Justus: Reform state’s mental health system -Hendersonville (NC) Times-News

By James Shea


State Rep. Carolyn Justus hopes North Carolina will continue to reform the mental health system, saying the system continues to suffer from an overhaul crafted by the General Assembly in 2001.

The Republican incumbent faces Democrat Paul Goebel in the Nov. 4 election.

Justus said she transferred from a public safety committee to a mental health oversight committee to help deal with the issue.

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Taking cigarettes out of the mental health equation - Raleigh (NC) News & Observer

Point of View: Katie Patsakham

CHAPEL HILL - Reports of violence, abuse and blatant neglect in North Carolina mental health treatment facilities demand appropriate responses. However, government leaders, mental health providers and citizens may be overlooking a more subtle but significant instance of neglect.

Few realize that 44 percent of cigarettes smoked in the United States are smoked by people with mental illness and substance use disorders (as reported in JAMA, the Journal of the American Medical Association, in 2000). High rates of smoking (two to four times higher than in the general population) and the large number of cigarettes consumed per day help to explain this staggering statistic.

As we envision ways to create safer and healthier environments for staff and residents in mental health settings, strategies to address tobacco use and dependence must be part of the plan.

For most of us, "tobacco-free" is an increasingly accurate descriptor of our lives. Hospitals, schools, work places and recreational areas are becoming tobacco-free, inside and out. In North Carolina, the majority (77 percent) of the population does not smoke. More than half of those who do smoke have tried to quit in the past year.

Seven over-the-counter and prescription medications are available to help people quit. Tobacco users have access to a free telephone counseling service (N.C. Quitline, 1-800-784-8669) as well as numerous Web sites, cessation programs, support groups and self-help materials.

Even in the most supportive environment, overcoming addiction is a tremendous struggle. Unfortunately, tobacco use is still the norm in many mental health residential facilities. (Smoking is now banned inside, but not outside, state mental hospitals.)

High rates of smoking among both staff and residents, the absence of formal training for staff in smoking cessation and the lack of adequate cessation treatment (counseling and medication) for residents make quitting extremely difficult.

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WIDESPREAD FAILURE TO ADDRESS THIS ADDICTION IN THOSE WITH MENTAL HEALTH DISORDERS is frequently portrayed as a compassionate approach. Family members and service providers argue that quitting is simply not a priority. Cigarettes serve as a reward, a source of comfort, a way to cope with stress and the only good thing in the lives of people who suffer tremendously. Nicotine improves their mood and social skills, and it may help people with schizophrenia reduce some of the symptoms associated with their disease.

These compelling reasons, in addition to the power of addiction, help to explain why many people with mental illness smoke.

While the needs of the mentally ill and concerns of their caregivers are certainly valid, smoking is not the solution. Not only does it cause significant morbidity and mortality in this population, but it is also associated with increased psychiatric problems.

For example, people with schizophrenia who smoke exhibit more positive symptoms of their disease such as hallucinations and delusions. Moreover, smoking actually interferes with the treatment of mental illness because it alters the way many drugs are metabolized, including psychiatric medications. As a result, smokers require significantly more medication than non-smokers to achieve the same effect.

In addition, evidence does not support the belief that people in substance abuse treatment who want to quit are placing their overall stability and recovery in jeopardy. In fact, participating in a smoking cessation program may actually facilitate abstinence from other substances. Families and providers need to understand that more and more people with mental illness and substance use disorders want to quit smoking. With appropriate treatment, they can succeed.

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COMPREHENSIVE CESSATION PROGRAMS ARE BEING DEVELOPED IN HOSPITALS across the state and the 2008 Clinical Practice Guidelines for Treating Tobacco Use and Dependence provides an excellent, evidence-based treatment manual.

Psychiatrists and other mental health providers can begin by educating themselves about the most effective approaches for treating nicotine addiction in their patients, including management of medications and withdrawal symptoms. Directors of residential facilities can review their current policies regarding tobacco use: Are residents given access to counseling and medication? Are staff trained to help residents quit? Does the social and physical environment support cessation? Family members can serve as essential sources of support and encourage their loved ones to seek additional help.

Given the hazardous nature of cigarettes, we simply cannot turn a blind eye to smoking in people with mental illness and substance use disorders. A truly compassionate response acknowledges the enormous challenges they face and supports them in quitting anyway, for the sake of their lives.

(Katie Patsakham is program associate with the UNC Nicotine Dependence Program in the Department of Family Medicine at UNC-Chapel Hill.)

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Pedaling on the road to recovery - Watsonville (CA) Register-Pajaronian

BY: TODD GUILD

About a year ago, Christopher Lawrence was in Iraq, serving as a corporal in the U.S. Marine Corps when he lost his right leg in an explosion. Now, he’s included an epic bicycle trip on his road to recovery.

“For four months, I couldn’t walk,” he said. “Now I’m putting my body to the test and pushing it.”

On Monday, Lawrence was in the dining room of the UC Santa Cruz University Inn, eating breakfast and preparing for the second day of a 420-mile “Road 2 Recovery” bicycle ride from San Francisco to Los Angeles.

“I do physical therapy every day,” he said. “That’s my job. This is just an extension.”

The morning sky was foggy and cool, a hint of mist floating on the light breeze — “perfect riding weather,” said one cyclist as he prepared to depart.

Lawrence joined about 60 other riders, most of them active duty or former military. Many of them were injured veterans themselves.

Although Lawrence relies on a prosthetic leg to walk, he said it hasn’t hindered his ride.

“That’s my good side,” he joked. “That’s where my power comes from. The only thing that stops you is yourself.”

“I’m in good shape for a marine, but this is something completely different,” he said.

The Road 2 Recovery ride was produced by the Fitness Challenge Foundation and the Veteran’s Affairs’ Voluntary Service Office. The goal of Road 2 Recovery is to promote bicycle riding to help the recovery of veterans with mental and physical injuries. The seven-day ride will pass several military bases in California.

Many of the veterans participating in the ride have visible injuries. Several cyclists have prosthetic limbs as a result of traumatic injuries suffered in various conflicts. Less tangible, but no less debilitating, are the injuries that lurk below the surface, such as post-traumatic stress disorder, which is being found in a growing number of people returning from war.

“We’re trying to raise the awareness of the benefits of cycling to heal injuries,” said John Wordin, an organizer from Road 2 Recovery. “No matter what their injuries, anyone can ride a bike.”

Wordin said he started with Road 2 Recovery about a year ago after a ride with the Palo Alto Veterans Administration.

“What they found is that riding makes a difference in the overall health of the vets,” he said.

Nick Lerma has been in the Marine Corps for nearly two decades, and has served in Somalia and Iraq. He said he began experiencing symptoms of PTSD after his first tour of duty. He joined a recovery program, and started riding a bicycle to alleviate stress about a year ago.

“A year ago I would have been in the corner, eating by myself,” he said. “This trip has really helped me get out there socially. I’m putting challenges back in front of myself.”

The cyclists ranged from veterans who returned from Vietnam more than three decades ago to those recently injured in Iraq, from business professionals to warehouse workers and from Olympic-level riders to those who haven’t been on a bike since they were children. All the riders, however, found a community by focusing on the same goal.

“All different backgrounds seem to level out,” said Jim Perseyres, a professional bicyclist who served in Vietnam and began riding soon after he returned. “There’s no social stratification here.”

Road 2 Recovery is supported entirely by donations and sponsors.

One sponsor is Patricia Kennedy, a Los Angeles resident who has been a supporter of dance for more than two decades.

About a year ago, she decided she wanted to do something to promote world peace. Kennedy sponsors an organization for dancers whose careers have been sidelined by injuries, and decided she wanted to do something similar for veterans.

Kennedy founded Step Up 4 Vets, a nonprofit organization committed to helping returning veterans make the transition from active military service to civilian life.

“We’re not here to say the war is right; we’re here to say the warriors are right, and that’s as far as it goes,” she said. “This is about our kids who are going into harm’s way.”

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For information or to sponsor a rider, visit Road 2 Recovery at http://r2rriders.com or www.stepup4vets.org/about.html

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*Photos by Tarmo Hannula*
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EastRidge working to improve finances -Martinsburg (WV) Journal

By Naomi Smoot

CHARLES TOWN - EastRidge Health Systems is planning changes in the coming months as the agency continues to work toward financial stability.

The mental health agency has struggled over the past several years as its programs have changed, resulting in mounting debt that at one point reached nearly $3 million, officials said.

"The debt is going down, but it just needs to go away," said Director Paul Macom, who noted that EastRidge's debts now stand at slightly more than $1 million.

Agency officials intend to institute a series to changes in the coming months in an attempt to increase revenues and decrease costs.

For starters, EastRidge will sell three buildings that it no longer uses. Two of the properties were previously used for group homes. A third structure housed an addiction treatment center.

The agency was forced to close its 28-day addiction treatment program this past spring because state funding was not sufficient to continue providing the service.

"We realize that's an important hole in the continuum of services," Macom said.

The agency is consolidating other properties and programs as well, he added.

Work and day treatment programs that took place in EastRidge's Jefferson Center will soon move to the Grove Center in Hedgesville. Moving the programs from Jefferson County to Berkeley County helped reduce the amount of unused space the agency has, while also ensuring that nurses and other staff are available for all clients.

"The building was four times what we needed. ... We're using literally 25 to 30 percent of it," Macom said.

While consolidating the properties could pose transportation problems for some clients, it will help ensure that they have more work to do during the day, he said, noting that finding contracts to fill at the Jefferson Center was difficult.

"They had virtually nothing to do a lot of the time," he said.

EastRidge officials are trying to increase the number of contracts for the agency's consolidated work program at the Grove Center, and they are also looking into items that could be manufactured easily and at low costs, he said.

But the agency is doing more than just realigning programs - a series of additions are also planned.

EastRidge is increasing the number of licensed therapists on staff, and increasing the number of billable hours which those therapists work, Macom said.

The agency has also agreed to team up with the Morgan County Board of Education, which will place its alternative school inside one of EastRidge's facilities. That will enable the agency to provide more counseling services to those students who need them.

"It's expanding the service, but there's revenue that goes along with that," Macom said.

A new suboxine clinic also was opened recently to help those dealing with opiate addictions, he said. The new program is "an extremely good treatment system," he said.

The changes come along with numerous others that EastRidge has in the works. If they are successful, it could help the agency get back in sound financial shape within 12 months, Macom said.

EastRidge's financial struggles are not unique among the state's behavioral health centers, he noted. Until recently, it was one of 14 such comprehensive behavioral health centers in West Virginia. One of those centers shut down because of bankruptcy, and a second has changed names for similar reasons, Macom said.

"There are three, four, or five (centers) that it's a month-to-month struggle," he said.

-Journal staff writer Naomi Smoot can be reached at (304) 725-6581 or nsmoot@journal-news.neta
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Construction begins on housing for mentally ill -Lompoc (CA) Record

By Bo Poertner/Managing Editor

The groundbreaking for a $9 million, 39-unit residential housing complex near downtown Lompoc for low-income, disabled, mentally ill and homeless people was held Monday.

The three-story Homebase on G, 513 North G St., is expected to open in Fall 2009.

Homebase on G is a partnership of Transitions Mental Health Association and the Santa Barbara Housing Assistance Corp., with funding from several sources, including Santa Barbara County Alcohol, Drug and Mental Health Services and the city of Lompoc.

The studio units will be large enough for one or two residents, and will include handicapped-accessible bathrooms and kitchens.

The units will lease for $396 to $485, including utilities, based on anticipated incomes of prospective residents.

There will be 19 units dedicated to mental health clients and disabled people who have been homeless, seven to low-income disabled people, up to 11 for low-wage workers, and two for live-in residential managers.

In addition, there will be a 15-member team of service providers on site. There will also be some staff office space.

Mayor Dick DeWees, addressing a small crowd that gathered on the site, called the complex a “fabulous facility that is so needed,” and said it will serve as a “bridge for people to get into the market and move on to other housing.”

Roger Heroux, a consultant who has worked on the Santa Barbara Countywide 10-year Plan to End Chronic Homelessness, told the audience that the focus is on the chronically homeless, a group that accounts for only 10 percent of all homeless but uses more than 50 percent of the services provided to all homeless.

He said there are about 6,000 homeless people in Santa Barbara County, but only enough space in shelters to serve about 500 of them. On any given night, he said there are thousands of people sleeping in vehicles or on the street.

In addition to the human hardship, taxpayers pick up the financial tab in terms of jails, hospital emergency rooms, psychological placement services and other social services.

“Every year it costs Cottage Health Systems an estimated $7,212,400 to provide services to homeless individuals, $350,400 for Marian Medical Center to provide services to homeless individuals, and $154,643 for Lompoc Hospital to provide services to homeless individuals,” according to the 10-year plan.

The report, from 2006, also states: “In Santa Barbara County, homelessness is a very real threat for many low-income residents. Santa Barbara County families earning 30 percent of the area median income ($19,110) can afford no more than $478 for monthly rent. However, median rent for the City of Santa Barbara is $960, for Lompoc it is $639, and for Santa Maria it is $675.

Don Dahl, 200 E. Maple Ave., who lives within sight of the lot where Homebase on G will be built, said the location is already home for homeless veterans “who sleep in the weeds.”

He said he welcomes the complex because the residents will have 24-hour supervision and help available to them.

“If it's going to help the people, I'll go for it.”

Bo Poertner can be reached at 737-1053 or bpoertner@lompocrecord.com.

September 30, 2008
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State offers mental health first aid class -Frederick (MD) News Post

By Ashley Andyshak

Just as taking a CPR class won't make you a medical professional, completing mental health first aid training won't make you a therapist.

But organizers hope people who complete the new 12-hour course will be prepared to recognize signs and symptoms of mental illness and provide initial assistance in a mental health crisis.

The concept of mental health first aid originated at Australian National University seven years ago, and Maryland is one of the first states in the U.S. to develop its own course.

State officials began studying the program earlier this year as a way to prevent tragedies such as those at Virginia Tech and Northern Illinois University, where mentally troubled students shot and killed a combined total of 38 people, said Amy Thompson, who coordinates the mental health first aid program for western Maryland.

Those trained in mental health first aid will have the skills to respond to mental health emergencies, like panic attacks, threats of self-harm, or suicidal feelings, in the same way those trained in first aid and CPR can provide initial intervention during medical emergencies. Skills learned in the course can also help trainees point friends and colleagues with signs of mental illness to appropriate help and resources.

The course will include information on depression, schizophrenia and bipolar disorder, as well as eating disorders, self-injury and substance abuse. The 12-hour course is divided into two six-hour days or four three-hour days, Thompson said.

The association also is working on an electronic version of the course that will require at least one in-person session with an instructor in addition to the computer classes.

The training will be available at no cost to mental health agencies, nonprofit organizations, government agencies and the general public until the end of the year, Thompson said. Beginning in 2009, all participants will pay a fee.

About a quarter of the U.S. population has a diagnosable mental illness during their lifetime, according to Pat Hanberry, chief executive officer of the Mental Health Association of Frederick County. Depression is the most common disorder, and is the cause of more lost work days than any other condition, mental or physical, she said.

Hanberry said she hopes the first aid training will help reduce the negative stigma attached to mental illness and encourage more people to talk about it and seek professional treatment.

The association also is looking for those interested in becoming mental health first aid instructors.

A five-day training is scheduled for Nov. 10-14 in Baltimore at no cost. Read more!

Pfizer to end heart, obesity drug development - Reuters

NEW YORK (Reuters) - Pfizer Inc will drop efforts to develop medicines for heart disease, obesity and bone health as part of its plan to focus research on cancer and five other therapeutic areas, a company memo showed.

The New York-based firm, set to provide a product development update on Tuesday, will end drug development in an area known for its flagship $12 billion per year cholesterol-lowering drug Lipitor, as well as some of it's biggest disappointments.

Alzheimer's disease, diabetes, inflammation/immunology, oncology, pain and psychoses (schizophrenia) were "higher priority areas" for Pfizer going forward, its Therapeutic Advisory Group wrote in an internal memo dated September 25 provided to Reuters from the company.

"These large markets, with rapidly advancing science, are the areas where Pfizer can take a leading position," the group wrote in the memo. The company is still considering whether to pursue ophthalmology.

"It's a continuous process to constantly evaluate our pipeline and make decisions based on high priority, unmet medical needs with market growth potential," Pfizer spokesman Ray Kerins said.

Sales of Lipitor, the world's top selling drug, are slowing as patients have opted instead for cheap generic forms of Merck & Co's Zocor. The sales are set to fall off a cliff in 2011 when generic versions are slated to hit the market.

Pfizer has been unable to come up with enough new blockbuster medicines to replace those that have lost, or will lose, patent protection, such as hypertension drug Norvasc.

In December 2006, the company scrapped cholesterol-lowering drug Torcetrapib after it was linked to deaths in a large trial, losing some $800 million in development costs.

It was a major setback for the company and investors, who had high hopes for the product, and the share price has languished ever since.

The recent shift in R&D focus was led by President Martin Mackay, a long-time Pfizer research executive who took over the division in October of last year.

The plan is expected to include job cuts and a reduction in spending, but will not affect products in late stage development or set to be launched in the next three years, according to Kerins.

That includes its co-development collaboration with Bristol-Myers Squibb Co on the experimental blood clot preventer Apixaban from a highly anticipated new class of medicines that has been targeted by several drugmakers.

(Additional reporting by Phil Wahba)

(Reporting by Edward Tobin; Editing by Clarence Fernandez)

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Lawsuit filed in teen beating case -Kalamazoo (MI) WWMT

Video available by clicking post title.

KALAMAZOO, Mich. (Newschannel 3) - A videotaped encounter between a Kalamazoo Department of Public Safety Officer and a teenager is now the basis of a $5 million lawsuit in Kalamazoo.

The video from May of 2008 shows Officer Derek Nugent ramming the boy's face into a wall, which knocked out his front teeth.

While Officer Nugent was suspended right after the incident, now the teen's legal guardian, Julia Frank and her attorney have filed a federal lawsuit against the city, the police department, and officer Nugent.

Frank and her attorney, Arnold Reed, say they feel they have to follow through with this lawsuit because there is no way to justify this level of brutality.

Since the incident happened back in May, Newschannel 3 determined that the teen has more than 20 open cases against him, many of them for violent crimes. However, he was diagnosed as mentally disabled six years ago, according to his guardian, and has never stood trial for the crimes.

So the question is, where are the parents, and why aren't they controlling their child? Newschannel 3 asked Julia Frank and her attorney that question Monday afternoon.

"I've been asking for help for Michael, and they keep telling me there's no funds," said Frank. "I'm not a psychiatrist, I don't specialize in that, and that's why I've been asking for the help for Michael."

Right now, the teen is receiving around-the-clock care at Edgewater, a mental health facility in Grand Rapids. Frank says the treatment is voluntary, but she would not say how she's paying for it.

Frank's attorney is working on a contingency bases, meaning if the teen doesn't win the suit, he gets nothing.

But Frank and Reed both say that they want it to be clear: the $5 million lawsuit is to punish KDPS for the physical abuse, and make to sure the teen gets the care he needs. None of the money will go to Frank herself.

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Shooter's rampage shows pitfallsfor mentally ill - Associated Press

SEATTLE - Isaac Zamora's mother begged him to get help when he was released from jail a month ago. State and federal laws prevented her from doing much more for the man who has now been arrested after a shooting spree in rural northwest Washington that left six people dead and four wounded.

The Tuesday afternoon rampage began close to the home of Zamora's mother, Dennise Zamora, near Alger, about 70 miles north of Seattle. It continued amid a high-speed police pursuit on Interstate 5 and ended in Mount Vernon, about 20 miles south of Alger, when Zamora surrendered at a sheriff's office.

In the wake of the shootings, Dennise Zamora has said she wants people to know that "my son was desperately mentally ill and we've been trying to get him help."

If someone resists help in Washington, a family member must demonstrate he is a danger to society or himself or is "gravely disabled" before he can be involuntarily admitted to a mental hospital.

Washington's laws offer more options for involuntary commitment than most other states, said Ron Honberg, legal director of the Arlington, Va.-based National Alliance on Mental Illness. But Washington families still can't petition in court for their adult relatives to get treatment.

States struggle to pay for treatment
The laws were designed to protect the rights of the individual, explains David Weston, chief of mental health services with the mental health division of the Washington Department of Social and Health Services.

Many states, including Washington, also struggle to pay for mental health services.

That might be part of the explanation why Zamora, who was ordered by a judge to seek a mental health evaluation as soon as he was released from jail in August, had not yet seen a counselor. He served six months for cocaine possession.

His evaluation was delayed while his parole officer tried to find money to pay for it, said Chad Lewis, spokesman for the state Department of Corrections, which was supervising Zamora after his release.

Zamora, 28, is being held on $5 million bail for investigation of murder and attempted murder.

According to friends and family, the gunman had been in and out of hospitals over the years, seeking help for mental illness.

In Zamora's case, the treatment was mostly involuntary, but Weston said the majority of mental health services are provided to people who ask for help.

Start with 911
Fewer than one-third of adults with a diagnosable mental disorder receive any mental health services in a given year, according to a U.S. Department of Health and Human Services report on mental health.

Honberg called it a sad irony that in most cases, the 8.1 million adults with schizophrenia or bipolar disorder in the United States are being cared for by their families, who have no legal standing.

Friends of Zamora said he had been diagnosed with both mental illnesses, but state officials would not say if such a diagnosis was part of his file.

Forcing an adult to get mental health services requires a complicated legal process in every state, and an appeal by a family member is not usually the most effective way to get that help.

"It's not unusual at all for the initial contact to be with law enforcement," Weston said. "911 is often the right place to start."

Family members may be more successful at getting their loved ones help for a mental disorder if they try an approach other than pleading or badgering, said Dr. Xavier Amador, author of a guide for getting treatment for a family member. Half of the people with schizophrenia or bipolar disorder in this country don't understand they are ill, Amador said.

Instead of trying to change the person's mind about treatment, family and friends can listen to the person's concerns and find a common area of agreement that can lead to the same result.

For example, the person may agree to treatment to keep the police away from their front door or may be willing to take medications as a way to avoid going to the hospital.

Amador, who said the method has been taught to families, health care providers and law enforcement officials around the world and helped get his own brother, who suffers from mental illness, into treatment.

"It's really pretty simple if you think about it," he said.
Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Guidelines alert heart patientsto depression risk - Reuters

Julie Steenhuysen

CHICAGO Sept. 29 - Heart patients should be screened routinely for depression, a common complication that can make a second heart attack more likely, according to guidelines released by the American Heart Association on Monday.

They reflect growing evidence that depression often follows a heart attack, and depressed heart patients are at higher risk for more heart trouble.

"Studies show that depression is about three times more common in patients following a heart attack than in the general community," said Judith Lichtman of Yale University School of Medicine, who helped write the new guidelines, which appear in the journal Circulation.

"Because there has been no routine screening for depression in heart patients, we think there is a large group of people who could benefit from appropriate treatment," she said in a statement.

Lichtman said more research is needed to understand why heart patients are more likely to be depressed.

For Barbara Forman of Dayton, Ohio, depression set in shortly after her double bypass surgery 5 years ago. "I had the idea that I would be an invalid for the rest of my life," she said in a telephone interview.

Forman believes the heart disease triggered her depression. She got help from medication, and now volunteers for Mended Hearts, a support group.

Getting help may save lives, Lichtman said. Studies show depressed heart patients are more likely than others to stop taking their heart medications and are less likely to stay on heart-healthy diets or get regular exercise.

Depression can also bring about changes in the body, including reduced heart rate and increases in blood factors that encourage the formation of blood clots.

The group recommends early and repeated screenings for depression. Heart patients showing signs of depression should be evaluated by a mental health professional and screened for other psychiatric disorders, such as anxiety.

Treatment options might include therapy, exercise, antidepressants, cardiac rehabilitation or a combination of these approaches.

(Editing by Maggie Fox and Jackie Frank)


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Event to honor couple’s daughter, promote prevention of suicide - Schenectady (NY) Daily Gazette

Kathy Ricketts

ALTAMONT — When David and Barbara Grapka lost their 25-year-old daughter, Lesley Elizabeth, to suicide on Jan. 2, 2007, their first thought was to lock their doors, shut their drapes and deal with their grief alone.

“The next morning at 7:30, the doorbell rang, and it was a close friend who came over just to be here,” recalled Barbara Grapka. “Then people started trickling in to visit and bring us food, and I remember thinking, ‘We don’t have enough chairs for all the people who are coming over just to be with us.’ And we really began to understand what it meant to have support.”

As a way to create awareness and raise funds for mental health issues, they started the LEGacy Project, a nonprofit organization. That project will sponsor “Out of the Darkness: A Musical Celebration of Life” from noon to 9 p.m. Sunday at Northern Lights, Clifton Park. Activities will include live music, food, a silent auction, games and contests.

Admission is $15. All money raised will be donated to The American Foundation for Suicide Prevention, a nonprofit organization dedicated to understanding and preventing suicide through research and education that reaches out to people with mood disorders and those affected by suicide.
Leaving behind

“We started the LEGacy Project because legacy means ‘what someone leaves behind,’ and our daughter’s name was Lesley Elizabeth Grapka — so the LEG is in capital letters,” explained Barbara Grapka, a reading specialist in the Bethlehem Central School District for 23 years. “We were also getting a lot of donations in Lesley’s name.”

With some of the funds, the couple planted a tree at Northeast Career Planning, where Lesley worked as a vocational-rehabilitation counselor. They also started a $1,000 scholarship at Guilderland Central High School, where Lesley graduated in 1999. She was also a 2003 graduate of Vassar College and earned a master’s degree from Albany State University in counseling/psychology in 2005.

“She was very bright, talented and funny,” recalled her father, project coordinator for Technology Resources for Education Center for BOCES.

The main goal of the LEGacy Project is to raise awareness about suicide prevention.

“It’s too late for us,” said David Grapka. “But part of our healing journey is to try to help others.”

The night of Dec. 31, 2006, Lesley Grapka visited her parents at their home.

“We tried to talk her into staying, but she said she wanted to be with her friends, and that was fine,” recalled her father. “But when she left, she gave us the biggest, longest hugs she had ever given us, and she was crying. She said she wanted to thank us and wish us a happy new year. She got in her car, drove away, and that was the last time we saw her alive.”

Lesley, who had been treated for bipolar disorder for several years, went to her apartment in Albany and wrote her parents a note in which she told them how much she loved them. After calling in sick on Jan. 2, 2007, she took her own life.

Her parents, who had recently returned from a trip to London, remembered they had forgotten to give their daughter a gift they had brought back, and so they called her at work. When they learned she had called in sick, they called her at home. Getting no answer, David Grapka drove to his daughter’s apartment.

“The shades were drawn and the television was on,” he recalled. “I knocked on the door, and no one answered. I couldn’t find her car; so I thought maybe she was with a friend.”

By early evening, when the couple still couldn’t get hold of Lesley, they began to worry, and once again David Grapka drove to his daughter’s apartment.

“I could see she was sitting in a chair against a bay window, and her head had fallen back and pushed the curtains open,” recalled Grapka. “I started screaming and pounding on the door, and when I couldn’t get in, I called 911.”

The next several days are a blur for the couple. Still, they found comfort from the more than 700 people who came to Lesley’s services.

“Depression is a disease, and it’s often a fatal disease,” said David Grapka. “Here was this beautiful, intelligent, loving young woman who took the time to write us a note telling us that it wasn’t our fault, but the grip of depression was so strong, she could not see any other option.”

Barbara Grapka said The LEGacy Project is a good way for the couple to channel their energy and to do something for others.

The idea for the musical celebration grew out of visit the couple had with several of Lesley’s friends who were in a band called Catfish.

“Lesley played the cello in the band, and after she passed away, several of the kids and other kids from high school and college would come to our home and talk to us about her,” recalled Barbara Grapka. “It was very healing for us.”

One of the young women in the band suggested a reunion in honor of Lesley, and before long, it grew into a musical celebration of life. They hope to raise about $4,000.

“I guess what it comes down to is we loved our daughter and were proud of everything she accomplished in her life, and the fact that she did this doesn’t make us love her any less,” said Barbara Grapka.
Ending stigma

Mary Jean Coleman, regional director for the Upstate New York chapter of the American Foundation for Suicide Prevention, said the stigma associated with mental illness should end.

“It’s time we stopped separating the mind from the body,” she said. “If your loved one has heart disease, we don’t hide that. We’ve come a long way, but we have a long way to go.”

More than 32,000 people in the United States die by suicide every year. It is this country’s 11th leading cause of death.

If you fear that someone may take their life, always be willing to listen to the person, said Coleman.

“We all have the ability to listen to another human being who is hurting, and then to try to help that person get some help,” she said. “Do not leave them alone until help is available.”

“I still wake up sad or crying some nights,” added David Grapka. “But we learned in our support group that it wasn’t our fault. So some days, we take it one breath at a time. That is how grief-stricken we are. Then it’s one hour at a time. And finally, one day at a time. But trying to do good things in her name is what keeps us going.” Read more!

Eastpointe will launch two mobile mental health crisis teams here - Goldsboro (NC) News Argus

By Matthew Whittle - September 29, 2008

In a move that was expected, but one that couldn't have come at a better time, Eastpointe announced last week that it has received funds from the state for the creation of two new mobile crisis management teams.

The one-time funds, totaling $200,000, will be used to start two new units to respond to emergency mental health situations. They will cover the traditional Eastpointe catchment area of Wayne, Duplin, Sampson and Lenoir counties, as well as Onslow and Carteret.

"It is a large area for two mobile crisis teams, and there could be a night in which you have as many as six different emergencies going on at the same time, but that normally doesn't happen," said Eastpointe Director Ken Jones.

But, he added, while more teams are needed, at least Eastpointe now has a way to respond to those emergency calls.

He explained that the point of the teams is to offer an alternative to going to the hospital when somebody is in crisis after regular business hours.

"Between 8 (a.m.) and 5 (p.m.) we've got a good plan for where people are supposed to go," Jones said.

After hours, however, is when people in crisis -- primarily those who are a threat to hurt themselves or others -- have been directed to local hospitals and then often to Cherry Hospital.

And while curtailing the number of unnecessary admittances is always a goal, Jones acknowledged that it's especially important right now with Cherry currently without federal funding and working under an independent management firm.

"The goal of the teams is to de-escalate the situation and help the client to somewhere other than a hospital," Jones said. "The point is to be a first-responder. If it's someone who is appropriate to go to the hospital, the teams will make sure they get to the hospital.

"But if they're able to help the client in the client's own environment and find a support service right there before it escalates into a hospital setting, that's a major advantage to the system."

And, he added, "there are a lot more options for care than there were a year ago."

The goal, Jones continued, is to have the teams hired and in place by November, and then active by December.

Each, he explained, will have access to a psychiatrist and will include somebody with a mental health background, somebody with a substance abuse background and somebody with a developmentally delayed background -- "so all the disabilities are covered" -- with at least one team member in each county so that at least one can respond to any scene in two hours or less.

The teams also will work with local law enforcement agencies, several of which have recently undergone crisis intervention training.

They will be employed by Easter Seals/UPC, an Eastpointe provider. In addition to the $200,000 in start-up funds, the local management entity also was promised $310,332 in recurring funds from the state for ongoing expenses.
Read more!

Tucson saves money by not locking up some homeless - Associated Press

Sept. 29 - A program that keeps homeless people out of jail for petty crimes has saved Tucson $3.8 million in jail costs since 2000, a city official said.

Tucson city Magistrate Michael Lex told caseworkers and others who work with the homeless how the program works during the Tucson Planning Council for the Homeless annual conference last month.

Lex created what he said was Arizona's first mental health court to help the homeless get services to help them avoid arrests and jail time.

The city court's homeless program has resulted in 31,777 charges dismissed since the program began in 2000.

Those charges represent 13,363 court dockets and nearly 6,000 individuals whose charges were thrown out after they completed a diversion program tailored to their needs.

