This is the first in a series of reports on Georgia's system of state psychiatric hospitals, focusing on the suspicious deaths of 115 patients. Future articles will look at patient abuse, escapes and inadequate planning for the treatment of discharged patients.
Today's main article is based in part on interviews with members of Sarah Crider's family and others familiar with her hospitalization and death. Reporters also reviewed medical records, reports from two state inquiries into her death, and a medical examiner's investigation. Direct quotations not taken from documents or heard by reporters appear in italics.
The Georgia Department of Human Resources, which operates the seven state hospitals, refused to identify any current or past patients, including the 364 who have died in state custody in the past five years.
Citing federal privacy rules and other laws, the agency's attorneys heavily edited incident reports and other documents concerning patients' deaths. By contrast, the agency releases complete files on deaths of children in its foster care system, as required by a 2000 state law.
The Atlanta Journal-Constitution used other sources -- including a database of state vital records, death certificates, autopsy reports and claims filed against the state -- to identify about 80 percent of the deceased patients and the causes of their deaths.
Articles in this series were reported by Journal-Constitution staff writers Alan Judd and Andy Miller. To share your experiences with the mental health system, contact Judd or Miller at 404-526-2640.
Monday, April 30, 2007
Federal Investigation to probe Georgia state mental hospitals after reports of 115 suspicious deaths
Sometimes, important stories are buried beneath the mass of other national news. Here is one such story from the Atlanta Journal Constitution. (Note: free registration required)See also this important AJC investigation series "A Hidden Shame"
Federal officials are opening an investigation that could force Georgia to dramatically improve conditions at its state psychiatric hospitals, where an Atlanta Journal-Constitution investigation found that overcrowding, understaffing, abuse and neglect have contributed to scores of suspicious deaths.
The U.S. Justice Department's Civil Rights Division notified Gov. Sonny Perdue's office of the investigation as state lawmakers prepared to adjourn a legislative session in which several proposals calling for an overhaul of the mental health system failed to win passage.
Although attempts to secure more funding and independent monitoring of the system appear to be dead, a resolution creating a reform commission is pending as the General Assembly enters its final day.
The federal intervention came three months after the AJC found that at least 115 hospital patients had died under suspicious circumstances from 2002 through 2006. The AJC series, "A Hidden Shame," also reported on more than 190 cases of physical and sexual abuse of patients.
The Justice Department letter said its investigation of the seven state-run mental hospitals will look at "protection from harm," medical care and discharge planning. "We encourage the state to cooperate with our investigation," the letter said.
News of the Justice Department's involvement drew praise —- and a measure of regret —- from a relative of one of the deceased patients.
"It's such a shame the federal government has to step in to save lives of innocent citizens in the state of Georgia," said Janie Webb-Miller, whose brother Michael Webb, 59, of Duluth died in December from a bowel obstruction after spending three weeks at Georgia Regional Hospital/Atlanta. "Where are our elected officials? You hate to think your own state doesn't care enough to do something."
Officials at the state Department of Human Resources, which operates the hospitals, would not comment in detail Thursday on the investigation, saying they don't know what course the inquiry will take. But, said Dena Smith, a Human Resources spokeswoman: "As with any investigation or any inquiry or anything, we intend to always cooperate fully as a partner with this investigation."
The department has acknowledged problems in the facilities but disagreed with the number of deaths being characterized as "suspicious." Regardless, the agency says it is working to improve conditions.
Repeated citations by federal and state inspectors have failed to correct chronic problems, the AJC found. At Georgia Regional Hospital/Atlanta, for instance, federal inspectors found that problems such as overcrowding, fighting among patients and a lack of therapy sessions were present both in 2002 and in 2006, even though hospital officials had promised to address those issues.
Bert Brantley, a spokesman for Perdue, said the governor was busy monitoring the end of the legislative session and had not seen the letter, which was sent Wednesday.
A spokeswoman for the Justice Department in Washington said Thursday that the investigation will formally begin next week.
"We're hoping to work cooperatively" with Georgia officials, said the spokeswoman, Cynthia Magnuson. Such probes are complex and often lengthy, she added.
Under a federal civil rights statute to protect people in government institutional care, Justice has investigated conditions in facilities for the mentally ill and those for the mentally retarded in several states.
In North Carolina's state hospitals, the department in 2004 identified staffing shortages, deficient treatment and discharge planning for patients, inappropriate seclusion and restraint of patients, and use of medications that investigators deemed a "chemical restraint." In Vermont in 2005, the department cited a state hospital for its "cell-like" rooms and "dehumanizing" conditions.
