say the city, county and school district must now learn from.

Just seven days ago, the issue of mental health in schools went nearly untouched.

But that all changed in one day.

"With this heartbreaking tragedy, we as a community are going to stop cursing the darkness and turn on the light regarding mental health and mental illness in our society and in our schools," Fresno Mayor Alan Autry.

Autry says it starts with a plan, and on Tuesday he announced a new partnership between the city, county, school district, police department and faith-based communities, to focus on mental health and school safety.

"As a society, and at every level of government, we are woefully ill-informed and woefully ill-equipped to deal with this crisis. That must change," Autry said.

The idea behind the partnership is to identify students struggling with mental health and get them help.

Mayor Autry didn't mention specifics, but he did say the program would hopefully establish an effective communication system, look at needs throughout the agencies and seek out legislation to provide money for mental health needs.

"I've always said what Satan intends for evil, God will use for good. And that's certainly what we want to take from this tragedy at Roosevelt High School. It's not only a drain on our resources, it's a drain on our families," Fresno Police Chief Jerry Dyer said.

"Once you de-stigmatize something, and mental illness becomes something like dealing with an inhaler and dealing with insulin shots, then we've really progressed as a society. We've become better. We've become more human," Autry said.

A lesson leaders hope can be learned from a tragedy they'll never forget.

Chief Dyer says this is an epidemic that plagues his department every day.

Just last year, Fresno Police committed nearly 100 high school students and more than 2,000 adults.

In the next few months, nine mental health clinicians will be added to Valley schools.
AddThis Social Bookmark Button
Read more!

More centers integrating mental health withprimary care - St. Louis Post Dispatch

By Mary Jo Feldstein
Wednesday, Apr. 23 2008

Dr. Heidi Miller, an internist in the Forest Park Southeast neighborhood, knows
her role as a primary care doctor can sometimes extend into treating complex
psychiatric disorders.

She once treated a patient who was recently released from prison. He had
violent thoughts, but they were not severe enough to call the authorities or
have him committed to a psychiatric hospital. Miller tried calling private
psychiatrists and even academic psychiatrists in hopes of finding a physician
willing to help, but no one was interested.

Miller did the best she could, and eventually the patient stopped showing up
for appointments, but she always worried she didn't do enough.

"I'm a good doctor, but I can't do brain surgery and I can't take care of
complex psychiatric disorders," said Miller, who works for Family Care Health
Center, a federally qualified health center. The center receives government
funding to offset the cost of patients who cannot afford to pay.

With too few psychiatrists in the area, especially ones interested in caring
for those

without insurance, Miller says she's often forced to "try her best" for
patients who need the expertise of a specialist.

Family Care is trying to change this with a program that integrates mental
health services with primary care. The health center hired a psychiatrist who
splits his time between Family Care's two locations and a third job.

The psychiatrist, Dr. Jaron ­Asher, is helped by the Family Care's small staff
of mostly part-time employees. Those professionals include a psychologist who
specializes in treating children and a social worker who handles case
management.

The concept of merging primary care services with mental health services has
been tried successfully elsewhere. Though some preliminary studies have shown
benefit, physicians are interested in learning more about how these
collaborations work. The Hogg Foundation for Mental Health launched its
Integrated Health Care Initiative grant program last year, giving five
organizations nationwide more than $2.6 million over three years. Their aim
will be to promote the effective identification and treatment of mental health
problems in primary care settings.

Locally, Crider Health Center, which provides mental health services, has hired
an internist to help with patients' primary care needs; and Grace Hill
Neighborhood Health Center, another federally qualified health center, is
collaborating with BJC Behavioral Health.

At Family Care, patients in need of mental health services typically fall under
three categories. For those with depression and other less complicated
conditions, Miller treats the patient but can look to Asher for assistance,
even informally through an e-mail or phone call. Others are first evaluated by
Miller and then sent to Asher for follow-up. These patients either remain under
Asher's care for their psychiatric diagnosis or can be monitored by Miller
after medications are established and they are stabilized. Patients must be
referred to Asher by Miller or another of the office's primary care physicians.

The integration of services has benefited Asher and Family Care's physicians in
other ways as well. Patients have one chart, so Miller and Asher can see other
medications patients have been prescribed and whether they showed up for
follow-up appointments with other staff members.

"That kind of information flow almost never happens," Asher said.

The integration plan was originally Asher's. He wanted to see patients who
needed help, but who couldn't afford time with a private psychiatrist.

He asked his wife, who has a master's in business administration, to help him
develop a business plan to present to Family Care's board. The board quickly
agreed, and Asher began seeing patients in February.

"We are extremely relieved that he is here," Miller said. "This collaboration
between mental health and primary care is more revolutionary than it should be."

mjfeldstein@post-dispatch.com

314-340-8209 Read more!

No place for the mentally ill - Florida Today

Titusville denies zoning for facility

BY JESSICA RAYNOR
FLORIDA TODAY

Ann Chappell of Titusville applauded after the City Council decided early Wednesday to deny a rezoning request that would have allowed a residential treatment facility for the mentally ill in the city.

"Of course I'm elated, because the council listened to us," Chappell said. "We voted them in, they are working for us, and they listened to us, and that was encouraging."

Chappell and others protested the plans of Renaissance Healthcare Group of Orlando to expand its operations into Titusville.

The company asked for a change from a tourist zone to a hospital/medical designation, so it could refurbish the vacant Randolph Inn into a 106-room, gated, "resort-style" residential treatment facility, caring for patients with depression, forms of schizophrenia and Asperger's syndrome (an autism-like disorder).

After 41/2 hours of public hearing and council discussion, shortly after 1 a.m. the city council voted unanimously to deny the rezoning.

It followed planning and zoning recommendations, which called the project too intense for the neighborhood -- the same concern of Chappell and other neighbors, who also complained that the facility's open campus and lack of security would increase crime.

"I feel the location is inappropriate," said Councilman Walt Johnson, who made the motion for denial in front of a standing-room-only crowd. "It's a change in character for the neighborhood."

Renaissance Healthcare Group President George Kachmarik said he is disappointed with decision.

His company isn't actively seeking any other properties in Titusville or elsewhere in Brevard County for such a project, he said.

"We thought we could do something really nice for the city," Kachmarik said. "In some ways, we feel the city loses by winning. I don't know what they're going to do with the property. We're done with it. We're moving on."

The debate on the issue dominated the meeting, pushing aside all other city business.

About 45 people spoke either for or against the rezoning.

Opponents reiterated safety concerns, bringing reports of almost 100 police calls over the course of five years to the company's 14-bed facility in Orlando.

Company officials said the police calls all were staff-initiated, and didn't concern crimes against neighbors.

Opponents of the proposal also talked about the negative image such a facility would project and how its presence could decrease property values in their neighborhood.

They preferred the facility be in an area near a hospital district, like near Parrish Medical Center, north of downtown.

"It doesn't belong in anyone's neighborhood," Cynthia Shepherd of Titusville said. "It belongs in the medical community."

Among those speaking in favor of the proposal were real estate agents, a lawyer and two psychiatrists.

Proponents of the project argued that refurbishing the property would be good for the community, bring in needed jobs and create a place for those with mental illness to get unique care.

They said it also would remove an eyesore and create an appropriate use for a property that may never see a hotel again.

"I firmly believe that this is a business that will benefit us," Pat Connor of Titusville said. "Just because the city says this is zoned one thing doesn't mean it shouldn't be changed or waivered to permit a good, viable business."

Contact Raynor at 360-1016 or jraynor@floridatoday.com Read more!

Simpson repays debt owed Medicaid -Elizabeth City (NC) Daily Advance

By BOB MONTGOMERY

A local counseling business has repaid nearly $500,000 in Medicaid funds a state agency said were misspent.

American Health and Human Services Inc. of Elizabeth City, which earlier this year changed its name to Christian Empowerment Center, finished repaying the Medicaid funds earlier this year, Brad Deen, a spokesman for the Department of Health and Human Services, said.

American Health was advised last year that it owed DHHS $271,084 because it had billed for services that were not clinically necessary. At the time, the Elizabeth City firm was one of 185 privately owned community service providers across the state found to have billed Medicaid $45 million in unnecessary charges.

All of the firms, which are paid to provide counseling and other services to mental health patients, were ordered to repay the monies DHHS said had been misspent. To speed up the repayments, DHHS began withholding 10 percent of the firms' Medicaid reimbursements.

A subsequent audit determined that American Health owed DHHS an additional $211,957 for other services deemed clinically unnecessary, raising its total Medicaid debt to $483,041. The company was given until Jan. 21 to retire the debt.

Andrea Simpson, American Health's CEO, initially said he would fight the repayment order. However, he apparently decided to repay the full amount, Deen said.

"That's it, as far as I know," Deen said. The entire $483,041 Simpson owed "is now apparently satisfied."

Simpson could not be reached for comment Wednesday.

Deen said American Health made a lump sum payment of $208,088.91 on Aug. 14, and had the 10-percent deductions applied to its remaining debt, which included a late payment penalty of $27,108.50 and interest of $8,534.76.

Deen said because the department is processing audits and recoupments totaling nearly $60 million from hundreds of providers it is difficult to obtain specific details on each provider's status.

"DHHS sought to recoup for overpayments for two reasons," he said. "First, they might have faced penalties and interest in addition to recoupment. Second, during the appeals process they might have either negotiated a settlement or had the recoupment amount reduced."

Meanwhile, Deen said four other community service providers with offices in the Elizabeth City area still owe the state for unnecessary services that were billed to Medicaid.

As of March 27, Pride in North Carolina still owed nearly $370,000; Health Services Personnel owed about $137,000; Life Inc., about $1.1 million; and Innovative Programming Associates, about $130,000.

In general, those providers, as well as most of the others that still owe money, have repaid about 25 percent of their debt through the withheld reimbursements, Deen said.

The state estimates that 500 providers owe a total of nearly $60 million in Medicaid repayments. Last week, the federal government announced it was withholding at least $138 million from North Carolina in Medicaid funding until it submits an acceptable plan to deal with the misspent funds. Read more!

Trip' an involving look at mental illness -Kalamazoo (MI) Gazette

Posted by James Sanford
April 23, 2008 17:01PM


KALAMAZOO -- Schizophrenia, bipolar disorder, mania: Scary words to some people. But "A Long Strange Trip," an enlightening and straightforward documentary by local filmmakers Tom Ludwig and Matt Clysdale, tries to strip away the prejudices and misconceptions often attached to such disorders.

Demystifying mental illness is also the goal of the PoWeR (Peers for Wellness and Recovery) Group, which sends representatives out to schools, churches and other places to talk frankly about what it's like to live with depression, schizophrenia or bipolar disorder. No one can say the members of the PoWeR Group aren't experts in their field: Not only have they suffered with these conditions, but many of them have also been worked over by the mental-health system.

"What better way to learn about mental illness than from someone who is walking on a daily basis with schizophrenia, for instance, or bipolar disorder?" asks film producer Lesley Crowell, liaison for peer-delivered mental-health services for Kalamazoo Community Mental Health & Substance Abuse Services and one of the organizers of the PoWeR Group.

"Trip" does an impressive job of examining the lives of several group members, telling their stories with sensitivity. We meet Tricia, who can't remember life without bipolar disorder. Tricia's parents admit they didn't understand her condition, but Tricia insists they were supportive nevertheless.

The same was true -- up to a point -- with Ian, who was diagnosed as "hyperactive" when he was a child and has struggled with various addictions since. He winds up in jail after his mother turns him in for stealing her car and loaning it to drug dealers. She maintains that she tried to help him through his troubles, but in this case he'd finally gone too far.

But the pressures and conflicts the PoWeR Group members must face are not always coming from the outside world. When Jay, a generally jolly and outgoing group leader, is accused by some of his fellow panelists of dominating one meeting, feistiness turns to fury.

While the friction between Jay and the rest of the group is certainly dramatic and clearly makes the point that relapses do happen, "Trip" might have been just as involving if it had sacrificed some of this subplot in favor of more footage showing the PoWeR Group's presentations and the feedback they get.

Still, the film ultimately does a thorough job of showing how its subjects cope with their problems using humor and bracing honesty. Patrick, a group member, recalls his first trip to a mental hospital, in which he was locked up, put on medication and treated harshly. "I just remember thinking, 'I thought this was America,'" Patrick says. "I thought I had rights."

"A Long Strange Trip" will be shown at 7 and 9:30 p.m. Friday at Western Michigan University's Little Theatre, at the corner of Oakland Drive and Oliver Street. Question-and-answer sessions with the filmmakers and PoWeR Group members will follow each screening. Donations will be accepted.

Read more!

Judge orders injections for Maine prisoner -Boston (MA) Phoenix

By: LANCE TAPLEY
4/23/2008

A Maryland court has ordered Maine prisoner Deane Brown — exiled in 2006 to solitary confinement in a supermax prison in Baltimore after he blew the whistle on abusive practices at the Maine State Prison — to be forcibly injected with insulin, if necessary.

A diabetic, Brown has conducted off and on in both Maine and Maryland what he calls a “medicine strike” to protest prison conditions. Recently he protested, by trying to refuse insulin, the dangerous way he says Maryland prison staff treat his diabetes.

Before his April 11 appearance in the Maryland court, Brown, 44, serving a 59-year sentence for burglary, filed a motion in federal court in Bangor asking for an injunction to prevent the Maryland Correctional Adjustment Center (MCAC) from treating him against his will and seeking his immediate transfer back to Maine. The federal court has not yet acted on his request.

This legal move is a development in the federal suit he began in 2007 against Maine Department of Corrections officials, alleging their violation of his civil rights by shipping him out of state to a dangerous maximum-security prison. His exile, he says, was to prevent — and was in retaliation for — his providing information to the news media about abuse by guards of mentally ill prisoners in Maine’s Supermax, the Special Management Unit of the state prison in Warren (see “Torture in Maine’s Prison,” by Lance Tapley, November 11, 2005).

The judge in the Baltimore Circuit Court who required Brown to be forcibly injected also ordered MCAC officials to give him something to eat within 45 minutes after each insulin shot. Brown had complained that the prison put him at risk of a fatal diabetic shock by not giving him food for hours after a shot, and in his federal-court motion he wrote that during one forced injection — performed before the court order was issued — a nurse didn’t disinfect the injection site.

Joseph Tetrault, a Baltimore attorney who works for a group funded by the state of Maryland to represent prisoners in their legal complaints against the prison system, says he believes his client is now accepting the insulin shots. But he says Brown has filed “grievances” within the prison because he claims MCAC personnel are still not giving him food for many hours after his shots, despite the court order.

Tetrault says he might ask for a trial on the insulin issue: “Under Maryland law, a competent adult has the right to refuse medical treatment. We’re ready to litigate the case.”

Brown, an articulate but often-despairing activist who says he is devoting his life to fighting for human rights for prisoners — sometimes by threatening suicide — has become a national prisoner-rights cause. Supported by the National Lawyers Guild and the Southern Poverty Law Center, attorneys in Maine and Maryland are working on his federal suit.

Maine corrections officials and Assistant Attorney General Diane Sleek, who represents them, have in the past refused to deal with Brown’s complaints about his treatment in Maryland. Sleek says she has no comment on Brown’s recent federal-court motion, though she must give a response to the court by April 25.

In the motion, Brown also argues that officials shipped him 500 miles from Maine in violation of a federal court order dating from the 1970s — unearthed by the Phoenix last year, but ignored by officials — requiring that the state respect prisoners’ Constitutional due-process rights, such as by a formal hearing, before being shipped to another prison. His Maine attorney, Lynne Williams, of Bar Harbor, calls him “a political prisoner” (see “Maine Prison Bosses Violate Court Orders,” by Lance Tapley, June 29, 2007). Read more!

Suspected polie-killer ruled incompetent -New Orleans Times-Piscayne

by Laura Maggi
Tuesday April 23
The man accused of killing New Orleans police officer Nicola Cotton cannot competently assist in his own defense and must be sent to a state mental hospital for treatment, a Criminal District Court judge ordered Tuesday.

Bernel Johnson, 44, will be sent to the state forensic mental hospital in Jackson where doctors will evaluate him and attempt to improve his psychiatric condition enough for him to stand trial in the death of Cotton, 24, who was shot with her own gun in late January after a struggle in a Central City parking lot.

Judge Julian Parker ordered that Johnson be immediately transferred to the hospital after the testimony of three specialists, who all concluded that Johnson suffers from a psychiatric disorder that currently impairs his ability to stand trial.

But given the long list of pretrial inmates across Louisiana awaiting placement at the Feliciana Forensic Facility, Johnson likely won't be transferred for at least 30 to 60 days, said Lauren Mendes, a spokeswoman for the state Department of Health and Hospitals. Typical patients wait four to six months, but Johnson should get care sooner because of his history of severe mental illness and his high-profile case, she said.

"Regardless if he is incompetent or not, this individual should never ever walk the streets of New Orleans again, not as a free person," New Orleans Police Superintendent Warren Riley said n an interview with WWL television. "He killed a police officer. He did it once, whether he is considered sane or not, it could happen again."

The New Orleans Police Department did not respond to a request for comment by The Times-Picayune.

After Johnson was arrested on a charge of first-degree murder, several family members described him as a promising student and artist who graduated from St. Augustine High School. But he was diagnosed with paranoid schizophrenia when he was 19 and has spent most of his life in and out of mental health institutions, they said.

Charles Vosburg, a forensic psychologist, and Dr. Michelle Garriga, a forensic psychiatrist, said they tried to interview Johnson on Tuesday morning to determine his competency, but found him largely unwilling to answer questions. Johnson previously has been diagnosed as having either schizoaffective disorder or paranoid schizophrenia, said Garriga, who has had some access to Johnson's medical records.

Dr. Sarah DeLand, a forensic psychiatrist hired by the defense team, testified that she believed Johnson suffers from either schizoaffective disorder, a bipolar condition or paranoid schizophrenia.

When she first interviewed Johnson, DeLand said he spoke nonstop, exhibiting manic tendencies. But when she talked to him in March, DeLand said she encountered the same difficulties as Vosburg and Garriga.

Prosecutor Mary Glass repeatedly questioned the experts about whether Johnson is possibly malingering, or faking the extent of his illness to avoid trial.

Vosburg acknowledged that some of Johnson's refusal to answer questions is a conscious choice, but said part of his stubbornness also seemed tied to his mental illness. The only way to determine the extent of Johnson's illness and restore his ability to assist with his defense is to put him in a hospital setting where medical professionals can evaluate him over time, Vosburg said.

"He does have a treatable illness. I assume he can get much better than he is now," DeLand testified.

Laura Maggi can be reached at lmaggi@timespicayune.com or (504) 826-3316.
Read more!

State delays closing facility for elderly mentally ill - Providence (RI) Journal

By Felice J. Freyer

The state has delayed closing the Virks Building at Eleanor Slater Hospital, in response to a suit by the state mental health advocate.

The advocate, H. Reed Cosper, alleges that the state has been moving elderly, mentally ill patients into an inappropriate setting where they can’t get adequate treatment and supervision. He called it “patient abuse” and a violation of the state Mental Health Law.

But Ellen R. Nelson, director of the state Department of Mental Health, Retardation and Hospitals, said she is as concerned as Cosper about patients’ well-being and that “running to court” was counterproductive.