Lex said sending homeless people to jail over and over again for petty crimes like urinating in public, trespassing and panhandling amounts to a life term on the installment plan. "It just doesn't work," he said.

After seeing the same people over and over again, Lex said he realized the mentally ill were very poorly served by the (criminal justice) system. Read more!

Losing Walt - Raleigh (NC) News & Observer

Thomas Goldsmith - Sept. 28

Walt Kline no longer remembers that he has Alzheimer's disease.

Until a few months ago, the IBM retiree, full of humor and handsome at 74, had accepted that he had the disease, which brings on dementia.

He had been fighting it for four years with every means he and wife Peggy could find. Those included cutting-edge treatments at Duke and UNC-Chapel Hill, stimulating activities such as brain puzzles and volunteer work, and Peggy's quest for the latest on the disease.

Walt and Peggy, 49, who works from home for IBM, have faced off against the disease since 2004. Their story, which they have shared with The News & Observer for 30 months, shows how hard and fast Alzheimer's attacks. And it demonstrates that, even with the best and most aggressive care available, the unstoppable disease slices away decades of recall and abilities within a few years.

Early on, Walt Kline showed only mild effects. In 2006, he could still cut the couple's lawn in Cary, though he often mowed the same spots over and over. But by spring and summer of this year, Kline frequently erupted in anger or tears. He walked into a room naked, oblivious, in front of a visitor. He would urinate almost anywhere in the Klines' neatly kept Cary home, unable to remember where the bathroom was.

"I can't take it," he said one morning in July. "I'm confused. I'm lost."

New cases of Alzheimer's strike more than 4,000 North Carolina families each year, a number that will almost certainly increase as the state's population ages.

Identified as a disease more than 100 years ago, Alzheimer's causes breakdowns in the way brain cells communicate. Success or failure in finding new treatments will directly affect millions of lives, including the Klines'.

"We have five million cases of Alzheimer's in this country, and that number could easily double or triple in the next 25 years," said Dr. P. Murali Doraiswamy, a Duke dementia expert.

Many who suffer with the disease wind up testing family bonds, running through financial assets and, ultimately, needing long-term care. The federal government's Medicaid program pays $19 billion a year on care for Alzheimer's patients in nursing or rest homes.

Early diagnosis helps

The Klines are better situated than most. Walt Kline took out long-term care insurance two years before he started having Alzheimer's symptoms. That policy, plus Peggy's salary, Walt's pension, Social Security, insurance payments and other bits and pieces provide the means to pay for good care throughout the process.

In addition to seeking top-level medical treatment, Walt and Peggy Kline have talked through their situation in support groups at the Alzheimer's Association office in Raleigh and received in-home help from the Center for Volunteer Caregiving. The couple must be careful what they spend on Walt Kline's care, but they have enough money and insurance to make his situation better than most.

Even after Alzheimer's started to cut deep into Walt Kline's good spirits, his upbringing in Depression-era Detroit drove his get-it-done attitude and reluctance to whine. Already retired from a 37-year career as an IBM computer systems manager, he was 70 and having memory problems when he answered an ad for clinical trials at Duke.

"We were recruiting people with forgetfulness," Doraiswamy said. "We felt that he a had a form of preclinical Alzheimer's disease."

Early detection for Walt Kline meant he could receive benefits from new-generation drugs such as Namenda and Razadyne, designed to slow the cognitive losses of Alzheimer's, Doraiswamy said.

In addition, early detection enabled him to take part in difficult conversations about the rest of his life, signing documents that would spell out his wishes for end-of-life treatment and Peggy Kline's responsibility for his financial matters and health care.

Because Walt Kline needed stimulation and activity and his wife needed to work, he spent most days in adult day care at the Total Life Center in Cary.

Early on, Walt still sounded articulate when he joked with friends or spoke out at a candlelight vigil in Raleigh. He also shared woes and triumphs with other couples at the Alzheimer's Association offices in Cameron Village and appeared on a CBS News segment about early detection of the disease.

"I don't like to lose my ability to remember things or do things right," Walt told the national TV audience.

Even in the summer of 2006, however, testing at Duke made clear that Walt Kline had trouble recalling simple facts.

"In all honesty, I have no idea," he said when asked the day of the month.

A sudden decline

At the end of 2006, Walt's treating physician, Dr. Daniel Kaufer of UNC-CH, told Peggy that Walt's condition seemed to have stabilized -- the best Christmas present she had had in years.

But a few short weeks later, as 2007 began, Walt Kline started having crying jags and temper tantrums, and antidepressants didn't always help. Peggy Kline grew stressed and prone to accidents as she tried to work, but found it harder and harder with her husband at home.

"I fell in my parents' garage," she said. "I took a big whack on a cement floor and had to go to the ER."

Specialists say looking after someone with Alzheimer's disease becomes a medical condition of its own. According to the nonprofit National Alliance for Caregiving, those who look after people with Alzheimer's are prone to sleep deprivation, poor eating habits, lack of exercise, staying on their feet when ill and failing to keep medical appointments. They are even at risk of earlier death.

"There's always ups and downs in any marriage -- you have to work at it," Peggy Kline said.

"When it comes to health, you just want to be there. It's an unconditional kind of thing."

Peggy Kline is 25 years younger than her husband, but the Klines didn't see that as an issue when they met in Detroit as late-shift IBM employees. They married when she was 29 and he was 54.

Despite her devotion, she has felt the toll of being a full-time caregiver. She has fallen, cut herself accidentally, gone sleepless night after night.

Peggy Kline decided to look into permanent care for Walt at a good assisted living center -- a hard decision that many families face as the disease progresses. One place she explored was HeartFields at Cary.

But when the center called in October with a place for Walt, Peggy couldn't go through with it.

"I wasn't ready to let Walt go," she said.

In November 2007, Peggy contracted bronchitis and had to hire help when she could no longer look after her husband for two weeks.

"At that time, I had never felt so frustrated and helpless at the same time," she said. "I thought it was time to get Walt set."

A wrenching choice

The ways that Alzheimer's works remain mysterious, but it's known that parts of the brain that control memory show increases in formations called plaques and tangles as patients have more trouble remembering and thinking. As Walt Kline's disease progressed from early to moderate stages, he tried again at Duke to answer questions.

His name and address?

"That's going to be tough," he said. "I'm not good at that."

Walt could no longer make a sandwich, tell time, use a phone or remember that he had worn the same clothes for three days.

Together, the couple visited HeartFields in December 2007.

"When he got there, the first thing he said was, 'These people are old; I'm the only young person here,' " Peggy said.

"I said, 'Walt, I'm always doing 10 things at one time. I get very sick when I get sick anymore. I need rest.' "

After a tense period of reluctance from Walt, he moved into a secure, locked dementia unit in HeartFields in February. After a few days of living there, he seemed washed out, pale, lacking even the lower levels of energy he'd shown in recent months.

He sat in a chair in his room and had a long, circling conversation with Peggy.

"The thing about it is, Peg, is that I need to get a job and make some money," Walt said.

She answered, several times: "You know you can't really have a job now, Walt."

After six days, Peggy took Walt home.

Going home untenable

Back home, Walt continued on a downward spiral of memory and ability. One day in July, he and Peggy were going through what she called one of his better mornings.

From the living room, she could be heard helping Walt through his ritual.

"Did you go?" she asked. "Put the paper in the toilet. Flush it. Don't go back to bed."

Walt Kline washed his face, dried it, then had to wet it again for shaving. Peggy Kline applied cream to his face, then carefully shaved him after he stopped midway.

He said he wanted to go to sleep, but she said no.

"You've got to go to the senior center," he said.

"No," Walt said, "God, no."

Peggy Kline patiently helped her husband finish dressing, then fixed toast, fruit and juice. They talked about the day ahead, but then his mind turned to something else.

"They usually get in the middle," Walt said.

Peggy asked, "Who does?"

Thoughts seemed to race through Walt's mind, but they emerged too tangled to be understood.

"I don't know where I'm supposed to go," Walt said. "Let's go, OK? That's the best thing to do."

Assisted living

As Alzheimer's progresses, the brain shrinks and the disease begins to destroy a patient's ability to respond to surroundings, to speak and ultimately to control the body's functions.

By this summer, Walt Kline's disease had entered what's known as the late moderate stage, characterized by real difficulties with daily routines and an increasing need for supervision.

Finally ready to let someone else look after Walt, Peggy found a spot for him at Woodland Terrace, a Cary assisted living center with a virtually spotless public record. He moved in in early August.

Walt is well looked after, but the Klines' life these days is far from the future the couple pictured during the late cups of coffee and dinners they grabbed at IBM, getting to know one another in Detroit.

On an August morning, Walt sat with a group in a sunny room at the center, sometimes singing along with old song lyrics on a video screen.

Woodland Terrace is well kept, with a plentiful, friendly staff. The food was OK, he told a visitor last week, but he didn't want to be there.

He grew anxious, glancing over his shoulder, searching for Peggy.

"I don't know where Peg has gone," he said.

Peggy would be back that evening, but Walt could no longer remember that she would return, as always.

ABOUT THIS STORY

(Walt and Peggy Kline agreed in spring 2006 to allow a reporter and photographer from The News & Observer into their lives as they fought Walt's dementia. To see firsthand the effect of dementia on patients and families, Thomas Goldsmith and Corey Lowenstein spent time with the couple, visiting their home and going along on medical appointments and testing, legal appointments, volunteering stints, support groups, trips to long-term care homes, and finally, to Walt's new home at Woodland Terrace.)

thomas.goldsmith@newsobserver.com or (919) 829-8929 Read more!

Children exhibit anxiety over direfinancial predictions - Associated Press

Linda Shrieves • September 29, 2008

Across the country, as the economic squeeze is tightening on America's families, it's causing a ripple effect on some forgotten victims: kids.

Children are worrying about whether their parents have enough money to buy groceries — or moving in with other family members because their parents can't pay their mortgages.

Call it trickle-down anxiety.

The effects on children are showing up at schools, where kids are complaining about stomachaches and sleep problems.

Some researchers estimate that 2 million children will be affected by the nation's foreclosure crisis. Meanwhile, jobs are being cut, too.

Although the worries — especially housing issues — are not hitting Rochester as hard as other areas, school counselors and social workers are seeing some of the same concerns among area students. They say some children are dealing with the strain of family incomes dipping because of layoffs or other concerns. They say these concerns manifest themselves in stress and in practical concerns such as college considerations.

In schools in some harder-hit states like Florida, the concerns are more widespread, says Aimee Jennings, who runs a school counseling program in and around Winter Park.

In one case, a fifth-grader told her school's counselor she was worried about her parents being able to pay all the bills because they were already losing their home. "Now," Jennings said, "she's starting to lose focus at school, and she's not getting her work done."

Many children are focused on money, with high school students talking about getting jobs to help out their parents.

"We have seen an increase in the number of children and the differences in behavioral symptoms — school phobia, ADHD, more anxiety and depression in the children, not knowing what's happening in their families," says Jim Berko, director of Seminole (Fla.) Community Mental Health. "Obviously they've picked up the anxiety from their parents."

George Schulz, a Winter Springs, Fla., psychologist, is seeing more children with sleep disorders and school phobia. Some younger patients are clingy and suddenly afraid of someone breaking into their homes. One boy is now terrified of the fire alarm at school.

Kids today already deal with more everyday stress than previous generations, Schulz says — because we've burdened them with too many worries.

"Parents are too open with their kids these days," Schulz says. "Even high school kids aren't old enough to handle that. I would not discuss the details of the family's financial situation with any child until they're adults. What's the use? They're just going to worry more."

Steve Rhode, president of MyVesta Foundation, a financial counseling service based in North Carolina, doesn't necessarily agree. He thinks you should be open, but not dramatic, when talking about money. For example, don't say you're going to lose your house if Daddy loses his job.

However, Rhode says, you should sit down in a nonconfrontational setting and lay out the situation. You might say that the family would be better served if everyone cut back and ask for ideas.

"Kids are always smarter than we give them credit for," he says. If you don't talk about it, "you might be saying volumes without opening your mouth. Instead of making your children guess — or ask 'is it me?' — you should talk about it."

The family as a whole can start practicing more prudent financial decision-making, asking whether they really need something.

At the same time, he says, when the news is on "and full of very dire statements," you need to explain to children what really affects them and why. The Wall Street bailout proposal, for example, is an opportunity to talk about personal finance versus the financial system and answer their questions to the best of your ability.
Read more!

Man shot by police officer -Raleigh (NC) News & Observer

Jay Price

CARY - A Cary police officer shot a man while responding to a call early Saturday in a neighborhood just north of Apex Community Park.

Police went to 202 Dundalk Way at 4:41 a.m. after getting a call that someone there was having a mental health crisis, Capt. Mike Williams of the Cary Police Department said.

"In the course of dealing with him, the officer had to use force, and that's when the shooting occurred," he said.

Members of the wounded man's family identified him as Jimmie Cummings, a former Marine who turned 31 years old Sunday. They said the officer shot him in the stomach, apparently after Cummings pulled out a BB pistol.

The family attended the wedding of Cummings' brother on Saturday and had returned home when Cummings started acting oddly and began hitting himself in the chest, according to his father, Jim Cummings of Hubert, a retired Marine gunnery sergeant.

Cummings' fiancee had dealt with a similar incident by having him taken to the emergency room, and she called 911 asking for help again, Jim Cummings said. She made it clear that Cummings wasn't dangerous, he added.

Jim Cummings said several police officers responded to the call and spent about 20 minutes trying to subdue Jimmie Cummings or calm him.

Jimmie Cummings went into the kitchen where a BB weapon was kept. His fiancee and two roommates couldn't see him, but they did see the officers draw their weapons They said they yelled for the officers not to shoot.

Jimmie Cummings was in stable but critical condition at WakeMed Raleigh on Sunday night, his father said.

Williams declined to release the name of the officer who fired, citing the current investigation by the State Bureau of Investigation into the incident. An investigation is standard procedure in shootings.

jay.price@newsobserver.com or (919) 969-8094 Read more!

Football (soccer) therapy - for the mentally ill - BBC

By Jane Elliott
Health reporter, BBC News

When Peter Smith was a young boy he was obsessed with football.

He would play every lunchtime at school and any other time he got the chance.

But when he hit the age of 19 he and his identical twin David were both diagnosed with mental health problems - both were bipolar.

They were frequently in and out treatment, and Peter found himself becoming more and more reclusive.

Became reclusive

"I spent almost a decade going in and out of hospital due to smoking cannabis and not really coming to terms with my mental illness or even trying to manage it.

"I was not going out, not socialising, just staying in."

This has helped me turn my life around and to see that there is light at the end of the tunnel
Peter Smith

But six years ago, Peter got involved with his local team Hackney FC - set up specifically for mental health patients by occupational therapist Janette Hynes, herself an ex-professional footballer.

She then set up her own league - the Positive Mental Action league - and now has 21 teams across London. She now hopes to branch out across the country.

Peter, who started first as a player, then became team captain and manager, is now a coach and mentor. He says the scheme has transformed his life, and that of his twin who also became involved.

"It helped me make friends and was a catalyst to make me more aware of my self-management, I gave up smoking cannabis and cigarettes and became more focussed in what I was doing. I was able to contribute in the way I wanted.

"My illness put stress on the family and friends. My brother and I both have children and we wanted to do more give support them, but we had the stigma and discrimination to cope with.

"This has helped me turn my life around and to see that there is light at the end of the tunnel and give me hope. It has also put me in the position to give others hope.

Health benefits

Janette said she had originally come up with the idea of their own league so that they could field both male and female players - unlike the FA.

Players are recruited through local hospitals, community groups and hostels and she said the benefits were soon apparent.

"I worked in the gyms helping people and I saw a need.

"Where could people go? People say go into the community, but where can they go. they sit in and have no social network to keep them well," she said.

When 15 members of Hackney FC were questioned after 10 months in the team, they reported significant improvements in their health.

Three quarters reported being able to reduce their medication after taking part in the course, the same proportion said they had a better social and family life and that they had gone on to get jobs or do further courses, like Peter.

People also reported other fringe benefits such as better general health and reduced weight and smoking.

Expansion plans

Janette, who recently won the the NHS Institute for Innovation and Improvement and the Department of Health's 'Health and Social Care Award for Leadership for Improvement' said she was delighted by players' improvements.

"They go out more and are more social.

"They talk to each other and are really proud of the league."

There are now plans to expand the scheme to the under 18s to help prevent them becoming isolated.

Neil Tinning, from the MDF Bi-Polar Organisation said schemes like this were a fantastic way of promoting health and keeping the mentally ill as well as possible.

"From my view point the PMA League is an excellent concept.

"Being bipolar I understand the issues sufferers face. Supported environments provide the much needed bridge between ill health and recovery.

"The sports element enhances the positive effect of physical well being.

"When you are ill, you feel very isolated. However, teamwork inspires camaraderie, and this helps you understand you're not the only one," he said. Read more!

NAMI exec campaigns for mental health -Billings (MT) Gazette

By MARTIN J. KIDSTON

HELENA - As a child, Matt Kuntz lost a friend to an eating disorder. When he entered Capital High School as a teen, he lost classmates to suicide.

Mental illness had always been there; it was always something he'd seen. It just wasn't an issue Kuntz stopped to consider for very long.

But last spring, he watched helplessly as his stepbrother, Chris Dana, lost his battle with post-traumatic stress disorder and ended his life in suicide. That, Kuntz said, changed everything.

More than 17 months into his unplanned but energetic campaign to improve mental health care in Montana, Kuntz is working to change the way mental illness is perceived by the public.

"We've got an opportunity right now to help develop a system that takes better care of Montana's mentally ill," he said last week at a downtown cafe. "I think there are a lot of challenges that need to be met. But people are working hard. There's no doubt about that."

The former Army infantry officer who became a lawyer but quit his practice to serve as the executive director of the Montana chapter of the National Alliance on Mental Illness admits that his road as been a strange one.

He adds that his new position with NAMI wasn't something he saw coming. Yet the timing was right and change was needed, and since last March, change is what he's been fighting to achieve.

Kuntz praised the system implemented by the Montana National Guard this summer in response to Dana's death. In less than two years, the Guard revamped its entire post-combat environment and adjusted the way it works with soldiers returning from deployment.

That effort began in March 2007 when Dana shot himself after returning home with the Montana National Guard from Iraq.

In the day's following his death, Kuntz began pushing for change within the service. He met with the press, wrote several op-ed pieces for the newspaper, called the governor's office and stayed abreast of the progress.

"The night before I wrote my first letter, I felt really sad and defeated," Kuntz said. "I didn't want Chris to die in vain, and I didn't want to read about other people in the paper. I just hoped the people would respond."

During a Memorial Day celebration at Fort Harrison last summer, a service member approached Kuntz and told him not to worry - told him the problems would be fixed. It was then, he knew, that things would finally began to change.

Gary Dana, Chris's father, has also watched the progress evolve over the past 17 months. He's pleased with the progress made by the Guard and admits to being more aware of PTSD and other mental-health issues, thanks in part to strong campaigns launched by the military and NAMI alike.

"I hear about it more than I did in the past," he said. "Not just the veterans, but other people who have gone through tragic events. I don't know if it's because I'm more in tune with it now, but it seems like I catch it a lot more."

While changes have been made within the Guard, which is now used as a national model of success, Kuntz has stepped back in his role as NAMI Montana's executive director to view the larger picture.

In his new position, he fields phone calls daily from around the country. He sees families dealing with mental-health issues, including the stigma that surrounds it. If the Guard can address the issue and achieve change, Kuntz believes, so can Montana.

"Our society is really working to address these things with our veterans, because it's very clear that we have a duty to address them," he said. "But when we see the gains we're making within the military population, it's going to be very hard not to ask why we're not giving everyone else the same level of treatment."

NAMI describes mental illness as a brain disorder that causes disturbances in the process of thinking, feeling, or outward behavior. It names depression, bipolar disorder, schizophrenia and severe anxiety as examples of mental illness.

The organization is pushing to create change through education and advocacy. It's a role Kuntz has enthusiastically assumed, and he's quick to discuss the progress taking place in Montana and beyond.

Among the efforts, he mentions Sen. Max Baucus, D-Mont., who is actively encouraging the U.S. House of Representatives to pass the mental-health parity bill. The Senate already passed the measure by a 93-2 vote.

"Every Montanan and American - no matter what their health ailment - deserves access to quality, affordable health care," Baucus said on Thursday. "For far too long, mental health illnesses have not been treated with the same coverage and care that other illnesses have."

Baucus, chairman of the Senate Finance Committee, inserted the Mental Health Parity provision into legislation. He said the bill would level the playing field and ensure that all illnesses, including those related to the brain, receive the same level of coverage.

Kuntz welcomes the bill, along with community peer-to-peer efforts, which resemble vet-to-vet programs used in the military. New programs, coupled with public education, he said, could affect change in the general community, just as it did in the Montana Guard.

"The men and women who have served so bravely and come home have served in more ways than one," he said. "They've served to defend their country and keep us safe, but also, through their sacrifices, we've taken some dramatic steps forward in understanding brain disorders and stigma and why that's such a big barrier to treatment.

"That sacrifice of theirs is going to be tremendous if we push it just a little further outside the service." Read more!

Asperger patient gains in maturity under center’s care -Worcester (MA) Telegram & Gazette

By Lee Hammel - lhammel@telegram.com

WORCESTER— Life has not been easy for Stephen Berthiaume and his family.

“He was a great baby,” recalls Judy Berthiaume, his grandmother. She and her husband, Donald, raised Stephen in Worcester from the time he was 2 weeks old.

But by the time Stephen, now 16, attended a Head Start program, his teachers noticed something was not quite right with the 4-1/2-year-old. He was not socializing with the other children, and his behavior was less mature than the others. He preferred to squeeze Play-Doh rather than put puzzles together, and scribbled rather than drew, his grandmother said.

The whole time he was at Nelson Place School was “horrible,” Stephen recalls. He had trouble staying seated in classes, and he came close to striking teachers.

The family tried different doctors but didn’t have much luck until Stephen went to the Wetzel Center, a YOU Inc. inpatient psychiatric program for children and adolescents that is celebrating its 10th anniversary this month.

Stephen recalls being angry, but he says he can’t remember why. “I was hitting my grammer (as he calls Mrs. Berthiaume). I wanted what I wanted when I wanted it,” he said.

His psychiatrist, Ludmilla L. Tonkonogy, said Stephen has a mood disorder, anxiety disorder and Asperger syndrome. Stephen had been misdiagnosed with post-traumatic stress disorder, but LADDERS, a diagnostic and treatment center then in Wellesley, diagnosed him with Asperger, one of the mildest forms of autism spectrum disorder. It can involve repetitive routines and rituals, socially and emotionally inappropriate behavior and the inability to interact successfully with peers.

Stephen’s behavior reached a crisis point in 2003 when he attacked Mrs. Berthiaume, kicking her, screaming and making animal-like sounds, Mrs. Berthiaume said. Her grandson was taken to UMass Memorial Health Center, where he waited from 6 p.m. until 8 the next morning until a bed could be found in a child psychiatric unit in Amesbury.

Neither child nor either grandparent has good memories of that experience. Oddly, Stephen recalls, “I was really, really scared there” because he feared he would never see his grandparents again, while Mrs. Berthiaume remembers that Stephen refused to see them during his 28 days at that hospital.

Stephen’s fear was not so far off base. Mrs. Berthiaume also remembers getting a telephone call from a psychiatrist at the hospital saying that Stephen would probably never come home. “I was devastated. I was beside myself,” she said. “I broke down and cried.”

A week later, the Berthiaumes got a call from clinicians at the Amesbury hospital saying Stephen would be transferred to an inpatient unit right in Worcester. That was the Wetzel Center, at 2 Granite St., which has 13 beds for children ages 7 to 12 and 15 beds for adolescents 13 to 18.

The Wetzel Center proved to be “the turning point for Stephen and our family,” said Mrs. Berthiaume, 67. At the center, Stephen received a regimen of drugs that had to be adjusted over time, individual and group therapy, extremely close supervision and occupational therapy. He was part of an explosion in the diagnosis of autism spectrum disorders, with one in 150 children in the United States being diagnosed with one of the disorders, according to the Centers for Disease Control and Prevention in 2007 — a 25-fold increase over the estimated incidence 20 years earlier. Now there are four times more Asperger children in YOU Inc.’s residential programs than those diagnosed with schizophrenia, Dr. Tonkonogy said.

Progress in Stephen five years ago was as precious as it was slow. He continued to avoid seeing his grandparents while in the Wetzel Center. When he finally saw them two months later, it took him 15 minutes to go through the door of the room in which they were waiting.

Stephen said his reluctance to see his grandmother was an effort to protect her. “I was afraid I’d hit Grammer again,” he said. But eventually, Mrs. Berthiaume recalled, Stephen entered the room with Rosie, a therapy dog, on a leash.

Stephen touched her hand, and, five minutes later, with the pointer’s leash still in his hand, he touched his grandmother’s shoulder. And then, without Rosie, “he hugged me,” Mrs. Berthiaume said.

After Stephen’s most recent stay at the Wetzel Center, he was released to the Devereux Foundation’s West Meadow residential program in Rutland for children with emotional and behavioral difficulties. He is home now, and Eric Gemboski, a Devereux support and stabilization family service worker, visits twice a week for four hours at a time.

Stephen attends the Goddard Learning Center, which is operated by the Central Massachusetts Special Education Collaborative in West Boylston.

Stephen bears little resemblance to the out-of-control child of five years ago. “He’s relaxed, he’s mature, he can joke about things — about himself,” said Dr. Tonkonogy, who is medical director of YOU Inc. “He had no sense of humor before whatsoever. It’s incredible. I’m very impressed with him.”

Stephen’s kind of impressed, too. “I’ve matured a lot,” he said. “I’m not hitting, kicking, scratching. I’m calmer, not swearing, not so anxious all the time.”

His grandmother predicts a job and an apartment are in Stephen’s future.


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Is Pakistan's new president up to the job? - LA Times

Corruption charges, jail terms, diagnoses of mental illness -- critics wonder if Zardari will be able to tackle nuclear-armed Pakistan's growing crisis.

By Henry Chu

ISLAMABAD, PAKISTAN — Only a year ago, Asif Ali Zardari was best known as the husband of Benazir Bhutto, a highflying businessman with a taste for fine living, polo and, his critics allege, bribes. He was a man who spent 11 years in jail while awaiting trial on unproven corruption charges, the stress of which, according to court papers filed by doctors last year and viewed by a British newspaper, induced bouts of dementia and depression.

Today, Zardari is the leader of this nuclear-armed country, a nation crucial to the security of the United States but one beset by an internal crisis whose outcome could, some say, determine whether Pakistan stands or falls as a modern Muslim state.

Just three weeks into his presidency, Zardari is facing an unprecedented challenge from Islamic extremists, who blew up the Marriott Hotel here in the Pakistani capital in a brazen suicide attack that killed at least 53 people. He is now under enormous pressure to improve security for his people and rescue a flailing economy.

Most delicate of all, he must find a way to cooperate with Washington in its war on Islamic militants without seeming to be bossed around by it or, worse, ignored as U.S. troops based in Afghanistan increasingly make forays against insurgents on Pakistani soil.

Whether Zardari is up to such a difficult task is a question on the minds of many of his compatriots, who wonder whether he has the charisma, clout and capability to rise above party politics and his personal interests for the sake of the nation.

Few Pakistanis can forget that Zardari, 53, is an accidental president, thrust onto center stage after Bhutto, a former prime minister, was assassinated in December by extremists. Zardari took the helm of his wife's Pakistan People's Party, which emerged as the biggest winner at the polls in February, and was elected president by lawmakers this month after the resignation of Pervez Musharraf.

From the beginning, Zardari pledged to unite the country and to bring back the rule of law, including the reseating of a number of judges sacked by Musharraf in an apparent bid to stay in power.

But Zardari has so far failed to deliver fully on those promises, leaving lawmakers divided and hostile at a time when unity is needed more than ever as Pakistan struggles to contain the burgeoning threat of Islamic militancy within its borders.



U.S. looms large

Sending troops in search of extremists, which has resulted in the deaths of hundreds of civilians, soldiers and suspected militants, has proved unpopular with many Pakistanis, who see Zardari as obeying the dictates of the U.S.

Even more infuriating to them are the U.S. military strikes in Pakistan from across the rugged, poorly marked border with Afghanistan, including an alleged incursion Thursday in which Pakistani and American troops briefly exchanged fire.

"This is a moment of national crisis for Pakistan," said Farzana Shaikh, an expert on South Asia at Chatham House, a British think tank. "Mr. Zardari should call on the support of parties across the political spectrum. It's only by being seen to forge a national consensus that Mr. Zardari could then claim that Pakistan is fighting a war that is as much in its own interests as the interests of the United States."

Instead of shoring up support from his opponents, Zardari's refusal to reinstate the nation's popular former chief justice, whom Musharraf fired, has led to a rupture with former Prime Minister Nawaz Sharif and his Pakistan Muslim League-N party, the only real rival to the PPP. Sharif pulled his party out of a coalition government over the issue.

"The new government has been far more engaged in political wrangling, in trying to outmaneuver . . . Sharif's party and trying to consolidate its own position rather than attending to the far more pressing problems of militancy and the economy," Shaikh said.

That has hardened perceptions of Zardari as a political schemer and opportunist rather than an inspirational leader dedicated to the greater good.

Many Pakistanis still regard him as a venal wheeler-dealer whose bank accounts suspiciously bloomed during his wife's two terms as premier. His nickname was "Mr. 10%," a reference to his allegedly crooked business practices. He was jailed twice, following each of his wife's terms as prime minister, spending a total of 11 years behind bars on corruption charges. He says the charges, which were never proved, were politically motivated.



Mental illness cited

Corruption charges were lodged against Zardari in several countries, including Britain, where he was able to delay legal proceedings because of diagnoses from two American doctors last year describing him as mentally ill, according to court affidavits seen by the Financial Times newspaper.

Such incidents have made people skeptical about him as their president.

"Is he a new Mr. Zardari, or is he the Zardari of the past?" asked Rasul Baksh Rais, a political scientist at Lahore University of Management Sciences. "That question is not yet settled, or the question of will he rise to the occasion and lead Pakistan out of crisis."

Rais and others see an opening, in the aftermath of the Marriott bombing, for Zardari to turn public outrage to his advantage, using it to rally the nation behind the fight against Islamic militants. Until now, opponents of that fight have succeeded in painting it as America's war, not Pakistan's.

But whether Zardari has the ability to rally such fervor is uncertain. His wife had charisma to spare, the ability to rouse thousands of people through impassioned speeches and soaring rhetoric that, if not always based in reality, rarely failed to inspire. Zardari is seen as more of a backroom dealer, a political insider who lacks mass appeal.

"It's a battle of hearts and minds," said author Ahmed Rashid. "He should go to the people. The party should be galvanized. He should meet with the opposition. There should be a consideration of a national government at this stage because of the crisis, and they should unite on one platform, which should be an anti-terror platform, which should be portrayed as a struggle to save Pakistan, not a struggle to save America."

Not all the problems facing Zardari are of his making.

The economy has been languishing for months. Foreign investment is down. Food prices are up. Frequent power outages have soured people's moods.



Cozying up to Palin

On the sidelines of the United Nations General Assembly meeting last week, Zardari was busy trying to drum up international aid for his battered nation. Yet as Pakistanis still reeled from one of the worst terrorist attacks in their country's history, he also found time for a chat of questionable propriety with Republican vice presidential nominee Sarah Palin, in which he openly admired her looks and said he might insist on giving her a hug.

Such coziness with the U.S. is unlikely to endear him to a populace already inclined to view his government as a lap dog of Washington.

Zardari, analysts say, needs to concentrate on convincing his people that going hard after Islamic militants, such as those who carried out the attack on the Marriott, is in Pakistan's own interest. Those people include some of the military rank and file, who find it difficult to fight their fellow Pakistanis. In a country that has spent half its existence under military rule, Zardari, as a civilian leader, still maintains only tenuous control of the army.

