Deputy: Shot followed policy -Wassau (WI) Daily Herald

By Jeff Strack

Wausau police officials say their officers acted appropriately during Thursday's shooting, citing the department's policy on deadly force.

Michael John Hager, 49, of Wausau was shot in the arm and abdomen after he reportedly made threatening advances with a knife toward an officer who was on the ground.

Officer Thomas Hines fired his handgun after he perceived Hager's actions to be a threat on officer Mark Timken's life, Wausau deputy police chief Bryan Hilts said.

"We don't train to use a less than lethal weapon to defend their lives or another person's life," Hilts said.

Officers are trained to use deadly force when an assailant with an edged weapon is advancing toward them and within 21 feet of them, Hilts said. A person can cover 21 feet in the time it takes an officer to assess the situation and draw a firearm, he said.

Hilts credited Hines for firing only one shot and Timken for using a Taser instead of a firearm.

Five witnesses of the incident were interviewed and gave similar statements, police said. The Marathon County Sheriff's Department is overseeing the Wausau Police Department's investigation.

Timken and Hines are on administrative leave, per department policy. Both will be formally interviewed in the next few days after a "cooling down" time.

Both officers are well trained, Hilts said. Timken has worked for the department for 21 years and is a defense and arrest tactics instructor. Hines has worked there for 16 years and is a firearms instructor.

Once a month, Wausau police train to use their firearms at a shooting range. They also attend an annual in-service that focuses on firearm and defense tactics training.

Police have had past contact with Hager.

An officer suffered a broken wrist July 16, 1997, while responding to a noise complaint involving Hager, Hilts said. Hager knocked officer Joseph St. Amand to the ground and at one point sat on top of him, according to a criminal complaint. A second officer arrived and knocked Hager off St. Amand and used pepper spray on him.

Hager was found guilty, but not guilty by mental defect or disease, on a charge of battery to a law enforcement officer, according to court records. Hager has had other criminal charges resolved in the same manner.

Hager has been diagnosed with and treated for schizophrenia and has spent time at Winnebago Mental Health Institute.
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Cuts could hurt state's mentally ill -Raleigh News & Observer

Lynn Bonner

The state will pay less for a mental health service offered to the state's seriously ill residents.

The 7 percent cut was a surprise to advocates for the mentally ill and to providers who said they are already losing money on the service, called assertive community treatment, or ACT, teams.

The teams include psychiatrists, nurses, therapists and social workers who offer comprehensive mental health care to people with severe illnesses such as schizophrenia.

"It's just devastating," said Debra G. Dihoff, executive director of the National Alliance on Mental Illness in North Carolina.

ACT is one of five new community-based services the state offers with a proven record of helping people, she said, and the state cannot afford to lose teams.

Brad Deen, a spokesman for the state Department of Health and Human Services, said the state's Medicaid division changed reimbursement rates for a number of mental health services introduced in March 2006. The new ACT team rates, Deen said, are based on a review of national data and cost information from state providers.

Rates will go up Oct. 1 for 11 mental health services. Prices will drop on three services.

The state was criticized for setting a high, $61-an-hour rate for a more basic service, community support, while paying too little for more intensive services such as ACT teams.

A News & Observer investigation this year found that the state wasted more than $400 million on community support. Companies offered the service to people who did not need it. Workers took clients to movies and basketball games. Most of the work was done by people without college degrees.

Companies sprang up to offer the lucrative basic service rather than provide higher-end services that help keep people out of hospitals. The state later cut the community support rate.

John Tote, executive director of the Mental Health Association in North Carolina, called the ACT team cut "completely ludicrous."

Tote said his organization has the most ACT teams in the state, serving more than 1,000 clients.

It costs an average of $1,850 a month to take care of each person, he said, while the state is now paying about $1,296. Under the new rate, companies will receive about $90 less per client each month.

Tote said he could not cover the shortfall by adding more clients. If he keeps all the ACT teams running, Tote said, he will have to cut staff salaries or health insurance benefits or find other savings.

ACT teams are proven effective in helping keep people out of mental hospitals, said Fred Waddle, lobbyist for Easter Seals UCP. Easter Seals operates nine ACT teams for 500 clients.

The state should be focused on getting more ACT teams, Waddle said, not cutting the rate.

lynn.bonner@newsobserver.com or (919) 829-4821 Read more!

Freedom To Heal - Forbes

Click on post title for video report on a self-help haven for those living with mental illness flourishing through the dream of one man. Read more!

Troubling gaps in Napa County mental health care - Napa Valley (CA) Register

By Gayle Whitlock and Lawrence Swaim
August 29, 2008

It is no secret that the Napa County mental health system has trouble hiring and retaining staff psychiatrists. As the higher ups, we will be pleased to tell you that is mainly because of changes in funding — the money isn’t there. But it’s not enough to acknowledge that things are bad financially. In such situations, dedicated people should search relentlessly for innovative ways to compensates for economic limitations.

New ways must be tried, fine-tuning them afterwards as needed.
One possible way is to form a med consortium composed of nurses, case managers and psych techs that can meet regularly to do a med review for clients. They’d review the med stories of the clients, interview them, get feedback from residential treatment teams and then arrive at recommendations regarding meds. They’d communicate those recommendations to the staff psychiatrists who’d have the option of seeing the client or continuing to prescribe the meds in place, based on the recommendations of the med consortium.

Many variations of this scenario are reportedly already in use, particularly those in agencies with a public health orientation. The med consortium idea has been used in hospital-affiliated mental health programs and community-based clinics. They can function as screening panels for domestic violence, substance abuse, children at risk and high-risk behavior generally. Staff psychiatrists could see patients whenever necessary but if a med regime is working there may not be any need to do so. Clearly the Napa County Mental Health system has got to do something and this approach deserves consideration.
Sadly, lack of staff psychiatrists isn’t the only problem adversely affecting the mentally ill in Napa County. Because of demographic changes, more Latinos are beginning to come into residential treatment in Napa and many of them feel more comfortable talking to Latino counselors than Anglo ones. It isn’t enough for some staff to speak Spanish. A counselor needs to be both bilingual and bicultural for the necessary therapeutic bond to be established.

It is an astonishing reality that in the two main residential programs in Napa County, where the present writers work, there are no bilingual, bicultural counselors. When will Progress Foundation, who administers these programs, launch a hiring campaign for Latino staff? Are they trying hard enough to find qualified candidates?
The mental health system is strapped for money. Many say that is the proximate cause for the problems we’ve discussed. Lack of money is no excuse for not striving to create innovative approaches aimed at providing adequate services. And while more poor people coming into the system necessitate more thoughtful programs, race isn’t a reliable indicator of socioeconomic status, and it would be un-American and illegal to use it in that manner.

Just like anyone else, Latino families should have access to professional and timely mental health services.

(Whitlock is a counselor at Progress Place. Swaim is the SEIU shop steward at Bella House.)쇓 Read more!

Healing Voices - Forbes

Philanthropic Pitch

Edited by Richard C. Morais 08.29.08

Will Hall
Profession: Graduate student
Cause: Treatment alternatives for mental illness

Why I was moved to support this cause:

Since I was a child I've struggled with extreme emotions, voices and powerful out of body experiences. I remember falling to the ground once in third grade, writhing in agony because I believed something was grabbing my back. I saw cartoons projected on the ceiling, and my fear was sometimes so strong I fell mute. I often hid away, alone, overwhelmed and unable to describe what was going on.

At age 26, I hit a breaking point and wandered the streets of San Francisco all night hearing angry voices telling me to kill myself. I ended up on a locked psychiatric ward. For the next year, I was in and out of hospitals and homeless shelters.

My diagnosis was schizoaffective schizophrenia, and the treatment was powerful anti-psychotic medications. What the doctors had to offer didn't help me, however. I left the hospital with more problems than I had going in, and I had to cope with the trauma of restraints, seclusion, plus a stigmatizing label that offered little hope for the future.

With nowhere to turn, I started to search for an answer on my own. In 2000, some friends in the Northampton, Mass., area let me stay with them, and I got a job in a local convenience store. Then I worked in a bookstore. The daily routine of a job, getting away from the memories in San Francisco, the small town tempo--it all helped. Step by step, over these difficult years, I learned a different way of responding to my madness.

I learned about nutrition and changed my diet. I took classes in yoga and meditation and began to see an acupuncturist. I watched for early warning signs of problems and began to consider the spiritual aspects of what I was going through, listening to the voices I heard and exploring their meaning. At one point back in San Francisco, for example, I heard a loud voice telling me I had to do yoga or I would die. It was frightening, but I realized it was like the voice of an angry parent or guardian looking out for me. So that voice is why I began to practice yoga.

I might be different than most people around me, but being different also means being creative and sensitive. I stopped seeing myself as a broken person with no chance for recovery. Most importantly, I reached out to other people who had also been diagnosed as mentally ill, and we began supporting each other in discovering our own pathways to healing. For too long I had been trying to do this all on my own.

The upshot is, as I grew stronger and healthier, I was inspired to dedicate myself to helping others make it through the ordeal I had survived. Though many people find good support from doctors and medications, growing numbers around the world are calling for alternatives to the mainstream "one size fits all" approach to mental health.

What I am personally doing to support this cause:

In 2000, I met Oryx Cohen, a University of Massachusetts graduate student who had suffered similarly to me. We hit it off. We were both looking for treatment alternatives, and we wanted to meet others like us. So in 2001, we co-founded the Freedom Center in Northampton, starting with a public library computer, a free e-mail account, and one support meeting a month held in a local church. The meetings took off. People came in to share their amazing stories.
Check out the Freedom Center by watching this video

Today we've grown to a weekly acupuncture clinic, two yoga classes, a writing group, meditation group and two peer support groups. Thousands have been helped by the Freedom Center. We're trying to reach people not helped by traditional care, people looking for alternatives to medication and diagnostic labels.

We try and give people space to find their own pathway and treatments and let them explore, with support, a variety of “wellness resources.” That might include medications or it might not. We do make people aware of the downside of the drugs, but we let them choose how they want to proceed.

Last September, for example, the Freedom Center and the New York-based Icarus Project jointly published a Harm Reduction Guide To Coming Off Psychiatric Drugs. There are a lot of risks coming off psychiatric drugs, and if someone is finding it too intense, we often say, “Why don’t you consider going back on the medication and focus for the moment on finding yourself a stable housing situation. Or feeding yourself better.”

The Freedom Center does a lot of educational work and public events, and we have been invited to talk in places like California, Alaska, Utah, Ireland and Europe. We had a “Bed Push” last summer, where we rolled a hospital bed around town to call for more choice and compassion in hospital care. I also founded “Madness Radio,” a community FM radio show now heard everywhere via the Internet. So the Freedom Center is growing from a local service to a national voice for mental health alternatives.

Hard to know where this will all lead in the future. I myself am now in Portland, Ore., completing a Masters Degree in psychology at the Process Work Institute. I miss my friends in Northampton.

What you can do:

Experiences that get called mental illness are shrouded in fear and misunderstanding. Take the time to listen without judgment or preconception to people diagnosed with mental illness and have the courage to speak up if you've ever had a brush with madness yourself.

I invite you to learn about alternative and holistic approaches and to take a stand for greater choice and options in treatments and care. And, if you are in Massachusetts, please come by and visit one of our acupuncture sessions or yoga classes.

Or visit our Web site, Freedom Center, to make a tax-deductible donation to help us spread our message of hope and vision for change. All of the Freedom Center’s services are free and run by people who themselves have a psychiatric diagnosis, so our budget is just $21,000 for the 2009 fiscal year. The volunteer-run Freedom Center is not itself a 501(C)3, but it is supported by the mental health non-profit, Choices. This umbrella group provides us with backroom services and charges us 5% for the gifts run through their organization. So tax-deductible donations are made to “Freedom Center/CHOICES Inc.”

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Lost in a lost system: a new report confirms fears - The Carrborro (NC) Citizen

Taylor Sisk - Aug 28, 2008

Valerie Kramer calls Carrboro her “fairy-tale town.” She and her son, Jeff, moved here when Jeff was entering the second grade and left, in 1997, when he was 14. Kramer was ending a bad relationship, was diagnosed with clinical depression and decided she and her son needed a new start in a new environment. She and Jeff moved to Asheville.

While in high school there, Jeff fell in with the Rainbow Family, to whom Kramer attributes his introduction to drugs. Jeff was busted for distribution of marijuana and was facing both felony and misdemeanor charges.

Around this same time, Jeff had begun to often act strangely.

Nothing he said made sense, Kramer says. “He said God sent him to this Earth to grow marijuana for sick people, and that was his mission.” Jeff’s defense attorney advised her to pay a forensic psychologist to have Jeff evaluated. He was diagnosed with paranoid schizophrenia and deemed incompetent to stand trial. He was 19.

“I didn’t know what schizophrenia was,” Kramer says. “But at 17 and 18, he really did things that I knew were not normal for him. And everyone said, ‘Well, he’s just a teenager …’ But I always knew. I mean, I had nightmares about it. I knew something was wrong.”

It must be drug-induced, Kramer believed. “I said, ‘When he gets off the drugs, he’ll be fine, right?’” She was assured by the doctors otherwise.

So she packed up all of her and her son’s belongings and moved back to the Triangle.
“I thought, ‘We’ll go back to Chapel Hill where, in general, there are more people with a higher education.’

“I asked around – everyone I knew – and they said that as far as state hospitals go, John Umstead is the best because you’ll have the brightest people there, the most resources – and so by moving here, I’m doing my son a favor. UNC Hospitals will take care of him and John Umstead is the best place. And now, five years later …”

Her nightmares persist.

The report

Last week the newly formed legislative Program Evaluation Division released a long-awaited report titled “Compromised Controls and Pace of Change Hampered Implementation of Enhanced Mental Health Services.” The report is largely focused on the now well-documented excesses in the provisioning of community support services and chronicles the general mismanagement, overspending and lack of oversight in our mental health system since the passing of reform legislation in 2001, which called for privatizing services.

Community support services include, for example, assistance with grocery shopping or homework or chaperoning to movies or ballgames. The News & Observer reported that between March 2006 and January 2008, the cost of these services rose to nearly $1.4 billion, or 90 percent of all spending for community-based mental health care services. The cost of community support services was then nearly 20 times the state’s original estimate.

State officials now acknowledge that too much money has been wasted in the provisioning of community support services and – granting that these services are vital for many who are poised to reintegrate back into their communities – that too much money is being allocated to them at the expense of services that are more time- and cost-intensive to provide – local in-patient care, for example, or everyday counseling.

The legislative report cites delays in securing federal approval of new services, which led to a delay in the implementation of oversight procedures, which in turn led to some new providers taking advantage of the system by “delivering an unchecked amount of services”; a failure to establish a baseline “against which to measure system performance and assess utilization and expenditures”; and reports to decision-makers that included “excessively dense data that are neither synthesized nor interpreted.”

In sum, the report is about mismanagement and abuses in the overhaul of our state’s pre-existing mental health care system – an initiative that most everyone now acknowledges is in serious need of some overhauling of its own.

What the report is not about is how mental health care reform is failing people – most particularly, those people most critically in need.

What remains unaddressed is whether the system we’ve put in place is structured to provide these more intensive services.

More to the point: Is it possible to provide comprehensive, effective mental health care services and make money at it?

Dr. Nicholas Stratas doesn’t think so. Stratas, a psychiatrist now in private practice in Raleigh, is one of the architects of a mental health care system in North Carolina that was, many years ago, considered a model of success. He served through the 1960s as deputy commissioner of what was then the state Department of Mental Health, which eventually was moved into the Department of Health and Human Services.

“How can you make money without cutting services?” Stratas asks. “I think it’s possible to make money at this, but it’s going to be at the cost of cherry-picking services” – providing only those services that are most cost effective – “and you’re going to have to provide truncated services. And you lose the integration of a unified system.”

A unified system, Stratas says, is essential to providing continuity of care, and continuity of care is “absolutely critical.”

“But now,” says Stratas, “we’ve got this person doing this piece and this person doing this other.”

Under the previous state-run system, community mental health clinics provided a broad suite of services under one roof.

Dr. Thomas Smith, an Asheville-based psychiatrist, is another longtime mental health care advocate who’s been vocal in his opposition to reform measures. He underscores the critical nature of those comprehensive, under-one-roof services.”

People with mental illness, he says, often face prohibitive transportation issues – no driver’s license, no car, little money for a taxi and, in rural areas, few if any public-transportation options.

“So to have everything in a central location within a community mental health clinic,” Smith says, “that was great. And to let that be destroyed was absolutely atrocious.

“Now there are private providers out there scattered here from hither to yon, all over the place; and it’s hard for these folks to get to them.”

Of cherry-picking services, Smith says: “Nobody wants to treat the difficult-to-manage folks,” those with whom it’s necessary to build a relationship over time,” those who are most in need.

Things changed

Jeff Kramer occupies a quiet space outside Weaver Street Market as a Friday afternoon gathers energy. He’s undisturbed; focused, in his manner. He’s a handsome young man; steady for the moment and sturdy. He’s on an out-patient commitment order, required to report once a month to Orange County’s community resource court. The court is a cooperative effort of the Orange County judicial and mental health systems that strives to help people who have mental health issues by linking sentences for selected offenses with services and support. After another brush with the law, and yet another brief stay in Umstead, Jeff is once again tasked to regain his footing.

Jeff has been refusing to take his medication. He’s taken it intermittently in the past, and his mother sees clear improvement in his ability to function when he does. He says now, though, that he’s through with it.

“They want to see me on medicine that is not doing anything but damage to my brain,” Jeff says. “When you put chemicals in the brain, they don’t do anything but harm. Antipsychotics will make someone sick.”

“He says he doesn’t have schizophrenia,” Valerie Kramer says. “He says it’s too bad that they convinced me of that. He says he thinks that it’s something that he did when he was younger, when he took the wrong path in life; maybe the drugs he did. He always blames himself for the way he feels and thinks he can eventually work it out. He told me the other day that he’d rather die than take the medication.”

Kramer has been frustrated by the care her son has received at UNC Hospitals: “They’ve turned him down; they’ve released him after several days. The last time he was in there – it was January of this year – he stayed only several days, was very sick, very delusional, paranoid, and this woman” – another patient – “kept kissing him.”

“They would say, ‘We can’t help him because he’s noncompliant. He doesn’t want to take his medicine.’ At the same time, that’s a classic symptom of paranoid schizophrenia. They also say he has zero insight – another classic symptom – and so they send him home.”

“The first time at Umstead,” Kramer says, “it was before all of these laws changed, and it was a good time. That was 2003. They kept him for, like, six weeks. They gave him the best treatment. I mean they really seemed to care.”

When Jeff was given his outpatient treatment plan, Kramer says, “they took so much time with me and Jeff” – doctors, social workers, a team of clinicians that he was to work with on the outside all participated.

“We all sat down and we covered this outpatient treatment plan in depth and my son actually followed it. It’s the only time in the five years that he has done that.”

Eventually, though, Jeff stumbled.

“And then they changed everything,” Kramer says, “and they started keeping him two days, three days, a week if you’re lucky.” Most recently, he stayed two weeks.

A pill, a platitude, a pat on the back

The liaison community mental health clinics used to have with hospitals was an important element in continuity of care, helping ease the transition back into the community. Once out, an ongoing relationship with a trusted professional is the next critical step.

“It takes time to build those things,” says Thomas Smith. “But they just threw that all to the four winds. Now it’s just a piecemeal thing.”

Smith refers to “P-P-P’” clinics: “You come in and you get a pill, a platitude and a pat on the back.”

He hastens to add that there are certainly still good providers out there – but believes most are just in it for the money. And the continuity of service, that comprehensive suite of services delivered by a team, as a team, is what appears to be lost.

In order to be effective, says Nicholas Strata, that team should include a representative from a state institution, another from a local in-patient program, another from an out-patient program; a team to provide whatever the patient needs.

“The survivor in me, my inner peace,” says Jeff Kramer, “will find a way to survive and figure out some kind of method of dealing with reality.”

His mother isn’t nearly so sure.

This story is the first in a series about mental health care in North Carolina. The names of mental health care recipients and their family members have been changed.

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Family's story aids officers' training -Witchita (KS) Eagle

BY RON SYLVESTER - Aug. 30

The news of her son's death, in Marge Eilert's view, made him out to be a bad guy.

But he wasn't, she said, just sick, suffering from schizophrenia.

Two years ago, after his girlfriend had called for help, Greg Eilert struck a police officer. Then Eilert led police on a chase through Topeka before being shot four times and killed in his car by an officer.

On the second anniversary of her son's death, Marge Eilert, her husband, Ralph, and their daughter, Nancy Eilert-Way, drove to Wichita to tell a group of law enforcement officers about what their family had gone through with Greg's illness before and in the aftermath of his death.

It was the latest in the weeklong training of police and sheriffs' deputies on crisis intervention for the mentally ill.

Agencies such as the Kansas Department of Corrections and the National Alliance for the Mentally Ill hope to take similar training around the state as a first step in keeping people with mental illnesses out of what has become a revolving door of the criminal justice system.

The number of mentally ill people who end up in prison has tripled nationally during this decade. In Kansas, most inmates in prison suffer from some form of mental illness.

Greg Eilert, his family said, was a gifted woodworker, athlete and good student until he began slipping in high school. He would withdraw and become quiet. He later would be diagnosed with schizophrenia.

"He didn't lie. He didn't steal things," Ralph Eilert said of his son.

He wasn't violent by nature.

"I never in my whole life felt threatened by him," Eilert-Way said of her brother. "He had the kindest heart."

Not even his girlfriend of nine years, who called police that day, said he hurt her.

"She was scared," Eilert-Way said. "But she told us he never harmed her."

The woman took out restraining orders against him.

"Then one of them would violate the order," Eilert-Way said. "She would invite him back into her life."

Eilert went to jail twice, the last time in the spring of 2006.

"He was in jail that March," Eilert-Way said. "He wasn't competent to stand trial, so he went to Osawatomie State Hospital. Then he went back to jail."

When he got out that summer, he talked about going to see his girlfriend. His sister said she repeatedly told him he couldn't go.

Five weeks later, he was dead.

The police officer was absolved of any wrongdoing in the incident. Greg Eilert wasn't armed, but police considered his car a weapon, the family was told.

"We felt like Greg was treated like a criminal," Marge Eilert said.

By participating in crisis intervention training, the family said they hope to help police learn how to better respond to such situations.

"If you learn how to do that," Ralph Eilert said, "maybe Greg's death won't be in vain."

The class of 44 officers is set to graduate today.

Reach Ron Sylvester at 316-268-6514 or rsylvester@wichitaeagle.com. Read more!

Victim drank too much water -Mt. Clemmins (MI) Macomb Daily News

By Christy Strawser

The Macomb Daily has learned the cause of death for Macomb Township mother Andrea Jean Bean, 42, though the mystery of her bloody condo is still unsolved.

Dr. Daniel Spitz, the county's medical examiner, said Bean died from very low sodium levels, which was caused by an underlying psychological condition that led her to consume vast quantities of water.

The water forced an electrolyte imbalance, followed by a seizure, and eventually death, Spitz said. The condition is called psychogenic polydipsia, and it is often associated with schizophrenia, experts said.

"With incredibly large amounts of water, you can dilute your blood," Spitz explained. "It's a really bizarre case."

Spitz said Bean suffered before from the water-consuming condition, though he did not believe she purposely brought it on again.

"She had been found unconscious before after having a seizure, and they found incredibly low sodium," Spitz said, adding he considered it an accident. "I don't think anybody could do it as a suicidal gesture. It falls under psychiatric behavior."

Bean's family said she was emotionally broken after she lost custody of her three children to her ex-husband. She had limited supervised visitation.

Her father, John Collier, also thinks the legal system and social services should have done more to keep her alive.

Collier and his wife, a doctor, tried to be appointed as her guardians during her recent divorce, but the court refused. An outside attorney was appointed instead.

"This is a death that had no business happening," Collier said, adding, "You would be amazed how Andrea was let down by those that should have helped her."

Death from water consumption is rare, but it happened to a 28-year-old California woman last year after a radio-station sponsored "Hold Your Water" competition.

Jennifer Strange consumed an estimated two gallons of water in a couple of hours, according to published reports, and died the same day after winning the second-place prize -- a pair of tickets to a Justin Timberlake show.

Spitz could not quantify how much water Bean consumed, except that it was "way outside what a normal person" would ingest.

Bean had no illegal drugs or alcohol in her system, Spitz added. There was also no indication of what caused the significant amount of blood in her condo or to whom the blood belongs.

Bean was found July 29 face down in her bed inside her condo at Card and 24 Mile roads in Macomb Township. A 19-year-old nanny discovered her while bringing the children, 2, 7, and 9 years old, over for visitation.

There was blood smeared all over the bedroom, kitchen, and a hallway, but Bean's body was clean and injury free.

Spitz said the blood was human, but he's still waiting for the Michigan State Police Crime Lab to determine if it belonged to the victim.

"I don't think it's related to her death," Spitz said. "It may be her blood, but we don't know how long it was there. Could it have been a nose bleed, something else? It could be related to an underlying psychiatric issue."

Bean was hospitalized for mental illness at least 17 times, including a stay that ended two weeks before her death, her family said.

She tried to commit suicide in December 2006 by jumping into Lake St. Clair, and ended up hospitalized for hypothermia, court records showed.

Bean was hospitalized again after a confrontation at her ex-husband's house on June 28, 2007, where she was described by police as incoherent.

Her ex-husband, Roy Bean, 53, of Macomb Township, tried to get a personal protection order against her in April 2007, but was denied by Judge Antonio Viviano on the grounds Read more!

Southeastern announces more cutbacks in care -Wilmingon (NC) Star News

By Vicky Eckenrode

Southeastern Center for Mental Health officials informed private providers Friday about another round of service reductions for people with developmental disabilities in the area.

The center will stop paying for two developmental preschool programs that cover about 25 area children with special needs, which administrators project will save $600,000 a year.

They said they would speak with local public school systems early next week to see if they are able to take on the funding for those children.

Also, about 200 people who receive developmental therapy services, in which providers teach them how to reach goals such as applying for jobs or living on their own, will see the maximum number of hours of help fall from eight a week to four in September.

Area Director Art Costantini said the people affected would be able to appeal the cutback and have to have their cases reviewed in order to not lose the service completely in October.

Costantini said the reviews will help determine if people are actually receiving developmental therapy or instead are getting community support services that involve helping clients with ongoing tasks like taking them to a job everyday or shopping.

Private providers can be reimbursed at about twice the hourly rate if they are giving developmental therapy compared to community support.

Southeastern is responsible for allocating state funds to the private providers in the area for mental health, developmental disabilities and substance abuse treatments.

The center has struggled to meet its budget for that state funding for much of the year, prompting cutbacks in other types of client services. State mental health officials stepped in earlier this month and assumed control of the center’s finances.

Costantini, who is currently working with the state officials on a plan to get back on track, said the latest moves could get the funding in line with the $8.3 million the center has this year in state funding.

“We hope this is the last set of reductions,” he said. “It looks like the budget will be in shape Nov. 1.”

Vicky Eckenrode: 343-2339

vicky.eckenrode@starnewsonline.com
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Durham VA hospital to renovate, expand -Triangle Business Journal

Dathan Kazsuk

DURHAM – With older veterans requiring increased care and younger ones returning from two war zones, the primary care and mental health facilities at the Durham VA Medical Center will be renovated and expanded.

The 55-year-old hospital at 508 Fulton St. near Duke University Hospital is on track to have 15 percent more patient visits this year than in 2007, says Sara Haigh, staff assistant to the hospital director.

“The general veteran population is either stable or expanding,” she says. Besides aging veterans and returnees from the wars in Iraq and Afghanistan, vets who are losing their private health care due to the sour economy are turning to the VA for help, Haigh says.

A total of 5,500 square feet of existing clinical space will be renovated, and 12,000 square feet will be added. Also added will be 9,250 square feet of research space, according to a request for proposals sent to general contractors.

Construction of the clinical facility, which will cost between $5 million and $10 million, is scheduled to begin in May 2009 and should take about 18 months. Construction of the research facility, which will cost between $2 million and $5 million, is scheduled to begin late this year and should be completed in March 2011. Following that, plans call for an addition to the research wing costing $5 million to $10 million.

The research space will be split between clinical and administrative work.

Contracts for the projects have not yet been awarded. Haigh says the U.S. Department of Veterans Affairs is in the process of reviewing proposals.

Because the VA is a federal hospital, state regulators with the Certificate of Need system, which is designed to keep health-care costs down, have no say over the project.

According to the Department of Veterans Affairs, 774,000 veterans live in North Carolina, making the state among the nation’s 10 most populated by military vets.

Douggy Johnson, director of the Wake County Veterans Services Office, an agency that assists veterans and their dependents, says veterans are having trouble getting primary care appointments at the Durham VA hospital.

“I think it’s very much needed,” he says of the expansion. “There are already a lot of veterans here who need services.”

Plans call for administrative offices on the first floor of the hospital to be moved. The first floor then will be renovated for patient care, and a two-story addition will be constructed. The second floor of the addition will house mental health facilities, which are needed to deal with brain injuries and post-traumatic stress disorder, or PTSD.

“PTSD has become much more of a circumstance veterans are willing to talk with us about,” says Dave Rainy, a Department of Veterans Affairs communications officer. “It’s been an ages-old problem but one the military and VA has been willing to deal with.”

The mental health center will allow for the screening of returning veterans for traumatic brain injuries. Haigh says many soldiers have suffered some sort of brain injury due to explosions, and the VA is being more vigilant in checking for such injuries and helping those who have been injured.

“Because of the number of … explosive devices used, that’s something that in past wars would have killed a soldier, but with better armor, they are more able to survive those injuries but might have a longer-lasting brain injury,” she says.

Sometimes, she says, the injury is so subtle that soldiers do not even realize they’ve been hurt.


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Family of slain coach sues hospital that freed mentally ill killer - Seattle Post Intelligencer

The family of slain tennis coach Michael Robb is suing Harborview Medical Center for releasing the West Seattle man's deranged killer days before the June 26, 2005 slaying.

Robb, who coached at Newport High School in Bellevue, was driving home when then-17-year-old Samson Berhe stepped up to his car and shot him in the side of the head. Robb, a 46-year-old married father of one, lost his life in the random attack.

According to the lawsuit filed in King County Superior Court earlier this month, Berhe had been confined in a Harborview psych ward at least three times in the year before the shooting. He'd also been involuntarily committed for months at a time, and was being monitored by a King County-paid social worker when the killing occurred.

Four days before Robb was slain, four Seattle police officers took Berhe to Harborview after he attacked a friend. In reports, officers said Berhe's family was afraid for their own safety and asked that he be held at the psych ward.

Social workers examining Berhe described him "very bizarre … disorganized and nonsensical," according to court documents. A psychiatrist examining him found he'd been off his medication for six months, and determined he was a threat to himself and other people.

Hours later, though, a hospital official ordered Berhe be released because officials had insufficient evidence to detain the young man, in part, attorney's for Robb's family argue, because Berhe's family didn't answer several calls to the house made after midnight the day after he was taken into custody.

Berhe was "acting crazy and running around on the street" when his parents picked him up outside the hospital June 23, 2005. Three days later, police say, he killed Robb.

Prosecutors charged Berhe days after the killing, which we wrote on here. He's currently in a state mental institution, deemed to have been insane at the time of the killing. You can read about that here.

Also named in the suit are King County and the University of Washington, which operate Harborview. No response has been filed.
Posted by Levi Pulkkinen at August 28, 2008 6:09 p.m. Read more!

Patient advocates: N.C.'s mental health system needs fixing - WRAL-TV Raleigh (NC)

Video link by clicking post title.

RALEIGH, N.C. — Recent reports of patient abuse and neglect at Cherry Hospital in Goldsboro is more proof that the state's troubled mental health-care system needs restructuring and more funding, patient advocates say.

"There isn't a system of psychiatric facilities in this state," said Vicki Smith, executive director of Disability Rights North Carolina. "What we have are individual hospitals."

Smith said there needs to be a consistent standard level of care across the state's four psychiatric hospitals and that right now, hospitals only try to meet the minimum standards of care to receive funding.

She blamed that on job vacancies, lack of training, lack of supervision and oversight and inadequate pay. Many state agencies also rely on a temporary work force, and that means the quality of patient care is not always the same, she said.

Better recruiting and retention are needed, she said, to attract more qualified and attractive job candidates.

