Medication Nation

http://www.nytimes.com/2009/10/22/health/22nami.html?_r=1

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By GARDINER HARRIS
Published: October 21, 2009

WASHINGTON — A majority of the donations made to the National Alliance on Mental Illness, one of the nation’s most influential disease advocacy groups, have come from drug makers in recent years, according to Congressional investigators.

The alliance, known as NAMI, has long been criticized for coordinating some of its lobbying efforts with drug makers and for pushing legislation that also benefits industry.

Last spring, Senator Charles E. Grassley, Republican of Iowa, sent letters to the alliance and about a dozen other influential disease and patient advocacy organizations asking about their ties to drug and device makers. The request was part of his investigation into the drug industry’s influence on the practice of medicine.

The mental health alliance, which is hugely influential in many state capitols, has refused for years to disclose specifics of its fund-raising, saying the details were private.

But according to investigators in Mr. Grassley’s office and documents obtained by The New York Times, drug makers from 2006 to 2008 contributed nearly $23 million to the alliance, about three-quarters of its donations.

Even the group’s executive director, Michael Fitzpatrick, said in an interview that the drug companies’ donations were excessive and that things would change.

“For at least the years of ’07, ’08 and ’09, the percentage of money from pharma has been higher than we have wanted it to be,” Mr. Fitzpatrick said.

He promised that the industry’s share of the organization’s fund-raising would drop “significantly” next year.

“I understand that NAMI gets painted as being in the pockets of pharmaceutical companies, and somehow that all we care about is pharmaceuticals,” Mr. Fitzpatrick said. “It’s simply not true.”

Mr. Fitzpatrick said Mr. Grassley’s scrutiny, which he described as understandable given the attention paid to potential conflicts of interest in medicine, had led his organization to begin posting on its Web site the names of companies that donate $5,000 or more. And he predicted that other patient and disease advocacy groups would be prodded by Mr. Grassley’s investigation to do the same.

“Everyone I talk to wants to have more balanced fund-raising,” Mr. Fitzpatrick said.

In a statement, Mr. Grassley praised the alliance for its disclosures. “It’d be good for the system for other patient groups to do what NAMI has done,” he said.

Mr. Grassley’s scrutiny has been unnerving for patient and disease advocacy groups, which are often filled with sincere people who are either afflicted with serious illnesses themselves or have family members who have been affected. Many join the groups in the hope of making sense of their misfortune by helping to find a cure or raising awareness of a disease’s risks and frequency.

Drug makers are natural allies in these pursuits since cures may come out of corporate laboratories and the industry’s money can help finance public service campaigns and fund-raising dinners. But industry critics have long derided some patient organizations as little more than front groups devoted to lobbying on issues that affect industry profits, and few have come under more scrutiny for industry ties than the mental health alliance.

For years, the alliance has fought states’ legislative efforts to limit doctors’ freedom to prescribe drugs, no matter how expensive, to treat mental illness in patients who rely on government health care programs like Medicaid. Some of these medicines routinely top the list of the most expensive drugs that states buy for their poorest patients.

Mr. Fitzpatrick defended these lobbying efforts, saying they were just one of many the organization routinely undertook.

The close ties between the alliance and drug makers were on stark display last week, when the organization held its annual gala at the Andrew W. Mellon Auditorium on Constitution Avenue in Washington. Tickets were $300 each. Before a dinner of roasted red bell pepper soup, beef tenderloin and tilapia, Dr. Stephen H. Feinstein, president of the alliance’s board, thanked Bristol-Myers Squibb, the pharmaceutical company.

“For the past five years, Bristol-Myers has sponsored this dinner at the highest level,” Dr. Feinstein said.

He then introduced Dr. Fred Grossman, chief of neuroscience research at Bristol-Myers, who told the audience that “now, more than ever, our enduring relationship with NAMI must remain strong.”

Documents obtained by The New York Times show that drug makers have over the years given the mental health alliance — along with millions of dollars in donations — direct advice about how to advocate forcefully for issues that affect industry profits. The documents show, for example, that the alliance’s leaders, including Mr. Fitzpatrick, met with AstraZeneca sales executives on Dec. 16, 2003.

Slides from a presentation delivered by the salesmen show that the company urged the alliance to resist state efforts to limit access to mental health drugs.

“Solutions: Play Hard Ball,” one slide was titled. “Hold policy makers accountable for their decisions in media and in election,” it continued.

The alliance’s own slides concluded by saying, “We appreciate AstraZeneca’s strong support of NAMI.”

Mr. Fitzpatrick said that the alliance frequently had such meetings and that the organization would fight for better access to mental health drugs “even if we had no relationship with pharmaceutical companies.”

Tony Jewell, an AstraZeneca spokesman, said that the company was “committed to improving health through partnerships with nonprofit organizations” and that “includes striving to ensure people can access our medicines through formularies managed by state Medicaid agencies.”

Miami Herald
Child’s death was anything but a suicide
By FRED GRIMM
April 27, 2009

Calling the death of Gabriel Myers a “suicide” lets his killers off the hook.

The 7-year-old was propelled by a vast conspiracy of abuse and neglect and malpractice. The boy only finished the job on April 15, when he locked himself in the bathroom of his Margate foster home and coiled a shower hose around his neck.

We know that his mother, currently in jail in Ohio, her parental rights severed by the courts, seemed to be preoccupied with other matters, including drugs.

AN ALARMING PATHOLOGY

And we know that something awful in his short, sad life had triggered an alarming pathology of aggressive sexual behaviors. This stuff doesn’t occur spontaneously. Someone, reportedly an older child, inflicted this kind of learned behavior on a small child. Gabriel was abused.

“Kids act out like this because someone hurt them,” said Andrea Moore, the longtime child advocate in Broward County and director of Florida’s Children First. “And they are trying to tell us they’re hurt.”

Gabriel was a child of obvious and urgent needs. He needed help, attention and therapy. What he got was Lexapro, Zyprexa and Symbyax (a combination of Zyprexa and Prozac). None of the three powerful psychotropic drugs doled out to Gabriel while he was a foster child was approved for children. All three drugs were known to raise the risk of “suicidal tendencies” in children.

And Moore points out that none of these anti-psychotic and anti-depressant drugs had a damn thing to do with repairing Gabriel’s underlying problems. “Give me a break. There is no drug that cures the pain of childhood sexual abuse.”

POSSIBLE SIDE EFFECTS

The drugs, which come with a long and sobering list of possible side effects in children, have been doled out to troublesome kids to make them more manageable. Eli Lilly was fined $1.4 billion – that’s billion with a B – in March for nefariously marketing the unauthorized use of Zyprexa for children, despite the known risks. A big chunk of those kids, like Gabriel, were foster kids, whose lives by definition were inflicted with the kind of trauma apt to cause unruly behavior.

State officials across the country seemed happy to pay $25 a pill to keep their unruly wards quiet. Eli Lilly also targeted elderly Medicaid patients. The federal lawsuit cited a “thinly veiled marketing of Zyprexa as an effective chemical restraint for demanding, vulnerable and needy patients.”

Foster kids were essentially guinea pigs in a vast, public-financed drug experiment.

Of course, safeguards supposedly protected foster kids. Florida requires so-called “informed consent” before some doctor pumps a kid up with psychotropics. Parents are asked first – though most foster children would hardly be foster children if it wasn’t for lousy decisions by irresponsible parents.\

Absent a parent, a judge must give the OK for psychotropics. But the courts and case workers from the Department of Children & Families are all too overwhelmed by caseloads and beset by budget cuts to spend time contesting a doctor’s judgment.

“No one was looking out for Gabriel,” Moore said.

What Gabriel got, instead of real help, were powerful adult drugs laden with dangerous side effects. His cause of death was listed as suicide. It was just another misdiagnosis.

Miami Herald: Broward child’s suicide raises questions about medication

A Broward foster child who killed himself last week had been prescribed powerful psychiatric drugs, some of which the FDA does not approve for children.
BY CAROL MARBIN MILLER
April 21, 2009

Gabriel Myers, the 7-year-old Broward boy who hanged himself in the shower of his foster home

Weeks before his death, Gabriel Myers, the 7-year-old Broward boy who hanged himself in the shower of his foster home, had been prescribed a powerful mind-altering drug linked by federal regulators to an increased risk of suicide in children.

In all, Gabriel had been prescribed four psychiatric drugs, two or three of which he was taking at the time of his death, said Jack Moss, Broward chief of the state Department of Children & Families. Moss said he is not sure which medications the boy was taking because Margate police took the foster home’s medication log as part of an investigation into Gabriel’s death last week.

Three of the psychotropic drugs carry U.S. Food and Drug Administration ‘’black box'’ label warnings for children’s safety, the strongest advisory the federal agency issues. Three of the medications are not approved for use with young children, though they are widely prescribed to youngsters ‘’off label'’ – meaning doctors can prescribe the drug even if not formally approved for that use.

In 2005 – reacting to a series of stories in The Miami Herald that as many as one in four foster children were prescribed potentially dangerous mind-altering drugs – state lawmakers approved a law aimed at curbing their use. Children’s advocates now question whether the law is being ignored.