"If the military doesn't do what he wants it to do, he doesn't have sovereignty," said Stephen Cohen, an expert on Pakistan at the Brookings Institution in Washington. "He's been elected president, but that's meaningless."

At the same time, Zardari has had to convince the United States of his commitment to eliminating extremism, particularly from the Taliban and Al Qaeda fighters who have set up bases along the lawless border with Afghanistan. The U.S. incursions from Afghanistan into Pakistan have added to the tension between Washington and Islamabad and worsened anti-American sentiment here.

It will take a leader of stature and savvy to unknot these difficulties and pull the country together. The jury is out as to whether Zardari is the man to do it.

henry.chu@latimes.com
Read more!

Intruder dies after struggle with renter -Indianapolis Star

By Francesca Jarosz and Tania Lopez

In a quiet enclave of four homes off West 79th Street, two families grieved for David Meyers late Sunday.

Earlier in the day -- in the middle of the night, actually -- Meyers, 52, broke into a teenage girl's room, naked and armed with a knife, and died after a struggle with her father, Robert McNally, 64, who heard his daughter scream for help.

The incident occurred in the home that McNally rents from Meyers' uncle, a few hundred feet away from where Meyers lived with his mother. It left both Meyers' family and McNally, who got along well with Meyers and sometimes had dinner with him, wondering why the registered sex offender did what he did. Saturday, Meyers had dinner with family members and had been talking about joining a church.

"Of the families on the lane, we're all kind of grieving together," said Bill Meyers, the older of David's two brothers, who lives in Zionsville. "Everybody seems to have taken the position that Dave kind of snapped."

About 3:20 a.m. Sunday, police said, Meyers entered the home in the 3500 block of West 79th Street through the 17-year-old girl's bedroom window, wearing only a mask and latex gloves and carrying rope, condoms and a knife.

The girl woke up, saw Meyers, and screamed, police said in a written release. McNally awoke to the screams and went to defend his daughter, according to Sgt. Matthew Mount, a spokesman for the Indianapolis Metropolitan Police Department.

A struggle ensued, beginning in the hallway of the home; when police arrived, they found McNally with his arm around Meyers' neck in the kitchen, police said.

Meyers was pronounced dead at the scene. Police said Meyers had a history of heart problems and that an autopsy will be conducted to determine whether he died of a heart attack or as a result of a choke hold.

Mount said McNally was not arrested, and it appeared unlikely charges would be filed because it seemed clear the resident was defending his family against an armed intruder.

In a brief telephone interview, McNally said his daughter was doing fine and went to church Sunday. He called the incident unfortunate but declined to elaborate Sunday evening.

"Nobody wins," McNally said. "It's a lose-lose situation for everybody. He has family, also."

David Meyers' aunt and uncle live next door to the rented ranch-style home where the incident occurred. David lived with his mother in the house behind his uncle's.

Bill Meyers said his family met with McNally on Sunday evening to talk about the incident. He said there were no hard feelings between the families, and McNally even asked if he could attend the funeral.

"It was awful, it was shameful, it was unforgivable," Bill Meyers said of his brother's actions. "He was insane for that period of time. That wasn't David on a day-to-day basis."

In 1998, David Meyers was convicted of criminal deviate conduct and criminal confinement, Marion County electronic court records show. He was sentenced to 13 years.

Mount said Meyers was registered as a sex offender in Marion County but was wanted in Boone County for failure to register as a sex offender there.

Bill Meyers said his brother had lived with his mother since his release from prison about six years ago. David Meyers had worked at a delicatessen and did seasonal construction work, but he struggled financially and suffered from mental health problems, his brother said.

David Meyers had a 14-year-old daughter and was divorced from her mother, Bill Meyers said. He said David's ex-wife distanced herself from him after he was charged in connection with the incidents in Marion County.

Bill Meyers said his brother brought most of his problems on himself but that his status as a sex offender made it difficult for him to get on with his life after serving his sentence.

David Meyers worked for a book manufacturing company but lost his job a few days ago. His brother said he had been prescribed a psychiatric drug but stopped taking it as recently as the past week.

"He did some stupid, stupid things," Bill Meyers said. "And he paid a heavy price." Read more!

Mother jailed in alleged drowning attempt -Sacramento Bee

By Phillip Reese - preese@sacbee.com

A Citrus Heights mother tried to drown her 2-year-old daughter late Saturday, leaving the child in critical condition at a local hospital, police said Sunday.

Fotini Huntley, 36, of Crosswoods Circle, was booked into the Sacramento County Main Jail early Sunday on suspicion of attempted murder. She is being held without bail.

Authorities said Huntley called 911 around 9:50 p.m. and told dispatchers that she had drowned her daughter.

When police arrived, Huntley was standing outside her apartment. Officers detained her and went inside to check on the toddler.

She was unconscious, so they immediately began CPR. It wasn't clear how long the child had been unconscious, said Citrus Heights Police Lt. Gina Anderson.

The child was rushed to UC Davis Medical Center.

Fotini Huntley's husband, Anthony Huntley, told The Bee that his wife has a history of mental illness, although she has never tried anything like this before.

"She's schizophrenic," he said. "She's been on medication for that for a few years."

Anthony Huntley said he wasn't home when the alleged incident occurred. He only spoke for a moment, saying he was exhausted from staying up all night.

Neighbors said Fotini Huntley often kept to herself.

Angela Quimby said her 2-year-old niece would sometimes greet the Huntleys' daughter as the family came home. "He always did all the talking," Quimby said of Anthony Huntley. "She (Fotini) just kept her head down."

Quimby and other neighbors said it was clear that the toddler was in loving hands.

"(Anthony) seems like a really good dad," Quimby said. "He would always hold her. The mom would just look down." Read more!

NYPD seeks crisis intervention unit -New York Daily News

BY MEREDITH KOLODNER

The NYPD needs a crisis intervention unit staffed with mental health experts to help cops deal with emotionally disturbed people, several police groups said Sunday.

The demand comes four days after a deranged Brooklyn man climbed onto his fire escape naked and fell to his death after a cop zapped him with a Taser.

"They have used more resources to save the lives of animals than they have used here to save emotionally disturbed people," said Anthony Miranda, chairman of the National Latino Officers Association.

The new crisis intervention team would respond to calls about violent and emotionally ill people - not the NYPD's Emergency Service Unit, the advocates said. The team would include mental health professionals, family advocates and cops.

State Sen. Eric Adams said he'll introduce legislation to force the NYPD to create the unit if it doesn't act by January.

In response to Wednesday's death of Inman Morales, 35, of Bedford-Stuyvesant, Police Commissioner Raymond Kelly ordered all ESU cops to undergo a day-long refresher course today in dealing with the emotionally disturbed.

But the police advocates said that's not enough; mental health experts need to be on site, they said.

"If you are not able to make at least an initial evaluation or assessment, you don't know how to appropriately respond," said Marq Claxton, a co-founder of 100 Blacks in Law Enforcement Who Care.

Deputy Police Commissioner Paul Browne said the NYPD responds successfully to more than 80,000 calls a year involving emotionally disturbed people.

"In virtually all instances department training and guidelines are adhered to," Browne said Sunday. "When they are not, appropriate action is taken."

The ESU officer who stunned Morales, Nicholas Marchesona, was placed on desk duty. Lt. Michael Pigott, 45, was placed on desk duty for ordering Morales Tasered when it was likely he would fall, brass said.

mkolodner@nydailynews.com Read more!

Couple say home's ex-owner tried to scarethem out - Associated Press

By MATT REED Associated Press Writer
Article Last Updated: 09/28/2008 02:32:09 PM EDT

GAHANNA, Ohio—John and Jamie Petree couldn't believe their luck. The home they bought in this Columbus suburb was near family and quality schools. Its huge backyard promised years of afternoon fun for their 2-year-old daughter and about-to-be-born son.

They spent about $25,000 on remodeling—a deck, fresh paint, new hot water tank.

They planned more—but instead they installed a security system, including outdoorvideo cameras and door alarms.

They accuse the previous owner, who had lost the house in a bank foreclosure, of trying to scare them away. Charges of menacing by stalking and other offenses involving two separate incidents were filed against Andrew Zukowski, then dropped after he was ruled mentally incompetent.

Now the Petrees have moved away, ending their eight-year struggle.

They and their neighbors say Zukowski went from door to door, handing out fliers and urging people to sign a petition to have "his" home returned.

The Petrees say he also photographed visitors, wrote down license plate numbers and at one point blocked the driveway with his pickup truck, refusing to allow a friend to leave.

"It never ended," said neighbor Ken Weimer. "You'd think he's gone, he's finally given up and then a month or two later he'd be back. And he'd just stop and stare at the house."

Zukowski, 62, a native of Poland, says he drove by the home only once after the foreclosure and never threatened the Petrees or handed
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out fliers or petitions.

He still hopes that someday he'll again walk through the front door.

"I lost my house but maybe God will take different option and maybe somebody will evaluate this situation and change their mind about my good standing, my good reputation because I am not a violator," he said.

Unhappy with the way the house was built, Zukowski had demanded that the county reassess its value for tax purposes. The Ohio Board of Tax Appeals eventually ruled that he
wasn't exempt from property taxes, board records show.

Then, with little savings and no job, Zukowski couldn't keep up with the $532 monthly mortgage payments, and the house sold at auction for $125,000.

"They started the auction: $100,000 ... 105 ... 110 ... 120. I stand up and I say 'I am Andrew Zukowski. What are you doing here? This house has not been foreclosed because I have a pending appeal,'" he said.

A few days after he was evicted in 2000, Zukowski was arrested on charges of criminal trespassing and felonious assault, accused of swinging a pipe at the investor who bought the house.

Four charges of menacing by stalking were dropped when a judge found him mentally incompetent to stand trial.

"Mr. Zukowski does have a persecutory mental disorder, delusional disorder," Dr. John Randall, a forensic psychiatrist, said in a 2001 hearing before the 10th Ohio District Court of Appeals. "Mr. Zukowski has repeatedly acted on delusions and beliefs in a way that have resulted in the fear and intimidation of others, particularly the current residents of the house."

After the Petrees bought the house from the investor, Gahanna police warned them to watch for the former owner.

That fall, John Petree noticed a truck slowly going by the house.

"I thought 'You know what, that's a red and white pickup truck. I wonder if he's hanging around.' So I started walking toward the truck, and it took off," said John Petree, 41.

Zukowski often parked where he had a clear line of sight through fenceless backyards to the back of the house, the couple said.

In May 2003, Zukowski and his wife, Teresa, were at the Petrees' front door. He said they thought the house might be empty.

"I was thinking that this house will be ours," said Zukowski, who now lives in another Columbus suburb. "I don't know. Maybe somebody wants to give back this house because they made a mistake."

Jamie Petree pushed her panic button, setting off the home alarm, and called 911. A dozen police cars blocked the street.

Zukowski was charged with menacing by stalking and resisting arrest. Those charges were dismissed, after three years, when an appeals court found that he hadn't been given a proper mental evaluation.

A probate judge's refusal last year to order Zukowski either committed to a mental hospital or closely monitored—meaning he was no longer considered mentally incompetent—persuaded the Petrees to give up. They say they have lost more than $100,000, including lost income and a lower home value.

"We're not letting our house go because we can't pay," John Petree said. "We're letting our house go because it's unsafe."

In May, they moved into a nearby rental home.

"It became challenging. We thought, 'He's not running us from our house,'" Petree said. "But over last summer, I just got mentally tired." Read more!

Counseling Services merge -Kenai (AK) Peninsula Clarion

By Phil Hermanek

Last November, Central Peninsula Health Centers and Central Peninsula Counseling Services came together under one roof, the new Peninsula Community Health Center on East Marydale Avenue in Soldotna.

This week, the two organizations will come together as one, serving the medical and mental health needs of the central Kenai Peninsula community as Peninsula Community Health Services.

Such mergers are often met with turf wars between the two formerly separate staffs, but Stan Steadman, who will be executive director overall, said because the focus of both organizations has always been on the customer, that will not be the case here.

"We want to assure that access to medical and mental health care is readily available," said Ellen Adlam, president of the new board, adding to Steadman's comment.

"Because so much of behavioral and mental health have a physical basis, treating the whole person makes sense," said Dr. Jeff Magee, medical director of the behavioral health side of the Cottonwood Health Center.

The former CPCS provided comprehensive clinical and rehabilitative services for seriously emotionally disturbed children and severely mentally ill adults, operated the Forget-Me-Not adult day care facility for the elderly and provided emergency psychiatric services.

CPHC operated Cottonwood Health Center and Aspen Dental Clinic providing services regardless of a patient's ability to pay.

In 2007, CPHC had 12,000 patient visits, treating 6,000 patients. CPCS served 1,266 clients during 55,351 encounters.

The boards of the two organizations have been conducting joint meetings to talk about coming together, according to Dr. Paul Sanders, medical director on the medical side of Cottonwood Health Center.

"We wanted to assure we would not harm the consumer," said Barry Creighton, who has been a board member of both organizations.

One benefit of the merger seen by Creighton is simply the psychological effect of walking into just one building to receive both mental and physical health care.

Sometimes it is difficult to convince someone to come in for health care at all, he said. The combined organization allows for coordinated care for the patient.

An article in Behavioral Healthcare magazine cites a 2006 Colton-Manderscheid study revealing that "persons with serious mental illnesses die 25 years younger than the general population, with much of the disparity attributed to inadequate medical care of chronic physical and mental disabilities."

Also a board member of the Alaska Mental Health Board, Creighton said the Alaska Mental Health Authority has been watching the merger to see how successful it is.

"The funders -- Rasmuson Foundation and the Denali Commission -- have considered this cutting edge," Creighton said.

"Because of combining (the organizations), there could be an increase in federal funding," he said.

Creighton also said, "For the staff to be part of something whose time has come is very exciting."

Although Steadman did not foresee any cuts in staff resulting from the merger, he said the two boards "saw efficiencies in collocating" into the new building, including sharing one building rather than operating several as well as shared parking, phone systems, information technology and utility costs.

"We've all been operating lean and mean already," Steadman said, adding the merger will allow the organization to combine human resources, marketing and purchasing functions for added efficiency.

He said the new organization will have 173 full-time and part-time employees.

"This is a community organization run by a community-based board," he said.

Adlam said bylaws dictate that 51 percent of the board members must be consumers. People wishing to serve on the citizen board can call 260-7300 for more information.

The target date for completion of the merger is Wednesday.

Phil Hermanek can be reached at phillip.hermanek@peninsulaclarion.com. Read more!

Shedding the stigma of mental illness -Panama City (FL) News Herald

By Donna Vavala / Contributing Writer

PANAMA CITY — Since she was sexually abused at age 4, Carol Durham has suffered from post-traumatic stress disorder, panic attacks and chronic depression. Despite years of prescription drugs, hospitalization and counseling, she still battles those dragons daily.

Between 1992 and 1994, Durham spent 200 days in a mental hospital and most of her life feeling worthless and socially inept.

However, since volunteering at Life Management of Northwest Florida, a Panama City mental health organization, in August to lead a depression support group and provide peer-to-peer mentoring, Durham said her self-esteem has soared.

"After 55 years, I feel like I can accept that I have value, that I am a success," she said. "I can accept that my experience can help someone else."

The first week in October is "Mental Health Awareness Week," as almost 58 million people in the U.S. suffer from mental disorders. They are ranked as the leading cause of disability in this country and Canada, for ages 15 to 44, according to the National Institute of Mental Health, and though the stigma of mental illness has decreased in recent years, Durham said there still is a long way to go to reach public acceptance and understanding and for parity in health insurance coverage.

As part of creating awareness, a host of organizations — the state Department of Children and Families, Life Management Center, Chemical Addictions Recovery Effort Inc., the department of Elder Affairs, Chipola College, Gulf Coast Community College and the Bay County chapter of the National Alliance on Mental Health, or NAMI — jointly organized Crisis Intervention Training last week for law enforcement officers in five area counties. The weeklong training, which was held at Chipola College, was aimed at better preparing law enforcement officers to handle crises involving people with mental illnesses. Among the classes offered were geriatric mental health, adolescent mental health, suicide/risk assessment, signs and symptoms and making appropriate referrals.

"We just wanted to be sure that law enforcement had the training to increase their understanding of mental illness," said Angel Trejo, circuit administrator for DCF. "Sometimes, in their daily work, they are confronted with someone who's going through a mental health crisis. This training teaches officers how to de-escalate and diffuse the situation."

It also taught them that dealing with adolescents is very different than dealing with adults. Max Pearson, who oversees 27 DUI programs throughout the state, also has a master's degree in social work and is a certified addictions professional. He taught a course on this subject, along with one on dual diagnosis and suicide/risk assessment.

"Officers that have gone through the program say it really shaped their attitude in dealing with people on the street," Pearson said, adding that this training is being offered nationally and that he previously taught the classes at a session in Tallahassee.

Bay County Sheriff Frank McKeithen, who introduced the speakers at Wednesday' s session, sent two deputies to the training.

"Anytime you have an opportunity to educate your officers, you should take that approach, especially in this day and time with mental health issues going on," McKeithen said. "There may be questions about whether someone should be placed in jail or a mental health institution."

Trejo said law enforcement often jails people with mental illnesses instead of referring them to places such as Life Management Center's emergency admitting when there's a problem because they are unfamiliar with the symptoms.

McKeithen said he plans to see how his deputies handle these situations and perhaps have the deputies who attended the sessions train others.

Durham believes any training that fosters understanding of mental illness is valuable, and she wants to encourage people who need help to get counseling and/or join a support group, so they know they are not alone and there is hope.

"My experiences have been a journey," Durham said. "In 2006, I joined NAMI. They didn't have a local depression support group. Life Management agreed to get one started if I would agree to facilitate. We meet every Friday, even on holidays. We have a membership of 35, with an average attendance of 11. I tell them that not only do I hear them, I've been there. I know what they're going through."

Durham also received training in peer-to-peer mentoring. She teaches people about their mental illness, how to cope with it and how to prevent relapses.

"NAMI's big phrase is ‘recovery is not only possible but probable,'" Durham said. "Recovery is a new word in the mental health field. In the past, it was stabilizing.

"We need to start looking at mental illness differently," she said. "People are not bipolar; they are ‘ dealing with' bipolar. They are not schizophrenic; they're ‘dealing with' schizophrenia. If we could just do that, it would take some of the stigma away from mental health.

"People with mental illness are just like people without mental illness. They fail, they learn to step back, they can love and have the same emotions that anyone in the world can have."

Fundraising walk set for Saturday

As part of "Mental Illness Awareness Week," NAMI Bay County is holding "Walk for the Minds of Bay County" on Saturday at McKenzie Park. Signup begins at 8 a.m., and the walk steps off at 9 a.m. Proceeds will go to mental health education.

On an ongoing basis, NAMI's educational programs meet the third Thursdays, from 6 to 7 p.m., at Forest Park United Methodist Church Annex, 1401 W. 23rd St. Also on Thursdays, from 7 to 8 p.m., the Family Members of Adults Support Group gathers at the same place.

Family Members of Youth Support Group meets the third Thursdays, from 7 to 8 p.m., at the church annex, and the Adult Consumer Support Group meets the third Thursdays, from 7 to 8 p.m., at the same location.

On Tuesdays, the Adult Consumer Support Group meets, from 10 to 11:30 a.m., in Life Management Center's small conference room. On Fridays, from 6:30 to 8 p.m., the Coping with Depression Support Group convenes at Friendship Center, 1234 Jenks Ave.

For more information on any of these groups, call Carol Durham at the Life Management Center, (850) 896-6202. Read more!

Social services agencies call for hikein spending - Houston Chronicle

By JANET ELLIOTT

AUSTIN — As pressure grows over systems that are failing to protect disabled Texans in institutionalized care and abused children in foster care, agency leaders are calling for a major infusion of new spending.

The social services budgetary requests for the 2010-11 fiscal years include salary increases for state employees in key positions, higher reimbursement rates for nursing homes and medical providers, and expanded mental health and substance abuse programs to divert low-level offenders from county jails.

"We have some critical needs in health and human services," said Albert Hawkins, executive commissioner of the Health and Human Services Commission. "And we're carrying those priorities forward in our legislative appropriations request."

Hawkins wants 10 percent raises for about 40,000 state employees. These workers do a variety of jobs, including caring for persons with mental illness or mental retardation, monitoring children who have been removed from their families because of abuse or neglect, and determining eligibility for safety net programs.

Turnover in many of those jobs ranges from 30 percent to 40 percent.

For example, annual starting salaries for direct care workers at state facilities for persons with mental retardation are between $20,500 and $23,600.

"I think with higher pay we can probably raise the quality of staff we are able to attract in those jobs. That results in better services to our clients and consumers," Hawkins said.

Rep. John Davis, R-Houston, said higher pay may be needed, although he would prefer merit raises to across-the-board pay hikes. He said that reducing turnover can save money in the long run because of the cost of training new workers.

"If we can increase those salaries and keep the higher retention, that's smart money," said Davis, who serves on the budget-writing House Appropriations Committee.

Hawkins also wants to increase rates for a variety of private providers, including doctors, foster parents, nursing homes and community group homes.

Raising state salaries and increasing provider rates will be costly, Hawkins said. His estimates are expected next month.

The needs are real, but with $3 billion in additional Medicaid costs expected over the next two-year budget cycle, it's unclear how many new initiatives will be funded next session.

$800 million for Ike
Although lawmakers are expecting to enter the session next year with a budget surplus, social services — which accounts for about one-third of all state spending — will be competing with public education, higher education, corrections and transportation.

Last week the state Insurance Commission told lawmakers that about $800 million will be needed in the 2010-11 budget to cover losses from the state-backed windstorm insurance pool because of the tremendous damage to coastal property done by Hurricane Ike.

Lawmakers may be persuaded to boost social services spending by federal investigations and reviews.

The focus is on a U.S. Justice Department civil rights investigation into conditions at state facilities serving 4,800 persons with mental retardation. Last month, the 3-year-old federal probe was expanded from two institutions to the entire system of 11 state schools and two smaller state centers.

An earlier Justice Department report on Lubbock State School and newspaper reviews of employee discipline records at other facilities found disturbing patterns of abuse, neglect and exploitation.

Lawmakers have increased funding for community living options during the past two sessions, but waiting lists have remained stubbornly long because of population growth. This year, Hawkins is asking lawmakers to budget $474.4 million to increase capacity of community services.

Another area where the federal government is pressuring Texas to do better involves high caseloads that prevent child welfare workers from making monthly visits with children and parents. Texas paid a $4 million fine for insufficient caseworker visits stemming from a 2002 review, and preliminary results from a second review this year again found the state deficient.

To address the issue, Hawkins is asking for about 240 new caseworkers. He said that would help Texas meet federal standards that call for monthly face-to-face visits of 95 percent of children in custody of Child Protective Services and their parents.

janet.elliott@chron.com
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-------------------

BY THE NUMBERS

$20,500: Annual starting salaries for direct care workers at state facilities for persons with mental retardation.

82,000: Number of disabled individuals on waiting lists for various community services.

9: Number of years some have been waiting for disability services.



c
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Study finds rural New Jersey has state's highest suicide rates - Star Ledger (NJ)

by Mike Frassinelli

Rural sections of New Jersey continue to record the highest suicide rates in the state, according to a state department of heath study.

The report, analyzing New Jersey suicide rates from 2004 to 2006, shows 10 counties located below Interstate 195 or in New Jersey's rural northwest corner have higher incidents of suicides, with Cape May County at the top of the list.

New Jersey's overall suicide rate dipped slightly, from 6.8 suicides per 100,000 people from 1999 to 2000, to 6.7 suicides per 100,000 from 2004 to 2006, according to the health department's Center for Health Statistics.

"We tend to think of rural life as comparatively less stressful, but it has been shown many times, in the U.S. as well as in some other countries, that suicide rates are higher where population density is lower," said Katherine Hempstead, director of the health department's Office of Injury Surveillance and Prevention, which analyzes injury data.

However, Hempstead said she is surprised the state's rural suicide rates mirror the national pattern because New Jersey is America's most densely populated state.

"What we call a rural area in New Jersey is not really all that rural, compared to places like Montana," she said.

The answer might lie in some of the factors that contribute to suicide, such as a scarcity of mental health services and a significant gun-ownership population.

Seven counties with the highest suicide rates in New Jersey, from 2003 to 2005, had firearm ownership rates above the state average.

"One aspect of rural life is greater likelihood of owning a gun, and with owning a gun comes greater risk of suicide," said Hempstead. "Guns kill more people through suicide than homicide."

According to the state study, 45 percent of suicides in Sussex County were by gunshot, compared to fewer than 16 percent of suicides in Essex County.

In Warren County, which has the state's sixth-highest suicide rate, firearms were used in 47.6 percent of the cases. Also, 24.6 percent of Warren County households own a firearm, more than double the 11.4-percent state average.

The sprawl of rural areas may make it appear mental health services are inadequate, but the opposite is true, say mental health experts. The problem, they say, is that many shun services because of the very nature of rural society.

"If you show up at an office, you may be more likely to see somebody you know," said Shannon Brennan, mental health administrator for Warren County.

"Group therapy is hard to get rolling in a rural community. You want to be anonymous and you go in a group and you end up seeing people you know from town."

Academics also point to the "selection theory," which suggests people in rural areas are individualistic, and may resist counseling.

Some suicides reported in rural areas have been gruesome. In Warren County, one man killed himself with a Miter saw and another set fire to his house then shot himself when good Samaritans with a ladder tried to rescue him.

Suicides overall were most prevalent among non-Hispanic whites, who also are most likely to use firearms, said Hempstead, whose office began a registry 5 years ago to track violent fatalities. Hispanics and Asians, she added, are more apt to commit suicide by hanging.

The state released its first report on suicide rates in 2004, covering data from 1999 to 2000.

Dolores Thomas calls suicide "the most misunderstood of all diseases."

Three years ago, her son Matty, a pilot and father of two young girls, who lived in Atlantic County, died at age 45 after he deliberately walked in front of a car.

"People have a misconception," she said. "Most people who do complete the act, they really don't want to do it -- they do it against their will. It is a breakdown of the emotional immune system. They don't know how else to stop the pain. The pain is so intense, the only light at the end of the tunnel is taking your own life."

Out of necessity, Thomas started a support group in the rural South Jersey counties of Atlantic, Cape May and Cumberland, to help others. She said no such group existed before to help people deal with the aftermath of suicide.

For the loved ones left behind, she said, "It leaves a piece of your soul." Read more!

Mental Adjustment - Cops Shift Tactics and Laser Play - New York Daily Pos

By REUVEN BLAU

The NYPD's deadly use of a Taser last week comes as cops and the city's health agencies are considering sweeping changes in how they deal with the mentally ill.

Police brass are working to create a vast database to allow officers responding to a report of an emotionally disturbed person to search for a history of incidents at the same address before they arrive on the scene.

The plan was among those recommended by a panel convened after last November's shooting death in Bedford-Stuyvesant of 18-year-old emotionally ill Khiel Coppin, who cops thought was brandishing a gun - but was actually holding a hairbrush.

The Mental Health and Criminal Justice Panel issued a 51-page report in June that concluded there is poor coordination between cops and mental-health experts.

The panel urged the NYPD to work with health officials to create a database of mentally ill individuals whom cops have been repeatedly called to handle.

The system could also help cops better handle domestic-violence calls, said NYPD spokesman Paul Browne, adding, "It would be a caution."

The NYPD has also begun talking with local health officials about gaining access to certain medical histories.

Perfecting such a system faces major obstacles. "How do you have a psychiatric record? How do police maintain the updated record? And would the Legislature allow that information to be given to the police?" said Browne.

The panel also called for improved training for 911 dispatchers and cops, the creation of a mental-health unit at the city's Probation Department, and added care for emotionally disturbed youths.

Police respond to nearly 200 calls a day about disturbed persons, according to the NYPD.

City Councilman Oliver Koppell (D-Bronx) has suggested the city consider crisis-intervention methods used by other cities, such as the "Memphis Model" where a cop team receives 40 hours of training by mental-health providers.

In the case of Inman Morales, who died last week shortly after being hit with an NYPD Taser as he stood naked ranting on a building ledge, police say they had never before been called to his Brooklyn apartment.

Lt. Michael Pigott, who ordered the weapon's use, has been stripped of his gun and shield. But the Post has learned that it's not the first time he's been disciplined.

Pigott was put on desk duty for a few months after an incident last year in which a member of his unit shot a dog, sources said.

The officers chased a man with a gun into his Bedford-Stuyvesant apartment when they were attacked. Sources said they were supposed to wait at the door for the Hostage Negotiation Unit to arrive.

Additional reporting by Brad Hamilton

rblau@nypost.com

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Man works to change perceptions of mental illness-Helena (MT) Independent Record

By MARTIN J. KIDSTON
As a child, Matt Kuntz lost a friend to an eating disorder. When he entered Capital High School as a teen, he lost classmates to suicide.

Mental illness had always been there; it was always something he’d seen. It just wasn’t an issue Kuntz stopped to consider for very long.

But last spring, he watched helplessly as his step-brother, Chris Dana, lost his battle with post-traumatic stress disorder and ended his life in suicide. That, Kuntz said, changed everything.

More than 17 months into his unplanned but energetic campaign to improve mental health care in Montana, Kuntz is working to change the way mental illness is perceived by the public.

“We’ve got an opportunity right now to help develop a system that takes better care of Montana’s mentally ill,” he said last week at a downtown cafe. “I think there are a lot of challenges that need to be met. But people are working hard. There’s no doubt about that.”

The former Army infantry officer who became a lawyer but quit his practice to serve as the executive director of the Montana chapter of the National Alliance on Mental Illness admits his road as been a strange one.

He adds that his new position with NAMI wasn’t something he saw coming. Yet the timing was right and change was needed, and since last March, change is what he’s been fighting to achieve.

Kuntz praised the system implemented by the Montana National Guard this summer in response to Dana’s death. In less than two years, the Guard revamped its entire post-combat environment and adjusted the way it works with soldiers returning from deployment.

That effort began in March 2007 when Dana shot himself after returning home with the Montana National Guard from Iraq.

In the day’s following his death, Kuntz began pushing for change within the service. He met with the press, wrote several op-ed pieces for the newspaper, called the governor’s office and stayed abreast of the progress.

“The night before I wrote my first letter, I felt really sad and defeated,” Kuntz said. “I didn’t want Chris to die in vain, and I didn’t want to read about other people in the paper. I just hoped the people would respond.”

During a Memorial Day celebration at Fort Harrison last summer, a service member approached Kuntz and told him not to worry — told him the problems would be fixed. It was then, he knew, that things would finally begin to change.

Gary Dana, Chris’s father, has also watched the progress evolve over the past 17 months. He’s pleased with the progress made by the Guard and admits to being more aware of PTSD and other mental health issues, thanks in part to strong campaigns launched by the military and NAMI alike.

“I hear about it more than I did in the past,” he said. “Not just the veterans, but other people who have gone through tragic events. I don’t know if it’s because I’m more in tune with it now, but it seems like I catch it a lot more.”

While changes have been made within the Guard, which is now used as a national model of success, Kuntz has stepped back in his role as NAMI Montana’s executive director to view the larger picture.

In his new position, he fields phone calls daily from around the country. He sees families dealing with mental-health issues, including the stigma that surrounds it. If the Guard can address the issue and achieve change, Kuntz believes, so can Montana.

“Our society is really working to address these things with our veterans, because it’s very clear that we have a duty to address them,” he said. “But when we see the gains we’re making within the military population, it’s going to be very hard not to ask why we’re not giving everyone else the same level of treatment.”

NAMI describes mental illness as a brain disorder that causes disturbances in the process of thinking, feeling, or outward behavior. It names depression, bipolar disorder, schizophrenia and severe anxiety as examples of mental illness.

The organization is pushing to create change through education and advocacy. It’s a role Kuntz has enthusiastically assumed, and he’s quick to discuss the progress taking place in Montana and beyond.