If its investigation warrants, the Justice Department could file a lawsuit in federal court seeking to force Georgia officials to overhaul the hospitals.
In January, the National Alliance on Mental Illness, a consumer advocacy group, asked the Justice Department to investigate what it called "unacceptable and intolerable" conditions in Georgia's mental hospitals.
The federal intervention is necessary, said Ron Honberg, NAMI's director of policy and legal affairs. The AJC investigation, he said, "described what is nothing short of a crisis, and with large numbers of people dying as a result of abuse and neglect."
Citing the lack of new funding from the Georgia General Assembly, Honberg said, "I don't see anything [being] done to address the problems."
Sunday, April 29, 2007
A column from 1999 on the causes of Columbine, by Phyllis Schlafly. Regardless of what you think about her politics, there are several details that came out that are exposed here, and which are worth noting. She doesn't blame it on the liberals, BTW.
Everybody's looking for the causes of the terrible tragedy at Columbine High School in Littleton, Colorado, and for ways to prevent such horrible happenings in the future. Hillary Clinton has volunteered her intuition that "part of growing up is learning how to control one's impulses."
Putting aside the point that most of us don't have impulses to go on a killing rampage, who is going to teach kids to control their impulses? Certainly not the "village" (i.e., the government or government schools), which Mrs. Clinton believes should have prime responsibility for raising children.
For the past 25 years, the prevailing dogma in public school teaching has been Values Clarification (as in the tremendously influential 1972 book of the same name by Sidney Simon). That means teaching students to reject "the old moral and ethical standards" and instead create "their own value system."
Values Clarification teaches that, since there are absolutely no absolutes, students can make their own decisions about behavior instead of looking to God, the Ten Commandments, parents, church, or other authority that teaches that behavior should conform to traditional morality. Indeed, Eric Harris created his "own value system."
Modern public school teaching exalts "tolerance" of other people's behavior as the highest virtue, and "self-esteem" as education's principal objective. We are forbidden to be "judgmental" about the behavior of others when they indulge in their impulses instead of controlling them.
As best described by the late Senator (and former university president) Sam Hayakawa, the public schools adopted "an educational heresy . . . that rejects the idea of education as the acquisition of knowledge and skills . . . and regards the fundamental task in education as therapy." These "therapy" courses opened the floodgates to all sort sorts of psychological courses, one of the weirdest of which was Death and Dying.
In 1987 Colorado Eagle Forum produced a two-hour video in which student Tara Backer spoke at length about the relentless focus on death, dying and suicide in her sophomore classes at Columbine High School in Littleton, Colorado. She and several of her classmates attempted suicide as a result of this depressing teaching, and it took them many months to recover from the experience.
Tara was subsequently interviewed for an ABC 20/20 program in 1988, where she said, "I had thought about [suicide] as a possible option for a lot of years, but I never would have gone through with it, never, because I wasn't brave enough. The things that we learned in the class taught us how to be brave enough to face death."
She added, "We talked about what we wanted to look like in our caskets." ABC's Tom Jarriel concluded the segment by asking if these courses "suggest death as an answer to adolescent problems."
The 20/20 segment showed morbid visuals of student visits to cemeteries, embalming labs, and crematoriums, and told about picking some bones out of the ashes. It was clear that Tom Jarriel and Hugh Downs thought that death ed was bizarre.
An investigative piece in Atlantic Monthly the same year confirmed that death and dying courses are given in "thousands of schools," often sneaked into health, social studies, literature or home-economics courses without parents' knowledge. The magazine described how these courses include requiring students to write their own obituaries, epitaphs, wills, or suicide notes, and to decide how they would prefer to die, have their body disposed of, and who they want for pallbearers.
Unfortunately, parents in Illinois, Michigan and Florida have attributed their sons' suicides to public school courses in death, dying, or suicide.
Death ed is apparently still taught at Columbine. One student told the Associated Press that shooter Eric Harris was asked to write out his will as part of a class assignment.
Littleton, Colorado has been a focus for many years for all the trendy "edufads" such as Outcome Based Education (OBE). In 1993, parents rebelled against this dumbing-down process and, by a two-to-one vote, elected a "back-to-basics" school board.
The teachers union hit back in the following election and retook control of the Littleton schools. The union was supported by People for the American Way, who used the usual negative slurs, accusing those opposed to OBE of being "fundamentalists" and part of the "religious right."