Gabriel was being treated by a Broward psychiatrist who is on a list of Florida doctors that the state Agency for Health Care Administration red-flagged as having ‘’problematic'’ prescribing practices, said Robert Constantine, director of AHCA’s Medicaid Drug Therapy Management Program, which tracks prescribing of psychiatric drugs to children.

The list flags doctors with a high volume of prescriptions of mental-health drugs or potentially dangerous combinations of the medications.

Dr. Sohail Punjwani has been on the list every quarter in which regulators have monitored the prescribing of psychotropic drugs since the program was created in 2006, said Constantine, a professor at the University of South Florida’s Mental Health Institute. The practices of about 17,000 Florida doctors who prescribe medications to children on Medicaid are studied every quarter, and about 300 to 450 end up red-flagged on the list.

And though Florida law requires that either a parent or judge consent to the use of psychotropic drugs on foster children, a source with knowledge of the boy’s case said Gabriel already had been taking a three-drug cocktail when Broward Circuit Judge Lisa Porter was informed at a March 11 hearing. The judge approved the medications over the objection of a court-appointed guardian, the source said.

‘’We are devastated,'’ said Jon Myers, the boy’s maternal uncle, who cared for him from June through October 2008. “Gabriel’s problems could not be solved by a pharmacy.'’

Four feet tall and 67 pounds, with short-cropped brown hair, Gabriel was a bright, charming and often sweet little boy, those who knew him say.

But he already had a sad past hinting at a troubling future. Records obtained by The Miami Herald show Gabriel may have been molested by an older boy while he was living with grandparents in Ohio, while his mother was in jail.

On Thursday, Gabriel locked himself in a bathroom and hanged himself with a detachable shower head after arguing with the 19-year-old son of his foster dad about his lunch, Moss said.

DCF petitioned a judge on Tuesday to unseal the boy’s records in response to requests from The Herald and other media, spokeswoman Leslie Mann said.

Punjwani told The Miami Herald that he is board certified as a child psychiatrist. He did not recall Gabriel, but Punjwani said he was part of a ‘’huge'’ group practice and may have been one of many clinicians to treat the boy.

Punjwani defended the use of psychiatric drugs on children, even if they are not approved for such use, saying the lack of approval stems from the reluctance of drug makers and the medical establishment to launch clinical trials on children.

The anti-psychotic drugs, he added, are used routinely to treat mood instability and insomnia among children.

Gabriel originally had been prescribed Vyvanse, an attention deficit/hyperactivity disorder drug approved for kids aged 6 through 12, Lexapro, an anti-depressant which is not approved for children, and Zyprexa, an anti-psychotic drug that also is not approved for kids, said Moss.

Both Punjwani and Moss said they think the Lexapro and Zyprexa were discontinued in recent weeks, and that a drug called Symbyax – which contains the medication in Zyprexa along with another antidepressant – was substituted.

Symbyax, recently approved for severe depression, is among a group of commonly prescribed anti-depressants, such as Prozac and Paxil, that the FDA warned in 2003 were linked to an increase in ‘’suicidal thoughts or behaviors'’ among children. Symbyax is not approved by the FDA for use on children.

Dr. David L. Katz, professor of public health at Yale University’s medical school, called the use of such drugs on youngsters ‘’extremely risky,'’ He questioned whether the boy needed to be taking such powerful medications absent a diagnosis of schizophrenia. ‘’These are medications that are potent and potentially dangerous,'’ Katz said. “They certainly are powerful drugs for anybody, let alone a 7-year-old boy.'’

Jon Myers, the uncle who cared for Gabriel after abuse investigators found him in a car in a Denny’s parking lot after his mother had passed out, questions whether Gabriel needed such potent medications to begin with.

Myers said the boy’s pediatrician had discontinued all psychotropic drugs while Gabriel lived with him, and the boy did well, earning A’s and B’s at the Hollywood Christian Academy.

‘’We did not have any issues with him having tantrums,'’ Myers said. “He would get upset, like little boys do.'’

A week or two before Gabriel died, his grandfather in Ohio expressed concerns that the boy sounded overmedicated. ‘’My father said that the last conversation he had a couple of weeks ago Gabriel sounded like he was too drugged,'’ Myers said.

“He sounded like he was doped up.'’

MANAGUA, Nicaragua – Nicaragua’s National Psychiatric Hospital houses about 140 patients. But with little financial help from the government, it lacks the resources to help them.

The World Health Organization has warned that the global financial crisis could worsen the situation for patients there, as well as in other mental hospitals in poor countries.

For now, private companies and good Samaritans have been donating food and helping the patients, some of whom have been housed there for 30 years, said Dr. Maria Esther Paiz, the hospital’s assistant director.

They depend on the hospital for complete support because their families have abandoned them, she added.

A church helped renovate the wing for elderly patients, which used to flood every rainy season.

Director Dr. Roberto Aguilar says the hospital, founded in 1936, needs new cars to transport those patients who are allowed to visit relatives. But limited government resources go to medical hospitals that need advanced equipment rather than to mental-health care.

“Other hospitals and clinics around the country are getting new equipment and are being renovated,” Aguilar said. “Here all we have to work with is our minds.”

http://www.washingtonpost.com/wp-dyn/content/article/2006/12/07/AR2006120701640.html

By Susan Levine
Washington Post Staff Writer
Friday, December 8, 2006; Page B03

District health officials and lawyers with a federally funded advocacy group for the disabled are investigating the death of an adolescent girl who had been receiving long-term psychiatric treatment at the private, for-profit Riverside Hospital in Northwest.

The 14-year-old, whose name has not been disclosed, died Friday of apparent complications from acute viral carditis, an inflammation of the heart, said officials with the city Health Department and Riverside Hospital. She had spent part of last week at Georgetown University Hospital, then was transferred Nov. 30 to Inova Fairfax Hospital for cardiac bypass surgery. She was taken off life support within 24 hours of the operation.

Lawyers with University Legal Services, the advocacy group, said they have many questions about how she fell ill at Riverside and whether the staff there sought outside medical care quickly enough as her condition declined.

“We have concerns,” attorney Mary Nell Clark said.

D.C. Department of Health spokeswoman Leila Abrar said yesterday that officials are reviewing the teenager’s medical records and visited Riverside to talk with staff. She said those records indicate that the girl began running a fever Nov. 22; two days later, she complained of shortness of breath and chest pain, at which point she was admitted to Georgetown. The records show that the doctors’ diagnosed that her heart had become inflamed, Abrar said.

A Riverside administrator gave a similar account yesterday, adding that there had been no delay in addressing the girl’s flulike symptoms. Barbara Grove, who handles communications and community education at Riverside, said the girl fell ill the Wednesday before Thanksgiving but seemed better by the next morning. She fell ill again the next day and was transported to Georgetown.

“It’s a big tragedy for the staff, a big tragedy for the mother, a big tragedy for all of us,” Grove said.

The hospital, on McArthur Boulevard at the edge of Georgetown, was founded in 1995 by a psychiatrist. It provides short-term acute care and months-long residential treatment for children in the District, including those in the foster care system. It averages 60 to 75 patients in its two units.

For several years, the hospital faced criticisms over its care, safety and procedures.

The girl, who Grove said had been at Riverside for six months, will be buried tomorrow.

http://www.washingtonpost.com/wp-dyn/content/article/2007/07/25/AR2007072502361.html

By Jenna Johnson
Washington Post Staff Writer
Thursday, July 26, 2007; Page B01

Children at Riverside Hospital in Northwest Washington are at risk from “serious and persistent abuse and neglect,” according to a report from an advocacy group, leading city mental health officials to start weekly visits to monitor conditions.

The psychiatric hospital for youths up to age 21 stopped accepting new long-term patients last week. But Riverside lawyers say the temporary halt in admissions has nothing to do with the report and was a “completely voluntary” way to provide patients with quality treatment as the hospital completes an “intensive program and plant renovation initiative.” The lawyers said they did not know how long this initiative will take.

University Legal Services Inc., a federally designated advocacy group for District children with developmental disabilities, produced the 13-page report summarizing its observations, interviews and investigations at the hospital since April 2006. There have been previous allegations of abuse at the private, for-profit hospital, including one into the death in December of a teenage resident. In 1997, federal regulators threatened to cut Riverside, which opened in 1995, from the Medicaid program.

The latest report, obtained under the Freedom of Information Act, provides a grim description of Riverside: Youths were punched, choked, slapped, pushed and threatened by staff members. Children were highly medicated as a form of restraint or placed in seclusion for reasons such as “being playful with his roommate.” A lack of supervision led to patients attacking fellow patients, grabbing bottles of medicines from nurses’ stations and cutting themselves with shards of glass. Treatment plans were not fulfilled. The facility had broken windows and mold. It was too hot in summer and too cold in winter.

The report, dated June 6, offered several specific examples of abuse. It said that on April 24, a University Legal Services staff member witnessed a hospital worker punching a male resident “two times in the eye, calling him a racial epithet.” The child was taken to nearby Georgetown University Hospital for treatment.

“Beyond these specific complaints, ULS receives many general complaints that staff purposefully take residents to the quiet room to assault them, and that violence against residents is a regular occurrence,” the report said.