Among the efforts, he mentions Sen. Max Baucus, D-Mont., who is actively encouraging the U.S. House of Representatives to pass the Mental Health Parity bill. The Senate already passed the measure by a 93-2 vote.

“Every Montanan and American — no matter what their health ailment — deserves access to quality, affordable health care,” Baucus said on Thursday. “For far too long, mental health illnesses have not been treated with the same coverage and care that other illnesses have.”

Baucus, chairman of the Senate Finance Committee, inserted the Mental Health Parity provision into legislation. He said the bill would level the playing field and ensure that all illnesses, including those related to the brain, receive the same level of coverage.

Kuntz welcomes the bill, along with community peer-to-peer efforts, which resemble vet-to-vet programs used in the military. New programs, coupled with public education, he said, could affect change in the general community, just as it did in the Montana Guard.

“The men and women who have served so bravely and come home have served in more ways than one,” he said. “They’ve served to defend their country and keep us safe, but also, through their sacrifices, we’ve taken some dramatic steps forward in understanding brain disorders and stigma and why that’s such a big barrier to treatment.

“That sacrifice of theirs is going to be tremendous if we push it just a little further outside the service.”

Reporter Martin Kidston: 447-4086 or mkidston@helenair.com Read more!

Editorial: Pay now for mentally ill -Sacramento Bee

Editorial:

What happened to Frank Perez in downtown Sacramento is everyone's nightmare. A homeless, apparently mentally ill, panhandler shot the disabled state worker when he refused to give her a handout.

It's ironic that the shooting took place in Sacramento. This community has worked harder than most to address the problem of the mentally ill homeless. When he was in the Assembly, Darrell Steinberg (now a state senator) pushed legislation to create programs that paired mental health workers with police. These teams waded into homeless encampments to bring into treatment people like the woman accused in Monday's shooting.

In 2004, again pushed by Steinberg, voters approved Proposition 63, which imposed a 1 percent tax surcharge on incomes above $1 million. The money collected, roughly $1.2 billion a year, is earmarked for mental health programs.


The initiative barred the state from cutting its support for mental health below 2004 levels; that safeguard has been ignored. The state cut funding for mental health by close to $100 million this year. Sacramento County's share of the cuts, about $5 million, would have funded services for up to 500 mentally ill homeless.

The loss of state funding cannot be blamed for last week's shooting on J Street. The woman accused had just stepped off a bus from Reno. She would not have been eligible for services. Nonetheless, she is an extreme example of what can happen when mentally ill homeless people are left untreated.

Most aren't packing guns. In fact, they are more likely to be victims than perpetrators. Still, there is a huge public cost to ignoring them.

Too many end up begging on streets and sleeping in doorways. They turn up at hospital emergency rooms, in jails and in prison. In the end, treating mental illness is far less costly for the public, for the homeless and for rare victims like Frank Perez. Read more!

More updates coming later today

Read more!

NC gubernatorial candidates spar over health care - Associated Press

CHARLOTTE, N.C. - Republican North Carolina gubernatorial candidate Pat McCrory's campaign is criticizing his opponent for not doing enough to improve the state's mental health care in her past eight years at lieutenant governor.

Democratic Lt. Gov. Beverly Perdue released a mental health platform Friday that calls for better case management of patient care to ensure a minimal level of mental health care statewide.

McCrory's campaign said in a news release Saturday that Perdue has been a lawmaker for 20 years and chairmwoman of the Health and Wellness Trust Fund since 2001 and has done nothing to help solve the state's mental health crisis.

McCrory is the mayor of Charlotte. Read more!

Psychiatric unit ready to reopen at hospital -Winston-Salem (NC) Journal

By Monte Mitchell |

LINVILLE - When Cannon Memorial Hospital closed its inpatient psychiatric unit in 2005 because of financial problems, the Northwest North Carolina mountain counties were left without any inpatient behavioral-health treatment centers.

But it wasn't long before hospital administrators were trying to work out a financial model that made sense so that the hospital could again offer inpatient psychiatric care.

Inpatient psychiatric care is set to reopen soon here as part of a pilot program that will provide more state support to community mental-health providers in an effort to reduce admissions to state psychiatric hospitals.

The Kate B. Reynolds Inpatient Behavioral Health Unit is scheduled to open Wednesday at Cannon Memorial, which is part of the Appalachian Regional Healthcare System.

"Our goal is to meet the needs of patients in this region so they don't have to go 40 miles away for care," said Stephanie Greer, the director of the behavioral health for Appalachian Regional Healthcare System. The nearest other inpatient psychiatric units at community hospitals are in Hickory, Asheville and Johnson City, Tenn.

The new inpatient psychiatric unit at Cannon Memorial will serve patients primarily from a 16-county area that includes Ashe, Alleghany, Avery, Watauga and Wilkes counties. It will also handle referrals from other counties as space is available.

The 10-bed unit will offer acute stabilization for patients ages 18-65 who have been diagnosed with such conditions as anxiety, depression and thought disorders. Patients will be treated by a team of psychiatrists, psychologists, nurses, social workers, therapists and certified nursing assistants.

Cannon Memorial had offered inpatient psychiatric care since 1979, before closing its geriatric psychiatric unit in 2005.

Chuck Mantooth, the chief executive officer of Cannon Memorial, said that the unit closed because the reimbursement system in place then made it difficult for the unit to break even.

When considering reopening a psychiatric unit, the hospital looked for a different source of reimbursements and also re-examined its focus, shifting from a geriatric center to one that served adults up to age 65.

"The last piece of the puzzle was the financial piece," Mantooth said. "How could we provide the service and make sure it's sustainable."

The hospital will participate in a pilot program through July 2009, involving Broughton Hospital, the state-run psychiatric hospital in Morganton. Broughton doesn't have the room for all the patients who need admission.

Twenty-seven percent of the patients cared for at Cannon Memorial's inpatient psychiatric unit will be indigent patients who might have otherwise been treated at Broughton. The state has provided money to Smoky Mountain Mental Health, which in turn will contract with Cannon Memorial for their care. The other patients at Cannon's unit will have private health insurance or Medicare or Medicaid.

The average length of stay is expected to be seven days. About half the patients are expected to come from a doctor or health service that's already providing care and will go back to that outpatient care after hospitalization. Other patients will be set up with outpatient care in the counties in which they live.

After Cannon's inpatient psychiatric unit closed in 2005, the space was used for the hospital's behavioral health-care outpatient program. The new inpatient unit will now reclaim the space where the previous inpatient psychiatric unit was housed. The outpatient program has been moved into new offices in the Sloop Medical Plaza, on the hospital campus.

The hospital has done about $125,000 in renovations for security and safety improvements to the inpatient center. The most expensive change was to install plumbing without exposed pipes anywhere, including shower fixtures. The goal is to eliminate places where a despondent patient could hang himself.

The money for renovations came from Smoky Mountain Mental Health, and the N.C. Department of Health and Human Services' Office of Rural Health.

■ Monte Mitchell can be reached in Wilkesboro at 336-667-5691 or at mmitchell@wsjournal.com. Read more!

For the patients - Raleigh (NC) News & Observer

Editorial:

A state judge has blocked the plan to begin the shutdown of Dorothea Dix Hospital in Raleigh next week, and Superior Court Judge Alan Baddour seems to have made a sensible and compassionate ruling. There are simply too many problems at the new Central Regional Hospital in Butner to proceed with the transfer of patients from Dix -- understaffing, a faulty security system, etc.

Dempsey Benton, former Raleigh city manager and now state secretary of the Department of Health and Human Services, has been charged by Governor Easley with fixing the chaos in the state mental health care system. He wanted to proceed with the transfer. But two accrediting groups have yet to give the OK, which the state argues should not hold things up.

Baddour offers common sense in siding with a patients' advocacy group, Disability Rights North Carolina, that had sought the halt. Given the problems with the entire mental health care system, documented by The News & Observer earlier this year, this is no time to charge ahead. There are pressures to do so from a variety of sources, from state officials who want to show some marked progress to various interests with a stake in what happens to the choice Dix property in the downtown area of Raleigh.

Disability Rights argues, persuasively, that patients must come first, and that a large move to Central Regional would be unwise at least until all the problems there have been successfully addressed. State officials say some of the problems have been fixed, and others are being corrected now. That's fine, but before such an important move is made, Central Regional needs to be truly ready.

All rights reserved. This copyrighted material may not be published, broadcast or redistributed in any manner. Read more!

Safe Haven Law: Frustrated families frustrate the system -Omaha World Herald

BY KARYN SPENCER AND MARTHA STODDARD

The friend had left the boy Sept. 13 at an Omaha hospital under the state's new safe haven law, saying she was unable to handle the boy's growing violence, threats and tantrums.

During a 15-minute hearing, the judge, lawyers and caseworkers agreed the boy needed several evaluations to determine his psychiatric, neurological and developmental problems and that he needed specialized therapy.

"Where were these people before?" Gulley asked after Wednesday's hearing.

"How many kids are we going to drop off before we do anything?" said Gulley, who has served on a local foster care review board. "This was a wake-up call. We need to wake up and do something about these kids."

Nebraska's safe haven law "No person shall be prosecuted for any crime based solely upon the act of leaving a child in the custody of an employee on duty at a hospital licensed by the State of Nebraska. The hospital shall promptly contact appropriate authorities to take custody of the child."
State social services officials disagree, saying parents and guardians need to step up and stand behind their children.

But frustrated families and child advocates say they can't find help. Three parents or guardians said professionals in the system informed them about the law.

People across the state and the nation have been shocked to see parents leave children as old as 17 under the new law.

Nebraska was the last state to pass a safe haven law and the only one not to set an age limit. Others set a maximum age of 1 year old.

About the children This month, 15 children have been left at hospitals and, in one case, a police station by families using Nebraska's unique safe haven law.

This month, parents and guardians have left 15 children — nine from one family — at Nebraska hospitals and, in one case, a police station.

These families and advocates say the cases expose the difficulties facing Nebraska families and the lack of resources for them.

The children, aside from the nine from the same family, have been diagnosed with or are suspected of having mental illnesses or behavioral problems, including violence, suicidal tendencies and aggression.

Eve Bleyhl, executive director of the Nebraska Family Support Network, hears complaints every day from families coping with similar problems:

• Families that get shuttled from provider to provider and back again.

• Families that are refused help because they have no insurance or their insurance ran out or it doesn't cover the needed service.

• Families that have been told the state can't step in unless their child commits a crime or is being abused or neglected.

"There's not enough places to turn," Bleyhl said. "We see the families who have exhausted all their avenues."

Connie Hammitt lived that nightmare for nearly 12 years as she and her husband tried to get help for a severely mentally ill daughter.

They didn't get the services they thought their daughter needed until Hammitt threatened to harm the girl. Hammitt said she made the threat using a script that had been suggested to her much earlier as a way to get help.

"I had been told she had to be in danger or she had to put others in danger," Hammitt said.

If the safe haven law had been in effect then, Hammitt would have considered using it.

She considers it an act of love, not abandonment.

"They're crying for help," she said of the families that have used the law.

Leaders at the Nebraska Department of Health and Human Services say the cases raise no concerns about problems within the system.

"The parents simply decided they did not want to continue on this journey with their kids," said Todd Landry, children and family services director.

He said he doesn't want to minimize the challenges the families face, but said taking a child to a hospital is not the way to deal with those challenges.

The department's initial review of the cases has not turned up problems with the state's system for responding to families in crisis, he said.

He said there has been no indication that the families had been hit by economic troubles, and said most of the children have been covered by the state Medicaid program, which could pay for services.

"It's been less an issue of knowing where to turn and more of an issue of 'I simply don't want to do this job,'" he said.

Three parents and guardians said they received information about the law from professionals within the system: a therapist, a hospital social worker and a staff member with a county attorney's office.

Kathy Moore, executive director of Voices for Children in Nebraska, said she wasn't surprised that professionals may have suggested the law as a way to access services, given the difficulty and complexity of getting services through other means.

"We hope lawmakers will hear these pleas for help, which they are, and respond with an appropriate measure," she said.

Nebraska ranks near the bottom for child care assistance and health care coverage for the children of working families, Moore said. It also is among the lowest in state spending on mental health care.

"I think we're experiencing the cumulative effect of not providing as much preventive and supportive services," she said.

Gov. Dave Heineman and several state legislators have said they think the law should be reconsidered, although opinions varied about what changes should be made.

Moore said the new law should have three parts: a system to protect infants; treatment for children and families needing special services; and better education and support for struggling families.

Staff at the Nebraska Appleseed Center for Law in the Public Interest, which promotes child welfare reform, thinks the law should be re-examined to focus on younger children, but said the state also should look at the needs of older children, as demonstrated by the use of the law so far.

"We would be remiss if we didn't look at our foster care and behavioral health system so parents don't feel like they have nowhere to go," said Sarah Helvey, director of the center's child welfare program.

Services also should be provided without punishing or shaming families, Bleyhl said. The comments by state officials criticizing families that used the safe haven law have followed the same punitive pattern that families often encounter when trying to get services, she said.

An uncle who dropped off his 15-year-old nephew Wednesday agreed that families need more avenues for help.

"Government needs to step up," he said. "They drag their feet when they know a child has got a problem. They don't bring their attention to it until they're forced to. Why should society be like that?"

---------------------

Some facts about the children:
9 (ages 1 to 17) were from one family. The rest, ages 11 to 15, were dropped off singly.

10 had one dead parent.

1 was orphaned.

4 were being raised by relatives other than parents.

3 have been diagnosed with severe mental or emotional disorders.

• Contact the writer: 444-1208, karyn.spencer@owh.com

Contact the Omaha World-Herald newsroom

Copyright ©2008 Omaha World-Herald®. All rights reserved. This material may not be published, broadcast, rewritten, displayed or redistributed for any purpose without permission from the Omaha World-Herald.
Read more!

Health care reforms back on governor's plate -San Jose (CA) Mercury-News

By Mike Zapler

SACRAMENTO — Gov. Arnold Schwarzenegger spent more than a year pursuing a radical overhaul of a health care system that leaves millions uninsured and virtually everyone else struggling with ever-growing costs for skimpier coverage.

Today, sweeping health care reform appears all but dead in California. But the state is considering changes to the system that would provide real relief, though only to a small portion of the population.

Bills passed by the Legislature this session and awaiting the governor's signature or veto take aim at what critics call some of the most egregious, but still relatively rare, practices in the health care system: insurers that cancel a patients' coverage after they get sick, hospitals and doctors that stick patients with huge bills while they're haggling with insurers for payment, and insurance companies that use customer premiums to pad profit margins instead of to pay for medical care.

Other bills would mandate that all insurance plans cover maternity care and all diagnosable mental illnesses, and boost fines on hospitals and other providers for medical errors. Schwarzenegger has until Tuesday to decide the measures' fates.

Few expect a renewed push for sweeping health care reform in California any time soon, even though if anything the problem has grown worse. The state's fiscal woes threaten to remove hundreds of thousands of children from a state health insurance program and lower reimbursements
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to doctors who treat the poor.

Still, the next big push for reform is more likely to come in Washington, after the next president takes office.

"People are going to be looking to the new administration and Congress to see what they're going to do," said E. Richard Brown, director of the UCLA Center for Health Policy Research. "If it doesn't happen there, the focus might shift back to California.

"This is a big come down from 'Let's fix the health care system' to 'Let's fix a handful of problems caused by the health care system,'" Brown added.

One problem that's received heavy media attention — and delivered a black eye to the insurance industry — is known in health care speak as "rescissions.'' The practice occurs when an insurer retroactively cancels a patient's policy after the person becomes ill and files claims.

Insurers say the practice is often justified in cases when a patient lied on his or her insurance application by not, for example, disclosing a pre-existing. But many unjustified cases have also come to light.

An estimated 4,000 to 6,000 health care rescissions in California have occurred in recent years.

Schwarzenegger highlighted one case in his annual State of the State address this year. He spoke of a 51-year-old San Diego man named Todd who bought an insurance policy on his own, and later developed lymphoma, a form of camcer.

Soon after contracting the disease, the governor said, the man's insurance company canceled his coverage. The firm cited a reason unrelated to his illness, the governor said: that he failed to disclose a prior knee injury on his insurance application. Months later, the man died.

"We are taking action so what happened to Todd will not happen to any other Californian," Schwarzenegger said in his January speech.

But it's unclear whether the governor will embrace the bill, AB"‰1945, designed to fix the problem. The measure, sponsored by Assemblyman Hector De La Torre, D-South Gate, says that a policy could be rescinded only if a patient intentionally misrepresented or omitted information on an insurance application. An independent board would have to approve any attempts to rescind coverage.

The proposal has widespread backing among pro-consumer groups that believe the insurance industry has invited such oversight with its own misdeeds. But insurance firms says the bill would force them to prove that someone intentionally lied before they could drop coverage — an impossibly high standard in their view.

Another measure takes aim at what some critics call the excessive profits of insurers. The bill, SB"‰1440 by Sen. Sheila Kuehl, D-Santa Monica, would require that insurance companies spend 85 percent of revenues from patient premiums on medical care, as opposed to administrative costs and profits. The proposal would also force insurers to disclose, on a plan by plan basis, the percentage of premium dollars going toward health care.

Schwarzenegger included a similar initiative in his health care proposal last year, saying it would boost accountability and rein in costs. But he also emphasized that the proposal was part of a comprehensive reform package, so it remains to be seen whether he will back the idea on its own.

One other high-profile bill is an attempt to prevent situations in which patients get trapped in the middle of billing disputes between health care providers and insurers — after, say, a visit to an hospital emergency room that's not part of the person's insurance network. The bill, SB"‰981 by Senate President Pro Tem Don Perata, D-Oakland, would ban a practice called "balance billing" — when an emergency room physician seeking payment from an insurer bills the patient in the meantime.

The measure would also set up an independent board to resolve emergency room-insurer billing disputes.

And two other bills, AB"‰1962 and AB"‰1887, the latter sponsored by San Jose Democratic Assemblyman Jim Beall, would mandate that all insurance plans cover maternity and mental health services.

"In other years this would be a decent slate of bills," said Anthony Wright, executive director of the pro-consumer group Health Access. "But after having major health care reform on the agenda, it's incredibly disappointing." Read more!

Two vulnerable adults losing home to predatory lenders - Minneapolist Star-Tribune

By Jim Buchta, Star Tribune

Like a pair of teenage sweethearts, David Parkes and Kathy Sakry live in the moment

As social workers and county caseworkers assigned to help the vulnerable adults gather to talk about the foreclosure of the couple's Hopkins townhouse, Parkes steps from the top of one coffee table to the next, landing cannonball-style on the couch next to Sakry.

She grins, but the talk quickly turns serious and she contorts her face to hold back the tears, her eyeglasses tilting,

Even as stories of people who can no longer afford their homes become depressingly familiar, the experience of Parkes and Sakry illustrates just how far some mortgage brokers and lenders were willing to go to cash in on the good times, and how few safeguards existed to protect consumers.

Parkes, 44, has an IQ of 56 and the math skills of a first-grader. Sakry is 43 and, like Parkes, faces challenges when it comes to planning and maintaining budgets. Despite their limitations, three different lenders persuaded them to keep refinancing their home until they burned up the equity in their house and could no longer afford the payments.

Congress, meanwhile, continued working this weekend on plans for a proposed $700 billion, taxpayer-financed plan that would help prop up the institutions that made those mortgages possible. It remains unclear whether the final package will include any relief for Parkes and Sakry or the estimated 28,000 Minnesotans who will lose their homes to foreclosure this year.

"This is a more egregious example of what's happened to a lot of average folks," said Prentiss Cox, an advocate for mortgage reform and professor of clinical law at the University of Minnesota. "You can draw a straight line from this line of conduct to Henry Paulson asking for a $700 billion check that will be paid for out of your child's future."

Parkes and Sakry owned a home because of the good intentions of others. Parkes was adopted when he was 11 after nearly nine years in foster care. His mother, Katharine Quigley, spent the next decade helping him develop a sense of trust in himself and others.

Parkes met Sakry more than 20 years ago when they were in school. They bought a house together through a nonprofit, Arc of Hennepin County, which partnered with a neighborhood group to help 14 families buy houses.

Though not married, Parkes calls Sakry his wife; Sakry says that Parkes is "the one for me." They were ecstatic when they closed on their two-bedroom townhouse in a quiet Hopkins neighborhood. "This must be a dream, this must be a dream," Parkes told his younger brother, Kevin O'Neil.

Parkes and Sakry relied on their Social Security checks and part-time jobs they've each held for more than 20 years to make their monthly house payment of $627. Their monthly income of about $1,100 each didn't go far. Like many families, they accumulated some credit card debt when the cash ran out at the end of the month.

By 2004 -- the height of the real estate boom -- the telephone calls came from around the country almost every day. The pitch was simple and appealing: Refinance your mortgage, lower your payments and pocket extra cash.

"They said, 'We have a great deal for you,'" said Parkes, who relies on a calculator to help keep track of how much is in his shopping cart. "They talked like it was a sweet deal."

The Legal Aid Society of Minneapolis has reviewed the case and concluded that there is no legal remedy for their situation, although even the company that now services the mortgage agrees the couple were treated shabbily.

"They were preyed upon, and yes, they didn't have the guidance that they needed," said Christine Holevas, spokeswoman for Chase Home Finance, which was not involved in any of the refinancings.

Dialing for dollars

Michael Harmer was one who got through.

He was working as a loan officer for the local office of the Lending Center, an Irvine, Calif., company that is now out of business.

Harmer said he called as many as 150 homeowners a day. He doesn't remember talking with Parkes and Sakry but has a vague recollection of their financial situation. He said that he thought he was doing a good thing by helping them refinance into a fixed-rate mortgage.

It wasn't obvious to him, he said, that Parkes and Sakry were vulnerable adults.

"I don't recall having a sense of that," he said. "It's pretty shocking to hear that."

Then again, Harmer said, his salary and job security depended on selling the mortgages, not explaining the terms. That was someone else's job.

"That happens at the closing table," he said. "The closers walk them through that information."

The closer, in that case according to the title company, was Sonja Pruisner, who does remote closings for title companies all across the country.

Pruisner doesn't remember meeting Parkes and Sakry, but since both rely on public transportation it's likely the mortgage documents were signed at their home, where the walls are lined with fading family photos and Parkes' marker-on-black-velvet drawings of puppies and race cars. A newspaper article that describes their involvement with Arc is taped to the wall just inside the front door.

Pruisner, who said that she's done a late-night closing at the airport and for a borrower who was drunk, rejected any suggestion that she has a responsibility to ensure the borrowers understand what they are signing. Her primary responsibility, she said, is to verify the identity of the borrower and to show them the figures.

"Unless they say they don't understand, I have no way of knowing that they don't," she said.

Dennis Unger, the past president of the Minnesota Land Title Association, said that with Internet lending increasing and more national companies doing business, such remote closings became more common because national lenders can get high-volume discounts by bypassing local companies.

To provide more protection for borrowers, the association proposed legislation aimed at strengthening and clarifying existing laws requiring closing agents to be licensed unless specifically exempted.

Closers do not give legal advice nor should they interpret the terms of a mortgage, which is a contract between the lender and the borrower.

"It is a shame that market forces -- good or bad -- are moving away from the benefits and experience a traditional closer can add to a transaction," he said. "Least of which is the ability to look out for best interests of the consumer."

Parkes says he now regrets that he didn't tell his family what he was doing, but he felt ashamed and was worried that he'd made a bad decision.

He was right, but didn't know it.

Two of those loans were adjustable-rate mortgages with expensive prepayment penalties. One was a highly complex "pick-your-own payment" negative-amortizing loan originally rolled out by the industry for wealthy, self-employed borrowers. It was originated by Diante Carridonna, a south Minneapolis loan officer who just months before had been fined $5,000 by the Commerce Department and banned from managing a mortgage brokerage after falsifying an appraisal.

Carridonna could not be reached and the company he worked for, Carson-Dell Financial, surrendered its state license earlier this year.

"This is unconscionable," Cox said. "This was too complicated a transaction for a mentally challenged adult to comprehend."

'We all feel stupid'

Like other family members, Quigley said she wrongly assumed that there were safeguards to protect her son's finances.

"We should have double-checked on it even though he wasn't under our care," said Quigley, who now lives in Ohio. "I think we all feel stupid that we weren't watching over them."

O'Neil was surprised, too.

"I was totally unaware of how independent Parkes was with his finances," O'Neil said.

Beth Fondell, executive director at Arc, said that while the organization helped Parkes and Sakry buy the house, it wasn't up to them to decide how much financial oversight was needed.

"We're dealing with vulnerable adults," she said. "But I don't think that we directly had the responsibility other than to make sure that people have the information."

Instead, she blames their situation on a lack of funding and coordination for county case management services: "If there was more prevention, up-front support and dollars invested, people like Dave and Kathy would be able to be as safely independent of the system as possible."

David Belmore, one of Parkes' social workers, said that, in hindsight, more oversight over their finances would have been appropriate, but they seemed to be managing just fine.

"There was some secretiveness about this," Belmore said. "He never asked for help."

Chase Home Finance, which now services the mortgage on Sakry and Parkes' house, has already offered two loan modifications, but has yet to fashion an agreement that O'Neil thinks Parkes and Sakry can afford long-term.

Holevas said that while Parkes and Sakry were obviously victimized, the company wasn't involved in the origination of any of the mortgages. It can't change the mortgage terms without approval of the investors who funded the mortgage. She said the company is working with the investor to see if a third modification offer is possible.

The prospect of losing their home and having to give up his dog, Sarge, depressed Parkes so much that he tried to cut his wrists. During another later bout of anxiety, he swallowed a bottle of pills and told his brother that he couldn't be left alone.

After three hospital stays, Parkes now copes with the depression by going to group sessions twice a week. Talking about it helps, and so do therapeutic craft projects like a blue-painted box that says "Sakry+Parkes" on the top and sides.

Sakry, who is now eager to get on with their lives and hopes to rent a nearby apartment if the sheriff's sale happens, uses the box for her medications.

Quigley said that the anxiety and suicide attempts were probably triggered by painful childhood memories of being mistreated by his birth family and later a foster family.

"When he made a mistake, he was abused, and so this was telling him, 'Hurt yourself, you don't deserve to live,'" Quigley said. "We told him, 'You just made a mistake and a lot of people make this mistake.'"

The situation has also robbed Parkes and Sakry of the trust in others they had worked so hard to develop. "That was the hardest to watch," Quigley said.

Unlike many of the thousands of homeowners who traded their equity for boats, cars and second homes, Parkes and Sakry now have little to show for the refinancing and no record of what happened to the money.

Their house is furnished with thrift-store finds. They bought their color TV a few years ago with their tax refund.

Parkes says that they probably spent some of the money on "Spider-man" and "Batman" movies and for movies, or taxi rides to work. His biggest splurge, he said, was a dog food bowl stand for Sarge.

"I spoiled my little boy for Christmas," Parkes said. "But not this year."

The foreclosure sale is scheduled for Oct. 14.

Jim Buchta • 612-673-7376
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Georgia juries rarely buy insanity plea -Atlanta Journal-Constitution

By BILL TORPY

Brian Nichols says he was insane. In his trial starting last week, his lawyers argued he was delusional and saw himself as a victim of an unjust system persecuting black people when he went on a 2005 rampage at the Fulton County Courthouse.

Nichols’ insanity defense has caused grumbling that once again a defendant is gaming the system. But judges, prosecutors and defense lawyers say it is rare for a defendant to plead not guilty by reason of insanity. It’s even rarer for it to work.

“There have been very, very few [successful insanity defenses], especially in hotly contested trials,” said Tony Axam, a defense attorney who in 1985 won such a case in Fulton County, where a postal worker killed two co-workers and wounded a third. The same year, an Atlanta woman accused of cutting off her 7-year-old child’s head got a similar verdict.

But such verdicts in metro Atlanta — in cases that have gone to trial — are few and far between.

The insanity defense is used in less than 1 percent of all felony cases and is successful less than a quarter of the time, according to a 1991 study in the Bulletin of the American Academy of Psychiatry and the Law and other research. And many of those successes have come when prosecutors agreed to a plea.

Jurors have grown more skeptical since 1982, when John Hinckley Jr. won an insanity defense after shooting President Ronald Reagan. The outcome drew public outrage and caused states, including Georgia, to toughen their laws.

“It’s a difficult story to sell; you’re saying this person has no responsibility for what he did,” said defense lawyer Torin Togut, who won a 12-year battle to win the release of a man hospitalized for killing his grandparents. “A lot of people are skeptical of psychological labels. There’s such a divergence of opinions. It’s a science, but it’s also an art.”

Veteran prosecutor Jack Mallard, who waged 40 years of courtroom battles in Cobb and Fulton counties before retiring last year, once turned back a defense based on multiple personalities by telling jurors “there’s only one person on trial here.”

“People are better educated now, more knowledgeable,” he said last week. “Jurors know [defendants] will use insanity as a last resort.”

An insanity defense can be a legal Hail Mary pass: A defendant admits the allegations and has little room to maneuver if the jury doesn’t buy what the mental health experts say.

To be found not guilty by reason of insanity in Georgia, a jury must determine a defendant cannot distinguish right from wrong or was suffering a “delusional compulsion” in which he acted logically within his deluded stated of mind.

To prove insanity, it helps to show prior doctor reports and bizarre behavior, Atlanta attorney Drew Findling said.

“You’re looking for a pattern of craziness,” said Findling, who was an attorney for Katrina Spriggs. She had cut off her young son’s head, saying God told her the boy was Satan.

If found not guilty by reason of insanity, a person is confined in a mental hospital until he proves to a judge he poses no risk to society. A search of such cases in Georgia found some patients were released relatively quickly while others spent decades, often about the same time as if they were found guilty.

There are 168 people who were found not guilty by reason of insanity in Georgia hospitals, according to the state Department of Human Resources. Not all are in for murder. Ten years ago, there were 250.

In the wake of the Hinckley verdict, Georgia enacted a “guilty but mentally ill” verdict under which a defendant is sent to prison and treated for medical problems while serving. That legal change “pretty much gutted” the insanity defense because the jury has another option to insanity and a guilty verdict, said John Turner, Clayton County’s executive assistant district attorney, who prosecuted the Spriggs case.

Axam says today juries are more likely to reject insanity claims. “The more troubled the times, the more you hear about violence, the harder it gets,” he said.

In the Nichols case, the defendant has admitted to the killings. The defense will have a nearly impossible task of proving insanity to jurors because they will worry about him leaving prison, said Axam, who is not involved in the case.

“Insanity is the least [likely option] for this jury to accept,” he said. “It’s fear. He killed four people. You ask a juror: ‘Are you going to want him to live next door to you?’ Not in this lifetime.” Read more!

Famed ukulele virtuoso shares song of hope - Honolulu KHNL-TV

Click on post title for video link.

By Diane Ako

HONOLULU (KHNL) - A world famous ukulele virtuoso uses his music to spread a message of hope. Roy Sakuma wrote a lyric some 30 years ago. Just recently, he dusted off the notes and started playing it to classrooms across the state.

Most know Sakuma as a legendary ukulele player and teacher, but behind the happy music is a sad story. "I had a rough childhood. I had a lot of problems, a lot of things where I was confused," said Sakuma.

It started when Sakuma's mother was diagnosed with mental illness. His dad told him, "'You can't listen to your mother because she won't tell you things that don't make sense.' She's my mother but at a young age I couldn't listen to her.

Then Sakuma's brother, best friend, and next door neighbor were all diagnosed with mental illness. The brother and neighbor both committed suicide. "With all this mental illness around me I lived in fear that I'd be the next victim," shared Sakuma.

Scared, alone, and afraid, Sakuma dropped out of school. "I was rarely ever in school. Thankfully I found the ukulele. That really helped turn my life around," he reflected.