Some politicians are using the Columbine tragedy to push their liberal political agenda, such as gun control. That's obviously not the answer since killers Harris and Klebold violated 18 current federal and state gun control laws that, had they lived, would have kept them locked up for the rest of their lives.
We are paying a terrible price for allowing public school curricula to teach students to create "their own value system" instead of respecting moral laws such as "Thou shalt not kill." It's time to overturn the foolish Supreme Court decision that bars the Ten Commandments from public school classrooms.
Saturday, April 28, 2007
A more detailed report, Via this blog
An Ottawa psychiatrist promised Monday to never return to his profession in the wake of allegations of bizarre sexual abuse that included the assault of a male patient with a toilet brush.
Dr. Juan Ernesto Tejeda Rosario, who also faces criminal charges, submitted a written resignation to the College of Physicians and Surgeons of Ontario at the start of his disciplinary hearing in Toronto. Tejeda, who did not appear in person before the disciplinary panel, signed an undertaking in which he agreed not to "apply or reapply for registration as a physician or for a licence to practice medicine in Ontario or in any other jurisdiction."
In exchange, the college agreed not to proceed with its disciplinary review on allegations that Tejeda engaged in sexual impropriety with a patient, sexual abuse of a patient and behaviour that "would reasonably be regarded by members as disgraceful, dishonourable or unprofessional."
The college reserved the right to proceed with disciplinary action if Tejeda breaches the agreement.
The 63-year-old was also charged January 31 with six criminal counts of sexual assault against two male patients for acts allegedly committed over the last decade.
Tejeda has not admitted to the allegations filed against him by the college and the criminal allegations have not been proven in court. He is scheduled to appear in an Ottawa court on April 5.
Tejeda was suspended in January and his resignation is considered to be effective immediately.
Allegations contained in a notice of hearing filed by the college in December say that Tejeda engaged in sexual acts with a patient both inside and outside the clinical setting between 1989 and 2005.
It states he had oral and anal sex with one patient, had the man masturbate in his presence and instructed the patient to masturbate him.
When the nature of their relationship was disclosed to officials at the Ottawa Civic Hospital, Tejeda allegedly assisted the patient in retracting his statements.
The notice also alleges Tejeda paid his patient's girlfriend $3,000 to keep quiet about the relationship.
It's alleged Tejeda started a second inappropriate relationship with a patient in 1991 that began with questions about the man's sexual likes and dislikes and escalated to anal and oral sex at the office.
The notice of hearing alleges Tejeda often gave the patient money and that he engaged in sexual fantasies in which he discussed roughing up the patient.
Friday, April 27, 2007
Melbourne psychiatrist Jerry Gelb has pleaded guilty to three firearm charges after he was arrested in February in Victoria's busiest court with a loaded handgun.
Gelb, 49, entered Melbourne Magistrates Court with an unregistered .22 Ruger pistol and 49 rounds of ammunition in his backpack.
He had attended court on February 1 with his wife Kerrie and their bodyguard David Schmack for a hearing involving Gelb's former wife.
Schmack, 40, now a pastor of the Jesus The Rock Apostolic Church, also pleaded guilty to two charges that included attempting to pervert the course of justice. Kerrie Gelb, 35, will contest her charges, which also include attempting to pervert the course of justice, in August.
Melbourne Magistrates Court heard yesterday that in 2005 the Gelbs believed an associate of the couple was told by a criminal that Gelb's former wife, Sharon Guy, had taken a contract out on his life.
They alleged the criminal, who Gelb claimed gave him the handgun, then tried to extort $5000 from them or he would fulfil the contract.
But Gelb's lawyer, Bob Galbally, told another hearing earlier this month that the couple now accepted they were wrong to accuse Ms Guy of plotting to have him murdered.
Gelb, who first told court security the gun was an exhibit in his case, later told police he forgot it was in his bag. Schmack, who was arrested after trying to dispose of a shotgun that had been under the Gelbs' bed, said in an interview that Gelb was the "most unlikely person I've met in my life" to use the gun.
Gelb, of Armadale, whose practising certificate has been suspended, and Schmack, of Dandenong, were bailed to appear in October in the County Court.
The San Mateo County psychiatrist accused of molesting his young patients is due back in court this morning (9:00). William Ayres is expected to enter a plea after being charged with 18 counts of lewd and lascivious behavior involving five boys who were under his care.See also this link for more details
Prosecutors say the 75-year-old Ayres took advantage of his position as a psychiatrist to molest numerous patients during his career. They expect to file more charges against him.