It's something the state's mental health oversight committee also suggested at a meeting earlier this week. John Tote, with the Mental Health Association in North Carolina, says the General Assembly needs to make more funding available.

Advocates believe Health and Human Services Secretary Dempsey Benton has taken aggressive steps to overhaul the system since taking over last year.

For example, he's starting to hold workers more accountable, Smith said. His recent decision to close a ward at Cherry Hospital in Goldsboro in the wake of a patient's death sends a big message, she said, partly because there aren't enough beds for patients there.

On Thursday, Benton said the Division of Mental Health must find an independent hospital management firm to evaluate Cherry Hospital.

However, Smith and Tote are concerned that any progress Benton is making could suffer a setback when a new governor is elected in November and if a new DHHS secretary is appointed.

"Four months left scares me," Smith said. "What concerns me is that with a new administration, the tendency will be to study the problems."

That would not be true if the gubernatorial candidates are already investigating and discussing the problems the mental health system faces. Advocates say they have not heard any specific plans from either candidate so far, however.

"Folks are going to be behind the eight ball, and if that's the case we'll see a perpetuation of the situation," Tote said. Read more!

Mental hospital to be run by outside firm -Raleigh News & Observer

Lynn Bonner

A management firm will take control of the state's troubled mental hospital in Goldsboro and conduct a top-to-bottom evaluation of the hospital's operations, staff and management.

The state Department of Health and Human Services hopes to have the firm in place by mid-September, said Leza Wainwright, a director of the state mental health division. She could not recall another instance in which the state hired a company to manage a hospital.

Cherry is in danger of losing its federal money after investigators discovered this month that a 50-year-old patient, Steve Sabock, was left sitting in a chair without food and adequate water for more than 22 hours while workers played cards and watched television. Last week, two workers beat a patient.

Federal investigators are inspecting the hospital this week, and a decision is expected Monday about whether Cherry can keep its federal payments. Cherry receives an average of $798,000 in federal funds each month.

The outside firm, which has not been chosen, will run the hospital during the evaluation, Wainwright said. The state wants the company to assess "staffing, organizational structure, the competence and effectiveness of managers and supervisors at all levels, and all other components of hospital management and operational activities."

Hospital director Jack St. Clair stays, Wainwright said. But St. Clair will report to the new managers, who offer "that additional comfort level that another set of eyes are looking at all situations."

DHHS Secretary Dempsey Benton last week expressed confidence in St. Clair, but also said hospital administrators did not do enough to discipline the 16 workers responsible for Sabock's poor treatment. One nurse resigned, but no one was fired. Two health care technicians accused in last week's beating were fired Wednesday.

Advocates for the mentally ill and concerned legislators are despairing over what to do about conditions at Cherry. The state personnel office is reviewing salaries of health care technicians and hospital directors, according to Gov. Mike Easley's office. Critics think those jobs pay too little to attract the best talent.

State administrators have also directed Cherry to hire more security officers. The hospital police have only one officer on each shift, and the state would like to have at least two people working at the same time, Wainwright said.

Cherry needs more security workers to respond to threats of violence, Wainwright said.

"Only having one individual in any eight-hour shift is not adequate," she said. Read more!

Virtually psychotic -Red Bluff (CA) Daily News

By RICH GREENE-DN - 08/28/2008

It may not be Universal Studios' new Simpsons ride, but the line sure is shorter and the lesson much more valuable.

Tehama County Health Services Agency is offering a rare experience this week - a chance to virtually step into the shoes and head of a schizophrenic.

A virtual simulator, on loan from Jensen Pharmaceuticals, lets people feel, see, hear and even smell what it's like to deal with schizophrenia

The simulation takes about six minutes and is available at the Mental Health Day Center at 1445 Vista Way from 8 a.m. to 5 p.m. today, and at St. Elizabeth Community Hospital Friday morning. Appointments can be made in advance or the public may simply stop by.

Mental Health Director Ann Houghtby said the idea is to educate the public about what it's like to deal with the mental disease.

Even those who work in the mental health field have said the simulator brings a new level of understanding.

"You never know for sure unless you experience some psychosis yourself," clinical social worker Wanda Cassairt said.

Cassairt went through the simulation Tuesday and said she believes it would be a good experience for local law enforcement to go through.

Houghtby said, while conditions differ from person to person, the simulator mirrors some of the more common complaints including voices in the head, command language and visual hallucinations.

Schizophrenia's symptoms do not creep up gradually, but instead sufferers experience what is known as a psychotic break,
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St. Elizabeth Imaging Center
according to Houghtby. The intense, brutal psychotic break often lands the patient in the hospital where it is diagnosed.

Advancements in drugs have come a long way from the anti-psychotics first used mainly to sedate those with schizophrenia, but they still have a long way to go, Houghtby said.

Some patients are able to work routine jobs, but finding the right balance of medication is an ongoing problem.

Even with a proper balance, sufferers often forget or won't their pills because of the voices in their head - an effect the simulator offers first hand.

---------

Staff writer Rich Greene can be reached at 527-2153, extension 109 or rgreene@redbluffdailynews.com
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Too pained to live - Chico (CA) News-Review

By Robert Speer - roberts@newsreview.com

By the time someone diagnosed Daniel Brocchini’s mental illness as borderline personality disorder, he’d been suffering for more than a decade. Unfortunately, the diagnosis, given on June 3, did not result in the care he needed. Two weeks later, on June 17, he was found dead on his bed at a local recovery house.

There were several empty pill containers on a nearby dresser and a binder containing a suicide note at the foot of the bed. “I can’t take anymore pain,” he’d written, quoting one of his favorite bands, Social Distortion. “None of you believed me. Maybe you’ll believe me now.”

His only directives: “Bury me in Tahoe. Forget I ever lived.” He was 26 years old.

The signs of his torment had been visible for years. There were scars up and down his arms and across his chest from where he’d cut himself. He’d attempted suicide several times. He suffered from panic attacks, clinical depression and extreme anxiety. He was in almost constant emotional and physical pain. And he was deeply addicted to alcohol and drugs.

For years his mother, Evelyn Denk, had tried to get help for him. Over and over, she’d tried to sign him into public mental-health inpatient facilities here and elsewhere (they lived for many years in Lake Tahoe). Most of the time they were turned away, and when he was admitted, it was only for short stretches.

To Denk, the events surrounding Dan’s suicide were the last in a long line of encounters with a broken mental-health-care system that didn’t seem to know how to treat this terribly troubled youth. Too often, she charges, it viewed him as just an alcohol and drug addict, without recognizing the underlying mental illness that was causing his addictions.

The system, she insists, is horribly dysfunctional.

She gives this example: In mid-May, Dan was seen at Butte County Behavioral Health for an evaluation. Several medications were prescribed, and he and she were told to obtain them through his family doctor. That was Dr. Robert Roth, at the Chico Family Health Center.

At the time Dan was living at Stairways, a clean-and-sober recovery house. In his May 16 notes on Dan, obtained by Denk, Roth writes that the request to provide medications wasn’t accompanied by “any of their diagnostic or therapeutic information and … I think it would be really helpful to have a more clear idea as to what the psychiatric diagnosis is given the problems he has.”

Roth could have called BCBH, but the agency has one of the most opaque phone systems in the county. You’re more likely to get a recording than get through to someone, but the recording doesn’t take messages: Call back later, a woman’s voice says. And when you do get through and ask to be transferred to someone, you’re liable to be told—as I was this week—"We don’t transfer calls here.”

Roth’s solution? He gave Dan a note to take to BCBH “because I really professionally reached the point of exhaustion with that organization in its failed communications.”

(Roth did not return a CN&R phone message.)

On June 10, clinicians at BCBH worked up a safety plan for Dan. He was to continue residing at Stairways, and Stairways staff was “to supervise [him] and ensure [his] safety.” He was also to call the BCBH crisis line and check in when he got home, to rely on a list of anxiety-relieving techniques ("Listen to music,” “Go for a walk,” etc.), to take his meds, to call the crisis line again the next day, and to check in with various resources (group therapy, BCBH Outpatient Services, Dr. Roth) in the coming weeks.

“For someone with Dan’s disease, I can tell you this is too much,” his mother said. “Plus it’s not Stairways’ job to do that.” She also wondered why a drug regimen prescribed on June 3 wasn’t to be evaluated until July 1, nearly a month later.

His group therapy was to be via Proposition 36, the treatment-not-jail initiative voters approved in 2000. He’d gone to court on June 4 to answer to a misdemeanor drug possession charge, and Judge Steven Benson had assured everyone in court that day that they would get help if they wanted it.

Evelyn Denk was there, and for a moment she was encouraged. “You put your hope in these programs and the things you’re told, and then they’re just not there. They’re so not there.”

According to the National Association for Personality Disorder, BPD is “a disorder in which a person is unable to regulate emotions or control impulses. Their behavior can be seen as maladaptive methods of coping with constant emotional pain.”

Thus the cutting, the alcoholism, the drug addiction and the attempts at suicide, which Denk sees as cries for help.

The disease, according to the NAPD, is a “biologically based disorder of the emotional regulation system that may be due to genetics factors, the environment or a combination of the two.” It tends to run in families with a history of mental illness, depression, ADHD or addiction, and often is characterized by abnormal levels of the neurotransmitters serotonin and dopamine in the brain.

It’s a difficult illness to treat. There’s no one-size-fits-all medication, and medications must be closely monitored and adjusted over time, as BPD symptoms often change. The best course is to combine such regimens with both individual cognitive behavioral therapy and group training that teaches emotional regulation skills, distress tolerance, improved interpersonal relationship behaviors and self-awareness, or mindfulness.

Needless to say, such a sophisticated treatment program was not available for Dan Brocchini. “He was work, hard, hard work,” Denk said, “and nobody wanted to invest that much.”

Laurie Feldman is the BCBH family nurse practitioner who diagnosed Dan Brocchini as having borderline personality disorder. In a phone conversation, she addressed a number of the issues raised by Evelyn Denk, while endeavoring not to talk specifically about her son because of confidentiality concerns.

The fact that someone is suicidal doesn’t necessarily mean he or she is a candidate for inpatient care, Feldman said. “Most people are not permanently suicidal,” she explained. “It tends to be off and on.”

So when is a suicidal person admitted? When that person is “being suicidal and is also unable to contract for his or her own safety,” Feldman responded. Signing what is known as a “no harm” contract, in which a person promises not to commit suicide and to stick to a safety plan, “is considered an adequate alternative to hospitalization.”

She agreed that BCBH’s communication is “a problem—oh yeah.” When she arrived at the agency six years ago, she wanted to make the system more accessible, she said. For a while she served on a health-care coordinating committee, which came up with the idea of having a central phone number and even went so far as to get a number, but “it never went anywhere.”

And she agreed that the entire mental-health-care system is broken. “We’re using our jails as inpatient units,” she said. “Taxpayers’ money is going to prisons, not health care. … The system fails people on a daily basis.”

In recent weeks, the county department had to lay off nearly 30 clinicians due to state-imposed budget cuts. A few have been rehired using money from the Mental Health Services Act, the initiative that taxes millionaires slightly for mental-health services, but the money must be used for new services, not existing ones, so the impact of the layoffs remains heavy, Feldman said.

(A phone message left for BCBH Assistant Director Lisa Cox was not returned.)

Dan Brocchini is the second of Evelyn Denk’s five children to die. She lost a 5-month-old baby boy to sudden-infant-death syndrome 23 years ago.

Her response then was to get involved in a national SIDS awareness chapter in her town and become a trained counselor to other parents who lost children. “They called me whenever they brought in a baby,” she said. She did that for three years, until it became too much emotionally. She shifted to other charitable work and is especially good at marketing, she said.

She intends to take a similar approach this time and has contacted the NAPD seeking to volunteer to raise BPD awareness in the Chico area. It’s the most stigmatized and least understood mental illness, she said, and too often its sufferers are dismissed as merely substance abusers.

In the meantime, she’s trying to obtain her son’s medical records from BCBH so she can find out what really happened to him there. The agency has insisted, however, that to get the records she must go through probate to become the executor of his estate, which she said amounts to “the $5 he had in his wallet and his comic books.”

All she has left of him now are some photos of a cute little boy, his many poems—some of them splattered with blood—and various documents and notes he obtained or made in the days before his death. They don’t take up much space in her north Chico apartment.

She’s convinced he didn’t really want to die. For one thing, the suicide note had no message for her, the person he loved most in the world. “He would have said goodbye if he meant to die,” she said. And it also contained a list of the meds he’d taken, as if he wanted whoever found him to save him.

“I believe he was trying to force them to treat him by taking himself to the edge,” Denk said, tears in her eyes. “He miscalculated, perhaps because he was clean and sober and his tolerances weren’t where he thought they were. An attempt to be taken seriously cost him his life.”
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Ravas ruled insane -Medina (OH) Gazette

By ALLISON WOOD - August 28th, 2008

MEDINA — Two psychological evaluations of the mentally ill man accused of killing his mother in her Hinckley Township home determined he was insane at the time of the offense last year.

Patrick M. Ravas, 27, is accused of stabbing Noella Ravas, 62, in her Salem Court residence several times while she was on the phone with a 911 dispatcher in the early morning hours of Nov. 28. She was pronounced dead at a local hospital a short time later.

Ravas is charged with counts of aggravated murder, murder and aggravated burglary, and has pleaded not guilty by reason of insanity to the charges.

Common Pleas Judge Christopher J. Collier has ruled Ravas is competent to stand trial, meaning he is mentally capable of contributing to his own defense.

Ravas was diagnosed with schizophrenia and was hospitalized years before his mother’s death, court records show.

The evaluations were completed by Kathleen Stafford and Dr. Stephen Noffsinger of the Akron Psycho-Diagnostic Clinic. Stafford’s evaluation was completed earlier this year, while Noffsinger’s recently was finished.

Both experts also offered testimony last year during the trial of Steven Latham, who was convicted on four counts of aggravated robbery for shooting a sheriff’s deputy and at three other deputies at his Litchfield Township home in 2006.

It will be up to a jury to determine if the experts’ testimony should be believed, county Prosecutor Dean Holman said.

Another pre-trial hearing is scheduled for Sept. 19.

Ravas has been in the Medina County Jail since his Nov. 28 arrest.

Wood may be reached at 330-721-4050 or allisonwood@ohio.net.
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Mental unit will take its services to the patients -Winston-Salem (NC) Journal

y Richard Craver

A 24-hour mobile crisis unit has been established to provide timelier mental-health care to residents in Davie, Forsyth and Stokes counties, Forsyth Medical Center said yesterday.

More than $1 million in grant money, including $675,000 over three years from the Duke Endowment, has been dedicated toward the unit within Forsyth Behavioral Health at the hospital.

An additional $350,000 was provided from CenterPoint Human Services through the hospital's foundation to help pay for equipment and operational expenses for the first 12 months.

The unit, which will operate year-round, is expected to complement the face-to-face assessment services already provided by a mental-health access team in the hospital's emergency department.

The mobile-crisis unit has been operated on a limited basis since May 12. It has three full-time employees and one vehicle. There are plans to add two more employees and another vehicle. There are no income criteria for eligibility for the service.

"This unit will help meet a huge need in our community regarding helping people with psychiatric, substance-abuse or disability issues," said Jeff Eads, the community-operations manager of CenterPoint.

"It will allow people to be treated at their home, their school, their work or other settings, rather than having them entering a hospital setting or being hospitalized to resolve their crisis."

According to the hospital, about 4,500 people were examined last year by its mental-health access team, "in part because of a lack of adequate community-based mental health-crisis services."

Forsyth officials project that the mobile crisis unit will serve more than 900 people in its first year.

A long-term goal for the hospital is establishing a behavioral-health crisis center on its main campus, which would include consultation rooms, a special waiting area and 24-hour observation.

According to the fiscal research division of the General Assembly, there are 1.1 million North Carolinians with health issues involving mental illness, development disability or addictions -- not including the homeless or those living in institutions.

The division also reported that an average of 350,000 residents are examined each year through programs focused on those three health categories.

Mental-health assistance and treatment received considerable focus during the recent General Assembly sessions, in part because of media reports of incidents in which mental-health patients were harmed by a lack of timely care.

Many problems have occurred since a 2001 overhaul of the state's mental-health system, which was intended to move patients from state psychiatric hospitals to community programs.

To help combat continuing problems, legislators approved $5.7 million for the 2008-09 budget to help subsidize the cost of 30 mobile crisis teams. There are currently 19 such units in the state.

They also approved $1.9 million for six crisis teams to help developmentally disabled residents, and $6.1 million for local walk-in clinics for crisis and immediate psychiatric care.

Local mental-health officials expect to learn by mid-September how much money they will receive from the state for the mobile crisis unit and the local walk-in clinics. Cornerstone operates a walk-in clinic at the Behavioral Health Plaza.

"We need to have something like a 24-hour walk-in clinic to evaluate and treat people going through a mental-health or substance-abuse crisis in a more appropriate and less-restrictive environment," said Andy Hagler, the executive director of the Mental Health Association of Forsyth County.

The creation of the mobile crisis team for the three counties is part of an initiative to provide such coverage "within 30 miles or 30 minutes of every resident in the state," said John Tote, the executive director of the Mental Health Association of North Carolina.

The funding "was recognition by the General Assembly that there is a tremendous assessment gap in the state," Tote said.

"But even with the expansion of the mobile crisis teams, we will continue to struggle with lacking enough resources

to meet the entire need," he said.

"The center that Forsyth is planning is a step in the right direction as well."

■ Richard Craver can be reached at 727-7376 or at rcraver@wsjournal.com. Read more!

Mental illness - past or present - is not a crime Toronto (Canada) Globe & Mail

ANDRE PICARD - August 28, 2008

Is having a bout of mental illness something that should result in a police record?

Astoundingly, that is the reality in much of this country.

It is an egregious breach of civil rights, yet the practice continues because people who suffer serious mental illnesses such as depression, bipolar disorder and schizophrenia are all too often voiceless, powerless and victims of well-entrenched stereotypes.

To understand this story, a little background is in order. In the post-9/11 era, police checks have become the norm in our society; it is a simple way of weeding out pedophiles and other "bad" people, or at least giving the illusion of doing so.

If you apply for a job or a volunteer position - fundraising at the local hospital, coaching a peewee hockey team, helping out with the school choir or any other of those innumerable, thankless tasks - you will have to agree to a police check.

These checks come in two forms.

The first is a search of the computerized records maintained by the Canadian Police Information Centre. If you have a criminal record, the information is likely to show up in CPIC.

The second is a police records check. In addition to CPIC, local, municipal and provincial police forces maintain their own computerized records.

These records contain all manner of information about any contact you have with police, whether you are a criminal, a victim or a witness.

When you have a loud party and the neighbours rat you out, both your names are in the system. A Good Samaritan calling 911 is in there, and so are the people they are calling about, even if they are harming no one but themselves.

People who suffer bouts of mental illness tend to have a lot of encounters with police. They make suicide attempts and threats of suicide. Sometimes they starve themselves, drink or drug themselves silly, make paranoia-spewing phone callsand trash their cars. And these are the "respectable" people with nice homes and good jobs, not the stereotypical "crazy" street people.

These encounters all result in a police record.

"So what?" you may ask.

Aside from the principle that we should not accept gratuitous violations of civil rights, there are practical harms being done every day. Take the example of Ontario, where the Mental Health Police Records Check Coalition has done a wonderful job bringing this issue to light.

If you apply for almost any volunteer post in Ontario working with children, the elderly, people with disabilities etc. you must undergo a Vulnerable Person Screening.

This report will tell the volunteer agency if there are red flags on a person's police record. Some police forces simply make the vague statement that there is "information of concern," while others provide details such as "suicide attempt" or "arrest under the Mental Health Act."

(Incidentally, when people are detained under the terms of the Mental Health Act, it is not an arrest. Police have the legal right to take people who are a danger to themselves for treatment at a medical or psychiatric facility, but police tend to use the misnomer "arrest.")

Mental illness is a medical issue. What business do police have disclosing this information to potential employers? Some police forces retain and release this information for up to 25 years after an "encounter."

Police in London, Ont., no longer release mental-health information contained in police records, a change made as part of a settlement of a human-rights complaint.

That should be the norm everywhere in Canada.

Police records contain other sensitive medical information, including whether a person who has encountered police is infected with HIV, hepatitis or other diseases. Police would not dream of releasing this information as part of a background check. So why is it okay to disclose suicide attempts, psychotic episodes and other cries for help?

It's done because of lingering stereotypes about people with mental illness being violent and untreatable.

The reality is that the mentally ill are far more likely to be victims of violence than perpetrators, and it is those with severe, untreated mental illness who tend to be violent, but are unlikely to be applying for work - volunteer or otherwise.

The reality, too, is that the vast majority of people who suffer a bout of mental illness get better. For many, part of the healing process from these horribly isolating and soul-destroying illnesses is reintegrating into the community. That means getting work, volunteering and building social networks anew.

That's what makes these policies doubly horrific. They not only discriminate against people for no good reason, but they can set back their recovery and destroy their hope of being a "normal" citizen again.

Having a mental illness - present or past - is not a crime. But discriminating against people with mental illness in this manner is.

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Cherry fires 4 workers -Raleigh News & Observer

Lynn Bonner

Cherry Hospital fired three employees Wednesday and told a part-timer not to come back to work, after the beating of a patient last week.

Two of the fired employees were health care technicians charged with beating a male patient at the state psychiatric hospital in Goldsboro.

Taniko Dominique Upton, 33, was accused of hitting the patient in the abdomen, then hitting and punching the man in the head and side after he fell to the floor. Upton said he was wrongly accused.

William Kenneth Johnson, 52, was accused of holding the man during the initial assault, then joining in the beating once the victim was on the floor.

The part-time worker and the third full-time worker were nurses, said Tom Lawrence, a state Department of Health and Human Services spokesman. Lawrence, who could not provide the nurses' names, said that he was not certain of the reasons for the action against the nurses but that they might have been held at fault for not reporting what they knew about the beating.

The firings came a day after investigators arrived at Cherry for a review of hospital operations. Investigators are checking to see what changes have been made at the hospital after the discovery this month that a patient, Steven Sabock, died in April after sitting in a chair for 22 hours without food while hospital staff watched television and played cards nearby.

Dempsey Benton, head of the state agency that oversees the psychiatric hospitals, criticized hospital administrators for their lenient treatment of the 16 staff members found to bear some fault in Sabock's negligent treatment. One nurse resigned, but no one was fired.

lynn.bonner@newsobserver.com or (919) 829-4821 Read more!

Jesse James Deconto, Staff Writer Comment on this story - Raleigh (NC) News & Observer

Jesse James Deconto

HILLSBOROUGH - Orange-Chatham District Attorney Jim Woodall could announce plans this fall for a fifth capital murder trial in a district that hasn't sent anyone to the death chamber since 1948.

On Wednesday, a judge scheduled a Rule 24 hearing for Kenneth White, 40, accused of killing his pregnant girlfriend, Ebony Robinson, 21, and their unborn child whom family members named Elijah. Woodall is scheduled to announce at the hearing Oct. 28 whether he'll pursue the death penalty for White.

Woodall will have to decide whether there are aggravating factors in the case. Examples would be the presence of additional felonies connected to the slaying or a manner of killing that is especially "heinous, atrocious or cruel."

On a Friday morning in early December, Robinson was found dead on a gravel road outside Hillsborough, shot several times. She was about eight months pregnant.

White is charged with one count of murder. No laws on the books in North Carolina would allow an additional homicide charge.

Superior Court Judge Carl Fox Fox, who scheduled the hearing, also found White competent to stand trial. In June, Superior Court Judge Allen Baddour had ordered a psychiatric evaluation in response to a defense motion to have the suspect committed for mental health treatment. Fox based his decision Wednesday on the results of that evaluation.

"He is viewed as capable of proceeding to trial," Fox said.

White lived for years at 4020 Sudbury Road, Durham, in a house he owned with his wife, Erica White. Across the street, about a half-dozen houses down, Robinson lived in the home of her mother, Effie Steele.

The day before the shooting, Robinson told her sister Sandra Steele that White was the baby's father, according to a search warrant. Steele wanted Robinson to confront White, but Robinson said he had previously told her, "I have a gun, and you know what I'll do."

Despite the threats, Robinson's mother told investigators White was supposed to help her daughter look for a place to live in Hillsborough on the day of the killing.

Instead, late that morning someone called Orange County 911 to report hearing a gunshot, a pause and then three more rapid shots. The caller reported seeing a maroon vehicle back quickly down Wrenn Road.

Robinson's body was found at the end of that road.

Later that day, investigators searched White's home, seizing bullets for at least two guns: a .357 Magnum and a 9 mm. They also took a stroller and baby swing with Ebony's name on it, according to the search warrant.

jesse.deconto@newsobserver.com or (919) 932-8760 Read more!

Brian Wilson pays tribute to that old Cali sun with new album - Associated Press

By SOLVEJ SCHOU

BEVERLY HILLS, Calif. – Brian Wilson sits on a plush couch in his living room, smiling nervously.

On the back porch of the Beach Boys visionary, his family's 15 pooches yip and scramble over one another. Inside, photos of his children with wife Melinda Ledbetter – 11-year-old Daria, 10-year-old Delanie and 4-year-old Dylan – lace the walls.

The two-story house, snuggled deep in a gated hillside community in Beverly Hills, is immaculately clean, with beige carpeting and marble floors. Housekeepers tidy up downstairs. A swimming pool overlooks the sun-drenched valley below. It all resembles a postcard.

"I'm happier now than I was a year ago," Mr. Wilson says. "I started exercising, and I started eating more of the right food, and I started feeling better. I just get up in the morning and say my prayers."

Gangly and tall in a pinstriped dress shirt, his graying hair swept back into waves, the wizard songwriter and composer behind such '60s Beach Boys hits as "Good Vibrations" and "California Girls" stares with sharp blue eyes, frequently fidgeting.

A lot has changed for the historically reclusive Southern California native, who speaks with a slight slur, a result of his drug-abusing past and medicated journey through mental illness.

He is a second-round father at age 66. (Musician daughters Wendy, 38, and Carnie, 40, from his first marriage, tour as The Wilsons.) Following 2004's long-awaited rock opera Smile and a 2005 Christmas release, he has a new, ambitious solo album, That Lucky Old Sun, due out Tuesday. He is touring behind the material, pushing through years of stage fright.

"I think the new album is just as good as anything the Beach Boys ever recorded," says Mr. Wilson. "Playing these songs live, I feel proud. You know that funny feeling you get in your stomach, like, 'Oh my God, this is sounding great!' "

Two years ago, he says, he recorded 18 songs, then chose 10 last year for Capitol Records/EMI. He came up with the album's lush orchestration and music while 43-year-old bandmate Scott Bennett scribed the lyrics, with colorful narrative interludes by longtime collaborator Van Dyke Parks.

The outcome is a blend of up-tempo pop and piano-based ballads. The title track, a cover of the old standard "That Lucky Old Sun," flows into the bouncy anthem "Morning Beat," setting the album's tone.

"Van Dyke Parks, Brian and Melinda thought this should be a love letter to Los Angeles. At this point, Brian was 65 years old, and it just felt right to embrace his legend and be a bit nostalgic," Mr. Bennett says.

Songs such as "Forever She'll Be My Surfer Girl" touch on Beach Boys melodies while "Mexican Girl" adds a dash of salsa flavor. "Midnight's Another Day" and "Oxygen to the Brain" reference Mr. Wilson's dark days in the '70s and '80s, when he receded from the spotlight into isolation, drugs and weight gain.

Ending the album on an uplifting note, "Southern California" reminisces about co-founding the Beach Boys in 1961 with his late brothers Carl and Dennis. Mr. Wilson sings, "It's magical/ Living your dream."

"Yes, Brian had a rough time of it, with his mental health, but I would kill to have the kind of catalog he does, and tour everywhere with his brothers like he did," says Mr. Bennett, who confirms that Mr. Wilson "is on a heavy dose of antidepressants."

Regardless, Mr. Wilson has hit a creative stride in his life.

Inspiration comes at night when he sits down alone at his Yamaha synthesizer and grand piano in his purple-curtained music room.

"When I go to the keyboard, I feel holy, like an angel over my head. I feel very holy. When we did [the Beach Boys hit] 'God Only Knows,' I felt holy about that, too. A godly something comes through me," Mr. Wilson says, motioning with his hands. "I'm always thinking about melodies. The melodies come from my brain and my keyboards. I play a really pleasant keyboard. It sounds so pleasant it makes me want to write melodies."

But life as a busy dad and touring musician can be overwhelming. Mr. Wilson describes a house full of kids and dogs as "very loud" and "a madhouse." He frequently takes walks at a nearby park.

"The kids make me feel a little jumpy," he says. "Sometimes I want to get out of the house to get away from my kids, but I love my kids a lot. I love my kids. ... Quiet time comes around 10 at night when I go to sleep. It's peace of mind. Things run smoothly at night. During the day, things are more rough."

Later on during this interview, when Ms. Ledbetter comes home with their small son Dylan – floppy-haired, barefoot and wearing a Hawaiian shirt – Mr. Wilson brightens. He's quieter when it comes to daughters Wendy and Carnie, who live fewer than 10 miles away.

"I don't talk to them very much. I used to. I recorded with them at one time, but I don't talk to them a lot," he says, explaining that the women are "really busy."

Questions about the Beach Boys' current status get lukewarm responses as well. Mr. Wilson, who formed the band with his brothers, cousin Mike Love and school friend Al Jardine, split with most of the group's surviving members years ago amid legal squabbles. Mr. Love and later Beach Boys bandmate Bruce Johnston tour as the Beach Boys Band while Mr. Jardine has his own Endless Summer Band.

Mr. Wilson stresses the subject's touchiness: "We don't want any publicity about me getting back with the Beach Boys, 'cause I don't want to. They're not my group anymore. That's Mike and Bruce's group now. I'm on my own, and I would rather do that than go back to the Beach Boys."

He says the unreleased songs he recorded, including a slow, smooth version of "Proud Mary," will form another album. He gushes that "the only person I really want to work with is Paul McCartney." He would also like to record "a rock 'n' roll album inspired by Phil Spector's type records – a really hard rock album that really rocks, with big orchestration, the whole bit."

Yet, he also views his future gingerly, as day to day.

"I look forward to today," he says.

"I never look forward to the future because I think to myself, 'What if there's an earthquake, what if I die or someone I love dies?' I get those kind of thoughts all the time."

Read more!

Program aims to free up jail space - Corvallis (OR) Gazette-Times

BY MICHAEL BOOTH

Benton County Sheriff Diana Simpson will start a pilot program by September that she hopes will free up jail space, save some money and get frequent jail inmates with mental illnesses the help and supervision they need.

Simpson’s office has rented two studio apartments in the county-owned complex at 525 Monroe Ave., where she intends to house two people with mental illnesses who would normally be held in the jail.

“People with mental illness issues require a lot more supervision in jail,” Simpson said. “The goal is to reduce reincarceration, improve care and aleviate overcrowding issues.”

Undersheriff Scott Jackson, the former jail manager, said that jailing people who suffer from mental illnesses interrupts their treatment, which only makes the problem worse.

“Social Security and disability (payments), Medicaid/Medicare and the Oregon Health Plan are either suspended or terminated when they are incarcerated,” Jackson said.

Benton County Commissioner Jay Dixon echoed Jackson’s frustration with the suspension or termination of services to the mentally ill while they are in jail.

“We think we’re in a system where you’re innocent until proven guilty,” Dixon said. “If you’re thrown in jail, the (services) stop. That’s just wrong.”

The apartments will cost the Sheriff’s Office $370 a month. That compares favorably with the average cost of $150 a day to jail every inmate — or $1,050 a week, Simpson said.

For inmates with mental health issues, Benton County Mental Health and the sheriff’s office share the bill for medical evaluations and medications.

The agencies will initially pay treatment costs for those participating in the housing project. But, if people in the housing project regain lost services by getting out of jail, they may not need to.

Although a committee has not been formed, Simpson has met with members of the Benton County Defense Consortium, Benton County Mental Health, agencies focused on the issues of mental health and homelessness, District Attorney John Haroldson and Judge Locke Williams to determine how best to implement the program.

“It will take both (prosecutors) and public defenders to buy into (the program) and help identify those who will be suitable for it,” Simpson said.

The first two candidates to be housed have not yet been selected. Mental health professionals, as well as attorneys, will help make that determination, Simpson said.

Drawbacks to selection for the program are funding-related, Simpson said.

Funding for the apartments will come from a portion of a renewed jail levy, which includes a provision for jail bed rentals from other counties. That provision allows for funding of the housing program.