One day, during a low point of his life, Sakuma wrote a song. "It came from my heart. It just came out," he said. "The chorus is, I am what I am. I'll be what I"ll be. Look, can't you see that it's me, all of me?"

Today, Sakuma and his star pupil Nick Acosta sing that song for kids at elementary schools. "It's a great message this song is sending to children, to everyone," he said.

It's not just for kids. It's for anyone having a tough time. "It's a struggle for lots of us," said Sakuma.

Simple words- with a powerful meaning. Sakuma asserted, "It's going to give a lot of people hope, and hope is the foundation that lets us work through things. If everyone had hope, that would be the key in life. Read more!

RI police trained to deal with mentally ill -Associated Press

COVENTRY, Mass. -- Police from departments around Rhode Island are learning how to deal more effectively with the mentally ill.

Last week, 20 officers from nine departments took part in a pilot program held in Coventry Town Hall.

The officers were being certified through the state to train officers in their departments.

The program was established after three mentally ill men died in police custody this year.

Coventry police Lt. Robin Winslow designed the program in about six weeks with Richard Crino of NRI Community Service. The pair used a $30,000 state grant.

Police took part from Central Falls, Coventry, Cumberland, East Providence, Johnston, Lincoln, North Providence, West Warwick and Woonsocket

The three-day workshop included discussions on policies for handling people with mental illness, training to deal with different situations and role playing. Read more!

NYPD To Retrain Officers After Fatal Taser Fall - NEW York WCBS-TV

Video available by clicking post title.

NEW YORK (CBS) ― It's back to school for more than 400 emergency services officers following a deadly altercation with a mentally ill man.

Starting Monday, the officers will undergo refresher training in how to deal with emotionally disturbed people. Commissioner Ray Kelly also appointed a new commanding officer to the emergency service unit.

Earlier this week, a cop tasered a naked, distraught man standing on a second floor ledge in Bedford-Stuyvesant. Inman Morales, 35, jumped up and down on top of a 10-foot high roll-down gate as he swung a florescent light bulb towards police officers who were trying to grab him on a nearby fire escape.

An officer on the ground then raised his Taser stun gun and fired a five-second jolt from the 50,000 volt gun, immobilizing him. Morales then fell head-first to his death.

"He wasn't hurting anybody, witness Racquel McDonald said. "They could have just grabbed him and bring him down, but they Tased him instead and he fell to his death and it was real wrong."

Officers had radioed for an inflatable bag as the incident unfolded, but it had not yet arrived at the scene when Morales fell.

"He was there cracking jokes, posing for the cops and everything. The man wasn't a threat to nobody but himself," said witness Kirk Giddings. They had about eight cops that could break the fall. They just moved back."

"We expect the police to say we were wrong. We made a mistake," City Councilman Al Vann, D-Brooklyn, said.

The NYPD has admitted violating guidelines in the use of the stun gun and punished two officers involved in the incident, but it's no consolation for the victim's grieving mother, Olga Negron.

Morales's mother was standing just a few yards away when her son fell. According to other family members, she called police because her son had a chemical imbalance and she believed he was suffering from a bad reaction to medication.

"The mother was screaming, 'He's gonna fall, he's gonna fall!' And they said 'Ma'am step back.' They wouldn't allow the mother to talk to him," said witness Charlene Gayle-Gordon.

The officers have been taken off the street and reassigned, but Morales' loved ones say police took much more away from them.

"My brother, I'll never get him back. Nothing can replace my brother," said Danny Morales, Inman's brother. Read more!

Grieving father to tell local student's Manda's story - Wabash (IN) Plain Dealer

By SHEILA RHOADES -September 27

srhoades@wabashplaindealer.com

He was anybody's dad.

He had just spoken to his 20-year-old daughter before she disappeared into the bathroom. Minutes later, he found his little girl in the bathtub, dead ... a needle floating beside her.

Today, Mann Spitler is everybody's dad.

Manda Spitler (pictured above), a beautiful young lady with everything to live for, had died of a heroin overdose. But even before the grief could begin to subside, her father vowed to do all he could to prevent this from happening to someone else's child.

Six years later, Dr. Mann Spitler III is coming to Wabash to tell students here his tragic story.

Spitler, a successful podiatrist from Valparaiso, will be at the Honeywell Center Ford Theater on Tuesday to speak to Wabash and Metro students - middle and high schools. The program is being supported by the Wabash Elks Lodge. However, donations are needed to assist in the schools' transportation costs.

The high school students will attend their session at 9 a.m. and the middle school's will start at 1 p.m. There will also be a session for parents and others beginning at 6 p.m. Each session lasts up to 90 minutes. He will return on Nov. 20 to address the students in North Manchester.

"Manda's Story," as her father calls it, was not always a tragic one. He remembers his daughter fondly.

"As a young child Manda was very joyful, healthy and happy. She was shy, sensitive and sweet. She loved animals and all living things," he recalled to the Plain Dealer. "But it all changed at the age of 13."

He said Manda was not unlike many teens who experience physical changes, mental and emotional adjustments, and, of course, peer pressure.

"She became confused, sad, and intermittently angry," he said. "She had started smoking and her friends became her focus."

He called cigarettes her first drug of choice and "a short step to marijuana."

"By 16 she was involved in other drugs and had one boyfriend after another," he said, "each worse than the last."

She eventually would meet a boy that introduced her to heroin.

"Her joy just melted away," he recalled. "She used and used until she had to keep using just to keep from getting sick."

Manda continued to deteriorate until she decided to shoot a lethal dose of heroin into her vein.

"I think I lost all capacity for anger," he said. "There was just profound sadness. I thought I would never again enjoy the things in life that I did before."

But somehow Spitler turned his sadness into an ability to talk to teens in a way that makes them think - long after he is gone.

He travels from school to school, but also speaks to church groups, clubs and anyone else that will listen to him. He encourages drug testing your children at home and suggests visiting a Web site which makes all kinds of testing kits available for purchase: www.testcountry.com.

He said drug testing at home also gives your child an "out" because they can tell their peers they really can't use because they could be tested when they get home.

Spitler thought a moment about how Manda would feel if she could see what has transpired.

"I think Manda would have a feeling of gratification," he said. "I think she would be honored and proud to know her dad is giving her death some meaning and purpose.

"And I am going to keep doing it until I can't do it anymore."

And in doing so, Manda's Story will live on. Read more!

Broader disability act may cut suits -Columbus (OH) Dispatch

By Misti Crane - Sept. 27

The Sutton twins wanted to fly planes for United Airlines, but without their strong eyeglasses to see, they didn't meet the company's requirements.

The women claimed discrimination under the Americans with Disabilities Act, but they lost their fight in the U.S. Supreme Court in 1999. The justices ruled that people whose conditions were corrected by medical intervention, including medication or eyeglasses, were not disabled and therefore not protected by the act.

That case and others set a precedent for many lower-court rulings that kicked out complaints from people with conditions that were either medically treated or were in remission.

This week, President Bush signed an amended act designed to, among other things, ensure that even those with correctable disabilities can seek legal shelter. It gives more concrete definition to the act while overturning several court decisions. Business groups collaborated with advocacy groups and Congress on the legislation, which takes effect in January.

It could make a difference for everyone from the person who has diabetes and needs to adjust his work schedule for dialysis to the person who is denied employment because of her well-treated epilepsy, experts say.

"Clearly, there are going to be a larger number of people who are going to be protected from discrimination, from dyed-in-the-wool prejudicial treatment," said L. Scott Lissner, Ohio State University's ADA coordinator.

"If I take my medication for schizophrenia, there's still a lot of prejudice against schizophrenia. I still need that protection from discrimination."

The U.S. Department of Justice and the Equal Employment Opportunity Commission still are charged with providing regulatory guidance to help employers and others understand exactly how to define what constitutes a substantial disability, Lissner said.

He expects the change will help employers and employees more easily come to agreements about what accommodations can be made.

In addition to most workplaces, the act covers state and local government services, public places such as movie theaters and grocery stores, and private colleges. Exemptions exist for religious institutions and private clubs.

"We've seen people who are quiet and they struggle and they work hard, and they ask for a small accommodation and they get told, 'No,' " said Michael Kirkman, an attorney and the executive director of the Ohio Legal Rights Service.

Historically, many of those people have left with the news that the ADA was unlikely to be of any help, Kirkman said.

In many cases, people may ask for minor concessions from employers, such as a brief respite from the workday to recover from side effects of epilepsy medication, said John Connelly, executive director of the Ohio Rehabilitation Services Commission.

Those with mental-health problems, including depression and bipolar disorder, often fear sharing their health status with employers or potential employers for fear of discrimination, said Steve Ostrander, spokesman for the commission.

Before the amendment, those people had essentially no hope for ADA protection, Connelly said.

"Hopefully, more and more employers will be open to hiring persons with disabilities. these are some of the most motivated workers they have," said Connelly, whose office helps Ohioans with disabilities find and keep jobs.

Kirkman, of the Legal Rights Service, said his optimistic side thinks the amendment will help prevent lawsuits by clarifying discrimination law for employers.

The lawsuits that do follow the amendment likely will better define just what constitutes discrimination and what constitutes a reasonable effort to accommodate those disabilities, he said.

Many cases that would have clarified those issues never made it to a courtroom because they were dismissed under the previous definition of what was a disability.

mcrane@dispatch.com
Top complaints

In the past decade, the Ohio Civil Rights Commission has fielded 7,861 discrimination complaints under the Americans with Disabilities Act. Most -- 7,278 -- aren't categorized by disability. Among those that are, several conditions are likely to be newly recognized under the act, which was amended this week and will go into effect in January.

Some of the top conditions for which complaints were filed:

• Depression: 58

• Back injury: 52

• Diabetes: 44

• Heart disease: 39

• Hearing impairment: 35

• Bipolar disorder: 30

• Cancer: 29

Source: Ohio Civil Rights Commission data from July 1998 through June 2008

Read more!

Mental health issues off radar - Canwest News Service

Senior executives know very little about the problem

Helen Morris - Sept. 27

OTTAWA -- Approximately 35 million workdays are lost every year in Canada due to mental illness, although senior executives have little awareness of the problem, according to a study released yesterday.

The survey of more than 450 Canadian organizations conducted by human-resources consultancy Mercer in conjunction with The Canadian Alliance on Mental Illness and Mental Health said low productivity related to mental illness adds significant cost to employers.

"It's too expensive not to do something," said Anne Nicoll of Mercer. "It actually is costing them more now than what it would if they put in a plan to deal with it."

Survey respondents indicated that mental-health issues are a growing concern for human-resources professionals. Nearly 80 per cent reported that mental-health issues have increased in importance compared with three to five years ago.

Yet in contrast, only 13 per cent of survey respondents said senior executives had a strong awareness of the impact of mental health on the organization.

"We are trying to raise awareness in the executive suite that mental illnesses are costing their companies an awful lot of money" said Philip Upshall of CAMIMH.

"The high ranking that mental health has on the HR priorities list combined with the lack of awareness at the top of the organization is cause for concern," said Nicoll.

But while big corporations are willing to put their logos alongside cancer and heart health-awareness campaigns, it is often much more challenging to achieve corporate backing for mental-health issues, such as depression, anxiety and schizophrenia.

"It boils down to society stigma," said Upshall. "We still are unable as a society to talk about them even although they are becoming the single most common costly illness that our health-care system faces."

In October last year Canada Post became the first major corporation in Canada to support mental-health when employees voted for it as their cause of choice.

"With 72,000 employees -- where mental health affects so many Canadians -- every employee at Canada Post is touched one way or another through friends, family," said Nicole Lemire, a spokeswoman at Canada Post.

Four hundred and fifty-two human resource professionals and business leaders participated in the online survey between April 17 and May 9, 2008. Read more!

Embezzler gets 3 years - Pueblo (CO) Chieftan

By ROBERT BOCZKIEWICZ - Sept. 27

DENVER - A tearful former chief loan officer of High Country Bank in Salida was led from court in handcuffs Friday to serve three years in prison for embezzling $404,741 from the bank.

Senior U.S. District Judge John Kane, rejecting a request for a lesser penalty, imposed the sentence on Marilea J. Rans.

"It's a crime against trust," the judge said. "Banks have to have trust to function effectively."

Rans' mother sobbed uncontrollably upon hearing the judge's sentence and his order to have marshals take Rans into custody immediately, rather than allow her to report to prison later.

The courtroom was almost filled with Rans' family and friends on one side of the aisle and about 20 employees of the bank and about six community members on the other side. Rans, 43, pleaded guilty in January to bank embezzlement. She admitted that starting in April 2005 she began taking the bank's money, putting it into her account and spending it.

She had worked for the bank for nine years when bank officials discovered the embezzlement in July 2006.

Kane said he would have imposed a longer prison term except for Rans being mentally ill. He also fined her $10,000 and ordered her to fully repay the bank.

A clinical psychologist who said she has been treating Rans since August 2007 testified Rans has been mentally ill for many years with narcissistic personality disorder and with the "most severe form" of bipolar disorder.

"I take full responsibility for my crime," Rans told the judge. "I couldn't control myself. The money that I stole . . . It got to the point I didn't even know what I was buying (with it)." Read more!

Foss High School killing case moves ahead -Tacoma (WA) News Tribune

ADAM LYNN - adam.lynn@thenewstribune.com - Sept. 27

It’s been nearly two years since a fatal shooting at Tacoma’s Foss High School, and it will be at least 2009 before the criminal case against the young man accused of killing a classmate is resolved.

Pierce County Superior Court Judge Ronald Culpepper on Friday found Douglas S. Chanthabouly competent to stand trial in the Jan. 3, 2007, death of Samnang Kok.

Chanthabouly, 20, has shuttled between the jail and Western State Hospital for mental health treatment several times since his arrest.

But the judge’s order only set the stage for more legal wrangling over Chanthabouly’s mental health.

While public defenders John McNeish and John Chin agree their client is now competent to stand trial, they contend Chanthabouly – who has a documented history of schizophrenia – was insane at the time of Kok’s death.

They plan to argue that he should be acquitted of the first-degree murder charge against him.

McNeish and Chin already had their client examined by a mental health expert in preparation for such a defense, Chin told Culpepper on Friday.

“It’s going to be a mental defense, your honor,” the attorney said.

Deputy prosecutors Fred Wist and Ed Murphy asked Culpepper on Friday to send Chanthabouly back to Western State Hospital to be evaluated on behalf of the state. The judge agreed.

Culpepper also set Feb. 17 for the beginning of a formal hearing to determine whether Chanthabouly was insane when he shot Kok in a school hallway before first bell. The judge will hear witnesses from both sides before rendering a decision. The hearing is expected to take several days.

If Culpepper decides Chanthabouly was insane when he shot the 17-year-old Kok, the judge can order the criminal charge against him dismissed and involuntarily commit him to a mental hospital for an indefinite period of time.

If Culpepper decides Chanthabouly was sane, the criminal case could go to trial, where McNeish and Chin can try to convince a jury that their client was insane when he shot Kok.

Culpepper has set March 9 as a tentative trial date.

Chanthabouly remains jailed.

Adam Lynn: 253-597-8644

blogs.thenewstribune.com/crime Read more!

Shelter opens its door on Reno's homeless campus - Reno Gazette Journal

By Susan Voyles • svoyles@rgj.com • September 27, 2008

Reno Mayor Bob Cashell had no problem listing the $2.15 million donated by the Nell J. Redfield Foundation or the $1 million from the Lincy Foundation in Beverly Hills before cutting a ribbon Friday to open the new family shelter and resource center for the homeless campus on Record Street.

But when it came to the Carmelite nuns, the mayor broke down and sobbed. "When they called my house, they'd tell my wife to tell me to 'get going' (on the project)," Cashell said. And in almost the same breath, the mayor said he has a son who is three years sober.
"We look over the whole city. We pray for the whole city," Sister Rosalind Forest said.

And some of their prayers have been realized.

"I can't imagine a better facility in the whole United States," said Sister Ann Weber, as she toured a fenced playground on the roof of the new building.

Three of the sisters formed a trio and gave a concert to raise $2,000 in donations for the family shelter. They're planning another concert for next month.

The $12.2 million building will have a family shelter on the third floor, including apartments for 21 families that open to a large central room. The lower two floors will be used for the Good Shepherd's Clothes Closet, the HAWC medical clinic, the Children's Cabinet and offices for social workers and job counselors.

All of the new facilities, including a women's shelter that now occupies the first floor that used to be a men's shelter, are scheduled to open on or before Oct. 15.

The new building as well as the new women's shelter features nonporous tile floors and other easy-to-clean surfaces, said George Ghusn Jr., the architect.

Volunteers of America in Sacramento won a $975,000 contract from the city this week to run the three separate shelters for men, women and families.

Leo McFarland, the non-profit group director, said he is impressed with the family apartments.

The walls and plastic mattresses are bare now, but he said families will add their own bedspreads and things to make it homey.

"For the children, this gives them some normalcy," McFarland said. "It becomes home so they lose some of the stigma."

More than 150 people attended the open house and ribbon-cutting ceremony. "This is something we have been working on for 30 years and it has all come together," Cashell said.

"This is a great celebration for this historic moment," said Councilman Dave Aiazzi, who mentioned the new triage center for people with addictions that opened earlier this year.

The campus opened in 2005 with the relocation of the Reno-Sparks Gospel Mission and St. Vincent's Dining Room from downtown.

In more than an hour of speeches, Reno businessman Bob Rusk and his ponytail was mentioned repeatedly. To keep up public pressure on the city to build a shelter, Rusk grew his hair to the middle of his back in a four-year protest. He had it cut in 2000.

At that point, the council had approved plans for homeless shelter on Sage Street. But it never got off the ground.

It wasn't until Cashell took office in 2002 and a year later won City Council approval for city-controlled property that became the Record Street campus.

With more than 1,500 garbage trucks, cement trucks and public works trucks passing the Sage Street site each day, Cashell said it was a dangerous place for people, especially those who are mentally ill.

From there, his fundraising began. In all, he said more than 50 individuals have donated more than $100,000 each. He said a recent $115,000 donation from the Nevada Women's Fund put the city over the top in fully opening the facility.

Cashell said McKissick raised $500,000 in the last 10 days to complete the project.

The state, Washoe County and Sparks, as well as the federal government provided grants. In all, the city has raised $26 million to build the entire facility.

Councilwoman Jessica Sferrazza said Cashell worked tirelessly on the shelter project.

"My dad was mayor for a very long time," she said, of Reno Justice of the Peace Pete Sferrazza. "He could never get the council to agree on where to put the shelter."

A humbled Cashell stood by as the crowd rose to give him a standing ovation. Describing the act as "the greatest honor in my entire life," Rusk presented the mayor with a crystal plaque for his efforts.

Outside St. Vincent's before the ceremonies began, a

69-year-old woman sat on a bench, surrounded by several bags containing all of her belongings. She said she spent four or five nights in a "tent city" that will close as the new shelters open over the next few weeks.

"This will be great," she said.

The woman said she left Turlock, Calif., because of the crime there and has been on the road for five years.

"I'm looking for a safe place to be," she said. "Just call me 'grandma.'"
Read more!

Adams County jail facing overcrowding -Associated Press

NATCHEZ, Miss. -Sept. 27 - The Adams County jail is so crowded that inmates soon may be sleeping in tents, says Sheriff Ronny Brown.

He said he had five open beds on Friday, and a deputy said they remained open Saturday. When they fill up, Brown plans to begin assigning new inmates to 30 mattresses on the floor. If those fill, he'll put up tents behind the jail, he said.

"We haven't seen it like this before," Brown said.

Brown said 10 rooms with double beds are used for storage because they cannot be locked and don't have toilets, and another two rooms are designed for mentally ill patients.

Increased drug arrests, clogged courts and inmates who cannot make bond all contribute to the crowding, Brown said.

He said about 80 inmates cannot make bond - and about a dozen await transfers from the city jail to the county jail.

"If you're selling drugs or stealing you belong in jail," he said.

Justice Court Judge Charles Vess said in August that court also needed to expand, because its schedule was so packed. He said Friday that he hadn't known about the jail crowding.

"It's a cumulative effect," he said.

The only alternative to tents would be sending inmates to other county jails, but that is expensive. Brown's office recently billed Amite County $32,000 for housing three inmates for a bit over a year.

Besides, other county jails are as full as his, he said.

"It's not a good situation," he said.
Read more!

Department of Mental Hygiene to receive $1M in funds - Dunkirk (NY) Observer

U.S. Senator Charles E. Schumer has announced that the Chautauqua County Department of Mental Hygiene will be awarded $1,000,000 under the Substance Abuse and Mental Health Services Administration Child Mental Health Initiative.

In February, Schumer sent a letter to the Department of Health and Human Services supporting the Chautauqua Department's application for the grant in an effort to secure the funds for the department. The funding will enable Chautauqua County to better serve children across the county through a family-driven and youth-guided rural system of care entitled "The Tapestry of Chautauqua Project."

"These funds are essential to providing children and families with the critical mental health and support services they need," Schumer said. "I am so glad we could deliver this much-needed money to help fund the department's efforts to maximize the available resources efficiently and effectively."

The Chautauqua County Department of Mental Hygiene is dedicated to planning, developing, and providing accessible, comprehensive, integrated, outcome-based mental hygiene services to residents of Chautauqua County.

Funding under the Child Mental Health Initiative will enable Chautauqua County to implement innovative changes to the way child mental health services are delivered throughout the county. Chautauqua County will focus on expanding evidence-based services including mentoring, school support and family support and crisis services, and more effectively reaching out to and serving families, especially those from minority groups and underserved populations, and those impacted by generational poverty. In addition, the project will work to decrease out of home placement as well as high school dropout rates. Special attention will be paid to the needs of Hispanic and African American children with SED (Serious Emotional Disturbance), as well as to the needs of their families.

"This grant of a record setting $1 million will enable us to broaden the scope adding all of the youth related services including Mentoring, Education and others to this work," said Chautauqua County Executive Greg Edwards. "All of our stakeholders will now have the incentive to come together to design an expansion of this work that I truly believe will be a model for the whole state if not the nation."

To help the Chautauqua County Department of Mental Hygiene receive the grant, Sen. Schumer sent a letter in February to the Department of Health and Human Services Secretary Mike Leavitt urging him to support the facility's grant application.
Read more!

Perdue releases updated mental health plan -Associated Press

RALEIGH, N.C. - Beverly Perdue says she'll make unannounced visits to state mental hospitals and community service offices if elected governor.

The Democratic nominee released an updated mental health platform Friday, expanding on comments the lieutenant governor has made during the campaign.

She also pledges to make "spot check" inspections within the Department of Health and Human Services to know what's going on.

Perdue also wants better case management of patient care to ensure a minimal level of mental health care statewide.

The creation of "mental health courts" also would have judges with special training help defendants find proper treatment. Perdue also wants to expand incentives for professionals to work in rural North Carolina and to improve training in community colleges and universities.

All rights reserved. This copyrighted material may not be published, broadcast or redistributed in any manner. Read more!

Homeless at the ballpark: Advocates gather to offer help, advice - Durham Herald-Sun

By Laura Collins
lcollins@heraldsun.com - Sep 26, 2008

DURHAM -- Nearly 150 people turned out for Project Homeless Connect Thursday.

The event, held at Durham Bulls Athletic Park, brought out representatives from a variety of organizations with the aim of helping the homeless.

"We offered a variety of different services trying to connect the homeless and the at-risk population to a variety of different services," said Lanea Foster, research specialist with the 10-Year Plan to End Homelessness and Project Homeless Connect coordinator.

The event's main goal was accessibility.

"Durham doesn't have a one-stop shop center where you can get a variety of different services under one roof. And so a lot of the homeless, and everybody, have to travel all over town to get help. If you don't have a car and have limited funds it's really difficult to do that. We bring everything in one location and we try to get as much services available on the same day here," Foster said.

Among the services offered were legal, housing, mental health and medical advice and credit counseling. Representatives of the county's Department of Social Services were on hand and showers and hair cuts were available.

"Housing is always hugely popular. DSS also did really well with medicaid and other different services," Foster said.

Foster said it's important for people to realize homelessness is a problem in Durham, and said homeless numbers are increasing in the area.

Kaaren Johanson, a volunteer who helped with voter sign-up and passed out toiletries, said problems with economy affect everyone.

"There are a lot of families here, people with young kids, and I'm sure the economic downturn has something to do with it. More and more people who are just on the edge and making it, all of the sudden aren't," she said.

Johanson said they hope to see even more people at next year's event, but that those who came Thursday were very appreciative.

"I talked to people who were just excited. It's nice that this is being done for them," she said. Read more!

Feds may cite new mental facility -Raleigh (NC) News & Observer

Michael Biesecker

RALEIGH - Federal regulators appear poised to cite Central Regional Hospital in Butner with at least one violation, further endangering a state plan to close Dorothea Dix Hospital in Raleigh and transfer patients to the new psychiatric facility.

According to an internal memorandum written Thursday by Dr. Michael Lancaster, head of the state mental health division, inspectors who showed up unannounced at the hospital this week indicated that both Central Regional and Dix are in danger of losing federal funding.

In an apparent violation of the state's contract with the federal Centers for Medicare & Medicaid Services, the new hospital, which is not yet accredited, has been billing for federal insurance reimbursements using Dix's provider number.

Tom Lawrence, spokesman for the state Department of Health and Human Services, confirmed that the inspectors, who are state employees working on behalf of Medicare and Medicaid, are sending a report on Central Regional to the federal agency's regional headquarters in Atlanta.

It is standard for inspectors to hold an exit interview with hospital administrators, where the reviewers disclose what they found wrong. Lawrence said he would not comment on what, if any, violations the inspectors told Central Regional officials they had found.

Lancaster has not responded to messages seeking comment.

It has been a difficult year for the state's mental hospitals. Earlier this month, federal officials cut funding to Cherry Hospital in Goldsboro after the death of one patient and the beating of another. Broughton Hospital in Morganton lost federal funding for nearly a year before regaining its certification in July.

The new $138 million hospital in Butner has been plagued by technical glitches and other problems since it partially opened in July.

The inspectors were dispatched to Central Regional following complaints about a security system that frequently sends out false alarms, emergency pagers that don't work, a roof that leaks in several places and malfunctioning air conditioning that keeps the temperature in the low 60s.

In court papers this week, an elderly patient was reported to have suffered from hypothermia this month after his condition went unnoticed too long by those who were supposed to be caring for him.

Merger in jeopardy

If federal regulators in Atlanta uphold the recommendation of the inspectors in the field, as is common, it will further imperil the plan of DHHS administrators to merge the two hospitals.

A state judge issued a temporary restaining order Thursday that bars the state from moving the bulk of Dix's patients to Central Regional, a process that had been scheduled to begin Oct. 1.

Superior Court Judge Allen Baddour acted in response to a class-action lawsuit filed Tuesday on behalf of Dix patients by Disability Rights North Carolina. The advocacy group's suit detailed 15 safety concerns at the new hospital.

A hearing in the case is set for Oct. 6.

It will likely be 60 days before another federal inspection of the hospital would be done, potentially quashing any move to merge the hospitals until December.

A state law that went into effect in July mandates that Dix's patients can't be transferred until Health and Human Services Secretary Dempsey Benton can certify that Central Regional meets Medicare and Medicaid standards. DHHS officials said this week that it will cost an additional $350,000 a month to keep Dix open.

Letter's consequences

Last week, more than 30 doctors and psychologists from Dix sent a letter to Lancaster protesting the pending move as premature and risky.

In his memo Thursday, Lancaster said he would try to address the concerns of the inspectors by dissolving the management structure at Dix and folding the hospital's operations under the administration at Central Regional, a group dominated by managers from the recently closed John Umstead Hospital.

The move effectively strips authority from Dix's clinical staff, whose protest letter last week embarrassed DHHS administration and was used in court Thursday to bolster the arguments of lawyers for Disability Rights.

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

© Copyright 2008, The News & Observer Publishing Company

A subsidiary of The McClatchy Company
Read more!

Psychiatrist faces review in wake of massacre -Toronto (Canada) Globe and Mail

KIRK MAKIN

The competency of a Toronto psychiatrist who was treating Chau Huc Minh at the time he massacred his family in 2006 is under scrutiny by the College of Physicians and Surgeons of Ontario.

The College has scheduled a hearing to determine whether the psychiatrist - Dr. Hung-Tat Lo - is competent to continue practising in light of his actions in the Chau case and 15 other unspecified cases.

The main complaint behind the hearing appears to be one lodged last year by Mr. Chau's sister, Jenny Chu. Ms. Chu alleged that Dr. Lo refused her plea to have Mr. Chau sent to a hospital for an assessment and possible treatment on Jan. 6, 2006. Five weeks later - on Feb. 9, 2006 - Mr. Chau used a meat cleaver to inflict fatal injuries on his wife, Shao-Fang, his three-year-old daughter, Vivian, and his five-month-old baby, Ivan.

A CPSO document states that its disciplines committee will decide whether Dr. Lo "failed to maintain the standard of practice and is incompetent in his care and treatment - including, but not limited to - his assessments, diagnoses, treatment and record-keeping, of 15 patients whose identities have been made known to Dr. Lo, between about July, 1983, and July, 2007."
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The Globe and Mail

It said the probe will also consider whether Dr. Lo displayed "a lack of knowledge, skill or judgment or disregard for the welfare of his patients of a nature," to the point that his practice should be restricted or terminated.

In the meantime, Dr. Lo has been told to submit sample medical charts and other patient information at least once every two weeks to a doctor appointed by the College to monitor his work.

CPSO spokesman Jill Hefley said in an interview yesterday that a complaint is referred to a disciplines hearing only if there has been a determination that "reasonable and probable cause" exists to believe it may be well founded.

Ms. Chu complained that she told Dr. Lo that her brother's behaviour had grown alarmingly erratic. "I was concerned that he might hurt his two young kids and wife" she said in her complaint. "Therefore, I urged Dr. Lo to send him to hospital with detailed descriptions of his strange behaviour."

Ms. Chu's complaint said that she told the psychiatrist that her brother was obsessed with a birthmark on his son's head that he believed was a sign of demonic possession.

Ms. Chu also said that she told Dr. Lo that her brother had begun to boil water in an irrational attempt to fend off evil spirits; had shaved his hair as a form of spiritual cleansing; and had destroyed Buddhist shrines at his sister's home and his own. Mr. Chau had cut up his children's clothes and photographs of them, and repeatedly threw the contents of his home outside, she said.

Upon leaving Dr. Lo's clinic that day - Jan. 6, 2006 - Ms. Chu claimed that she tried to coax her brother to go straight to the hospital. She said that Mr. Chau became furious, and said: "Even Dr. Lo said that I was okay. Why must you make me go to a hospital?"

Mr. Chau was found not criminally responsible in the killings earlier this week by a Toronto judge.

According to a transcript from Mr. Chau's 2007 preliminary hearing, Dr. Lo denied that Ms. Chu asked him to admit her brother to hospital at the Jan. 6, 2006, meeting. Dr. Lo acknowledged that he saw Mr. Chau for just 140 minutes during the 12 years that he treated him. However, Dr. Lo, who stated he sees 15-20 patients a day, said that he didn't see it as necessary to spend more time with Mr. Chau.

Dr. Lo's office was closed this week, and he did not return telephone messages.

Peter Lindsay, Mr. Chau's defence lawyer, expressed misgivings yesterday about the quality of care his client was given. "The compelling story here is that Dr. Lo sees him so little. If you do the math, he saw him for just over 11 minutes a year. I'm not a doctor, but I think that's far short of what he should be seeing this guy."

A psychiatrist who assessed Mr. Chau last year, Dr. Hy Bloom, found that "highly modest" injections of a medication Mr. Chau was being given may have lost their effectiveness, and likely should have been increased or administered more often.

Other victim

Chau Huc Minh was not the first of psychiatrist Hung-Tat Lo's mentally ill patients to explode into violence.

In 2004, two years before Mr. Chau's killing rampage, a 36-year-old Chinese immigrant, Xuan Peng, drowned her four-year-old, autistic baby in a bathtub at her Scarborough home.