“We’re on the same side of the issue here,” Nelson said. “We’re trying to make sure we have adequate facilities and clinical care and medical care for all patients, and do that with a facility that’s less than ideal.”

Only nine people remain at Virks, which until recently had 50 patients. For more than a year, the state has been gradually moving patients to nursing homes or other buildings in the state-run hospital, which has campuses in Cranston and Burrillville. Some of the patients had lived for decades at Virks, which is in Cranston.

The state agreed to temporarily stop those discharges after a hearing in Superior Court on April 11, according to Cosper. The two sides met in a status conference at Superior Court yesterday, and now plan to hire an expert to try to reach agreement about the patients’ care, Cosper said.

Virks specializes in elderly, mentally ill patients who cannot live in nursing homes because of combative, inappropriate or dangerous behaviors. But the building is decades old, and located apart from other hospital buildings. Food has to be trucked in and patients needing medical care have to be transported in ambulances to other parts of the hospital. Nelson wants to consolidate hospital services in and near the six-story Regan Building, in Cranston.

Recently, the fourth floor of Regan received designation as a “mental health facility” by the state Division of Mental Health. That means that the unit meets standards for the housing of mental patients who have been involuntarily committed. The state wants to move the rest of the Virks patients to Regan 4, which has 28 beds and currently 18 patients.

Cosper said he will take his suit to trial unless the state can convince him that Regan 4 will not be more restrictive or less safe than Virks. He also is seeking a promise from the state to accept elderly mentally ill patients who have failed in nursing homes. And he said he would oppose housing more than 24 patients in Regan 4.

“I anticipate we can reach agreement,” Cosper said. “Or else we’ll have a hearing. There are issues that are non-compromisable.”

Nelson said she learned about Cosper’s suit from a reporter, and until then had not heard of his objections. “He couldn’t have a more cooperative director than me. I take his phone calls any time. I meet with him any time. I always listen to his point of view,” she said. “… If you can’t go with cooperation and collaboration first as an approach, it’s counterproductive in the long run. We’re hopeful that we can settle this thing soon.”

ffreyer@projo.com Read more!

Lack of answers leads to community rally -Niagra (NY) Gazette

04/23/08
By Mark Scheer

A group of concerned citizens and community care advocates gathered Tuesday outside Niagara Falls Memorial Medical Center to voice their displeasure about the lack of public involvement in plans to close a unit dedicated to psychiatric care for young people.

While generally resigned to the fact that the hospital’s Bridges Child and Adolescent Behavioral unit will close as planned, several rally participants said they wished the community had been given more consideration before such a significant change was made in mental health services for families in Niagara County.

“What do we do for people in need of services now?” said William Kane, director of Independent Living of Niagara County, the community health organization that sponsored the informational rally. “How will the children who need these services get them?”

Kane said his organization has been asking those questions and others of hospital officials since the health care facility’s board of directors announced its decision to close the 12-bed unit. Their biggest concern, he said, is developing comparable services locally.

“Ultimately, we would like to see these services remain in Niagara County,” Kane said.

Jacqueline Miller, a Buffalo resident who has been tending to the mental health needs of her 17-year-old grandson since he was 5, said she was “horrified” by the board’s decision.

Miller, whose grandson has received care in facilities as far away as Rochester, said Bridges offered not only convenience to families dealing with mentally ill children, but also a level of care unmatched in the region.

“It’s scary,” she said. “They are not thinking about the kids’ welfare.”

On Tuesday, officials from Memorial tried to make it clear that the transition plan they developed in preparation for the unit’s closure does take into account the needs of local children and families. Those attending the outdoor rally were invited inside the health care facility where they received new details about the location of future services and potential transportation options for children and family members.

According to Memorial officials, the unit’s proposed May 2 closure date has been accepted by the state Department of Health and has also been authorized by the state Department of Mental Health, pending county approval. The county’s Community Services Board endorsed the closure plan during a meeting Monday night, which should clear the way for the unit to cease operations as planned.

The unit will stop accepting new patients on Friday. In the future, children under 12 who visit Memorial and are in need of mental health assistance will be transferred to Brylin Hospital in Erie County. Adolescents older than 12 will be directed to Erie County Medical Center.

Nancy Kelleher, Memorial’s behavioral health administrator, said parents of child patients are still being advised to bring their children to the hospital for evaluation before they are transferred to BryLin. In non-emergency situations, she said parents are advised to transport adolescent patients directly to ECMC.

Memorial officials said Rural/Metro Medical Services will provide transportation for patients from the hospital to service providers in Erie County. In most cases, they said, the transportation costs would be covered by the patients’ insurance. In cases where transportation is not picked up by insurers, Memorial’s behavioral health administrator Nancy Kelleher said the hospital would pick up the cost.

“I know it’s tough,” Kelleher said. “Believe me, we are not having a good time here either.”

Todd Vaarwerk, disability rights advocate at the Western New York Independent Living Project, expressed concern about the transportation arrangements, wondering what will happen in instances when children from Niagara County are denied admittance once they are transferred to Erie County. In some cases, Vaarwerk said, individuals may not have the resources necessary to get them or their lived ones back home.

“What happens is you have the family isolated in Erie County with no way to get home?” he said.

Officials from Memorial also agreed to work with residents and community health organizations to develop an ad-hoc committee that would meet regularly to discuss various aspects of the plan and to assess its effectiveness.

In addition, the hospital will soon begin sending out informational letters to area hospitals, public safety organizations and parents of Bridges patients. A flier announcing the details of how to access services after May 2 will be sent to patient families, physicians, schools, service agencies and first responders.

“The process doesn’t end here,” said Memorial spokesperson Patrick Bradley.


For more info

Individuals with questions or who are in need of assistance with matters related to the unit’s closure are encouraged to contact Niagara Falls Memorial Medical Center at 278-4405 during normal business hours. Individuals seeking non-emergency services are asked to call Crisis Services at 285-3515 or Monsignor Carr at 205-0825 for outpatient assessments and treatment. Read more!

Medicaid plan stirs worry in N.C. -Raleigh (NC) News & Observer

Lynn Bonner
04/23/08

North Carolina would get about $514.6 million less than expected from the federal government in the first year of a Medicaid cost-cutting plan, according to a national advocacy group.

Families USA calculated the reduction in its first year would cost 11,700 North Carolina jobs and $412.1 million in lost wages. The group considered how federal spending ripples through the economy in its calculation of job losses.

To cut Medicaid costs, the Bush administration has rewritten the rules to limit payments to hospitals and eliminate federal funds for school-based outreach, among other changes.

"It's just a drastic reduction in Medicaid services at a time when people are struggling," U.S. Rep. David Price, a Chapel Hill Democrat, said during a teleconference Tuesday. The House is scheduled to vote today on a bill that would put the changes on hold until next year.

Hospitals have been lobbying hard to get Congress to stop the changes, stressing the threat to hospital survival and the health of poor patients. The state hospital association has estimated that 3,000 to 6,000 hospital jobs could be lost. Hospitals in the Triangle worry about losing tens of millions of dollars a year.

Medicaid is the state-federal insurance program for the poor and disabled, where the federal government pays about two-thirds of the costs. With a cut in federal funding, said Ron Pollack, executive director of Families USA, the state will have to decide whether to reduce services or pick up all the costs. "It puts the state in a very difficult situation," he said.

But in congressional testimony last year, Dennis G. Smith, federal Medicaid director, said the rules were a response to states' pushing more costs onto the federal government and asking for more money than they're owed.

In North Carolina, state officials realized in 2003 they had overpaid hospitals by hundreds of millions of dollars through the same program the rule changes target. In 2006, North Carolina and 51 hospitals agreed to repay the federal government $151.1 million for six years' worth of excess Medicaid charges.

Dan Gerlach, Gov. Mike Easley's senior policy adviser, said the changes would add to the financial burden on hospitals and endanger a state plan to convince more of them to care for mentally ill patients.

lbonner@newsobserver.com or (919) 829-4821

Read more!

Milford man admits knife attack on officer -Nashau (NH) Telegraph

04/23/04
By ANDREW WOLFE Telegraph Staff
awolfe@nashuatelegraph.com

NASHUA – A Milford man admitted Tuesday to slashing a police officer while attempting "suicide by cop" and was sentenced to at least one year in jail, most of which he has already served.

Christopher Dadley, 28, formerly of 95 Powers St., has been jailed since his arrest May 26, and the time he's served will count toward his sentence.

Dadley pleaded guilty to first-degree assault and a misdemeanor assault charge, admitting he threw a chair at Milford police officer Christopher Blastos, then later slashed Blastos' forearm with a knife while scuffling with officers who were trying to subdue him.

Dadley, who suffers from bipolar disorder, later told police he had intended to commit "suicide by cop," the prosecutor, Assistant Hillsborough County Attorney Paula Philbrook, said.

No one from the department was present for the plea and sentencing hearing Tuesday in Hillsborough County Superior Court.

Milford Police Chief Fred Douglas had commended the officers for their restraint in Dadley's arrest, saying his actions could have justified the use of deadly force. Douglas later clarified he didn't mean the officers would have shot Dadley.

Dadley fought with police at the Woodland Heights apartments after fleeing from a traffic stop on Route 101A, Philbrook said.

Dadley was sentenced to 18 months in jail, but is expected to serve about a year with time off for good behavior, his lawyer, Robert Moses, said. Dadley will remain on probation for three years, with an additional six months in jail deferred and then suspended so long as he stays out of trouble.

Dadley also will be required to abstain from alcohol or illicit drugs, undergo anger management counseling, and pay restitution to Blastos for any uninsured medical costs, and to the department for any damage he caused.

Dadley has a history of altercations with police, including a 2005 conviction for assaulting a Merrimack police officer. He also was questioned, though never charged, about a 2004 road rage fight in Merrimack in which a man was stabbed.

Judge Diane Nicolosi told Dadley his sentence was lenient considering the crime, and urged him to take full advantage of another chance.
Andrew Wolfe can be reached at 594-6410 or awolfe@nashuatelegraph.com
Automatic email verification now required to post comments. Anonymous posts still allowed. Details here.
Display Name(disqus.com/people/username — view full profile)
:)
blogfacebooklinkedintwitterdel.icio.usflickrtumblr
Follow comments
Is this you? Claim this profile.

clout (reputation points)
Powered by Disqus — Grab this!
discussion by DISQUS
Add New Comment
Expand Options [+] Read more!

Question jail care - Daytona Beach News Journal

Editorial: County should consider rebidding health contract

When Volusia County contracted with a controversial Tennessee-based company to provide health services at the Branch Jail, many warned that the company had a history of trouble.

In other areas, Prison Health Services had been accused of denying needed care to inmates, ignoring warning signs of dangerous health conditions and contributing to deaths. The most problematic area of the company's practice centered on mental health care -- lawsuits claimed that inmates entered correctional facilities stabilized on psychoactive medication, but quickly became worse when Prison Health Services doctors took those medications away.

It wasn't long before Volusia County started hearing similar complaints -- and then the lawsuits began to pile up. Some of those cases may well be nuisance suits. But local mental-health officials say they're seriously concerned about the standard of care at the jail. They cite stories, including that of a mentally retarded man who died in June after his condition deteriorated sharply at the jail, that the County Council should heed as it considers whether to renew Prison Health Services' contract.

County officials floated the idea of asking Prison Health Services to subcontract with Act Corp., the Daytona-Beach-based mental-health agency. That course was recommended in February by the Flagler/Volusia Behavioral Health Consortium, a group of mental-health and substance-abuse agencies and local leaders.

On one level, that proposal makes sense. Many of the people who encounter problems at the jail are Act clients, and Act has experience in institutional settings -- the agency subcontracted with Halifax Health Systems, which provided health care at the jail before Prison Health Services underbid it and won the contract in 2005.

But there's a bigger question to consider: Why keep Prison Health Services at all?

When the county signed on with Prison Health Services, the company promised to save the county $2.2 million through October 2008 over Halifax's rates. But in 2006, the company asked the county to increase its spending by $1 million. The company is asking for a $1 million increase in its next contract. To be fair, that includes a projected increase in jail population as well as a cost-of-living adjustment. But those figures don't include the cost of defending pending lawsuits, the latest of which was filed in April by a man who claims he went more than a month without the medication he needed for major clinical depression and schizophrenia.

County Chairman Frank Bruno says that if Prison Health Services doesn't strike an agreement with Act, he's ready to consider putting the entire jail health contract up for bid again. That seems like the wisest course. Other counties have made the decision to jettison Prison Health Services, and Volusia officials have a viable alternative -- Halifax and Act provided good care at the jail before, and presumably would be willing to do so again.

The county doesn't need to mollycoddle inmates -- but it's important to remember that many of the people in the jail have not been convicted of any crime. The county does need a provider willing to supply the care necessary to keep people from becoming sicker while in county custody. That should be the goal, and it seems as if that goal is not being met by the current contract with Prison Health Services. Read more!

Shedding light on mental illness -Pacifica (CA) Tribune

By Jane Northrop

The voices in her head told Kathleen Bernard to leave her home one February morning wearing nothing but a pair of cowboy boots on her feet and a towel around her neck.

Those same voices told her to knock on the door of the home of her Westcliff Court neighbor.When the neighbor opened the door, the voices told Bernard to punch her neighbor in the back and kick her stereo to the ground because they were in her way. She purposely strode to the stairway to get to the garage.

Once downstairs, Bernard tried to start the neighbor's Camaro. The neighbor stopped her, but not before Bernard bit her on the arm and pulled her hair. Bernard got out of the car, knocking some motorcycles down in the process, threw some tools at the neighbor and struck her in the back with a three-foot metal pipe, knocking her to the ground.

After Bernard tried but failed to start the neighbor's truck, she got on one of the racing motorcycles in the garage and coasted out of the driveway. When the neighbor tried to stop her, Bernard bit her on the hand.

Police caught up with Bernard circling the motorcycle around Gateway and Skyline and they apprehended her. She was taken into custody, but not before propositioning one of the officers.

Bernard, then age 30, was taken to San Mateo County Medical Center by ambulance and spent the next 72 hours receiving intense psychiatric care. Anti-depressants were prescribed. That episode was the worst manifestation of her mental illnesses - bipolar and schizophrenia - that she had experienced since first being diagnosed at age 15. She was eventually charged with use of a deadly weapon, vehicle theft and vehicle damage.

She could only remember that she briefly "woke up" on the motorcycle and the police were chasing her before she was about to go down a steep hill. When she "woke up" again, she was in the hospital. When her mother filled her in about the rest of her behavior, she felt thoroughly humiliated.

Her brushes with the neighbor and with the police were written up in a "Police Beat" item and published in the Feb. 15, 1995 Pacifica Tribune.

"I felt the humiliation. It was overwhelming," she said. "I was really humiliated, and then to have it in the paper! At least they didn't put my name in it, but people knew me from the address. People asked me if I was drunk or taking drugs. I said, 'no, I had a psychotic episode.'"

The incident didn't bode well for Bernard's standing in the community. She felt shunned from PTO leadership activities at her daughter's school, where she had previously taken an active role, and she said she was ridiculed by some of the parents.

Now Bernard, age 43, is more in control of her mental illness and has developed several ways to cope. She's been down a long, painful road that began in adolescence. She's expressed her deepest feelings in poetry and in an autobiography.

"If my story can help one person understand how devastating mental illness is, if my humiliation can save one person's life in getting help, then it's worth it. It's nothing to be ashamed of. The stigma is very big, but it's an illness and not a curse. It can be treated," she said.

Her first symptoms appeared when she was 15. She wonders now if her breakdown was triggered because her dad had died just a year before on her fourteenth birthday. After the diagnosis, she took medication and was in and out of the hospital for about a year.

"I just lost touch with reality. I thought I had the same powers as Jesus had. The medication pulled me out of the manic episode. I was high as a kite. I was telling people I loved them and everything was wonderful. Jesus was wonderful," she said.

She experienced another breakdown in 1993, a prelude to her very difficult morning with the neighbor in 1995. The night before the 1995 episode, she started hearing threatening voices for the first time. The voices said they wanted her dead.

"I sat there in a daze. I took my daughter to kindergarten the next day, took a shower and blacked out," she said.

It took a few more years, but she finally got to the point where she knew she was going to survive.

"By that time I was more aware of the mental illness and more grounded about the illness being severe," she said.

Even though she is now under a doctor's care and taking medication, Bernard still has disturbing symptoms. She still hears voices she knows are separate from reality, but she can do nothing to stop them.

"I still hear them. There is no magic pill for auditory hallucinations. Some people have to live with it. It's a chemical imbalance in the brain. There is not enough research for people who hear voices all the time. I wish they could make an earpiece so you could hear something pleasant," she said.

Just last March, Bernard was once again influenced by those voices.

"l blacked out and took a bottle of tranquilizers. I don't know if the voices took over. I was blacked out for two days. There are some people with mental illness who kill themselves by accident and they call it a suicide. The voices are always threatening - 'I'm going to kill you, today you die. I hate you.' Anything negative. My belief in God helped me get through this," she said.

She had no warning signs before that episode.

"My doctor can't explain it and I can't explain it. Research does need to be looked into auditory hallucinations. I think they are a health hazard," she said.

Because she has had more than half her lifetime to reflect on her mental illness, Bernard has become an advocate for more education, funding and research for patients and more support for their families.

She sits on the board of the San Mateo Commission of Mental Health, appointed by County Commissioner Rich Gordon in December. Meeting once a month in San Mateo, the board is a cross section of those who are affected by mental illness - family members, consumers and professionals.

Bernard has worked as a plumber's apprentice and holds a cosmetology license. She cuts hair for free for the homeless and volunteers to cut hair in a local hospice.

As an advocate, she goes to the places where mentally ill people gather or where they are given services. She reaches out to them.

"I'm going to find out what their needs are so I can express them to the board. I talked with one person in a group home who is not being treated well at all. Some are not fed enough. Some caregivers are abusive," she said.

On the flip side, Bernard also passes along helpful information and resources to the people she visits.

"These people are mentally and spiritually wounded. I want to get that information out to them. It's comforting knowing all this is out there. I was in the dark for a long time. My mother didn't know about these things when I was 15. I searched them out myself. I didn't know about them in 1995 either. It's like finding a rock and turning it over and finding a gold piece," she said.

Part of the information Bernard wants to pass along is the work conducted by the National Alliance on Mental Illness (NAMI) San Mateo County.

Founded in 1974, NAMI San Mateo County is dedicated to improving the quality of life for people with mental illnesses and their families through support, education and advocacy. NAMI advocates for access to quality health care, housing, education and employment, educates the public, works to eliminate the stigma of mental illness and advocates for increased funding for research into the causes and treatment of mental illnesses.

Kim Nobles, education program coordinator for NAMI San Mateo County, described how important it is for people with mental illnesses not to live in isolation.

"We run support groups for family members and offer resources and social and educational opportunities for people with mental illness. Because people with mental illnesses tend to isolate, it's important for them to get themselves involved in social and recreational activities with others with mental illnesses, at least initially, because they know each other," Nobles said.

Part of NAMI's work is helping law enforcement personnel anticipate what to expect when dealing with a person with a mental illness. Another part is helping people with mental illness feel more in control.