“We have raised all of these issues with Riverside directly, in one form or another, and requested remedies, but the response in the vast majority of instances has been inadequate,” the report added. “Children at Riverside remain at risk.”

Sanford M. Saunders Jr., an attorney for Riverside, said hospital officials had not seen or heard of the report until The Washington Post contacted them for comment. The report was sent to the D.C. Health and Mental Health departments, both of which have investigated past complaints and injuries at the hospital, said Jennifer Lav, staff attorney for the advocacy group.

“We’ve been very concerned about Riverside,” said Mental Health Department Director Stephen T. Baron.

In a statement, Riverside officials disputed the report, saying it “fails to place matters into the overall context of Riverside’s operation.” Given that the hospital houses up to 50 teenage long-term patients with behavioral problems, “instances of peer-to-peer and patient-to-staff aggression are expected.” The officials said that anytime an incident occurs, they conduct a full internal investigation, suspend suspected staff members and alert the necessary D.C. agencies.

The Department of Mental Health has not referred anyone since last week. Spokeswoman Phyllis Jones said the department usually refers youths to facilities outside the District for specialized treatment. Riverside patients are generally referred by private physicians, public schools or agencies such as Child and Family Services, she said.

The department has investigated several incidents at the hospital, she said, including the death of a 14-year-old girl. After being ill for several days in late November, the girl was transferred to Georgetown University Hospital and put on a ventilator, then flown to Inova Fairfax Hospital for emergency cardiac surgery. She died in December.

A department investigation concluded in late June that the hospital staff did not document the girl’s vital signs, order basic tests, notify a physician of her worsening condition or note the girl’s family history of heart disease. The “pattern of poor documentation” continued even after the girl was admitted to Georgetown, as the Riverside night shift continued to mark her chart the next day with comments such as “appeared to be sleeping all night” and “monitored every half hour,” according to the report.

Riverside officials maintain that they properly cared for the girl and appropriately responded to her flulike symptoms. But the Mental Health Department recommended improved staff training and new policies for documenting care and notifying physicians.

This month, the Mental Health Department increased its monitoring of the hospital, Baron said. During weekly visits of at least five hours, a department representative talks with senior staff members and patients, reviews records and recommends improvements.

When asked whether children were safe at the hospital, Baron replied, “All that I can tell you is that we have not seen the need to decertify them.”

Baron said the department hopes the hospital improves rather than loses its certification.

Staff writer Henri E. Cauvin contributed to this report.

http://www.sacbee.com/101/story/1459402.html?mi_pluck_action=comment_submitted#Comments_Container

By Carrie Peyton Dahlberg
cpeytondahlberg@sacbee.com
Published: Tuesday, Dec. 09, 2008 | Page 1A

Lucinda Smith, a former teacher who has struggled with depressive episodes since childhood, is treated with transcranial magnetic stimulation by UC Davis physician Dr. Gouhua Xia as part of a pilot study of the new treatment at the UC Davis Center for Mind and Brain last month.

Once a week, Lucinda Smith tucks earplugs into both ears, flips her auburn hair over a neck rest and waits for a powerful magnetic burst to be aimed at her skull.

The magnet’s jolts arrive with a rattle, like a woodpecker drilling into a tree. Timed and positioned just right, they could chase away the depression that has darkened her life.

“I climb out of the well every day,” said Smith of Sacramento, a former teacher who has struggled with depressive episodes since childhood. She marks good days with small accomplishments – going grocery shopping or taking her dog for a walk. On bad days, she doesn’t leave home.

She has come to the UC Davis Center for Mind and Brain, in an office park in east Davis, to take part in a pilot study into whether a newly approved treatment for depression might also help people with bipolar disorder.

“We’ve encountered this huge new territory, and we’ve just walked a few steps in,” said Dr. Gouhua Xia, a UC Davis professor studying repetitive transcranial magnetic stimulation, or TMS.

About 14 million Americans in a given year are affected by some form of depression, according to the National Institute of Mental Health.

Researchers have known for years that powerful, pulsed magnets can create electrical fields in the brain, speeding up or slowing down neuronal activity depending on where and how they are aimed.

The effect has been studied as a potential treatment for stroke, brain injuries, chronic pain, migraines and a wide range of psychiatric disorders.

So far, its use for depression is farthest along, with the federal Food and Drug Administration in October approving TMS for people who haven’t been helped by the first medication they are prescribed.

The treatment could be available in California early next year, according to Neuronetics, the Pennsylvania company whose Neurostar TMS equipment now has FDA approval.

“The intriguing thing about it is it’s noninvasive. That’s the biggest appeal,” said Dr. Jaimie Henderson, a Stanford neurosurgeon who is president of the North American Neuromodulation Society.

TMS can feel like a dull tapping or thumping, not painful, but sometimes a little startling at first. Unlike medications, it doesn’t cause sleepiness, weight gain or other systemic side effects. And unlike electric shocks now more commonly called electroconvulsive therapy, it doesn’t cause confusion or memory loss.

Still, TMS has one thing in common with just about anything else that doctors can throw at depression – it only works for some people. In different studies, it has helped as few as 20 percent to more than 60 percent of those who try it.

“We have a lot left to learn about which specific kinds of depression respond to TMS,” said Dr. Joshua Rosenow, a neurosurgeon at Northwestern University in Chicago studying TMS as a way to help reactivate brains after serious injury.

TMS also requires lots of time and careful placement.

“The effect is very dependent on who is delivering the TMS,” Rosenow said. “The way you hold the coil, where you put it, the rotation, the angle” affect what happens in the brain.

Doctors still don’t know which intensities and sequences of pulses will help most, Xia said, and are just now working through issues of frequency and duration.

For depression, a common approach has involved giving people a series of magnetic jolts every weekday for four to six weeks, with each patient’s visit taking 20 to 40 minutes. The benefit seems to last only a few weeks before follow-up sessions are needed.

“For about a month I did great,” said C. Hensley, another subject in Xia’s study. She asked that only her first initial be used because she doesn’t want her children to have to deal with the stigma some still place on people with bipolar disorders.

Hensley was diagnosed bipolar in her 20s. In two decades she has been treated with a variety of antidepressants, antipsychotics and anticonvulsants.

“They put together cocktails, cursed cocktails,” she said. “I’d say 99 percent of them have some type of side effect, whether you’re exhausted or nauseated or just not yourself.

UC Davis Center for Mind and Brain: http://mindbrain.ucdavis.edu/research

Call The Bee’s Carrie Peyton Dahlberg, (916) 321-1086.

One of the things we fight against here at Medication Nation are ridiculous blanket studies bearing information that is worthless in the grand scheme. Worthless to mankind, but in this case certainly not worthless to the American Psychiatric Association and the pharmaceutical corporations.

According to past analysis and research studies, it can be pretty easily assumed that just about EVERY SINGLE PERSON ON OUR PLANET HAS HAD A PERSONALITY DISORDER AT ONE TIME. If you are alive it is likely you have dealt with at least one issue of mental instability or emotional breakdown or neurosis in your life time.

Now, to put it bluntly, the APA vultures, who do not have enough guinea pigs to practice on are trying even harder to drum up more work for themselves, by making a clearly blanket statement that YOUTH surprisingly have a higher incidence of these “issues” of “mental health".

If it were not enough that children are now being diagnosed at the age of 3 with adult psychiatric disorders, if it were not enough that at least 1 in 10 women were taking an anti-depressant drug in 2002 ^[1], and that no data is EVER reported as to the exact or approximate widespread use of psychiatric medications in our country, the APA continues to try to hook more and more victims into their scheme of manufactured illness and unneccesary treatments.

I am reminded of the days (which may still be the case) when the big Tobacco industry advertised in an effort to convince kids across American to start smoking, or to want to start. Making smoking seem cool, and socially necessary. Obviously a deadly product leads to a high mortality rate, and new customers are needed constantly.

Such seems to be the case for our psychiatric friends in the industry, pacifying, institutionalizing, paralyzing and killing their severe patients doesn’t seem to pay the bills enough. They need more case work, and hence, a manufacturing of mental illness is on the way. Well, technically it is already here, with the promise of more to come.

1 in 5 young adults has personality disorder

CHICAGO – Almost one in five young American adults has a personality disorder that interferes with everyday life, and even more abuse alcohol or drugs, researchers reported Monday in the most extensive study of its kind.

The disorders include problems such as obsessive or compulsive tendencies and anti-social behavior that can sometimes lead to violence. The study also found that fewer than 25 percent of college-aged Americans with mental problems get treatment.

One expert said personality disorders may be overdiagnosed. But others said the results were not surprising since previous, less rigorous evidence has suggested mental problems are common on college campuses and elsewhere.

Experts praised the study’s scope — face-to-face interviews about numerous disorders with more than 5,000 young people ages 19 to 25 — and said it spotlights a problem college administrators need to address.

Study co-author Dr. Mark Olfson of Columbia University and New York State Psychiatric Institute called the widespread lack of treatment particularly worrisome. He said it should alert not only “students and parents, but also deans and people who run college mental health services about the need to extend access to treatment.”