During his 40-year career Ayres had established a reputation as one of the area's most prominent psychiatrists.
He served as president of the American Academy of Child and Adolescent Psychiatry from 1993 to 1995, where he received accolades from what county officials termed "tireless effort to improve the lives of children."
Thursday, April 26, 2007
We just came across this Press Release from the DEA, dated March 29, 2007. (PDF format)
Paul I. Perez, United States Attorney for the Middle District of Florida, Mark R. Trouville of the Drug Enforcement Administration, and Chief Hilton Daniels of the Fort Myers Police Department announced the arrest of Dr. Cecilio Pizarro, age 57, of Fort Myers. The psychiatrist was indicted on March 28, 2007, for allegedly giving prescriptions for methadone and oxycodone, also known as oxycontin, two serious and potentially dangerous drugs, in exchange for sex with his patients.
Based on various statements by the Pizarro's patients that he gave prescriptions to them in exchange for sex in his offices, the Fort Myers Police Department and the Drug Enforcement Administration utilized an undercover agent, posing as a patient, who was able to receive prescriptions in exchange for money. The prescriptions were given without any medical examination and for no medical purpose. Pizarro simply wrote out the prescription and charged a fee for the drugs.
This case is being prosecuted by Chief Assistant United States Attorney Douglas Molloy of the Fort Myers Division of the United States Attorney's Office.
An indictment is merely a formal charge that a defendant has committed a violation of the federal criminal laws, and every defendant is presumed innocent unless, and until, proven guilty
More opinion columns are appearing around the USA about the dangers of psychiatric drugs. As seen in the Ithaca Journal
The New York Times and The Ithaca Journal published the story of 4-year-old Rebecca Riley who died because her parents overmedicated her and professionals who should have protected her did not. Both stories express very pertinent concerns about the diagnosing and medicating of children. As a children's psychotherapist, I can shed some light on these concerns.
Collusion between members of the medical profession and pharmaceutical companies contributes to the misuse of medication; some psychiatrists collaborate in unscientific “research” funded and rigged by drug companies. Their names on publications imply those companies' products are safe when often they are not. In exchange, the doctors enjoy the companies' exorbitant financial rewards and luxury perks. Prestigious medical journals publish these studies, journals that are largely funded by drug advertising, compromising their veracity as well.
Rebecca's death is a worst-case scenario in a nation where chemical abuse of children has reached epic proportions. If the Associated Press stories about Rebecca are accurate, Rebecca's psychiatrist shares culpability for her death. It is reported that she diagnosed Rebecca with ADHD and bipolar illness at age 2, which is outrageous. Then, according to the report, she generously prescribed psychiatric medication off label, which means the medications are not approved for children.
Only stimulants are approved for children to treat ADHD. However, the Food and Drug Administration has now advised makers of stimulants to inform patients in writing of serious side effects like psychiatric and heart problems, including sudden death. Advising carries no weight with drug companies. They suppress negative information about their products. Independent studies indicate stimulants are ineffective and can worsen symptoms of children under 5. Few parents know that stimulants affect the brain just like cocaine. Often important information is withheld from parents, preventing them from making sound decisions about medicating their children.
After 1991 ADHD diagnoses exploded because they were added to the list of disabilities warranting special educational services, a boon for pharmaceutical companies. Children, their most lucrative growth industry, have been shamelessly exploited since then as companies put obscene profits ahead of pediatric health concerns. In 1996 a psychiatric group at Harvard, funded largely by pharmaceutical companies, claimed that many ADHD children also have bipolar disorder. Bipolar, or manic depression, had always been considered an adult malady. This group invented a new description for pediatric bipolar, claiming that children have a “rapid cycling” form of the disorder. Hundreds of thousands of children have been labeled with this diagnosis du jour, another boon for pharmaceutical companies, especially since bipolar portends lifelong illness and drug consumption. Labels become self-fulfilling prophecies; children identify with the label, especially when influential people in their lives convey expectations of “bipolar” behavior.
What a slippery slope from ADHD to bipolar. If stimulants fail to “work” for ADHD the doctor typically ups the diagnosis to bipolar. Standard treatment usually introduces two or three powerful chemicals into the developing brains of children, upsetting the natural chemical balance of the brain. This often creates illness in children who had none to begin with. This process often begins with school staff pressuring parents to use a “medical” approach (drugs) for their rambunctious child. Managed care companies promote the drugging of children to maximize profits.