"Some groups do outreach in the street in lieu of calling the police. We do training for law enforcement in the county twice a year. How do you deal with situations when you get a call someone is having a breakdown, or an episode of hallucinating or is paranoid? Most often the usual law enforcement aggressive stance backfires because of the messages that are going on in the people's heads. We train them to anticipate that these people are not going to be able to respond to you because they are too busy struggling with angry self-destructive voices in their head. If you are in a particular stage of an illness, such as bipolar mania, you can become quite confrontational. Anyone who encounters you; they don't know. That's why we think what we do in terms of education and support is really important. There's a whole self-help aspect as well, some people with mental illness providing to others," Nobles said.

What NAMI provides on the social level, NARSAD provides on the scientific level. Previously known as National Alliance for Research on Schizophrenia and Depression, the organization now goes by NARSAD: the leading charity dedicated to mental health research to reflect its broader interests. It was originally incorporated in 1981 by three national mental health organizations. It has distributed more than $219 million in research grants to scientists throughout the world.

Research is ongoing on multiple fronts and new reports are published frequently on the NARSAD website. To help Bernard and others like her, one team is seeking ways to detect mood disorders and bipolar disorder through a blood test, although their work is not yet ready for clinical applications. Another team is examining the disease from a cellular level because of the difficulty treating the disease based on the way it presents itself in various stages. Another researcher is looking to bring bipolar patients quicker relief through Tamoxifen to supplement the mania medication that takes three weeks to work, too long for those who may make irreparable bad decisions in the meantime. With the genes for bipolar identified, scientists are hopeful they can do more than treat mania and depression, they hope they can restore people to their normal lives. (source: www.narsad.org)

Bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year. Approximately 2.4 million or about 1.1 percent of American adults have schizophrenia in a given year. Mental illnesses are the second leading cause of death and disability in the world, surpassed only by heart disease. In developed countries, barely 25 percent of government research spending goes to the study of psychiatric disorders. In the rest of the world, funding for mental illness is almost non-existent. (source: World Health Organization).

Bernard is a survivor. She enjoys going to the Oceana pool and walking on the beach and spending time with her daughter, now 19, and her mother. She enjoys working on her poetry and would like to see her autobiography published.

Here are a few excerpts from her poem, "What the hell is your problem?"

— "People can be different you will find, They may look normal yet suffer from an Illness of the mind, This is an Illness people try to ignore and cover, But let's get real it's time to discover! The reality is I have my pride, I am mentally ill and I will not hide!"

Here is an excerpt from her poem "Free at Last."

— "I hid my Illness, it was a shame to man, I remained in the darkness then in my mind came a plan, Seeking the truth my heart did fill, To give hope to others who are mentally Ill, It's time to come forward and let others know, I may live in a different life now it's time to grow, Sharing my story and how I survive, May bring you hope even keep you alive."

She recommends the book "Surviving Schizophrenia: A Manual for Families, Consumers and Providers" by E. Fuller Torrey, the movie "A Beautiful Mind" and Patty Duke's book, "A Brilliant Madness: Living With Manic Depressive Illness." On the other hand, she'd like to outlaw those tee shirts that read, "the voices made me do it."

"Some people don't take it seriously. This is a devastating illness," she said.

Because she is a survivor, she is keen to help others.

"Yes, you can survive. They need more education for the people who are out there already. I'm doing everything I can to keep myself sane and seek spiritual help," she said. For advocacy information, email Kathleen_Bernard@yahoo.com




Read more!

Murray seeks resignation of top VA mental health official - Associated Press

April 22, 2008

WASHINGTON - A Democratic senator on Tuesday called for the chief mental health official of the Department of Veterans Affairs to resign, saying he tried to cover up the rising number of veteran suicides.

Sen. Patty Murray, D-Wash., said Dr. Ira Katz, the VA's mental health director, deliberately withheld crucial information on the true suicide risk among veterans.

"Doctor Katz's irresponsible actions have been a disservice to our veterans, and it is time for him to go," said Murray, a member of the Senate Veterans Affairs Committee. "The number one priority of the VA should be caring for our veterans, not covering up the truth."

Murray and other Democratic senators said they were appalled at e-mails showing Katz and other VA officials apparently trying to conceal the number of suicides by veterans. An e-mail message from Katz disclosed this week as part of a lawsuit that went to trial in San Francisco this week starts with "Shh!" and refers to the 12,000 veterans per year who attempt suicide while under department treatment.

"Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?" the e-mail asks.

A VA spokesman declined immediate comment Tuesday.

Another e-mail said an average of 18 war veterans kill themselves each day - and five of them are under VA care when they commit suicide.

"It is completely outrageous that the federal agency charged with helping veterans would instead cover up the hard truth - that more and more Americans coming home after bravely fighting for their country are suffering from mental illnesses and in the most tragic circumstances, committing suicide," said Sen. Tom Harkin, D-Iowa. "Anyone at the VA who is involved in this cover-up should be removed immediately."

Harkin, Murray and Sen. Russ Feingold, D-Wis., introduced legislation Tuesday calling on the VA to track how many veterans die by suicide each year. Currently, VA facilities record the numbers of suicide deaths and attempts in VA facilities - which have increased from 492 in 2000 to 790 in 2007 - but do not record how many veterans overall take their own lives.

The new bill would require the VA to report to Congress within 180 days the number of veterans who have died by suicide since Jan. 1, 1997, and continue reports annually.

Two veterans groups last year filed the class-action lawsuit against a sprawling VA system that handled a record 838,000 claims last year. A government lawyer on Monday urged a judge to dismiss the lawsuit, saying the agency runs a "world class" medical care system.

Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Read more!

County studies mental handling; jail burdened with inadequate system for housing patients - Memphis Commercial Appeal

By Wayne Risher
April 22, 2008

Parkwood Hospital's CEO offered DeSoto County a deal Monday on treating mental patients who'd otherwise languish in the county jail.

Dr. Andy Mayo said the private mental health facility in Olive Branch could serve a limited number of county patients for slightly more than half the state's average treatment cost.

At $400 a patient a day, plus a $65 physician fee, Mayo's offer would be much lower than the state average $782. However, officials told Mayo they weren't sure county government can afford to pay for what's supposed to be a state government responsibility.

The handling of mental patients in jail has been a controversial topic in DeSoto County and around the nation in recent years. Mayo and Hernando attorney Jim Franks addressed the Board of Supervisors about the county's burgeoning caseload and the current system's inadequacy.

Supervisors took no action, but asked Mayo and Franks to speak to a Council of Governments gathering of city and county leaders to see if cities would join the county in funding better services.

Sheriff Bill Rasco said the 370-bed jail on any given day holds in the "low 20s" mentally ill people awaiting processing or transfer to state institutions. While it costs the county only about $20 a day to jail them, the mental patients aren't getting the treatment they'd receive at Parkview or the state hospital.

Last May, a 30-year-old woman awaiting transfer to a state hospital died at the jail. Rasco said a female patient currently in the jail has been there six months pending availability of a bed at a state institution.

Mayo said his offer of discounted services was intended to provide the county with an alternative to keeping people in jail for extended periods while waiting for the state to provide treatment. Parkwood has 36 adult beds.

"The volume of commitments we have in the county is growing at an unbelievable rate," Mayo said.

He said there were 55 commitments from Baptist DeSoto in the first quarter of 2008, compared to 152 people last year.

Franks represents Baptist DeSoto, Parkwood, Lakeside and others in the mental health system. He said probably 20-30 percent of the mentally ill inmates in the jail are there because they've stopped taking prescribed medications.

An inmate sent to Parkwood might require a stay of seven to 10 days to be fully stabilized and put back on medication, Mayo said. After such a stay, the individual might be released to family members and required to undergo after-care -- a regular checkup to make sure they stay on the medications.

The jail has an attending physician, but the doctor is not a mental health specialist and wouldn't be as familiar with the wide range of mental disorders and drug treatments available, Mayo said.

"It's inhumane," Supervisor Bill Russell said of the current system, "but I don't think we can afford to send all of them to Parkwood."

County Administrator Michael Garriga said he's exploring grants that could help the county tackle the problem.

Board president Allen Latimer asked if mental health programs are a proper function of county government.

Franks said, "In my opinion, the state's not pulling their load. They're not funding the state hospital. They're not taking care of the mentally ill."

Garriga said although it's a state responsibility, some Mississippi counties have taken initiatives to improve the lot of their mentally ill. Harrison County, for example, spends $1 million a year on a crisis intervention center.

Said Franks, "It's the right thing to do. It's the medically right thing to do, and it's the morally right thing to do."

-- Wayne Risher: (662) 996-1421
Read more!

Mentally Ill Man Dies In Struggle With Richmond Police - NBC11 San Francisco

April 22, 2008

A mentally ill Richmond (CA) man who had reportedly been threatening a woman at a local treatment facility died early Tuesday morning after four Richmond police officers attempted to subdue him, Richmond police Lt. Mark Gagan said.

At about 3:11 a.m. officers were called to a mental health treatment facility in the 3200 block of Florida Avenue on the city's south side.

Staff members at the facility had reported that Uriah Samson Dach, a 26-year-old male resident, was out of control and threatening a female resident, Gagan said.

Two officers attempted to control Dach, a 6-foot 3-inch, 350-pound man, with verbal commands, but he wouldn't listen, authorities said.

The officers called for emergency backup and then began attempting to physically subdue him using pepper spray, a Taser stun gun and a baton, but Dach continued to resist, Gagan said.

The struggle moved through several rooms inside the facility and then outside, where two more officers joined the effort. The four officers were eventually able to handcuff Dach with several pairs of handcuffs, Gagan said.

Once Dach was handcuffed, however, officers realized he had stopped breathing.

The officers began administering CPR with help from an ambulance crew that had been called to the scene earlier in the struggle. The ambulance was standing by because the officers had been intending to have Dach committed to a secure facility, Gagan said.

Dach was taken to Doctors Medical Center in San Pablo, where he was pronounced dead.

His death is being investigated by the Contra Costa County District Attorney's Office.

The Richmond Police Department's professional standards unit is conducting a parallel investigation.

There was no obvious cause of death, Gagan said, and officials will be relying on an autopsy to determine how Dach died.

"None of the force the officers used could be considered lethal force," Gagan said.

Dach's family has been cooperating with the investigation. Police have worked with his mother in the past. She has been called to help control Dach multiple times, including an incident Monday where Dach allegedly became aggressive and confrontational against a nurse at Doctors Medical Center, Gagan said.

Police have also been called to the Florida Avenue facility three times in the past two months on reports of out of control behavior. In one incident, Dach was allegedly armed with Mace, Gagan said.

Sign Up For Breaking News E-mail Alerts

Read more!

Homeless Violinist, Journalist Forge Unlikely Friendship -National Public Radio

This audio broadcast can be heard here.

April 22, 2008 · Los Angeles Times columnist Steve Lopez was strolling through the city when he saw a homeless man playing classical violin. His name, Lopez discovered, is Nathaniel Ayers. And, in addition to musical talent, Nathaniel has schizophrenia.

Lopez talks with Farai Chideya about his friendship with Ayers and how he captured it in his new book, The Soloist: A Lost Dream, an Unlikely Friendship, and the Redemptive Power of Music. Read more!

Special-needs N.C. Medicaid payments held up - Asheville (NC) Citizen Times

Leslie Boyd

The federal government will withhold up to $175 million in Medicaid payments to North Carolina for a service offered to people with severe mental illnesses and developmental disabilities.

The service, called community support, helps people with everyday tasks, but last year billings were millions of dollars over original estimates, and the Department of Health and Human Services cut the rate it pays for the service.

The overruns also caused the federal Center for Medicare and Medicaid Services to review the service, and the agency is demanding a review. It will withhold the money until the service is defined to its satisfaction and the issue of abuse is resolved, said William Lawrence, acting director of the N.C. Division of Medical Assistance.
“Right now it’s a deferral, not a disallowance,” Lawrence said. “The state has 60 days to address the issue, and it can ask for a 60-day extension. We are working to address the issues.”

Cost overruns

The service was approved by Medicare and Medicaid Services two years ago, but the cost overruns prompted the N.C. Department of Health and Human Services to slash the rate it pays for the service from about $60 an hour to $40. The rate later was raised to about $50 an hour.
“The problem was that the definition for the service wasn’t clear,” said Debra Dihoff, executive director of the North Carolina chapter of the National Alliance for Mental Illness. “People interpreted it pretty widely, and it was written so they could do that.”
Some service providers used the service to help children with developmental disabilities learn social skills by taking them to public places like movie theaters and parks, and then-Health and Human Services Secretary Carmen Hooker Odom accused them of bilking the system.
Joe Martin, executive director of Alpha-Omega Health’s Western Region, said there were abuses, but the vast majority of providers were trying to do the best for the people they serve.
“There were people who came in hoping to make a killing,” Martin said. “But in the end, we all got painted with the same brush.”

Too little guidance?

Martin said the state provided little guidance or oversight for the service until the costs got out of hand, then the federal government took notice and demanded change. Originally, though, Medicare and Medicaid Services approved the definition as it was written.
“The federal government approved the plan,” said Dan Gerlach, senior policy adviser to the governor for fiscal affairs. “They signed off on it.”
Martin said everyone has blamed everyone else in the fiasco, but he believes someone should have noticed how easy it would be to abuse community support, especially when the state offered little guidance on what services would be appropriate.
“Somebody should have known better,” he said.
Lawrence said the state is working with Medicare and Medicaid Services to address the issues surrounding community support, but some fear that will mean fewer people who really need day-to-day support will get it.
“We’re afraid there’s an attempt to remove people with chronic illnesses,” Dihoff said. “They want to see improvement — something they don’t ask for in treatment of chronic illness on the primary care side. It flies in the face of everything we know about disease management.”

Read more!

Study: Midwest has the worst drunken driving rates - Associated Press

By KEVIN FREKING

WASHINGTON -- The upper Midwest has the worst drunken driving rates in the country, according to a government report that says 15 percent of adult drivers nationally report driving under the influence of alcohol in the previous year.

Wisconsin leads the way. The federal government estimates more than a quarter of the state's adult drivers had driven under the influence. Rounding out the worst five are North Dakota, Minnesota, Nebraska and South Dakota.

Utah had the lowest incidence of drunken driving. It was the only state where fewer than 10 percent of adult motorists reported driving under the influence. Following closely behind were a slew of Southern states that often fare poorly when it comes to government health statistics. This time, however, they're serving as models. West Virginia, Arkansas, Kentucky and North Carolina all had drunken driving rates for the prior year of less than 11 percent.

The report on drunken driving relies on data obtained from the National Survey on Drug Use and Health. The survey, based on a scientific random sample of households, asked 127,283 adults in 2004, 2005 and 2006 whether they had driven under the influence in the past year. Health experts say the state-by-state breakdowns support other surveys showing that residents in northern states are more likely to engage in heavy alcohol consumption.

"It's not surprising, but it means that these jurisdictions should take this data and think about how they approach public education campaigns and enforcement campaigns," said Dr. H. Westley Clark of the Substance Abuse and Mental Health Services Administration, which released the report. The agency is a part of the Department of Health and Human Services.

Eric Goplerud, research professor at George Washington University Medical Center, said cultural and demographic issues probably have a role in the higher rates of driving under the influence in certain states. He said that religious affiliations in the Southeast often strongly discourage drinking, but that doesn't occur so much in the upper Midwest.

"A good part of the social life is around drinking," said Goplerud, who is also director of Ensuring Solutions to Alcohol Problems, which call for increased access to treatment programs.

Also, blacks drink at substantially lower rates and at less hazardous rates than whites, he said. The populations in those states are heavily white.

Jeffrey Ratliff-Crain, associate professor of psychology at the University of Minnesota-Morris, noted that the Minnesota Legislature is considering a bill that would let bars stay open until 4 a.m. during the Republican National Convention, pouring more money into the economy.

"We're making it easier to drink to all hours of the night, but (drinking and driving) didn't come into the discussion," Ratliff-Crain said. "There is a seeming acceptance that this is the way it is. Of course people are going to be drinking and driving, and well, that's it."

Clark said states with the lowest rates for driving under the influence shouldn't take comfort in the data.

"Even in Utah, which reported the nation's lowest rate, nearly one in 10 drivers report driving under the influence of alcohol within the past year," Clark said. "So, even in states that have low consumption rates or low DUI rates, they too need to reflect on the approach they're taking. We don't want people to lull themselves into a false sense of security."

A majority of Utah residents are Mormon. The religion bars the use of alcohol.

It's illegal to drive with a blood alcohol level of 0.08 percent or higher.

In the past decade, the number of impaired drivers involved in alcohol-related crashes has remained relatively stable _ from 12,348 in 1996 to 12,491 in 2006. Those figures cover drivers with a blood-alcohol level of 0.08 percent or higher.

The federal government also released estimates of driving under the influence of illicit drugs. The rates were highest in the District of Columbia, 7 percent; Rhode Island, 6.8 percent; and Massachusetts, 6.4 percent.

The states with the lowest rates for driving under the influence of illicit drugs within the past year were New Jersey, 3.2 percent; Alabama, 3.4 percent; and North Dakota and South Dakota, 3.5 percent.

___

Read more!

Democrats seek resignation of top VA mental health official - Associated Press

WASHINGTON (AP) -- Two Democratic senators on Tuesday called for the chief mental health official of the Veterans Affairs Department to resign, saying he tried to cover up the rising number of veteran suicides.

Sens. Daniel Akaka of Hawaii and Patty Murray of Washington state said Dr. Ira Katz, the VA's mental health director, withheld crucial information on the true suicide risk among veterans.

''Dr. Katz's irresponsible actions have been a disservice to our veterans, and it is time for him to go,'' said Murray, a member of the Senate Veterans Affairs Committee. ''The No. 1 priority of the VA should be caring for our veterans, not covering up the truth.''

Akaka, the committee's chairman, said in a letter to the VA that Katz's ''personal conduct and professional judgment'' had been called into question by his response to veteran suicides.

Veterans, and the VA itself, ''would be best served by his immediate resignation,'' Akaka said.

A number of Democratic senators said they were appalled at e-mails showing Katz and other VA officials apparently trying to conceal the number of suicides by veterans. An e-mail message from Katz disclosed this week as part of a lawsuit that went to trial in San Francisco starts with ''Shh!'' and claims 12,000 veterans a year attempt suicide while under department treatment.

''Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?'' the e-mail asks.

A VA spokesman declined to comment Tuesday.

Another e-mail said an average of 18 war veterans kill themselves each day -- and five of them are under VA care when they commit suicide.

''It is completely outrageous that the federal agency charged with helping veterans would instead cover up the hard truth -- that more and more Americans coming home after bravely fighting for their country are suffering from mental illnesses and in the most tragic circumstances, committing suicide,'' said Sen. Tom Harkin, D-Iowa. ''Anyone at the VA who is involved in this cover-up should be removed immediately.''

Harkin, Murray and Sen. Russ Feingold, D-Wis., introduced legislation Tuesday calling on the VA to track how many veterans commit suicide each year. Currently, VA facilities record the number of suicides and attempted suicides in VA facilities -- but do not record how many veterans overall take their own lives. The agency, however, is reluctant to disclose specific numbers, veterans advocates complain.