Counting substance abuse, the study found that nearly half of young people surveyed have some sort of psychiatric condition, including students and non-students.

Personality disorders were the second most common problem behind drug or alcohol abuse as a single category. The disorders include obsessive, anti-social and paranoid behaviors that are not mere quirks but actually interfere with ordinary functioning.

The study authors noted that recent tragedies such as fatal shootings at Northern Illinois University and Virginia Tech have raised awareness about the prevalence of mental illness on college campuses.

They also suggest that this age group might be particularly vulnerable.

“For many, young adulthood is characterized by the pursuit of greater educational opportunities and employment prospects, development of personal relationships, and for some, parenthood,” the authors said. These circumstances, they said, can result in stress that triggers the start or recurrence of psychiatric problems.

The study was released Monday in Archives of General Psychiatry. It was based on interviews with 5,092 young adults in 2001 and 2002.

Olfson said it took time to analzye the data, including weighting the results to extrapolate national numbers. But the authors said the results would probably hold true today.

The study was funded with grants from the National Institutes of Health, the American Foundation for Suicide Prevention and the New York Psychiatric Institute.

Dr. Sharon Hirsch, a University of Chicago psychiatrist not involved in the study, praised it for raising awareness about the problem and the high numbers of affected people who don’t get help.

Imagine if more than 75 percent of diabetic college students didn’t get treatment, Hirsch said. “Just think about what would be happening on our college campuses.”

The results highlight the need for mental health services to be housed with other medical services on college campuses, to erase the stigma and make it more likely that people will seek help, she said.

In the study, trained interviewers, but not psychiatrists, questioned participants about symptoms. They used an assessment tool similar to criteria doctors use to diagnose mental illness.

Dr. Jerald Kay, a psychiatry professor at Wright State University and chairman of the American Psychiatric Association’s college mental health committee, said the assessment tool is considered valid and more rigorous than self-reports of mental illness. He was not involved in the study.

Personality disorders showed up in similar numbers among both students and non-students, including the most common one, obsessive compulsive personality disorder. About 8 percent of young adults in both groups had this illness, which can include an extreme preoccupation with details, rules, orderliness and perfectionism.

Kay said the prevalence of personality disorders was higher than he would expect and questioned whether the condition might be overdiagnosed.

All good students have a touch of “obsessional” personality that helps them work hard to achieve. But that’s different from an obsessional disorder that makes people inflexible and controlling and interferes with their lives, he explained.

Obsessive compulsive personality disorder differs from the better known OCD, or obsessive-compulsive disorder, which features repetitive actions such as hand-washing to avoid germs.

OCD is thought to affect about 2 percent of the general population. The study didn’t examine OCD separately but grouped it with all anxiety disorders, seen in about 12 percent of college-aged people in the survey.

The overall rate of other disorders was also pretty similar among college students and non-students.

Substance abuse, including drug addiction, alcoholism and other drinking that interferes with school or work, affected nearly one-third of those in both groups.

Slightly more college students than non-students were problem drinkers — 20 percent versus 17 percent. And slightly more non-students had drug problems — nearly 7 percent versus 5 percent.

In both groups, about 8 percent had phobias and 7 percent had depression.

Bipolar disorder was slightly more common in non-students, affecting almost 5 percent versus about 3 percent of students.

___

On the Net:

Archives of General Psychiatry: http://www.archgenpsychiatry.com

[1] - Antidepressant Use By U.S. Adults Soars - Cost and Risk Questions Mount in Face Of Overall Surge in Prescription Drugs By Shankar Vedantam http://www.washingtonpost.com/wp-dyn/articles/A29751-2004Dec2.html

http://news.yahoo.com/s/ap/20081203/ap_on_re_us/texas_mental_hospitals;_ylt=AjeiDzFV5e9SuEGpWlXrPkSs0NUE

By JEFF CARLTON, Associated Press Writer Jeff Carlton, Associated Press Writer
December 3, 2008

Farhat Chishty, right, spends time with her mentally retarded son Haseeb Chishty at Denton State School in Denton, Texas, Jan. 16, 2008. In 2002 Haseeb nearly died after a beating and is now confined to a wheelchair and unable to feed himself or use the bathroom. A care worker repeatedly kicked and punched Haseeb and is now serving 15 years for aggravated assault.
(AP Photo/Donna McWilliam)

DENTON, Texas – For more than a century, thousands of mentally disabled Americans were isolated from society, sometimes for life, by being confined to huge public hospitals.

In at least one place, they still are.

Texas has more mentally disabled patients in institutions than any other state, and the federal government has concluded that the state’s care system is stubbornly out of step with modern mental health practices.

Critics allege that Texas remains stuck in an era when the mentally disabled were hidden away in large, impersonal facilities far from relatives and communities.

“In Texas, it’s like a time warp,” said Jeff Garrison-Tate, an advocate who wants to close the 13 hospitals called “state schools” and move patients into group homes.

“It got to the point where it was fun beating him, torturing him,” said former care worker Kevin Miller, who is now serving 15 years for aggravated assault.

For the third time in three years, the criticism has attracted the attention of the Justice Department, which on Tuesday accused Texas of violating residents’ constitutional rights to proper care.

Investigators found that dozens of patients died in the last year from preventable conditions, and officials declared that the number of injuries was “disturbingly high.”

In addition, hundreds of documents reviewed by The Associated Press show that some patients have been neglected, beaten, sexually abused or even killed by caretakers. Inspection reports also describe filthy rooms and unsanitary kitchens.

Many of the nation’s mental hospitals were first built in the 1800s, when they were often called insane asylums. But by the 1960s, most experts concluded that patients fared better in smaller, community-based settings.

The American Institution on Intellectual and Developmental Disabilities says large care facilities — usually those with at least 16 residents — “enforce an unnatural, isolated, and regimented lifestyle that is not appropriate or necessary.”

Because of those concerns, eight states have abolished large institutions for the mentally disabled. Another 13 states closed most of their largest facilities, leaving just one open in each state.

But Texas has remained “the institution capital of America,” said Charlie Lakin, director of the Research and Training Center on Community Living at the University of Minnesota.

The 13 facilities in Texas house nearly 5,000 residents — more than six times the national average.

On a per-capita basis, Texas has 20.4 people per 100,000 in large institutions, Lakin said. The national average is 12.2 people.

Other states with large populations such as New York and California — which have rates of 11.2 and 7.5 people, respectively — rely far less on large institutions.

Federal law requires the mentally disabled to be treated in “the most integrated setting” possible — a factor that led to the Justice Department rebuke of Texas.

Laura Albrecht, a spokeswoman for the Texas Department of Aging and Disability Services, said the agency is expanding community-based services. Texas officials say keeping the facilities open is a matter of preserving as many treatment options as possible.

But critics allege that “warehousing” patients in large institutions invites abuse. Patients are isolated from their families and communities, making regular contact with loved ones more difficult. And caretakers often get overwhelmed by the large numbers of patients, Garrison-Tate said.

In Texas, officials verified 465 incidents of abuse or neglect against mentally disabled people in state care in fiscal year 2007. Over a three-month period this summer, the state opened at least 500 new cases with similar allegations, according to federal investigators.

An AP investigation earlier this year revealed that more than 800 state employees have been fired or suspended since the summer of 2003 because they abused, neglected or exploited mentally disabled residents.

And in the one-year period ending in September, as many as 53 deaths in the facilities were due to potentially avoidable conditions such as pneumonia, bowel obstructions or sepsis, the Justice Department said. Some families tell horror stories of their loved ones in the state facilities. For instance, Michelle Dooley said her son spent three months in the Austin State School, which she described as a place of “dingy yellow floors and patients running around without any clothes on.”

During his time there, he refused to leave his bed and often languished in his own excrement, she said.

Dooley eventually moved her son into a group home in Denton where treatment costs average about $50,000 per year — roughly half as much as the costs at state schools, Garrison-Tate said. Medicaid often picks up most of those costs.

“It was just horrible,” Dooley said. “If he goes back to a state facility, he will shut down and die.”

At the San Angelo State School, inspection reports from 2007 took note of scuffed walls pocked with holes, rotting food, dirty kitchens, broken furniture and missing shower curtains.

More seriously, two employees were fired after throwing a resident into a pool while he was wearing a restraint jacket. The employees had made a bet with the resident that he would be unable to dunk another resident under water. When he lost the bet, the employees restrained him and threw him in the water, according to the reports.

Other families say they are happy with the state care.

Neil Davidson said his daughter Susan, who has cerebral palsy and is mentally retarded, has flourished during her 10 years at the Lubbock State School.

“I’m very impressed with the level of care she has received,” Davidson said. “As far as I am concerned, it’s Mr. Rogers’ neighborhood. Everybody is looking out for everybody else.”

A visit to the Denton State School, the largest in Texas, reveals a sprawling campus spread across well-kept lawns. Superintendent Randy Spence described the place as a “happy, homelike atmosphere.”

“The vast majority of our employees love the people they work with,” said Cecilia Fedorov, another spokeswoman for the Department of Aging and Disability Services. “They think of them as extended family.”