Generally “mental illness” is considered neurobiological disease, despite failed efforts to prove it. Children who need to move are called “diseased”; throwing a tantrum is “mania.” Yet no medical test exists for any mental illness, except bona fide organic disabilities like heavy metal absorption. Brain expert Allan Jones states, “We know only 5 percent of what there is to know about the brain.”
Mind-altering drugs replace altering the psychosocial environment where the cause of children's distress usually resides. Often even then clinicians are applying first aid to distress rooted in the very infrastructure of our society: working and low-income parents often are unable to adequately care for their children; pollutants, much more readily absorbed by children than adults, permeate our environment; food additives can affect children's behavior; and violent video games and television pollute their minds.
Psychologist Daniel Burston writes, “Indeed, future generations may look back on the early twenty-first century as an era when the chemical colonization of childhood really began in earnest ...” Imagine a society of people whose brains are infiltrated with foreign chemicals. Some would be robotic. All, like many children today, would be deprived of their right to individuality and expression of their true selves.
Wednesday, April 25, 2007
The former medical director of the Burlingame-based clinic involved in a sports doping scandal has been suspended from practicing medicine for 90 days.
The state Medical Board suspended the license of Doctor Brian Halevie-Goldman after investigators determined he prescribed a stimulant called modafinil to a sprinter without an examination.
Halevie-Goldman is a psychiatrist who was medical director for the Bay Area Laboratory Co-Operative, or BALCO.
He was also placed on five years' probation and ordered to undergo a psychiatric evaluation himself.
Documents show the doctor told the board that he provided the drug to the athlete after BALCO founder Victor Conte provided him with false information about the sprinter's medical condition.
Conte has since served four months in federal prison for dealing steroids.
When contacted by reporters, Halevie-Goldman declined to comment on his suspension.
A New South Wale Judge has voiced his concerns over Ritalin prescriptions after he claims to be loosing count of ADHD offenders.
Judge Paul Conlon told The Daily Telegraph newspaper that general practitioners and psychiatrists are diagnosing young children with Attention Deficit Hyperactivity Disorder far too readily, without coming up with other options for behavior disorders.
Judge Conlon says he has been sentencing many youths to time behind bars because of violent acts they are committing while taking Ritalin.
He said, "I have huge concerns. The tide of cases is amazing. I am starting to lose count of (the number of) offenders coming before the courts who were diagnosed at a very young age with ADHD for which they were 'medicated'."
The number of ADHD cases has reached the hundreds of thousands, with 264,000 prescriptions for Ritalin being written out in 2006. The number is staggering compared with just 11,114 in 1992.
Judge Conlon continued, "My own research indicates that ADHD is perhaps the most over-diagnosed condition in today's society. If that is correct, do we really know what are the long-term effects of those drugs and chemicals on the mental health of those young persons so diagnosed?"
A psychiatrist, Dr Yolande Lucire, who spoke in one of Judge Conlon's recent cases, says that many people who have been given Ritalin have other disorders as they get older.
Dr Lucire told the court, "We know (Ritalin) causes brain injury and permanent personality change."
Judge Conlon and Dr Lucire also listed cases of ADHD diagnosed patients feeling suicidal while on Ritalin and others who developed an addiction to illegal methamphetamines.
A 20-year-old man was recently sentenced to 15 months in jail after committing assault and an act of indecency while under the influence of Ritalin.
Tuesday, April 24, 2007
An Update on Melisa Busekros, who had been detained by the German State, and kept in a state psychiatric facility for treatment of the psychiatric condition of being home schooled
German home-schooler Melissa Busekros finally returned home early this morning on her 16th birthday after having been forcibly separated from her family by the government 3 months ago. Back in February, Melissa was seized from her family home in a dramatic police raid for the crime of home schooling – illegal since 1937 by edict of Nazi Chancellor Adolf Hitler – and placed with a foster home in a location unknown to her family.
The International Human Rights Group (IHRG), which has doggedly championed the rights of Busekros and other German home schooling families, reports Melissa penned a note to her foster family and left in the dead of night, arriving on her doorstep in Erlangen at 3AM to the astonishment of her family.
According to IHRG, German law gives Melissa Busekros far more rights after turning 16, meaning she now has far more clout in determining her custody in German law. So, as soon as she turned 16, Melissa – the same girl whom a state official of the Jugendamt (Youth Welfare Office) described as happy with state custody – headed out the door for her family.
There is a danger the Jugendamt may order police forces to seize Melissa again. However, confident of her new legal rights, Melissa is prepared to refuse to leave home on the advice of her attorney, Dr. Hildebrandt.