The new bill would require the VA to report to Congress within 180 days the number of veterans who have died by suicide since Jan. 1, 1997, and continue reports annually. Harkin's office said statistics provided earlier this year by the VA showed that 790 veterans under VA care attempted suicide in 2007. That figure is contradicted by the e-mail revealed this week.

Two veterans groups last year filed the class-action lawsuit against a sprawling VA system that handled a record 838,000 claims last year. A government lawyer on Monday urged a judge to dismiss the lawsuit, saying the agency runs a ''world class'' medical care system.

Read more!

Report estimates NC could lose $2.7 billion in Medicaid dollars - Asheville (NC) Citizen-Times

Leslie Boyd
April 22, 2008

A series of new Medicaid regulations proposed by President George Bush would slash an estimated $514.6 million from North Carolina in the coming year, according to a report issued this morning by Families USA, a national advocacy organization.

“States have two alternatives,” Ron Pollack, executive director of Families USA, said during a morning press conference. “They can discontinue services the federal government won’t pay for or they can try to pay for all the services themselves.”

According to the report, “Bad Medicine,” the state stands to lose $2.7 billion over the next five years, and the ripple effect will cost the state 11,700 jobs and $412 million in lost wages during the first year alone.

“This is just an incredibly morally bankrupt policy,” said U.S. Rep. David Price (D-NC 4th District). “And this is exactly the wrong time to do this. It’s like a $50 billion anti-stimulus bill for the economy.”

The regulations were issued by the administration without congressional review, and Price is leading an effort to pass legislation that would put their implementation on hold for a year. The House is scheduled to vote on the bill, HR5613, tonight.

President Bush has threatened to veto the bill, but Price believes there is enough support to override a veto.

Medicaid is a state-federal financial partnership. For every dollar a state spends on Medicaid, the federal government contributes matching funds. For every dollar North Carolina spends on Medicaid, the federal government contributes $1.78.

“The problem here is not that the federal government is telling us what to do or not to do,” said Dan Gerlach, senior policy advisor to the governor for fiscal affairs. “The problem is they’re just shifting the cost.”

The regulations in question affect rehabilitation services for people with developmental and other disabilities and mental illness, school outreach programs that help eligible children get Medicaid, education programs and funding for public hospitals.

“It’s a direct hit, right away, to people with mental illness and developmental disabilities,” Gerlach said. Read more!

Panel questions law as solution to homeless colony - New Orleans Times-Piscayne

by Katy Reckdahl
April 21, 2008

Councilwoman Shelley Midura on Monday summarized why Mayor Ray Nagin's administration wanted a new public habitation law to move vagrants to a bunkhouse at the New Orleans Mission.

"What you're saying is that we need a way to round them up and get them into the bunk beds. Is that a fair statement?" Midura asked Anthony Faciane, deputy director of neighborhood stabilization for the city's Office of Recovery Development and Administration.

That was fair, he told the council's Housing and Human Needs Committee.

But more than a month after city officials announced an initiative to enact a new law, which outlaws people living in public spaces and replaces one declared unconstitutional more than 20 years ago, the homeless compound under the elevated section of Interstate 10 remains entrenched.

"Is it legal? Has it worked?" Midura asked.

"Has the method worked anywhere?" Councilman James Carter asked.

When told by Faciane that the city couldn't yet afford to house and provide social services to Claiborne Avenue denizens, Carter responded, "So, the ordinance is premature?"

The meeting was punctuated with expressions of impatience about the visible homeless colony, a collection of people and bedrolls just off Canal Street. "What button needs to be pushed -- what needs to happen?" Midura asked Faciane.

Discussion about the public-habitation ordinance gave way to its underlying motive: making the Claiborne Avenue tent city disappear.

In the end, Faciane and Martha Kegel, head of the homeless-services collaborative UNITY of Greater New Orleans, agreed: The colony's days are numbered. Within three months, it'll be gone, said Kegel, who said state funds expected within the next few weeks will help move many of the homeless from under the bridge into government-subsidized apartments.

Moving many of the homeless awaited completion of a city-financed renovation of the dayroom at the New Orleans Mission, Faciane said. Finished Monday, it transformed the shelter from nights-only to a round-the-clock operation. Next week, the mission also will open a family center, for women with children, he said.

What the mission calls its "bunkhouse," an air-conditioned, heated Quonset-style tent erected at the back of its property, can hold 140 men. About 100 more men can sleep on the mission's second floor, but only if the shelter hires a "firewatch," because of its building's current fire hazards. Women stay in a separate house, which has space for eight more, said Ron Gonzales, the shelter's director.

But the Nagin administration insists that the proposed ordinance is intimately connected to the fate of Claiborne Avenue's tent city.

"The public-habitation ordinance is a critical tool that will greatly enhance our ability to address issues of homelessness in New Orleans .¤.¤. such as what is occurring near the intersection of Claiborne Avenue and Canal Street," Nagin said in a statement released during the committee meeting.

In February, Nagin announced a plan to move the camp to the mission. New Orleans would begin enforcing its "habitation laws," he told WWL-TV. "We have beds for these folks and they just don't want to take them. ... So we're going to try to push the issue, if you will," he said.

But in 1986, a federal judge found the city's public-habitation ordinance unconstitutional. It was stricken from municipal code six years ago.

As drafted, this ordinance is different, in several ways. The newly proposed law mandates that no one will be arrested for inhabiting public spaces if all local shelter beds are filled. Neither Faciane nor the city attorney's office lawyers could provide detail about ordinance-described "safe" zones: public places to sleep lawfully on public property.

Still, a long line of citizens spoke against the ordinance. Offering shelter beds in lieu of arrests won't work for those suffering from mental illness, who typically cannot tolerate the crowded, noisy conditions in a shelter, said Kathleen North, a social worker who works with the homeless. "To many mentally ill people, saying, 'You have to go to a shelter,' is like saying to someone in a wheelchair, 'You have to go up those stairs.' "

Katy Reckdahl can be reached at kreckdahl@timespicayune.com or (504) 826-3396. Read more!

Program keeps the mentally ill out of state jails -Jacksonville (FL) Times-Union

By WENDI ZONGKER,
The Times-Union

YULEE - The man, hallow-cheeked with dirty blond hair, stood before Judge Brian Davis in Nassau County's mental health court this month.

With his hands clenching his wrists behind his back, he looked down and laughed nervously as Davis asked questions about how his court-ordered treatment was progressing.

The mission of Nassau's mental health court - one of 10 statewide - is to keep mentally ill people out of Florida's jails, said Judi Evans of Florida's National Alliance on Mental Illness. It was the first such court in Northeast Florida.

Evans said 40,000 people with mental illnesses are incarcerated in Florida.

A revolving door

"We're trying to provide a means for people whose mental illness has been the driving force of their involvement with the justice system an opportunity to avoid what is usually a revolving door," Davis said. "It's a misuse of the jail system to have sick people there."

Duval County began a pilot mental health court in January and has six clients, Director Joe Stelma said.

The man meeting with Davis has been seeing the judge for short sessions every two weeks for three months after his arrest for having a concealed weapon.

"I understand that he's trying to help me not to come back here," he said of Davis.

Another man, who appears timid and stutters when he talks, has been before Davis' court every two weeks since December and he said he plans to participate as long as it takes to get him well again.

And that's the program's goal, Davis said.

"The program is not designed to release violent, mentally ill people back onto the streets," he said.

Violent offenders are not eligible. But Davis and Stelma said prosecutors, public defenders and mental health professionals can refer clients who have committed misdemeanors or low-level felonies.

A voluntary program

Mental health professionals screen referred candidates to determine if their mental illness can be treated with counseling and medication. If so, they are invited to participate in the voluntary program in which they are ordered to attend treatment and take medication. Davis said most will participate for six months to a year, after which the charges are dropped.

But choosing not to participate or dropping out of the program means those charges are reinstated, Davis said.

Nassau's pursued a mental health court for years but didn't receive state funding until October when the state Department of Children and Families awarded Nassau a three-year $75,000 grant, bringing the court's total budget to $225,000 a year, Davis said.

But Stelma said Duval's mental health court hasn't received any state funding and instead relies solely on local agencies such as River Region Human Services and Gateway Community Services, agencies also stretched thin for funds.

Nassau's budget pays the program director's salary, administrative costs and services such as treatment, medication and transportation for clients.

Evans said Florida ranks 49th nationally for mental health spending and treatments.

And she doesn't expect that rank to go up anytime soon.

"We are way down, bottom of the barrel," she said. "And with the budget cuts we're looking at, we're going to get worse."

wendi.zongker@jacksonville.com

261-7606, ext. 6353

Read more!

Mentally ill offenders may lose triage center -Orlando Sentinel

Kate Santich

Proposed state cuts to a highly touted program for those with mental illness and substance-abuse problems in Orange County likely will leave already-overcrowded emergency rooms and jails to take up the slack.

The Florida Legislature is cutting $2.25 million from the county's Central Receiving Center -- essentially a triage area where law-enforcement officers can take people who are disturbing the peace, trespassing or committing other nonviolent crimes because of a mental-health problem. Workers there then assess the person's condition and decide the best placement, such as a psychiatric unit or a treatment center.

"A lot of times, people who are disorderly because of their mental illness or because of their [addiction] can become combative, or they can be doing a number of things that are illegal," said Donna Wyche, manager of the Mental Health and Homeless Issues Division for Orange County. "But all they may really need is to get back on their medication."

Advocates say closing the center will be bad for everyone -- the mentally ill, the police who chaperon them, the jail personnel who book them, the hospitals that treat them, and even emergency-room patients who may have to wait for treatment because of them.

"The community cannot afford to let the center close," said Rich Morrison, regional vice president of Florida Hospital and vice chairman of CRC's governing board. "In the scheme of things, it's not terribly expensive, and we hope once the impact is realized, cuts will be made elsewhere instead."

Like advocates for other social-service programs on the chopping block, Morrison hopes the money will be restored in a conference committee of the state House and Senate. But no one predicts an easy fight.

Before the CRC opened in 2003, two women died during unsupervised methadone withdrawal at the Orange County Jail, prompting lawsuits that cost the county more than $5.5 million in settlements with the women's families. In part because of the deaths, a jail oversight commission recommended some 200 changes, including the creation of the receiving center.

The concept for the center is a model for the state and even the nation. Representatives from other states have toured the facility, hoping to replicate the program. Law-enforcement officers also have embraced the idea because it puts them back on patrol quickly instead of leaving them tied up with paperwork to process those in their custody. On average, they spend about eight minutes dropping off a patient at the CRC. A trip to an emergency room is likely to last hours.

"These patients tend to be very disruptive, and they have to be constantly supervised," Wyche said. "If you've got 15 psych patients in an emergency department and you're sitting there trying to get your child in for some stitches in the back of his head, you're going to be waiting a while."

Putting the person behind bars is hardly a good option, either, officials said. "The jail truly is not the place for someone who suffers from a serious mental illness," said Lt. Deanne Adams, the crisis-intervention team coordinator for the Orange County Department of Corrections. "Someone who is in the throes of that illness needs to have one-on-one contact. They need to have therapy, and they need to have medication readily available. . . . We're not a treatment facility."

Adams added that merely being brought to a jail is often traumatizing in itself, especially for someone who is unstable. The receiving facility, on Mercy Drive in Orlando, looks like a doctor's waiting room.

It handles about 6,000 patients a year, a number expected to increase as the population grows. Yet last year lawmakers cut funding slightly from the $2.8 million the CRC got in 2005.

But cutting the money altogether ultimately means someone else will end up paying, Morrison said. Likely it will be the county and privately insured hospital patients who will subsidize the poor and uninsured.

"That's just a hard reality," Morrison said. "There's no free lunch."


Kate Santich can be reached at 407-420-5503 or ksantich@orlandosentinel.com.

Copyright © 2008, Orlando Sentinel Read more!

Creating a richer life -Staten Island (NY) Advance

Monday, April 21, 2008
By ANDREA BOYARSKY

STATEN ISLAND, N.Y. -- Rob R.'s unframed paintings hang side by side. On one canvas, a solitary boat sails past a mountainous landscape. The other shows lush green grass, trees, a mountain, blue sky and bright sun.

Tacked beneath these two distinct works, a poem written by the artist reads: "Hope is there for all who seek, giving strength to those who are weak. Hope supports you when you fail, giving a smile during great travail."

To the passerby, they're two paintings and a poem. To the art therapists at Richmond University Medical Center (RUMC), they're signs of getting better, overcoming obstacles and coping with mental illness.

"Art therapy is a means of communicating without words," said Adrienne Yurinko, a licensed and registered art therapist at the West Brighton hospital. "[For] a lot of patients, their biggest obstacle is to have a sense of normalcy. They become something more than a patient. They become an artist here."

In March, the hospital held an exhibit during national Creative Arts Therapy Week showcasing the paintings, drawings, sculptures and writings of more than 270 mental health patients in three art therapy programs. The patients have persistent mental illnesses, such as depression, anxiety disorders, schizophrenia and bipolar disorder. Their ages range from 18 to 70.

Ms. Yurinko and fellow art therapist Linda Iacurto said the artwork helps them assess how a patient is feeling. For example, Rob R.'s painting of the boat was drawn during his first few months in the program, while he was struggling with depression and psychosis.

"There's a lot of space, emptiness. It's disconnected and disorganized," Ms. Yurinko said. "As he progressed, the artwork become fuller and brighter."

Throughout the country, art therapy is used in hospital, educational and rehabilitation settings, as well as prisons to help address mental health needs, explained Laura Greenstone, chair of the National Coalition of Creative Art Therapies Associations. Ms. Greenstone uses art therapy in her job at a domestic violence agency in Monmouth County, N.J.

POSITIVE EXPRESSION

Art therapy helps alleviate emotional problems and promotes expression in a positive, healing way, she said. Many people with mental health disorders have trouble expressing their experiences or emotions. Art allows them to do so through a canvas or paper. It can also be less threatening than talking to someone directly about their problems, Ms. Greenstone said.

"People with mental illness may feel very isolated, it may be hard for them to engage with other people," she added. "Art gives them a common ground. It can be self-esteem raising. They can feel positive about something that is positive and productive."

Art became part of "Jack's" life 10 years ago. He has been participating in RUMC's art therapy program for more than three years. Before he began, he suffered from anxiety and depression. Art, he said, has given him a better equilibrium and helps him relieve tension.

"Every day gets better and better for me because I'm expressing myself through art," said the Staten Island resident, noting that he now wants to go out and is looking forward to getting a job. "I can stand up for myself and say, 'I accomplished something.'"

Leading a productive life is one of the goals for patients, explained Martin Phillips, administrator for RUMC's continuing day treatment program. Art therapy helps teach patients the cognitive and behavioral skills they need to function in the real world, he said.

"This is not arts and crafts," said Phillips. "This is people who otherwise would not be able to do what they're demonstrating.

GROUP DYNAMICS

During a recent RUMC art therapy session held on the grounds of Sea View Hospital Rehabilitation Center and Home, Jack was working on a painting of two people kneeling together. He held up the work -- done in shades of red and blue -- in front of the class of around 15 telling them, "I want to make it look worthwhile."

To help build the group's self-esteem and foster communication between them, Ms. Yurinko asked the patients about their artwork and to comment on the work of others.

One man, "an abstract artist," held up a design featuring multi-colored blocks. "I just picked up a pencil and ruler and came up with the design," he told the class. Ms. Yurinko asked him, "How do you feel about this one?" He replied, "I feel pretty good."

In another room within the Sea View building, a group of people practiced a more recreational therapy. Ronni Donza, a mental health nurse, helped more than a dozen people knit, crochet and do needlepoint.

Some people in her class used to sleep all day, she said. Now, they are up and knitting. Others were afraid to interact with people, added Ms. Donza, and now offer their help to the group.

"It's taught me how to be a little more patient with myself," explained one of two men in Ms. Donza's group.

"Gina," who is also in the art therapy group, crocheted when she was younger, but stopped when she became ill. Four years ago, Gina returned to her hook and yarn. She enjoys the satisfaction she gets when she completes a project and it keeps her busy.

"I don't think too much about my illness," she said. "I try to concentrate on painting and crocheting."

Andrea Boyarsky is a features reporter for the Advance. She may be reached at boyarsky@siadvance.com.

© 2008 Staten Island Advance
© 2008 SILive.com All Rights Reserved.
Read more!

Disorder Blamed In Theft - Associated Press

The former head of New Haven's police narcotics unit, who stole thousands of dollars planted during an FBI sting operation, suffered from post-traumatic stress disorder after gang members killed his son, his attorneys say.

William White, who faces about three to four years in prison when he is sentenced April 28, is seeking a lower sentence.

His attorneys say the theft was an aberration in an otherwise remarkable life in which he played a key role in bringing down violent drug gangs, an effort that won national praise.

"It is not an overstatement to submit that there has never been a member of the New Haven Police Department who made a more positive impact on New Haven than Billy White," his attorneys wrote in court papers, calling White one of the most decorated officers in the department's history.

But federal prosecutors say White should receive 37 to 46 months in prison as suggested in sentencing guidelines, saying he had a history of corruption before he was caught.

They said there was no evidence that post-traumatic stress disorder caused his conduct, and that White violated the public trust out of greed.

"When an officer compromises that trust, as White did here, he further corrodes the public's declining respect for the institutions that are most critical to a civil government," prosecutors wrote in court papers Monday.

"A lenient sentence would simply confirm that the public's trust in its institutions is misplaced, its faith in its public servants an illusion," prosecutors wrote.

Attorneys for White, 64, said his son Tyler was killed in Bridgeport in 1994 by gang members who were targeting an acquaintance. White's attorneys called the killing "an unbelievably cruel twist of fate" given White's work against gangs.

White was devastated and felt guilty about his son's murder, but never sought counseling, his attorneys said.

White pleaded guilty in U.S. District Court last year to conspiracy to commit bribery and theft of government property. He was fired after his arrest.



Copyright 2008 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Read more!

Group Urges Heart Exam Before Kids Get ADHD Drugs - Associated Press

By STEPHANIE NANO

NEW YORK —

Children should be screened for heart problems with an electrocardiogram before getting drugs such as Ritalin to treat hyperactivity and attention-deficit disorder, the American Heart Association recommended Monday.

Stimulant drugs can increase blood pressure and heart rate.

For most children, that isn't a problem. But in those with heart conditions, it could make them more vulnerable to sudden cardiac arrest — an erratic heartbeat that causes the heart to stop pumping blood through the body — and other heart problems.

About 2.5 million American children and 1.5 million adults take medication for attention-deficit hyperactivity disorder, or ADHD, according to government estimates. Stimulant drugs, such as Ritalin, Adderall and Concerta, help children with ADHD stay focused and control their behavior.

The medications already carry warnings of possible heart risks in those with heart defects or other heart problems, which some critics said were driven more by concerns of overuse of the drugs than their safety.

The heart group is now recommending a thorough exam, including a family history and an EKG, before children are put on the drugs, to make sure that they don't have any undiagnosed heart issues.

"We don't want to keep children who have this from being treated. We want to do it as safely as possible," said Dr. Victoria Vetter, a pediatric cardiologist at the University of Pennsylvania School of Medicine and head of the committee making the recommendation.