But Denton is also the site of Texas’ most notorious case of state school abuse.

In 2002, a care worker repeatedly kicked and punched a resident in the stomach and groin. Haseeb Chishty nearly died after that beating. He is now confined to a wheelchair and unable to feed himself or use the bathroom.

“It got to the point where it was fun beating him, torturing him,” said former care worker Kevin Miller, who is now serving 15 years for aggravated assault.

In a statement videotaped by Chishty’s lawyer, Miller said he and many of his fellow care workers used methamphetamines, cocaine and Oxycontin on the job.

Chishty’s mother filed a lawsuit against the facility, but it went nowhere. In Texas, government entities are all but immune from lawsuits.

Some critics want to close the state schools. But because the Texas Legislature created each one, only lawmakers can close them.

Many of the institutions are large employers in small towns, and they often pay more than other jobs in rural areas. Lawmakers fear taking action that would lead to layoffs, Garrison-Tate said.

“Even if we said we wanted to close all state schools, the community resources aren’t there at this time,” said state Rep. Larry Phillips, chairman of a legislative committee studying the facilities.

Kelly Reddell, the lawyer whose client’s son was beaten nearly to death, said the state is not doing right by its mentally disabled.

“The very nature of the institutional setting, I think, creates the environment for the abuse to take place,” she said. “How in the world can you think this system is the best and it makes sense?”

http://www.sacbee.com/101/story/1406600.html

By Andy Furillo
afurillo@sacbee.com
Published: Tuesday, Nov. 18, 2008 | Page 3B

Napa State Hospital’s attempt to release a killer into community treatment in Sacramento was based on the “horrifying” testimony of a psychiatrist who “clearly committed perjury in this court,” a judge said Monday.

Sacramento Superior Court Judge Kevin J. McCormick made his comments about the Napa psychiatrist, Dr. Nathan Thuma, when he ruled from the bench that Ronald Benjamin Toppila is not fit for outpatient treatment and must remain in the mental hospital for killing his mother four years ago.

In a decision that will keep Toppila confined indefinitely on a jury’s verdict that he was not guilty by reason of insanity, McCormick lashed Thuma for recommending in March that the defendant be released into community treatment even though at that time the psychiatrist had examined the client for barely a half hour.

McCormick said Thuma “could not have had enough information” to make the recommendation and that it was “beyond belief” the doctor could have reviewed Toppila’s medical records in the short time he’d been on staff at Napa.

Thuma demonstrated “a total lack of independence and judgment” by concluding that Toppila did not present a danger because, in quoting the psychiatrist, “we all trust Mr. Toppila,” McCormick said. The judge said Thuma’s “demeanor and manner” in court “could only be described as horrifying.”

“He clearly committed perjury in this court,” McCormick said of Thuma. “He testified inconsistently at varying times. He showed a complete lack of any insight whatsoever into Mr. Toppila’s history.”

Thuma did not return a telephone call for comment Monday. A spokeswoman for the state Department of Mental Health said agency director Stephen Mayberg plans to review the judge’s comments about Thuma.

“He would take it very seriously and look into it,” the spokesman, Nancy Kincaid, said.

“If the judge expressed concern over someone’s testimony or professional performance, that would be looked into both by the director of the department and by the executive director at the hospital.”

McCormick did not specifically identify areas of Thuma’s testimony where he thinks the psychiatrist lied under oath. In Thuma’s testimony on Oct. 27, however, he wound up on both sides of a question on whether he thought Toppila had “malingered” to sway the therapists who were evaluating him. There were also inconsistencies in Thuma’s testimony over whether he was aware of evaluations done on Toppila before the Oct. 7, 2004, beating death of his 86-year-old mother, Hilma Tone.

Deputy District Attorney Dawn Bladet hailed the judge’s ruling, saying in an e-mail: “Toppila’s continued confinement in Napa State Hospital is necessary to protect the public safety interest.”

Toppila’s lawyer, Robert J. Saria, said Toppila and his client’s family were disappointed by the ruling. Saria said Toppila “is committed to returning to Napa and pursuing his treatment plan and engaging in all the treatment he is required to.”

Toppila, 68, a long-time licensed clinical social worker, stabbed his mother 52 times and also bludgeoned her in the fatal attack in her South Land Park apartment.

Judge McCormick said he was also disturbed by the testimony of Antonio Alocer, an official from the Central Valley Conditional Release Program, which would have coordinated Toppila’s community placement if he was released from Napa. McCormick said no treatment plan had been determined for Toppila in the event of his release. The judge said Alocer “could not tell me” where Toppila would be placed.

Alocer could not be reached for comment Monday.

“I cannot state with any degree of certainty based on the evidence that I heard in this courtroom that Mr. Toppila no longer poses a danger to the health and safety of others,” McCormick said.

Call The Bee’s Andy Furillo, (916) 321-1141.

An influential mental health nonprofit finds its ‘grassroots’ watered by pharmaceutical millions

By Ken Silverstein

November/December 1999 Issue

The National Alliance for the Mentally Ill (NAMI) bills itself as “a grassroots organization of individuals with brain disorders and their family members.” The alliance was a prominent participant in last June’s White House Conference on Mental Health. Earlier, President Clinton named its executive director, Laurie Flynn, to the National Bioethics Advisory Commission.

But some mental health activists say the Arlington, Virginia-based organization – which is widely viewed as an independent advocate for the mentally ill, and an influential voice in mental health debates – is overly influenced by pharmaceutical companies. It’s certainly well funded by the industry: According to internal documents obtained by Mother Jones, 18 drug firms gave NAMI a total of $11.72 million between 1996 and mid-1999. These include Janssen ($2.08 million), Novartis ($1.87 million), Pfizer ($1.3 million), Abbott Laboratories ($1.24 million), Wyeth-Ayerst Pharmaceuticals ($658,000), and Bristol-Myers Squibb ($613,505).

NAMI’s leading donor is Eli Lilly and Company, maker of Prozac, which gave $2.87 million during that period. In 1999 alone, Lilly will have delivered $1.1 million in quarterly installments, with the lion’s share going to help fund NAMI’s “Campaign to End Discrimination” against the mentally ill.

In the case of Lilly, at least, “funding” takes more than one form. Jerry Radke, a Lilly executive, is “on loan” to NAMI, working out of the organization’s headquarters. Flynn explains the cozy-seeming arrangement by saying, “[Lilly] pays his salary, but he does not report to them, and he is not involved in meetings we have with [them].” She characterizes Radke’s role at NAMI as “strategic planning.”

As a matter of policy, NAMI does not reveal the amounts of specific donations. But spokesman Bob Carolla acknowledges that the group receives substantial funding from drug firms, who provide “most if not all” of the antidiscrimination campaign’s $4 million annual budget. In addition, Carolla told Mother Jones, corporate donations account for $310,000 of NAMI’s 1999 core budget of $7.1 million – with most of that coming from pharmaceutical firms. The rest of the budget, he says, comes from charitable and membership contributions. (Another affiliated program, the NAMI Research Institute, has a budget of $20 million. Focusing on the biological causes of mental illness, it is fully funded by the private Stanley Foundation.)

Janet Foner, a co-coordinator of Support Coalition International, an activist organization of “psychiatric survivors,” says NAMI does a good job in some areas, but argues that the group’s corporate sponsors help shape its agenda. “They appear to be a completely independent organization, but they parrot the line of the drug companies in saying that drugs are the essential thing.”

Many experts believe that the umbrella term “mental illness” embraces a broad array of conditions with equally diverse causes. NAMI spokesman Carolla says the group views mental illness as a disease, like diabetes or Alzheimer’s, that can be treated most effectively with medications. “Mental illness is a biologically based brain disorder,” he says. “That’s not to say that other factors can’t affect mental illness, but the core problem is biologically based.”

NAMI’s critics agree that mental illness can be triggered by biological factors, but point also to environmental causes such as incest, child abuse, family dysfunction, and other traumas. NAMI’s approach “reduces human distress to a brain disease, and recovery to taking a pill,” says Sally Zinman of the California Network of Mental Health Clients. “Their focus on drugs obscures issues such as housing and income support, vocational training, rehabilitation, and empowerment, all of which play a role in recovery.” Furthermore, Zinman argues, Thorazine, Prozac, and other drugs routinely prescribed for the mentally ill can be counterproductive and even harmful.

NAMI’s Flynn says her group is “not a captive of any outside industry.” But she acknowledges there is at times a “synergy” in goals between NAMI and the drug companies. For example, both favor so-called health care parity laws, which would require insurers to view mental illness as they do other diseases. “[The drug companies] want more and greater markets, and we want access and availability to all scientifically proven treatments. We don’t think drugs are everything, but for the vast majority they are important.”

Flynn says the Campaign to End Discrimination is funded separately to ensure that drug industry money is not comingled with funds earmarked for NAMI’s core budget. Sally Zinman, for her part, says that taking money for any purpose from drug companies – which have a direct financial stake in the mental health debate – is at odds with the ideal of independent advocacy. “NAMI is seen by the media as the voice of the mental health community, but the integrity of its work is called into question by its sources of funding,” she says.

http://cbs5.com/wrapper_consumer/seenon/quiet.room.schools.2.771296.html

Reporting Anna Werner

SAN FRANCISCO (CBS 5) ― It sounds like cruel and unusual punishment: locking a school kid away for hours all alone, or taking them down to the ground and pinning them there, just for misbehaving in class. Investigative reporter Anna Werner first exposed the practices here in California. Now we’re learning it’s a growing problem nationwide.