The language of the levy states the money can be used only for those on probation or parole. Because the Probation and Parole department is funded by the State, the Sheriff’s Office only receives funding for those with felony convictions.

Essentially, Simpson must choose inmates with mental health issues who have a felony record, are on probation or parole, are homeless and do not present a risk to the public.

Despite the restrictions, Simpson said there are plenty of candidates to choose from.

Once in the program, they will be supervised by a parole and probation officer trained in mental health issues.

Parole and probation officer Abe Griswold will get additional training in how to deal with the mentally ill and will be supervising the program.

“I’m anticipating frequent contact, two to three times a week,” Griswold said. “We’ll make sure they’re taking their meds and have a structured environment.”

Those housed in the apartments will have to volunteer willingly to be housed and must follow the standard rules of their parole or probation, including a curfew of 10 p.m. to 8 a.m., dependent upon employment hours.

Dixon said the larger problem of mental health and homelessness cannot be solved in the criminal justice system.

Benton County District Attorney John Haroldson agrees, but sees the program as an important step.

“We work in a system where you only benefit by having more options,” Haroldson said.

Simpson knows the program cannot end homelessness or mental illness, but she hopes the program will be successful and, potentially, can expand.

“We’ll reassess the program after six months or a year,” Simpson said. “If it has been a success, perhaps we can look into stable funding and more apartments. If not, we’ll scrap it and find something more effective.”

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Roseville assemblyman fights psychiatric hospital expansion - Sacramento Bee

By Cynthia Hubert - chubert@sacbee.com

A state assemblyman is trying to block the expansion of troubled Sierra Vista Hospital in Sacramento, despite arguments that the region is facing a critical shortage of beds for psychiatric patients.

"I am not going to enable dysfunction," said Assemblyman Ted Gaines, a Republican from Roseville. "I will apply as much pressure as possible to see that this expansion does not go forward" until Sierra Vista passes a state audit and shows "true management accountability," he said.

The hospital, which has been cited by state inspectors more frequently than any private psychiatric facility in California since 2004, is planning to add 48 beds. Construction has begun at the facility on Bruceville Road, but before Sierra Vista begins treating more patients, the hospital needs approval from the state Department of Public Health.

In a recent letter to public health director Mark Horton, Gaines said he has "grave concerns" about the quality of care at the hospital. He urged the department to fully investigate Sierra Vista and "if necessary, revoke their state license."

Sierra Vista officials responded Wednesday by announcing they have hired two administrators to work with a "best practices" team to improve conditions at the facility.

"Our goal is to provide the highest level of quality, compassionate care for individuals and their families during times of crisis," Sierra Vista's chief executive officer, Nancy Purtell, said in a written statement.

Hospital administrators argue in their expansion application that more psychiatric beds are badly needed. Sierra Vista has 72 beds.

Figures from the California Hospital Association show that Sacramento County and the state have far fewer beds for mentally ill patients than experts consider "minimal."Sacramento County has one psychiatric hospital bed for every 4,336 people, compared with the one bed per 2,000 people recommended by national experts.

"We're in dire straits," said Sheree Kruckenberg, vice president of behavioral health for the hospital association. "We are a state of 37 million people, and we have only 6,000 psychiatric beds. We are at crisis proportions."

People in immediate need of mental health services in the area routinely get stranded in emergency rooms, endure treatment delays or are sent far outside the region, Kruckenberg said.

State officials will not consider the bed shortage when deciding whether to approve Sierra Vista's $8 million expansion.

"The application will be evaluated on its merits," said state health department spokesman Ken August.

The hospital's regulatory record includes 111 citations by state inspectors since 2004. At least three patients have died because of poor care at the facility since 2000, according to state regulators. Most of Sierra Vista's problems stem from inadequate staff and training, according to records.

Including Sierra Vista, Sacramento County has three private, acute psychiatric hospitals, plus a county mental health center, for a total of 317 beds, according to the hospital association. Yolo, Placer and El Dorado counties have a combined total of only 51 beds, according to the hospital association's figures.

The association's figures show that the number of psychiatric beds in California has plunged by 31 percent since 1995.

Part of the reason for the shortage, Kruckenberg said, is that insurance reimbursement rates often fail to cover the full costs of psychiatric care. California hospitals also are subject to costly requirements for earthquake protection and relatively high mandates for nursing coverage, she said.

In a report released earlier this year, the Treatment Advocacy Center, a nonprofit advocacy group for mentally ill people and their families, said California has about 17 public psychiatric beds per 100,000 people, and that represents a "severe" shortage.

Georgia Jenkins, whose daughter Jennifer died at Sierra Vista in 2000 at age 16, said her family felt they had no choice but to send her to the hospital when she expressed fear that she might harm herself. "Nobody really gave me an option," Jenkins said.

Records show that the Sierra Vista staff ignored "critical changes" in the teen's condition and failed to keep close watch on her. Jennifer Jenkins tied a sheet around her neck and hanged herself from a doorknob.

"The place is not safe," said Georgia Jenkins, who successfully sued Sierra Vista for wrongful death. "It scares the hell out of me that they are thinking of expanding."

Sierra Vista's new management structure should help iron out problems, Purtell said.

Sierra Vista has added a chief operating officer who will work with Purtell on "implementation of ongoing improvements," her statement said, and a new compliance officer will seek guidance from the state to make sure the hospital meets regulatory standards.
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Social service advocates back Perdue reorganization - Atlanta Journal Constitution

By CRAIG SCHNEIDER - August 27, 2008

Social service advocates on Wednesday praised Gov. Sonny Perdue’s plan to restructure the state’s health and human services superagencies, if only because they say the services couldn’t get much worse.

“There are so many issues with so many of the programs, it can’t help but help,” said Linda Lowe, a consumer health-care advocate.

The plan announced by the governor Tuesday aims to improve services to the most vulnerable Georgians“ the elderly and mentally ill, and abused and neglected children. Some of the agencies responsible for assisting them have been wracked with scandals, lawsuits and federal reviews.

The plan, which requires the Legislature’s approval next year, would separate mental health into its own department, apart from its current umbrella agency of the Department of Human Resources. The plan also would combine under a Department of Health agencies overseeing public health, the regulation of health care providers and the administration of health insurance plans like Medicaid for the poor.

Supporters hope the restructuring also improves the health of Georgians in general. They stressed the desperate need to do so; Georgia routinely ranks among the worst states for obesity, cardiovascular deaths, infectious disease and diabetes.

The agencies slated for change track illnesses, prevent the spread of disease, enable the elderly to live satisfying lives, ensure that restaurant food is safe, and create public health policies.

State Rep. Mark Butler (R-Carrollton), who served on the task force that formed the recommendations, said all citizens benefit when the state takes care of its most vulnerable residents, such as the mentally ill.

“If the state doesn’t take care of these people,” Butler said, “they end up committing crimes, sometimes property damage, sometimes hurting people. They end up in our jails.”

Lowe, a health-care advocate for 30 years, said the state’s Division of Public Health has been neglected as its parent agency, the Department of Human Resources, has focused on the scandals over mental health and children’s welfare.

“Public Health protects us from hazards, whether it’s bioterrorism or infectious disease,” she said. “The general public needs all of that.”

Supporters of the restructuring said, though, that they see numerous hurdles ahead for the plan. Public hearings this fall will precede the filing of legislation in January, Butler said.

Opposition could come from those who see the plan as adding on to government due to the creation of a separate mental health department, Butler said. But he said the structure for a separate mental health agency is largely in place, and that he does not expect the restructuring to cost the state more money.

If anything, Butler expects the restructuring will lend itself to a top-to-bottom review of services, aiming for greater efficiency and cost savings.

While some social service advocates praise the plan, a few have expressed concerns that splitting up various services could hamper communication between agencies and their assistance to people.

The restructuring itself could be rough, Butler said, coming at a time of reduced state money, and could lead to “turf wars” as agencies fight to hold onto their funding.

If the Legislature passes the restructuring bill by the start of the next state fiscal year in July, some changes and funding shifts could begin soon after, Butler said. The entire restructuring of the health and human services could be in place by the middle of 2010, he said.

– Staff writer Andy Miller contributed to this report.
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Jealousy may be murder motive -Raleigh (NC) News & Observer

But defense cites poor mental health

Martha Quillin

RALEIGH - Charles Dickerson didn't want Brenda Fox to marry another man. If he couldn't have her, nobody would.

That's what Wake County Assistant District Attorney Frank Jackson told jurors during opening arguments in Dickerson's first-degree murder trial Wednesday.

Dickerson did explode with anger and beat Fox beyond recognition on Feb. 10, 2006, but his attorney, George Kelly, told the jury it was because Dickerson had suffered a series of psychological blows. Bipolar disorder and borderline mental retardation made him ill-equipped to cope with the strain.

Dickerson's attorneys have acknowledged that he killed Fox, a 42-year-old mother of four who had also taken care of one of Dickerson's sons, Charlie. Fox went to Dickerson's Raleigh home on Feb. 10 to discuss taking custody of the boy. Fox had already told Dickerson she was going to get married the next day.

When Fox didn't return home that evening, her fiance, Tom Kennedy, testified, he and two of her daughters began calling area hospitals to see if Fox had been injured in an accident. Then the two young women went to Dickerson's house.

They found the door locked. When a neighbor told them Dickerson had left earlier in their mother's car, they first feared he had left her bound and possibly injured to prevent her from getting married.

Brenda Fox's two daughters testified about finding their mother's body. Jenny Fox, 24, told the jury she helped her sister reach an unlocked bedroom window and look inside.

Her sister, Jolyn Fox, 20, testified: "It was the worst sight I'd ever seen. I said, 'Jenny, there's a body in there, and I think it's Mom.' "

During jury selection, lawyers had warned that evidence in the case would include a number of grisly crime scene photographs showing large amounts of blood. Wednesday afternoon, the state introduced those pictures along with a 30-minute video of the Pettigrew Street house where the killing took place.

Jurors watched the video in silence except for occasional narration by a Raleigh police officer who was in the courtroom to tell jurors what they were seeing.

They passed photos of Fox's body through the jury box as well, seeing what police encountered in the house: Fox's body, face down on the floor in her own blood, and her battered face when they turned her over.

Dickerson's attorneys had asked visiting Superior Court Judge Orlando Hudson not to allow the photos, saying they would serve no purpose but to inflame. Anticipating they would be allowed, Kelly asked that the jurors also look at what he called the bigger picture of Dickerson's life.

The defense attorney said that life included being raised without a father; losing both his grandparents and then his mother; being unable to step up to the role of a good father to his own two boys because of his mental health problems; losing the family home he had inherited to foreclosure; and then, learning that the woman he loved was going to marry someone else.

The state is seeking the death penalty in the case. The trial is expected to last up to two weeks.

martha.quillin@newsobserver.com or (919) 829-8989 Read more!

Look Closely, Doctor: See the Camera? -New York Times

SARAH KERSHAW

PSYCHOSIS in the 21st century looks something like this: You think your every move is being filmed for a reality television show starring you, and that everyone in your life is an actor.

Or you think you are under intense surveillance by an army of spies, whom you refer to as the “www people,” as in the World Wide Web, and they wiretap your furniture and appliances.

Or else you refuse to drink water because you fear that another cup drawn from your faucet will, once and for all, deplete the world’s water supply.

Those thoughts are from three case studies of what psychiatrists interested in the intersection of mental illness, culture and society are calling, respectively, Truman Show delusion, Internet delusion and climate change delusion; all of them a window, through madness, into the modern world.

If you have delusions of grandeur in this century, you are probably not Napoleon, but you may be Bill Gates.

The Truman Show delusion, or Truman Syndrome, has drawn attention in recent months, in the United States and Britain, as psychiatrists in both countries describe a small but growing number of psychotic patients who describe their lives as mirroring that of the main character in the 1998 film “The Truman Show.”

Played by Jim Carrey, Truman Burbank leads a mundane existence in the suburbs, starting from the time he was in the womb, while being filmed for a documentary television show that he cannot escape. Everyone is in on it, including his wife, and no one will believe Truman when he discovers clues that his life is being chronicled all the time by cameras.

With Internet delusion, patients typically incorporate the Internet into paranoid thoughts, including a fear that the Web is somehow monitoring or controlling their lives, or being used to transmit photographs or other personal information.

The delusions are fueling a chicken-and-egg debate in psychiatry: Are these merely modern examples of classic paranoia fed by the current cultural landscape, or is there something about media like reality television and the Internet that can push people over the sanity line?

“Most likely these people would be delusional anyway,” said Dr. Joel Gold, a psychiatrist at Bellevue Hospital Center in New York, who said he saw five patients at the hospital from 2002 to 2004 with Truman Show delusion. Dr. Gold and his brother, Dr. Ian Gold, the Canada research chair in philosophy and psychiatry at McGill University in Montreal, came up with the term “Truman Show delusion.”

“But the more radical view is that this pushes some people over the threshold; the environment tips them over the edge,” said Dr. Joel Gold, who is a clinical assistant professor of psychiatry at New York University. “And if culture can make people crazy, then we need to look at it.”

One way of looking at the delusions and hallucinations of the mentally ill is that they represent extreme cases of what the general population, or the merely neurotic, are worried about. Schizophrenics and other paranoid patients can take common fears — like identity theft because of information transmitted on the Internet, or the loss of privacy because of the prevalence of security cameras to fight crime — and magnify them, psychiatrists say.

“There is the old saying that just because you’re paranoid doesn’t mean there’s not somebody after you,” said Dr. Jeffrey A. Lieberman, chairman of the Department of Psychiatry at Columbia University.

The prevailing view in psychiatry is that a delusion is just a delusion, psychosis is psychosis, and the scenery is incidental. Fear, a sense of persecution and grandiosity are static features of delusional thinking, many psychiatrists say.

During World War II, for example, psychotics might have believed a neighbor was a Nazi. During the cold war, they might have thought the K.G.B. or C.I.A. was following them. In a post-Sept. 11 world, the persecutor might be Al Qaeda or the Department of Homeland Security.

“Cultural influences don’t tell us anything fundamental about delusion,” said Vaughan Bell, a psychologist at the Institute of Psychiatry at King’s College in London, who has studied Internet delusion.

“We can look at the influence of television, computer games, rock ’n’ roll, but these things don’t tell us about new forms of being mentally ill,” said Dr. Bell, who said he had also treated patients who believed they were part of a reality television show.

British psychiatrists, writing in this month’s edition of the British Journal of Psychiatry about the phenomenon, called it the Truman syndrome and said they had seen a growing number of patients claiming to be the stars of a filmed reality show.

The Diagnostic and Statistical Manual of Mental Disorders defines a delusion, considered still to be little understood in psychiatry, as, essentially, a false belief that is not grounded in reality and that is held with absolute conviction despite proof to the contrary. The manual lists a caveat that a belief is not delusional if it is something widely accepted by other members of a person’s culture or subculture — for example, religious faith. But some psychiatrists say the exception is too vague.

Some experts studying conditions like Truman Show delusion and other culture-bound delusions, which are specific to a time or place, are questioning the premise that culture is only incidental to psychosis, even as a growing body of evidence has pointed to brain abnormalities and other biological causes for illnesses like schizophrenia.

Psychiatrists have studied delusions like turabosis, which is the belief that one is covered in sand, and which has been documented in Saudi Arabia but would be unlikely to occur in, say, North Dakota.

Another study found a delusion occurring only in rural West Bengal, India, in which women and men bitten by dogs believe they have become pregnant with puppies.

Dr. Joel Gold, who is writing a book about Truman Show delusion with his brother, said that three of the five patients he saw with the condition specifically mentioned the film. He said what distinguishes this delusion from most others is that it involves the patient’s entire world, and everything real is unreal.

Other delusions are typically narrowly focused — there is a microchip in my brain, aliens are trying to abduct me, I’ve been to Mars — and in those, things that are not real become real.

One of Dr. Gold’s patients told him, “My family and everyone I knew were actors in a script, a charade whose entire purpose is to make me the focus of the world’s attention.”

Another patient traveled to New York City and showed up at a federal building in downtown Manhattan seeking asylum so he could get off his reality show, Dr. Gold said.

The patient reported that he also came to New York to see if the Twin Towers were still standing, because he believed that seeing their destruction on Sept. 11 on television was part of his reality show. If they were still standing, he said, then he would know that the terrorist attack was all part of the script.

Psychiatrists say that other movies whose characters are living in a unreal world or being watched by malevolent forces, including “The Matrix,” “Edtv” and even the film based on George Orwell’s “1984,” have come up in conversations with psychotic patients. But the premise of “The Truman Show” (“What if you were watched every moment of your life?” according to a promotional blurb) is strikingly similar to what patients describe as their own experiences.

Reinforcing their beliefs is the fact that in the movie, Truman is right about being watched and recorded at all times. Every other character is part of the conspiracy.

Since the Golds first presented their findings in 2006, they have learned of about 40 cases of people who say they are experiencing the delusion or have in the past. Sometimes patients contact them directly.

Recently, Joel Gold received an e-mail message from a woman who told him, “It’s my show.”
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Hospital director wants transfer to continue -Associated Press

RALEIGH, N.C. - The leader of the new state mental hospital in Butner says plans to transfer patients there from aging Dorothea Dix Hospital in Raleigh should move ahead.

The state Department of Health and Human Services said Wednesday interim Central Regional Hospital director Michael Lancaster made the recommendation this week.

The state has been working for months to complete the transfer but it's been delayed due to safety issues.

The Legislature said this summer that Central meet safety standards by outside agencies before completing the move.

Lancaster said it's not possible to meet one agency's standards until patients move in. But representatives with one agency have told regulators everything is in place for a successful transfer.

Central already had admitted patients from nearby John Umstead hospital.

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Hayes made right decision -Winston-Salem (NC) Journal

Published: August 28, 2008

Michael Hayes made the right decision in waiving his right to a hearing on whether he should be released from a state psychiatric hospital. Hayes, probably with a lot of help from his lawyer, apparently realized that emotions are just too raw this year, the 20th anniversary of his fatal shooting spree, for any judge to turn him loose right now. But eventually, he will be released, and state lawmakers must come to a realization of their own: Closer monitoring of the criminally insane is crucial.

Hayes killed four people and wounded five others during a deranged shooting spree in July 1988 in Forsyth County. He pulled out his rifle while in a psychotic state aggravated by his use of alcohol and marijuana. He was found not guilty by reason of insanity in 1989.

In the years since, he has been at Dorothea Dix Hospital in Raleigh. One reason Hayes didn't push for release this year, in addition to the 20th anniversary timing, was the fact that he will be allowed to stay at Dorothea Dix, instead of being transferred to a new state psychiatric hospital.

At Dorothea Dix, he has spent many days on unsupervised leave, spending time with his girlfriend and their two children and working in a convenience store. He has passes that allow him to spend about a week away from the hospital unsupervised each month, the Journal's Dan Galindo reported, and he has passes that allow him to work in Wake County.

To the families of his victims and many other people, it's just not right that this man who took the lives of four people has gone on with his.

North Carolina law must provide for closer monitoring of the criminally insane who kill or commit other violent crimes. That's needed while the criminally insane are in state mental hospitals, and upon their release. That's especially needed in a state where cases of all kinds constantly slip through the cracks of a terribly flawed mental-health-care system.

The law should also be much better prepared for the times when mental-health experts determine that those found to be criminally insane have become sane. The way it is now, killers such as Hayes are either in, or they're out. They're either committed to a state psychiatric hospital, or they're found to be sane and released without monitoring.

Hayes has the right to a hearing each year at which he can ask a judge to determine whether he remains mentally ill or is dangerous to others. At Hayes' hearing last year, several psychologists and psychiatrists testified that he was neither mentally ill nor dangerous. The only psychiatrist called by the state told the court that Hayes still has an unspecified personality disorder, and said he recommended that he be released with conditions.

But state law does not provide for that type of release.

The law on verdicts of not guilty by reason of insanity must be strengthened. That won't help in the Hayes case. He'll eventually be released without monitoring. But lawmakers should work to make sure that doesn't happen in future cases involving criminally insane killers. Read more!

Court reverses death sentence, upholdsanother - Associated Press

JEFFERSON CITY (AP) - The Missouri Supreme Court has overturned the death sentence of a man convicted of killing his prison cellmate, ruling that jurors at his first trial never heard critical evidence in deciding his punishment.

Along with ordering a new punishment proceeding for Michael D. Taylor, the court yesterday also upheld the death sentence for Scott A. McLaughlin for fatally stabbing an ex-girlfriend in 2003.

Taylor entered prison in 1998 on a life sentence for the 1995 rape, beating and drowning of a classmate, Christine Smetzer, in a bathroom stall at McCluer North High School in St. Louis County. Both Taylor and Smetzer were 15 years old at the time of the killing.

In 1999, Taylor was accused of strangling Shackrein Thomas, a fellow inmate at Potosi Correctional Center. Taylor was convicted in 2003 of first-degree murder in Thomas’ strangulation, and the Supreme Court yesterday upheld the conviction.

But the court ordered a new punishment proceeding, finding in part that prosecutors improperly withheld evidence including letters from a prison informant that showed a pattern of deceit.

The Supreme Court also faulted Taylor’s defense lawyers at the 2003 trial for failing to delve deeply enough into his history of mental health problems.

Taylor had admitted to an investigator that he strangled his cellmate because "father" from the "dark side" instructed him to "send" Thomas to him. The defense argued for an acquittal by reason of insanity.

But the defense failed to present all of the evidence available to it of Taylor’s mental problems and abusive childhood, the Supreme Court said. Such evidence included a threat at age 10 to commit suicide at school by jumping off a window ledge, beatings by his father and an attempt to have his "demons" exorcised from him.

Taylor has been diagnosed with paranoid schizophrenia and anti-social personality disorder.

Also yesterday, the state Supreme Court upheld the death sentence given to McLaughlin for fatally stabbing an ex-girlfriend in 2003.

During the penalty phase, the jury agreed beyond a reasonable doubt that McLaughlin had acted with the necessary depravity of mind to be executed. Jurors couldn’t agree on his punishment and deadlocked on whether mitigating factors demanding a life prison sentence trumped the aggravating factors.

A trial judge, relying on the jury’s conclusion that McLaughlin had acted with depravity of mind, sentenced him to be executed.

At issue was a 2002 U.S. Supreme Court ruling that found only juries could decide on the facts that would warrant giving a defendant the death penalty. McLaughlin’s attorneys argued that means that he should not have been ordered to be executed by a judge.

The Missouri Supreme Court ruled that a jury made the decision that a necessary aggravating factor was present and that state law allows for a judge to decide whether someone should receive the death penalty if the deadlocked jury has concluded that aggravating factors are present. Read more!

Dad forgives son for wife's murder -Chicago Sun-Times

BY DAN ROZEK - August 28, 2008

His son brutally killed his wife, but David Newcomer said Wednesday he has forgiven him.

And Newcomer said he believes his slain wife, Marilyn, would understand his attitude towards their son, 27-year-old Cliff Newcomer.

“Me and his mother still love him,” David Newcomer said after his son was sentenced to 30 years in prison for the 2006 slaying.

As part of a plea deal with DuPage County prosecutors, Cliff Newcomer received the prison term after pleading guilty but mentally ill to killing his mother.

He suffocated her, then slashed her throat on Jan. 12, 2006 — just days after threatening her life, prosecutors said.

The former Wheaton man has a long history of mental illness and had been diagnosed with bipolar and personality disorders, prosecutors told DuPage County Judge Blanche Hill Fawell.

David Newcomer blamed his son’s mental illness for the attack, saying his 55-year-old wife and their son normally had a close relationship.

“Cliff and my wife were best friends,” said David Newcomer. “They went to dinner and a movie the week before this happened.”

He found his wife’s body in their Wheaton-area home after getting home from work. An autopsy found she’d been choked to death, and then her throat was slashed. A knife found nearby contained a bloody palm print that matched her son’s hand, prosecutor Michael Pawl said.

Newcomer said his religious faith has helped him come to terms with the loss and to forgive his son, whom he has visited weekly in the DuPage County Jail since the killing. He plans to keep visiting him in prison.

“We must forgive everyone,” Newcomer said.
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Decomposing body was in Casey Anthony's car -WFTS-TV Tampa

Reported by: Cary Williams - cwilliams@abcactionnews.com

ORANGE COUNTY, FL -- Several Orlando TV's stations reported Wednesday that samples taken from Casey Anthony's car indicate that, at some point, there was a decomposing body in the trunk.

Earlier this month, the Orange County Sheriff's Office sent air samples taken from the trunk to the University of Tennessee's Body Farm for analysis. These are the first scientific test results to bolster suspicions that a body had been in the vehicle.

The car was found abandoned in an Amscot parking lot.

When reports first surfaced about the odor, Casey's mother, Cindy, said the smell was that of a rotting pizza that had been left in the car for several weeks.

Casey is being offered limited immunity if she helps detectives find Casey, but the deal expires Thursday.

In another turn of events, bounty hunter Leonard Padilla now questions his decision to bail Casey Anthony out of jail.

Tuesday night, he told CNN's Nancy Grace he doesn't think he would have posted the $500,000 bond for her freedom if he had read newly-released documents beforehand.

He told Grace, "After reading it, I don't believe I would have talked my nephew Tony Padilla into posting the bond. And I don't think I would have come to Orlando after reading that. I
mean, I'm still hoping that little girl's alive, but there's a lot of information in those 400 pages that would lead those people to believe something different."

The documents paint an unflattering picture of the Orlando mother. Some of the most negative opinions of Anthony come from her own family and friends. Anthony's mother Cindy called her daughter a "sociopath".

In a written statement to police, Anthony's father said she was very vague when he asked about his granddaughter, Caylee, saying:

"Each time we have asked to see her... my daughter would always have a different answer."

The documents also detail a grilling by an Orange County detective, who told Casey, "We need to end it. It's very simple. We just need to end it." To which Casey replied, "I agree with you. I have no clue where she is."

Friends interviewed by investigators described Casey Anthony as bipolar. One high school classmate said Anthony had talked about putting her baby up for adoption when she was pregnant, but claimed her mother would not let her.

The documents also revealed poems and blogs written by members of the Anthony family, including one by Cindy Anthony which read:

"This mother gave chance after chance for her daughter to change, but instead more lies and betrayal."

On Tuesday, an Orange County sheriff's deputy reportedly was fired for lying about his relationship with Casey Anthony.

According to Orlando station WFTV, detectives obtained computer records showing that Casey and deputy Tony Rusciano had been communicating. Rusciano reportedly was introduced to Casey by her ex-fiancee, Jesse Grund, while at the police academy.

When Rusciano was questioned by detectives about the relationship, he denied it. Because he was still in his probationary period, he was fired.

Detectives say he had nothing to do with the disappearance of Casey's missing 3-year-old daughter, Caylee.

The 3-year-old was reported missing in July. Casey was jailed shortly thereafter and charged with child neglect and lying to investigators.
Read more!

Dickerson portrayed as jealous in murder trial -Raleigh (NC) News & Observer

By Martha Quillin - August 27

RALEIGH - Charles Dickerson was upset that Brenda Fox was about to marry another man and decided if he couldn't have her, nobody would.

That's what Wake County Assistant District Attorney Frank Jackson told jurors during opening arguments in Dickerson's first-degree murder trial today.

Dickerson did explode with anger and beat Fox beyond recognition on Feb. 10, 2006, but his attorney, George Kelly, told the jury it was because he had suffered a series of psychological blows. Bipolar disorder and borderline mental retardation made him ill-equipped to cope with the strain.

Dickerson's attorneys have acknowledged that he killed Fox, a 42-year-old mother of four, who had also taken care of one of Dickerson's sons, Charlie. Fox went to Dickerson's Raleigh home on Feb. 10 to discuss taking custody of the boy. Fox had already told Dickerson she was going to get married the next day.

When Fox didn't return home that evening, her fiance, Tom Kennedy, testified he and two of her daughters began calling area hospitals to see if Fox had been injured in an accident. Then the two young women went to Dickerson's house.

They found the door locked. When a neighbor told them Dickerson had left earlier in their mother's car, they first feared he had left her bound and possibly injured to prevent her from getting married.

Jenny Fox, 24, told the jury she helped her sister reach an unlocked bedroom window and look inside.

"It was the worst site I'd ever seen," Joyln Fox, 20, testified. "I said, 'Jenny, there's a body in there, and I think it's mom.'"

The state is seeking the death penalty in the case. The trial is expected to last up to two weeks.

martha.quillin @newsobserver.com or (919) 829-8989. Read more!

Milford lawyer facing 1-year suspension -Worcester (MA) Telegram & Gazette

By Shaun Sutner - Aug. 27

WORCESTER— A Milford lawyer could be suspended for a year from practicing in U.S. District Court and made to pay $5,000 in court fines plus other payments to a 19-year-old Medford woman for whom he admitted he filed bankruptcy without her knowledge or consent.

Lawyer Robert F. Creasia also is the subject of allegations that he filed similar unauthorized bankruptcies for two Central Massachusetts residents who were facing foreclosures on their homes.

Mr. Creasia’s lawyer told U.S. Bankruptcy Court Judge Henry J. Boroff yesterday that his client acknowledged filing the unauthorized bankruptcy, but that he did so because of poor judgment stemming from bipolar disorder and serious personal problems, including a divorce.

“Mr. Creasia has remorse over this mistake,” lawyer Daniel Doyle told the judge. “This is a mistake made by him, not intentional. There was no intent to do harm.”

Mr. Doyle proposed the one-year suspension, other payments and a few other measures, including removing the false bankruptcy from the credit reports of Amanda Masci of Medford, who was in the courtroom yesterday morning.

Judge Boroff said the proposed punishments appear appropriate, though he called the one-year suspension term “a little on the light side.”

The judge said he would also refer the matter to the criminal division of the federal court and to the Massachusetts Board of Bar Overseers, which publicly reprimanded Mr. Creasia last year for improperly billing a client in 2001. The bar overseers also issued an admonition to Mr. Creasia in 2005 for illegally borrowing money from a client.

“He gets a letter to the BBO and U.S. District Court that all this happened, and that I am satisfied with the discipline and they are free to do whatever they want,” the judge said in court.

Judge Boroff continued the case until Sept. 23, to allow bankruptcy and court trustees time to investigate allegations that Mr. Creasia also filed unwanted bankruptcies for Kim M. Carville of Auburn and Sharon Cuthbertson of Bellingham, formerly of Uxbridge.

Ms. Cuthbertson and her lawyer, Margaret M. Melican, were in the courtroom for yesterday’s hearing involving Mr. Creasia.

After the hearing, Ms. Melican, who also represents Ms. Carville, said now that Mr. Creasia has admitted responsibility in Ms. Masci’s case, her client feels confident in pressing forward with claims against Mr. Creasia.

“This means there will be at least some recognition of the harm they have suffered and they have the attention of the court to do the right things by them,” Ms. Melican said.

Ms. Carville is also the plaintiff in a lawsuit that indirectly involves Mr. Creasia.

She and Auburn Fire Lt. Francis X. Hartnett have sued three area business people, including Allen J. Seymour of Oxford, who was arrested Feb. 8 in Florida while trying to flee the country with $1.3 million in his luggage, for allegedly stealing the title to their home.

Mr. Seymour was recently named by the state attorney general’s office as the mastermind in an alleged mortgage fraud scheme in an inquest involving up to 60 Central Massachusetts properties.

Mr. Creasia was an associate of Mr. Seymour and was the notary public on two mortgages recorded for Ms. Carville and Mr. Hartnett.

After the hearing, Ms. Masci said she was satisfied with the punishment that appears to be going to be meted out.

“I never gave him a license or a signature or anything,” she said. “If he has one, he forged it.”

Contact Shaun Sutner by e-mail at ssutner@telegram.com. Read more!

Teen gets 16 years in transit center murder - Bowie (MD) Star

by Meghan Tierney - Aug. 27

The teen who set off a chain reaction of gang-related violence in Gaithersburg when he stabbed a man to death at the Lakeforest Transit Center in November will serve 16 years in a mental hospital for his role in the attack.

Ronald Antoine, 16, of Gaithersburg pleaded guilty in April to second-degree murder in the death of Robert Troy Jackson Jr., 21, of Germantown. He was charged as an adult and on Friday was sentenced to serve 25 years with all but 16 suspended. He will serve his time at the Patuxent Institute, a state psychiatric facility.

After an emotional two-hour hearing in Montgomery County Circuit Court, members of the Jackson family said they did not think the penalty was strong enough.