The label warnings were added after a review by the Food and Drug Administration of its databases found reports of 19 sudden deaths in children treated with ADHD drugs and 26 reports of other problems including strokes and fast heart rates between 1999 and 2003.

An EKG can detect abnormal heart rhythms that can lead to sudden cardiac arrest. With careful monitoring, Vetter said, children with heart problems can take the ADHD drugs if needed.

Vetter said a screening of about 1,100 healthy children found that about 2 percent of them had some kind of heart problem.

But Dr. Steven Pliszka, a child psychiatrist at the University of Texas in San Antonio, said he was baffled by the EKG recommendation.

He said there's no evidence that sudden death is a bigger problem for children taking stimulants than for children who aren't taking the drugs.

Pliszka said an EKG might deter people from seeking treatment because it's an added expense and hassle.

The American Academy of Child and Adolescent Psychiatry recently updated its treatment guidelines for ADHD, and did not recommend routine EKGs, said Pliszka, who was the lead author.


Read more!

Mental evaluation sought for student accused in bomb plot - Associated Press

CHESTERFIELD, S.C. (AP) -- A prosecutor urged a mental health evaluation for a teenager whose alleged plot to bomb his high school was foiled when his parents discovered he had ordered explosive materials on the Internet.

Ryan Schallenberger, 18, was arrested Saturday after his parents called police because he had ordered 10 pounds of ammonium nitrate, which they retrieved after getting a delivery notice from the postal service, authorities said.

His parents had sought help earlier in the week from mental health experts when he slammed his head into a wall, but the clinic offered no help, authorities said Monday. His parents took him to a hospital.

Schallenberger was not badly injured, though he made a 4-inch indentation in the wallboard, according to prosecutor Jay Hodge, who said he would request at a bail hearing Tuesday that the teen undergo a mental health evaluation.

A spokesman for the mental health clinic would not confirm or deny any contact with Schallenberger's family, citing state law.

Ammonium nitrate is an explosive commonly used as fertilizer and was employed in the deadly 1995 Oklahoma City bombing. Authorities said Schallenberger bought the ammonium nitrate off eBay.

Schallenberger's mother and stepfather likely saved lives at his high school, authorities said.

''Without the parents, Chesterfield County would've suffered. We thank them,'' Sheriff Sam Parker said.

Police said they discovered a hate-filled journal lauding the Columbine killers, an audiotape to be played after Schallenberger died during his rampage and a year's worth of plans for the bombing that included a hand-drawn map of the school.

''He's just a soft-spoken little kid,'' Hodge said at a brief hearing Monday, adding that Schallenberger threatened to do something ''very violent.''

Schallenberger was charged with making a bomb threat and will be charged Tuesday with possession of bomb-making material, Hodge said. He was assigned a lawyer, William Spencer, who did not return calls from The Associated Press.

Schallenberger's mother and stepfather, John and Laurie Sittley, could not be reached for comment. Their phone number was unlisted, they did not attend the hearing and their home about 10 miles from the school was blocked by ''No Trespassing'' signs.

Authorities said Schallenberger's journal did not specify targets of an attack, or a date that he planned to carry it out. Police Chief Randall Lear said Schallenberger was ''just mad at the world.''

Authorities checked the school for bombs over the weekend, and students walked through newly installed metal detectors and past law officers on Monday.

Acquaintances said they were surprised by the allegations against the straight-A student.

''He wouldn't hurt a flea,'' neighbor Carl Parker said. ''People just don't know him like I do. He's a good kid.''

Students said Schallenberger often ate alone in the cafeteria. ''I never thought he'd be the dude to do something like this,'' said James Ford, a 16-year-old sophomore.

Chesterfield is a town of about 1,500 people in northeastern South Carolina near the North Carolina line.

Read more!

Judge orders mental test before killer can defend himself - Associated Press

BOISE, Idaho (AP) -- A confessed child killer must be evaluated for mental competency before he can act as his own lawyer in death penalty proceedings, a federal judge ruled Monday.

U.S. District Judge Edward Lodge indicated he's inclined to grant Joseph Edward Duncan III's request to defend himself, but he'll review the psychologist's report first.

Duncan pleaded guilty in December to 10 federal charges in the 2005 kidnapping of two children, Dylan and Shasta Groene of Coeur d'Alene, and the 9-year-old boy's killing at a Montana campsite. Three of those crimes can carry the death penalty.

Duncan earlier pleaded guilty in state court to murdering three other members of the children's family but the penalty for those crimes is not at issue here.

When he asked the judge to allow him to defend himself, Duncan said he liked his attorneys but knew they couldn't ethically represent his ''ideology.'' Duncan didn't elaborate on what he meant.

The evaluation will be available to the court and attorneys but sealed from public view, the judge said.

Duncan's defense lawyers said a mental evaluation should include observation over a length of time, and a quick, local evaluation could miss important facts.

''the defense investigation raises questions that the court may deem require substantial exploration before allowing Mr. Duncan to jettison his attorneys in this capital case,'' the defense team wrote in a brief filed Monday.

The crime spree began in 2005 when Duncan, a convicted pedophile originally from Tacoma, Wash., first saw the children playing outside their Coeur d'Alene home. He stalked the family before entering the house in mid-May 2005, killing 13-year-old Slade Groene, his mother Brenda Groene and her fiance Mark McKenzie. Duncan drove away with the two children, sexually abusing and torturing them for weeks in the remote Montana wilderness before killing Dylan and leaving his body behind.

If Duncan is allowed to represent himself at his sentencing hearing, it may mean more delays. Some questioning of potential jurors began last week. It also raises the possibility Duncan could cross-examine witnesses -- perhaps including Shasta Groene, now 11.

Read more!

Talking Veterans Down From Despair - New York Times

By PATRICIA COHEN

CANANDAIGUA, N.Y. — Nancy Nosewicz was busy fielding calls at the new national veterans hot line on a recent afternoon when someone from the Department of Veterans Affairs in Topeka, Kan., phoned. He had a 55-year-old Army veteran from the Northwest on the line who had called to complain about his benefits, but now the guy, drunk and crying, was talking about not wanting to live. Could Ms. Nosewicz pick up?

In a slurred voice, heavy from weeping, the veteran, named Robert, told her that he was homeless and wanted to “just lay down in the river and never get up.”

Ms. Nosewicz, a social worker, listened. Then in a voice firm and comforting like a big sister, she said: “We don’t want you to either. Today we’re not thinking about the alcohol or the housing, Robert. Today it’s about keeping you safe.”


She gave an assistant Robert’s phone number to find his address and alert local police to stand by. The chain of care resembled a relay race, with one runner trying not let go of the baton until the next runner had it in hand.

The veterans hot line is part of a specialized effort by the Department of Veterans Affairs to reduce suicide by enabling counselors, for the first time, to instantly check a veteran’s medical records and then combine emergency response with local follow-up services. It comes after years of criticism that the department has been neglecting tens of thousands of wounded service men and women who have returned from war zones in Iraq and Afghanistan.

On Monday, a class action suit brought by veterans groups opened in San Francisco charging a “systemwide breakdown,” citing long delays in receiving disability benefits and flaws in the way discharged soldiers at risk for suicide had been treated. Kerri J. Childress, a department spokeswoman, said Monday that there were an average of 18 suicides a day among America’s 25 million veterans and that more than a fifth were committed by men and women being treated by Veterans Affairs.

Up and running since August, the hot line tries to respond to at least some of those in crisis. Over eight months, it has received more than 37,200 calls and made more than 720 rescues — sending out, from a narrow office here in upstate New York, emergency responders all over the country to find someone on a bridge, with a gun in his hand, with a stomach full of pills.

Paul Sullivan, the director of Veterans for Common Sense, one of the groups involved in the lawsuit, said of the department: “I’m pleased they’re responding. However, much more needs to be done so vets aren’t turned away from health care and don’t have to wait for benefits.”

Mr. Sullivan says suicidal patients have not been able to get care promptly; he cited the case of Jonathan Schulze, who was turned away twice from a Veterans Affairs hospital before he killed himself in January 2007.

“More than 600,000 veterans are waiting, on average, more than six months for disability benefits,” said Mr. Sullivan, who worked at the department monitoring benefits.

Experts agree that veterans are more likely, perhaps twice as much, to commit suicide as people who have never served in the military. Meanwhile, a study released last week by the RAND Corporation estimates that roughly one in five veterans of Iraq and Afghanistan has symptoms of post-traumatic stress disorder, which heightens the risk of suicide.

Yet whatever larger failings may exist, the staff of social workers, addiction specialists and nurses who keep the hot line running — 24 hours a day, seven days a week — can count at least some victories by the end of each shift.

Unique about this hot line, said Janet Kemp, the national suicide prevention coordinator with the department, is that now the counselors have medical information at their fingertips, which they use to connect vets with counseling near their homes. The model evolved from a new research program on suicide prevention paid for by the department.

“For years people thought that asking questions about suicide put the thought in people’s mind, but now we know that’s not true,” said Dr. Kemp, who travels throughout the country training V.A. staff.

The department is spending about $3 million to start and operate the hot line during its first year, said a spokesman, Daniel Ryan, and another $2.9 million on a mental health research center at the sprawling red-brick V.A. Medical Center in Canandaigua. Referring to the hot line’s relay model, Kerry Knox, the director of the new research center, said, “You don’t want them to fall through the cracks.”

With Robert, for example — whose last name was not provided for confidentiality — Ms. Nosewicz gradually nudged him to agree to be taken to a hospital and to give his name and Social Security number so she could check his file and put him in contact with the department’s suicide prevention coordinator in his area.

Meanwhile, Denise Slocum, a health assistant, relayed questions from the local police dispatcher. “The police are asking if you’re near an elementary school,” asked Ms. Nosewicz, who then nodded her head at Ms. Slocum.

“No, no, no — no handcuffs,” Ms. Nosewicz reassured Robert. “You’re going to go to the hospital.”

“Do you have a tissue to blow your nose? Then use your sleeve.”

“When they come in, you put them on the phone with me, and I’ll tell them to treat you with respect.”

Twenty minutes later, Ms. Slocum called the police again to confirm that Robert had been taken to a hospital. Ms. Nosewicz alerted the prevention coordinator. One is at each of the department’s 156 health centers.

Robert’s name was added to a board near the doorway so that the staff could follow up to ensure a local counselor actually met with him.

Of course, sometimes a crack is unavoidable.

“He’s going to do it. He’s really going to do it,” said Terri Rose, a counselor who was working the noon-to-midnight shift. She was wiping her red-rimmed eyes. A caller from Texas, who said he was 65 and a helicopter gunner in Vietnam, said he had a suicide pact with his friend, but the friend had gone off and killed himself. Now he, too, was ready to die, saying he had even found a coffin for $150, said Ms. Rose, who is an Air Force veteran herself. The veteran hung up and had stopped answering her calls.

Sometimes veterans have a lot of trouble asking for help, said Jacalyn O’Loughlin, a counselor. “They keep saying, ‘I’m sorry, I’m sorry, I’m sorry,’ ” Ms. O’Loughlin said. “Especially marines. They feel they’re weak if they reach out.”

Mr. Ryan said about half the calls to the hot line — 1-800-273-TALK (8255) — were from veterans, split fairly evenly between Vietnam and Iraq. Family members and friends also frequently call. About 30 percent of the veterans are women.

A couple of months ago, Ms. O’Loughlin said, a distraught woman called from Oregon who was driving to the woods and then threatened to “walk and walk and walk and never come back.” Ms. O’Loughlin rang the tiny silver bell on her desk to signal the health technician. The health tech checked the area code and phoned the closest Veterans Affairs health center.

“And lo and behold, that suicide prevention coordinator knew her just by her first name,” Ms. O’Loughlin said. The tech called the police and the coordinator called the woman’s husband, getting the car’s make and model. Ms. O’Loughlin kept her on the line; when she hung up, Ms. O’Loughlin called her back. “This went on for hours,” she said. “I could hear her getting out of the car. I could hear the rustling from the leaves.”

Meanwhile, the police and her husband were driving up and down roads. They spotted the car, dashed through the trees and found her. She had a bottle of pills in her hand but had not yet swallowed them.

Sometimes, the victories are smaller but no less satisfying. That morning, Ms. Nosewicz spoke to a veteran whose house was destroyed by Hurricane Katrina; he had been relocated to a different state.

“He called crying because he can’t find a job, saying ‘my teeth are so rotten and my mouth stinks,’ ” Ms. Nosewicz said.

Dental referrals are not exactly part of the job description, but Ms. Nosewicz tried dental schools in his area until she found a school to do the work. “He was crying on the phone,” she recalled, “and said, ‘Thanks so much. Thanks so much.’ ”

All in all not a bad day’s work, Ms. Nosewicz said, as she got ready to leave. “Three rescues, four consults and one set of teeth.”

Read more!

Police, Family Question Denial ofSilver Alert - WRAL-TV Raleigh (NC)

Video report here.

Hillsborough, N.C. — The death of a Hillsborough man has raised questions about a communication breakdown in the state's Silver Alert system for people with brain disorders.

Jasper Villines, 73, was helping his wife return a rental car to Raleigh-Durham International Airport at about 6 p.m. Saturday when he took a wrong turn off the Durham Freeway and became lost, relatives said.

Although he had recently been diagnosed with dementia, he insisted he could follow his wife to the airport from their Hillsborough home.

"He said, 'Oh no, I can do this. I can drive. I'll follow you,'" Leola Villines said.

Jasper Villines was walking east in the westbound lane of N.C. Highway 98 at about 12:45 a.m. Sunday when he was hit by a car at the intersection with Sherron Road and was killed, authorities said.

His wife and daughter said they think he was trying to find his way home when he was hit. His vehicle was found a short distance away.

"I feel like he could've been found and wanted to be found," Leola Villines said.

They question why Durham police refused their request to issue a Silver Alert on him hours before he was killed.

The state launched the system in December to more quickly locate adults with mental impairments like Alzheimer's disease. Bulletins are issued to law enforcement agencies and media statewide.

WRAL.com sends subscribers a Breaking News alert and posts that on the Web site whenever a Silver Alert is issued for someone in the WRAL viewing area.

Leola Villines called Orange County 911 from her home to report her missing husband and was transferred to Durham County dispatchers because Jasper Villines was last seen in Durham.

Eventually, the Villines' daughter, Ava Johnson, went in person to the Durham Police Department to request a Silver Alert. She said officers turned her down.

"I said, 'Why? Why you can't do this?' They say, 'You're father is not old enough,'" Johnson said. The state issues Silver Alerts for people of varying ages, including one recently for a 24-year-old man who suffered from a mental impairment.

The North Carolina Center for Missing Persons oversees the Silver Alert program, and center officials said they can activate an alert only at the request of a local law enforcement agency.

"We were very concerned because it seemed like nobody cared," Leola Villines said.

Durham police initially told WRAL Monday that they didn't have a record of the case. Later, department spokeswoman Kammie Michael said officers issued a bulletin for police to be on the lookout for Jasper Villines, even though there was no Silver Alert.

Michael said the department is looking into why the family's request was denied.

Leola Villines said she knew her husband of 50 years was in declining health, but his sudden death is hard to take.

"I really can't describe because we were very, very close," she said.

* Reporter: Kelcey Carlson
* Photographer: Richard Adkins
* Web Editor: Matthew Burns

Copyright 2008 by WRAL.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Read more!

Oxford writer uses the pain of his youthto help others - Associated Press

4/20/2008
By TODD SOUTH

OXFORD, Ala. (AP) — Don Winston remembers screaming and crying.

He remembers something not quite right about his mother and his young life.

Winston knows the pain of a jumbled youth, a fractured family and not feeling wanted.

Despite all that, despite troubles that might send most to the bottle or jail, he smiles.

He smiles in a way that makes others want to smile.

He laughs, and his eyes show a joy that most take for granted.

And through his books he shows others that they can get through the emotional roller coaster of foster care just as he did.

When Winston was 6 years old, he and his three brothers were taken from their mother.

His mother had mental illness, he says, perhaps schizophrenia, which made her paranoid enough to lock the boys up at home and leave for what seemed like days.

The neighbors heard their cries and worried. Finally, someone called social services.

Winston remembers that day — the police cars, all the neighbors watching, his mother screaming and crying.

His youngest brother, Brian, an infant at the time, was adopted. He hasn't seen him since.

Winston and his other two brothers, Tramale and Brandon, shuffled together between foster families for the next eight years.

He was separated from his brothers when he was 14, after tension building between him and the family boiled into an argument.

Over the years, Winston bounced between seven different homes in Anniston and Bynum. He attended most of high school in Saks before finishing in Gadsden.

On the advice of an influential counselor, he wrote through the pain. The writing helped to release the sadness and fury that had grown inside.

But when his foster family found a journal, they didn't like what they read. They didn't like his criticisms of the life he had.

So he quit writing until late in high school, when teachers pushed him to express himself.

First he filled spiral-bound notebook pages front and back with his thoughts, wishes and pain.

Then, with a little more encouragement, he focused his written emotion into essays for scholarship contests.

He won those contests.

The scholarships paid for him to learn welding at Gadsden State Community College. He was hungry for knowledge and finished the program six months before most of his classmates and made the dean's list.

With a semester to burn, he took psychology, English, and courses heavy in reading and writing.

As he worked two jobs and finished courses that would help frame a reference for his experiences, Winston began writing a memoir.

In about four months he'd finished 302 pages.

Winston's first book, "I've Found the End of the Rainbow," chronicles his life in foster care, what he remembers of the early years before, and how he overcame crushing circumstances to educate himself and remain independent.

The book helped him sort through his turbulent life, but Winston felt a pull, a drive to share his words.

He wrote, called and e-mailed every major publishing house he could find.

And like many first-time authors, he was rejected.

He was rejected, but undeterred.

Winston did the math and realized he'd worked this hard for this long, why bother to let someone else profit from his work?

So he self-published the book. Using the same determination that got him through his childhood, he has sold his book to anyone who is interested.

And he's started work on a second book that picks up after his high school years with a working title of "Everything That Glitters Isn't Gold."

At 23 years old, a published author four chapters into his second work, Winston sees writing as his chance to lend some hard-earned wisdom to others.

He's not yet a wealthy best-selling author, but Winston hopes he's on his way.

___

Information from: The Anniston Star, http://www.annistonstar.com/ Read more!

Suicide-by-cop' may have been Lowry's intent -Roseburg (OR) News Review

CHELSEA DUNCAN, cduncan@newsreview.info
April 20, 2008

As dawn broke and light began to creep onto the steep mountainside, Donald Eugene Lowry got out of his car, tucked his pistol into his waistband and scanned the hillside, locking eyes one by one with the police officers crouching nearby.

He reached suddenly into the vehicle, barricaded by police cruisers at the dead-end of a logging road west of Roseburg, and grabbed a down vest. He put it on and tucked it behind the gun, positioned for a right-hand draw.

He closed his eyes. When he opened them, said Rick Wesenberg, Douglas County’s assistant district attorney, Lowry reached for the weapon.

“He firmly gripped the handgun,” Wesenberg said, “draws it from his waistband and points it in the direction of the officers.”

At least one officer reported seeing a flash from the muzzle of Lowry’s gun as five Oregon State Police troopers and one Roseburg police officer opened fire around 6 a.m. last Sunday, four hours after the armed standoff began about 4 1/2 miles off Callahan Road.