“I am a boy whose life is a wreck,” writes 5th grader Nick Valles in a letter to his school principal. “I feel like my teacher hates me.”

Nick is yet another child who says his school left him in seclusion, day after day in the small room behind this door in his classroom. “I was completely alone. I just felt like really weird and angry and sad.”

Why? His mother says that was the method chosen by the teacher at St. Cyprian School in Sunnyvale for handling Nick’s ADHD.

“He had panic attacks, he couldn’t sleep. He had night terrors where he would wake up screaming in the night,” said his mother Carmen Valles.

But his mother says for months, it was kept a secret from her. “I am a very involved parent and I didn’t know. I was just so disappointed and so upset that they would humiliate and treat such a nice child in this way.”

She contacted CBS5 Investigates after we reported on problems with seclusion and physical restraint of children in schools. Children kept in closets like this one in a school in Livermore. Or restrained with duct-tape like this child in Southern California.

And it turns out it’s not just California: Since that first story, parents across the country have contacted us to say it’s been happening to their children too. A mother from Florida describes her son as being “locked in closets and prone restrained almost daily” at his school. And in Georgia, another mom says there,” they scare (the kids) into not telling.”

“I think it’s a national issue,” said Maggie Roberts, an attorney with Protection and Advocacy, an Oakland non-profit for the disabled. “There are a few states that have made a big effort to move from a culture of restraining and secluding kids. But a lot of states including California just aren’t there yet.”

And how big of a problem is it? There are no firm statistics. But Denise Marshall with the Council of Parent Attorneys and Advocates said “There are hundreds of incidents. The most sensational make the news, but that is the tip of the iceberg.”

In fact, another national advocacy group documented 128 deaths of children nationwide from the use of restraints and seclusion, many in residential facilities, but some in schools. “We believe that we all have a collective responsibility to make it stop,” said Marshall.

But Carroll Schroaeder with The California Alliance of Child and Family Services said “We need to have both of those options.” The group represents non-profit providers and is opposed to a California bill that would immediately end the practices. “You make it go away by good practices, reducing, reducing, reducing until one day its eliminated.”

He believes that will take years. But advocates like Maggie Roberts disagree. “I don’t agree, I think that you can.”

Families meanwhile say change can’t come too soon. “It’s going to be hard to like, get it out of my mind,” said Nick Valles. And his mother said “I believe they do need to have national legislation. I don’t want this to happen to one more child.”

St. Cyprian’s school principal turned down a request for an on-camera interview. His only comment: no comment.

So how do you deal with kids that have behavior disabilities without restraining or locking them up? Anna interviewed an expert on that. Watch her Q&A on our web extra.

(© MMVIII, CBS Broadcasting Inc. All Rights Reserved.)

Experts question benefit of school time-out rooms

By MICHAEL J. CRUMB, Associated Press Writer – 48 mins ago

Isabel Loeffler, 12, poses in the hallway of her home, Thursday, Oct. 16, 2008, in the Calabasas section of Los Angeles. After failing to finish a reading assignment, Isabel Loeffler was sent to the school’s time-out room, a converted storage area under a staircase, where she was left alone for three hours. Some educators say time-out rooms are being used with increased frequency to discipline children with behavioral disorders. (AP Photo/Mark J. Terrill)

DES MOINES, Iowa – After failing to finish a reading assignment, 8-year-old Isabel Loeffler was sent to the school’s time-out room — a converted storage area under a staircase — where she was left alone for three hours.

The autistic Iowa girl wet herself before she was finally allowed to leave.

Appalled, her parents removed her from the school district and filed a lawsuit.

Some educators say time-out rooms are being used with increased frequency to discipline children with behavioral disorders. And the time-outs are probably doing more harm than good, they add.

“It really is a form of abuse,” said Ken Merrell, head of the Department for Special Education and Clinical Sciences at the University of Oregon. “It’s going to do nothing to change the behavior. You’re using it as an isolation booth.”

Segregating children removes them from the positive aspect of the classroom and highlights that they’re different from other children, said Stephen Camarata, director of the Kennedy Center for Behavioral Research at Vanderbilt University. And isolating an autistic child might be particularly counterproductive.

“They don’t like being around other people so they might increase their negative behavior because they view it a reward,” he said.

Though there are no data on the use of time-out rooms, Camarata speculates that they’ve become widespread as schools confronted a growing enrollment of children with behavior disorders.

“I believe it’s because classrooms are much less flexible with more focus on compliance,” he said.

The Disability Rights Education and Defense Fund in Berkeley, Calif., receives calls from parents across the country who complain about time-out rooms, said Cheryl Theis, an education advocate for the organization.

“Parents call and say their child’s disability has been exacerbated by this and are traumatized by this,” she said.

Merrell said he’s encountered time-out rooms he felt were unsafe.

“I once consulted with a school in another state and had a weekly appointment with a child to do some counseling and when I got there they told me he was in a time-out room,” he said. “He was in a janitor’s closet with no windows, no ventilation, open cans of paint, a mop bucket with disinfectant, and he had been in there for over an hour.”

Merrell, who has published nearly 100 studies and 10 books on teaching social and emotional skills, said time-out rooms can be used effectively but seldom are. The key, he said, is to combine the time outs with social skills training.

Patti Ralabate, a special education analyst with the National Education Association, said time-out rooms are common but should be used sparingly.

“And when they are used, all of the educators involved need to have appropriate professional development to see how this is used and how to use them appropriately,” she said.

Ralabate said a time-out room can be effective if it is intended to provide a space for a child to calm down and reflect on their behavior.

“If it is used to isolate the child, punish the child for a behavior, then we would view it as not productive and not positive,” she said.

In Iowa, Doug and Eva Loeffler started to notice changes in their daughter in December 2004, soon after she began school in the Des Moines suburb of Waukee. It prompted them to take Isabel to University Hospitals and Clinics in Iowa City for evaluations.

“We laid awake at nights thinking we’d have to institutionalize her,” Doug Loeffler said. “We went to three evaluations at the hospital and all of a sudden we find out she’s being mistreated.”

Loeffler said they weren’t told in school evaluation reports that their daughter had been restrained and placed in a time-out room. During one incident in December 2005, Isabel wet herself because she was locked in the room for three hours and not allowed to use a restroom, he said.

Loeffler said the time-out room rules required that before she could be released, she must sit on the floor with her legs crossed without moving a muscle for at least five minutes.

“If she said something, grimaced at them, they would restart the clock and she was not capable of doing that,” Loeffler said. “That’s why it was three hours.”

Loeffler said the couple home-schooled Isabel until he took a new job and the family moved last year to California. Isabel, now 12, has shown signs of progress and is back in public school, he said.

David Wilkerson, superintendent of the Waukee school district, declined to speak about the accusations because of the pending lawsuit. But he said time-out rooms are a “pretty common practice” and that the district complies with the state’s guidelines for such rooms.

Loeffler said he is pressing ahead with the lawsuit and hopes to draw attention to the need for nationwide standards for time-out rooms.

Soteria-Alaska is a home where people who are experiencing symptoms that are associated with diagnoses of mental illness can live while they begin their recovery process. The primary services are peer support, homelike environment/milieu, inclusion in the community. Families are encouraged to participate at the desire of the resident. The home will welcome the sharing of diverse cultural traditions as determined by the residents in the home. Soteria-Alaska is a place for people who might otherwise go to the hospital if an alternative was not available or who have been in the hospital for a brief period of time, but would benefit from the Soteria environment. It is not a permanent residence. It is a 24 hour staffed home that is located in Anchorage, but accepts residents from all of Alaska. Soteria values choice, self determination, the power of peer support and respect for all people.

Soteria-Alaska is recruiting for a House Manager and eight to ten Residential Assistants.

The House Manager will oversee day to day operations, supervise staff under the direction of the Executive Director and with the Executive Director set the tone of the environment. People who understand and exemplify the Soteria philosophy are encouraged to apply. Individuals with personal experience with recovery and people with licensure or eligible for licensure in Alaska will be strongly considered for the House Manager position.

Residential Assistants will work under the supervision of the House Manager and the Executive Director. They will provide support to individuals who are experiencing acute symptoms such as hearing voices, fear, anxiety, and inability to sleep. They will participate with residents in the operation of the house such as shopping, cooking and cleaning. Residential Assistants will be compassionate and respectful and will honor personal choice of individuals while acknowledging the needs of the community. Individuals with personal experience with recovery will be strongly considered for Residential Assistant positions.

Volunteers and Student Interns are welcome to join the Soteria House team. Volunteers and Students will work under the supervision of the House Manager and the Executive Director and will work along side Residential Assistants in providing support to residents. Soteria-Alaska has signed a memorandum of Agreement with the Alaska Division of Vocational Rehabilitation (DVR) and welcomes participation from individuals seeking training and experience who are clients of DVR.