"I don't think Patuxent will help him. He already took someone's life," said Jackson's cousin Nakia Jackson. "…It's been traumatic. I never thought I could hurt like this."

The incident occurred around 6:30 p.m. on Nov. 5 when Antoine and a group of friends took a bus to the transit center because he heard someone had gotten in a fight with another friend at the nearby Wendy's, according to Assistant State's Attorney Jeffrey Wennar. There he got in an argument with Jackson, stabbed him multiple times in the torso, threw away the knife and fled, Wennar said. Jackson, who was not involved in the earlier fight, died at a hospital the next morning. Antoine was arrested on Nov. 14.

The stabbing sparked two other acts of violence that left one man with life-threatening stab wounds and two more with minor gunshot injuries, prosecutors said. Antoine was the last to be sentenced in the series of attacks.

Antoine was indicted Nov. 30 for murder, conspiracy to commit murder and carrying a weapon. Those charges were dropped as part of the plea agreement.

Antoine's attorney Rene Sandler said he suffered from post-traumatic stress disorder after years of psychological and physical abuse from his father.

"He's a good kid; he's been through a lot. Ronald has, I guess, two sides to him," his mother Claudette Pope said at the hearing, her voice breaking. "…I wish I could have done something. I'm so sorry."

Read more!

Psychologist: Murder suspect not lying about delusions - Asbury Park (NJ) Press

By KATHLEEN HOPKINS - August 27

A psychologist testified today that he does not believe the man accused of
beheading his grandmother and ex-girlfriend in Ocean Township in 2004 fabricated delusions that God ordered the killings in order to further an insanity defense.

"He was not faking it,'' Elliot Atkins, a clinical psychologist with practices in New
Jersey and Pennsylvania, testified at the trial of Rosario "Russell'' Miraglia.

Atkins, a defense witness who met with Miraglia on four occasions and reviewed evidence in the murder case, said Miraglia was insistent that he did not want to put forth an insanity defense at his murder trial.

"He was very much against having a mental-health evaluation, very much upset if he would be found to be mentally ill,'' Atkins testified, being questioned by Miraglia's attorney, Joseph Krakora.

"His whole focus was getting his day in court so he could be revealed to the jury ... as the son of God,'' Atkins testified.

In fact, Atkins said Miraglia wanted to hide any evidence of his being mentally ill,
although the psychologist said the defendant had a long history of mental illness, including three psychiatric hospitalizations -- one in 1991 and two in 2002.

One of the hospitalizations in 2002 occurred after Miraglia was found, disoriented and naked, walking along Route 66, Atkins said. He was involuntarily committed that time at Monmouth Medical Center, where staff said he believed he was dead and he was talking to people who weren't there, Atkins said. Later in 2002, he was again involuntarily committed at Monmouth Medical Center after he called the police to tell them, "I gave everyone AIDS,'' Atkins testified.

That time, Miraglia told workers at the hospital, "I am the son of God. The judgment day is going to be soon,'' Atkins testified.

Miraglia, 36, whose last address was in a Newark halfway house, is on trial before Superior Court Judge Paul F. Chaiet. He is charged with the murders on June 8, 2004 of his grandmother, Julia Miraglia, 88, and his ex-girlfriend, Leigh Martinez, 31, the mother of his young son, in their home on Lakeview Avenue in Ocean Township. Both women were decapitated, and their hands and feet severed.

Miraglia testified Tuesday that God ordered him to commit the killings. Krakora maintains his client was suffering from religious delusions when he killed the women.

Executive Assistant Monmouth County Prosecutor Richard Incremona has argued that Miraglia has made up the story that God ordered the killings to further his insanity defense.

A psychiatrist is to testify for the prosecution this afternoon. Read more!

Man called danger to himself, community - Greenville (SC) News

By Paul Alongi • August 27, 2008

A federal judge on Tuesday ordered that a Greenville man immediately undergo physical and psychological testing after he was accused of threatening people in his community and possessing a sawed-off rifle.

Magistrate Bruce Howe Hendricks set bond at $250,000 for James Edward Nelson, 37, and directed U.S. marshals to deliver him to the nearest U.S. Bureau of Prisons psychiatric facility.

"I think he's a danger to himself," she said, "and I think he's a danger to the community."

Agents found the loaded .22-caliber rifle and seven blasting caps when they searched Nelson's home at 6 Hillhouse Street on Aug. 22, according to an affidavit filed by agent David Sanford of the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives.

Assistant U.S. Attorney James Galyean alleged that Nelson made indiscriminate threats against people in his community. Nelson denies it, said public defender Ben Stepp.

Howe Hendricks scheduled a preliminary hearing for 9 a.m. Thursday at the federal courthouse in downtown Greenville to address the threat allegations. The judge said she might be persuaded to lower the bond, but the rifle, blasting caps and Nelson's statements convinced her that he needs evaluation.

"He needs to be seen ASAP," Howe Hendricks said.

Nelson stood quietly next to Stepp through the hearing, speaking only to tell the judge he understood the charges. Nelson is charged with possessing an unregistered firearm, according to a criminal complaint.

Stepp said that Nelson is a long-time marijuana smoker who grew up in coal mining country and didn't know it was illegal to saw the barrel off of a rifle. While he has mental health issues, Nelson hasn't had any major problems with the law, Stepp said.

Nelson told agents that he bought the rifle from a friend about four years ago and sawed off the barrel to "make it easier to shoot rats," according to the ATF affidavit. Nelson said he found the blasting caps as many as 15 years ago in an abandoned storage building near an Ohio strip mine, according to the affidavit.

He said he hasn't been taking his depression medicine because it costs too much, according to the affidavit.

Agents took the rifle, blasting caps and other items as evidence, according to search warrant records.
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commentingforfun wrote:
"..called danger to himself." HUmm? Wonder by what name he "called it"? Called attention? Caused danger? Possibly created a danger to himself and the community?

Called? :o)
8/27/2008 4:21:42 PM
"..called danger to himself." HUmm? Wonder by what name he "called it"? Called attention? Caused danger? Possibly created a danger to himself and the community?

Called? :o) commentingforfun
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OldPicker wrote:
remf
8/27/2008 10:30:07 AM
remf OldPicker
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OldPicker wrote:
Sounds like they finally caught up with poor ol' joop1......
8/27/2008 10:29:25 AM
Sounds like they finally caught up with poor ol' joop1...... OldPicker
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Health Net pays $41M for underpaying state members

By LISA G. RYAN - Aug. 27

TRENTON -- A managed health care company that was routinely underpaying its New Jersey members for out-of-network medical care they received has paid a record $41 million in fines and restitution for its misconduct, state insurance officials announced Tuesday.

Health Net of New Jersey, which does business throughout the state, spent the past two months reaching out to 88,000 of its former and current members to compensate them for medical, dental, mental health and chiropractic claims filed between 1996 and 2006 the company had not paid in full. The members received a reimbursement check and letter explaining the situation.

"I'm pleased that we were able to obtain the return of this money to Health Net's New Jersey members, together with interest, since this is what Health Net promised to pay but had not," said Banking and Insurance Commissioner Steven M. Goldman in a prepared statement.

The company has paid a record $26 million in unpaid claims and interest on those claims. It also paid $2 million in examination fees and a record $13 million fine to the state.

"We are happy that this matter is resolved," said Alice Ferreira, a Health Net spokeswoman. "There were errors that were made. Claims were not being accurately processed. The company recognized there was a problem and worked with the state to correct it."

"Twenty-six million dollars is not insignificant, but it is minor when you think of how many out-of-network claims we processed and paid over those 10 years," Ferreira said.

With Health Net's cooperation, the state Department of Banking and Insurance conducted a 21-month investigation that ended in May into out-of-network claims paid by the company and its predecessors, First Option Health Plan of New Jersey and Physicians Health Services of New Jersey. The department found Health Net's vendors for chiropractic services and mental health services also underpaid members.

The department learned of the problem in 2002 through a consumer complaint. It settled with Health Net in December 2002 for more than $800,000 in restitution to more than 4,700 members, but reopened the case three years later when it learned of more underpayments. Read more!

Mental ills may have an evolutionary upside - MSNBC

By Robin Nixon - Aug. 26, 2008

Natural selection wants us to be crazy — at least a little bit. While true debilitating insanity is not nature's intention, many mental health issues may be byproducts of the over-functional human brain, some researchers claim.

As humans improved their gathering, hunting and cooking techniques, population size increased and resources became more limited (in part because we hunted or ate some species to extinction). As a result, not everyone could get enough to eat. Cooperative relationships were critical to ensuring access to food, whether through farming or more strategic hunting, and those with blunt social skills were unlikely to survive, explained David C. Geary, author of "The Origin of Mind" (APA, 2004), and a researcher at the University of Missouri.

And thus, a diversity of new mental abilities, and disabilities, unfurled.

Nature of joy
It might seem as though modern man should have evolved to be happy and harmonious. But nature cares about genes, not joy, Geary said.

Mental illnesses hinder one in every four adults in America every year, according to the National Institute of Mental Health. And this doesn’t count those of us with more moderate mood swings.

To explain our susceptibility to poor mental health, Randolph Nesse in "The Handbook of Evolutionary Psychology" (Wiley, 2005) compares the human brain with race horses: Just as horse breeding has selected for long thin legs that increase speed but are prone to fracture, cognitive advances also increase fitness — to a point.

Let's take common mental conditions one-by-one.

People with aggressive and narcissistic personalities are the easiest to understand evolutionarily; they look out for number one. But even if 16 million men today can trace their genes to Genghis Khan (nature's definition of uber-success can be measured by his prolific paternity), very few potential despots achieve such heights. Perhaps to check selfish urges, in favor of more probable means to biological success, social lubricants such as empathy, guilt and mild anxiety arose.

For example, the first of our ancestors to empathize and read facial expressions had a striking advantage. They could confirm their own social status and convince others to share food and shelter. But too much emotional acuity — when individuals overanalyze every grimace — can cause a motivational nervousness about one's social value to morph into a relentless handicapping anxiety.

Pondering the future
Another cognitive innovation made it possible to compare potential futures. While other animals focus on the present, only humans, said Geary, "sit and worry about what will happen three years from now if I do that or this." Our ability to think things over, and over, can be counterproductive and lead to obsessive tendencies.

Certain types of depression, however, Geary continued, may be advantageous. The lethargy and disrupted mental state can help us disengage from unattainable goals — whether it is an unrequited love or an exalted social position. Evolution likely favored individuals who pause and reassess ambitions, instead of wasting energy being blindly optimistic.

Natural selection also likely held the door open for disorders such as attention deficit. Quickly abandoning a low stimulus situation was more helpful for male hunters than female gatherers, writes Nesse, which may explain why boys are five times more likely than girls to be hyperactive.

Similarly, in its mildest form, bipolar disorder can increase productivity and creativity. Bipolar individuals (and their relatives) also often have more sex than average people, Geary noted.

Sex, and survival of one's kids, is the whole point — as far as nature is concerned. Sometimes unpleasant mental states lead to greater reproductive success, said Geary, "so these genes stay in the gene pool."

© 2008 LiveScience.com. All rights reserved.

URL: http://www.msnbc.msn.com/id/26410186/ Read more!

Wrongly Accused? Psychiatrist Says Ben Fawley is Innocent - Richmond (VA) Style Weekly

by Chris Dovi - August 26

Merritt W. Foster Jr. is a psychiatrist of the old school. Wearing an immaculate yellow sports jacket and matching tie, and with a full head of white hair, the 88-year-old looks more like a trusted family lawyer to well-heeled clients than a clinician who, over his 60-odd years of practice, has probed some of the most deranged criminal minds in Virginia history.

Lolling back in an overstuffed leather office chair behind a heavy wooden desk in his Franklin Street office, he smiles like a friendly country doctor as he relates with clinical detachment his expert knowledge of twisted sex practices.

“There’s a fine line between intensification of an orgasm and erotic asphyxiation that causes death,” Foster says, with a wise air.

It’s a fine line that he claims 17-year-old Taylor Marie Behl may have crossed willingly -- albeit recklessly -- on Sept. 5, 2005, when the Virginia Commonwealth University freshman died during a sexual encounter with Benjamin William Fawley.

Whether Fawley killed Behl, or Behl put a bag over her own head to increase her sexual stimulation, is an unaired point of contention that has led Foster to spend the past three years looking for a lawyer willing to take Fawley’s case and to seek a new trial.

The case never received a full public airing, because Fawley pleaded guilty, averting a lengthy trial in Mathews County.

Recently, though, Foster’s long quest finally found a voice. Richmond lawyer Hayden Fisher filed a habeas corpus motion with the Mathews County Circuit Court last week, charging among other things that Fawley’s guilty plea was made “upon errant, misguided and ill-conceived advice and recommendation of his court-appointed counsel, William E. Johnson, Esquire.”

Fisher’s filing also says Fawley was not of sound mind when he entered his plea, and says that Johnson later ignored Fawley’s request to file a motion to suspend execution of judgment a year after the conviction.

Though Fisher says he typically handles civil matters and has no experience as a criminal-defense lawyer, he felt compelled in this case. “Right is right and wrong is wrong,” Fisher says. “Ben Fawley, I don’t think, ever had a fair trial.”

Behl’s mother, Janet Pelasara, sees things differently. She says Fisher’s quest for a new trial for Fawley is an insult to her daughter’s name. Pelasara maintains that her daughter’s relationship with Fawley consisted of a single sexual encounter and that her daughter had broken it off long before she disappeared that September.

The idea that Fawley was somehow mentally incapacitated or didn’t know what he was doing when he pleaded guilty, she says, stinks of buyer’s remorse and desperation.

“It’s on tape with him saying yes, that he understood what was going on” when he entered his plea, Pelasara says by telephone from Northern Virginia.

She says Fawley’s legal wiggling is a “slam” of Taylor “which is so disgraceful, because it’s trying to put Taylor on trial.”

Hearing that such a motion had even been made, she says, was “sickening to my stomach. How dare him do this. The fact [is] he changed his version of what happened that night at least three times.”

During one of those alterations, she says, Fawley admitted he “flipped out” and killed Behl in a fit of rage after she told him she planned to turn him in for statutory rape.

The psychiatrist, Foster, insists that he knows and understands things about this case that Pelasara can’t.

Born in Mathews, not far from where Behl died, and with deep family roots in that community, Foster was raised in Williamsburg where his father was a superintendent at Eastern State Hospital. Foster fully expected that his lifelong knowledge of psychiatry would be called upon by the defense at Fawley’s trial: He’d spent nearly six hours with the forlorn amateur photographer in a jail cell evaluating him.

Foster says he developed an understanding about the events leading up to Behl’s death; how they fit tragically with classic symptoms for two people suffering from bipolar disorder.

In an interview with Style and in court pleadings filed last week, Foster says he can shed light on Fawley’s fragile emotional state and what Foster calls a sad, codependent relationship between two clinically ill people that ended horribly. After meeting Fawley in July, Foster says he enthusiastically related his findings to Johnson.

Foster -- so convinced of Fawley’s innocence that he was providing his services free -- was never called. Instead Johnson dismissed him via letter Aug. 3, 2006, just six days before Fawley’s guilty plea. “We have changed our tactics in this case for a variety of very good reasons which I will explain later,” Johnson wrote in his letter to Foster. “Please discontinue all services on behalf of Mr. Fawley.”

There seemed nothing but finality to Fawley’s conviction: a hefty 30-year sentence for second-degree murder. Fawley previously admitted to police investigators that Behl asphyxiated during a bout of bizarre, but, he said, consensual sex. He acknowledged dumping her body in a ditch near the secluded Mathews County beach where Fawley says the two had trysted.

Within hours of his Alford plea -- a legal term that means one admits only that prosecutors have enough evidence to convict at trial -- authorities whisked Fawley away to a remote state prison in Saluda, seemingly not to be seen again until the end of his sentence.

Much of attorney Fisher’s argument in his filing last week relies singularly on the assertions of Foster, developed after his July visits with Fawley at the Mathews County jail where the self-described “goth/skater from the ’80s” was being held.

Foster’s own involvement in the case began shortly after Behl’s badly decomposed body arrived at the State Medical Examiner’s Office. His friendship with Geoffrey Mann, a retired chief coroner with the state, first drew him in after the two talked at length about the case -- and its eerie similarity to a case the two had shared an interest in years ago.

“We had a case, a 16-year-old male student at Washington and Lee,” Foster says. Police photos at the time showed the student as he was found, naked at the foot of his bed, choked to death midmasturbation by his bathrobe belt.

Mann years ago presented a slide show on cases of erotic asphyxiation at a Virginia Bar Association dinner, Foster recounts with a sly smile, noting the picture of the unfortunate Washington and Lee freshman was included: “Some of the people attending -- particularly their wives -- were astounded.”

As shocking as the presentation might have been, the science behind it, Foster says, is sound -- and instructive in the Behl case.

“Patients that die with that bag over their head don’t struggle and carry on,” Foster says. Instead, Foster says, death typically comes peacefully -- even pleasurably. And when the bag is being used to heighten sexual pleasure, the victim often may have participated willingly in causing his or her own death.

Again, Pelasara says Foster is grasping at straws: “For him to say it was consensual is crap. [Fawley] used duct tape … to bind her hands. My understanding … to strangle someone, it isn’t a quick death. It would have taken minutes. Not two minutes, maybe five minutes.”

In Behl’s case, Foster says, there may have been another mitigating reason behind why he thinks the pretty and popular Behl would participate in risky sex.

The coroner’s report on Behl revealed very little other than the presence of two anti-depression drugs, venlafaxine and norvenlafaxine, in her bloodstream. But this singular finding is significant, Foster says.

Both drugs, according to medical literature, have a history of leaving their users unable to achieve orgasm. According to some medical literature, the drugs, both of the same class of anti-depressants, also carry an increased risk of suicide or risky behavior in young patients. Both carry a medical “black box” health warning, Foster says, and in all his research on the case he’s been unable to ascertain who prescribed the drugs to Behl and who was monitoring her use.

Pelasara says Foster’s assertion is bunk.

“The negative side effects that he quotes in his motion are only during the first few months,” she says, noting that her daughter had been prescribed the drugs for several years.

And the notion that Behl was bipolar is also an assertion made without any basis in fact: “Her prescriptions were for depression. She was not bipolar. Her doctors would dispute that adamantly.”

But Foster maintains that it was under the influence of these drugs, possibly suffering from a frustrating inability to reach sexual climax, and with a diminished concern for taking risks, that Behl may have insisted on trying erotic asphyxiation -- starving the brain of oxygen as a means of heightening sexual stimulation.

“It’s not unheard of for this drug to be in the brain of people who self-destruct,” Foster says. “According to Ben, she insisted on keeping this bag over her head.”

Foster describes Fawley’s part in the relationship not as a domineering older man. Instead, Foster says, Fawley painted himself in interviews as one dominated by a girl who whispered “jailbait” in his ear each time they parted as a reminder that she was in control in the relationship.

The nature of the sexual relationship painted by Dr. Foster may be disturbing, but more disturbing, Fisher says, is the sort of legal advice the convicted killer received from Johnson, his court-appointed attorney.

“Johnson’s public comments about this case raise serious questions about whether he was grossly negligent and ineffective as Fawley’s counsel or whether, instead, he deliberately suppressed evidence that could have exonerated his client,” Fisher’s court filing reads, recounting Johnson’s appearance on “48 Hours” after the case in which he “commented regarding his success in convincing Fawley to plead guilty.”

Johnson did not return calls for comment by press time.

But Pelasara has plenty to say: “What’s funny is he had two lawyers and one of them [Christopher Collins] is well known, well respected and one of the best defense attorneys not only there, but in the state. He is not [mentioned in Fisher’s pleadings] which is interesting,” she says. “I was told [by legal counsel who has seen the pleadings] that the motion is fraught with error, there is nothing in it worth hearing and it is just an abuse of the legal system.

“Ben Fawley is guilty, he admitted his guilt,” she says. “There is nothing in here that’s new evidence, which is one of the requirements for this to be heard. I believe in my heart that it will not go anywhere.”

That will be up to Mathews County Circuit Court Judge William H. Shaw III. On Aug. 14, he allowed Fawley’s petition to proceed. The Attorney General’s office has 30 days to answer the petition.
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Caylee Anthony wasn't a child who was wanted, court records show - Orlando Sentintel

Amy L. Edwards, Sarah Lundy and Bianca Prieto
August 26, 2008

Casey Anthony wanted to give up her unborn child for adoption. But those plans were nixed by her mother, who insisted she keep the baby.

These new details and dozens more about Anthony, her family and her missing daughter, Caylee Marie, were made public for the first time Monday when prosecutors released more than 431 pages of documents in response to an Orlando Sentinel public records request.

Anthony, 22, is charged with child neglect and filing a false report to law enforcement. She remains on court-ordered home confinement since her release from the Orange County Jail last week on $500,200 bond.

The investigation began when Anthony was forced by her mother to report 3-year-old Caylee missing on July 15. She told investigators that she left Caylee a month earlier with a baby sitter who disappeared with the toddler.

The documents include interviews with Anthony's friends, who depict her as a caring mother and are shocked by the disappearance. Yet the same friends say Anthony lied and stole. Writings on MySpace show a family in turmoil. Detectives seeking the truth questioned Anthony but got little in response. Among the investigators' findings:

*Anthony's mother, Cindy Anthony, posted a lengthy message on the social-networking site MySpace on July 3 -- nearly two weeks before Caylee was reported missing -- "This precious little angel from above gave me strength and unconditional love . . . Jealousy has taken her away. Jealousy from the one person that should be thankful for all of the love and support given to her . . . "

*A posting titled "diary of days" that appeared on Casey Anthony's MySpace page July 7 stated: " . . . What is given, can be taken away. Everyone lies. Everyone dies. Life will never be easy. . . . " Anthony posted the message while she was apparently watching American Psycho, a horror movie about a New York executive who is also a serial killer.

*Anthony's ex-fianc� Jesse Grund discovered she had deleted more than 200 photos of her and her with Caylee that were online.

*Childhood friend Kiomarie Torres Cruz said that during Casey Anthony's pregnancy, she wanted to put the baby up for adoption. Cruz told Anthony she would be interested in adopting the unborn child because she couldn't have children herself. Cruz said she thought Anthony was bipolar. At times, Anthony would ask her something one day, and then would not remember later that she asked the question.

*Longtime friend Ryan Pasley got a call from Cindy Anthony earlier this summer. He said she warned him against talking to Casey because "she's been lying about a lot of stuff and . . . stole money from her and her grandmother." Cindy Anthony called her daughter a "sociopath." When asked what would make Casey Anthony open up to detectives, Pasley replied, "the fear of God."

*Ricardo Morales said when he dated Anthony, she often brought Caylee to his home. All three slept in the same bed. "I feel like the person we're talking about now and the person I knew before are two different people," he said.

*Anthony Lazzaro, Anthony's most recent boyfriend whom she met online, said she was a loving and caring mother. Though he said Anthony "pretty much shacked up here," he saw Caylee only a few times. Anthony would tell Lazzaro that Caylee was at Walt Disney World or the beach and repeatedly would say they stayed an extra day. He felt "weird" about that. He described Anthony as being "a perfect girlfriend." While she stayed with him, Anthony did his laundry, cleaned and cooked.

*On July 2 or July 3, Anthony got a tattoo of "Bella Vita," which means "Beautiful Life," on her shoulder. On July 15, she went back to the tattoo parlor and made an appointment for herself and a friend for July 19.

*Simon Birch, a manager at the wrecker yard where Anthony's vehicle was towed June 30, noticed the odor from her vehicle. When Anthony's father, George Anthony, picked up the car July 15, the manager said the vehicle smelled like another once stored on the lot -- in which a man had committed suicide.

*Anthony's friend Amy Huizenga said Anthony "is someone who starts believing her lies." She said Anthony brought Caylee to a few adult parties held at night, which Huizenga didn't like. When questioned by detectives, Huizenga said, "I think something accidentally happened . . . Casey freaked out. I don't know how she solved that problem. But then created this story in her head . . . "

*On July 16, the day Anthony was arrested, detectives pressed her for truthful answers. A detective asked, " . . . Unless we start getting the truth, we're going to announce two possibilities with Caylee. Either you gave Caylee to someone that you don't want anyone to find out because you think you're a bad mom. Or something happened to Caylee and Caylee's buried somewhere or in a trash can somewhere and you had something to do with it . . . Either way, right now it's not a very pretty picture to be painting."

The detective continued, "Everything you've told us is a lie. Every single thing."

Anthony replied, "No it isn't."

Near the end of the interview, Anthony admitted she should have notified authorities sooner.

"I didn't want to involve a bunch of people that maybe didn't know the situation. The biggest mistake was not calling you guys right off the bat. . . . But the worse [sic] is I've done this to my daughter by allowing her to still be with a baby sitter."


Amy L. Edwards can be reached at aledwards@orlandosentinel.com or 407-420-5735. Sarah Lundy can be reached at 407-420-6218 or slundy@orlandosentinel.com. Bianca Prieto can be reached at bprieto@orlandosentinel.com or 407-420-5620.

Copyright © 2008, Orlando Sentinel
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State eager to speed patients' move to Butner -Raleigh (NC) News & Observer

Lynn Bonner and Michael Biesecker

State mental health officials want to start moving mentally ill patients from Dorothea Dix hospital in Raleigh to a new state hospital in Butner, even if they have to break the law to do it.

State administrators cannot meet the standards that legislators established last month to allow Dix patients to move to Central Regional Hospital in Butner, Dr. Michael Lancaster, co-director of the state mental health division, said Tuesday.

But the state is facing more than a legal problem with the move. State officials are also dealing with safety and equipment problems in the new hospital that critics say make the building unfit for patients.

Since Central Regional opened last month, top hospital administrators have been getting e-mail messages from staff members who say that the hospital has areas where emergency communication by pager and cell phone is unreliable. They also say that rooms set up for one-on-one talks with patients are unsafe.

The patient advocacy group Disability Rights North Carolina has heard so much about problems that it is convinced that the state is not ready to move Dix patients, said executive director Vicki Smith.

Last week, a doctor was called to a patient emergency, but the pager did not work, a hospital administrator confirmed.

"We do have a problem with pagers," said Dr. Stephen Oxley, Central Regional's clinical director. The hospital does not know what happened last week, he said. It could be that the phone needed a new battery.

But steel in the hospital walls and the hospital's location in relation to a telecommunications tower has resulted in pager dead zones, Oxley said. As back-ups, the hospital has regular telephones and cell phones. But the cell phones don't work all the time, either.

Despite that, Lancaster said he will recommend to his boss, state Health and Human Services Secretary Dempsey Benton, that they proceed with the transfer of Dix patients to Central Regional Hospital. Lancaster also ordered that after noon today, Dix will no longer accept patients older than 65.

The legislature tried to put into the budget safeguards that legislators thought would ensure that Central Regional was safe for Dix patients by requiring that the new hospital meet safety standards set by two outside agencies.

One of those, the Joint Commission of Accreditation of Healthcare Organizations, has said it will not even visit Central Regional because Dix patients and staff are not there, Lancaster said.

That set up a Catch-22, said Lancaster, who is also interim director at Central Regional. The hospital cannot be accredited because Dix staff and patients are not there, but staff and patients aren't there because it is not accredited.

'It's not safe'

State Rep. Jennifer Weiss, a Cary Democrat, is convinced that Central Regional is not ready for Dix patients. She was bothered that state administrators now say they cannot meet move-in requirements they helped write into law just weeks ago.

"It's not safe to add new patients," she said, and to move now "is not in keeping with the spirit of the law."

Staff members are working through problems and will be for months, Lancaster said. But he assured legislators at a mental health committee meeting Tuesday that Central Regional is safe.

But late last month, Lancaster was copied on an e-mail message from a Central Regional psychiatrist about the lack of safe rooms where doctors can evaluate patients. Most of the interview rooms are isolated from busier areas, making it hard for staff to spot dangers.

"As you know, there are concerns from the medical staff as well as other clinicians about the dangerous design of the new (patient care units) as well as the lack of appropriate rooms in which to evaluate patients," the message says.

Lancaster said the interview rooms were a known problem, but the staff is working on alternatives. The hospital is going to keep finding things it has to fix, he said, but they should not stop Dix patients from moving.

Not all Dix patients will be moving to Central Regional.

The state has decided to keep in Raleigh about 23 forensic patients -- people who cannot stand trial or who are found not guilty of crimes because of mental illnesses -- who live in their own building on the Dix campus and hold jobs in the hospital or the community. These patients are entitled to their jobs and less restrictive housing, under federal law, and they cannot be offered comparable work and living arrangements in Butner.

Raleigh will keep space for about 40 children, rather than move them to the old John Umstead Hospital that needs renovations. Costs have not been determined, the problems may take four to six months to fix, Lancaster said.

Additionally, Dix will have 60 beds for other adult patients that it will keep for about three years.

lynn.bonner@newsobserver.com or (919) 829-4821. Read more!

SBI wraps up portrait case; no action taken - Raleigh (NC) News & Observer

The SBI has ended its probe into the purchase of a portrait by former state mental hospital director Patsy Christian without action.

The investigation was requested by the state Department of Health and Human Services in June after reports in The News & Observer about a painting of herself that Christian commissioned from J. Lee Harris, a hospital nurse who sidelined as an artist.

The artwork was paid for with vending machine revenue from John Umstead Hospital that the state budget manual says should be spent to benefit patients.

After public uproar about the portrait, Christian resigned as chief executive officer of Central Regional Hospital in Butner and was reassigned to a newly created position within the department at 95 percent of her former salary.

DHHS Secretary Dempsey Benton ordered that the portrait not hang in the new hospital and that state money paid for the artwork be recovered. Harris refunded the $572 she was paid for the "executive portrait" and its frame.

Though state law forbids the awarding of service contracts to state employees, Erik Hooks, an assistant SBI director, wrote in an Aug. 14 letter that he had concluded "no further inquiry by the SBI is necessary at this time."

Wake County District Attorney Colon Willoughby, who was consulted by Hooks, said he saw no need to prosecute Christian or Harris.

"It looked like more of a management issue to me than something that rose to the level of a criminal matter," Willoughby said.

As for what may be the most infamous portrait in state government, the department will say only that it is in private hands. Read more!

Feds descend on Cherry Hospital - Raleigh (NC) News & Observer

Michael Biesecker and Lynn Bonner

RALEIGH - A large team of federal regulators arrived at Cherry Hospital on Tuesday to perform a top-to-bottom review of the state mental facility's operations and investigate new complaints of patient neglect and abuse at the Goldsboro hospital.

The group is expected to seek information on the beating of a patient by two hospital employees last week, as well as a previously undisclosed incident from December when a patient fell down a laundry chute.

The increased scrutiny could further imperil the hospital's ability to receive federal money, potentially costing North Carolina taxpayers millions in lost revenue.

Jeff Horton, director of the state division that ensures compliance with federal regulations, said about 10 people were on the team sent to Cherry.

"It takes a lot of people to do a full survey," Horton said. "We're going to look at everything."

The Centers for Medicaid and Medicare Services threatened this month to withdraw federal insurance reimbursements from the hospital after the April death of a patient who choked on his medication, hit his head and then was left sitting in a chair 22 hours while nearby staff played cards and watched television.

Federal officials have accepted a plan submitted by hospital administrators to address the multiple violations cited in a report last week. The surveyors now at the hospital, state employees working on behalf of the federal agency, are charged with making a recommendation by Sept. 1 as to whether Cherry's certification should be withdrawn.

The intensive review is similar to what happened at Broughton Hospital in Morganton last year, when federal support was removed after the death of a patient who had been restrained by staff.

Horton also confirmed that the team sent to Cherry on Tuesday would be investigating new complaints against the hospital staff, though he said federal rules forbid him to give details.

Tom Lawrence, spokesman for the state Department of Health and Human Services, said hospital administrators indicated the surveyors were looking into the reported assault Aug. 18 of a patient and injury Dec. 28 of another patient.

Taniko Dominique Upton and William Kenneth Johnson, both health-care technicians at Cherry, were charged Friday with simple assault on a handicapped person, a misdemeanor.

Upton is accused of knocking a male patient to the floor, then kicking and punching him. Johnson is accused of holding the man during the initial assault, and then joining Upton in the beating, according arrest warrants.

The News & Observer requested information this month on a report of a female patient who fell down a laundry chute.

Cherry administrators provided a copy of a one-page incident report with information blacked out. The report indicates only that the patient went unaccounted for after eating an afternoon snack of grapes and that a search was initiated.