About 11 rounds were fired from the officers’ weapons. Three bullets struck Lowry, two in the chest area, one in the head. The 46-year-old Myrtle Creek man dropped to the ground beside his vehicle and died.

At a press conference Friday afternoon at the Douglas County Sheriff’s Office, authorities described an erratic and irrational man.

He’d left them little, if any, choice but to use deadly physical force, authorities said, and a grand jury on Friday found the shooting justified.

The events leading up to the shooting began shortly after 1 a.m. that Sunday. A state trooper conducting a traffic stop on Interstate 5 saw a suspicious white Honda on a dirt road at the Douglas County Fairgrounds and decided to check it out.

The trooper got out of his patrol car and approached the Honda, and the driver — later identified as Lowry — on foot.

“Mr. Lowry was sweating profusely,” Wesenberg said. “He appeared nervous and distressed.”

The trooper asked whether the man needed help, then noticed a rifle sitting on the passenger’s seat and a semiautomatic pistol in the man’s lap.

Lowry refused to follow the trooper’s orders not to touch the weapons. He then put the car in gear and fled north on I-5. Lowry took the Edenbower Boulevard exit and headed south to Stewart Parkway and Garden Valley Boulevard at speeds up to 85 mph.

Roseburg police officers took the lead in the pursuit as Lowry headed west, eventually ending up on Callahan Road. He took a gravel road and continued until he reached the logging landing where the standoff ensued.

Officials believe Lowry was familiar with the area, and led officers there. At the clear-cut site, where more than a dozen officers would surround the man, police had little but the darkness and tree stubs to hide them.

“The officers at the scene were in grave danger,” Wesenberg said. “They were all easily within the range of either his pistol or his rifle.”

Lowry refused ongoing police orders to get out of his car, rolling his window up or down depending on whether he felt like talking.

One officer saw Lowry make a “throat-slashing motion,” Wesenberg said. After about a half an hour, Lowry tried to ease his car around the police cruisers, ignoring warnings about the spike strips on the ground and flattening his tires.

A negotiator with the Sheriff’s Office arrived and continued to try and convince Lowry to come out. During the discussion, Lowry made bizarre and threatening statements, at one point, holding the gun to his head and throat, Wesenberg said.

“Let’s get this on,” Lowry reportedly said. “What do I need to do, come out shooting?”

Concerned for the safety of Lowry’s family members, deputies went to the Lowry home in the Clarks Branch area. Lowry’s wife, Billie Rae, told police her husband was bipolar. He had been hallucinating, she said, was armed and possibly under the influence of methamphetamine. He thought police were out to get him.

Just days before, on April 10, police had been called to the Lowry home because of the man’s irrational behavior. Lowry refused to come to the door, but talked to police on the phone.

“He advised them that he was not suicidal,” said Sheriff’s Lt. John Hanlin, who headed up the investigation by the Douglas County Major Crimes Team, “and in fact, he just wanted to be left alone in the house.”

Hanlin said Lowry did not appear to be a danger to himself or others, which is the criteria necessary to take a person into custody. Police followed up the next day and learned Lowry had sought treatment at Mercy Medical Center in Roseburg. He later checked himself out.

At the scene of the standoff, OSP SWAT members began to arrive shortly before 5 a.m. Minutes later, Lowry threw the car door open and got out, carrying the silver handgun by his side. He walked away from the car, then back, refusing orders to drop the weapon and surrender.

He returned to the car, and about 45 minutes later, he got out again, for the last time.

Both of Lowry’s weapons were loaded, Wesenberg said, and a box of bullets were found in the car. Police found a shell casing in the area of the car’s door handle, consistent with having been fired from the man’s gun.

Authorities said other choices, like leaving Lowry alone on the mountain, or using less lethal force, were not realistic. They didn’t want to leave the man there for fear someone else might encounter him.

“He was out in the public,” said Roseburg Police Lt. Pat Moore, “and obviously a threat either to himself or to others or to both.”

Tasers or so-called bean-bag guns aren’t necessarily meant to be used against someone with a deadly weapon, and may have exacerbated the situation, Moore said.

According to common procedure, the officers who fired at Lowry were placed on paid administrative leave. They are expected to return to work soon, and will receive counseling.

“These guys are going to have to live with it for the rest of their lives,” said OSP Capt. Randie Martz, adding that Lowry’s family members have been apologetic that Lowry placed police in that situation.

The officers who shot at Lowry were identified Friday as Senior Trooper David Glass, a 10 1/2-year veteran assigned to the Springfield OSP office and OSP SWAT; Trooper Casey Codding, a 7-year veteran with the Springfield office and a SWAT member; Senior Trooper Jamin VanMeter, an 8 1/2-year veteran with the Springfield office and a SWAT member; Trooper Jason Stedman, a 6-year veteran with the Roseburg office; Trooper Brian Jewell, an officer assigned to the Roseburg office who has two years with the department; and Roseburg Police Officer Keith Young, who’s been a Roseburg officer for 2 1/2 years.

Authorities said they’re not sure what prompted Lowry’s actions. The results of toxicology tests that will reveal whether he was on drugs are not back yet.

Asked if officials believe Lowry might have been trying to commit “suicide-by-cop,” where somebody seeks their own death by putting police in a position where they have to use lethal force, Moore said it’s possible.

“The set of facts as they stand,” he said, “do tend to fit that scenario.” Read more!

Lawsuit: Veterans Affairs has failed to prevent suicides - Associated Press

By PAUL ELIAS
4/20/2008

SAN FRANCISCO - The U.S. Department of Veterans Affairs isn't doing enough to prevent suicide and provide adequate medical care for Americans who have served in the armed forces, a class-action lawsuit that goes to trial this week charges.

The lawsuit, filed in July by two nonprofit groups representing military veterans, accuses the agency of inadequately addressing a "rising tide" of mental health problems, especially post-traumatic stress disorder.

But government lawyers say the VA has been devoting more resources to mental health and making suicide prevention a top priority. They also argue that the courts don't have the authority to tell the department how it should operate.

The trial is set to begin Monday in a San Francisco federal court.

An average of 18 military veterans kill themselves each day, and five of them are under VA care when they commit suicide, according to a December e-mail between top VA officials that was filed as part of the federal lawsuit.

"That failure to provide care is manifesting itself in an epidemic of suicides," the veterans groups wrote in court papers filed Thursday.

A study released this week by the RAND Corp. estimates that 300,000 U.S. troops about 20 percent of those deployed are suffering from depression or post-traumatic stress from serving in Iraq and Afghanistan.

"We find that the VA has simply not devoted enough resources," said Gordon Erspamer, the lawyer representing the veterans groups. "They don't have enough psychiatrists."

The lawsuit also alleges that the VA takes too long to pay disability claims and that its internal appellate process unconstitutionally denies veterans their right to take their complaints to court.

The groups are asking U.S. District Court Judge Samuel Conti, a World War II U.S. Army veteran, to order the VA to drastically overhaul its system. Conti is hearing the trial without a jury.

"What I would like to see from the VA is that they actually treat patients with respect," said Bob Handy, head of the Veterans United for Truth, one of the groups suing the agency.

Handy, 76, who retired from the Navy in 1970, said he founded the veterans group in 2004 after hearing myriad complaints from veterans about their treatment at the VA when he was a member of the Veterans Caucus of the state Democratic Party. The department acknowledges in court papers that it takes on average about 180 days to decide whether to approve a disability claim.

"I would just like to see the VA do the honorable thing," said Handy, who is expected to testify during the weeklong trial.

Justice Department spokeswoman Carrie Nelson declined comment Friday.

But government lawyers have filed court papers arguing that the courts have no authority to tell the VA how to operate and no business wading into the everyday management of a sprawling medical network that includes 153 medical centers nationwide.

The veterans are asking the judge "to administer the programs of the second largest Cabinet-level agency, a task for which Congress and the executive branch are better suited," government lawyers wrote in court papers.

If the judge ordered an overhaul, he would be responsible for such things as employees workloads, hours of operations, facility locations, the number of medical professionals employed, and "even the decision whether to offer individual or group therapy to patients with" post-traumatic stress, the papers said.

The VA also said it is besieged with an unprecedented number of claims, which have grown from 675,000 in 2001 to 838,000 in 2007. The rise is prompted not from the current war, but from veterans growing older, government lawyers said.

"The largest component of these new claims is the aging veteran population of the Vietnam and Cold War eras," the government filing stated. "As they age, older veterans may lose employment-related health care, prompting them to seek VA benefits for the first time."

Government lawyers in their filings defended its average claims processing time as "reasonable," given that it has to prove the veterans disability was incurred during service time.

They also noted the VA will spend $3.8 billion for fiscal year 2008 on mental health and announced a policy in June that requires all medical centers to have mental health staff available all the time to provide urgent care. They said that "suicide prevention is a singular priority for the VA."

The VA "has hired over 3,700 new mental health professionals in the last two and a half years, bringing the total number of mental health professionals within VA to just under 17,000. This hiring effort continues," they said. Read more!

Many questions in Rock Haven’s future -Janesville (WI) Gazette

By ANN MARIE AMES
Sunday, April 20, 2008

JANESVILLE — It seems like an old black and white movie.

At the turn of the 19th century, county-run health care was new to Rock County. Care was provided to the “insane” and “deviant.”

The number of patients far outstripped the number of caregivers, and the county didn’t hire a nurse until 1957.

That’s a far cry from Rock County’s health care system today.

At Rock Haven Nursing Home, 3418 County F, 260 nurses and support staff care for 130 frail, elderly and severely disabled patients.

The national push is to get people out of nursing homes, and programs and money now are available to keep many more elderly or developmentally disabled adults living with their families or in small group homes.

While it’s easy to see how things have changed, nobody knows what the future of county-run health care will be—or if Rock County will stay in the game.

Although the Rock County Board approved $80,000 in its 2008 budget to study Rock Haven and the needs of county residents who would use it, the study has been called off while health care officials look at regulation and funding questions, including:

-- When will the federal government require fire sprinklers in nursing homes?

-- When will Rock County get into Family Care, a state-mandated program that’s pegged to streamline funding sources to care for the elderly, disabled and developmentally disabled?

Answers to those questions and others will determine whether it would be more cost effective to renovate Rock Haven or to build a new facility if the county decides to keep providing care.

Those answers also could change the demographic of people who are cared for at Rock Haven now and in the future.

Director Sherry Gunderson said Rock Haven is “comfortable” with 130 patients. The skilled care nursing home was built in 1964 to hold 248 beds, so today, the building has space for offices and day rooms. Most patients have private rooms.

Rock Haven is home to people with traumatic brain injuries and those who are too chronically mentally ill to live in the community, Gunderson said. The home also cares for the frail elderly and an increasing number of patients with dementia and Alzheimer’s disease.

The home had its first major downsize to 180 beds in 2000 and another to 130 beds in 2007. The county has added lighting, boilers and generators to “buy five or 10 years” while it debates Rock Haven’s future, Gunderson said.

“We’ve done a whole lot of things to be able to stay here,” Gunderson said.

That doesn’t mean she wouldn’t like to see Rock Haven move into a new building. Continuing to upgrade Rock Haven could get expensive, she said.

The building is at its maximum electrical capacity, she said, and it will be a chore to add fire sprinklers if they become a requirement.

Legislation requiring all nursing homes to have a sprinkling system is pending at the federal level. While Gunderson doesn’t know when the bill will become law, it would cost about $1.3 million to install sprinklers at Rock Haven, she said.

It would cost another $2 million to air condition the building, Gunderson said.

Many of the patients’ bathrooms are not approved for accessibility by the Americans with Disabilities Act, she said.

Despite the questions, Gunderson hopes the county stays committed to providing care.

“It would be a shame if the county decided to get out of the nursing home business,” Gunderson said. “We have provided such a service to the community for so long.”

HEALTH CARE HISTORY

The history of health care in Rock County:

-- 1854—The Rock County Board buys property at Johnstown Center for the Rock County Poor Farm and Alms House. The site contains a hotel and barn. It was in Wisconsin that the classic system of the county care system was developed.

-- 1881—The Rock County Asylum opens. Residents are referred to as “inmates.”

-- 1893—The Rock County Board buys the current location of the county complex and builds a hospital and poorhouse. The facilities open the next year as the Asylum for the Chronic Insane and the Alm House.

-- 1911—The poor farm and asylum operate for many years with the inmates doing the bulk of the work. Long-term care consists of food, clothing, lodging and social supervision but not treatment by professional staff. The facility houses “deviants” including epileptics, unwed mothers, drug abusers and prostitutes.

-- 1925—The Alpha building opens as the women’s residence. The women work in the kitchen and laundry.

-- 1929—The Pinehurst Tuberculosis Sanitarium opens.

-- 1939—The Beta building opens as the men’s residence. The men work in the laundry and on the farm.

-- 1942—The county hospital has a capacity of 247 and the poor house 80. Patients continually exceed capacity. Staff work 12 hours days, have one day off per week and one weekend off per month.

-- 1957—The county hires the hospital’s first nurse.

-- 1961—About 50 staff members care for 302 patients. (Today, 260 staff care for 130 residents at Rock Haven.)

-- 1964—After 15 years of planning and many setbacks, Rock Haven opens as a skilled nursing home with 248 beds.

-- 1970—The Pinehurst sanatorium closes. (Today, the building is part of the Rock County Jail).

-- 1972—The Rock County Health Care Center opens with a capacity of 282 beds. Over the next 25 years, Rock Haven served the frail and elderly while the health care center served as a regional center for those with chronic mental illness or dementia with behavioral concerns.

-- 1988—Rock County contracts with Keefe and Associates on a needs assessment for Rock Haven and the health care center. Keefe’s report suggests six options, including staying at 388 beds or cutting beds for a variety of services.

Keefe projects that by 1995, the county would have 445 more beds than needed because of initiatives to provide at-home and community care.

-- 1991—Keefe makes six more recommendations, including maintaining status quo, selling Rock Haven or minimizing some services. Keefe notes that the closure of the 328-bed Caravilla Nursing Home and potential downsizing of the Rock County Health Care Center could impact the needs of county patients.

-- 2000—The burden of both Rock Haven and the health care center become too much for Rock County taxpayers. The health care center is cut to 180 beds and limited to Rock County residents.

Rock County is home to nine nursing homes with a total of 1,257 beds. In 2000, the bed need is 1,021 and projected to drop to 997 by 2010.

-- 2005—Residents and offices are moved from the health care center to Rock Haven. Emergency management, information technology and the intoxicated driver program move into the health care center.

-- 2006—Rock Haven closes its Intermediate Care Facility for the Mentally Retarded. Volunteers build a fenced entry garden, fire emergency doors are installed and smoking is banned.

-- 2007—Rock Haven is cut to 130 beds.

Source: Rock Haven Director Sherry Gunderson Read more!

Twin Valley closing will have massive impact on area - Dayton (OH) Daily News

By Anthony Gottschlich
Sunday, April 20, 2008

DAYTON — When Gov. Ted Strickland announced Jan. 31 he was closing Twin Valley Behavioral Healthcare in a budget-saving move, it came as a surprise to local public and health care leaders who immediately decried the decision as ill-conceived, short-sighted and potentially disastrous for the region, the mentally ill and their families.

Nearly four months later and about two months before Twin Valley's June 30 closing, local officials are scrambling to figure out how they will handle the fallout from losing the Dayton region's only public psychiatric facility.

"The impact has been immediate and it's going to be long-term," said Bryan Bucklew, president of the Greater Dayton Area Hospital Association.

The state also is closing a psychiatric hospital in Cambridge to help plug a $733 million deficit in the 2009-2010 budget cycle, which begins July 1. Those who use Twin Valley will have to travel to Cincinnati, Columbus or Toledo for treatment.

By closing the former Dayton State Hospital and consolidating services, the state expects to save $13 million next year.

"I wish I had more resources, quite frankly, but the reality is we've got a very serious set of budget conditions that make it necessary to make decisions that I find painful," Strickland, a Democrat and a former prison psychologist, said in a March interview.

State leaders told local officials they could keep Twin Valley open after June 30 but the Dayton community would have to pay for it.

Local leaders immediately rejected the idea.

"I don't know why Dayton should be the only major urban area in the state where the (Ohio) Department of Mental Health isn't paying for its own facilities," said Tom Breitenbach, president and chief executive of Premier Health Partners, parent corporation to several hospitals in the region, including Miami Valley and Good Samaritan.

"The state is looking for answers that won't cost them money, and there really is no answer that won't cost them money. The only answer is for them to keep it open."

By all indications, that's not going to happen. The state began moving patients out of Twin Valley on April 3.

Here's a look at the impact area residents and leaders expect from Twin Valley's closing.

Patients and families

Twin Valley treats hundreds of civil and so-called forensic patients — the mentally ill caught up in the criminal justice system — at its 110-bed facility on Wayne Avenue.

For area families, having their relatives close by for treatment can mean the difference between a fast or slow recovery, said Walt Lichtenberg, past president of the Montgomery County chapter of the National Alliance for the Mentally Ill.

"It's part of the healing process," said Lichtenberg, who has a family member who's been hospitalized at Twin Valley. "If (the patient) knows that you accept his illness and still love him and deal with him, it's going to affect his attitude. If he's out in the middle of nowhere — you know, 'Why was I shipped here instead of being close to my loved ones?' — how would you feel? You're dealing with a person's emotions and they're very fragile when they're hospitalized."

Add in the time, distance and fuel costs involved with a trip to Cincinnati and, "it really becomes a burden," Lichtenberg said. "You have some people who are really going to be financially strapped to see their loved one."

ODMH spokeswoman Amy Cooper said the state is exploring "creative solutions" to mitigate any of the negative impact, including travel issues, the Twin Valley closing will have on the Dayton region.

Wright State's medical school

"Twin Valley's closure is going to be a major hit to the training of our residents and students," said Dr. Howard Part, dean of the Wright State University Boonshoft School of Medicine.

"We're going to lose nine high quality faculty based at Twin Valley, which has been an outstanding training site for our students and residents," Part said.

Twin Valley won't close until June, but the school's already feeling the loss, Part said. None of Boonshoft's graduating students this year sought a psychiatry residency in Dayton, breaking a proud tradition for the medical school.

Dayton will feel the loss, he said, because many of the school's psychiatry residents who train at Twin Valley go on to work in the public sector.

"These are individuals who are going to play an important role in public mental health," Part said.

He said the closure will "destabilize" Boonshoft's psychiatry program and jeopardize the school's relationship with Wright-Patterson Air Force Base Medical Center, which provides 20 psychiatry residents to the Dayton community.

"If the Air Force feels the psychiatry program is weakened, or there's been a substantial change, they could take those residency slots and take them to San Antonio," site of the Air Force's only other training ground for psychiatric residents, Part said.

Earlier this month Strickland dispatched Eric Fingerhut, chancellor of the Ohio Board of Regents, and ODMH Director Sandra Stephenson to discuss with Wright State possible solutions to the quandary.

The leaders proposed that state and local officials form two workgroups: One would focus on mitigating the impact on Wright State's training programs; the other would study alternative uses for the land and buildings at Twin Valley.

Part said he appreciates the state's offer to help; he just wishes it would have come long ago, not 12 weeks before Twin Valley's scheduled closing.