Soteria has some limited, affordable, temporary housing available to people who are relocating to Anchorage to work in Soteria House.

Contact: Susan Musante, Executive Director Soteria-Alaska, Inc. and CHOICES, Inc.

susan@soteria-alaska.com (907)333-4343

Provided From:

James B. (Jim) Gottstein, Esq.
President/CEO

Law Project for Psychiatric Rights
406 G Street, Suite 206
Anchorage, Alaska 99501
USA
Phone: (907) 274-7686) Fax: (907) 274-9493
jim.gottstein[[at]]psychrights.org
http://psychrights.org/

PsychRights® Law Project for Psychiatric Rights

The Law Project for Psychiatric Rights is a public interest law firm devoted to the defense of people facing the horrors of forced psychiatric drugging. We are further dedicated to exposing the truth about these drugs and the courts being misled into ordering people to be drugged and subjected to other brain and body damaging interventions against their will. Extensive information about this is available on our web site, http://psychrights.org/. Please donate generously. Our work is fueled with your IRS 501© tax deductible donations. Thank you for your ongoing help and support.

You have been sent this e-mail because we think you are interested in PsychRights’ mission to mount a strategic litigation campaign against forced psychiatric drugging and electroshock. If this is incorrect or you otherwise do not want to be removed from this list, or if you have any questions about this list, e-mail contact@psychrights.org.

http://beyond-vsh.blogspot.com/2007/11/new-report-on-vt-state-hospital.html

Ethan Allen Institute
4836 Kirby Mountain Road
Concord VT 05824

News Conference: Monday, November 26, 2007 10:00am State House Cedar Creek Room
(Full report on the Web Saturday at www.ethanallen.org/publications/specialreports/VSH.pdf)

New Report Urges Mental Patient Recovery in Community, not in Large, Costly New Facilities

“Building an enormously expensive new replacement facility for VSH, at the urging of a state bureaucracy and its employee union allies, over the objections of the Public Oversight Commission and most advocates for the mentally ill, will create a large and unnecessary burden for a generation of Vermont taxpayers, while offering inadequate recovery services for Vermonters with mental illness. It is not sound public policy.”

That’s the conclusion of a new report on the future of the Vermont State Hospital and treatment of severe mental illness in Vermont, issued by the Ethan Allen Institute Monday.

The Institute released the report, entitled “Don’t Send Me to Waterbury!", in anticipation of a major debate on the future of the new-decertified Hospital in the 2008 legislative session. Both administration and legislative study commissions have proposed retaining the 110-year old hospital, or creating a new state-run institution system at a cost of as much as $100 million.

“A major policy question,” says report author Bethany Knight,” is whether the inmates of the 110-year old Hospital will move to community settings, or to one or more costly new state institutions. That question must be informed by a modern awareness of the nature of mental illness, and the efficacy, expense, and humanity of various alternative methods and settings for treatment and recovery.”

“Perhaps most importantly, public policy and practices must be shaped in close partnership with the dedicated community of Vermonters who have lived experience with mental health crises, rather than shaped by the preferences of bureaucrats, clinicians, and the employee labor union.”

“Vermont now has the opportunity to fully develop mental health care system where three fourths of the present Hospital’s population can find support and healing in small, safe, secure and far more cost-effective community settings.”

The report recommends that

• The operative policy for Vermont’s seriously mentally ill population ought not be removal from society, but recovery in community. Vermont’s mental health system should be centered on community-based services, not built around a centralized psychiatric facility.
• The Department of Mental Health should abandon its relentless quest for the construction of new high-cost state-owned mini-VSH facilities, whether in Waterbury, the FAHC Burlington campus, or elsewhere.
• The DMH and designated agencies should welcome new private providers of services, such as residential recovery housing, and faith-based and peer-run drop-in centers. Every temptation to secure a monopoly, so damaging to the interests of consumers, must be stoutly resisted.
• Community hospitals must evolve to holistically address the physical and mental health of the people in their communities, and address the issue of forced medication as a serious question of medical ethics.
• Designated mental health agencies should employ peers and give them authority to serve creatively, not simply direct new workers to provide old models of care. Providers should seek new compassionate staff members who like people and are not looking for opportunities or evidence to punish clients.

The report contains numerous examples of community-based recovery programs, including three in Vermont (Safe Haven in Randolph, Home Intervention in Montpelier, and Second Spring in Williamstown). Of special interest is the highly successful Fairweather Lodges, founded in 1968 in Minnesota.

The report is sharply critical of the present state hospital’s penchant for forcible medication of patients. It also opposes the use of physical restraints on patients, a practice which has brought sharp criticism of the Waterbury hospital by the U.S. Department of Justice.

The report also says that “notwithstanding the reemployment language pushed into Act 147 of 2006 by the Vermont State Employees Union, providers should avoid automatically hiring former VSH staff members for patient care positions. Anyone who has been a part of the dehumanizing seclusion, restraint and forced drugging investigated by the U.S. Department of Justice and others ought to seek other types of employment.”

Of the union’s efforts to preserve at any cost the 200 union jobs at the present Hospital, the report notes that “legislators will need to keep in mind the interests of mental patients and of their taxpayer constituents when the VSEA presses for its special interest in preserving state employee jobs.”

The report’s principal author, Bethany Knight of Glover, was formerly executive director of the state nursing home association. She has served on the Vermont Human Services Board and the Public Oversight Commission, and as a volunteer in free peoples’ clinics in India.

The Ethan Allen Institute is Vermont’s independent free-market public policy organization. It earlier released comprehensive reports, also authored by Ms. Knight, on the Vermont developmental disability program and the home health care monopoly.

Link: http://www.teenscreentruth.com

President Bush in league with the American Psychiatric Legion of Doom or APLD [I made that up] are now hoping to begin foraging for fresh young psychiatric guinea pigs within our hospitals, schools and homes! Everyone should be made aware of the governmentally sanctioned practices that are being alerted about on TeenScreen Truth. Please read the following article to get more information and find out What You Can Do: Sign the petition to stop TeenScreen

Please also see the article on the Mothers Act, ANOTHER government/psychiatric screening legislation that threatens to take over the world.

Video compilation of news and media coverage

Click to read the article

Excerpt:

By Sue Weibert

Screening for mental illness is the most controversial topic concerning mental health today. Various government entities, private foundations, organizations, think tanks and universities, all flanked by cunning public relations firms, are hard at work trying to make mental health screening as common as a dental checkup. Despite public outrage over screening, these entities are working feverishly to establish this system. With so much clamor of disagreement for such a program, why, then, do these entities push forward with such ferocity? This article reveals exactly how this all got started, who’s really behind “the big push,” and how President Bush was tricked into establishing what might be the most detrimental program in the history of mankind.

In 2002, President George W. Bush established the New Freedom Commission on Mental Health (NFC), and charged it with the mission of reviewing mental health care in the United States.1

The following year the NFC released its findings and recommendations. The report called for the establishment of an ambitious, Orwellian plan to screen every American for mental illness, from pre-natal to the elderly.2 The NFC recommended that screening is to be followed by “treatment” and “support”, but these help-oriented euphemisms are a major cover-up for barbaric psychiatric methodologies that include, but are not limited to, powerful, mind-altering drugs to Electro-Convulsive Therapy (ECT) – ultimately proven to create zombies, mass murderers and even death in those subjected to these kinds of “treatments.” Sound comforting? So, then, why would anyone want to forward the progress of such a system? The answer is the same for all of the horrific things committed against the people since the beginning of time — money, power and control.

So who stands to gain from widespread screening? To answer this question, one need only to look at these sister programs: the Texas Medication Algorithm Project (TMAP) and Columbia University’s TeenScreen — both were recommended in the NFC’s final report as “model programs”. How did these two make the cut when hundreds of public, private and faith-based programs are available to deal with mental health issues? Finding out who lobbied for their inclusion, we quickly see who stands to gain billions of dollars, reputation and power if these programs are implemented.

Link: http://medication-nation.com/media/blogs/links//AHCDS1.pdf

The PDF provided by the Office of the Attorney General of State of California is located at the link above. Provided as a copy from our site, you can also obtain it by following either of these two links:

http://ag.ca.gov/consumers/general/adv_hc_dir.htm
http://ag.ca.gov/consumers/pdf/AHCDS1.pdf

And Oops! I guess I copy and pasted the wrong text into here... That's what I get for making changes in a hurry... Well, I will have to rewrite it out later. Until then here is another link to a site which offers information for AHCD:

http://www.nrc-pad.org/

California Q and A

Ten commonly asked questions about PAD's for California

Please note: the following 10 FAQs are designed to provide a quick and accessible guide to what your state’s Statutes say – or do not say – about PADs. The FAQs do not attempt to provide a complete picture of the law in your state, nor can they take the place of legal advice. The answers were accurate when written in October 2006.