She had been under Dr. Lo's care at the time.

According to a 2005 bail ruling that freed Ms. Peng pending her first-degree murder trial, Dr. Lo was treating her for a bipolar disorder at the time that her daughter, Scarlett, drowned.

The presiding judge at the bail hearing was Ontario Superior Court Judge David McCombs.

He was persuaded to grant Ms. Peng bail partly based on testimony from Dr. Lo, who said that she was capable of being managed in the community and agreed to supervise her treatment.

"While Dr. Lo's objectivity may have been somewhat compromised by the fact that he was the treating psychiatrist at the time of the alleged homicide, I am nevertheless satisfied that Dr. Lo is both qualified and motivated to help Ms. Peng and to ensure that her mental illness is appropriately managed," Judge McCombs added.

The judge noted that Dr. Lo, a graduate of the University of Hong Kong in 1971, had "impressive credentials."

"He has been a psychiatrist for over 30 years," Judge McCombs said.

"He is an assistant professor at the University of Toronto. He is the founder of Hung Fook Mental Health Service. Hung Fook has been in existence since 1982, and is an important facility, dedicating and assisting people of Asian background who have mental health problems.

Police arrested Ms. Peng seven months after Scarlett's death. Last March, she was found guilty of second-degree murder, notwithstanding her history of mental illness. Read more!

Did a cop dump a homeless man in NL -New London (CT) The Day

By Chuck Potter, columnist

Two police departments are investigating the delivery of a mentally impaired homeless man onto a New London street early Monday morning.

The incident fortifies my perspective that seeking financial support for the Homeless Hospitality Center's overnight shelter from regional municipalities might be feeding a monster that will rapidly outgrow its cage.

Just before 1 a.m. Monday New London patrol officer Thomas Lawton was observing traffic from the parking lot of a Colman Street auto dealership when a Stonington police cruiser passed by and stopped a short distance up the street.

According to Lawton's incident report, the Stonington officer, Randy Holt, got out, opened the back door and let a man out of his cruiser. Lawton said he approached and asked what was going on. According to the report, Holt told Lawton he was bringing the man from Stonington to New London because the man was trying to get to New York. Holt told Lawton that he couldn't take the man any farther, the report said. The man had no identification.

When asked why he didn't take the man to the city's transportation center downtown, Lawton's report said Holt contended it didn't matter where the man went because the man was mentally ill, crazy. Lawton also said Holt told him that he didn't take the man to the hospital because the man was not a threat to himself or others.

”We don't need him in Stonington,” the report quotes Holt as telling Lawton. “He would be better off in New London.”

That might be true. The man was provided care at Lawrence & Memorial Hospital (where, by the way, he did become combative and had to be restrained). If New York was the man's destination, New London has a bus and train station. And it has a homeless shelter.

Holt didn't take the man to the hospital, train station or homeless shelter. So, was he acting out of compassion for his fellow man, or was he, as a loyal town employee, trying to rid Stonington of a potential problem?

Choose a perspective and blog accordingly. Be polite.

What really matters is that a Stonington problem became a New London problem through questionable actions. Both departments are looking into the matter.

”I was very disappointed,” New London Chief Bruce Rinehart said. “The same with Stonington. I talked with Chief (J. Darren) Stewart over there. He's as concerned as I am, and he's promised to look into it. I didn't get the sense that it's a departmental practice.”

Stewart confirmed that it was not a departmental practice. He withheld further comment pending the outcome of an internal investigation.

Stories abound about people being steered to New London to avail themselves of the services. But it's done on the down low.

If the Council of Governments and the Homeless Hospitality Center are successful in getting the regional towns to contribute $3,000 each to the operation of the shelter, those communities will surely assume the right to officially refer people to the shelter. The number of bed-seekers could quickly rise beyond the ability of the shelter to provide.

Those communities might also feel the right to impose or ignore rules, such as the breath testing. Some might want to expand to drug testing, limit bed space to families, or to females.

Stonington Borough Warden Don Maranell, beyond concern that his tiny haven that is part of Stonington might be too strapped to come up with the $3,000, takes issue with the breathalyzer at the New London shelter. If he kicks in, can he vote on that rule?

Also, it should be known that Stonington spends more than $92,000 supporting the Westerly Area Rest Meals (providing shelter and meals to homeless people in conjunction with local churches since December 1987) and the Mystic Area Shelter and Hospitality.

Jay-Z quoted the late Biggie Smalls when he said “More money, more problems.”

Even in the realm of homeless hospitality such wisdom applies, as does another old axiom: Be careful what you ask for. Read more!

Mental health experts launch awareness campaign - Norman (OK) Transcript

By Tom Blakey

People need to change the way they think about mental health issues, says Terri White, commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services.

"Mental health and addictive disorders are often overlooked when we speak of public health or medical issues," White said. "Yet these illnesses are primary public health concerns."

White and other mental health officials presented a Community Leadership Breakfast Friday morning at Griffin Memorial Hospital, as part of a campaign to raise public awareness about society's approach to mental health and addiction concerns.

White said mental and addictive disorders affect 26 percent of Oklahomans and 21 percent of Oklahoma's youth.

"Yet 95 percent of our youth don't receive the services they need to overcome mental health or addictive issues," mainly due to a lack of funding and available resources, White said.

"Too many people are turned away from appropriate care," she said.

The stigma associated with addiction and mental illness also prevents people from seeking help, she said.

"Discrimination has to stop," she said. "Addiction is a disease of the brain, yet it's treated differently than a disease of the pancreas or the lungs."

White recognized Associate District Judge Stephen Bonner who attended the program, and commended the Norman community for its "innovative programs" such as Drug Court. Judges in Cleveland County are "aggressively identifying people who need treatment rather than incarceration," she said.

Drug courts have proven to be an effective alternative to incarceration for drug and alcohol offenders, White said. Only 23.5 percent of drug court graduates were re-arrested four years later, compared with 38.2 percent of successful standard probationers and 54.3 percent of released inmates.

Cost comparisons showed that drug courts have saved Oklahoma taxpayers millions of dollars, White said.

Norman resident Bob McDonald, a member of the Board of Health and former state assistant attorney general, shared the story of his struggle with alcoholism.

"The best thing that ever happened to me was when someone took me to jail," he said.

McDonald said he was suicidal and suffering from major depression when he wound up as a patient at Griffin Hospital in 1978. McDonald began on his path of recovery, going to a halfway house in California and returning to Oklahoma.

"Everything has been restored. I stand here today, happy, joyous and free," McDonald said.

Other speakers included Deputy Commissioner Caletta McPherson and Jeff Dismukes, ODMHSAS director of public information.

"These issues must be addressed as priority public health concerns, yet mental and addictive disorders continue to be overlooked when we speak of public health or medical issues," Dismukes said.

To address stigma and discrimination related to mental and addictive disorders, ODMHSAS is implementing the Community Champions Initiative, an education and awareness program targeting employees of community businesses and corporations, along with members of nonprofit and civic organizations.

The Community Champions Initiative seeks to help individuals and family members know where to turn when in need, and how to respond to potentially preventable health problems, Dismukes said.

Tom Blakey 366-3540 tblakey@normantranscript.com
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Mower hits gravestone, finds neglected cemetery - Associated Press

CHIPPEWA FALLS, Wis. (AP) - A forgotten cemetery has come back to life in Chippewa Falls, thanks in large part to maintenance worker Mike Winscher.

He was cutting grass when the mower hit something hard. It turned out to be a gravestone.

When Winscher began investigating, he found records at the Chippewa County Historical Society and located 262 gravestones, all of them overgrown with grass, weeds and even trees.

But that was a year ago, and now the grave sites have been leveled and gravestones reset with the help of inmate crews from the nearby Chippewa Valley Correctional Treatment Facility who completed the work Thursday.

The graves are from 1901 to 1965. Most of the dead were from old county facilities for the mentally ill and homeless.

The historical society plans to erect a sign to mark the cemetery.

Information from: Leader-Telegram, http://www.leadertelegram.com/

Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Read more!

Missing baby found safe in Tennessee -Salt Lake City ABC 4

Video link available by clicking post title.

Reported by: Brent Hunsaker

JOHNSON CITY, Tenn.(ABC 4 News) – At 8:45 Friday evening, police in Johnson City, Tennessee, knocked on a door and found a mother and 7-week old girl missing since Wednesday from Utah. The officers were acting on a request from Midvale police.

Midvale Sergeant John Salazar said a phone call had placed the mother, 27-year old Sheila Crump, somewhere in Tennessee. They tracked down the address of her biological mother in Johnson City asked the local police to check it out. Officers report that baby Vanessa was dirty, but otherwise okay. Crump is in custody on a fugitive warrant.

How did Sheila Crump manage to run off with her baby daughter? The mother was in a drug treatment center and her baby was in the protective custody of the state of Utah. So how could this happen?

It may well have come down to timing and opportunity.

While Sheila Crump was under supervision at a drug treatment center run by Valley Mental Health, a state judge allowed her to have the “trial placement” of her baby Vanessa Ochoa. Vanessa was born August 3, 2008 suffering from utero substance abuse. Sources say the baby had become addicted to cocaine while in her mother’s womb.

While together at the treatment center Vanessa became sick. A little after midnight, Wednesday, an ambulance was called. The fateful decision was then made to send mother in the ambulance with baby and without a staff escort. Connie Hines, a spokeswoman for Valley Mental Health said she could not comment on why the decision was made. Perhaps it was because of reduced staffing at night, or because of the medical urgency of the situation. Whatever the reason, Sheila Crump and baby Vanessa arrived at Primary Children’s Medical Center alone.

Emergency room personnel treated Vanessa for about two hours. And what’s mother doing all this time? Midvale Police Sergeant John Salazar said, “She made a number of calls from the hospital.” Without an escort, Crump was free to plan an escape. And without an escort, the PCMC staff would have no idea she did not have custody of her baby. At 3:25 a.m. Wednesday, Sheila Crump was given care instructions by nurses and Vanessa was released in her care.

Midvale police detectives now believe that after leaving the hospital, she stopped briefly at a house in Taylorsville, then got a ride to the Greyhound station where she caught a bus to Nashville, Tennessee on a ticket paid for by her biological mother.

Sheila Crump now faces an extradition hearing. If she does not fight extradition, she could be back in Utah by the end of next week.

Her 7-week old daughter will probably be returned before then. She’s now in the care of child protective services in Tennessee. Separate arrangements for her return will be made by Utah DCFS.
Copyright 2008 Newport Television LLC All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. Read more!

Advocacy group releases mental health law guide for students - The Jurist

Recommended if interested that you click post title for this article and to download the guide.

Andrew Gilmore

The Judge David L. Bazelon Center for Mental Health Law [advocacy website] this week released a guide [text, PDF; press release] addressing the legal rights of students seeking help for mental illness or emotional distress.

The report, Campus Mental Health: Know Your Rights!, provides guidance to students on privacy, academic and disciplinary issues associated with mental health treatment at American colleges and universities. The guide advises students who are placed on involuntary leave or refused re-admission because of mental or emotional health issues to file grievances with their school's disability compliance officer. The Bazelon guide echoes the concerns of US Sen. Dick Durbin (D-IL), who introduced legislation [S 3311] in July to improve mental and behavioral health services on college campuses. The bill is being reviewed by the Senate Committee on Health, Employment, Labor and Pensions [official website].

On Tuesday, Congress passed legislation [H.R. 6983 text, PDF; JURIST report] to reduce inequities in the insurance coverage of mental health and addiction treatment by amending the Employee Retirement Income Security Act of 1974 (ERISA) [text]. The bill would bring insurance payments for such treatment in line with those for treatment of physical disorders. Mental health advocacy groups and insurance industry groups applauded the legislation, praising it as a step forward in the legal and social protection of those suffering from mental illness. Read more!

A mum's story of bi-polar disorder - The Press, New Zealand

KIM THOMAS.

Before she tried to throw herself from a moving bus, Lorelei Burdett was a typical suburban mum. But during a holiday bus trip to Lake Manapouri, near Te Anau, in 2001, Lorelei "lost the plot".

"I had this desperate urge to exit the bus no matter what," she recalls. "It was moving and I was pounding on the door, shouting abuse at the driver to open the f...ing door. He finally did and I ran, not knowing where I was going but I just had to keep going."

The incident resulted in a several-month-long stay in Christchurch's Hillmorton Hospital and a diagnosis of bipolar affective disorder, also known as manic depression.

Lorelei's childhood provided few clues to her later diagnosis. "I was a model child, who was taught not to break the rules. I was pretty happy."

In her 20s, Lorelei suffered bouts of postnatal depression after the births of her two daughters, Sarah (now 23) and Roseanne (now 17) which were probably signs of her illness.

She spent some time in a hospital psychology ward after both births. Lorelei's midwife noted after a home visit soon after Roseanne's birth that the new mum was behaving strangely.

"She spent most of the day in her bra and pants ... She suspected if she got dressed we would take her to the Wellington psychiatric unit, of which she had horrific memories from her last admission," the midwife wrote.

"By the third day (in hospital) we'd noted some unusual behaviour such as leaving the bay alone and going down to the chapel without telling anyone where she was ... within a matter of 12 hours there was a sudden change, to one of hyperactivity and erratic behaviour such as rushing around the house, dancing in the shower, over-talkative, unable to relax, mood swings and suspicion."

Lorelei also went "manic" one Sunday morning about 10 years ago, running out into her quiet suburb and lying down in a nearby street.

The experience provided the title of her recently published book about her life with bipolar disorder, called "Mummy, why did you lie in the middle of the road?"

It is based mostly on her frantic scribbling while in Hillmorton, as she tried to make sense of her experience.

"Going into Hillmorton was horrible. I had been bought up to think you should never bring shame on your family and suddenly I was in the nut-house dosed up on drugs."

Lorelei says when she first entered Hillmorton she had no sense of reality. " My thoughts whizzed. My foremost notion was that the doctors, nurses and other patients were all actors and were all performing for my benefit."

She spent much of her time painting, writing in her diary and listening to her radio late into the night, rebelling against the authority of the staff like a small child.

"I listened to my headphones all night, listening to songs and frantically writing lyrics down. Because I wasn't sleeping, I wanted to prowl. The night staff weren't impressed and consequently a male nurse removed my headphones forcibly he was not sympathetic. I was totally distraught my headphones. What right did he have!"

After a while, Lorelei says she began to understand there was a reason for her stay in what her family called "Hotel Hillmorton".

"At first, I looked around at the other people in Hillmorton and thought they were pretty `out there'. I hadn't accepted that they were in there for the same good reason as me. They had to go there to be put together."

Her husband Peter and daughters visited. "When I wasn't freaking out about being in the hospital I worried about the impact it would have on my family," she says. "I still think about the hell I put them through."

Lorelei left Hillmorton but struggled to adjust. "I thought people wouldn't like me any more because I was mental."

On a visit home during her stay at Hillmorton, Lorelei was picking flowers in her neighbour's driveway when they suddenly arrived home. Confused and ashamed, she dived over the concrete fence separating their properties to escape having to talk to them.

"I thought I would be OK to be back at home, but I wasn't. I was unmanageable and oh so hard to handle."

When she first came home Lorelei went for weekly appointments with a psychologist at a community clinic.

Gradually, the weekly appointments turned into fortnightly then monthly. Now she goes for check-ups once every six months.

She was readmitted to Hillmorton in 2006 after a relapse when she verbally abused a neighbour's child and yelled at her husband for leaving the house without her.

She has fought against the reality of being on medication for the rest of her life, sometimes stopping the drugs to see what effect it had. "I realised pretty quick that I was all over the show without my medication. I don't like having to take pills every day, but I do it so I can remain in one piece for my family."

Lorelei says that with hindsight she can see the mental-health system saved her life. On several occasions, including when she ran off the bus near Lake Manapouri, she contemplated taking her own life.

She hates it when the media write stories about tragedy or the system "failing people" as she knows first hand how wonderful, and patient, staff were with her.

"People with mental illnesses are difficult, there's no denying that," she says. "You can't save everybody but it certainly gave my life back to me."
You may not copy, republish or distribute this page or the content from it without having obtained written permission from the copyright owner. To enquire about copyright clearances contact clearance@fairfaxnz.co.nz. Read more!

Father: Son Accused In Slaying 'Mentally Ill' - San Diego NBC-TV

Video available by clicking on post title.

LA JOLLA, Calif. -- The distraught father of man accused of killing his roommate made a tearful statement outside the hospital where his son was arraigned on murder charges.

"Last Monday, Ian called me and he cried out for help. He asked me to help him find a doctor because his mental illness was getting worse," said a tearful Nathan Suazo. "He told the doctor he was suicidal. The doctor still refused to help us. I did not understand the severity of the crisis."

Ian Suazo pleaded not guilty from his hospital bed at Scripps Memorial in La Jolla Friday. He's accused of killing his roommate, Ocie Rains, 39, then apparently trying to commit suicide by stepping in front of a car.

The bizarre chain of events unfolded Wednesday. San Diego police said they received a call from a citizen at 4:53 a.m. reporting a dead body had been found in an apartment in the 800 block of Agate Street. Investigators said Rains' body was found inside. Blood spatters started outside the apartment complex, and continued all the way down to Tourmaline beach, then back up to Mission Boulevard.

According to Lt. Kevin Rooney, as homicide detectives interviewed neighbors and prepared a search warrant to enter the apartment, officers responded to a pedestrian versus car crash at 9:06 a.m. nearby at Chalcedony Street and Mission Boulevard. Rooney said the driver of the vehicle told officers that the man she struck stepped into traffic in front of her.

The wounded man was identified as Suazo, 21. He was arrested and has been under guard during his hospitalization.

Investigators are still trying to figure out a motive. But the victim and the suspect worked together at Sinbad's Cafe.

"My family wants to convey our sincere and deepest sympathies to Ocie and his family," Nathan Suazo said. Read more!

Routine caregiver duties create overload - UPI

BLACKSBURG, Va., Sept. 26 (UPI) -- Using diaries of baby boomers, U.S. researchers conclude that helping a parent results in a downward trajectory of health and well-being for the child.

Jyoti Savla of Virginia Polytechnic Institute and State University and colleagues systematically studied diaries that examined the stresses of daily life in conjunction with helping an older parent about two or more days each week.

"The accumulation of small and large daily stressors such as work deadlines, PTA meetings, supporting family and friends as well as providing routine assistance to a parent living outside one's house can build up," Savla said in a statement. "Sooner or later, they can spill over into other areas of life with negative mental and physical consequences. Days when help is provided to parents are more stressful than days when it is not."

Most individuals who provided help to parents were also juggling multiple roles each day, which could lead to conflicts between the roles, or feeling overloaded.

The study, published in the Journal of Gerontology: Social Sciences, found that in addition to helping parents, most people spent nearly five hours on work-related activities and two hours on work in their own household, with about 10 hours for sleep, leisure and exercise.
Read more!

Persons With Serious Mental Illness Face Higher Prevalence of Obesity - Wall Street Journal Market Watch

SAN FRANCISCO, Sep 26, 2008 (BUSINESS WIRE) -- Obesity is a public health crisis within the general population; however, overweight and obesity issues are even more prevalent in persons with serious mental illness, according to a new report, scheduled to be released on October 3, 2008 by the National Association of State Mental Health Program Directors (NASMHPD).

Findings and recommendations from the report appear in the September 22 issue of Mental Health Weekly, making the journal the first major media outlet to inform the public of this new technical report.

NASMHPD calls the crisis "an epidemic within an epidemic," and say they hope the new report will go a long way toward improving the systems that provide care and treatment to the SMI population.

The specific recommendations, when implemented, should substantially reduce the weight and improve the overall health of a population with SMI, according to NASMHPD. "This report can be viewed as a rallying call for more prevention and intervention strategies for people with SMI struggling with obesity issues," said Robert W. Glover, Ph.D., NASMHPD executive director.

The report also notes that some medications can cause weight gain for people with SMI, and notes that medications that are more weight neutral should be considered by physicians. "Medical interventions are needed to address issues with medications that can cause obesity and that includes behavior and counseling treatments, medications for weight loss, and surgery," said Joseph Parks, M.D., chair of the NASMHPD Medical Directors Council and medical director for the Missouri Department of Mental Health.

The report, Obesity & Prevention Strategies for Individuals with Serious Mental Illness, represents the 15th in a series of technical reports. Two years ago, NASMHPD released its report, Morbidity and Mortality in People with Serious Mental Illness, which found that people with SMI die 25 years sooner than the general population.
In its new report, NASMHPD has issued a series of recommendations at the national, state and local levels. Recommendations include the implementation of national obesity surveillance/monitoring system for persons with SMI and the promotion of opportunities for healthcare providers, including peer specialists, to teach health lifestyles to families, individuals and older adults.

Mental Health Weekly provides information on business trends, state funding and policy issues, litigation, and more. The publication is a trustworthy source for community-based mental health program directors, hospital administrators and others in the mental healthcare profession.

About Wiley
Founded in 1807, John Wiley & Sons provides must-have content and services to customers worldwide. Its core businesses include scientific, technical, and medical journals, encyclopedias, books and online products and services; professional and consumer books and subscription services; and educational materials for undergraduate and graduate students and lifelong learners. Wiley has publishing, marketing, and distribution centers in the United States, Canada, Europe, Asia, and Australia. The company's corporate headquarters is located in Hoboken, New Jersey. The company is listed on the New York Stock Exchange under the symbols JWa and JWb. Wiley's internet site can be accessed at www.wiley.com.
SOURCE: John Wiley & Sons

John Wiley & Sons
Amy Packard, Publicity Manager, 415-782-3177
Apackard@wiley.com

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Judge Sends Tampa Officer's Killer Back To Mental Hospital - The Tampa Tribune

By TOM BRENNAN

TAMPA - When Carlos Bello takes his medication, no one questions his mental competence.

But prosecutors say that every time he faces being sentenced for killing one Tampa police officer and wounding one in an aborted drug bust in July 1981, he stops taking the medicine.

Prosecutors were unable to persuade Hillsborough Circuit Judge Ronald Ficarrotta today to proceed with imposing punishment, continuing more than 20 years of legal yo-yoing.

"The burden is on the state to prove the defendant's present ability to be competent," Ficarrotta said. "I find insufficient evidence at this time."

Experts contacted by The Tribune say there is not much the state can do to force an inmate to take medication.

Bello was convicted and sentenced to death in 1987 for killing Detective Gerald Rauft and shooting Detective Robert Ulriksen. The Florida Supreme Court upheld the conviction in 1989 but overturned the sentence. Bello has been found incompetent repeatedly since then and confined at various institutions, the latest being Florida State Hospital in Chattahoochee.

Doctors there and a psychologist and psychiatrist hired by the state attorney's office in August said Bello was malingering and only shows symptoms when forced to discuss his crime.

"He has the capacity to be competent, but he chooses not to be," State Attorney Darrell Dirks said.

Tampa psychiatrist Bala Rao, called by Bello's defense, testified today that Bello has a 35-year history of chronic mental illness and has been diagnosed as schizophrenic. He said that since being moved from the state hospital to the Hillsborough County Jail, Bello has stopped taking his medication and eating and has become delusional. He said those changes undermine the findings of the prosecution's experts.

"They can deteriorate quiet significantly," he said of such patients.

Ficarrotta ruled that Bello is unable to assist in his defense or comprehend the legal proceedings. He ordered him returned to the state hospital

"I want this case closely monitored." the judge said, adding that the case will proceed as soon as Bello can be stabilized – if he can.

Local officials said that county jail officials can't force inmates to take medication. Mental hospitals can.

Forcing inmates to take medication creates mountains of problems, said Frank Ochberg, a clinical professor of psychiatry at Michigan State University and former associate director of the National Institute of Mental Health.

It is so vexing -- ethically, legally and morally," he said. "Is it a physician's responsibility to restore someone's health to have them executed?"

Bruce Jacob, a professor at Stetson University College of Law, said there seem to be few legal impediments in forcing Bello to take his medication.

"I think it could be done, but the statute doesn't cover this exact situation," he said.

Jacob said prosecutors would have had to obtain a court order, and the law specifies what they would have to prove, including the medical necessity and whether there are less intrusive alternatives.

"It is not as clear as it should be," he said.

The ruling outraged Tampa police officers who attended the hearing.

"This person has skipped off death row by not taking his medicine," said Detective Greg Stout, president of the Tampa Police Benevolent Association. "I find that incredible."

Bello was found incompetent after his arrest, and it was six years before a trial could be held. He was ruled incompetent in 1990, 1991, 1993, 1995, 1996, 1998, 1999, 2000, 2001, 2004 and 2005.

Reporter Tom Brennan can be reached at (813) 259-7698 or tbrennan@tampatrib.com. Read more!

Community Concerned Over Taser Death -New York WYNC Radio

Full radio report available by clicking on post title.

by Fred Mogul

NEW YORK, NY September 26, 2008 — Mayor Bloomberg and police officials are trying to placate concerns that the NYPD is not equipped to deal with the mentally ill. It follows the death of a man who fell from a ledge outside his apartment building after an officer used a stun gun on him. WNYC's Fred Mogul reports.

REPORTER: Bloomberg praised the training of police officers and said everyone should feel comfortable calling them for help. But many advocates and community members say they are concerned with how the NYPD responds to the mentally ill, and they say incidents like the one that led to the death of 35-year-old Inman Morales on Wednesday only increase their fear.

Several groups favor a program other cities use in which police officers work together with mental health professionals in Crisis Intervention Teams. But the NYPD says its own units have adequate training. Spokesman Paul Browne says two of the officers involved in the standoff with Morales have had their duties modified, pending investigation. Browne says department policy forbids the use of taser stun guns on subjects in elevated areas from which they could fall. For WNYC, I'm Fred Mogul.
Read more!

Study: Kids, this is your brain on food -Salt Lake City Tribune

By Brian Maffly - 09/26/2008

In adolescents, food engages the primal brain, a lower part of the cerebrum associated with immediate gratification and base urges.

But in adults, food experiences appear to trigger more nuanced responses in the frontal cortex, the part of the brain that processes abstract thought associated with long-term goals, according to a neuroscientist with the University of Utah's Brain Institute.

It's more evidence that adolescent brains are still developing, which holds implications for early intervention in mental illness and for treatment of juvenile offenders.

"The adolescent brain responds differently to these rewarding cues than the adult brain," said Deborah Yurgelun-Todd, who uses magnetic resonance imaging (MRI) to study how stimuli affect brain activity, measured in terms of blood flow around the 3-pound organ.

Yurgelun-Todd presented her findings Thursday at the inaugural Lunch with Leo, a new lecture series The Leonardo will host with the Utah Science, Technology and Research initiative. USTAR recruited Yurgelun-Todd, a 25-year veteran of psychiatric research, to lead the U.'s Cognitive Neuroimaging Center with her husband Perry Renshaw.

Yurgelun-Todd's work has been cited in Supreme Court arguments backing elimination of the death penalty for teens and is used by the Indiana juvenile justice system to reduce teen recidivism.

"The more we carry out this research the more we realize the brain is plastic, undergoing change throughout the lifetime," she said, noting that there is a general consensus that the brain reaches "adult" maturity around age 25.

The human brain reaches full size around age 5, but the organ keeps changing.

"The volume of the brain might not change but there is substantial remodeling during adolescence," Yurgelun-Todd said. It's that remodeling that her research seeks to understand.

For the food study, researchers put healthy people, both adolescents and adults who had no first-degree relatives with psychiatric disorders, into an MRI machine. They recorded changes in brain activity while exposing the subjects to 30-second glimpses of food and non-food images.

The results were clear: Adolescents' responses to food were strictly subcortical. This suggests youngsters' reward systems remain relatively unformed, which makes it harder if not impossible for them to understand long-term goals.

"Reward is incredibly important in goal-directed behavior. If your reward system is driving you to the extent that your inhibitions can't control impulse, you won't be able to control short-term gratification in favor of long-term goals," Yurgelun-Todd said.

bmaffly@sltrib.com
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Report details troubles at care facility -Charlotte Observer

Contact information if you've seen this woman at end of story.

By Pam Kelley - pkelley@charlotteobserver.com
Posted: Friday, Sep. 26, 2008

Mouy Tang didn't talk much, but she did talk about going home. Sometimes, Tang, who emigrated from Cambodia, talked of long-ago memories of rice paddies.

On Sept. 3, the 46-year-old woman disappeared from Unique Living, a troubled adult care home in Cleveland County.

Following her disappearance, state officials shut down the home.

But Tang, who has schizophrenia and requires insulin to control diabetes, remains missing. Family members fear she may be dead, and they blame state officials for failing to act sooner.

“They've failed us and our family,” says SueLee Waller of Raleigh, Tang's niece. “The problems run much deeper than losing my aunt. It's a reflection on the health system and how people view and treat the disabled.”

A new report, released this week, details violations the state found after Tang's disappearance, including broken door alarms and a staff that wasn't properly supervising its 60 residents.

Unique Living administrators couldn't be reached Thursday.

The report also describes Tang, who escaped Cambodia's brutal government in 1983, but spent much of her life in America struggling with schizophrenia.

She was usually confused, Unique Living staff members told state inspectors. She needed to be reminded to come for meals and medication. Sometimes, she put her clothes on backwards or tried to wear pants on her arms.

She spent most of her waking hours with a male resident, her best friend.

A facility administrator told inspectors that up until Tang disappeared, she never left Unique Living alone. One resident said otherwise: Sometimes, Tang would go into the front yard alone.

Tang had lived at Unique Living since 1993, when the facility was called Yelton's Health Care. After one resident died from choking on a sandwich and another died from scalding in a tub, Yelton's reopened in 2005 under different ownership as Unique Living.

The facility, near Fallston, about 50 miles west of Charlotte, had been repeatedly accused of poor patient care and unsafe conditions. Though most of its residents were mentally ill, it was licensed to care for elderly adults. It housed mentally ill people on Medicaid because the state didn't have anywhere to put them.

In 2006, the state fined the home $16,000 after a man with diabetes and dementia wandered from the facility and died. Some mental health advocates had argued then that it should be closed.

In June, Cleveland County Department of Social Services officials told the state that utility companies were threatening to cut services because the facility hadn't paid its bills. It asked the state to take over management of the home, warning it was “only a matter of time” before a resident was injured or harmed.

The letter “reflected what we thought was a collapse of the supervision and the management of the facility,” Cleveland Social Services Director John Wasson says. “They couldn't the pay bills. We felt if they couldn't pay the bills, they couldn't do anything else.”

The state responded with a July inspection. It found nine exit doors that lacked alarms to alert staff when a resident was walking out. Mattresses were ripped and stained. Pillows were soiled with brown stains.

But those violations weren't serious enough to warrant a management takeover, state officials say. And many of the problems the county listed in its June letter couldn't be verified, said Jeff Horton, acting director of the state Division of Health Service Regulation.

On the morning of Sept. 3, Tang wandered away from the home. She was spotted about two miles away, near Burns High School. Since then, family members have organized searches and offered a $15,000 reward, without success.

“It's just been very traumatic and heartbreaking for us,” Waller says.

One day after her disappearance, state officials returned to Unique Living.

They found that door alarms hadn't been fixed, even though they'd given the home an Aug. 29 deadline. The executive director told state inspectors that the electrician hired to fix the doors had stopped work “due to non-payment for previous work.”

But on this visit, inspectors also found that staff members weren't properly supervising residents, putting them in imminent danger, according to the new report.

That plus the broken door alarms prompted the state to suspend the facility's license, Horton said Thursday.

Cleveland County officials see the Unique Living saga differently.

They say staff members' inability to supervise residents is a longstanding problem.

Residents went in and out of the facility all the time, to smoke, or take a walk or blow off steam, says Teala McSwain, program manager for Cleveland's Department of Social Services.

Though many workers cared about the residents, staff monitoring of everyone “would have been almost humanly impossible,” she says.

What finally persuaded the state to close Unique Living, says Cleveland County's Wasson, is Tang's family – “a very caring family who advocated for her in Raleigh. When you have an active, involved family, I think it was really hard for them to blow this thing off like they usually do.”