"This isn't even close to being figured out yet," he said.

Local hospitals

About half of Twin Valley's patients are civil cases, those not ordered into care through the criminal justice system, according to ODMH.

Hospital leaders fear a shuttered Twin Valley could mean more patients seeking care at local hospitals, emergency rooms and mental health floors that are already overcrowded and ill-equipped to handle critical psychiatric cases.

"You can't put a patient with a serious mental illness, one who is potentially violent, next to an elderly patient with Alzheimer's disease," said Dr. Jerome J. Schulte Jr., medical director of psychiatry at Good Samaritan Hospital.

Hospital officials have a similar concern at Upper Valley Medical Center in Troy, where residents in Miami, Darke and Shelby counties use UVMC's Dettmer Behavioral Health Services for psychiatric care.

"We don't have a locked inpatient unit that would be appropriate to serve these clients in the tri-county," said Keith Achor, a nurse and vice president of UVMC patient services.

With Twin Valley closing, the state has told judges in Miami County to send its forensic cases 125 miles away to Northcoast Behavioral Healthcare Organization in Toledo, five times the distance to Dayton.

"We think that's a pretty huge injustice to those individuals," Achor said. "These patients desperately need their families with them."

County budgets

Nearly three-quarters, or 72 percent, of Montgomery County's budget supports criminal justice services, County Commissioner Judy Dodge said.

"Right now we're spending approximately half a million to a million dollars a year just putting (inmates) in different counties because we don't have space at the jail," Dodge said. "It's breaking our backs."

Toss in a soft economy, declining revenues and the estimated $89,000 per year it will cost the county to transport inmates to Summit Behavioral Healthcare in Cincinnati. "We don't know how we're going to do it," she said.

In Miami County, Sheriff's Capt. Dave Duchak said a trip to Northcoast in Toledo will require two deputies and at least six hours out of service. "It's a tremendous, tremendous hardship," Duchak said.

State law doesn't require sheriff's deputies to transport mental health cases to psychiatric hospitals unless a judge orders it, Duchak explained. But law enforcement usually accepts the task in the interest of public safety and the welfare of the inmate or person arrested, he said.

"The sheriff's office, the Troy police, the Piqua police, we can't take two officers off of a shift on a Friday or Saturday night for a six-hour trip to Toledo. We just can't do that from a personnel standpoint," Duchak said. "That's why we're trying to work together locally to come up with the best possible solution for the safety of the community and those needing mental health services."

One idea floated so far includes using off-duty sheriff's deputies for the transport. The Tri-County Alcohol, Drug Addiction and Mental Health Services Board would pay a negotiated hourly rate with the deputies and cover fuel costs, Duchak said.

"For not a whole lot of savings, (state leaders) have created an extremely large mess," said Duchak, echoing the sentiment of many. "The sad part is the people who are going to pay are the people who need mental health assistance."

Contact this reporter at (937) 225-7408 or agottschlich@DaytonDailyNews.com.

Read more!

Research could improve schizophrenia care -Augusta (GA) Chronicle

By Tom Corwin
Sunday, April 20, 2008

Medical College of Georgia research teasing out how the brain's off-switch mechanism contributes to schizophrenia could lead to new drugs, experts said.

MCG researcher Lin Mei was honored for his schizophrenia work this month with a $100,000 Distinguished Investigator Award from NARSAD, the leading charity funding research into mental illness. He was among 11 chosen from 150 prominent mental health researchers, said selection committee chairman Jack Barchas, the chairman of the Department of Psychiatry at Weill Medical College of Cornell University. The scientists who reviewed Dr. Mei's work universally praised it as "elegant," Dr. Barchas said.

"That in our business is extraordinarily high praise," he said. "That says that it is extremely well thought out. He has ways of cutting right to the gut issues."

The problem with schizophrenia is that, unlike other disorders such as Parkinson's or Alzheimer's diseases, the disease process is not as distinctive, Dr. Mei said.

"It doesn't have a clear-cut pathologic hallmark," he said, which has hampered the ability to study it.

Dr. Mei has focused on two genes that have been associated with the disease -- neuregulin-1 and ErbB4. Both are involved in the development of neurons early on, said Dr. Mei, who is the chief of the Program of Developmental Neurobiology at MCG.

But they are also involved in the regulation of two key neurotransmitter systems, the chemical signals that neurons in the brain use to communicate. One is glutamate, an excitatory transmitter that turns neurons on; the other is GABA, an inhibitory transmitter that turns them off.

Those neurotransmitters appear to be involved in activities such as memory or learning. Two of the clinical symptoms of schizophrenia, in addition to auditory or visual hallucinations, are social disconnect or isolation and impaired learning and memory, Dr. Mei said.

Neuregulin appears to promote the release of GABA, the inhibitor of neuron function, which could lead to decreased ability to learn and remember, he said.

Dr. Mei was recently awarded a three-year, $514,000 grant from the National Institutes of Health to create a genetically altered mouse that produces more neureglin-1. It would be difficult to ascertain if the mouse is experiencing hallucinations, he said.

"An easier question for us to ask is to see whether they have learning and memory defects, in particular working memory defect," Dr. Mei said.

And that is what is exciting about the work, Dr. Barchas said.

"It's actually important work just in terms of our knowing more about how the brain works," he said. And it could lead to compounds that target neuregulin.

"This is the type of thing that absolutely leads to new medications and to new approaches," Dr. Barchas said. "It's a wonderfully promising, wonderfully exciting piece of work."

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

Read more!

Experts: Careful analysis critical to inmates -Pittsburgh Post-Gazette

Sunday, April 20, 2008
By Gabrielle Banks

Jason Kindler tried to kill himself several times as a free man. In his cell at the Allegheny County Jail in January, he succeeded.

It wasn't until his father saw jail records that he learned Jason had told an intake nurse he was having suicidal thoughts, he was in withdrawal from prescription drugs obtained on the street and he'd previously been diagnosed with bipolar disorder.

These three factors triggered a mental health referral, but a specialized screener deemed the 28-year-old Sharpsburg man "stable." Officials placed him on a detox cellblock, where he hanged himself with a bed sheet five days later.

Dana Phillips, director of the Allegheny Correctional Health Services, which oversees health care at the Allegheny County Jail, said the jail screens new prisoners for suicide risks. But, she said, "No screen is perfect and the number one prevention for suicide is, of course, observation."

Corrections officials have known for decades that people with mental illness and drug and alcohol addiction are at a heightened risk for suicide after incarceration.

Nationally, 300 inmates committed suicide in local jails each year, on average, between 2000 and 2005, according to the Bureau of Justice Statistics.

Lindsay M. Hayes, a Massachusetts criminologist who studies jail suicides at the National Center on Institutions and Alternatives, said jails have better suicide prevention programs than they did 20 years ago and suicide rates have dropped since he began researching the phenomenon in the 1980s.

Allegheny County Jail may be moving toward improved suicide prevention after Mr. Kindler and two other new inmates took their own lives in five months. Warden Ramon Rustin said recently he plans to implement new safety measures on the cell blocks.

But suicide experts say before inmates make it to their cells, they often say things or show behavior that should send up red flags for officials. Given the growing number of mentally ill people who are incarcerated each year and the likelihood that inmates will experience drug and alcohol withdrawal, experts say careful intake and follow-up practices are vital to preventing suicides in correctional facilities.

The 126 doctors, nurses and social workers employed by Allegheny Correctional Health Services understand their interactions with inmates are critical, said Ms. Phillips, who runs the $11 million nonprofit facility inside the jail.

If nurses note an inmate is significantly injured when he enters the jail, he will be transported to a hospital. If providers determine an inmate is psychotic or acutely suicidal, he may be clothed in a suicide prevention smock and transported to an acute mental health unit. The jail provides 25 acute beds for males and 25 for females and extensive supervision, she said.

Everybody else who comes in the door sits through an extensive intake interview that assesses an individual's personal background and physical and mental health history. Intake nurses ask about drug use and look for signs of withdrawal. They ask about prior suicide attempts and watch for suicidal behavior.

The health center does not notify families when an inmate is suicidal, she said.

Usually, a psychiatrist won't prescribe medication while a patient is in detox, Ms. Phillips said.

"It's not a hard-and-fast rule, but you can't fully assess a person's mental heath situation while they're still under the influence of street drugs. It depends on what our mental health professionals determine[the] suicide risk to be."

For a person showing symptoms of psychiatric problems, "acute mental health trumps pretty much anything," Ms. Phillips said.

Overall, she said, "It's really pretty easy to access help if you want it and ask for it."

But John Kindler came to a very different conclusion after reviewing his son's intake records.

Jason Kindler entered the county jail at 3 a.m. Jan. 21, and he explicitly asked for a mental health referral. He said he had been hospitalized multiple times for psychiatric concerns and had attempted suicide on at least two occasions.

Jail records also show that he reported he'd been diagnosed with bipolar disorder, he'd used drugs within days of incarceration and he felt depressed. An intake worker circled that Jason presently had suicidal "thoughts" and issued a "routine" mental health referral.

Ms. Phillips declined to comment on specific cases due to privacy laws, but she said the jail's mental health assessments usually last 10 to 20 minutes. One objective is to screen again for signs an inmate is acutely suicidal.

A health center employee jotted down in his assessment that Jason Kindler was "stable" and could be housed in the general population. The employee also noted that a clinic appointment would be scheduled. As far as Jason's father can tell from the documents the jail provided, the follow-up visit never happened.

Jason received detox medication and was placed on a men's intake pod for people undergoing detox. Inmates on this unit have double cells. During lockdown, guards check their cells more frequently than on regular units.

Jason had a cellmate at first, but the man was transferred, his father learned.

Five days after he arrived at the jail, at 4:15 p.m. Jan. 26, Jason Kindler was found hanging by a sheet. He had no pulse, respiration or blood pressure. Officials pronounced him dead and notified the mother of his two young sons.

Mr. Hayes, a jail suicide expert who has consulted for the Pennsylvania Department of Corrections and advised a Luzerne County facility on an inmate-on-inmate monitoring program that Allegheny County Jail plans to emulate, said most jailhouse suicides occur within first two weeks of confinement.

He said it matters whether mentally unstable inmates are in single or multiple-person cells. But before that, he said, intake workers must be trained to decipher routine from emergency referrals.

After hearing the basic details of Jason Kindler's intake report, he said, "nothing strikes me as routine." He said, jail employees "just become indifferent, unless an inmate says, 'If you put me in, I'll kill myself.' They've seen too many inmates being processed."

If Jason was truly contemplating suicide, "That would absolutely warrant suicide watch regardless of any other answers" he gave, he said.

Dr. Frederick Maue, the former chief of clinical services and former psychiatric director for the state Department of Corrections, said Jason Kindler's "bipolar disorder" alone should have put Allegheny County Jail officials on alert. Like Mr. Hayes, he had no firsthand knowledge of the case, but he said, "If [inmates] don't want to go on with their lives and they're telling you that, they should be in a different area of the prison, in a mental health area."

He currently advises jails and prisons that when inmates require more than one treatment, for example, both detox and psychiatric medications, they should put the inmates on both treatments at the same time.

He added that health officials at jails are under extreme pressure during intake: "Pretty quickly you get acclimated. Most of the time your judgments are pretty good, but sometimes you get burned."

John Kindler, 48, of Shaler, said his son Jason was "a bright, intelligent, sincere and good kid who was in a lost world in his mind." He feels Jason should have been placed on a psychiatric pod and given psychotropic medication. Or, at the very least, he should have had a roommate.

The father admitted he wasn't shocked his son was capable of suicide, just that it could happen while he was in such a supervised setting.

"From the time he walked in that door, he was under their supervision. What happened is unacceptable," he said.
Gabrielle Banks can be reached at gbanks@post-gazette.com or 412-263-1370. Read more!

Lawmakers should get real on prison crowding -

Editorial: Sunday, April 20, 2008

After two decades of longer and longer prison sentences, California's prisons are overcrowded, and they are housing increasingly older, sicker prisoners.

Gov. Arnold Schwarzenegger and lawmakers have known since July 2006 that if they do nothing to change sentencing practices, California will need to build 5,000 prison medical beds and 5,000 mental health beds within 10 years for chronically ill, physically impaired, feeble inmates.

Yet legislators were shocked, shocked last week to hear what it will cost to build these facilities: $6 billion.

Well, now they have a choice.

They can continue with current sentencing practices and face the fact that they've got to foot the $6 billion bill for the facilities.

Or they can change course. In the short-term, that means evaluating all 22,000 prisoners who are over age 50 for possible release or lower-cost options (electronic bracelets, halfway houses, etc.). Crime rates for 57-year-olds are a whole lot less than for 22-year-olds. Long-term, it means fixing the broken sentencing system. Start with placing a moratorium on lengthening existing sentences.

Legislators no longer can sit in utter denial of the consequences of existing sentencing patterns. California's prison health system is so broken that a federal judge took the drastic step of placing it in federal receivership.

And the federal receiver has run out of patience.

Assuming that California will do nothing to change sentencing practices, he has proposed building seven free-standing facilities of roughly 1,500 beds each at existing prisons or on state-owned land. The construction schedule would be ambitious: breaking ground every three months beginning January 2009 and opening all seven facilities between January 2011 and July 2013.

Consulting teams have estimated that the state already is short between 3,224 and 3,500 beds for housing chronically ill, physically impaired prisoners. And if lawmakers do nothing to change sentencing practices, that increases by roughly 230 beds a year. By 2017, the continued aging of the population will require between 4,970 and 5,750 beds for inmates with long-term care needs. Dealing with the one in six prisoners who are severely mentally ill adds another 4,292 beds.

Currently, the prison system has only 800 in-house medical beds distributed across the state's 33 prisons. These, however, are for short-term care only. The prison system has no beds for those with chronic conditions or ongoing physical needs.

This shortage has a number of effects. First, older, sick prisoners take up regular prison cells that younger prisoners could occupy – adding to prison overcrowding. Second, the long-term ill and impaired population is taking up expensive short-term acute beds. Third, when the 800 existing medical beds are filled, prisoners are transported to community hospitals with prison guards at huge cost.

Lawmakers no longer can avoid the tough decisions. If they choose to stay on the same sentencing path, they have to build facilities and pay the day-to-day costs of dealing with aging prisoners. They can haggle over details to reduce building costs, but they have to face the fact that the cost will be huge. Or they can change course. Quickly. The federal receiver isn't interested in more delays.
Read more!

Medicine for an ailing system -New Orleans Times Piscayne

EDITORIAL: Sunday, April 20, 2008

Mental patients who end up living on the streets or in jail cells are casualties of Hurricane Katrina and the direct hit it took on Louisiana's already inadequate mental health care system, but they're not alone.

Families who struggle to cope with a mentally ill relative at a time when stress is high and services are scarce are affected, too. So are police officers who get the calls to bring people in crisis to the hospital -- 200 per month, according to the New Orleans Police Department -- and the emergency room doctors and nurses who treat them.

Gov. Bobby Jindal is taking aim at this pressing public health issue with a plan to spend $89 million in mental health care programs around the state, including $26 million for outpatient services. In addition, the state is putting $2 million in emergency financing toward outpatient care programs that could begin as early as next month.

The Jindal administration's mental health agenda also includes a legislative package to address shortcomings in the system, and lawmakers should adopt the four bills that the governor is pushing.

Senate Bill 228, for example, seeks to ease the burden that's been placed on hospital emergency rooms since the storm by establishing mental health crisis centers. The bill, sponsored by Sen. David Heitmeier of Algiers, would require the Department of Health and Hospitals to devise statewide licensing requirements for the centers and require each region of the state to come up with a plan for coordinated care for people suffering from acute mental illness.

While the bill's goal is to have such a center in each region of the state, the first one would be located in New Orleans. Gov. Jindal's budget includes $3.5 million for a pilot program, to open within six months.

Sen. Heitmeier's bill drew complaints from some members of the Senate Health and Welfare Committee because other areas of the state are not in line for money. But the need is most acute in New Orleans. The loss of Charity Hospital and its mental health beds has put a tremendous strain on other hospital's emergency rooms, and it makes sense to start here. The bill was passed unanimously by the committee and the full Senate and now heads to the House.

Gov. Jindal is also backing House Bill 930, which would provide more local control of public health dollars through the creation of human services districts. The bill would also beef up state oversight of those agencies.

Both steps are appropriate. Local districts should be able to provide better insight into the needs of the area they serve, but there's also a need for accountability based on what happened with the Metropolitan Human Services District, which serves New Orleans and St. Bernard and Plaquemines parishes.

That agency, which was new when Katrina hit, foundered after the storm. Health and Hospitals Secretary Alan Levine appointed a retired Army officer to lead a transformation team for the troubled agency. Building in oversight from the beginning is prudent.

A separate proposal, Senate Bill 182, takes aim at another difficult issue, mentally ill patients who refuse to comply with treatment. The proposal is also known as Nicola's Law, after New Orleans police officer Nicola Cotton, who was killed in the line of duty. The man accused of killing her has been described by his family as a paranoid schizophrenic who often refused to take medication and made threats.

This bill, sponsored by Sen. Cheryl Gray of New Orleans, would allow judges to mandate outpatient treatment for patients with a history of refusing treatment, and it's a necessary and compassionate measure.

The final piece of the package is a proposal to help psychiatrists make emergency evaluations of patients in cases where access to doctors is difficult. House Bill 653, by Rep. John Labruzzo of Metairie, would allow doctors to use video conferencing technology to evaluate patients, and it's a practical solution.

Gov. Jindal rightly paints mental health as a storm recovery issue, but that's not his only objective. "Our goal here is to improve a safety net that wasn't even adequate before Katrina," he said.

These bills, along with the resources to provide better care, should help the state achieve that goal.
Read more!

Mentally ill come back solo - New Orleans Times Piscayne

Sunday, April 20, 2008
By Katy Reckdahl


In post-Katrina New Orleans, people like Alvin Thomas, a schizophrenic man exiled to North Carolina by the flood, often arrive back home alone, said Mike Miller, a UNITY caseworker.

The New Orleans Police Department's homeless outreach unit gets weekly calls for assistance from the Greyhound bus station, said Sam Scaffidi, half of the unit's two-person crew.

"I've run across people with severe problems discharged directly from mental hospitals to New Orleans," he said.

Sometimes the bus ticket comes courtesy of social workers, caseworkers or even family members, he said, recalling one displaced New Orleanian, a blind, schizophrenic drug addict who recently stepped off the bus alone.

"They just put them on a bus and ship them to us," Scaffidi said.

"It's all well-intentioned," Miller said. "They ask, 'Where do you want to go?' The evacuee says, 'I want to go home.' "

Many, like Thomas, end up in abandoned family houses. And many are unable to properly care for themselves, Miller said. He recently persuaded a man who was living inside an empty house to go to a hospital, saying he had moss growing on his legs. Another suffered severe burns from a fire he started to keep warm.

Scaffidi has gone into similar houses and pulled out people in grave condition. One young woman had a staph infection on her back, he said, and another man had a spider bite so infected that doctors amputated his arm.

In recent months, some squatters have emerged from those houses, drawn to meals served by do-gooders and church groups. UNITY found that two-thirds of the people living at the homeless camp under the Claiborne Avenue overpass at Canal Street came from abandoned houses.