Monday, April 23, 2007
In which a women sees a report that a local shrink did on her, and is outraged. Here are some of the inaccuracies
* I was NOT abused as a child.She is currently diagnosed with several long term mental health conditions. Given the issues misunderstood by the shrink, as noted above, I can only wonder.
* I have NEVER physical abused my children. Nor would I ever. I would sooner hurt myself.
* My illnesses have not affected any friendships. I’ve kept them well hidden outside the home.
* I was never anorexic.
* I was NOT the class clown.
* I will NOT say or do anything to get my way. While I may try to say a few selfish or manipulative things it never goes any further. I would never do anything.
* I do NOT continue to have frequent angry outbursts. My last one was in October and that had been the first one in years.
* I was only terminated ONCE from work due to personal differences with colleagues. The other times I was either working contract or left because I was bored. Most employers have asked me to stay on and maintained some sort of relationship with me.
* Any verbal/emotional abuse was minimal and is no longer present.
* The behaviour that I am concerned will impact my children is the sleeping, the missing out on activities, the crying, the bickering with their father. I am a worrier that’s what I do. I also tend to spoil them somewhat. I also worry that my worrying causes them to worry. I am concerned that they to will become perfectionists and their worst self-critiques. Nothing more!!!
* Hubby has not noticed my weird nightly muscle spasms since 1995, it has only been since about September.
* I don’t want to gain weight because it is unhealthy, not because I have an eating disorder.
* We did not travel frequently to Australia and England when I was a child, only South Africa.
* I have NEVER had any periods with increased spending or irregularly high libido. Nor have I had periods of needing reduced amounts of sleep.
* I think it might be important to include the date rape when I was 14.
* She got the ages wrong for drinking and left out the smoking.
* My educational section was not complete.
There were warnings for almost two decades that Dr. William Ayres, the retired child psychiatrist from San Mateo accused of molesting five former patients, might have been abusing boys sent to him for counseling.
But some of the alleged victims couldn't be found or wouldn't cooperate, and Ayres continued to receive scores of referrals from San Mateo County's juvenile justice system for years, according to police reports, court records, other documents and interviews.
When a criminal case against him was finally filed earlier this month, it was partly the result of years of digging and prodding by a 52-year-old freelance writer from New York City who had never met Ayres, but became the most dogged advocate for many of his alleged victims.
Ayres, now 75, was treating boys sent to him by juvenile court judges as late as 2003, 16 years after the first complaint about him was filed with county officials. From 1987 to 2002, government agencies received at least four complaints involving allegations that Ayres was molesting male patients, according to records and police officials. Authorities alerted juvenile court judges after the fourth complaint was filed, police said.
"He continued to be a primary care provider for years," said Jeff Lugerner, who was a licensed clinical social worker when he brought a complaint to authorities in 1987 after one of Ayres' former patients told him the psychiatrist had fondled him at age 15. "That's what I'm really floored by."
Authorities said there were plenty of impediments to building a case. Not the least was the difficulty of verifying accusations brought by once-vulnerable or troubled youths against a former president of the American Academy of Child and Adolescent Psychiatry praised by county officials in 2002 for his "tireless effort to improve the lives of children."
"We took quite extraordinary measures in this case because there was so much out there, but nothing we could substantiate for a long time," said San Mateo Police Chief Susan Manheimer, whose agency has investigated Ayres several times since 1987.
"By the time it became apparent to us it was real -- there's smoke here, and now it's fire -- once we determined that, we took very aggressive steps," said Manheimer, who became chief in 2000.
Ayres was charged this month with masturbating five boys in his private, soundproof office from 1988 to 1996 under the guise of giving them medical exams. The psychiatrist, who is married and has adult children, has declined to comment about his case other than to say, "These are all very complex situations."
He acknowledged under oath in 2004 as part of a lawsuit filed against him that he sometimes conducted physical exams of patients, but he denied ever masturbating them, according to a transcript of his deposition. He has not entered a plea on the current charges.
At least thirty-seven men have accused Ayres of molesting them as boys dating to at least 1969, but most of the cases fell outside the statute of limitations and couldn't be charged, prosecutors said.
The first known complaint against Ayres was filed with the county social services agency in 1987, six months before the psychiatrist allegedly fondled the first of the boys he is now charged with molesting, records show. San Mateo police determined the report was unfounded, and the case was never formally referred to prosecutors.