1. Can I write a legally-binding psychiatric advance directive (PAD)?

Yes. California’s Health Care Decisions Law allows you to appoint an agent to make decisions about your treatment if you become incompetent to make decisions; write instructions about how you would like your health care to proceed; or both. This law covers all types of health care, including psychiatric treatment. Protection & Advocacy, Inc has published a helpful guide for consumers, which includes the latest version of the statutory Advance Health Care Directive (AHCD) form . This form is not mandatory but is highly recommended. Protection & Advocacy also offers a detailed Trainer’s Manual on the subject of AHCDs. The state of California maintains a central registry of Advance Directives, which you may wish to use but is not mandatory. Click here for more information on that program.

2. Can I write advance instructions regarding psychiatric medications and/or hospitalization?

Yes. The statute allows you to set out your instructions on any aspect of your health care treatment, which could include advance decisions about psychiatric medications and/or hospitalization. The statutory AHCD form gives a variety of prompts for you to state your instructions in the event of a crisis (for example, you could state that you would prefer to remain in a quiet room). If you wish, you may make advance decisions to refuse medications and/ or hospitalization. If you do this, however, note that that state law may require your hospitalization in an emergency, even if you have declined it in your instructions.

3. Does anyone have to approve my advance instructions at the time I make them?

No. However, the document containing your advanced instructions must be notarized, or signed by two witnesses. Neither witness can be an employee of your health care provider, and one must be a non-relative. If you are a patient in a “skilled nursing facility”, meaning a facility providing skilled nursing care on a long term basis, your form must additionally be signed by a Patient Advocate or Ombudsman.

4. Can I appoint an agent to make mental health decisions for me if I become incompetent?

Yes, in one of two ways:

(1) You may appoint an agent (called a “surrogate” in California), using your AHCD. Your agent must be someone other than an employee of your health care or community care provider, unless he/she is also related to you. If you have a conservator under the Lanterman-Petris-Short Act, you must seek the authorization of an attorney before appointing an agent.

(2) If you are already being treated in a health care facility, you may designate a surrogate to act during your current stay, for a maximum of 60 days in total. To do this, you need only inform your health care provider. The person nominated in this way has priority over any agent you already nominated in an AHCD, but only during that particular period of treatment, or 60 day period in total.

5. If I become incompetent, can my agent make decisions for me about medications, and/or hospitalization?

Yes, with some exceptions. In general, once you are determined to be incompetent (see below) your agent may make decisions about anything that you could decide on if you were competent. However, your agent cannot consent on your behalf to your commitment to, or placement in, a mental health treatment facility; nor can he/she consent on your behalf to psychosurgery, electroconvulsive treatment (ECT), sterilization or abortion. If you wish, you may use your AHCD to limit your agent’s authority to a certain type, or types, of decision.

6. Does my agent have to make decisions as he/she thinks I would make them (known as “substituted judgment”), or does he/she have to make them in my “best interests”?

Your agent must exercise substituted judgment to the extent that he or she can do so, based on your advance instructions and/or on your preferences as known by the agent. If it is not possible to make a decision in that way, your agent must make the decision in your best interests.

7. Is there any rule that says that I can only make advanced instructions, only appoint an agent, or that I must do both?

No. You may do one, the other, or both.

8. Before following my PAD, would my mental health care providers need a court to determine I am not competent to make a certain decision?

No. The California statute allows you to choose when your AHCD must be followed. Your AHCD will be followed when your primary physician determines that you do not understand the benefits and/or risks of a particular mental heath care decision. Alternatively, you may state on your form that your AHCD should be followed at all times, whether or not you are competent to make decisions.

9. Does the statute say anything about when my mental health providers may decline to follow my PAD?

Yes. Your providers must decline to follow your AHCD if they would violate professional standards in doing so, or for “reasons of conscience”. In these situations, your provider must assist in trying to find another provider who will follow your AHCD. Additionally, your providers could decline to follow your AHCD if you became subject to compulsory treatment or hospitalization under California law.

10. How long does my PAD remain valid?

Your AHCD is valid as long as you do not revoke it. If you wish, however, you may specify an expiry date for your AHCD.

Citing a 1967 law California wants a Galt woman to pay $335,000 for holding disturbed spouse in facility

By Jim Sanders - Bee Capitol Bureau

Published 12:00 am PDT Sunday, May 6, 2007
Story appeared in MAIN NEWS section, Page A4

Honorato Rodriguez had a history of mental illness and delusions that neighbors were out to get him when he lobbed a Molotov cocktail over the fence of his Galt home.

Nobody was hurt and no home burned down, but the dangerous act landed the 55-year-old Rodriguez, a victim of Parkinson’s disease, in a state mental hospital.

Rodriguez’s care is costing $455 per day. His wife, Gloria, a seasonal cannery worker whose only major asset is the family’s 30-year-old, three-bedroom home, is billed for the amount under state law.

“If I had the money, I would pay it - but I don’t have the money,” Gloria Rodriguez said of demands by the state Department of Developmental Services for payment of $335,000 owed by May 2006.

The Rodriguez case is sparking questions about whether, and under what conditions, the state should seize assets from families that could neither prevent, nor predict, a violent act from an insane relative.

Murderers, rapists and robbers don’t pay for their imprisonment, but Rodriguez and others too mentally unstable to be guilty of any crime are liable for massive state hospital costs.

Rodriguez was sentenced to state care by Sacramento Judge Thomas Cecil, who found him not guilty of arson by reason of insanity. Family members did not choose the location or the duration of the placement, yet they must pay for it.

Assemblyman Guy Houston, R-San Ramon, recently wrote a letter asking state agencies temporarily to suspend collection efforts.

“It is unconscionable that the state of California is allowed to collect money under these circumstances,” he wrote.

Houston said he understands, and does not necessarily oppose, efforts to reimburse taxpayers for bankrolling public services.

“There has to be a middle ground,” he said.

Kirsten Macintyre, spokeswoman for the state Department of Mental Health, said the agency is bound by state law to collect from the Rodriguezes but is trying to do so sensitively.

“This is the law and we have to follow it,” she said, adding that she does not know lawmakers’ rationale for passing the reimbursement statute in 1967.

Targeting patients’ families provides taxpayers with some hedge against very expensive care not covered by Medi-Cal. Collections last year totaled $3.3 million from 230 patients.

The state initially filed court papers seeking the entire Rodriguez estate, which would include the home, but later issued a settlement offer that would place a lien against half the residence and not force Gloria Rodriguez to move.

“There was never any talk about taking her house from her, as long as she was living,” Macintyre said.

The settlement offer would resolve current debts, but not necessarily Rodriguez’s future state hospital costs of $166,000 annually.

Rodriguez is not expected to regain his sanity any time soon, if ever, raising the specter of astronomical expenses that could jeopardize assets of his two grown children, Raquel, 29, and Fabian, 28.

“You know, it’s OK if I lose my house,” Gloria Rodriguez said. “But they’re just starting.”

A 2005 psychiatric report in Rodriguez’s court file describes his delusions as “severe and pervasive.” It mentions an incident in which he tried to head-butt a nurse while in custody.

“Unfortunately, the Parkinson’s disease is going to inexorably worsen in time,” the report said.

Gloria Rodriguez recalls happier times. She met Honorato when both were 22. Both had immigrated from Mexico legally. He was a student in an English class where she was an aide, she said.

The Rodriguezes married in 1975. Honorato, a high school dropout, worked various jobs at a farm, dairy and a company that made rubber mats.

“He was a good person,” Gloria Rodriguez said. “He was always a family person.”

Honorato was stricken with Parkinson’s disease at 37 or 38. His speech became slurred, his limbs stiff, and he often had trouble walking, she said.

His mental condition also deteriorated.

“It was mostly like the neighbors were out to get him,” she recalled. “He thought they were looking through the windows, or at night, he could hear them jumping over the house and trying to get in the house.”

Gloria Rodriguez does not know what provoked her husband, who had no criminal record, to toss a Molotov cocktail into the backyard of her neighbor in July 2002.

He ultimately was sentenced to eight years in a state hospital or until he regains his sanity.

Rodriguez’s psychiatric report from Atascadero State Hospital said he allegedly had “bashed in the windows of his neighbor’s truck” prior to the arson and “chased the neighbor’s children with a stick.”

The longtime Galt resident currently is housed at Napa State Hospital.

Rodriguez’s ailment, Parkinson’s disease, is a degenerative neurological disorder for which there is no known cure.

Lew Uhler, president of the National Tax Limitation Committee, which supports seeking reimbursement for other programs, said there is no compelling reason to charge the Rodriguezes.

Taxpayers should pay to confine insane offenders, as they do for regular prisoners, because both pose the same danger to public safety, he said.

“The only distinction is mental competence,” Uhler said.

Attorney Randy Rosá, representing the Rodriguezes, argues the state’s reimbursement laws may violate constitutional rights to due process and equal protection.

While some mentally disordered offenders are placed in a state hospital, others land in a different type of locked facility – licensed by the state, funded largely through Medi-Cal and operating under less stringent reimbursement statutes.

State law sets no limits on a state hospital patient’s cumulative bills, and it makes a patient’s spouse, parents and children jointly and separately liable, he said.

“It just strains my belief in a fair and moral system,” Rosá said.
About the writer:

* The Bee’s Jim Sanders can be reached at(916) 326-5538