The agency estimates that there are 12,000 homeless living in Jefferson and Orleans parishes and that most of them are squatting in empty houses. Those who are the worst off might not be seeking assistance, said UNITY head Martha Kegel.

"That's our fear, that people are suffering alone in abandoned houses," she said.

. . . . . . .

Katy Reckdahl can be reached at kreckdahl@timespicayune.com or (504) 826-3396. Read more!

Legislature approves psychiatric patientrights bill - Anchorage Daily News

LISA DEMER

ANCHORAGE, Alaska — Four years after an Anchorage couple started pushing for a psychiatric patient rights bill, the Legislature finally approved the measure — in the last hours of the session.

The bill says adult psychiatric patients have the right to request the gender of the staff member providing intimate care in a hospital. That includes help with bathing, dressing and using the bathroom.

In the Senate, the bill passed unanimously while it cleared the House on Sunday, the last day, by a 23-12 vote.

"I am just on top of the world," said Faith Myers, an advocate for patient rights, after Senate Bill 8 passed.

Patients sometimes need personal care because psychiatric drugs can knock them out for long stretches, or they may have injuries that prevent them from doing for themselves, she said.

"You might be too groggy to change your clothes. Some people are even in kind of a coma and have to have diapers changed. This would give them a chance to request their choice of gender," Myers said. In extreme cases, their guardian can explain, or maybe they've given wishes ahead of time.

"We just want to make sure patients are in on the conversation regarding their own personal care," said her partner, Dorrance Collins.

Myers and Collins have reputations as tireless fighters on Alaska mental health issues. Myers, who has been diagnosed with schizophrenia, learned from her own experiences as a patient at Alaska Psychiatric Institute and elsewhere.

A big case involving Myers went to the Alaska Supreme Court, which ruled in 2006 that before a psychiatric patient can be forced to take mind-altering drugs against his or her will, a judge must rule that the medication is in the patient's best interest and that a less-intrusive option doesn't exist.

Myers and Collins spent years working on evolving versions of the new legislation, and they still are working on other issues, including strengthening an existing law that gives psychiatric patients the right to file a grievance.

"They are very diligent in what they do," said Sen. Bettye Davis, D-Anchorage, one of the prime sponsors of Senate Bill 8 and chair of the Senate Health, Education and Social Services Committee.

If they hadn't pushed so hard, narrowly focused Senate Bill 8 wouldn't have passed during the 90-day session, she said.

"Nobody was giving it much attention," Davis said.

Myers and Collins testified at every hearing and drummed up support from groups including the Disability Law Center, the Alaska Mental Health Board and the Law Project for Psychiatric Rights. They emphasized how people who have been abused sexually or physically may end up hospitalized for mental problems and said the victims should not be traumatized again in the hospital.

Davis said some legislators were concerned about whether psychiatric patients were capable of deciding who should provide personal care. Some thought the measure might force hospitals to hire extra staff.

"And that's not necessarily true, either," said Davis, who worked as a nurse and a social worker at API when she first came to Alaska. "If you were short-staffed and needed somebody to come down, you pulled somebody from another floor."

The bill applies not only to API but also to any Alaska hospital that provides mental health treatment to adults.

It says adult psychiatric patients have the right to ask for the gender of the staff providing help with bathing, dressing and the like, and if the hospital for some reason can't comply, that must be noted in the patient's record. In addition, routine safety checks of bedrooms, bathrooms and shower areas need to be done by a staff member who is the same gender as the patient, under the bill.

API was against the bill, because its staff members already follow such a policy, at least since the institute moved into its new building on Providence Drive in 2005, said Ron Adler, API's chief executive officer. Patients stayed in dorms at API's former home next door, and it was harder to ensure privacy. There's only been one complaint about the issue over many years, he said.

"Why are we legislating things that don't need to be fixed?" Adler said.

But policies can change in a flash, and other hospitals may not have one, Myers said. The bill ensures that this right can't be taken away, she said.

Now it's up to the governor, whose office said she hasn't yet been briefed on the bill.

Myers and Collins are waiting.

——— Read more!

Better to aid mentally ill outside of jail, report says - The Denver Post

04/19/2008

One of every five inmates jailed in the seven- county Denver metro area has a serious mental illness, and housing them takes a $34.4 million annual bite out of the counties' tight budgets, according to a new report by a Metro Area County Commissioners' task force.

Seriously ill inmates spend 5 1/2 times longer in jail than average inmates and cost $8.28 more per day because they receive more services and may be housed in special units, the report found.

"If we could reduce the number of mentally ill people in jail by one-third, we could cut the jail population in half," said Jefferson County Commissioner Kathy Hartman, chairwoman of the metro group. Mentally ill inmates also revolve in and out of jail more frequently.

The report, "Taking Action for Change," said cuts in mental-health programs and few available psychiatric beds mean jail cells end up as the last resort for people with depression and schizophrenic and psychotic disorders.

Money could be saved by plugging service gaps with community programs, the report said, thereby diverting the mentally ill from the criminal justice system and providing a range of help upon release.

The problem is not new. Since 1991, the percentage of inmates with serious mental illness has increased 1 percentage point each year, according to the Colorado Department of Corrections.

The issue has been trying to find money to pay for state and county programs for the mentally ill.

But Hartman said spending money for community-based programs costs one-tenth as much as jail. And for counties such as Jefferson, which is facing a $150 million jail expansion, the savings could be significant.

In community programs, not only would people receive proper treatment, the report said, but jail bed space would be freed up, inmates would be less likely to return to the criminal justice system, and jail costs would be limited.

"For the first time, mental health (officials) aren't saying this. This is the courts, the sheriffs, people in the community," said task force co-chairman Rick Doucet, executive director of the Community Reach Center in Thornton. "They're saying that this is a problem and we need to address it."

Priorities, the task force said, should include triage centers, mental- health courts, expanded diversion programs, affordable housing, homeless services and access to benefits.

Each county has identified parts of the problem it can work on, whether it's getting ID cards for inmates to use for benefits when they are released, or ensuring Medicaid doesn't drop the inmates from its rolls.

"We're all dealing with the same issues, only we do it a little bit differently," said Adams County Undersheriff Paul Siska, a task force co-chairman. "We have the same goal, and we need to do it all together."

Boulder County's Partnership for Active Community Engagement, or PACE, began in 1999 and has been credited with a 72 percent decrease in overall jail use, saving more than 10,000 jail-bed days each year at a cost of $61 per bed per day, according to a University of Colorado study.

Another successful program was created in late 2005 by community mental-health and correctional agencies.

The John Eachon Re-entry Program, or JERP, reports 40 percent of the participants work and live on their own, and 35 percent are in school.

Parolees Dave Carter and Scott Urich churned in and out of prison until they linked up with JERP.

Both have schizoaffective disorder,
click on image to enlarge
which causes them to hear voices if they don't take medications.

Now 51, Carter served time for stealing cars, robbery and burglary since he was 17. Each time he was released, he had no meds or other help. "If I had stayed in jail, I don't think I would have made changes," said Carter, who has been with JERP for two years.

Urich, 46, took and dealt drugs since his teen years, with spirals into violence and prison. Now, Urich lives on his own and attends community college, hoping to earn a degree in fine arts. "They make sure we don't fall through the cracks," he said. "This is such a vital program."

The problem continues to be money, though some help looms.

A 2004 law allows sheriffs to collect a booking fee, with 20 percent earmarked for mentally ill inmates.

A bill passed by the Colorado Senate and assigned to the House Judiciary and Appropriations committees earmarks $279,000 from the general fund for training to assist inmates in accessing health care, housing and job benefits. It also sets up grants for two- year county pilot projects.

Ann Schrader: 303-278-3217 or aschrader@denverpost.com Read more!

Emotional struggles detailed in essays - Chicago Tribune

By Jodi S. Cohen and Stacy St. Clair
April 20, 2008

Well before his murderous rampage at Northern Illinois University, Steven Kazmierczak described himself as a victim who had overcome hard times.

In graduate school applications, reviewed exclusively by the Chicago Tribune, Kazmierczak wrote that his own mental-health struggles would one day enable him to help others—a vision that tragically imploded Feb. 14 in one of the deadliest campus shootings in U.S. history.

"For as long as I can remember, I have always been an extremely sensitive individual, and feel as though I am able to empathize with other people's emotional and social needs," he wrote. "However, some of my peers were not very understanding or accepting, and I feel as though I was victimized to a certain degree during my adolescent years."

The essays offer unprecedented and chilling insight into the mental-health troubles of the 27-year-old graduate student who two months ago fatally shot five students at Northern Illinois University, wounded 16 others and then killed himself.

Before doing so, Kazmierczak went to great lengths to hide his past. He removed the hard drive from his computer, tossed out his cell phone's memory card and left no suicide note.

And so the voice of the killer has been absent as people have tried to understand what happened.

But in four personal statements he submitted to NIU and University of Illinois graduate schools, Kazmierczak lays out in his own words the history of his emotional troubles.

The records, accessed under the Freedom of Information Act, show an intelligent man determined to reinvent himself after a troubled adolescence. They relate the alienation he felt as a high school student, his parents' decision to place him in a group home and the help he got from an inspirational social worker.

His father, Robert, in his first in-depth interview since the shooting rampage, told the Tribune Friday that the essays are both accurate and sincere.

He said the family sought help for his son's mental illness by putting him in the group home, though Robert Kazmierczak would not talk about a specific diagnosis or any treatments.

"We did everything we could to help him. My wife and I worked very hard to help my son. I thought he was doing well," Kazmierczak said Friday. "He still had a lot of support. He knew I would help him if he was in trouble."

Kazmierczak's father said he thinks his son was sincere when he wrote, in his application to the U. of I. School of Social Work, that he hoped to use the graduate degree to help others conquer the types of problems he thought were behind him.

"I aspire to work with the mentally ill within the criminal justice system, a group home setting, or for a non-profit organization that caters to the needs of those in society who need guidance and direction, like I did so many year [sic] ago," the younger Kazmierczak wrote.

Problems surfaced early
Kazmierczak's troubles began before he was 11. By middle school in Elk Grove Village, he already had begun meeting with social workers to discuss his problems adjusting to school and the social pressures that often overwhelmed him.

"In hindsight, I feel that this was largely a result of the sensitivity that I often exhibited toward other classmates, which was not necessarily accepted by others," he wrote in his personal statement to U. of I., the essay in which he most thoroughly writes about his troubled past.

Kazmierczak wasn't without friends, though. In high school, he often hung out with the "anti-clique," a group whose members wanted to show they didn't care if they weren't popular.

"He felt lost and disconnected in spite of his friends," former classmate Justin Hammang said.

Kazmierczak wrote that he learned techniques for dealing with stress during counseling sessions with social workers, but he still "felt profoundly lost."

"I perceived that I had no where [sic] to turn," he wrote.

Kazmierczak's parents arranged for a multitude of social services, but Kazmierczak wrote he couldn't open up in therapy.

After his high school graduation in 1998, his parents made the "heartbreaking" decision, he wrote, to place him in a group home that treats mostly young adults with schizophrenia, bipolar disorder, behavioral problems and other mental illnesses.

While Kazmierczak did not identify his specific mental illness in his writings, Hammang said Kazmierczak had confided he was taking lithium, a drug primarily used to treat people with bipolar disorder.

Kazmierczak's father said that although the family sent Steven to a Chicago psychiatric treatment center—Thresholds-Mary Hill House—to deal with his mental illness, they also wanted to get him away from one of his closet friends, who had been arrested several times for dealing drugs. He said his son never had a drug problem, but he worried associating with a bad crowd could lead to trouble.

"The fact is we wanted to make sure he was away from that kid," he said.

'A sense of direction'
Kazmierczak lived in Thresholds for about a year, house manager Louise Gbadamashi said. When Kazmierczak first arrived at the home, he continued his anti-social behavior, frequently ran away and resisted taking his psychotropic medications. He also began intentionally cutting himself.

Social workers persuaded him to change by pointing out the stress it caused his mother, Gail, who was in the early stages of Lou Gehrig's disease.

Kazmierczak wrote that much of his improvement took place under the watchful eye of an unnamed Thresholds social worker.

"A caring public servant with a background in sociology helped me to gain a sense of direction and helped me to better myself through education by showing me how to navigate through a bureaucracy," Kazmierczak wrote in his NIU graduate school application in 2005. "It was then that I realized the impact that one person working with a social service agency could have on a person's life."

As part of his rehabilitation, Kazmierczak moved into his own apartment after about a year in the group home, Gbadamashi said. He had a job at a computer repair store and seemed to be coping, but he eventually found single living too stressful and moved in with his parents.

On Sept. 7, 2001, he enlisted in the Army, according to the Pentagon.

Kazmierczak told friends he was kicked out of the Army after military officials discovered his past psychiatric problems. He received an administrative discharge on Feb. 13, 2002.

On his undergraduate application to NIU, dated Feb. 21, Kazmierczak listed himself as a veteran. However, when he applied to the U. of I. four years later, he wrote that he had never been in the military. It was an equivocation perhaps done to avoid answering the next question: "If yes, did you receive a less than honorable discharge?"

Again, Kazmierczak answered, "No."

A reinvention
Kazmierczak seemed to successfully reinvent himself at NIU.

He later wrote in his graduate school applications that he was grateful that NIU was willing to admit him despite his past.

"Over the last several years, I have become increasingly aware of the fact that I was fortunate enough to attend college, given the fact that I used to be a resident in a state group home," he wrote.

A dual major in political science and sociology, Kazmierczak's NIU transcript shows he earned straight A's in every class he took in those departments and A's and B's in his other liberal arts classes. He graduated summa cum laude with a 3.88 grade-point average in May 2006, winning the sociology department's Dean's Award.

He began graduate school in sociology at NIU the next month, and his academic accomplishments continued.

The exceptions to his success came when, as a graduate student, he inexplicably took three undergraduate psychology courses: disturbing behaviors in children, social psychology and psychopathology, the study of mental illness. He got two F's and an incomplete after he stopped going to the classes.

Though it's unusual for a graduate student to enroll in undergraduate courses, Kazmierczak's psychopathology professor, Phillip Krasula, said some students take his courses to learn more about themselves. "People will have issues and that is why they will take the class—to learn something about themselves or because they have had mental health problems themselves," he said.

Perhaps he stopped going to class because he learned, in a letter dated Feb. 28, 2007, that he had been admitted to the U. of I. He was awarded an achievement grant that covered one semester of tuition.

Before leaving for the U. of I., Kazmierczak told his professor and mentor, Jim Thomas, that he had overcome his anti-social tendencies at NIU.

"When I came to NIU . . . I was practically a recluse, and was somewhat anti-social," Kazmierczak wrote in an e-mail to Thomas. "I have grown throughout the years due to your influence."

He rarely mentioned his troubled past to his classmates, but fellow graduate student Will Mingus said Kazmierczak had mentioned his stay in the group home.

"To me it was the quintessential success story," Mingus said. "He'd had a tough time, but went to college, did really well and achieved."

Desire to make difference
That was the story Kazmierczak told in his application to the U. of I. School of Social Work, in which he wrote that he wanted to specialize in community mental health. He conveyed an image of someone who had overcome adversity.

"I truly do feel as though I would be an altruistic social worker, mainly due to my past experiences, because I view myself as being able to relate to those segments of society that are in need of direction," he wrote.

Despite the essays' sincere tone, admissions officers and mental-health experts can glean little from such statements, said Jerald Kay, chair of the American Psychiatric Association's committee on college mental health.

Most applicants, Kay said, paint themselves in a positive light, and unless the writings are incoherent or threatening, they do not have enough depth to raise red flags.

"You have to give the student the benefit of the doubt," Kay said.

Kazmierczak's father confirmed his son's desire to "make a difference in the lives of those of whom I am able to connect with."

"My son always wanted to help people," he said. "He had a lot of support growing up. He wanted to make sure others had that same kind of support."

Kazmierczak wrote about the importance of that support in his personal statement—acknowledging that he had the "familial and emotional support structure" he needed to survive the rigors of graduate school.

He appeared on a path toward success at the U. of I., earning three A's and an A-minus in the social work classes he took last summer and fall. He had enrolled in four classes this spring, which are still listed as "IN PROGRESS" on his transcript.

But early this semester, on Feb. 8, Kazmierczak added to his two-gun collection by purchasing a Remington shotgun and a Glock 9 mm handgun from a small store in Champaign. He had already purchased two ammunition magazines.

On Feb. 14, Kazmierczak carried his guns onto an auditorium stage in Cole Hall, the building where he had taught a sociology class. The man who once described himself as "extremely sensitive" opened fire on a geology class, injuring 16 students and killing Daniel Parmenter, Ryanne Mace, Julianna Gehant, Catalina Garcia and Gayle Dubowski.

He then shot himself.

Police said Kazmierczak had been acting erratically and had stopped taking his mood-stabilizing medication. An autopsy showed he had trace amounts of an anti-anxiety drug, nicotine and cold medicine in his system.

There's still no known motive for his killing spree, and it is unknown why he chose his alma mater, a campus he wrote about with such gratitude. His final, brutal act couldn't have been further from the goals he espoused in his applications.

"I feel as though I needed to genuinely express myself so that those who read this statement can understand my strong desire to give back [sic] those in need of guidance and a helping hand," he wrote. "Everyone, regardless of where they come from, may need someone to rely on in their time of need."

Tribune reporters Carolyn Starks and Josh Noel contributed to this report.

jscohen@tribune.com

sstclair@tribune.com Read more!

Office attack defense: Insanity -The Detroit News

Mike Martindale
April 19, 2008

TROY -- It's been more than a year since witnesses and police say Anthony LaCalamita III casually walked into the Long Lake Crossing office building and opened fire, killing one former co-worker and wounding two others with blasts from a 12-gauge shotgun.

LaCalamita is charged with first-degree, premeditated murder in the slaying of Madeline Kafoury, 63, of Warren, and the attempted murders of others in the April 9, 2007, incident at his former accounting firm.

Jury selection begins on Monday in Oakland Circuit Judge Rudy Nichols' courtroom and the men and women who are seated will hear several days worth of evidence and testimony, including from several doctors, on what occurred that day and what prompted the shootings.

Who is responsible for the shootings is not expected to be an issue, attorneys say. Several eyewitnesses, including two surviving victims, Alan Steinberg of Bruce Township and Paul Riva of Sterling Heights, are expected to testify that LaCalamita appeared about 10 a.m. in the offices of Gordon Advisors and calmly asked them "Do you want to get shot?" before pulling the trigger on the shotgun.

"I think our doctor has done a proper assessment of my client and will convince the jury," said defense attorney Jerome Fenton, who will seek an insanity defense for LaCalamita.

LaCalamita has a history of mental illness, including two suicide attempts. LaCalamita reportedly has been diagnosed with depression and a bipolar, manic disorder that requires medication.

LaCalamita's estranged wife's attorney, Jose Fanego, said LaCalamita attempted to kill himself in 1998, and again in 2002 by overdosing on pills.

Under Michigan law, an insanity defense requires a defendant to prove he or she couldn't differentiate between right and wrong at the time of the crime, or conform to the law because of his or her mental illness.

"He has been examined -- several times -- and found mentally competent to stand trial,"