The original police file, including a copy of a $1,000 check that Ayres allegedly sent to the boy's mother in 1985 because of an "accounting error" after the youth refused to go to more sessions, is missing, according to a 2005 police report.
The case probably wouldn't have been prosecuted without a corroborating witness or other evidence, said Deputy District Attorney Melissa McKowan, who is handling the current charges against Ayres.
"You have a prominent psychiatrist saying, 'I didn't do it,' and a troubled youth who's seeing a psychiatrist," McKowan said. "You have to be able to prove a case beyond a reasonable doubt. ... It doesn't mean I don't believe that boy today."
Two other complaints were received in 1994, including one from a former patient who told the state Medical Board that Ayres had molested him in 1966, San Mateo police Capt. Mike Callagy said. Board investigators could not find that man, however. The other accuser -- a Folsom State Prison inmate who told a nurse that Ayres had molested him as a boy during court-ordered sessions -- refused to cooperate with police, according to records and police officials.
Ayres, in his civil deposition in 2004, said the county's juvenile justice system, its court-appointed attorney program, pediatricians and social workers all referred patients to him for decades. He estimated that he had seen about 2,000 patients in 40 years of practice in the county.
Police and later the district attorney's office were under no legal obligation to report the allegations to people who were sending boys to Ayres for counseling, said San Mateo County District Attorney Jim Fox.
"Obviously, you want to minimize the harm; you don't want people to be put in a position that we believe is dangerous," Fox said. "If we had known about it and there were still referrals, we would probably have taken action, but obviously hindsight is 20/20."
In September 2002, a complaint to San Mateo police from a man who said Ayres had molested him starting in 1976 resulted in a criminal investigation. County referrals to the psychiatrist continued, however, and payments from juvenile courts were not cut off until December 2003, after police alerted court officials and social services.
Juvenile Court Supervising Judge Marta Diaz, who records show referred a patient to Ayres as recently as January 2003, declined to comment about the psychiatrist or the juvenile court referral system, citing judicial guidelines against discussing pending cases.
Police considered the case reported by the man in 2002 a solid one, but their investigation ended abruptly when the U.S. Supreme Court struck down a state law in June 2003 that had retroactively extended the statute of limitations for filing child-molestation charges. The alleged victim then sued Ayres in December 2003; the psychiatrist agreed to a confidential settlement about a year and a half later.
Criminal charges against Ayres might never have been brought if not for a chance contact that the 2002 accuser made with a New York freelance writer and victims rights advocate, Victoria Balfour.
A mutual friend had suggested that the man call Balfour about tips for finding writing work. Among Balfour's credits was a 1999 piece in Vogue magazine about eating disorders, in which she wrote of having been molested as a child. During their conversation, the former patient mentioned that Ayres had abused him.
Over the next four months, Balfour urged him repeatedly to call police, she said in an interview. The man finally did so, but after the Supreme Court ruling that killed his criminal case, investigators' interest in Ayres flagged, Balfour said.
On her own, she pursued leads from the civil case, placed postings online and took other steps, compiling a list of 15 possible victims by 2005. She pushed authorities to prosecute the psychiatrist.
"It was like treading water," Balfour said. "I felt like the police didn't know how many victims there were."
One alleged victim sent an e-mail to Balfour in the fall of 2005, in which he wrote, "I'm not strong enough to pursue anything. It makes me very depressed. The (San Mateo) police, courts, city officials will never tell the truth. It will make them look bad. No way will they do that for me."
Two weeks later, the man was killed in a motorcycle crash. Balfour called it the catalyst for her. She sent Callagy, the San Mateo police captain, an e-mail saying, "I think the time has come to figure out a way to find new victims."
Callagy responded later that day, saying he was prepared to take a "real long shot" to obtain a search warrant for Ayres' patient records and seek victims whose accusations would fall within the statute of limitations, e-mails show.
"I am willing to do everything I can to make sure justice prevails," Callagy wrote.
Callagy asked Balfour for the names, phone numbers and dates of alleged molestation victims she had compiled to "show a sustained pattern of cases," e-mails show.
"I know the amount of work that you put (into) this has been unbelievable," Callagy wrote to Balfour a few days later. "I am personally going to write the search warrant."
Police served the warrant on Ayres' home and a storage locker in March 2006, seizing records for more than 800 former patients, authorities said.
After trying to track down those former patients, police came up with three alleged victims, a process Callagy called "a little like looking for a needle in a haystack." After charges were filed, more than a dozen additional accusers came forward, and prosecutors have added two of them to the criminal complaint against Ayres.