Lawrence confirmed Tuesday that the patient had removed a grate from an unused laundry chute at the hospital, climbed inside and fallen to the bottom. He said he did not know how many floors the patient fell or the extent of her injuries.

Members of a legislative committee on mental health that met Tuesday expressed outrage at the circumstances surrounding the death of patient Steven Sabock on April 29. Sabock's death triggered the initial federal review this month.

The legislators sought to solve what they called deep-seated problems in the state's mental hospitals and suggested better pay to attract better workers. The starting salary for the technicians is about $25,000 a year.

"I'm not sure we had people involved who care about the patients," said Sen. Martin Nesbitt, an Asheville Democrat and committee co-chairman. "That is a systemic problem I don't know how to fix."

michael.biesecker@newsobserver .com or (919) 829-4698 Read more!

A quality-of-life threat -Ventura County (CA) Star

There has been a lot of opposition surrounding the proposed prison hospital, and rightly so, since a federal receiver selected the Ventura Youth Correctional Facility near Camarillo to be converted into one of seven prison hospitals for physically and mentally ill adult inmates.

There are too many issues that must be addressed and I, for one, vigorously oppose having this facility in our community.

Many might argue that this proposed prison hospital is a Camarillo problem and we should not concern ourselves. I would have to disagree. As an Oxnard City Council member, I am concerned with the impacts that a facility such as this will have on the Oxnard community.

My recent conversations with Bob Conroy and Bob Klope of the Prison Hospital Action Committee provided me with insight into some of the negative effects and impacts our community would suffer from such a facility.

One of the more worrisome issues for me has to do with the qualified medical personnel that the prison hospital would require. Doctors, nurses and medical technicians will be recruited for the prison, aggravating the current shortage in our county. Medical experts will be pulled away from existing facilities, which will further exacerbate the healthcare issues that we currently face.

The existing sewer system that services the Camarillo area has exceeded its useful life. This prison facility can only contribute to a more rapid deterioration of the infrastructure systems in the area.

Prisoner patients having to be transported from the prison hospital facility to another medical facility will place additional demands on local law-enforcement agencies, reducing services for the local communities involved.

In recent times, Oxnard and Ventura County have been the dumping grounds for negative- impact facilities. For example, Oxnard has had three landfills, two electrical power plants, and the Halaco scrap metal plant that is currently on the Environmental Protection Agency Superfund National Priorities list for hazardous materials. This is in addition to two liquefied natural gas projects and a peaker-power plant at Mandalay Beach.

Enough is enough! The preservation of the quality of life for Oxnard residents is very high on my list. A prison hospital within a stone's throw of our community does not support that.

I stand opposed to a prison hospital — in such close proximity to Oxnard — which threatens our community's quality of life.

— John C. Zaragoza is an Oxnard City Council member and a candidate for District 5 supervisor. Read more!

Judge declines argument to reduce amount due to mental illness

BY NATE TAYLOR - NateTaylor@coloradoan.com

The Loveland man accused of kidnapping a Fort Collins woman at gunpoint in July and driving her to the West Coast and back thought he was Ichabod Crane during a recent police interview, his attorney said Tuesday.

A Larimer County judge Tuesday declined to reduce the $1 million bond for Travis John Kness, who's charged with second-degree kidnapping, menacing with a deadly weapon and reckless endangerment. Prosecutors say he kidnapped Rosanna Martinez, 45, as she left work with a co-worker.

Judge Daniel Kaup's decision means Kness will remain in the Larimer County Detention Center on $1 million bond.

During his argument to have his client's bond reduced, public defender Eric Vanatta said Kness, who has been diagnosed as being bipolar, is mentally ill.

"In his first interview with police, which was in the fairly recent past, he thought he was Ichabod Crane and that the TV was talking to him," Vanatta said. "Mental health aspects play into this decision heavily."

Kness' brother, Jim Kness, said Monday that Travis has a history with thinking he is a movie character. Jim Kness said that, in January when Travis waived around a BB gun in a Loveland bar, he was acting out a scene from the movie "Young Guns."

Kness was convicted of felony menacing for the incident in Loveland and was put on court-ordered medication.

When prosecutor Michael Pearson argued Kness' bond should not be reduced because of the seriousness of the charges against him, Kness interrupted telling Judge Daniel Kaup, "sir I did not." Kaup stopped Kness and told him not to interrupt.

Prosecutor Michael Pearson said Kness' bond shouldn't be reduced because of the seriousness of the charges against him, which could result in a 48-year prison sentence.

Kness on Tuesday waived his right to a preliminary hearing.

Kaup was hesitant to allow Kness to waive the right because Kness told him, "I don't know what I'm doing. I'm just listening to (Vanatta)."

Kness also said he didn't understand the charges against him.

"The district attorney thinks I kidnapped somebody?" he asked Kaup.

After Kness expressed confusion, Kaup explained to him the charges he faces. Read more!

Official calls for new facility in Las Vegas for mentally ill criminals - Las Vegasn Sun

By Cy Ryan - Aug 26, 2008

CARSON CITY – A Sparks facility for the evaluation and treatment of dangerous mentally ill persons accused of crimes is full and an additional facility is desperately needed in Las Vegas, a state official says.

The state has purchased 10 acres in the northern part of Las Vegas, near Las Vegas Motor Speedway and the Summit View Youth Center, for more than $5 million and has gained zoning approval from the Clark County Commission despite some objections of nearby residents.

Dr. Betsy Neighbors, head of Lake’s Crossing mental offender unit in Sparks, says the facility is “bursting at the seams” and she has urged the state Public Works Board to approve a $49.6 million 50-bed psychiatric hospital for the disordered criminal offenders in Clark County.

“We have some of the most dangerous individuals in the state,” she said, adding it is dangerous to crowd them in a small space in Sparks. It is dangerous to transfer them from Las Vegas to Sparks, Neighbors said.

The Sparks center is licensed for 56 beds and other buildings on the campus of the state’s mental health property are being used to handle the overflow.

The inmates are evaluated and treated to make them mentally capable of standing trial.

The Public Works board is hearing two days of testimony from agencies that are asking for $1 billion in state money for construction projects in the next two years. There is only $495 million available in bonds to take care the requests and there won’t be any cash because of the state’s dire financial straits, according to officials.

Harold Cook, superintendent of the state Division of Mental Health and Developmental Disabilities, told the committee one of his top priorities is a $64 million office building in Sparks to replace eight old buildings. These smaller buildings, he said, are costing $1 million a year in utilities because of single-pane windows and little insulation in the walls.

They are a “health hazard” to those people who work in them, he said. “These buildings are falling down around us.”

The Nevada Higher Education System also presented its priorities for future construction asking for $307 million in state funds. One of the system’s top priorities is getting $29.4 million for construction of the Advanced Clinical Training and Research Center to be built on the Shadow Lane Campus in Las Vegas. It would house the school of medicine and the school of nursing for the university system.

The project was approved for $4.4 million for planning but the $29.4 million was withheld two years ago. If approved by the 2009 Legislature, it should be completed in 2011. It would have to raise $25.8 million in private or federal funds to match the state’s contribution.

The Nevada State College in Henderson is also proposing a $41 million nursing and science building at its Henderson Campus. It would be the second building on campus and $10 million would have to be raised in private or federal funds. A spokesman said that $4.5 million has already been collected.

Another project proposed for Southern Nevada is a $5.8 million expansion of the Veterans Cemetery in Boulder City. It was suggested by the state Division of Veterans Affairs.

The Public Works board will meet in late September to make recommendation to Gov. Jim Gibbons on what projects should be funded in the $495 million available.
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Antipsychotic drugs may not work as assumed, Duke researchers report - WRAL-TV Raleigh (NC)

Aug. 26 -- Editor’s note: WRAL Local Tech Wire recently added more sources for news, including stories, photos and graphics produced by the news services of various universities. Such stories are labeled as UniversityTech and with the appropriate source. By adding stories and information from collegiate news services, LTW is enhancing significantly its coverage of scientific and research efforts at regional universities where many of tomorrow’s discoveries are being made and the foundations of new companies are in the process of being created.

DURHAM, N.C. – Antipsychotic drugs that are widely used to treat schizophrenia and other problems may not work as scientists have assumed, according to findings from Duke University Medical Center researchers. The information could lead to changes in how these drugs are developed and prescribed.

Scientists have known that all antipsychotic drugs target the D2 receptor inside cells. New tests developed at Duke, however, reveal that the biochemical pathways linked to this receptor – the pathways along which the drugs deliver their therapeutic effects – may function differently than previously understood.

The Duke team developed specialized tests and studied two main pathways that stem from the receptor. The first is the G-protein-dependent signaling pathway, and the other is the beta arrestin pathway.

Most antipsychotic drugs in use today were developed to target the G-protein signaling that occurs at the receptor. Only recently, beta-arrestin, a protein known as an "off-switch" for G-protein receptors, has been shown to also play a role in directing other cellular activities.

The tests uncovered surprising results.

"Our work showed that all nine antipsychotic drugs we examined uniformly and more potently block the beta-arrestin pathway downstream of the D2 dopamine receptor," said Bernard Masri, Ph.D., lead author and postdoctoral researcher in the Duke Department of Cell Biology.

The drugs, however, showed a variety of effects at the G-protein pathway. "Some activated it, some blocked the G side totally, some blocked it only 50 percent – the drugs had different profiles for the G-protein pathway," Masri said. "So with this new information, drug manufacturers would want to make sure new compounds for antipsychotic use block the beta-arrestin pathway."

There may be even more pathways not yet known to flow from the D2 receptor, he added, pointing up the difficulty of developing a drug with the greatest possible effectiveness and fewest side effects. To further complicate the situation, antipsychotic drugs also work on receptors other than the D2 receptor. The drugs are used mainly to treat schizophrenia, which affects about 1 percent of people in the United States.

G-protein coupled receptors have been the most common target of such therapeutic drugs. The findings about beta arrestin's dual role open possibilities for developing new drugs. The importance of this concept for G-protein coupled receptors, especially the dopamine receptor, was demonstrated at Duke by the acclaimed receptor pioneer Robert J. Lefkowitz, M.D., and Marc G. Caron, Ph.D., the senior author on the current study.

"This work with antipsychotic drugs represents an entirely new approach for studying drug effects and developing new ones," Masri said of the Duke team's research, published the week of Aug. 25-29 in the Proceedings of the National Academy of Sciences.

In this study, the scientists used a technique called bioluminescence resonance energy transfer (BRET) in cells in culture. "Using cells to monitor specific receptor signaling pathways could provide more selective medicines with fewer side effects," said co-author Ali Salahpour, Ph.D., also a postdoctoral researcher in cell biology. "This is where pharmaceutical research is headed."

BRET is a luminescence-based technique that monitors interactions between molecules. One assay in this study followed the variation of cyclic adenosine monophosphate to look at the G-protein dependent pathway, and the other measured the direct interaction of beta arrestin with the dopamine D2 receptor. The antipsychotics were tested with both assays to look at which pathway(s) they were activating or blocking, and with what strength and efficacy.

Caron, the James B. Duke professor in the Department of Cell Biology and director of the research laboratory, said, "Using these assays as a means to develop antipsychotics should be a useful way to target precise responses and improve patient symptoms." Unwanted side-effects, such as spasms or movement problems that cause the whole body or parts of the body to move uncontrollably, are associated with some of the antipsychotic drugs studied.

"Not all drugs used for schizophrenia have the same degree of movement-related side effects," Caron said. "For some of the drugs, these side effects may stem from interactions on the G protein part of the pathways." Therefore, evaluating antipsychotic drugs early that act less or not at all on the G side, but are effective on the beta arrestin side, could provide improved efficacy with many fewer side effects.

The next project for the scientists is to study these drugs and the relevant pathways in both normal mice and mice with traits of psychosis.

Other co-authors included Michael Didriksen, Valentina Ghisi, Jean-Martin Beaulieu and Raul R. Gainetdinov, all of the Duke Department of Cell Biology. Didriksen is now with Lundbeck Discovery Biology Research in Valby, Denmark, and Beaulieu is now with CRULRG, Research Institute, Université Laval, in Quebec City, Canada.

The study was funded in part by NIH grants, a European Marie-Curie Outgoing International Fellowship and a Canadian Institutes of Health Research fellowship.

Copyright 2008 by WRAL.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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A storm brewing over ‘Tropic Thunder’ -Abilene (TX) Reporter-News

By Kermit Klaerner

August 26 - It was with interest that I read the front page article about Ben Stiller’s movie, “Tropic Thunder,” in the Abilene Reporter-News on Friday.

In an age of a “politically correct” mind-set, it amazes me that much of society still retains its stigma against people with mental illnesses/mental retardation. According to these individuals in our society, it is OK to make fun of, ridicule, point fingers or even humiliate mentally ill people. Now, sadly enough, a movie has been produced and made available to the public which labels people with mental illnesses as “retards!”

This is not politically correct, even when done under the guise of humor and entertainment.

Many people automatically think of “stupid” when they are told that someone has a mental illness. These individuals take mental illness and mental retardation and put them in the same pot, stir them up and serve a big helping of stupidity. Perhaps this misconception occurs because society has heard the term mental health/mental retardation so frequently that no distinction is made between the areas of mental illness and mental retardation. However, the two elements are quite different and should be separated in society’s thinking.

Mental illness is defined by Wikipedia (www.righthealth.com) as “a mental condition assessed as abnormal or maladaptive and involving significant distress or disability. This can involve cognitive, emotional, behavioral and interpersonal difficulties.” A Mayo Clinic psychiatrist offers the following definition: “Mental illness is a term that refers to all the different types of mental disorders, including disorders of thought, mood or behavior. To be classified as a mental illness, the condition must cause distress and result in a reduced ability to function psychologically, socially, occupationally or interpersonally.”

Many people with mental illnesses have brilliant minds, are highly intelligent and have scholastic degrees from institutes of higher education. With proper medication and professional help, these individuals can usually function effectively in society and lead productive lives, as evidenced by the testimonies of some of the individuals quoted in the Abilene Reporter-News article. They are leading productive lives.

On the other hand, a person with mental retardation is defined as someone who “has lower than average intelligence.” The Centers for Disease Control and Prevention Web site (www.cdc.gov) states that “mental retardation is characterized both by a significantly below-average score on a test of mental ability or intelligence and by limitations in the ability to function in areas of daily life, such as communication, self-care and getting along in social situations and school activities.”

Mental retardation may include developmental disabilities, global developmental delay or learning difficulties. Mental retardation is usually considered a disability rather than a disease. Although there is no “cure” for an established MR disability, with appropriate support and teaching, most people with MR can learn new skills or advance the current level of their abilities. These individuals learn throughout their lives and can learn new skills even late in life.

Whatever the case may be (mental illness or mental retardation), it is not politically, socially or in any other manner acceptable to label these individuals with derogatory names or place a personal stigma in their way, even when humor is intended or it is done in the name of entertainment.

Remember, the person with a mental illness is ill, not stupid! This individual is a human being trying to cope with life under adverse conditions.

Kermit Klaerner is the director of the Mental Health Association in Abilene.

Mental Health Matters is sponsored by the Mental Health Association, e-mail mhaa@bitstreet.com, phone (325) 673-2300. Read more!

State's legal fees top settlement - Madison (WI) State Journal

Jason Stein, jstein@madison.com

Aug. 26 -- The state paid outside lawyers $169,120 to defend four current and former workers at a state mental hospital in Madison against a lawsuit by a patient — more than the recently announced settlement with the patient.

The bills, according to state Department of Justice spokesman Bill Cosh, included nearly $30,000 paid to represent a former Mendota Mental Health Institute employee whom state officials this month admitted had "inappropriate contact" with the patient.

Dennis Strong sued the state in January 2007 alleging a former female caregiver had an improper romantic relationship with him while he was a patient there.

Together with the $162,000 settlement reached earlier this month with Strong, the legal bills bring the total cost to taxpayers from the case to $331,120. That amount does not include the costs of state lawyers at the Department of Justice who defended the state, Cosh said.

Strong's attorney, Amy Scarr, said it was normal for defendants to want to wait and see the evidence against them before deciding to settle a case. At the same time, Scarr, who took over Strong's case in June, said the lawsuit appeared to take a long time to settle, which added to the state's legal bills.

"This case did seem to go on for quite a while," Scarr said.

Stephanie Marquis, a spokeswoman for the state Department of Health Services, which runs Mendota, said Tuesday she was unable to comment on the legal bills because the agency lawyer familiar with the case was not available.

But earlier this month, agency chief counsel Diane Welsh said the settlement was intended to put the incident behind the agency so "we can focus on our responsibility for those in our care and those we employ."

Strong was sent to Mendota after pleading not guilty by reason of insanity in December 2003 in Waupaca County to charges of battery and false imprisonment and has said he was diagnosed with paranoid schizophrenia. He has since left the institution.

The state assigned three outside law firms to represent the four defendants in the case last year because of conflicts or potential conflicts between their interests and those of the state in the case, Cosh said. The firms, which had to be approved by Gov. Jim Doyle's office, were Cullen, Weston, Pines & Bach; Bell, Gierhart & Moore; and Lathrop & Clark.

"If there's a conflict or a perceived conflict, we can't represent them," Cosh said of the defendants.

Strong accused one of the four employees, former nurse's aide Kelly Vitense, of having sex with him unlawfully at Mendota. His lawsuit alleged other Mendota employees knew or should have known about the relationship.

Sex between a patient in an institution such as Mendota and a caregiver is always a felony sexual assault under state law, since the patient is considered not able to give consent. But no criminal charges have been filed in the case.

In a deposition in June 2007, Vitense acknowledged kissing Strong, sending him gifts and calling him nearly every day after she was forced to resign from Mendota. But Vitense, who was also sued by Strong, has denied they had sex.

Vitense said Tuesday she was thankful the case was over.

"Dennis isn't totally innocent in this," Vitense said. "I'm a good person, and this has affected my life drastically."

On June 29, 2007, the state decided to stop paying for a private lawyer to represent Vitense, court records show. State officials made that decision the same week the State Journal reported the state was paying thousands of dollars for private lawyers for Vitense and other current and former Mendota officials.

Scarr praised the settlement — in which Strong dropped all claims against both the state and Vitense — as fair and said she hoped it would lead to better training and oversight of Mendota employees, including lower-level workers such as Vitense. Better supervision of Vitense might have prevented her improper conduct or detected it earlier, she said.

"I feel management at Mendota failed not only Dennis Strong but Kelly Vitense as well," Scarr said.
Read more!

The roots of madness - Boston Globe

Exploring a family's illness leads to Ireland

By James Sullivan - August 26, 2008

The voices inside her head assured the woman she'd be better off if only she had her teeth removed. So, to her husband's everlasting horror, May Sweeney White persuaded a hapless dentist to pull them all.

When May's grandson, Patrick Tracey, was old enough to ask about his grandmother's long battle with mental illness, Grampa White was characteristically tight-lipped. "She's away with the fairies," he'd say.

If Patrick wanted to know more, he should go to Ireland, the family's ancestral home. Shake the family tree, Grampa White would say, and "lots of lunatics would fall out."

It took Tracey much of his adult life to take his grandfather's advice. After watching his mother's brother and then two of his own sisters fall ill, like May, to schizophrenia, he sank into a wilderness of alcoholism and drug abuse that stretched across decades. A few years ago, clean and sober and living in London, Tracey struck up a conversation with a British doctor. The doctor mentioned the recent discovery of the first genetic link to schizophrenia, in County Roscommon, in Ireland - the home of Tracey's maternal family.

Tracey's new book, "Stalking Irish Madness," which hits bookstores today, grew out of his desire to explore the roots of his family's affliction. "On us sanity rests no more securely than a hat blown off in the wind," he writes in the book, equal parts family history, scientific inquiry, and Emerald Isle travelogue. Even in a culture inundated with recovery memoirs and media-driven survivors' tales, Tracey says, schizophrenia remains a "no-go zone."

"It's a country no one wants to visit," he says. "I want the book to be a conversation starter."

Though the Irish have long believed they suffer disproportionately from mental illness, the fact is, Tracey reports, that people of Irish descent are no more genetically prone to schizophrenia than those from anywhere else in the world. There is, however, a "three-legged stool" of factors that seem to correspond to heightened rates of occurrence: famine in previous generations, pronounced substance abuse, and men fathering children at advanced ages. The Egans of Roscommon, Tracey's mother's lineage, hit the unlucky trifecta.

"At a primal level, I think madness is our deepest fear," says Tracey, sitting outside near the apartment he rents along Revere Beach Boulevard. "I'd rather lose an arm or a leg than my mind."

As the wind picks up and a storm cloud rolls in, he hollers across the street to his sister Seanna, who smiles and waves as she rushes for the bus in her stockinged feet, carrying her shoes. Now in remission after a bout with lung cancer, she is on her way to a checkup. Seanna had her own long struggle with addiction, sometimes sleeping on the streets of Cambridge while her young son, Chris, lived with Patrick in Washington, D.C. "He calls me 'Funcle' " - part father, part uncle, says Tracey. Chris recently celebrated his 28th birthday behind bars, serving a six-month sentence in the South Bay House of Correction for breaking and entering.

Clearly the Traceys' troubled history has taken its toll. It's been a long way down from a once-promising future for the brood.

When they were growing up in a three-story brick house in leafy Milton, their father (also Patrick) ran a lucrative business, Tracey's Religious Artifacts, near Downtown Crossing. His wife, Millie, was noted on the front page of The Boston Globe in 1960 as the first mother of five to be sworn in as a lawyer in Massachusetts.

The girls were treated like princesses, budding fashion models who went to school with some of Boston's best and brightest. One of Tip O'Neill's sons, says Tracey, was an usher for Seanna at her cotillion. Oldest sister Elaine was once engaged to Babson College graduate Edsel Ford II, great-grandson of Henry.

But after the family moved to Providence, and then Patrick and Millie divorced, their unfortunate inheritance began to catch up with them. First it was Chelle, who was training as an actress in New York. After she had a breakdown, friends sent her home on the bus. Telling her family she planned to marry a boy named Jesus Christ, she once marched into a church service in the nude, Tracey writes.

Not long after the onset of Chelle's manic illness, their sister Austine returned home, too, from Florida. Unlike Chelle, whose schizophrenia plays itself out theatrically, Austine's illness is much darker. After her own voices emerged, she once pulled a knife on one of Elaine's boyfriends.

While the book details his sisters' parallel descents into madness, Tracey says he made a conscious decision to limit the number of episodes he recounted.

"There's some harrowing stuff," he says, his blue eyes burning, his forehead tanned and reddened from his morning jogs on the beach. In cargo pants and black Chuck Taylor sneakers, he's wearing a black T-shirt commemorating his book's selection to the Indie Next list, a booksellers' survey. It's a welcome change, he jokes, from the green Paul Pierce T-shirt he has been living in since the Celtics won the championship.

Some of his sisters' wilder incidents, he says, are too outrageous to be believed. Contrary to the liberties taken by certain memoirists, he says, "I've actually soft-pedaled some of it."

He also minimized the details of his own back story, despite a downward spiral that in itself would put readers on the edges of their seats. As a freelance contributor to Washington's City Paper, he wrote some brutally graphic feature stories about hard living, some of them in the first person. "I'd say my beat was high people in low places," he says with a wry smile.

He does acknowledge his alcoholism in "Stalking Irish Madness," if only to explain how he met so many Irishmen in pubs while nursing bottles of sparkling water. "I was gagging a bit for the Guinness," he admits.

But the book is not for himself but his sisters - the only gift he can give them, he says, other than the bottles of purportedly redemptive well water from Glennagalt he brought back.

His new apartment is two floors above Seanna's basement flat, where he slept on the floor as he wrote the book. Chelle and Austine have lived in group homes for years. These days, Chelle talks to Seanna on the phone every night.

"They're very close," says Tracey, who has been living off his $75,000 advance and is working on his second book, a novel. "They have a sweet relationship."

Now that they have stopped running from their family's history, he says, he and Seanna "live in each other's pockets."

"I love it here," he says quietly, cracking open a can of tuna to toss to the gulls. Read more!

Dallas County hit with $900,000 verdict in jail neglect case - Dallas Morning News

By KEVIN KRAUSE - Augu. 26
kkrause@dallasnews.com

Dallas County was slapped Tuesday with a $900,000 verdict in a federal jail neglect case involving a prisoner who suffered a stroke while in custody after being denied proper medical care, the man's lawyer said.

Stanley Shepherd sued in 2005 in federal court, saying the county violated his constitutional rights by denying him basic medical care while he was in the Lew Sterrett Justice Center.

The jury issued its verdict Tuesday morning after deliberating since about 1 p.m. Monday, said Don Tittle, the attorney for Mr. Shepherd. The trial began last Monday. If lawyers' fees and interest are granted, the county could have to pay more than $1 million, he said.

Tuesday's verdict is significant for two reasons, Mr. Tittle said. First, it's the largest jury verdict over a jail neglect suit to go against Dallas County. And second, the verdict is an indictment of the county's entire jail health system instead of one or several isolated cases, he said.

"It's a finding that they failed to meet the basic essential needs of an inmate," Mr. Tittle said.

Mr. Shepherd, who testified during the trial, entered the jail in October 2003 and suffered the stroke in January 2004. He is currently confined to a wheelchair with a complete loss of function to his left side, Mr. Tittle said.

County officials could not immediately be reached for comment. When contacted by a reporter, Commissioner Mike Cantrell said he hadn't heard about the verdict and didn't want to comment until he got confirmation and details.

In February 2007, commissioners agreed to pay $950,000 to the families of three mentally ill former inmates, one of whom died, to settle a federal civil rights lawsuit over medical care at the jail.

James Monroe Mims didn't get his medication for two months and nearly died after water to his cell was shut off for two weeks.

Clarence Lee Grant Jr. died in his jail cell in 2003 after he did not receive any medicine for five days. And Kennedy Nickerson was found lying sick in the street after being released from the jail without medication or notice to his family.

Dallas County's jail system has been subjected to several scathing reports critical of its medical care, and the jails haven't met state jail standards since 2003. In late 2006, the U.S. Department of Justice said jail conditions contributed to the death and injury of numerous inmates and placed others at "risk of serious harm."

Since then, the county has been under a federal court order to improve conditions.

In early 2006, Parkland Memorial Hospital took over jail health duties from a contractor, and commissioners have since authorized millions of dollars worth of improvements.
Read more!

State has yet to start mental illness registry -Charleston (WV) Daily Mail

CHARLESTON — More than two months after the law took effect, the state hasn't started compiling a mental health registry meant to prevent potentially dangerous individuals from buying a gun.

The names of at least 708 West Virginians housed in mental facilities could be placed on the registry right now.

The registry will include basic information about people who have been involuntarily committed to mental health facilities or found unfit to stand trial because of mental illness.

These people will be precluded from purchasing a handgun.

Lawmakers created the registry during the regular session this year in the wake of a massacre at Virginia Tech last year, in which a gunman with a history of mental problems killed 32 people before killing himself.

Despite being found mentally ill by a judge, Seung-Hui Cho was able to buy a Glock 9mm handgun at a Roanoke, Va., retailer. He later used that weapon in the killings, authorities said.

Virginia Gov. Tim Kaine almost immediately issued an executive order that closed an information loophole between the state and the FBI's National Instant Criminal Background Check database. Previously, information about involuntary commitments for mental illness in Virginia was not shared with the federal government.

That also was the case in West Virginia.

In February, the state applied for a $300,000 grant through the federal Justice Department's National Criminal History Improvement Program to establish the registry.

Supreme Court officials are still waiting to hear whether or not the state will get the grant, which the court will have to match with $82,500 from its own budget.

"We are highly optimistic that we will get the grant, and when we do, we will go forward with appropriate funding with the greatest speed possible," said court administrator Steve Canterbury.

"This is highly important. It is fundamental to public safety. We have been hard at it to get the grant application in and to get people ready for the next part of it."

Once a decision on the grant is known, Canterbury will seat a committee to begin work on the registry, said court spokeswoman Jennifer Bundy.

The committee will include members of the state's Domestic Violence Planning and Evaluation Committee, the State Police and the Department of Health and Human Resources, Bundy said.

The domestic violence team has a sense of how to establish a computer-based registry as it's working on a list that will include information on domestic violence protective orders and other issues.

County circuit clerks will supply the information for the registry. The information will be limited to the person's name, date of birth, date he or she was committed or adjudicated as "mentally defective" and their address at the time of either of those court actions.

The information will not include anything about the person's diagnosis.

The law says the registry must be operational by Jan. 1, 2010, and allows for people to petition the court to restore their gun rights.

Whether or not the state gets the federal grant will have no bearing on its progress on the registry.

"We'll worry about the 'what ifs' when that happens," Bundy said. "However, the court will comply with the (law) by Jan. 1, 2010, no matter what."

West Virginia has received a total of $6.1 million in NCHIP grants since 1995. The state did not receive any awards in 2006 or 2007, according to the Justice Department.

Marsha Dadisman with the state DHHR said the majority of the people placed on the registry will be those who are ordered into a mental health facility - either permanently or temporarily - by a mental hygiene commissioner.

Those found unfit to stand trial because of mental illness will be a much smaller portion of the group, Dadisman said.

As of June 4, there were 708 people housed in mental facilities in the state, Dadisman said.
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Providers fighting for funding -Sarasota (FL) Herald Tribune

By Dale White - Aug. 25

Suicidal teenagers, drug addicts trying to get clean and low-income residents who need mental health treatment could be left with nowhere to turn if a proposed state funding cut happens next year, local agencies say.

If the state Legislature cuts $16 million that goes toward nonprofit mental health agencies, as it is bracing to do next year, those who provide that care predict dire consequences.

When those who need help cannot get it, taxpayers then must contend with the negative impact on schools, jails, courts, emergency rooms and other services, providers say.

"We can pay for it when we can do some good or when you have to pick up the pieces," said Mary Ruiz, chief executive officer of Manatee Glens Hospital and Addiction Center in Manatee County.

Last week, Ruiz invited numerous candidates for state and local offices to Manatee Glens to meet the staff and hear her pleas. Many of the officials and candidates agreed that the potential cuts could have widespread ramifications and indicated that, if elected, they will lobby to save the programs.

In Sarasota, Manatee and Charlotte counties, more than $3 million in funding for core programs is at stake.

With sales tax revenues dropping, legislators this spring examined what programs they can cut for the budget that takes effect on July 1, 2009. They looked at several programs funded through the Department of Children and Families that originated as "special projects" but have continued to receive state dollars.

In the current budget, legislators instead labeled that $16 million as "non-recurring revenue." That means they promised to keep those programs running for this year only. Unless they restore those line items in the 2009-10 budget, the programs will be automatically deleted.

"Some of these projects date back a decade," said Bob Sharpe, executive director of the Florida Council for Community Health. "They are now considered essential parts of the health care structure in these communities."

First Step of Sarasota could lose $900,000 for a 20-bed treatment center for adolescent drug addicts, and $278,000 for treatment and prenatal services for pregnant addicts could go away.

Coastal Behavioral Healthcare Inc. in Sarasota may lose $500,000 for a family emergency treatment center. The center provides mental health counseling and other services for people, usually uninsured, who otherwise might end up in emergency rooms or with no care at all.

Manatee Glens faces a potential loss of more than $1.5 million. Ruiz estimates that one out of every 30 families in Manatee County could be affected.

Manatee Glens would have to close its walk-in center that offers free mental health counseling to about 3,000 people annually, Ruiz said. It would also have to close its crisis center that treats children and teenagers who are suicidal or have other severe emotional disturbances.

Ruiz said a children's community action team would be disbanded. The team is available 24 hours a day to provide in-home care of children with extreme behavior disorders to help overwhelmed parents and keep the children out of foster care or the juvenile justice system.

Charlotte Behavioral Health Care CEO Jay Glynn said his agency could lose $90,000 for medical expenses, such as dental care and medications, that Medicaid or Medicare will not cover for residents in a 16-patient mental health facility it operates for the elderly.
Read more!

SBI probing patient's death -Raleigh (NC) News & Observer

Michael Biesecker

RALEIGH - The district attorney for Wayne County has asked the State Bureau of Investigation to review the inaction of Cherry Hospital employees who played cards and watched television as a dying patient sat unattended a few feet away.

Hospital administrators and internal police have not always provided all evidence against their employees, District Attorney C. Brandon Vickory III said Monday. Last week, he invited the SBI to investigate the death of Steven H. Sabock, 50. A patient at the Goldsboro state mental hospital, Sabock died after choking on his medication, hitting his head on the floor and then being left in a chair for 22 hours without food or water.