Wasson maintains that Tang might now be safe with her family if the state had heeded Cleveland County's June letter.

“Just given everything that's gone down, I think the (Department of Health Service Regulation) makes Wall Street regulators look efficient.”

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-------------------------------------

Have you seen her?

Mouy Tang is 5 feet 2 inches and 148 pounds. She has medium-length black hair and brown eyes. She was wearing a white shirt and beige capri pants. Family members think she may have gotten a ride with someone, so she could be outside Cleveland County.

If you have information, call Cleveland County Sheriff's Office Detective Sgt. Bryan Gordon, 704-484-4822. Read more!

Public safety 'overriding interest' in Taser case -Tallahassee Democrat

by Nic Corbett -September 26, 2008

A Tallahassee police report about the Tasering of a mentally ill man earlier this month concluded it wasn’t excessive force, but the incident has caused concern for some readers.

Police were called Sept. 12 about a man in the nude walking his dog on the sidewalk of Hartsfield Road. The 40-year-old man, Matthew Heiman, told an officer Allah commanded him to watch a Bruce Willis movie at 4 p.m. and then walk down the street naked. He was eventually Tasered by another officer when he wouldn’t do what they asked.

The incident is an example of why Crisis Intervention Team training is so important, said Beth Dees, a mental-health peer specialist at Ability 1st. It’s not clear if the officers involved had gone through it.

“They’re pretty much on the front line,” said Dees, who has spoken to officers about her own struggle with mental illness. “If there’s a problem, they’re the ones that get called.”

Lt. Dewey Riou of the Tallahassee Police Department said more than 150 law-enforcement officers in the Tallahassee area have been CIT trained. TPD has enough officers trained so that at least one is on duty for every shift. Another 40-hour course will be held Oct. 27.

After reviewing the police report, Dees said it appears the officers followed standard procedure, but she thinks the Taser was not the best option.

“A mentally ill person in crisis may not be able to understand or respond to regular commands,” she said, “but unless they are aggressively threatening themselves or others, Tasering seems extreme.”

Police spokesman Officer David McCranie said it would’ve been a different situation if Heiman were having a crisis in a house or another contained area.

“We cannot afford to allow someone in the public who obviously is in need of mental health services to endanger the lives of the officers or the public,” McCranie said.

Jim Pasco, executive director of the national Fraternal Order of Police, agreed.

“The overriding interest here is public safety,” Pasco said.

The first officer to respond gave Heiman an emergency blanket to cover himself. Heiman was holding a plastic bag in each of his hands and would not drop them when the officer told him to.

Two more officers arrived as backup. They asked Heiman several times to drop the bags and turn around. When he wouldn’t listen, an officer Tasered him. Heiman fell to the ground, suffering minor scrapes. Officers took him to Tallahassee Memorial Hospital for involuntary mental-health evaluation and treatment under the Baker Act.

Instead of asking Heiman if he had been “Baker Act-ed,” which caused him to get upset, Dees said the officer should have asked him something like “How was the movie?” to build a rapport with him.

The officer with the Taser reported Heiman was “increasingly agitated” and holding the leash to a medium-sized black dog that looked part pit bull. The officer wrote in the report he was concerned for his own safety. When asked if the dog would bite, Heiman said “she might.”

The dog was later found to be friendly and was picked up by Animal Services.
Read more!

Stressed out? Blow bubbles, expert says -Salt Lake City Tribune

By Mike Gorrell - 09/25/2008

Stressed out?

You're not alone.

Try blowing some bubbles.

That's one bit of advice offered by clinical psychologist Jane Blackwell, the Salt Lake Chamber's featured speaker recently when it honored companies that implemented different practices to enhance their employees' quality of life - and to boost their productivity in the process.

"Stress is a fact of life, but Americans are having a harder and harder time finding healthy ways to cope with stress," says Blackwell, who has a private practice in Holladay and is the American Psychology Association's public education coordinator for Utah.

In the latter capacity, she says, "one of my duties is to spread the word about how to have psychological health. What better way to do it than at a grass-roots, employee-based awards ceremony."

Blackwell has some sobering numbers for her chamber audience.

One-third of Americans report living with extreme stress. More than half say their stress levels are higher now than five years ago.

Among those who feel stressed, 75 percent cite money and work issues. One in four Americans suffer from headaches, most stress-related. Sleeping disorders abound. Gastro-intestinal problems are on the rise.

"We can go on and on about the domino effects of stress contributing to physical problems,"Blackwell says.

People often turn to unhealthy solutions for relief, she noted, citing substance abuse, eating "comfort foods" and vegging out in front of the television at the expense of more meaningful interactions with family and friends.

To go down a more appropriate path, Blackwell advises her listeners to figure out what stresses them out and how it physically manifests itself. "Do they get grumpy, fatigued, zone out?" she asks rhetorically, noting that introspection helps because "we have a tendency to ignore our bodies and the effects that are happening all the time."

Clearly, there are some tried-and-true ways to cope with stress. Going for a walk. Listening to music. Finding some other purely personal activity of relaxation are a few possibilities, Blackwell says.

But she has one particular favorite - blowing bubbles.

Blowing through the little wand and inflating the soapy liquid works well, she insists.

"To have good bubbles, you have to listen to yourself breathe, which is a relaxation technique. If you blow too hard, the bubble will pop. To have good bubbles, you have to be in control."

And feeling in control helps drain stress.

If these techniques do not work, Blackwell emphasizes, don't be afraid to reach out for support.

"We isolate ourselves and don't like to admit we're stressed. Reaching out to friends, talking to a professional, it makes you face [the stress], but it gives you more opportunity to do something about it."

mikeg@sltrib.com

Jane Blackwell
Who: Clinical psychologist with private practice in Holladay
Education: Doctorate from Washington State University
Background: Founding director of medical psychology at St. Benedict's Hospital in Ogden, founding director of eating disorders unit at Cottonwood Hospital and Wasatch Canyons Hospital, conductor of meditation programs at Utah State Prison
Professional ties: Former Utah Psychology Association treasurer, American Psychology Association's public education coordinator for Utah Read more!

Rep. Watt 'hit cold' by VA changes - Salisbury (NC) Post

By Mark Wineka - mwineka@salisburypost.com

U.S. Rep. Mel Watt, D-N.C., sent a letter Wednesday to Veterans Affairs Secretary James Peake asking for justifications behind changes planned for the Hefner VA Medical Center in Salisbury.

Watt told Peake he was "deeply disappointed that this decision, which will affect many of my constituents, was made without any notice to or consultation with my office."

The VA announced Friday the Salisbury hospital would be changed to a community-based outpatient clinic and "Center for Excellence for Mental Health and Long-Term Care."

Inpatient care and emergency room services will be provided to veterans through "contracts with community partners," the VA said, meaning they probably will be sent to local hospitals such as Rowan Regional Medical Center.

The changes also will affect employees and the overall mission of the Salisbury medical center. Meanwhile, the VA plans to expand its clinics in Charlotte and Winston-Salem into "health-care centers," providing more services to veterans.

Employees at the Hefner VA Medical Center, the county's fourth-largest employer with a workforce of about 1,700, heard of the changes for the first time Friday.

"We were hit cold with this," Watt said of his own office, "and are being called upon to explain and comment on changes, the specifics and rationales for which we had no prior knowledge about and still have not been briefed."

He asked Peake to provide a written description of and justification for the changes and said he welcomed an opportunity to discuss the matter with someone from the VA.

While he was pleased with the Department of Veterans Affairs' plans to expand access to care in Charlotte and Winston-Salem, Watt said he also was concerned about three things:

- The impact the changes could have on the quality and quantity of services at the Hefner VA, "which for years has been a full-service hospital and health center for veterans and in recent months has made substantial upgrades to serve this purpose better."

- The impact the changes will have on the Hefner VA's workforce.

- Whether veterans, if they are sent to non-VA facilities, will be subjected to long waits before they receive care.

"Discussions with non-VA hospitals throughout the district suggest that no arrangements have been made with them to serve veterans effectively," Watt said.

Hefner VA Medical Center Director Carolyn Adams acknowledged last week in a formal notification to American Federation of Government Employees Local 1738 that employees assigned to inpatient services would be affected and a realignment of staff will occur.

She said management would work with the union to minimize the impact on employees as a whole and develop a plan for a transition.

A meeting of the Rowan County Veterans Council has been scheduled for 6 p.m. Tuesday at the J.C. Price American Legion Post on Old Wilkesboro Road to discuss the VA Medical Center changes. Read more!

More mental health care, abuse aid in VA bill - Washington D.C. Times

Legislation passed by the House on Thursday would expand veterans' treatment for substance abuse and mental health care, including post-traumatic stress disorder (PTSD), as well as provide counseling for families of veterans.

The House approved by voice votes the Veterans' Mental Health and Other Care Improvements Act and the Veterans' Benefits Improvements Act.

The Senate is expected to pass both measures before Congress wraps up its work this weekend.

The benefits package would provide a faster system to process claims, expand pilot programs that offer adjustable rate loans and offer legal help to military reservists who lose their jobs because they are deployed overseas.

"It's a disgrace that veterans have to wait months or years for the benefits they have earned because of a bureaucracy that simply doesn't work," said Rep. John Hall, New York Democrat.

"A nimble, responsive VA claims system could go a long way to help our nation live up to its commitment to care for wounded veterans and their families. It could prevent suicides, bankruptcies, poverty, family disruptions and homelessness among our nation's disabled veterans," Mr. Hall said.

Rep. Bob Filner, California Democrat and chairman of the House Veterans' Affairs Committee, said the bills would help modernize the Department of Veterans Affairs (VA) to become a "21st-century world class entity that reflects the selfless and priceless sacrifices of those it serves - our veterans, their families survivors."

The health care bill includes a pilot program to establish rural health care for veterans who must travel hundreds of miles to get treatment and expands benefits to children of Vietnam and Korean war veterans who are born with spina bifida.

Chris Needham, senior legislative associate for the Veterans of Foreign Wars (VFW), called the legislation "tremendous" and said his organization is "highly supportive."

"We hope the Senate will pass it quickly. We've been waiting a long to get a veterans health care package passed this session," Mr. Needham said.

"The treatments for veterans with post-traumatic stress disorder are just wonderful, and this will greatly improve care for thousands of returning service members," Mr. Needham said.

Rep. Michael H. Michaud, Maine Democrat and chairman of the Veterans Affairs subcommittee on health, pushed for more treatment for veterans suffering from substance-abuse disorders but said it needs to be included with treatment for veterans who also have PTSD.

"Substance-use disorders frequently co-occur with other mental health conditions, and the need for services is increasing," Mr. Michaud said. "VA needs to rededicate itself to providing comprehensive services that can address both substance-abuse and other mental health conditions such as PTSD."

As lawmakers were wrapping up the legislation Thursday, the VA building in downtown Washington was closed for two hours due to an anthrax scare. A suspicious package and a letter warning of anthrax inside was investigated and determined to be a hoax.
Read more!

A hopeful sign in Riverhead - Long Island (NY) Newsday

Opinion:

It was once a hotel with a bar favored by lawyers, judges and reporters. Then it was a dingy adult home for about 120 residents with psychiatric disabilities. Now, it is Concern Riverhead, a much-improved home for 50 residents, more like an assisted living facility than a typical adult home. And it's a hopeful sign for the future of this fragile population.

The state's policy of "deinstitutionalization," at its height three decades ago, did not work. Patients did leave large hospitals and move into the community, but the dollars to give them adequate care did not follow them. So they ended up in grubby adult homes or single-occupancy hotels. Many ended up in prison. That's "transinstitutionalization."

In recent years, due to inadequate state reimbursement, adult homes have been closing, creating a care gap. The good news is that a Medford-based nonprofit, Concern for Independent Living, is working to create studio apartment-style living spaces - with the necessary services - for 50 people each in three locations: West Sayville opened last year; East Patchogue is about seven months from completion and Riverhead has been open for three months.

Yesterday was a ritual grand opening for what used to be the Hotel Henry Perkins in Riverhead. Town, state and county officials gathered to celebrate. Two state agencies, the Office of Mental Health and the Division of Housing and Community Renewal, played key roles. So did the county's Division of Community Mental Hygiene Services and Department of Social Services, and the town itself.

Now, in a space where politicians once gathered for adult beverages and tale-telling, public-private cooperation has produced a better paradigm for the care of the mentally ill. It's a brighter new chapter in a long, sad story.
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Stop the insanity ... New York Daily News

Editorial: The madness goes on, and this time a mentally ill man is dead and two police officers face a criminal investigation for what appears to have been a tragic error in judgment.

Inman Morales should be alive today, the recipient of appropriate care and medication for the demons that, running loose, drove him to stand naked and deranged on a ledge 10 feet up the side of a Brooklyn building.

It was there that, wielding a fluorescent light tube, Morales met his end after two Emergency Service Unit cops took part in shooting him with a Taser. Stunned, Morales fell onto his head on the pavement.

There is no question the officers set out to do the right thing in trying to prevent a troubled man from injuring himself or others. They are highly trained members of an elite team that takes on the toughest assignments. Often, they risk their lives in subduing emotionally disturbed individuals.

Here, though, the officers, a lieutenant who gave the order and a cop who fired, made the mistake of zapping Morales when he was at clear risk of plunging to the ground and was no special danger to anyone. Sadly, they did not wait for the arrival of an air bag or take a different tactical approach.

Commissioner Ray Kelly stripped the lieutenant of gun and badge and placed the cop on administrative duty. NYPD guidelines bar the use of Tasers when the target might fall.

Of necessity, Brooklyn District Attorney Charles Hynes is looking at the case. Whatever responsibility attaches to the officers, he would do a service by also getting to the bottom of whether Morales slipped through gaping and dangerous cracks in New York's system for treating the mentally ill.

For two years, this page has chronicled instance after instance in which disturbed individuals stopped taking medication and went haywire with disastrous consequences. Some inflicted violence on others. Some forced the police into shooting them.

Mayor Bloomberg and then-Gov. Eliot Spitzer convened a task force that produced reforms aimed at reducing the carnage. Every new outbreak is supposed to be investigated, confidentially, as a way to devise more reforms. But the bloodshed continues.

Morales' case feels all too familiar. Unable to reach him and worried he had stopped taking his medication, Morales' mother went to his apartment. He became verbally abusive. She asked a worker at a nearby salon to call 911. ESU cops responded, as they do to some 80,000 calls about emotionally disturbed people every year. Only this time, there was tragedy.

Someone prescribed Morales' medication. Someone was supposed to be watching him. Someone dropped the ball. We need to know who and how.

... and drop the Tasers

The death of Inman Morales should also put to rest any idea of arming all 36,000 members of the NYPD with Tasers.

Some argue that widespread distribution of the electric-shock weapons would cut down on police shootings. The claim is that, rather than pulling the trigger, cops would temporarily incapacitate people by zapping them.

It's a nice-sounding idea, but it's perilous hokum.

First, NYPD shooting incidents have steadily fallen. They now run at a little more than 100 a year. Perhaps some would be averted. But it is certain cops would Taser lots more people rather than subdue them with lesser force.

If the NYPD started zapping at the rate Cincinnati cops zap, the number of shocked New Yorkers would top 12,000 annually. And that would be insane.

The flip that flopped

David Blaine, the famous magician and death-defying daredevil, reports he is very unhappy with his recent Central Park stunt, and what a small world it is, as so is everyone else.

Never mind that his climactic Dive of Death got glitched by technical difficulties. It was supposed to be, he says, "the most amazing ending for a stunt ever." Okay, well. That's just bad luck for you. Houdini himself kind of botched his last trick, you'll remember.

But it was the hanging-upside-down thing that was a little, shall we say, unsatisfactory. Hanging upside-down for 60 hours, blood rushing to his head, heroically staring Mr. Death right in the face. Except he was taking breaks every hour or so and standing upright for a few minutes. So as not to, you know, die.

Dazzle-wise, this stunting was not exactly up there with, for example, sitting atop the 225-foot flagpole at Atlantic City's Steel Pier for 49 days, which the immortal Shipwreck Kelly did in 1930. Still, we suppose some of magician Blaine's fans are impressed.

Ourselves, we find a lot of our interest in magician Blaine has magically disappeared. Read more!

In our view: Mental-health parity -Clark County (WA) Columbian

Editorial: The hackneyed, unfunny-by-now joke is that Brian Baird’s background as a clinical psychologist prepares him especially well for working in Congress. Har-har. If Baird had a dollar for every time he’s heard that one, he could bail out a bank or two.

But the more practical and sensible application of Baird’s professional background enables him to push key legislation on a more serious social need: improving the quality of life for people who receive mental-health treatment. They look to the U.S. representative from Vancouver as a strong and steady advocate.

Baird came through for them — for all of us — again with Tuesday’s passage in the House of a mental-health parity bill. Approved by an overwhelming 376-47 bipartisan vote, the bill would require group health plans with 51 or more employees to cover mental health treatment equally with the medical care of people with physical ailments.

In Washington state, a mental-health parity bill was approved three years ago, and strengthened this year. In Congress, the Senate also this week passed a mental-health parity bill overwhelmingly (93-2), but as Kathie Durbin reported in Thursday’s Columbian, the two bills must be reconciled. However, the calendar and the clock are working against this year’s bill. Congress is scheduled to recess today. As of Thursday afternoon, there was continuing talk of extending the session.

Even if the bill dies in this session, a compelling precedent has been established. With the combined passage by 90 percent of the House and Senate members, Congress has affirmed the importance of mental-health parity. And although a delay would be troubling, this year’s affirmation should set the stage for swift action by a post-election Congress next year.

The need for this legislation cannot be overstated. People with mental illnesses should not have to pay higher co-pays than people with physical illnesses, nor should their health insurance cover fewer office visits. Such inequities exist today, however, and they are simply inhumane.

Some lawmakers such as Baird are motivated by their professional background. “We know that (mental health) treatment is effective and it can improve people’s lives,” Baird said. “And we know that it’s cost-effective from an economic standpoint.”

Other lawmakers are motivated by personal experience. One is U.S. Rep. Jim Ramstad, R-Minn., who helped usher the bill through the House. “I am alive and sober today only because of the access that I had to treatment following my last alcoholic blackout on July 31, 1981,” Ramstad said, according to The ­Associated Press. Another is U.S. Rep. Patrick Kennedy, D-R.I., who has recovered from depression, alcoholism and substance abuse to become a congressional advocate for ­mental-health parity.

As Brendan Daly, spokesman for House Speaker Nancy Pelosi, said this week, “The will is there in both the House and Senate to get this done.” The only question is: When? Immediately would be in the best interests of mental-health patients, specifically, but also for society in general as we seek to become more compassionate, more attentive and more civilized.

No longer are mental-health issues dismissed as hopeless mysteries. Science, technology and medicine have made significant advances. It’s time now — or next year — for Congress to make its own overdue strides. Read more!

Randolph County social service agency lays off one third of staff - Belleview (IL) News-Democrat

BY MIKE FITZGERALD

RED BUD -- The state's severe cash crunch has forced Human Service Center, the provider of a wide range of social services to Randolph County residents, to lay off 27 workers -- one-third of its staff-- the agency announced Thursday.

As a result, services for about 300 mentally ill and developmentally disabled adults will be cut, curtailed, or delayed, while waiting lists to see mental health workers will grow significantly, said Gary Buatte, the agency's executive director.

The layoffs, which take effect Monday, stem from a $400,000 backlog of unreimbursed bills owed by the Illinois Department of Human Services, Buatte said.

The laid-off employees include eight workers in agency administration, three mental health caseworkers and four counselors, two workers in the sheltered workshop and a supervisor in the developmental training program.

The agency has scheduled a press conference at 2 p.m. today at its Red Bud office to announce the layoffs.

Buatte said he is hopeful the department can find a way to speed up its reimbursement schedule, enabling it to bring back the laid-off workers.

"What we're hoping is that in some way that these delays will stop," Buatte said, "and we will get restored the funds they need to pay us in order to get everyone back."

The cash flow problems besetting Human Service Center are an familiar story for state-funded social service agencies statewide, especially those that care for the mentally challenged.

Community Link, of Breese, has already announced it might be forced to shut down a group home for developmentally disabled adults in Highland because of $1.1 million in unreimbursed bills owed by the state Department of Human Services.

Department spokesman Tom Green blamed the payment delays on the hard economic times gripping the state, resulting in dwindling comptroller coffers.

"The issue is that there is not enough money in the comptroller's office to pay all the bills that they have," Green said.

Even so, the department has been working with the comptroller's office to advance payments to Human Service Center, Green said.

Indeed, on Sept. 18, that office mailed a check for $135,500 to the agency to avert layoffs, he said.

"We're very concerned about the potential loss of services for that community and we're working to try to avoid it," he said.

What is a long-term solution to the money crunch?

"For the economy to turn around and for the state to get more income," he said.

Contact reporter Mike Fitzgerald at mfitzgerald@bnd.com Read more!

Mental Health Hospital Closing -Middletown (NY) Times Herald-Record

By Christian Livermore

CORNWALL — After a loss of $3.5 million and two years of searching for funding, St. Luke's Cornwall Hospital is closing the mental-health unit at its Cornwall campus.

A combination of chronic underfunding by the state, inadequate insurance reimbursements for mental-health care and a large amount of uncompensated care made keeping the unit open untenable, according to Beth Duffy, chief financial officer and senior vice president of finance for the hospital.

"This one's breaking my heart, but we just can't see a way around it," she said. "We've been talking to state and county officials for close to two years, and nobody can seem to come up with a solution. We've become the player of last resort, and due to the enormous amount of resources needed to address these patients, we can't continue this."

It will take between three and six months to close the unit. The hospital must first submit a closure plan to the state Department of Health outlining what other resources are available to patients in the area. As part of the plan, the hospital must also set up a process for patients to find and access that care.

A significant void

The unit, which opened in 1991, treats more than 500 patients a year and employs 18 full-time and 14 part-time workers, as well as additional per-diem workers who work as needed.

The employees will have to apply for other positions in the hospital. Duffy could not say exactly how many positions would be available, but thought it was a good number.

The hospital already eliminated the equivalent of about 22 full-time positions in May, some of them at the mental- health unit, and cut the number of beds on the unit from 22 to 14, but it was apparently not enough to staunch the losses. Workers have been saying that understaffing was making the unit unsafe for patients and workers.

Finding other treatment options for its patients won't be easy. A lack of coordination of care and outpatient treatment has long plagued mental health services nationwide. And the state's current fiscal crisis won't help.

St. Luke's not alone

The St. Luke's unit is by no means the first casualty of the mental-health funding shortage.

The Middletown Psychiatric Center closed about two years ago. Orange Regional Medical Center has an in-patient mental health unit. One of the other nearest facilities, the Rockland Psychiatric Center, is about 50 miles away.

And typical behavioral health facilities lose money, according to a February 2008 report, The Crisis in New York's Behavioral Health System, by the Healthcare Association of New York State. Hospitals surveyed for the report lost an average of $1.8 million last year.

Many people ascribe the start of the decline to Reagan-era mental health cuts that closed psychiatric facilities and put thousands of mentally ill patients on the streets.

Mental-health funding has long been a lower funding priority because it affects a relatively smaller portion of the population, Angela Skretta, vice president of the Northern Metropolitan Hospital Association, said in a previous interview.

"The situation was (made worse) because there were cuts to the New York state Medicaid reimbursement in the budget that passed for mental health services," she said. "It's pretty awful nationwide."

At its peak in 1955, New York state's psychiatric hospital system had more than 90,000 beds. Now it has about 5,000, according to the Healthcare Association report.

"If programs continue to endure financial pressures and close," the report says, "patients will be forced to travel much further for care."

clivermore@th-record.com Read more!

Altered landscape for mental health -Jacksonville (NC) Daily News

Onslow Memorial Hospital CEO Ed Piper says that since state officials closed the local mental health crisis center two months ago, the hospital has been dealing with a flood of mental patients for which the facility is inadequately prepared. This is really a much larger issue than it initially appears.

The federal government, both directly and indirectly, created many of the problems that currently exist with the treatment and care of mental patients. As a result of well-intended but misdirected legislation, these patients often have fewer and shorter courses of treatment open to them, while guardians such as parents, spouses and siblings often find themselves unable to access information or help for their loved ones.

After investigations exposed thousands of mental patients forgotten by the system and living in inhumane and often brutal conditions, many state mental institutions, including Dorothea Dix Hospital right here in North Carolina, closed, forcing thousands of these patients across the country onto the streets. Many found themselves without access to adequate treatment, medicine or a place to live. Countless numbers joined the homeless population.

Added to this problem is the tragic tendency by much of society to view mental illness as anything other than what it is: a physical illness that manifests itself neurologically. This attitude, almost unchanged since the Dark Ages, places huge roadblocks in the path of eliminating discrimination toward the mentally ill.

Those who suffer from mental illnesses, particularly from diseases such as schizophrenia and bipolar disorder, can no more help being ill than individuals with heart problems or cancer. And drug and alcohol addiction, while often curable, many times are manifestations of other mental illnesses that must also be treated.

It is understandable that an institution like OMH, which is not set up to deal with mental patients, finds itself under a strain when bombarded with patients for which it is not prepared. The obvious solution would be to put those resources in place on a permanent basis. Otherwise, Onslow County could see situations similar to that of a mentally ill New York City resident named Andrew Goldstein who pushed a young woman, Kendra Webdale, onto the tracks of an oncoming train, killing her.

At his trial, the evidence showed that Goldstein, who suffered from diagnosed schizophrenia, had repeatedly sought treatment at area hospitals and was given short-term treatment - or no treatment at all - and sent on his way.

This is not to suggest that OMH develop the resources to become a long-term facility for the treatment of mentally ill patients, but it seems logical to conclude that the Boy Scouts aren't the only organization that should be prepared. Because, if the county's only general hospital cannot meet the immediate needs of a mentally ill individual in crisis, the next Andrew Goldstein could fall right through the cracks here in Onslow County.
Read more!

Dix closure delayed - Raleigh (NC) News & Observer

Michael Biesecker

RALEIGH - A state judge has stalled the plan to start shutting down Dorothea Dix Hospital next week and transferring its patients to a new state mental facility in Butner dogged by safety and staffing concerns.

Superior Court Judge Allen Baddour issued a temporary restaining order Thursday that bars the state Department of Health and Human Services from moving the bulk of Dix's patients to Central Regional Hospital, a process that had been scheduled to begin Oct. 1.

It is not clear how long Baddour's order might forestall the demise of the 152-year-old Raleigh institution, but some Dix employees and advocates for the mentally ill were hopeful Thursday that the decision might buy enough time for a new governor to take office.

Both gubernatorial candidates, Republican Pat McCrory and Democrat Bev Perdue, have urged the administration of Gov. Mike Easley to hold off on closing Dix.

The judge acted in response to a class-action lawsuit filed Tuesday on behalf of Dix patients by the advocacy group Disability Rights North Carolina, which has been monitoring conditions at Central Regional since the new $138 million hospital partially opened in July.

"We are pleased with the decision, obviously," said Vicki Smith, the executive director of Disability Rights. "What the danger is when courts get involved is that the lawyers start arguing small points and we forget why we're there, which is to document that patients are safe."

The lawsuit details 15 concerns at the new hospital, including a faulty security system and insufficient staff that the advocacy group said would endanger patients. The legal maneuvering is not intended to keep Dix open permanently, Smith said, but to postpone its closure until the new hospital is demonstrated to meet the standards of outside accrediting agencies.

Thursday's court ruling could pose serious problems for the state in light of a review this week of complaints about Central Regional by inspectors from the federal Centers for Medicare & Medicaid Services.

According to an internal memorandum issued Thursday by Dr. Michael Lancaster, co-director of the state's mental health division, regulators are threatening to withhold federal funding from both Dix and Central Regional because of the failure of the two institutions to merge.

Lancaster, who was in court Thursday, looked stunned as Baddour made his ruling. Afterward, he expressed his disappointment. The staff at Central Regional had already fixed some of the safety problems and would continue to make positive changes, he said.

The judge scheduled a hearing for Oct. 6 to hear further arguments from lawyers representing Disability Rights and the state Attorney General's Office. The state lawyers claimed in court that the nonprofit group, which has a federal mandate to investigate claims of patient neglect and abuse, has no legal standing to challenge the move.

A state law that went into effect in July mandates that Dix's patients can't be transferred until DHHS Secretary Dempsey Benton can certify that Central Regional meets the standards of two organizations that accredit hospitals -- The Joint Commission and the Centers for Medicare & Medicaid.

Though neither group has signed off on the new hospital, Benton said that he has independently made the determination that Central Regional meets those standards.

In Baddour's courtroom, Mark Lodge, a special deputy attorney general, said the legal requirement had been met.

"The secretary is the one to make the determination," Lodge said. "It's not Disability Rights. It's not the patients."

The judge disagreed, finding from the bench that the group has the right to fight the state and that the group's lawsuit has merit.

Disability Rights' case was bolstered Thursday by an affidavit disclosing recent incidents that raise questions about the quality of care inside the new hospital.

According to court documents, within the last month a patient at Central Regional who was supposed to be under increased supervision managed to tear out her stitches after abdominal surgery without anyone on staff noticing.

In another incident, a malfunctioning air conditioning system at the new hospital kept the internal temperature so low that an elderly patient was found to be suffering from hypothermia. No one on the staff noticed he was in danger until a physician assistant passing by saw the unresponsive patient.

Still, the affidavit says, it took an hour for the staff to locate a rectal thermometer, further delaying medical treatment.

"What we have [at Central Regional] is a system that is operating in the margins at present that would be pushed over the edge with the addition of another 170 patients" from Dix, John Rittelmeyer, the director of legal services for Disability Rights, told the judge.

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

Wash. high court allows brain-harvesting lawsuit - Associated Press

By GENE JOHNSON

SEATTLE (AP) - The family of a man whose brain was harvested for mental health research when he died can pursue a lawsuit against King County as well as the institute that received the organ, Washington's high court ruled Thursday.

The state Supreme Court unanimously found that a lower court judge was wrong to dismiss all claims brought by the family of Jesse Smith, who died of heart problems in 2003 shortly after his 21st birthday.

Smith was an organ donor, and his mother, Nancy Adams, of Snoqualmie, said she and her husband consented by phone to providing brain tissue to the nonprofit Stanley Medical Research Institute of Maryland. Instead of taking a small tissue sample, however, the King County Medical Examiner's office provided the entire brain.

"This was devastating to her to find this out," Adams' lawyer, Steve Bulzomi, said. "It was hard enough to lose her son. To find out she was deceived on the worst day of her life, it was very, very difficult for her."

Stanley Research, with an endowment of over $300 million, created its brain bank in 1995 and calls itself the world's biggest private source of philanthropic support for psychiatric research. It has provided hundreds of thousands of brain-tissue samples to scientists around the world, and said in a statement issued last year that to its knowledge it has never obtained brains without full consent from next-of-kin.

But several families have disputed that. More than a dozen families in Maine have said they did not give consent for entire brains to be harvested, and a North Carolina woman also sued the King County Medical Examiner's Office, saying no such consent was given when her brother, Bradley Gierlich, died of a drug overdose in 1998. The Gierlich case is pending before the Washington Supreme Court.

Thursday's ruling clears the way for a trial in King County Superior Court on whether Adams consented only to the donation of a small tissue sample, as she contends. Bulzomi said she intends to seek damages for emotional distress.

Smith had no history of mental health problems. The institute collects such brains to use as controls for its studies.

The institute says it is necessary to have whole brains because there is a dearth of knowledge about where in the brain abnormalities associated with psychological problems are located.

Stanley Research and the medical examiner's office argued that Smith's status as an organ donor, established when he got his driver's license, allowed the harvesting of his brain for research. But in an opinion authored by Justice Susan Owens, the court held that Washington's Anatomical Gift Act - as it stood at the time - only authorized organ donations to hospitals, not research institutions, unless the deceased or next of kin specifically expressed other wishes.

The ruling barred some of Adams' claims, including one for fraud and another for invasion of privacy, but it allowed her to pursue claims of conspiracy and wrongful interference with a dead body.

Grant Degginger, a lawyer for the county and the institute who is also the mayor of Bellevue, said he was pleased that much of the lawsuit had been dismissed.

"It was undisputed that there was consent given, but there's a dispute about the extent of that consent," he said. "That's what we'll determine at trial."

Stanley Research paid for a pathologist in the King County Medical Examiner's Office from 1995 to mid-2004, and the office provided the institute with 255 brains.

Maine's high court ruled early this year that two of the lawsuits against Stanley Research in that state could go forward.
Read more!

Sheriff Bristles At State Attorney's Criticism Of Police Shootings - Jacksonville (FL) News 4

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JACKSONVILLE, Fla. -- The feud between Jacksonville's sheriff and its state attorney bubbled over again Wednesday when John Rutherford got a letter from Harry Shorstein questioning why police had to fatally shoot a mentally ill man.

Officers who were called to assist a mental health worker checking on the welfare of a client shot and killed the man, 30-year-old Sierra White.

Police said White was threatening them with knives outside his Arlington apartment.
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In a letter to the sheriff, Shorstein said: "The shooting of White was legally justified ... but many questions exist as to whether or not this severely mentally ill, non-criminal had to die.

"It is difficult to understand why several officers armed with expandable batons, which would seem to be perfect weapons to strike the hands and or knives and even break his hands if necessary, were unable to diffuse the situation or avoid killing this very sick person," Shorstein wrote.

Rutherford said he found the letter "offensive."

"Those officers did everything properly. To suggest that they did anything that wasn't out of the best of training or the best of intentions was just wrong," Rutherford told Channel 4's Dan Leveton on Thursday.

In his letter, the state attorney also brought up January 2007's police-involved shooting of another mentally ill man --Harry Lamar Shuler -- who was holding his family hostage inside their northwest Jacksonville home. He cited both cases in saying that officers need more training in dealing with those types of situations.

"I understand and appreciate the fact that failing to use deadly force against the two mental patients would have created some risk of danger to the officers. But, isn't that the case when every military person is in hostile territory, every police officer jumps in the water to save a child or every firefighter enters a burning building? Isn't that what we do?"

The sheriff said that even suggesting his officers did anything wrong is offensive.

"I don't see him out there with these officers trying to take down people with guns and knives," Rutherford said. "For him to sit back and from the comfort of his office, pen a letter like that, is just offensive."

The public feud between the two men should end soon. Shorstein did not seek re-election and his term will end in December. Rutherford actively campaigned against Shorstein's chief assistant, Jay Plotkin, in the August primary, and supported Angelia Corey, who won in a landslide.

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Human Services facing cuts - Salt Lake City Tribune

By Julia Lyon

The mentally ill, substance abusers, the elderly and the disabled are among the Utahns who would face significant cuts if the Department of Human Services slashes $11.7 million as proposed this morning.

Some of the cuts will be a step backward for the state.

Disability advocates have spent years trying to decrease the list of Utahns waiting for services and had received $1.1 million to shrink the list. A proposed $300,000 cut will force 55 residents to go back to the list.

Some cuts could lead to a domino effect of problems from more children in foster care to more addiction.

A nearly $500,000 cut to the family preservation program would focus it on those families assigned by the courts, which could lead to more children and parents in crisis.

"I can't promise you won't see more kids in foster care," said Lisa-Michele Church, Executive Director of the Department of Human Services.

Her choices hinged on federal requirements and the potential for revenue - among other factors, Church said. Programs such as child support collections, which bring in $4 for every $1 spent, are not being severely cut.

Some cuts such as the proposed $250,000 drop in local mental health services will lead to a loss of $1.3 million in Medicaid dollars. About 200 Utahns could lose services as a result of the state cut.

Sen. Chris Buttars, R-West Jordan, argued that the $2.1 million saved by cutting Drug Offender Reform Act programs would be lost in the increased demand on services. The act requires offenders to be screened and treated for substance abuse.

"It's one of those deals you cut your nose to cut your face," he said.

Church said, "I have 5,000 employees and I promise you if we can avoid cutting anyone we will. But, she added, "it's $11 million."

"We're cutting some of the fat, some of the muscle, hopefully we won't get down to the bone," said Sen. Allen Christensen, R-Ogden during a morning committee hearing. "We are still fabulously blessed in Utah to have the economy going the way it is. We just have to be very careful with it." Read more!

NC Health and Wellness Trust Fund Announces 'Breathe Easy, Live Well' Program - Raleigh (NC) Chronicle

RALEIGH - The NC Health and Wellness Trust Fund (HWTF) announces the creation of a new statewide tobacco cessation program for mental health consumers called "Breathe Easy, Live Well." Approximately 70% of individuals with serious mental illness smoke cigarettes, and individuals with mental illness or addiction consume nearly half of all cigarettes purchased in the United States.

The program, which will be implemented in psychosocial treatment centers across the state, aims to reduce the harmful effects that tobacco has on individuals with mental illness by providing them with equal access to smoke-free environments and cessation programs, in addition to increasing their awareness about overall wellness.

The project is funded by the HWTF as part of its overall tobacco cessation initiative. To date, HWTF has spent $54.3 million to address tobacco use in the state since its efforts began in 2003.

"The NC Health and Wellness Trust Fund is committed to reducing the health effects of tobacco use in our state for all populations," said Lt. Governor Bev Perdue, HWTF chair. "Through this initiative, the Commission is intensifying its efforts to reach out to this particularly vulnerable population with specialized services designed to better meet their
unique needs."

HWTF has awarded $505,000 to the NC Evidence Based Practice Center, part of Southern Regional AHEC, to pilot the program in mental health community/day treatment centers, also known as clubhouses.

The first four pilot programs include Adventure House in Shelby, Atlantic House in Morehead City, Sanctuary House in Greensboro, and Threshold Clubhouse in Durham. The clubhouses are non-profit, psychosocial rehabilitation programs serving
North Carolina adults with severe and persistent mental illness.

The clubhouses will begin training in November/December 2008, and wellness and cessation courses will launch in January 2009. For more information, please visit www.healthwellnc.com. Read more!

Cops: Taser death may have violated rules -Long Island (NY) Newsdy

ROCCO PARASCANDOLA - rocco.parascandola@newsday.com

It shouldn't have happened.

The New York Police Department all but admitted Thursday that Iman Morales should not have been stunned with a Taser gun, a jolt of 5,000 volts that incapacitated the naked, emotionally disturbed man as he plunged to his death, falling face first from a store ledge in Bedford-Stuyvesant in Brooklyn.

The officers involved in the Wednesday afternoon confrontation -- elite Emergency Services Unit officers trained in Taser use -- had no game plan in place for what to do once Morales was stunned, police said.

"None of the ESU officers on the scene were positioned to break his fall," said the NYPD's top spokesman, Deputy Commissioner Paul Browne, "nor did they devise a plan in advance to do so."

Browne also said two ESU cops -- the lieutenant in charge of the operation and the officer who followed the lieutenant's order and used the weapon on Morales -- are now being investigated because departmental guidelines clearly state that "when possible, the should not be used ... in situations where the subject may fall from an elevated surface."

The lieutenant, Michael Pigott, 45, a 21-year veteran, was placed on modified duty Thursday, stripped of his gun and shield, and assigned to a desk. The officer, a 10-year veteran whose name was not released, was taken off the streets and also assigned to a desk job, though he still has his gun and badge.

The Brooklyn District Attorney's office, meanwhile, has asked that the NYPD not interview Pigott or the officer -- both of whom have been assigned to Emergency Services since 2002 -- until it has completed its review.

Also Thursday, the autopsy on Morales, who lived alone on Tompkins Avenue, was inconclusive and the medical examiner's office said tissue and toxicology tests must be conducted to determine the cause of death.

On Wednesday, he berated his mother when she showed up at his door, worried because she had not heard from him and feared he was not taking his medication, sources said.

When he stepped out of his third-story apartment and onto the fire escape he was naked, police and witnesses say, and he was talking about wanting to die. During the ensuing 20-minute standoff, Morales climbed onto a metal security container that sits atop a vacant storefront on the ground level of his building.

He reached down and grabbed an 8-foot-long fluorescent tube from underneath the container and waved and poked it at officers -- those who had descended down the fire escape and those on the sidewalk.

By then, police said, officers had called for backup to come to the scene with an inflatable airbag. But before those officers arrived, the lieutenant gave the order and Morales, stunned by the Taser, tensed up and fell 10 feet, 5 inches to the ground, striking his head. He died at Kings County Hospital.

It appears, sources said, that the order to fire was given when Morales tried to strike an ESU officer who had turned his back and was trying to secure his harness to the fire escape in an attempt to pull Morales to safety.

In June, the Rand Corp., a think tank hired by the NYPD after the Sean Bell shooting to study police tactics and how it reviews shootings, suggested that the department make wider use of Tasers, first by using them in a pilot program involving several precincts.

Police Commissioner Ray Kelly by then had already signed off on adding 520 more Tasers to the department's arsenal, with sergeants carrying them on their belts, but he has yet to go forward with the Rand suggestion.

Wednesday's altercation took NYPD brass by surprise because it involved the unit whose officers most regularly use Tasers.

But Anthony Miranda, a retired NYPD sergeant who is now chairman of the National Latino Officers Association of America, said such an death would not occur in an upscale neighborhood or a white neighborhood.

"The real issue is, in minority neighborhoods they're not responding with the right equipment," he said. "If this was a different neighborhood the response would have been different."

The NYPD has said Emergency Services has 80,000 contacts with the emotionally disturbed every year with little or no problem, and that 180 people have been Tasered this year with no fatalities. But State Sen. Eric Adams (D-Brooklyn), a retired police captain, said the NYPD needs to do a better job dealing with the mentally ill.

On Thursday, dozens of neighbors and residents gathered in front of the building where Morales fell, recapping the day's horrific events and blaming police for Morales' death.

"Is this supposed to pacify us?" said Sharonnie Perry, 54, who grew up on Tompkins Avenue, and stood next to the spot where Morales fell. "These officers allowed the mother of this man to watch them Taser her son to death. This really affects me as a mother."

At a news conference Thursday near where Morales died, Adams said the punishment against the officers was inadequate.

"Putting them on modified duty is like putting Band-aids on broken bones," Adams said. "There is a culture in the police department that treats people with mental illness as criminals."

Maria Alvarez contributed to this story.

Copyright © 2008, Newsday Inc. Read more!

Sheriff's Office Affected By New State Budget -Sonora (CA) My Mother Lode News

BJ Hansen - September 25, 2008

Sonora, Ca -- The new $146 billion state budget that was signed earlier this week includes some cuts to local law enforcement.

“The first thing that jumps out at us is the MIOCR grant, which is Mentally Ill Offender Crime Reduction,” says Tuolumne County Sheriff Jim Mele. “This accounts for $44.6 million (statewide), and the money is now gone completely.”

MIOCR was a partnership between the Sheriff's Office, Department of Mental Health and Probation Department. It allowed the Sheriff's Office to hire extra staff to attend to mental health patients incarcerated in the County Jail.

Cal-MMET was also cut by $10 million statewide, which helps fight methamphetamine addiction.

Mele says he was pleased to see that no cuts were made to Rural and Small Counties Sheriffs funding, which provides a total $18.5 million to 37 California Counties.

“We didn't come out great, but it could have been a lot worse,” adds Mele.

Written by bjhansen@mlode.com
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'Bellingham Herald' Web Poster Arrested for Alleged Threat - Editor & Publisher Magazine

By Gene Johnson - September 25

SEATTLE A Washington state man who wrote on a newspaper Web site that he was going to shoot up a shopping mall says he was just making a point after a mentally disturbed man went on a shooting spree. But prosecutors say he was making a threat.

Jeffrey N. Gargaro, 28, faces possible jail time for writing that he should shoot up a mall "just for the hell of it. ... No drugs, no mental illness." He is fighting the charge on free-speech grounds.

Gargaro is one of several people investigated in recent years for postings that tested the limits in the freewheeling arena of the Web.

"We admit he was stupid," said Jeffrey Lustick, Gargaro's lawyer. But "people say some pretty unusual things on blogs."

Isaac Zamora, 28, began his rampage Sept. 2 near the town of Alger, 70 miles north of Seattle, and continued it on Interstate 5, investigators said. Described by his family as mentally disturbed, he was captured after a police chase and charged with six counts of murder.

The dead included a man who had accused Zamora of trespassing, a woman who lived nearby, two construction workers, a motorist along the highway, and Skagit County Deputy Sheriff Anne Jackson, who had responded to a call to check on Zamora.

The next day, Gargaro began his post on The Bellingham Herald's Web site by telling another commenter to "shut up." He added: "Also to all of you who blame drugs ... shut up as well. You know what, I am going to go shoot up sunset square today ... just for the hell of it. No drugs, no mental illness ... you can blame todays episode on video games and George Bush's example of 'pay back' to society."

An officer in St. Louis saw Gargaro's post the day after the shootings and pointed it out to the Bellingham Police Department. A detective obtained a search warrant and tracked Gargaro down at his home in Blaine, north of Bellingham.

Whatcom County Prosecutor Dave McEachran wrote in charging papers that the detective was "in reasonable fear ... that the threat would be carried out, and people could be killed or injured at the Sunset Square Mall."

But Lustick said his client was clearly trying to make a political point — awkward though it may have been. The comment must be considered within the context of such reader-feedback sections and blogs, which can be "notoriously bombastic," he said.

Noting his client was charged with felony harassment, Lustick also said it was unclear who was supposedly being harassed — the Web site's readers, shoppers at Sunset Square or the detective whose reaction is cited in charging papers.

"There is not one identifiable person in regard to the threat to kill," he said.

The charge carries a maximum sentence of five years in prison, but Gargaro has no prior convictions and would face a standard range of one to three months if found guilty.

The prosecutor did not return calls seeking comment this week.

Gargaro, a married father of two, told The Associated Press he doesn't own guns, didn't intend his comment as a threat and was trying to take issue with people who were assigning blame for the shooting before all the facts came out.

"I could have definitely worded it better, but I'm not sorry for what I wrote," he said. "I was just trying to get an open debate going." He is free on $10,000 bond pending trial.

Whether people are charged for making such comments often turns on whether what was said is a true threat, given its context. In December, prosecutors in Wisconsin declined to charge a teacher who sarcastically praised the Columbine High School gunmen in a blog, saying they "knew how to deal with the overpaid teacher union thugs. One shot at a time!"

A month earlier, a man in North Dakota was sentenced to 18 months for posting a comment that the Virginia Tech massacre was funny and including plans for a school shooting rampage in Bismarck.

Stewart Jay, a constitutional law professor at the University of Washington, said it's perfectly reasonable for police to investigate such comments. But, he said, given the tone of the comment and that Gargaro apparently had no intention of following through on what he wrote, that should have been the end of it.

"He's making, if not a political point, a sarcastic point about shifting blame or not taking blame for things," Jay said. "In context, it's just robust political speech."

Gene Johnson Read more!

Candidates get an earful at forum on mental health - Columbia (MO) Tribune

By JASON ROSENBAUM - September 25, 2008

Citing a shortage of space and experts to treat people with mental illness, speakers at a candidate forum urged state legislative candidates last night to keep the issue at the forefront when the General Assembly reconvenes in January.

The event sponsored by the National Alliance for the Mentally Ill of Missouri at the Boone County Government Center was one of the first public settings for legislative aspirants to flesh out their views during the campaign leading to the Nov. 4 general election.

Five Democrats - state Sen. Chuck Graham, D-Columbia, 25th House District candidate Mary Still, 23rd House District candidate Stephen Webber, 21st House District candidate Kelly Schultz and 24th House District candidate Chris Kelly - and two Republicans - 19th Senate District candidate Kurt Schaefer and 22nd District Rep. Therese Sander of Moberly - attended.

The gathering featured presentations by individuals involved with treating people with mental illness as candidates listened.

Physician Dan Vinson told candidates that local programs to assist the mentally ill are "overwhelmed with the needs" of patients. "Let’s turn it around," he said, advocating a boost in support for mental health workers.

"We face lots of opportunities because we know that these diseases can be treated," Vinson said. "They can be managed. There is solid evidence that community interventions, that public policies, that medications" and "support systems make a big difference in the lives of people with all of these diseases I’m talking about."

Speakers favored the concept of mental health parity, which they said would eliminate provisions in law that allow insurers to provide less coverage for mental illness than for physical illness.

Cynthia Keele, executive director of NAMI Missouri, said Mid-Missouri has seen a reduction in the number of beds for the mentally ill in local facilities.

"We’re left with very few options," she said, noting that the Mid-Missouri Mental Health Center in Columbia has 69 beds, including 12 reserved for children. "So essentially, we’re left with about as half as many beds as we had 15 years ago."

Keele said the state’s 2005 Medicaid cuts also had an impact on people with mental illness. As the state program’s eligibility was being cut back, she said, NAMI’s hot line was inundated with calls from "desperate" people facing elimination from the program.

Keele’s remark prompted Democrats Still, Webber, Schultz and Kelly to say they would support reversal of the program cuts.

"It is absolutely nonsense to suggest that the health-care cuts were necessary," Kelly said. "The health-care cuts were made because people with power wanted the money and got the money."

Schaefer, a Republican, said the cuts "were no doubt very painful" but noted the situation that "allowed the state to get to that point was inexcusable."

Sander - the only forum participant to vote for the Medicaid cuts - said a tight budget often forces legislators to make tough choices. "But I know I’m going to be facing some of those hard decisions again," she said. "There’s not enough general revenue there to cover all of those needs unless the people of Missouri are convinced that they want to pay more to the state."

Reach Jason Rosenbaum at (573) 815-1724 or jrosenbaum@tribmail.com Read more!

U.S. Kids Take More Psychotropic Drugs Than Europeans - Business Weekly

By Steven Reinberg

WEDNESDAY, Sept. 24 (HealthDay News) -- American children are three times more likely to be prescribed psychotropic medications for conditions such as ADHD and bipolar disease than European children are, a new study finds.

Differences in regulatory practices and cultural beliefs about the benefit of medication for emotional and behavioral problems may explain this dramatic difference, the U.S. researchers added.

"There is significantly greater use of atypical antipsychotics and SSRI-type antidepressants for child mental health treatment in U.S. than in Western Europe," said lead researcher Julie Zito, from the pharmaceutical health services research department in the School of Pharmacy at the University of Maryland. "Since most of the use is 'off-label' -- without adequate evidence of benefits and risks, close monitoring should be considered when these medications are used."

The report was published in the Sept. 24 online edition of Child and Adolescent Psychiatry and Mental Health.

For the study, Zito's group looked at the use of antidepressants such as Prozac and stimulants such as Ritalin in the United States, the Netherlands and Germany.

Researchers found that the annual prevalence of psychotropic medications among children in the United States was significantly greater than in either the Netherlands or Germany. In the United States, 6.7 percent of children were taking these drugs, compared with 2.9 percent in the Netherlands and 2 percent in Germany.

In addition, use of antidepressants and stimulants was three or more times higher in the United States than in the Netherlands or Germany, and use of antipsychotic drugs was 1.5 to 2.2 times greater in the United States than in either of the other countries.

The difference in the use of these drugs may be partly due to differences in diagnosis systems. For example, in the United States, there are more diagnoses of bipolar disease among children and adolescents than there are in Europe, the researchers noted.

In addition, there are more child psychiatrists in the United States per capita than in Europe, and many children in the United States are taking two or more psychotropic drugs in a single year.

"Direct-to-consumer drug advertising, which is common in the U.S., is also likely to account for some of the differences. The increased use of medication in the U.S. also reflects the individualist and activist therapeutic mentality of U.S. medical culture," the researchers concluded.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, thinks finding out what accounts for these differences may be important in determining the best treatment for children with emotional and mental problems.

"It has been said many times that the U.S. has a sick-care system, rather than a health-care system, with a particular emphasis on use of drugs and procedures for diagnosed conditions," Katz said. "This study reaffirms that pattern, with more use of medication for various mental health conditions among children in the U.S than other countries."

What this study cannot show is whether the use of medication is appropriate, given variations in culture, or whether other countries under-prescribe psychotropic drugs or whether the U.S. over-prescribes them, Katz added.

"To make that determination, a comparison of outcomes associated with these differing practice patterns is required," Katz said. "The value in comparing and contrasting resides ultimately in gaining insights about best practices. We now know that practices vary, but don't know which pattern, if any, is demonstrably superior to the others."

More information

For more about children and mental health, visit the U.S. National Library of Medicine.

SOURCES: Julie Zito, pharmaceutical health services research, School of Pharmacy, University of Maryland, Baltimore; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Sept. 24, 2008, Child and Adolescent Psychiatry and Mental Health, online

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Cherry workers upset at flaws in new payroll system - Goldsboro (NC) News-Argus

By Phyllis Moore

The state's new payroll system, which was introduced at state hospitals in April, is not working, say some workers at Cherry Hospital.

Peggy Evans, a health care technician at Cherry Hospital for nine years, said Wednesday workers are not receiving their money, putting them behind on car and house payments.

"People are losing their homes. It's not right," she said. "A lot of people that I have talked to have been hurt by the BEACON system."

State agencies began using the new payroll system in mid-December. The state Department of Health and Human Services, the Department of Corrections and other agencies started using it April 1. BEACON is an acronym for Building Enterprise Access for NC's Core Operation Needs.

Employees are paid once a month. The system has been complicated by the fact that glitches have yet to be corrected, Ms. Evans said.

"We get paid on time. We're just not getting our money," she said. "Our check stubs, we can't read them because we don't know what the abbreviations are. There's a lot of people here not getting their pay."

She rattled off a list of examples -- from one staffer who checked and his bank account only had $7 in it to one shortchanged by $500, another by $800.

"Right now we have got a petition, asking the governor to declare a state of emergency because people can't sleep on the streets," Ms. Evans said. "People don't understand that we want our money now and we need it.

"Gas is going up, everything is going up, and you ain't getting paid. ... It's a hardship because people are getting behind in their bills. Fix the system or go back to the one we had."

Larsene Taylor, a health care technician at Cherry for 16 years, said the issue is statewide.

Before it came to this, though, workers from state hospitals across North Carolina had already begun meeting to lobby for better working conditions. Meeting in Greensboro in January, they devised the Mental Health Workers Bill of Rights, which will be voted on in October.

"That's when we mobilized together all the workers to come together from different institutions, and held a public hearing in May," Ms. Taylor said. "Since then, we have been getting together to explain to workers we have got to have this bill of rights."

In the midst of the effort, however, the BEACON system was introduced, adding fuel to the fire.

A contingent has also visited the state controllers office, with future plans including the October vote for the bill of rights and lobbying the General Assembly in January.

"How do we get our money back? We can't make them pay us," she said. "So we have to apply as much pressure as we can."

The women are doing their part, affiliated with the UE Local 150, N.C. Public Service Workers union. Ms. Evans is vice president and Ms. Taylor is secretary-treasurer. A noontime rally was schedule for Wednesday outside the hospital's administration building. Similar rallies were held at other hospitals around the state, Ms. Taylor said.

The only ones who turned out for the Cherry rally were the two women.

"I'm really upset, disappointed," Ms. Taylor said. "There's a fear factor and I understand that. We have what I thought were some strong leaders, willing to stand up and take a stand."

Tom Lawrence, public affairs director for DHHS, admitted the payroll system is flawed.

"We have had issues for several months now, various types of issues, primarily because our department is different than that of most state government," Lawrence said, citing the unusual work-shift structure at state hospitals as part of the reason.

"The system is not set up to handle those things very easily. There's also an issue with people not filling out forms properly."

Lawrence said the state controller's office has been working closely with the institution's personnel department, but was aware that state hospitals, as well as the Department of Corrections and other agencies, are still experiencing problems.

"We have been attempting, at least up here, to handle employees on an individual basis," he said. "I think things have smoothed out, at least for a bit.

"We feel their pain but there's nothing we can unilaterally do if the state is committed to (the BEACON system). If they're having problems down there (at Cherry), just know that they're Read more!

Police investigation continues: Peterson still in critical condition - Nevada (IA) Journal

By Marlys Barker and Tiffany Cornelius

9/25/08 - A Nevada resident is in critical condition at Mercy Medical Center in Des Moines, and two Nevada police officers are on paid administrative leave, following an event that occurred in Nevada last Friday evening.

According to the report from the Story County Communications Department (dispatch center) and an interview with Nevada Police Chief Michael Tupper, the incident occurred as follows.

At 5:52 p.m. Friday, John Page, who lives at 1416 M Ave., called Story County 911. Page stated he had gotten a call from his home (he was not home at the time), and he was told that Eric Peterson, age 33, 1406 M Ave., was at the Page home and was choking his son-in-law, Sam Maley. It was reported that Peterson thought the Maleys had taken his dog.

A second 911 call came shortly after from Leta Maley, who reported that Peterson was chasing people with a knife. Although the type of knife has not been identified, Tupper said the crime lab reported a blade between eight and 10 inches in length.

As Nevada officers Adam Fischels and Kailen Fitzgerald were dispatched, they received information that Peterson was armed with a knife, threatening pedestrians in the area, had attempted to choke another person and had jumped on top of a vehicle.

Fischels was first on the scene, arriving in less than two minutes.

A dash cam video from Fischels' car shows Peterson running toward the patrol car with a knife in his hand, jumping on the hood of the vehicle, up onto the roof and then jumping off. After that, Fischels' radioed to dispatch that Peterson was chasing his vehicle. Peterson cannot be seen in the footage, but the video shows Fischels turning his car in a circular pattern in the parking lot located at 13th Street and M Avenue. Tupper said that Fischels was trying to maneuver into a safe position to exit the vehicle.

Fitzgerald arrived at the scene after Fischels. Fitzgerald's dash cam video shows him approaching the parking lot entrance, and as he turns into the lot, Peterson runs toward the vehicle with the knife. The collision between the patrol car and Peterson happens within seconds of Fitzgerald entering the parking lot.

Tupper said, after watching the video, the collision "looks more incidental than intentional."

Tupper said it is important that the public consider the totality of the situation. "This was a deadly force situation," he said. "The officers were immediately confronted by a very violent, out-of-control, enraged person. There was no opportunity (for them) to safely or unsafely exit their vehicles."

Tupper said in this case, the officers also had to think about the safety of residents and pedestrians in the area, including a number of children who were practicing on the soccer fields less than two blocks away at Harrington Park.

"People get involved in law enforcement because they want to help people. We have a great group of officers (in Nevada) that try to do that every day. Unfortunately, sometimes the officers have to deal with dangerous and deadly situations."

After the collision, emergency personnel responded to the scene, and Peterson was airlifted to Mercy Medical Center in Des Moines. He is listed in critical condition at this time.

On Sunday afternoon, the Peterson family issued a statement through Jim Hibbs of Wixted, Pope, Nora, Thompson and Associates, a communications firm in West Des Moines. Hibbs said he spoke with an aunt of Eric Peterson, who asked him to share the following information on behalf of Peterson's parents, Arlyss and Michael Peterson of Nevada.

"The family of Eric Peterson thanks friends and supporters for standing by them during this difficult time. Eric remains in critical condition and is fighting for his life. We hope and pray that he will make a complete recovery.

"The family was allowed to view the police-recorded videotape of the incident and want to ensure the public has all the facts of the case. Eric did not attack either officer. Eric did not try to get into either police car. He was holding a knife, but not brandishing it. He did jump on the hood of the first police car and run onto the roof and over the vehicle, but his actions were not an attempt to gain entry into the vehicle. As that car drove away, Eric was chasing it on foot, and not likely to be able to catch it. The second police officer arrived and appears to purposefully strike Eric.

"Eric is mentally ill and his actions are not always within his voluntary control. Nevada police officers, including the two involved in this incident, are well aware of Eric's mental illness.

"We do not want to place blame at this time, but we want to ensure that all the facts of the case be distributed on Eric's behalf. We appreciate your continued support, prayers and respect for our privacy. The family will have nothing further to say on this matter at this time."

Tupper said, "I'm very saddened for the Peterson family and I'm praying that Eric is O.K. But it's not a fair assertion that the officer (Fitzgerald) set out to run him down...The Nevada Police Department is very concerned about issues related to mental illness, and I think we've taken a proactive stance during my tenure to deal with these problems. Outside of (Iowa Law Enforcement) academy training and department field training, we continually seek additional training for our staff that deals with people who have mental illness or who are emotionally disturbed."

Officer Kailen Fitzgerald was cleared for active duty at the beginning of August after a confrontation with Tony Hayes on July 27 on Lincoln Highway. Hayes fled to Nevada by bicycle after he walked into the Casey's General Store on Lincoln Way in Ames and shot 27-year-old Lacrissa Davis to death. During the confrontation, Hayes was able to get into Fitzgerald's patrol car and flee the area. Hayes was pursued by several law enforcement agencies to State Center, where he died from a self-inflicted shotgun wound.

Tupper does not believe that the July 27 incident played a part in the officer's actions in this case. Fitzgerald was cleared by an internal investigation, as well as an investigation by the Iowa Division of Criminal Investigation. "Our investigation showed that he acted within department policy and within the law," Tupper said.

On Monday, Tupper and members of DCI met with Story County Attorney Stephen Holmes. Tupper told the Nevada City Council Monday night that Holmes advised that the officers were justified in their actions and that the DCI officials' preliminary findings do not find the officers at fault.

"That doesn't change how we feel about it," Tupper said. "Our officers are distraught and upset. I am upset. But this incident was not caused by the police officers or their actions. They did everything they could to defend themselves and the community."

The Nevada Police Department's internal investigation of the incident continues. "We are going to conduct a thorough and detailed investigation and once we've gathered everything, we will release it to the public," Tupper told the council. "Mental illness does play a part in this, but we cannot be blamed for what happened. I stand by my officers, and I stand by what happened."

Fitzgerald and Fischels are on paid administrative leave while the investigation continues.

*LISTEN TO AND VIEW full versions of the 911 calls and the Nevada Police Department dash cam videos online at www.nevadaiowajournal.com. Also online is a letter to the editor from Arlyss Peterson, mother of Eric Peterson, after a 2006 incident involving Eric and Nevada Police officers. Read more!

New official fires mental health director -Associated Press

DES MOINES, Iowa - The head of the state Mental Health and Disability Services Division has been fired because of disagreements with his new boss.

Allen Parks had been director of the agency for two years but was fired Thursday by Gene Gessow, the new head of the Department of Human Services. Department spokesman Roger Munns says Gessow "did not believe the two of them could work effectively as a team."

The firing is effective immediately.

Munns said Bill Gardam would serve as the acting director. A search will be launched soon for a permanent replacement. Read more!

Epilepsy, Autism, Schizophrenia: Master Switch That 'Balances The Brain' Found - Science Daily

(Sep. 25, 2008) — Neuroscientists at Children's Hospital Boston have identified the first known "master switch" in brain cells to orchestrate the formation and maintenance of inhibitory synapses, essential for proper brain function. The factor, called Npas4, regulates more than 200 genes that act in various ways to calm down over-excited cells, restoring a balance that is thought to go askew in some neurologic disorders.

Synapses, the connections between brain cells, can be excitatory or inhibitory in nature. At birth, the rapidly developing brain teems with excitatory synapses, which tend to make nerve cells "fire" and stimulate their neighbors. But if the excitation isn't eventually balanced, it can lead to epilepsy, and diseases like autism and schizophrenia have been associated with an imbalance of excitation and inhibition. The creation of inhibitory connections is also necessary to launch critical periods -- windows of rapid learning during early childhood and adolescence, when the brain is very "plastic" and able to rewire itself.

Npas4 is a transcription factor, a switch that activates or represses other genes. The researchers, led by Michael Greenberg, PhD, director of the Neurobiology Program at Children's, demonstrated that the activity of as many as 270 genes changes when Npas4 activity is block