In the last two years, Vickory's office has dropped cases against at least six hospital workers arrested for assault. Vickory, prosecutor for Greene, Wayne and Lenoir counties, said Monday that the facts of what happens inside the state mental hospital are often murky. But on April 29, a security camera captured footage showing the hospital's staff ignoring Sabock sitting in a day room through parts of four shifts, according to a report issued by federal regulators last week.

The written account of the death that hospital administrators sent the Wayne County medical examiner that month makes no mention of the choking or fall, however, saying only that the patient "was sleepy all day, and that oral intake was poor." The pathologist concluded that Sabock died of natural causes.

Vickory said he was disturbed by the federal findings.

"Everybody's not sitting on their hands on this one," Vickory said. "But there's at least two two sides to every story, and we've got to get them both."

On Aug. 8, Vickory's office dismissed a misdemeanor assault charge against Tonivia Bryant, a Cherry health care technician arrested by hospital police in May after officers said she hit a woman in the face and head.

Exchange of violence

According to a police report, the patient assaulted Bryant and was restrained. Once the woman was held down, Bryant attacked the patient, striking her 11 times, the report said. Bryant then had to be physically restrained by other employees to stop the assault, which was recorded by a hospital security camera, according to the report.

Vickory said Monday that hospital police and administrators never told his office about the video footage of the assault.

After Bryant was arrested, Vickory said, she went to a magistrate and swore out a misdemeanor assault complaint against Lakeisha A. Harris, the patient she was accused of assaulting.

Both were given the same court date, and Vickory said the two mutually agreed to drop the charges against one other. Without knowledge of the video, Vickory said, the assistant DA handling the case agreed to the deal.

"Everybody apologized and hugged and there was sort of a 'Kumbaya' moment," Vickory said. "Sometimes it works out that way."

Harris, who could not be reached Monday, was not represented by an attorney in court or in the negotiations with the assistant DA and Bryant's lawyer.

Vickory said his assistant assured him that Harris seemed to know what she was doing.

Bryant said Monday that she was the victim, but didn't dispute that she hit Harris while the patient was being restrained by other employees.

"She hit me and pulled my hair," Bryant said Monday. "What I did was a natural human reaction. I was defending myself."

Bryant was fired and said she has had difficulty finding health-related work because of Cherry Hospital's reputation.

Retaliation forbidden

Hospital staff are trained to use specialized defensive techniques when they are attacked, but a state law regarding the use of force in mental hospitals bars staff members from retaliating with violence.

Jack St. Clair, the hospital director, has not returned calls requesting comment about Sabock's death or the arrest of two more employees on Friday for beating a patient last week.

Noelle Talley, spokeswoman for Attorney General Roy Cooper, said two SBI agents sent to the hospital are from the attorney general's Medicaid Investigations Unit -- a team of lawyers, investigators and auditors that reviews and prosecutes allegations of physical abuse of patients in facilities that receive Medicaid money.

Another assault

In addition to Sabock's death, the agents will also review the assault of a teenager with developmental disabilities.

Ricky Luciano, a patient, was struck in the back by Cherry psychiatrist Ralph Berg during a tussle over a T-shirt. The incident occurred April 28, the same day Sabock choked and fell. The doctor told investigators he hit Luciano after the patient bit him.

Though hospital cameras also captured that incident, Berg was never charged.

Federal officials have cited Cherry for serious deficiencies in the care of both Sabock and Luciano, and have threatened to cut off millions in Medicaid and Medicare payments from the hospital.

michael.biesecker@newsobserver.com or (919) 829-4698 Read more!

Hospital takes steps to keep money -Raliegh (NC) News & Observer

Lynn Bonner

The state mental hospital in Goldsboro retrained nurses on patient care this month in hope of keeping federal money.

Last week, Cherry Hospital director Jack St. Clair sent federal officials a list of corrective actions, which included training sessions for all nurses and health care technicians held from Aug. 13 to 19 and 15 days of extra monitoring in admissions wards.

The state hopes to convince the federal government that the hospital should keep its money despite a case of negligence that has become a national example. Earlier this month, outside investigators found that a patient, Steven Sabock, 50, was left in a chair more than 22 hours without food or help going to the bathroom. He died April 29.

Video cameras recorded staff members playing cards and watching television in the day room where Sabock sat.

Last week, the head of the agency that oversees state mental hospitals said staff members who neglected Sabock were removed from regular jobs for "re-education." The hospital closed the ward where Sabock died.

Standards chief Mabel Sudderth was reassigned, although St. Clair's letter names her as contact person about the correction plan.

Critics said the hospital did not take quick or forceful action.

"If someone is responsible for a death on videotape, they get fired," said Debra Dihoff, executive director of the National Alliance on Mental Illness in North Carolina. "There's something very wrong with the culture in our state hospitals."

The hospitals have a history of problems. In the past year, the federal government has threatened to take money from all four.

After Sabock's death, Cherry's own investigation identified 16 staff members who were negligent or broke policies. Discipline for 13 ranged from counseling to five-day suspensions. One nurse resigned during the investigation. The fate of the other two is unclear.

The correction plan said that all nurses involved were reported to the N.C. Board of Nursing, and all health care technicians were reported to the health care personnel registry run by the DHHS.

The hospital added the training and monitoring because investigators made clear that Cherry had not done enough, said Jim Osberg, the DHHS administrator in charge of state institutions.

State Rep. Verla Insko, a Chapel Hill Democrat, said Sabock's death was the latest evidence of long-standing problems.

"I think we have to beef up our hospital administration at the state or the institutional level, or maybe both," said Insko. "Maybe bring professional hospital administrators in. We tend to promote from within the system."

lynn.bonner@newsobserver.com or (919) 829-4821 Read more!

Judge signs Hayes order - Winston-Salem (NC) Journal

By Dan Galindo - Journal Reporter

A judge signed an order yesterday sending Michael Hayes, the man who killed four people and wounded five in 1988, back to a state psychiatric hospital for another year.

Hayes, who was found not guilty of the crimes by reason of insanity, had agreed with prosecutors last week to go back to Dorothea Dix hospital voluntarily. All that was left was for Stuart Albright, a Superior Court judge, to sign the order yesterday morning.

Hayes agreed to it in part because state officials recently decided that he would not be moved to the state's new psychiatric hospital, Central Regional, said Karl Knudsen, his attorney.

"What that did was it removed that urgency that we felt, that we absolutely felt we had to get this hearing done if he was going to get moved," Knudsen said. "If he got moved, he was going to lose his treatment opportunities."

Hayes has the right to a hearing each year to try to show a judge that he's no longer mentally ill or no longer a danger to others. If he can show that either is true, the law requires a judge to release him unconditionally.

Hayes would have lost at least three treatment programs if he had been moved, Knudsen said:

□ Hayes works about 50 hours a week as part of a program, called Reintegration Through Work, that wouldn't be available to him at Central Regional, Knudsen said.

Hayes supports his girlfriend and two children. Knudsen said that they would probably have lost their house if Hayes lost his job.

□ He also would have had trouble visiting his family, which he can do from Dix for about a week per month, unsupervised. Dix is in Raleigh; Central Regional is 30 miles away, in Butner.

□ Hayes lives in a cottage at Dix, where the hospital's workers check in on him a few times a day. No similar living situation is available at Central Regional.

Hayes is a patient in Dix's forensic unit, which evaluates people awaiting trial and treats those determined to be mentally incompetent to stand trial, or found not guilty by reason of insanity. His treatment programs are designed to prepare him to rejoin society.

Knudsen had been considering filing a lawsuit to stop the state's plan to move Hayes and others to Central Regional, arguing that keeping them at a hospital that does not offer the treatment they need is a violation of their constitutional rights.

It's not clear when state officials changed their minds about moving Hayes and other forensic patients in similar programs.

Tom Lawrence, a spokesman for the N.C. Department of Health and Human Services, confirmed that the agency's plans changed, but he didn't know when the decision was made or who made it.

Disability Rights North Carolina, a nonprofit that advocates for people with mental illnesses and people with developmental disabilities, met with DHHS officials about plans to move the entire forensic unit to Central Regional. Knudsen said he found out last week that Hayes would stay at Dix from attorneys at Disability Rights.

Susan Pollitt, an attorney for the group, said it would not comment on those discussions with DHHS.

The new hospital opened in July and was meant to replace Dix and John Umstead hospitals.

Knudsen is among the many observers who have said the state's plans for improving mental health have been haphazard and ill-conceived.

"Apparently the forensic unit didn't get a lot of consideration," he said. "There were some things that just weren't very well thought through."

■ Dan Galindo can be reached at 727-7377 or at dgalindo@wsjournal.com. Read more!

Man guilty but insane in dad's death - Associated Press

Associated Press

A man who fatally stabbed his father last winter has been judged guilty except for insanity and placed in the custody of the Oregon Psychiatric Security Review Board for the rest of his life.

Andrew J. Siegel, 21, was charged with murder in the Jan. 6 death of Martin Siegel, a mechanical engineer with the U.S. Army Corps of Engineers. Prosecutors said the father died from a stab wound to the chest that was delivered in the kitchen of the family's rented home in Lowell, southeast of Eugene.

Siegel was returned Monday to the Oregon State Hospital, where he had been sent after being found mentally unfit to stand trial Feb. 19. After several months of treatment, state corrections officials returned him to Lane County this month, saying he had improved enough to assist in his defense.

Appearing Monday before Lane County Judge Mary Ann Bearden, Siegel waived his right to a jury trial and acknowledged that prosecutors had enough evidence to prove he intentionally murdered his father.

Herlinda Siegel, Martin Siegel's wife and Andrew Siegel's mother, did not speak at the hearing. Afterward, she told The Register-Guard newspaper that her son is going to get the care he needs.

"I had a loving family," she said. "I had a loving husband. I had a loving son. And they loved each other. They were friends. They were buddies. It's just this horrible illness. I don't know what goes through people's heads."

In a report issued in February, a psychologist wrote that Siegel was diagnosed with paranoid schizophrenia as a teenager, and at the time of the stabbing had been taking two anti-psychotic medications and two anti-anxiety drugs. He had no prior criminal history.
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A setback, then a chance to help others -Kansas City Star

By MALCOLM GARCIA

Sometimes her clients don’t know she can’t see.

She puts two tape recorders on her desk at Community Employment Inc., a nonprofit that helps people with disabilities find and keep jobs.

The tape recorder on her left will ask them a series of questions about their work history; the one to her right documents their answers. Later, she will enter their answers in her computer. But at the time of the interview, she turns, faces the sound of their voice and listens without the slightest hint that she can’t see them.

“Physical disability doesn’t mean mental disability,” Christine McDonald says of her clients, all of whom, like her, are blind or have very low vision.

“People don’t understand what we’re capable of.”

After years on the street selling her body for crack, Christine cleaned up but then lost her eyesight in 2005 when she was pregnant with her son Ricky, now 2. Her blindness resulted from an inflammation called uveitis. Blood vessels burst during her pregnancy, her eyes swelled and she lost her sight. Her right eye was removed.

Last year, physicians at the Barnes Retina Institute in St. Louis operated on her remaining eye, hoping to restore some vision, but the surgery was not a success. For months, she considered going overseas for stem-cell treatments, but the costs were prohibitive. Then Christine learned that her remaining eye was so unhealthy it would have to be removed.

Her stomach sank to the ground. She had held onto that eye and the hope for treatment so one day she could see the face behind Ricky’s giggle. Blindness had allowed her to see people from the inside out. It hadn’t been horrible, but it was not the same as seeing, really seeing. She tried not to think about it too much.

Instead, she completed her high school degree and enrolled in Metropolitan Community College. In June, she decided it was time to find a job.

“I came into my kitchen, did some dishes and decided to look at Craigslist,” she recalled from her trailer park home, where she has a computer equipped for blind users. “I found a person-wanted ad to help people with disabilities. Honey, I was on it.”

She noticed one detail: Valid driver’s license required. She ignored that, but Derrill Grim, program supervisor at Community Employment, 819 Walnut St., could not. After a short interview, he turned her down.

But while she waited on the first floor for a ride home, he reconsidered.

“She had such a bubbly attitude,” he said, “having a disability and not letting it stop her. It was real refreshing. It was amazing.”

After several minutes, Grim walked downstairs and told Christine he would give her a try.

“She’s great, real warm and friendly,” he said. “After what she’s been through, it doesn’t happen. Most of us, if we don’t get our two pumps of latté, our day is damaged. Not her.”

• • •

On a Monday morning, Christine, 39, arranged her tape recorders, sat back and collected herself with a cup of coffee. What’s better for a blind girl than coffee delivered to your office, she quipped.

It had been an interesting weekend. The hallway floor of her trailer in east Kansas City collapsed and only a brown rug covered the gaping hole. She will have to replace it, but doesn’t know when. Still, the trailer is better than a lot of places she has lived. A neighbor, Benny, and his mama cut her grass. Ricky has a yard to play in. When he wants her outside with him, he takes her hand and leads her down the three front steps.

There you go, he says.

No one knocks on her door at odd hours. She has a nice, quiet place, even if she has never seen it, even if it is floorless at the moment.

Christine shook loose thoughts of her home, refocused on her job and considered some of her clients. She makes cold calls to employers, but too many sighted people don’t see how blind people can work. They can, using adaptive equipment. They just need employers to suspend their disbelief and give them a chance, as much as blind people must give themselves a chance.

Oh, I’m blind, some clients tell her. Honey, she responds, I’ve been blind for three years. Get over it. It is what it is. That’s the truth. What are we going to do about it?

“Hi, this is Christine McDonald at Community Employment. We help people with disabilities get employment. I’m calling to see if you have positions open we could send some people to apply for. OK. Thank you.”

She put the phone down.

“Call back. Everyone’s always in a meeting.”

She has two men who have graduated from community colleges. One tried for a receptionist position, but was up against 175 other applicants. Christine had no doubts he was fully capable, but going up against that many people and being disabled? She shook her head, knowing she would have to continue working with him.

The other gentleman is an artist. Christine has decided to introduce him to a blind man who makes birdhouses to show him it is possible to pursue his vocation. The fingers of her left hand crab-walked to a phone and she punched in a number.

“Hi, Pete, how the heck are you? I’ve got a client, he’s blind and he wants to work with wood. Anyway, I could set him up with you and bring him over? Thursday? That’ll work. I’ll put you in my book. I’ve always wanted to say that.”

She called her client.

“Hey, you, how the heck are you? You sound out of breath, you cutting your grass? Bless your heart. You want to hang out with a blind carpenter who builds birdhouses for a living? You would, wouldn’t you? You tell me a time, and I’ll tell him.”

She put the phone down.

“He told me he stole his neighbor’s lawn mower to fix his. I won’t touch that.”

• • •

Twice a month after work, Christine and her friend Kris Judd, a minister at Community of Christ Church, buy bottled water and dozens of cheeseburgers and drive Independence Avenue looking for people in need.

Christine once worked around Independence and Spruce avenues. Nobody made her leave as she stood on the corner, and although she can no longer see it, she has never forgotten it or the men and women still out here. She sure wished someone had given her a hamburger a time or two. Water, food, socks in the winter.

“Here’s a man,” Judd said on a Thursday evening.

“Want a burger?” Christine shouted out the window.

The man, stoop-shouldered and staggering slightly, kept walking.

“Is he coming?”

“No.”

“I sure wish I could see.”

They drove to a slanted house just south of Independence Avenue on Sixth Street where they had stopped before. A puppy romped in the overgrown yard, dashing around a shopping cart stuffed with cans and scrap metal. The door opened and an elderly woman peered out.

“You hungry?” Judd shouted. “How many you got?”

“Me, my old man, sister, my granddaughter.”

Christine began counting out 12 burgers from paper sacks, feeling each one.

One, two, three. . .

She hasn’t given up hope that one day she will regain her sight. She plans to meet with doctors at the University of Utah to discuss the possibility of joining a cortical implant study for artificial vision.

Abruptly, she stopped counting. Think about it. From six prison stints to 20 years off and on the street to working downtown. Wow. She resumed counting, accepting the idea that despite herself she has become a successful blind person. She even has health insurance and might get sick for the pleasure of seeing a doctor and getting some attention.

… eight, nine, 10 …

Her good fortune is not the same as seeing, but as she picked up the stack of hamburgers, and Judd looped a hand around her elbow to guide her toward the house and the family waiting, Christine asked herself the question she poses to her clients:

Honey, what are we going to do about it?
To reach Malcolm Garcia, call 816-234-4328 or send e-mail to mgarcia@kcstar.com Read more!

Dallas VA Medical Center praised for swift upgrades after suicides - The Dallas Morning News

By SCOTT FARWELL / The Dallas Morning News
sfarwell@dallasnews.com - Monday, August 25, 2008

The U.S. secretary of Veterans Affairs and Sen. John Cornyn on Monday praised administrators at the Dallas VA Medical Center for what they called an "aggressive response" to four suicides by mentally ill patients earlier this year.

Hospital administrators closed the psychiatric ward for 45 days, solicited input from two panels of experts and retrofitted the 68-year-old wing to increase patient safety.

"The most important thing is what you do when you realize you have a problem," said Veterans Affairs Secretary James Peake. "The lessons learned here will be translated throughout the [Veterans Affairs] system."

The VA Office of Medical Inspector and a team from the VA Office of Mental Health Services evaluated the psychiatric unit less than a month after it was closed in April. Their reports included a recommendation to remove some suicide risks – such as metal trash cans, linen hampers and geriatric chairs in the showers – but did not criticize the care veterans received.
MARK M. HANCOCK/Special Contributor
MARK M. HANCOCK/Special Contributor
Veterans Affairs Secretary James Peake checked in on patient Jonni Booth Carnley of Hugo, Okla., on Monday while touring the Dallas VA Medical Center, including the psychiatric unit, which was closed in April after four patient suicides
View larger Photography Photo store

Veterans Chris Demopolis and Pat Ahrens committed suicide in January, days after being released from the government hospital on Lancaster Road in southeast Oak Cliff. A few months later, two other patients hanged themselves in the 51-bed unit.

Within days, administrators stopped accepting new patients, transferring veterans to government and private hospitals in Dallas.

Doctors' quick response and candor earned kudos from Mr. Cornyn, R-Texas, a member of the Senate Armed Services Committee.

"It is a testimony to the responsiveness of the VA that they have taken this seriously and they have been open with the press and public," said Mr. Cornyn, who added, "The staff at the Dallas VA has demonstrated they are committed to making significant improvements to the facility and the level of care provided. I was pleased to see progress under way and will continue to closely monitor these enhancements."
Read more!

Students may stop mental health medication -UPI

CLEVELAND, Aug. 25 (UPI) -- U.S. researchers want to know if college students taking psychiatric medications experiment with stopping their medication while away at college.

Case Western Reserve University researchers in Cleveland said that the National American College and University Health Services reports that about 20 percent of the students visiting counseling centers are on prescribed medications for a range of mental illnesses from depression, bipolar disorder to attention deficit disorder.

Researchers are beginning a two-year campus-based study, which will also contribute to a larger international project, under the direction of McGill University in Montreal investigating the social and cultural differences associated with taking psychiatric medication among college students in Japan, Canada and the United Kingdom.

Jerry Floersch and colleges at Case Western Reserve University are examining not only how the students taking psychiatric drugs are managing the transition from home to college, but what faculty members do when students disclose they have a mental illness.

The researchers will conduct a quantitative survey of 120 undergraduates and conduct intensive qualitative interviews with 15 first-year and 15 third-year students about their experiences with their illnesses and management of medications over a two-year period.
Read more!

Kansas to issue permanent Medicaid cards -KSNW-TV Witchita (KS)

TOPEKA, Kansas, August 25, 2008 (AP) - Beginning in September, Medicaid beneficiaries in Kansas will be issued permanent identification cards to replace the monthly paper cards they currently receive.

The Kansas Health Policy Authority said it will issue the new cards beginning Sept. 1, as part of an effort to reduce the administrative costs in state health care.
Story continues below ↓advertisement

The health authority said the new plastic cards will have a magnetic stripe on the back that will allow providers instant access to the beneficiary's eligibility through the health authority's Medicaid Management Information System.

The state has about 275,000 Medicaid recipients. Read more!

Man Who Died At Hands Of Police Acquitted For Insanity - NBC4-TV Columbus (OH)

Chris Dumond

AMHERST, Va. --A man who died while in the custody of Amherst County Sheriff's deputies in 2005 was acquitted by reason of insanity in a 1997 Richmond homicide and committed to a state mental hospital, newly released records show.

Sanchez Taylor's death is at issue in a $15 million wrongful death lawsuit against four Amherst deputies accused of suffocating him during an arrest in June 2005.

Hundreds of pages of records were filed in the federal civil suit in advance of hearings last week. Thursday, the lawyer for the deputies asked Judge Norman Moon to throw out the case, and Friday, lawyers sought to settle the case in a mediation hearing.

Moon had not filed a decision in Thursday's hearing, nor had any settlement filings been made as of late Friday. The suit is scheduled to go to trial next month.

The hearings came a week after a special commonwealth's attorney filed a report in state court clearing the deputies of criminal wrongdoing.

According to the newly filed documents:
- Taylor was released from a state mental hospital in 2003 and was being monitored at the time of his death by the Central Virginia Community Services Board;
- Deputies say no one handled the man in a way to restrict his breathing and that they used the least amount of force possible to get him under control;
- Dr. Gregory Wanger, the medical examiner who autopsied Taylor, said the injuries that suffocated him were caused by the deputies, although they may not have intended to kill him or have known what they were doing to him was hurting him, and;
- Medical experts hired by the deputies have filed reports stating Taylor's death was an accident, though the judge has ruled the medical experts can't testify should the case go to trial in mid-September.

According to law enforcement statements filed with the court, Taylor was seen on June 16, 2005, running away from his car, which he had parked in the passing lane of U.S. 29 in Amherst County. Within minutes, a witness called police to report Taylor appeared to be trying to break into Bethel Welding, a nearby business.

Shortly after, deputies Debbie Tinnell and Darren Givens found Taylor at the back of the welding shop and tried to arrest him. They say Taylor fought them, although he was handcuffed on a metal ladder. When they tried to carry him off the ladder, he continued to fight, they say, and he was put down on a metal rack. Then, two more deputies, Brian Drewry and Kelly Dodson, arrived and helped pick up Taylor, still fighting.

A few feet later, still unable to get him under control, the officers put him on the ground. As a fifth deputy, Betty Wise, came on the scene, deputies noticed Taylor was having trouble breathing and was having a seizure.

Taylor never recovered and died within two hours.

His mother's lawyer contends the deputies held him down on the ladder and metal rack despite her assertion that he was clearly having a mental episode. She contends they crushed his stomach, suffocating him and starting a chain reaction inside his body that killed him.

Richmond Circuit Court records show Taylor was indicted in 1997 on charges of murder, attempted murder and two related gun crimes in the shooting death of his friend, 22-year-old Carey Hughley III. According to a court record filed by a defense medical expert, Taylor shot Hughley in an attempt to "recycle the victim's soul into heaven."

A year later, Taylor was found not guilty by reason of insanity by a Richmond judge. He was subsequently committed to Central State Hospital in Petersburg, court documents show.

A few days after the fifth anniversary of the killing, the court ordered Taylor to be released under strict supervision by the Central Virginia Community Services Board here in Lynchburg, where his parents and grandmother lived.

During her deposition, Lynn McBride, a Central Virginia Community Services counselor who worked with Taylor, said he had been diagnosed with schizoaffective disorder, bipolar type.

According to the Diagnostic and Statistical Manual of Mental Disorders, the disorder can include hallucinations, delusions, disorganized speech, catatonic behavior, major depression and mania.

She said he occasionally discussed the 1997 killing and admitted he was responsible.

Under community services care, he was first given his medicine at his home by a staff member twice a day to make sure he was taking it, McBride said. Some time later, he was allowed to take his morning dosage on his own because he would leave for work before a community services worker could meet him.

By January 2005, though, things were starting to break down, McBride said. Community services then wrote a letter to the Richmond court asking for Taylor to be warned about compliance. When there was no response, another letter was written in March.

According to court records, this resulted in a hearing in May, the month before his death, in which Taylor was given another 90 days to comply with the conditions of his release.

A note written by McBride in Taylor's file, referenced in the deposition, notes that McBride and Taylor's mother were confused by the circumstances of his death since he had a good session with counselors the day before.

McBride also told the lawyers that Taylor had always tested clean in drug screens leading up to his death in spite of the fact that he tested positive for low levels of cocaine when he was admitted to the hospital.

In addition to cocaine found in his car, a large quantity of his psychiatric medicine was found as well, McBride noted in Taylor's file.

"Sanchez had a month's worth of meds, but (I) don't know over what period he didn't take them," she wrote.

Statements of the five deputies who participated in Taylor's arrest note that none of them had any history with the man or were aware of his medical or legal background.

Of the four who handled Taylor, their statements all note that the man fought with them continuously, did not comply with their orders, that he did not speak through the entire encounter and that they did not crush him or do anything to suffocate him.

The statements all note that the deputies did the least they could to restrain Taylor and get him under control. Those statements go on to note that when Taylor appeared to be having problems, his handcuffs were taken off and that deputies who were trained as emergency medical providers tried to help him.

In more than 60 pages of transcribed deposition, Dr. Gregory Wanger, the Roanoke-based state medical examiner who autopsied Taylor, said there were clear signs of restraint and suffocation. Wanger assigned Taylor's cause and manner of death as homicide and suffocation due to multiple restraints with cocaine abuse and heart disease as contributing factors.

Wanger said deep tissues inside Taylor's belly showed bruising and evidence of compression. He said compression like this could have kept Taylor's diaphragm from flattening enough to let him breathe.

"This comes as a surprise to some people," Wanger said. "Even though their mouth and their nose and so on is open, they can't breathe."

He also noted that not everyone with this kind of injury dies right away, but instead the suffocation causes a "cascade" of events resulting in death, especially considering his other medical problems.

Although defense experts attribute Taylor's death to a condition called excited delirium, Wanger denied it was involved in this case because of evidence Taylor's abdomen was compressed while he was on the ladder and metal racks.

In the deposition, he said the ruling of homicide did not imply the deputies meant to kill Taylor, just that he died at the hands of another.

He said he couldn't put himself in the shoes of those deputies, but if he could, he would have expected Taylor to be making some noise while he was on the metal racks.

"And the fact that you are not able to make a noise and you're maybe making some mumbling noises, I guess, in my head, I would say, 'well, you know, do we've got an airway problem or what?' I mean, there is something going on," he said.

"But I have medical training they don't have."

Two medical doctors consulted by the deputies' lawyer filed reports that contradict the official medical examiner's findings.

Dr. Edward Gordon, a medical examiner from Farmville hired by the defense attorney, stated he doesn't believe Taylor could have fought as hard as he did with police if he was being suffocated.

Instead, Gordon reported, Taylor died of excited delirium, a fatal combination of problems brought on by the stress of resisting arrest, the man's mental illness, cocaine use, high cholesterol and the heart disease found during the autopsy.

Dr. Daniel Davis, a state medical examiner in Oregon, reached a similar conclusion and also noted that if he had been suffocated while struggling on the ladder and metal planters at Bethel Welding, he would not have been able to continue struggling with the deputies after they tried to drag him away.

An Aug. 6 order by Judge Moon is likely to keep the medical experts for the deputies from testifying and disputing Wanger's findings.

An earlier court order gave the deputies until late March to file a list of expert witnesses, but they did not file until June 30, Moon found.

Under the judge's order a former FBI agent hired by the deputies to review the case would also be barred from testifying about his conclusion that they did nothing wrong.

Stay tuned to NBC 4 and refresh nbc4i.com for the latest news and information.

To send a news tip or submit a story idea, e-mail stories@nbc4i.com.
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Restraining of mentally ill foster kids questioned -Miami Herald

BY CAROL MARBIN MILLER - August 25

Last month, a 16-year-old Broward County girl was brought into Circuit Judge John A. Frusciante's courtroom for a hearing. She was handcuffed, her legs shackled with cloth restraints, with two armed deputies leading her by the arm.

Her offense? She's never been charged with one. A mentally ill foster child who was neglected by her mother and wound up in a psychiatric center, the teen was being restrained to keep her from running away, her attorney said.

The girl, who is not being identified to protect her privacy, is among scores of foster children in locked psychiatric centers in Florida recovering from abuse and neglect.

Now, the practice of restraining mentally ill foster children in court is prompting questions in both Broward and Miami-Dade counties.

In Fort Lauderdale, Walter Honaman, the 16-year-old's lawyer and an advocate for foster kids, is working with Frusciante and court officials to develop a voluntary policy to discourage deputies from handcuffing mentally ill foster kids who come to court.

And in Miami, a nurse practitioner who worked briefly as a director of patient care at Jackson Memorial Hospital's mental health center filed complaints with state regulators seeking to end the practice of restraining children who leave JMH's residential treatment center, or RTC.

''We bring these kids into the courtroom in handcuffs with armed deputies,'' said Honaman, who works for Legal Aid Service of Broward County. 'That's nuts. We don't maintain these kids' dignity, and we send the message that they are being punished. They are being treated like criminals. These are kids that need serious help.''

Administrators at Jackson have defended the use of ''walking restraints'' when children from their treatment center leave the facility, arguing many kids run away, which can endanger them.

The treatment center ''uses walking restraints for safety and prevention of elopement when clients are sent to an urgent medical appointment or court hearings that they can't miss early in their admission,'' Helga Mayrgundter, a program director for one of JMH's children's psychiatric units, wrote in an April e-mail.

Lorraine N. Nelson, a JMH spokeswoman, said the children's psychiatric unit uses walking restraints on less than 1 percent of its patients when they are being transported outside the facility, and follows all regulatory agency guidelines.

''The fabric restraints are only used when a patient is determined to be a flight risk and are removed immediately after a patient has returned safely to the facility,'' Nelson said. ``A board-certified psychiatrist with extensive experience in childhood trauma and behavioral management must write an order for the use of restraints.''

Jackson's use of foot restraints came under scrutiny beginning in April, when a new nurse administrator questioned the practice. The nurse, Lisa Burton, later filed complaints, including one to the Miami-Dade County Commission on Ethics and Public Trust.

The ethics commission ''conducted a thorough investigation of the allegations and ultimately dismissed the complaint,'' said JMH's Nelson. The commission findings, ''speak for themselves,'' she said.

In an April em-ail with other JMH administrators, risk manager Tish Batchelder wondered whether halting the restraints would lead to more escapes, thus ''putting patients in danger.'' But she also acknowledged: ``I hate the idea that we do it.''

Real leg shackles -- the metal kind -- routinely have been used for delinquent children who appear in court, though several public defender offices mounted a statewide campaign two years ago to end the practice. In most counties, shackling continues, said Miami-Dade Public Defender-elect Carlos Martinez, but The Florida Bar is lobbying for a new rule requiring hearings before restraints can be used.

Some judges say there is even less justification for restraining mentally ill foster kids who have not been accused of delinquency.

''It's a horrible stigma,'' said Miami-Dade Circuit Judge Cindy Lederman, who heads Miami's juvenile courts. ``These kids already have mental health problems. I would imagine this would exacerbate them. . . . These are not bad children, and they have not done anything wrong. They are just ill.''

Frusciante said he has been asking questions of treatment center and courthouse staff members who bring children to court in restraints. Among them: Do we have to do this?

''It was very disturbing,'' said Frusciante, who oversees child welfare cases in Broward. He said he wasn't disturbed enough to outright ban the practice at the courthouse, but he is working with Honaman to find ways to limit the use of restraints.

Most treatment centers elsewhere in the state have abandoned the use of restraints, according to internal JHM e-mails obtained by The Miami Herald.

''We do not use them here when we transport children,'' said Robyn Baskin, a children's program director at Personal Enrichment Through Mental Health Services in Pinellas County. If a child is too great a risk, Baskin said, travel will be postponed or additional staff i Read more!

Britain's 'Iron Lady' has dementia: Thatcher's daughter - Toronto (Canada) Globe and Mail

August 25, 2008

LONDON — Former British prime minister Margaret Thatcher — once known as one of the world's most formidable political minds — has been suffering from dementia for the past seven years, according to her daughter, Carol.

Carol Thatcher tells in her memoirs of how her 82-year-old mother, nicknamed the "Iron Lady" for her tough reputation, often struggles to remember things and repeats questions.

In a memoir serialized in the Mail on Sunday newspaper, her daughter paints a picture of a very different woman from the political heavyweight who strutted the world stage in the 1980s.

"The woman who had dominated discussions for so long could no longer lead debates or keep up with the thread of a drinks-party conversation," she wrote.

"On bad days, she could hardly remember the beginning of a sentence by the time she got to the end."

Thatcher rarely appears in public these days after being advised by doctors in 2002 that she should avoid public speaking following a series of minor strokes.

People suffering with dementia have a significant loss of the mental skills that affect daily life. It is caused by various factors such as strokes, tumours, head injuries and Alzheimer's disease and affects some 700,000 people in Britain, around two-thirds of them women.

Carol Thatcher said the first sign of dementia appeared when her mother was about 75, when she confused the Falklands and Bosnian conflicts in a conversation over lunch.

"I nearly fell off my chair," Carol Thatcher wrote, according to excerpts of the book which will be published next month. "Watching her struggle with her words and her memory, I couldn't believe it. She was in her 75th year but I had always thought of her as ageless, timeless and 100 per cent cast-iron damage-proof."

Thatcher took power in Britain in a general election on May 3, 1979, becoming the nation's first and only female prime minister. She left the famous Number 10 Downing Street office after a record-breaking 11 years in power.

At the peak of her powers in the early 1980s, Thatcher's sheer strength of personality made her one of the West's best known figures, famous for "handbagging" her opponents into backing her, or at least backing down.

Carol Thatcher wrote that one of the most difficult episodes in recent years had been the death of her father Denis Thatcher in 2003, which her mother often forgot had happened.

"Losing Dad ... was truly awful for Mum, not least because her dementia meant she kept forgetting he was dead," she wrote.

"I had to keep giving her the bad news over and over again."

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Valley council to assist mental health recovery - New Haven (CT) Rebister

By Patricia Villers - Aug. 25

ANSONIA — Birmingham Group Health Services has formed a Peer/Family Advisory Council in an effort to assist individuals and families dealing with mental health issues.

Rebecca Collyard, family advocate at Birmingham Group Health Services, is coordinating the council. She said Thomas P. Kirk, commissioner of the state Department of Mental Health and Addiction Services, will be guest speaker at the council’s kickoff next month.

The first meeting will be held at 6 p.m. Sept. 11 at the organization’s main office, 435 E. Main St. Light refreshments will be provided. The council will meet monthly.

Birmingham Group Health Services is a behavioral health organization based in Ansonia.

Trudy Higgins, the agency’s vice president of services, said, “Recovery is so key. The view is everyone can work toward a level of independence.”

Higgins said people with mental health issues are no longer just being “maintained” with medication and treatment. “We are maintaining hope that people will move forward and recover,” she said. “That’s the underlying philosophy of the Birmingham Group. We believe in recovery.”

Collyard said the council’s monthly meetings will focus on three areas. “We will be alternating the meetings on (the topics of) education, first-hand information and support,” she said. “We will alternate because those three things are something consumers need.”

Collyard said mental health issues are seen “across the life-span. We are seeing children and the elderly having mental health issues, and we can help to get them in services.”

Higgins said, “Many times people don’t know where to go” for assistance with their mental health problems. “We can direct people,” she said.

Collyard said the Valley used to have a National Alliance for the Mentally Ill chapter, and now the closest chapters are in Trumbull and Hamden. The council will serve as a place for those family members and consumers to turn for information and support, she said.

“If you don’t get the support you need, the situation is going to get worse,” Higgins said.

Collyard said the council concept stems from a New Freedom Commission on Mental Health that President Bush established in 2002 that looks “at the state of mental health care in the U.S.”

One of the goals of the commission is “all citizens will understand that mental health is essential to overall health” and it will be treated “with the same urgency as physical health.”

Patricia Villers can be reached at pvillers@nhregister.com.


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County boldly housing the unwanted -Corvallis (CA) Gazette-Times

Gazette-Times editorial for Monday, Aug. 25

We’ve already indicated our support for Benton County’s pioneering efforts to find places to house homeless with chronic mental illness or other debilitating conditions rather than repeatedly arresting them.

Oregon leaders dedicated to the ambitious plan of halting homelessness in 10 years have concluded that it’s better — and far less expensive — to provide a modest dwelling for the small number of people who are — for whatever reason — chronically homeless.

In coming days, two new apartments at Fifth and Monroe will be occupied — at taxpayer expense — by such people. They may be homelessness and mentally ill. They may have been released from prison. But instead of being given a ticket out of town and left to wander at will, with no help or hope, they will live across the street from the law enforcement personnel. The facility will have some monitoring.

It’s a good idea, worth a try.

Yet we can hear the objections now; Corvallis will get the reputation of handing out free lodging, no questions asked. And what about the working poor, who often are homeless because they cannot afford the high cost of housing? Is this fair to them?

It is perhaps in anticipation of such questions that Sheriff Diana Simpson, who told us of the apartments two months ago, has been slow to publicly detail the specifics of the conditions and qualifications of the people who will occupy those apartments.

But it isn’t too early to give the public a heads-up that Benton is trying something new, and we will soon follow up with news story that answer those questions.

What may surprise some residents is that the county already has a six-bed “transition center” for convicted predatory sex offenders, located in the same vicinity. The people who live there are supervised between 8 a.m. and 11:30 p.m., seven days a week. Jail personnel monitor them from 11:30 p.m. to 8 a.m. the following morning, but no one is there onsite.

The result is pretty good, according to straight-talking Sgt. Jenna Morrison with the county’s parole and probation department. She said the county has a simple and logical plan: “We never want to have a predatory sex offender go homeless.”

Not a bad idea, when you think about it. The sex offender registry was started so that people who fit into that small group of sex offenders who are most likely to reoffend can be monitored. It’s better to know where they live.

Actually, because they are so heavily supervised, Morrison said these population has among the lowest repeat rates of any criminal group, contrary to popular belief.

However, common sense often crumbles under the pressure of overheated rhetoric. For instance, last week a group of leaders, including Gov. Chris Gregoire, met in Seattle to ponder whether Washington should join the 23 states where convicted sex offenders would not be allowed within a certain distance of universities, on the legal theory that they, too, are schools.

But that raises the legitimate question of just where sex offenders can live.

Benton County has 60 sex offenders under supervised parole; 13 of them are predatory sex offenders, and three sex offenders live in the vicinity of Oregon State University.

We do not for a minute believe that sex offenders and the chronically homeless are the same people or belong in the same demographic. They are, however, two different groups of people who share similar housing problems: They need housing, and few people want to either provide it or want them as neighbors.

Morrison and other county officials are facing that issue boldly, with a reasonable solution. It’s an issue many people ignore or avoid, but we can no longer avoid having a reasoned discussion of the county’s reasonable efforts to meet these sensitive housing needs affordably and responsibly. Read more!

The Buzz: 'We are not angels,' Steinberg says - Sacramento Bee

Monday, August 25, 2008

A painting of an angel hangs in state Sen. Darrell Steinberg's Capitol office, given to him by a Humboldt County artist who suffered from mental illness and was once homeless. In a Senate speech last week, Steinberg said the painting represents the state's commitment to helping the mentally ill, one that has fallen short. "We are not angels," he said.

"This is a ramrod job. I know it. You know it. You should be working on the budget."

DOUG PRINGLE, of the California Charity Alliance, which opposes a bill to ban electronic bingo. The comment was greeted with hearty applause at a committee hearing.

Gov. Arnold Schwarzenegger sought over the weekend to head off support in his own party for more borrowing to close the budget gap. "Albert Einstein said that insanity is doing the same thing over and over again and expecting a different result," he said in his weekend radio address. "It was year after year of overspending and borrowing that put us in this mess."
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Bipolar over general education requirements -UV Review (Utah Valley University)

By: Heather Jones

Me: I'd like to introduce you to my other personality. The two of us don't see eye to eye on the subject of general education requirements, so I have consented to share my column with her.

Her: It's about time. What are you whining about now?

Me: Why, oh why, do I have to take biology? I don't like biology, but more importantly, I don't have any reason to learn about biology. Unless I plan to communicate in the field of biology, which I don't, I see no reason to spend a semester of time and tuition studying it.

Her: You might like biology. How will you know if you never try?

Me: It's biology. I know.

Her: Remember the political science class you took last year? That was so interesting. You don't regret that.

Me: True. But biology?

Her: The truth is that general education is an important component of a student's education. It gives you a common academic experience that you share with your fellow students. It is designed to expand our historical, aesthetic, cultural, literary, scientific and philosophical perspectives. For us to be well-educated, successful, and valuable participants in our rapidly changing global community, we need more than professional or vocational training. In order to prepare for our exciting, challenging future, we need to do more than specialize in a major and train for a career; we must become more broadly educated, truly conversant with at least some of the many rapidly changing disciplines. We need to gain a sense of our past achievements, present developments, and future possibilities.

Me: Did you come up with that yourself?

Her: Well, no, it's a conglomeration of shtick taken from a variety of college Web sites. But that doesn't mean it's not true.

Me: My education should be my choice. There are general education requirements that seem redundant. I'm a healthy, active adult. I don't need to spend a semester learning how to be fit for life. And how can an instructor at UVU lecture me about ethics and values? Whose values are we talking about anyway? The requirements are too specific and restrictive.

Her: So you would have chosen to take a course on American government?

Me: Absolutely not.

Her: Knowledge is valuable no matter what the subject. The general education program prepares you for more in-depth study in your major while also preparing you for a career, or, possibly, a family. Have you ever tried to help a 4th grader with their homework?

Me: No, I usually leave that to you.

Her: What else are you going to leave for someone else? Competition is fierce. How will you keep up?

Me: Look. I know what my major is. I know what I want to do for a living. I will never need biology.

Her: There is a big world out there, and as brilliant as you are, you don't know squat. You don't know where you will be in 10 years. You don't know what direction your path my take. You can plan all you want, but in the end, what you know will determine your success. Knowledge is power. And "the beginning of knowledge is the discovery of something we do not understand."

Me: I don't understand biology.

Her: Exactly. Read more!

Newly released documents reveal violent past for man who died in custody of Amherst deputies - Lynchburg (VA) News & Advance

By Chris Dumond - August 23

A man who died while in the custody of Amherst County Sheriff’s deputies in 2005 was acquitted by reason of insanity in a 1997 Richmond homicide and committed to a state mental hospital, newly released records show.

Sanchez Taylor’s death is at issue in a $15 million wrongful death lawsuit against four Amherst deputies accused of suffocating him during an arrest in June 2005.

Hundreds of pages of records were filed in the federal civil suit in advance of hearings last week. Thursday, the lawyer for the deputies asked Judge Norman Moon to throw out the case, and Friday, lawyers sought to settle the case in a mediation hearing.

Moon had not filed a decision in Thursday’s hearing, nor had any settlement filings been made as of late Friday. The suit is scheduled to go to trial next month.

The hearings came a week after a special commonwealth’s attorney filed a report in state court clearing the deputies of criminal wrongdoing.

According to the newly filed documents:

- Taylor was released from a state mental hospital in 2003 and was being monitored at the time of his death by the Central Virginia Community Services Board;

- Deputies say no one handled the man in a way to restrict his breathing and that they used the least amount of force possible to get him under control;

- Dr. Gregory Wanger, the medical examiner who autopsied Taylor, said the injuries that suffocated him were caused by the deputies, although they may not have intended to kill him or have known what they were doing to him was hurting him, and;

- Medical experts hired by the deputies have filed reports stating Taylor’s death was an accident, though the judge has ruled the medical experts can’t testify should the case go to trial in mid-September.

According to law enforcement statements filed with the court, Taylor was seen on June 16, 2005, running away from his car, which he had parked in the passing lane of U.S. 29 in Amherst County. Within minutes, a witness called police to report Taylor appeared to be trying to break into Bethel Welding, a nearby business.

Shortly after, deputies Debbie Tinnell and Darren Givens found Taylor at the back of the welding shop and tried to arrest him. They say Taylor fought them, although he was handcuffed on a metal ladder. When they tried to carry him off the ladder, he continued to fight, they say, and he was put down on a metal rack. Then, two more deputies, Brian Drewry and Kelly Dodson, arrived and helped pick up Taylor, still fighting.

A few feet later, still unable to get him under control, the officers put him on the ground. As a fifth deputy, Betty Wise, came on the scene, deputies noticed Taylor was having trouble breathing and was having a seizure.

Taylor never recovered and died within two hours.

His mother’s lawyer contends the deputies held him down on the ladder and metal rack despite her assertion that he was clearly having a mental episode. She contends they crushed his stomach, suffocating him and starting a chain reaction inside his body that killed him.

Richmond Circuit Court records show Taylor was indicted in 1997 on charges of murder, attempted murder and two related gun crimes in the shooting death of his friend, 22-year-old Carey Hughley III. According to a court record filed by a defense medical expert, Taylor shot Hughley in an attempt to “recycle the victim’s soul into heaven.”

A year later, Taylor was found not guilty by reason of insanity by a Richmond judge. He was subsequently committed to Central State Hospital in Petersburg, court documents show.

A few days after the fifth anniversary of the killing, the court ordered Taylor to be released under strict supervision by the Central Virginia Community Services Board here in Lynchburg, where his parents and grandmother lived.

During her deposition, Lynn McBride, a Central Virginia Community Services counselor who worked with Taylor, said he had been diagnosed with schizoaffective disorder, bipolar type.

According to the Diagnostic and Statistical Manual of Mental Disorders, the disorder can include hallucinations, delusions, disorganized speech, catatonic behavior, major depression and mania.

She said he occasionally discussed the 1997 killing and admitted he was responsible.

Under community services care, he was first given his medicine at his home by a staff member twice a day to make sure he was taking it, McBride said. Some time later, he was allowed to take his morning dosage on his own because he would leave for work before a community services worker could meet him.

By January 2005, though, things were starting to break down, McBride said. Community services then wrote a letter to the Richmond court asking for Taylor to be warned about compliance. When there was no response, another letter was written in March.

According to court records, this resulted in a hearing in May, the month before his death, in which Taylor was given another 90 days to comply with the conditions of his release.

A note written by McBride in Taylor’s file, referenced in the deposition, notes that McBride and Taylor’s mother were confused by the circumstances of his death since he had a good session with counselors the day before.

McBride also told the lawyers that Taylor had always tested clean in drug screens leading up to his death in spite of the fact that he tested positive for low levels of cocaine when he was admitted to the hospital.

In addition to cocaine found in his car, a large quantity of his psychiatric medicine was found as well, McBride noted in Taylor’s file.

“Sanchez had a month’s worth of meds, but (I) don’t know over what period he didn’t take them,” she wrote.

Statements of the five deputies who participated in Taylor’s arrest note that none of them had any history with the man or were aware of his medical or legal background.

Of the four who handled Taylor, their statements all note that the man fought with them continuously, did not comply with their orders, that he did not speak through the entire encounter and that they did not crush him or do anything to suffocate him.

The statements all note that the deputies did the least they could to restrain Taylor and get him under control. Those statements go on to note that when Taylor appeared to be having problems, his handcuffs were taken off and that deputies who were trained as emergency medical providers tried to help him.

Inmore than 60 pages of transcribed deposition, Dr. Gregory Wanger, the Roanoke-based state medical examiner who autopsied Taylor, said there were clear signs of restraint and suffocation. Wanger assigned Taylor’s cause and manner of death as homicide and suffocation due to multiple restraints with cocaine abuse and heart disease as contributing factors.

Wanger said deep tissues inside Taylor’s belly showed bruising and evidence of compression. He said compression like this could have kept Taylor’s diaphragm from flattening enough to let him breathe.

“This comes as a surprise to some people,” Wanger said. “Even though their mouth and their nose and so on is open, they can’t breathe.”

He also noted that not everyone with this kind of injury dies right away, but instead the suffocation causes a “cascade” of events resulting in death, especially considering his other medical problems.

Although defense experts attribute Taylor’s death to a condition called excited delirium, Wanger denied it was involved in this case because of evidence Taylor’s abdomen was compressed while he was on the ladder and metal racks.

In the deposition, he said the ruling of homicide did not imply the deputies meant to kill Taylor, just that he died at the hands of another.

He said he couldn’t put himself in the shoes of those deputies, but if he could, he would have expected Taylor to be making some noise while he was on the metal racks.

“And the fact that you are not able to make a noise and you’re maybe making some mumbling noises, I guess, in my head, I would say, ‘well, you know, do we’ve got an airway problem or what?’ I mean, there is something going on,” he said.

“But I have medical training they don’t have.”

Two medical doctors consulted by the deputies’ lawyer filed reports that contradict the official medical examiner’s findings.

Dr. Edward Gordon, a medical examiner from Farmville hired by the defense attorney, stated he doesn’t believe Taylor could have fought as hard as he did with police if he was being suffocated.

Instead, Gordon reported, Taylor died of excited delirium, a fatal combination of problems brought on by the stress of resisting arrest, the man’s mental illness, cocaine use, high cholesterol and the heart disease found during the autopsy.

Dr. Daniel Davis, a state medical examiner in Oregon, reached a similar conclusion and also noted that if he had been suffocated while struggling on the ladder and metal planters at Bethel Welding, he would not have been able to continue struggling with the deputies after they tried to drag him away.

An Aug. 6 order by Judge Moon is likely to keep the medical experts for the deputies from testifying and disputing Wanger’s findings.

An earlier court order gave the deputies until late March to file a list of expert witnesses, but they did not file until June 30, Moon found.

Under the judge’s order a former FBI agent hired by the deputies to review the case would also be barred from testifying about his conclusion that they did nothing wrong.
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Take time to get to know a special-needs person and enrich your world - Asheville (NC) Citizen-Times

Cynthia Reese

Recently we were car pooling with our van full of children to some outing or other and one of my 11-year old son’s friends said, “Don’t be a retard” to our 8-year old daughter.

Now our daughter, Hannah, is exceptionally bright, athletic and very pretty.

She, of course, was outraged, but not for herself. Her twin brother, Eli, has Down syndrome.

I told the boy that we don’t use that kind of language in our family and he immediately apologized. End of story? Not quite.

The terms, retard (a verb) or retarded (an adjective) are derived from the Latin word retardare meaning “back in place” or “delay.”

This is also the root of the word “tardy.” In music it means you slow the tempo. Otherwise it means, according to Webster’s Dictionary, “relatively slow or backward in mental or emotional development or in academic achievement.”

Eli is a lot like the musical version of this word.

He hits all of the notes, but he plays his song slower — sometimes holding certain notes longer than others like crawling for almost two years instead of walking.

When he finally hits that next note it is more beautiful than any normal song.

Loaded words

Even so, this word is deeply offensive and hurtful to many families in the special needs community.

As many words do it delivers a 10-piece luggage set of meaning from the days not so long ago when persons with cognitive disabilities had virtually no rights or future. It still carries a sting of rejection and meanness.

Back to the boy in the minivan. He’s not the only one — this is a common pejorative with the middle-school set.

The recently released Hollywood satire, “Tropic Thunder,” uses it liberally and callously.

This movie targets virtually every faction, all of whom ultimately receive understanding and vindication but one.

People with cognitive disabilities are crassly targeted without consideration or decency.

They are one of the last groups that are still socially acceptable to degrade (just as we were making progress).

In short, please don’t see the movie and give them your money and time.

So what did Hannah say to the boy? She called him an “idiot.” I guess we’ll work on that next.

Do some exploration

So what can we do? One thing is to make friends with someone with special needs. Get to know them and dare I say, love them.

You have a great opportunity at the Buddy Walk in October.

The Western North Carolina Down Syndrome Alliance will sponsor its 11th Annual Buddy Walk on Saturday, Oct. 11. Registration is at 11 a.m. and the walk is at noon.

The walk is one lap around and then we play, dance and eat. Come make a buddy and change your world.

For more information check out their Web site at www.wncdsa.org.

Cynthia Reese is a full-time mom and the president of the Western North Carolina Down Syndrome Alliance. She worked in health policy and administration for 17 years. She and her family live in Fairview. Read more!

Comedy's portrayal of disabled prompts boycott - Evansville (IN) Courier-Press

By Libby Keeling

Halie Bruder has not seen the film "Tropic Thunder," which hit the top of the box office in its opening week and was anticipated to top the charts again over the weekend.

Like many in the disabled community, Bruder is offended by the R-rated film's depiction by Ben Stiller of an actor portraying an individual with a developmental disability and the use of the word "retard."

"I won't go see the movie. I won't go see anything that puts disabled people down," said Bruder, who has cerebral palsy.

The 22-year-old, who shares an Evansville apartment with a roommate who suffered a traumatic brain injury, is employed as a self-advocate for The Arc of Indiana.

She also serves as acting president of the South Western Advocacy Group, composed of about 20 individuals representing The Arc Training Center and Arc Industries in Evansville.

The advocacy group has joined numerous national organizations, including The Arc of the United States, Special Olympics, The National Down Syndrome Congress and The American Association of People With Disabilities, in boycotting the DreamWorks production directed, co-written and starring Stiller.

"It's portraying the character as funny," said Mike Chapman, who is coordinator for Special Olympics of Vanderburgh County. "They're laughing at him, not with him."

Chapman, a special education teacher at Bosse High School, saw the movie and said the objectionable scenes are not essential to the story line and could have been cut, as advocates requested.

In "Tropic Thunder," Stiller plays an action movie hero who tries to make the jump to serious films by portraying a character called Simple Jack, who has a developmental disability.

"The portrayal is so over the top, and it's meant to be funny because it's simply poking fun at someone with a mental disability," Chapman said.

Amy Mangold, development director for Evansville ARC, has not seen the film. However, she said the national organization found portions of the movie very negative and demeaning.

"We are definitely encouraging people not to fund the movie producers because of the contents of the movie," she said.

Language in the movie qualifies as hate speech, according to Peter Berns, executive director of The Arc of the United States.

"In recent interviews, you've said that the film is not intended to make light of people with intellectual disabilities but is instead a satire on actors and the industry," Berns wrote in a recent letter to Stiller.

"I've seen the movie, and the use of words such as 'retard,' 'imbecile' and 'moron' and the use of caricature in the depiction of an individual with intellectual disabilities are simply unacceptable."

Although mental retardation remains a clinical diagnosis, the disability community has adopted the terms "developmentally disabled," "developmentally delayed" or "intellectual disabled" because of connotations now associated with the term, according to Mangold. Using the word "retard" identifies an entire group of people as without value, she said, and disregards the qualities of individuals.

Millions of Americans have developmental disabilities. Mangold said being exposed to the "R-word" hurts not only them but also their family members and others who love them.

In recognition of the changing nature of the word, The Arc, formerly The ARC (Association of Retarded Citizens) changed its name at local, state and national levels to simply "The Arc" in the 1990s.

For every negative portrayal of a person with a disability, Mangold said, the organizationcan provide numerous success stories about individuals working, volunteering and contributing to the community.

"When people that are in public gawk and stare at us, we know what's going on. We know what they're thinking: That we're stupid," Bruder said. "We're smart. Everybody is smart in their own way. Whether you have a disability or you don't."

Being stared at makes Bruder, who requires the services of a caretaker, feel uncomfortable. Being ignored makes her mad.

"They ask my caretaker questions, and my caretaker says: 'She can talk for herself. She's not mentally delayed,'" said Bruder, who also is an advocate for the accessibility rights of individuals with disabilities.

Disabilities occur on a spectrum, and many people with disabilities are highly functioning, Chapman noted. Being called names upsets them.

"They understand it's meant to be hurtful," he said. "I'm close to so many people with intellectual disabilities and I know what they're like, and know that this was way over the top, and I was upset that people view other people that way."

Although supportive of the boycott, Chapman said people need to make their own decisions. Perhaps the best thing to come from "Tropic Thunder" and its related controversy will be an open discussion.
Read more!

Hospital program helps kids face their fears- of school - Chicago Daily Herald

By Sheila Ahern

Jocelyn Brame was not a fan of sixth grade.

She missed a lot of school because of horrible headaches that lasted for days. When she did go to school, she wanted to be home. She couldn't keep up with the homework assignments she missed, and her friends paired up for class projects without her. She thought other students were whispering about her.

"I was scared all the time," said Jocelyn, who lives in Libertyville. "I was stressed out all the time."

Things didn't get any better in seventh grade. And in eighth grade, Jocelyn missed 48 days of school.

"Her life was taking over our lives," said Judy Brame, Jocelyn's mother. "Every day depended on whether she went to school. Then all day, we worried, did she stay at school all day? Did she come home? This was just not something we could do anymore."

The Brames heard about the school refusal therapy program at Northwest Community Hospital in Arlington Heights - the only one of its kind in the country. It includes inpatient treatment and intensive therapy for both the students and parents.

School refusal behavior is not about a student faking a stomach ache to stay home one day, said Maggie Hahn, the program's clinical coordinator. These students aren't just nervous about school; they're terrified. And the longer they stay home, the harder it is to go back.

"These kids stay home from school one day and then the anxiety builds and builds," Hahn said. "We had one girl who hadn't been to school in two years."

Typically, school refusal behavior strikes kids who are between 12 and 18 years old. It happens to some kids when they face a major transition, such as starting middle school or high school. It affects as many as 25 percent of school kids at some time in their lives - across gender, racial and income groups, Hahn said.

"Parents can't stand to see their child so upset," Hahn said. "Picture it: your child is crying and afraid to go to school. It's pretty darn hard to force them to go to school."

Children with school refusal behavior feel depressed, anxious or fearful about being at school. Some students fear crowded hallways, claustrophobia in the classrooms or bullying. Others lack the necessary social skills, Hahn said.

Since the program started about five years ago, the Northwest Community program has treated between 200 and 300 children from throughout the Chicago area. About half of the 12 beds in the hospital's adolescent mental health unit are for kids with school refusal behavior and there's sometimes a waiting list to enter the program.

After a physical exam, kids with severe school refusal are admitted to a weeklong inpatient program, followed by a week of full-day treatment where the child sleeps at home. The next week, the child spends half of each day at school and the second half day at treatment, while their parents are also in therapy twice a week. Eventually most kids return to school full time - many with the help of anti-depressants or anti-anxiety medication. Still, the chance of relapse is very high, Hahn said.

"You have to stay on top of it," she said. "All of a sudden the child stays home with the flu for three days and then doesn't want to go back to school again."

Kids can call a nurse at the hospital for support if they run into trouble. Hahn has been on the receiving end of many of these calls, which often come on the first day the child is supposed to return to school.

"Once I had to talk a boy out of his house," she said. "I told him, 'I want to hear you brushing your teeth. Good, now I want you to walk out the door,'" Hahn said.

Insurance usually covers much of the program's costs, Hahn said.

Unlike other phobias, kids with school refusal behavior are fine when school is not in session. During the summer, parents often think their kids are cured, Hahn said.

"The longer a child suffers from school refusal behavior and is allowed to stay home, the more difficult it is to return to school," she said. "It's important to seek solutions and get them quickly back on the right track."

Judy Brame agrees with Hahn. Her advice to parents in a similar situation is simple: "Don't wait."

"It's frustrating to admit that a stranger may know your kid better than you, but don't wait another day," she said. "Every new school, we thought it would be different. The teachers are different. The kids are more mature, but don't kid yourself."

Untreated, the behavior gets worse. Kids can become depressed and possibly suicidal. School refusal behavior can affect their college success, relationships and the ability to get a job, Hahn said.

"It's a widespread problem that is often mistreated," Hahn said. "A lot of parents become frustrated and home school the kids, but that should only be a last resort."

Before finding the program at Northwest, Jocelyn's parents tried just about everything. They talked with the school nurse to find a place for Jocelyn to take a break and relax when the headaches started. The had incentives for good attendance, but nothing seemed to help. The nurse's office was too crowded and the headache medicine didn't work. When Jocelyn did return to school she'd find projects already started and all her friends were paired up. Gradually, friends stopped calling her and she couldn't be in the school musical because she missed so many days of school.

The reasons to skip school piled up.

Jocelyn started out with two weeks of full-day treatment at the hospital in the spring of 2007. Then she went to half days, spending the morning at the hospital and the afternoon in her eighth grade classroom. If she started feeling like she wanted to go home, she called the professionals at the hospital instead of her mom.

Today, she actually looks forward to school.

"I love my lit class and seeing my friends," said Jocelyn, 15, and a high school sophomore. "I changed my whole way of thinking. Now everything isn't such a big deal."

She still gets occasional headaches. The difference is now, she knows how to treat them and they don't last for days. Outside of school, Jocelyn is taking tuba, voice and dance lessons. Driver education classes start this week.

After she graduates, Jocelyn wants to attend college and major in music or theater and eventually have a career on Broadway.

"If I can help one kid who is going through what I went through, that would be great," Jocelyn said. "I want to tell them how well I'm doing."

Symptoms of school refusal behavior

• Failing grades

• Frequent physical complaints

• Social problems

• Anxiety or panic attacks

• Depression

• Fatigue

• Dangerous or risk-taking behaviors

• Drug/alcohol use

• Physical aggression or threats

For more information, go to www.nch.org and search "school refusal" or call Northwest Community Hospital Youth Services at (847) 618-4110. Read more!

Medicare is bad, but Medicaid has even more problems - American Medical News

OPINION : By Joseph M. Heyman, MD, Sept. 1, 2008.

A message to all physicians from Joseph M. Heyman, MD, chair of the AMA Board of Trustees.

Now that we have an 18-month reprieve, giving us time to work on a replacement of the flawed sustainable growth rate formula for Medicare payment, let's take a look at Medicaid. As bad as the Medicare problem is, it pales in comparison with the enormous inequities for patients and physicians that come from the patchwork of Medicaid programs.

While Medicare provides health care for seniors (some of our most passionate voters in all income brackets), Medicaid is a safety net for our poorest patients. It is so complicated.

I know from direct experience that Medicaid patients in my state are clearly second-class health care citizens. Often they cannot afford transportation, parking and child care. They are frustrated by a complicated application process, more visits than other patients need for the same level of care, less access to specialty care, and the common knowledge that their insurance coverage is not attractive to their physicians. There are demeaning extra requirements of consent forms and waiting periods for sterilization. Mental health care is restricted to sometimes crowded groups or clinics that require medication-prescribing clinicians. Mental health counseling is very difficult to obtain.

You don't want to be a Massachusetts Medicaid patient who needs a dermatologist, a psychiatrist or neuropsychologist, because there are few who accept Medicaid patients. With so many newly insured patients in Massachusetts there aren't enough primary care physicians.

Physicians in Massachusetts are frustrated with Medicaid. MassHealth requires women needing gynecologic care to get a referral from a primary care physician, a burden that other women in Massachusetts don't have, and added work for both the primary care physician and the gynecologist.

If a patient comes for an annual exam in my office and reveals a serious bleeding problem, or I discover a breast mass, I may not do the endometrial biopsy or the cyst aspiration on the same day unless I am willing to forgo payment. MassHealth does not accept the CPT modifier 25. So either I make a sacrifice or my patient must.

A study by AthenaHealth showed MassHealth has more denials than any other insurer in the state. MassHealth has its own claim forms and rules for electronic billing that make it more difficult to file a clean claim.

Explanations for denials are all coded and must be searched for among about 1,000 different codes in a complicated, constantly changing provider manual, about 4 inches thick. Many services that are electronically billed require paper evidence, so it is a combined system with delays. And, of course, MassHealth pays less than every other insurer.

On top of the problems already associated with MassHealth is a mandatory revenue-neutral physician pay-for-performance program. It is not likely to change behavior, but surely will make the payment system more complicated for physicians. For some, it may be the last straw.

Here are some points cited by the American College of Obstetricians and Gynecologists:

* Medicaid provides essential health care to more than 20 million women, 69% of adult beneficiaries.
* Most nonelderly women in Medicaid are in their reproductive years (69%), have incomes below the poverty level (56%) and are raising children younger than 18 (60%).
* Women in Medicaid report poorer health status than do women with private insurance or the uninsured.
* Medicaid provides essential well-woman care, including maternity care, family planning, and treatment for breast and cervical cancers. It also provides care for women with disabilities. One barrier faced in nearly every state is poor reimbursement for obstetric services, which limits the number of physicians accepting Medicaid patients. With reimbursement often 15% below the Medicare benchmark and half that of private insurance rates, ob-gyns accepting a significant number of Medicaid patients have difficulty breaking even.
* More than half of Arkansas' births are paid for by Medicaid, making many ob-gyns dependent on the program. But, in 2003, reimbursement was only 78% of Medicare's rates.
* California doctors were recently hit with a 10% Medicaid cut, threatening access for 7 million people.
* Low provider participation makes it more difficult for pregnant patients to find a health care professional and schedule an appointment.
* Patients often face complicated enrollment procedures and documentation requirements that delay access to early prenatal care. Only 30 states expedited enrollment for pregnant women.

Stuart Cohen, MD, of the American Academy of Pediatrics, shared pediatric goals for Medicaid. The federal share of Medicaid spending, known as the Federal Medical Assistance Percentage, varies by state and ranges from 50% to 77%, with an average of 57% of funding coming from the federal government. Dr. Cohen says the pediatricians want a change, so as not to disadvantage large states with huge numbers of very poor residents.

They want parity with Medicare payment (an irony, when you consider our troubles there). In most cases, as bad as Medicare payment has been, Medicaid is worse.

While we work on Medicare, professional liability, and access, we cannot forget that Medicaid reform is an absolute necessity. The AMA supports uniform Medicaid eligibility, standardization of the Medicaid benefit package, and improved payment for participating physicians. The AMA also wants patient-centered efforts, such as a streamlined enrollment process and referral options that promote continuity of care.

The American Medical Association, the Practicing Physicians Advisory Council to the Centers for Medicare & Medicaid Services, and the AAP all have recommended federal legislation to establish a Medicaid Physician Advisory Commission to advise CMS and Congress on policies impacting physicians and patients related to state Medicaid programs.

Medicaid may have a robust coverage policy, but because of its hassles and inadequate payments, Medicaid patients have the least access to health care. Because it is a shared state-federal program, it is much harder to change and monitor.

Federal law requires Medicaid payments to be sufficient to ensure equal access with private insurance. It just isn't happening!

Dr. Heyman is an obstetrician-gynecologist with a private practice in Amesbury, Mass. Learn more about Dr. Heyman at the AMA's bio page or contact him by e-mail. Read more!

Court upholds damages in bipolar disorder discrimination case - Ottawa (Canada) Citizen

Thulasi Srikanthan- August 24, 2008

OTTAWA - An $80,000 judgment against an Ottawa company that dismissed a man with bipolar disorder has been upheld by an Ontario court.

In 2001, Paul Lane was dismissed from his new job as a quality assurance analyst with ADGA Groups Consulting Inc., after advising a supervisor that he required accommodations for his bipolar disorder.

Last year, the Ontario Human Rights Commission found that ADGA discriminated against Lane, and awarded him nearly $80,000. After his dismissal, Lane became deeply depressed and was hospitalized for 12 days. He lost his savings, wife and home.

A recent appeal of that case was dismissed by an Ontario Divisional Court on Aug. 8 and the tribunal's award was upheld. The commission's cross-appeal to increase the sum awarded for damages was also dismissed.

"I am quite ecstatic that decision was made in our favour," Lane said.

An official said ADGA is disappointed with the outcome. Since the decision, ADGA has filed an appeal application to the Ontario Court of Appeal.

"I am going to save my celebration until the final appeal is heard and ADGA loses," Lane said.

The Divisional Court's decision is significant because it reaffirms that employers have a duty to accommodate employees with mental disabilities, including bipolar disorder, said Raj Dhir, a lawyer for the human rights commission.

"Before an employer refuses accommodation, they must obtain all relevant information about the employee, including his or her medical condition, prognosis for recovery, job capabilities and ability to do alternate work," Dhir said.

"An employer must be able to demonstrate that it is not possible to accommodate employees without undue hardship."

The case marked the first time the commission had dealt specifically with the needs of employees who suffer from bipolar disorder and the obligation of employers to accommodate them.

Dhir said the decision by the divisional court was also important because it recognized that mental disabilities often create fear and stereotyping. A person may have no limitations in everyday activities other than those created by prejudice and stereotypes, he said.

Ottawa Citizen with files from Dan Robson Read more!

Report: Health inspectors failed to report unsafe nursing home conditions - Associated Press

CINCINNATI (AP) -- Health inspectors failed to report deplorable conditions at Cincinnati nursing home facilities that were later declared "unsafe and unsanitary," a newspaper reported Sunday.

An investigation conducted by the Cincinnati Enquirer found that inspections since 2003 — and as recently as February — did not include reports of unsafe conditions at Westside Health Care Center and the Terrace at Westside.

A police raid on March 13 revealed soiled mattresses, roach-infested rooms and fire doors tied shut, among other unsanitary conditions.

State health inspectors have since documented nearly 200 pages of violations at both facilities.

The Medicaid-funded nursing homes, known as "The Hill," provide nursing home care and assisted living for more than 60 low-income residents, many of whom are mentally ill. Now the state wants to cease funding the homes. Their owner, Abe Fischer, was fined $100,000 and faces criminal charges of violating the city's building and fire codes.

The Cincinnati City Council will hold hearings next month to determine how the conditions went unnoticed for so long.

"How was this missed?" asked City Councilman Chris Monzel.

Health officials told residents of the homes on Wednesday they should find a new place to live.

In January, Ohio Department of Health inspectors visited the facilities to determine whether they met Medicaid standards. They found 10 minor violations, such as an unsanitary dishwasher, that indicated a level of compliance typical of other homes.

City fire inspectors checked the Terrace and Westside on Feb. 4 and found no problems.

On Feb. 26, city health inspectors found problems at the Terrace similar to those reported after past reviews. They noted five violations, including a lack of first-aid training, improper storage of medications and failure to conduct fire drills.

But on Feb. 25, one day before city inspectors made their second visit, Cincinnati police Officer Aaron Layton visited the center while searching for a suspect. Appalled by what he saw, Layton got a search warrant and returned two weeks later with dozens of police and city and state health inspectors.

Deplorable conditions surfaced during the raid, including vomit in the hallways and pipes held together with shoe string.

Inspectors found Westside's hazards presented a "real and present danger" to residents, including unsafe medication storage and residents smoking near an oxygen tank.

Inspectors also discovered workers made mistakes administering medication 20 percent of the time — four times the industry's acceptable error rate.

No staff member was trained to deal with psychological problems, even though every resident had some degree of mental illness.

"You basically went there or you went to the streets," said Cynthia Alexander, whose mother, Fannie Lee Daniels, 75, spent 10 years in the facilities before leaving in January.

The facilities deteriorated each year her mother lived at Westside, Alexander said.

Alexander said adult diapers were rarely available, and her mother's bedsheets were often filthy. She worried that her mother did not receive her medications properly.

Westside and the Terrace get more than $3.2 million a year from Medicaid and other social service programs.

Fischer said his facilities are safe and clean. The state and advocacy groups are trying to run him out of business, he said.

State inspectors attributed poor conditions to the loss of Westside's nursing director for several months earlier this year because of a medical problem.

"It does not take long when you have no professional staff directing your staff for care to deteriorate," said Carla Brumby, chief of the Ohio Department of Health's bureau of long-term care quality. "That's the biggest contributing factor to how you go from a mediocre facility to a bad facility. It's how you go from in compliance to out of compliance."

The facilities have since been cleaned and repaired. Mold has been cleaned from the walls, fire doors are accessible and cigarette butts that littered rooms are gone.

Cincinnati is the only city in the state that performs its own nursing home inspections.

City health officials said Thursday they are considering dropping the nursing home inspection program due to budget cuts and retirements — not the conditions at Westside. Read more!

Fatal fire at Perris home for developmentally disabled adults is called arson - Riverside (CA) Press Enterprise

By JEFF HORSEMAN and GAIL WESSON - Aug. 24

One man died and two people suffered minor burns in an early morning arson fire Saturday at a facility for developmentally disabled adults in Perris, according to the Cal Fire/Riverside County Fire Department.

Fire investigators determined the fire at Perris Place Adult Residential Care Facility was intentionally set, leading the Riverside County Sheriff's Department to send out homicide investigators to assist in the investigation, sheriff's spokesman Matt Diaz said by phone. He did not have details on what led investigators to determine it was arson.

A call for help came at 3:12 a.m. from a pay phone near Perris Place, and deputies helped Cal Fire with evacuation of the residents, Diaz said.

Multiple people were trapped in the 20-room, 5,000-square-foot building in the 150 block of East Second Street, and the fire was "heavily involved" in the interior, Capt. David Hudson of Cal Fire's Perris station said.

The fire was extinguished by 4 a.m. During a search of the building, the body of a white male adult was found in the lobby, Diaz said. It was not immediately known whether the man was a patient or worker at the care home.

Perris Place is licensed for 42 residents, according to the California Department of Social Services Web site. The home houses adults with physical and mental disabilities.

The fire loss was estimated at $200,000, according to Cal Fire spokeswoman Massiel De Guevara.

Two patients were taken to an area hospital for treatment. Forty residents were displaced and the facility operator was trying to place them elsewhere, De Guevara said.

No one appeared to be at the facility Saturday afternoon. A fence surrounding the one-story building was padlocked.

The building's red-tiled roof was heavily damaged and the front door was warped, blackened and off its hinges. A pile of insulation sat in the back driveway, which had a basketball hoop.

Next-door neighbor Lupe Torres, 22, said she got up during the night and noticed the fire. She said she called 911 as her brother raced to pound on the home's door.

She said the fire appeared to be burning inside the building. She did not know any of the residents at the home.

"I was scared everyone was burning," she said.

Reach Jeff Horseman at 951-375-3727 or jhorseman@PE.com

Reach Gail Wesson at 951-763-3455 or gwesson@PE.com Read more!

Not just crass, but hurtful - Boston Globe

By Beverly Beckham - August 24, 2008

First things first: "Tropic Thunder" is not an intentionally mean movie that denigrates the developmentally delayed. It is a comedy that pokes fun at Hollywood's preposterous and stereotypical portrayal of all the people Hollywood thinks it knows but doesn't. A big vulgar, way over-the-top film, it's a series of fun-house mirrors exaggerating the bloated egos of actors, producers, agents, and the never-ending sham that is pretense.

But it is also the worst thing to come along for the developmentally disabled since public schools used the dunce cap.Because in 107 minutes the word "retard" (or "retarded") is said 17 times. This gives a green light to the movie-going public: If "retard" can be tossed back and forth on the big screen, getting laughs, getting legitimized, why not use it on the schoolyard or at the water cooler?

"Tropic Thunder" is a nonstop vulgarfest full of gross and offensive words strung together in new and creative ways. It targets women, blacks, gays, the military, writers, the Viet Cong, heroes, priests, half the world.

It seems at first glance to be an equal-opportunity insulter.

But it isn't. Body parts cannot take offense to what is being said. And excrement is only excrement. These words are just crass. Nothing more. "Retarded" is personal. "Retarded" targets people. "Retarded" hurts. This is why advocates for the mentally disabled are speaking out.

I have a 5-year-old granddaughter. Her name is Lucy Rose. She has blonde hair and green eyes and loves to swim and dance and sing and run and read picture books. Lucy also has Down syndrome. Say the word "retarded" and you don't picture a little girl who loves to swim and sing. "Retarded" is a stereotype too long perpetuated by Hollywood. No much different from Step 'n' Fetchit. Condescending. Controlling. And however unintentional the result may be, this new "don't take it seriously" version of the retarded man is serious because it stirs up and serves up some very old themes.

This is the "Tropic Thunder" story line: A washed-up actor (played by Ben Stiller) is making a new film. His last was "Simple Jack," about a boy who stutters and stammers and shambles along. Stiller is upset because he didn't get an Oscar for playing Jack. The costar on his new film (Robert Downey Jr.), who plays an Australian actor playing a black man in blackface, tells Stiller the reason he didn't get an Oscar is because he went "full retard."

This is the dialogue:

Stiller: There were times when I was doing Jack when I actually felt retarded. Like really retarded. . . . In a weird way, I had to sort of just free myself up to believe that it was OK to be stupid or dumb.

Downey: To be a moron.

Stiller: Yeah.

Downey: To be moronical.

Stiller: Exactly.

Downey: An imbecile.

The conversation continues.

Downey: Everybody knows you never do a full retard.

Stiller: What do you mean?

Downey: Check it out. Dustin Hoffman, "Rain Man" - look retarded, act retarded, not retarded. Count toothpicks to your cards. Autistic. Sure. Not retarded. You know, Tom Hanks, "Forrest Gump." Slow, yes. Retarded, maybe. Braces on his legs. But he charmed the pants off Nixon and he won a ping-pong competition? That ain't retarded. You went full retard, man. Never go full retard.

The joke of Simple Jack being a "moron" weaves its way throughout the movie. Simple Jack is a big part of the movie, with his bad hair and his bad teeth, stuttering and stammering away.

This is why Special Olympics, the National Down Syndrome Association, the National Down Syndrome Congress, and ordinary mothers and fathers and grandparents like me are so disturbed by this film. Because people learn what they see. Because people repeat what they hear. And what they are hearing over and over in the context of a joke, as entertainment, is a word that the disability community has been working for decades to eliminate.

In June, Massachusetts included in its budget a provision that will change the name of the Department of Mental Retardation to the Department of Developmental Disabilities next year. Massachusetts was one of only six states still to use the words "mental retardation" in its department title. It was a quiet change. Not many people outside the community of the disabled know.

They'll know about Simple Jack, though. It's pop culture. It's a silly controversy to people who don't know how much a word can hurt.

Beverly Beckham can be reached at bevbeckham@ aol.com. /span> Read more!

Stress of war may help cause schizophrenia - Reuters

By Maggie Fox - August 22

WASHINGTON (Reuters Life!) - Pregnant women who live through wars are more likely to give birth to a child who develops schizophrenia, U.S. researchers reported on Thursday in a study linking prenatal stress with the mental illness.

Babies born to women who were in their second month of pregnancy during the height of the 1967 Arab-Israeli "Six-Day" War were significantly more likely to be diagnosed with schizophrenia as adults, they found.

Similar patterns are likely among many stressed women, said Dr. Dolores Malaspina of the New York University School of Medicine, who led the study.

"The stresses in question are those that would be experienced in a natural disaster such as an earthquake or hurricane, a terrorist attack, or a sudden bereavement," Malaspina said in a statement.

Writing in the BioMed Central journal BMC Psychiatry, the researchers said they studied data from 88,829 people born in Jerusalem from 1964 to 1976.

"The raw data suggest a two- to three-fold excess of schizophrenia in the cohort born in January 1968, whose mothers would have been in the second month of pregnancy in June 1967," they wrote.

"The population of Jerusalem would have been most stressed during the three days of bombardment on June 5-7."

Because the war was so short, they consider the situation a natural experiment.

Now the team is looking to see if perhaps people with a genetic predisposition were more or less likely to be affected. It may not necessarily be the case, said Karine Kleinhaus, also of NYU, who worked on the study.

"The hypothesis is that it may induce epigenetic changes, but we didn't look at blood here," Kleinhaus said in a telephone interview.

Epigenetic changes affect how a gene works, but not the DNA sequence itself. Schizophrenia, which affects about 1.1 percent of the population globally, is know to have some genetic causes but many cases have no known family links.

"It could affect people without a family history," Kleinhaus said.

Several studies show that stress in pregnancy can lead to type 2 diabetes, high blood pressure and other types of heart disease in the offspring.

In this study, the effects were seen more in women than in men, with females who had been in their second month of gestation during the conflict 4.3 times more likely to develop schizophrenia than females born at other times. Males were 1.2 times more likely to develop schizophrenia if their mothers were pregnant during the war.

"The placenta is very sensitive to stress hormones in the mother. These hormones were probably amplified during the time of the war," Malaspina said.

Some evidence suggests that male fetuses are more likely to be miscarried if the mother is stressed, so it may be that female fetuses survive with the damage that eventually leads to schizophrenia, the researchers said. Read more!

Treating the homeless - Greenville (NC) Daily Reflector

By TOM MARINE

GREENVILLE, N.C. — Carol Jenkins walked into the Greenville Community Shelter Clinic on a recent Monday night with a noticeable limp.

Her left knee was swollen, she said, and a sharp, shooting pain ran around her knee cap every time she put pressure on the leg.

"Do whatever you can do for me," Jenkins told the clinic staff in her New York accent. "This knee has been giving me a lot of trouble. It's stiff all the time."

Jenkins, who has been living at the Greenville Community Shelter for nearly two months, spent the next two hours being examined by medical students and doctors before leaving with a half-filled bottle of generic pain relief medication.

The Daily Reflector of Greenville reported that eleven patients, most of them from the shelter, would come to the clinic that night seeking medical attention. For Jenkins and the rest of the homeless population, they say nothing is easy - not even getting pain medication for a body ache.

"Their problem is they don't have access to care," said Lynda Bridges, a medical student at the Brody School of Medicine and member of the board of directors for the clinic, which provides free, basic medical services. "We have (treated) people that were hearing voices and not getting the medication they need."

Due to the limited number of health care options available to them, Bridges said many in the homeless population must get their medical treatment from local clinics or at the emergency department at Pitt County Memorial Hospital, where federal law requires health professionals to admit all patients.

The Emergency Medical Treatment and Active Labor Act requires all hospitals that receive funds from Medicare and Medicaid to provide emergency health care to everyone who needs it, regardless of their ability to pay.

"They go to the emergency room when we are closed because they can't be turned away," Bridges said. "It is a problem. It's a waste of resources and it frustrates the emergency room doctors."

Dr. Timothy Reeder, clinical director of the Pitt County Memorial Hospital emergency department and associate professor of emergency medicine at East Carolina University, said he is not aware of PCMH keeping track of its homeless patients. However, he said that information could come up during the discharge process when the hospital staff identifies where patients live and what ability they have to pay for their medical treatment.

"Sometimes we know because they tell us," Reeder said. "But it is not something we ask on a regular basis, unless it is related to what we are treating."

Reeder said homeless patients are not much different from other indigent patients who are either uninsured or have no means to pay for their medical care. In fact, he said most times the hospital staff doesn't even know what insurance or medical coverage patients may have until they are discharged.

In some cases, Reeder said he suspects there are patients that stay longer in the hospital because they do not have a permanent place to stay.

"The hospital wouldn't put anybody out if they didn't have a safe, secure place to go," he said.

Statistics provided by PCMH show uninsured patients make up about eight percent of the total patient population while Medicare and Medicaid patients constitute more than 60 percent. During the 2007 fiscal year, University Health Systems of Eastern Carolina provided $57 million in unreimbursed indigent care for uninsured and underinsured patients.

Of that figure, $42 million was written off as bad debt by PCMH and $15 million was considered outright charity care. These costs, which are essentially free health care, are expected each year and the hospital plans to absorb it, a PCMH spokesman said.

Similar to PCMH, the Public Health Center does not keep records of patients who are homeless, said Dr. John Morrow, Pitt County public health director.

"If we know a patient is homeless, we certainly take that into account for their treatment options," Morrow said. "Again, if the patient doesn't reveal those things to us, we have no way of knowing."

Morrow said one of the biggest public health concerns in the homeless population is communicable disease control, which can include tuberculosis, HIV-AIDS and other sexually transmitted diseases.

"It is not necessarily the fact that they are homeless that concerns us," he said. "It's the factors that led them to be homeless, such as the lack of a social support structure or the lack of medical insurance.

"It's unstable. That is the key thing that defines it."

According to the National Resource and Training Center on Homelessness and Mental Illness, between 20 and 25 percent of the single adult homeless population suffers from some form of severe and persistent mental illness. That means there is a disproportionate number of mentally ill people among the homeless population when compared to the general population.

"If you don't have a strong mind, you would lose it over there," said Jenkins, referring to her time in the shelter. "You'd be discouraged too if you were looking for housing and employment and nothing was coming your way."

Reeder said when looking at the entire homeless population, meaning both short-term homelessness and long-term homelessness, the No. 1 cause for people to be chronically homeless is mental illness. Substance abuse also can play a large role, he said.

To help provide health care and gain some experience, students from the medical school are volunteering at the clinic, which is scheduled to operate every Monday and alternating Thursdays.

Jennifer Vu and Bobby Scott, both of whom are medical students at the Brody School and board members for the clinic's board of operations, said there is a huge demand from both the Brody students and the local homeless population to keep the clinic open every week.

"There are pre-med students and Brody students that want to do this," Scott said. "Anytime a doctor signs up, within a day the volunteer list is full."

However, they said getting a trained physician - who must be present to supervise the medical students and write prescriptions for the patients - to volunteer has become a problem.

"It's very frustrating because I feel like I'm begging doctors to come supervise us," Bridges said about running the clinic, which was only open two times during May and June.

Because of this inconsistency, Bridges said they have been forced to turn people away because so many show up for medical care. Keeping the clinic open every week, she said, would help the entire situation because the patients will wait to seek treatment if they know the medical students and physicians are coming back.

"They experience the exact same problems as other people in eastern North Carolina, it's just that they don't have insurance," Bridges said in reference to the homeless population. "They come to us for ibuprofen and aspirin. That four dollars may be dinner for them."

In addition to the clinic, the James D. Bernstein Community Health Center provides primary care, dental care and pharmacy services for low-income people in Pitt and surrounding counties. The 15,000-square-foot facility is owned and operated by Access East, an independent, charitable, nonprofit organization.

"They are extremely grateful," Bridges said of the shelter's residents. "They are very thankful because they know we are trying to help them and it gives them a sense of pride that they are helping with our education."

---

Copyright 2008 by The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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Lunch to raise money to aid mentally ill -Greensboro News & Record

By Kathy Johnson

This is a story about neighbors and community.

"No one in High Point is exempt from knowing someone who might have mental health problems," said Linda Myers, a volunteer with the Mental Health Association in High Point since her retirement from the Guilford Center in 2001. "It might be your brother, sister, neighbor, child or someone at work."

Widespread changes several years ago shifted most treatment programs for the mentally ill to local agencies and community groups, said Joyce Terres, who became president of the Mental Health Association in High Point in July.

"We have tremendous services to offer and a tremendous staff that is very dedicated to providing services for members of the community who have mental illness," Terres said.

As demand has increased, so has the need for volunteers and financial help.

The association will have a fundraiser lunch Tuesday at High Point Country Club at Emerywood.

The event offers "good food, good fellowship, great fun, and a great chunk of change," said Sue Allred, who, along with Linda Walser, is co-chairing the fundraiser.

The jar of change is being contributed by treasurer Jack Hendrix, who has been saving it for years.

Speakers include Jeff Furst, director of community development for the Mental Health Association in North Carolina, Ted Thomas of the Piedmont Behavior Health Service and someone who uses the association's services.

"We want to educate people about the issues of mental health and how they are being addressed locally," Walser said.

The association is a private, nonprofit agency funded by the United Way, grants and donations.

Myers said the association also needs volunteers to help teach classes in sewing, woodworking, gardening and computer skills. They also could use help with paperwork and answering phones.

The association was organized in 1967 by a group of concerned citizens, Myers said. The function of that group was to serve as advocates for clients and to provide education for the community.

Today, mental health agencies are serving more people with greater problems but with fewer resources, said Ellen Cochran Jones, the executive director of the Mental Health Association in High Point.

"The further we go in the system, the more needs we uncover," Jones said. "Law enforcement tells me there was an increase in commitment papers filed in 2007, and they are seeing more and more people with mental health problems in emergency rooms and in homeless shelters. The good news is that Guilford County offers more services than several other counties. The county is doing a good job of maintaining some of the critical services and contracting others."

Local services include Destiny House, a psychosocial-rehabilitation day program, and another program that teaches life skills such as housekeeping and grocery shopping.

The association has also helped some consumers resume their education.

One of the life skills taught was the planting and care of a vegetable garden.

The Market Sample Store -- which Martha Stewart (yes, High Point has its own Martha) helped organize in 1999 -- raises funds for the association and provides job training for consumers.

Stewart had worked with the International Home Furnishings Market and helping organize the store was her way of helping the association.

Today the Market Sample Store has a full-time manager, Loren Burdick. The store, at 910 Mill Ave., where Highland Cotton Mill once operated, sells unusual furniture and home-decorating items at or below wholesale prices. Designers receive a 10 percent discount and the bargain room is open at 2:30 p.m. Tuesday through Friday and all day on Saturday with items discounted 50 percent.

"There is not one single person working or volunteering at the association who does not have a heart for the mentally ill," Jones said. "We are at a place in our history that they are able to live more normally than at any other time. We know what to do, if we have the means to do it. The real message, as a community, is to decide what's important. What our response is going to be? My confidence is that our area is going to make the most humane choices."

If you have news of High Point people or events, please contact me at mjohnson2@triad.rr.com
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Can't we all just get along? -Tulsa (OK) World

By JANET PEARSON

Are there lessons to be learned from the recent apartment complex controversy that could help quell, maybe even obviate similar conflicts in the future?

Judging from responses to last week's column about rampant negativity toward public initiatives, there's a huge disconnect here between rank-and-file citizens and local leadership. Citizens feel they are left out of the decision-making loop, dictated to by a powerful elite. When they hear of proposed plans, they seem to be done deals.

Local leaders and their allies, on the other hand, feel they are often unfairly criticized for only trying to get a job done and improve the community. They complain citizens often don't take the opportunity to get involved ahead of time, so they might better understand what's going on and how to affect the outcome.

Let's re-examine the apartment complex controversy with the aim of trying to determine if the controversy could have been minimized.

Property owners near the apartment site at 10 S. Yale Ave. were shocked that the 76-unit complex was nearly a fait accompli when they first heard of the plan. All that remained to be done when the news broke was for
the City Council to accept state funding for the project. If state funding were not involved, the complex could have been built without any notification requirements.

Perhaps area residents would not have become so concerned had they known there already are numerous housing arrangements around Tulsa for people with mental illnesses and formerly homeless individuals who have proven to be good neighbors that cause few problems. In fact, these housing facilities typically are inconspicuous, blending into neighborhoods like any other housing.

The Mental Health Association in Tulsa began developing housing in the late 1980s, and currently owns 230 units and leases another 31 in a variety of neighborhoods, including south downtown, the University of Tulsa area, the Pearl District near downtown, and midtown along south Harvard and Yale avenues.

It also might have calmed fears for property owners to know that these programs are operated under strict guidelines. There is 24-hour, on-site staffing at some sites to help supervise residents who need care. Case management and referral services that help ensure residents' needs are addressed.

At other sites, residents who have demonstrated the ability to live on their own function independently without supervision. In some complexes, there is a mix of residents, including some who have no background of mental illness or homelessness. It might have allayed the fears of the Yale area property owners to know that nearly half of the planned new complex — 35 of the 76 units — will be available to any area residents. Believe it or not, such mixes of residents are not uncommon.

It also might have improved the understanding of opponents if city leaders had made it clear early on that laws and court decisions prohibit discriminating against homeless and mentally ill people in housing actions. The law demands these populations have the same access to decent housing as the rest of us; after all, they're not criminals, just troubled or ill. In the eyes of the law, neighbors have no right to insist they have a say in where these individuals may live.

Developing housing for the homeless and mentally ill in community settings, so that they can be reintegrated into local society, is the aim of a nationwide movement called Housing First. Here in Tulsa, the effort isn't just about moving the homeless out of the downtown area, though that is one objective. The greater goal is to see that their primary needs, such as housing and food, are met in neighborhood settings so that they can then learn to live more productively.

"How in the world can you be expected to shower every day and go to work if you're just in survival mode?" asked Karen LaPlante, Mental Health Association in Tulsa's director of communications and education. If housing and food issues are "taken out of the equation," there is a greater likelihood of employment and stability.

Perhaps it would have helped the opponents in this case to know that residents of such developments are eager to fit in to their new neighborhoods.

Said LaPlante: "We want to be good neighbors. Our residents want to be good neighbors. These people take home and neighborhood really seriously. These things are really important to them."

A new resident made the same point, LaPlante related, at a recent dedication ceremony. "He said, 'This is our home. If someone moves in and causes problems, we don't want them living here.'"

Another lesson in getting along can be gleaned from the experience of the Forest Orchard neighborhood near eighth Street and Peoria Avenue. When residents learned earlier this year a complex was to be located in their neighborhood, many at first reacted warily.

"Our first attitude toward it was negative," said Kimberly Norman, neighborhood association president. Even a local pastor, Dean Maas, said his first reaction was, "I don't think so."

But rather than fight back in fear, the neighborhood took a closer look at the issues and united to embrace the social and economic diversity of their unique enclave. "It's the education that is so vitally necessary to make social change," said Maas.

What lessons can we learn from this latest controversy? Outcomes can be less painful if stakeholders keep their minds open and do a little extra homework, if everyone involved attempts to address issues before it's too late.

In a democratic society, everyone has a job to do. While it appears we Tulsans generally have good intentions, we don't always do the necessary legwork to carry out objectives to a successful conclusion. We can do better.



Janet Pearson, 581-8328
janet.pearson@tulsaworld.com Read more!

Cooperation secures beds for mentally ill -Benton County (AR) Daily Record

By Gary Lookadoo

BENTON COUNTY - The recent announcement of the release of in excess of $2 million in state money from the General Improvement Fund followed close cooperation among many entities - public, private and nonprofit. They worked toward a common goal: better care for the mentally ill, agreed two state lawmakers from Benton County.

Medicaid-funded beds are again available for seriously ill mental patients in northwest Arkansas, said the Benton County lawmakers, state Rep. Keven Anderson, R-Rogers, and state Sen. Kim Hendren, R-Gravette.

Up to 29 beds are expected in a Springdale facility, a psychiatric unit set to open in 2009.

It is to be operated by Northwest Medical Center in Springdale and the University of Arkansas for Medical Sciences. Northwest Health System, the University of Arkansas Medical Science's Psychiatric Research Institute, Ozark Guidance, Care Foundation Inc., Washington Regional Medical Center and Mercy Health System will all work together for the facility, the announcement said.

While the governor and people representing many private and nonprofit entities worked together toward the goal, he probably saw best the close cooperation among state lawmakers from all over northwest Arkansas, Anderson said.

In the previous six years, there have been many efforts to restore some beds and needed funds lost in 2002, but those legislative efforts to get funding picked up momentum in 2007, Anderson said.

"Last session, we made a concerted effort," he said.

In the closing days of the 2007 session, making a deal as they rushed to complete the Revenue Stabilization Act, state House lawmakers provided around $ 500, 000 and state Senate lawmakers about $ 300, 000 of the money, Anderson said.

Still, there's lot of credit to pass around among public officials and people representing private or nonprofit entities, all of whom helped, Anderson said. "It was definitely a group effort," he emphasized.

Hendren seconded Anderson's recollection of strong cooperation among northwest Arkansas' legislators, then seconded his notion that the success came as a result of cooperation among many people in government and many people in other walks of life.

He also cited by name three people, two of whom aren't in govern- ment, but all of whom had worked tirelessly on the project. Hendren lauded Gov. Mike Beebe, former state legislator Jodie Mahony of El Dorado and David Williams, who retired as chief executive officer of Ozark Guidance, the mental-health center based in Springdale.

The new beds are especially welcome and will more than make up for some the region lost in 2002, when a 20-bed unit was closed and there were no Medicaid-covered beds available for adults in the region in need of acute mental-health care, the lawmakers said. Read more!

More updates later today - 8/24/08

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Ranks Of Homeless Veterans Growing -New London (CT) The Day

By Jennifer Grogan

Genavesse Spader depended on a paycheck from her job as an accounts payable analyst and child support from her ex-husband to care for her three children.

In June, her contract position with Fidelity Investments ended and, a week later, her ex-husband was laid off from work.

“We went from two incomes to no income,” said Spader, 31.

Born in New London and a Fitch High School graduate, she moved to New Hampshire in January to work for Fidelity.

She served in the Connecticut Army National Guard from 1995 to 2001, where she fixed communications systems in the aircraft at the 1109th Aviation Classification Repair Activity Depot in Groton.

Without a job, she left her apartment in New Hampshire and moved back to Connecticut, to be near family. But there was not enough room at relatives' homes for her and her three children so she turned to the Covenant Shelter of New London.

“If the economy wasn't this way, I would've gotten a job in a short period of time and it would've stopped the progression of everything else that happened,” said Spader, who has lived in the shelter since late July with her three children, ages 10, 4 and 2.

As the economy has worsened this summer, local shelters and organizations that assist veterans have seen an increase in the number of veterans, like Spader, seeking their services.

Many are worried about how they will cope with the predicted influx in the winter months, when rising home heating costs become an additional burden on those already struggling to make ends meet.

“We're a very small operation and we have very limited funding,” said Catherine Zall, executive director of the New LondonHomeless Hospitality Center, which runs the overnight shelter at St. James Episcopal Church.

The 110 beds across the state used by the federal Department of Veterans Affairs for transitional housing for homeless veterans are almost always full.

“We have never had a May, June, July and August where we have not only every bed that we have in the state occupied, but we have waiting lists,” said Laurie Harkness, director of th