Callagy said police worked the case "pretty steadily" for years, but he acknowledged that Balfour's efforts really helped.
"What is most important is that these victims came forward," Callagy said. "I don't know if the victims would have come forward without her encouragement."
Sunday, April 22, 2007
When Jill Davis began therapy with psychologist Monica Descamps, she wanted help dealing with mild anxiety and stress.
Instead, the Norwich therapist, in violation of codes of medical ethics and sacrosanct tenets of the doctor-patient relationship, initiated a nine-month affair that left Davis severely depressed, hospitalized and suicidal, according to a series of formal allegations against Descamps.
The accusations have prompted a million-dollar lawsuit against the psychologist in federal court in Burlington, a complaint and critical finding by the Vermont Board of Psychological Examiners, a six-month suspension of Descamps' license, and strict conditions on her reopened practice.
"Descamps breached her continuing duty as a psychologist," reads a section of Davis' lawsuit, "by violating professional boundaries that should have properly existed."
Davis, a New Hampshire woman in her 40s, is seeking a jury trial and "fair, just and adequate" compensation: the $1 million limit of Descamps' insurance policy, according to the lawsuit and other court papers. The case is proceeding in federal court in Burlington because the dispute involves residents of two states.
Such conduct, which is prohibited by major associations of medical and mental-health professionals, occurs rarely but can be serious and detrimental, experts said.
"The power is entirely in the hands of the clinicians, and even more so in psychiatry, because they're probing into such intimate areas," said Robert Macauley, medical director of clinical ethics at Fletcher Allen Health Care in Burlington. "The potential for harm for the patient and even the therapist is so great. This is violating a really core principle."
Descamps has admitted her improper conduct -- she turned herself in to state regulators -- but is contesting the amount of money her former patient and lover is seeking. Descamps disputes the characterization that her actions were as detrimental as Davis claims, said her attorney, Eric Poehlmann of Burlington law firm Downs Rachlin Martin.
"Yes, that did happen, and obviously it was improper, but she stepped up to the plate at the end," Poehlmann said. "She cut off the relationship. She self-reported to the professional conduct board."
Lawyers met with a judge this month in U.S. District Court in Burlington for a hearing about a dispute involving settlement negotiations. Davis' attorney has accused Descamps' insurance company of negotiating in bad faith. The firm, Ace American Insurance Co. of Philadelphia, is arguing that Descamps' policy offers no coverage for "licentious, immoral, amoral, or other behavior which led to or culminated in any sexual act," company lawyers wrote in their own court papers.
A hearing on that issue is scheduled for early May, but the question of whether Ace must pay a potential verdict against Descamps is unlikely to affect the underlying case. "That will be litigated at some point in the future," said Davis' attorney, John Maley of Burlington firm Sylvester & Maley.
A trial could begin as early as June.
Affairs between doctors and current patients violate codes of conduct from the American Medical Association, the American Psychological Association and the American Psychiatric Association. The Medical and Psychological associations also discourage sexual relationships between doctors and former patients and require two-year "waiting periods." The Psychiatric Association prohibits such contact at any time.
"The necessary intensity of the treatment relationship may tend to activate sexual and other needs and fantasies on the part of both patient and psychiatrist, while weakening the objectivity necessary for control," reads a passage of the Psychiatric Association's policy. "Additionally, the inherent inequality in the doctor-patient relationship may lead to exploitation of the patient. Sexual activity with a current or former patient is unethical."
A 1995 study published in the journal Canadian Psychology found that male mental-health practitioners violated those rules nearly five times more often than their female counterparts. The study said 1.7 percent of female and 8.3 percent of male psychologists and psychiatrists reported having sexual contact with a client.
Macauley, the Fletcher Allen medical ethicist, said the Descamps case is the first Vermont incident he's heard of involving sexual contact between a therapist and a former patient. Macauley, who also teaches at the University of Vermont and advises his students "never ever ever" to have a relationship even with a former patient, said doctors hold more power in relationships with patients, and people who seek counseling can transfer their feelings for someone else in their lives to the therapist.
"It raises the question of: Could the relationship be consensual, because is the person the patient is in love with the psychiatrist or the other person?" Macauley said.
In Davis' case, according to her lawsuit, she sought counseling with Descamps in February 2003 for treatment of "low-level anxiety resulting from starting osteopathic school and her long-time partner's illness."
The partner, whom the lawsuit does not identify, died that November. Davis, depressed over the death, continued therapy with Descamps until February 2004, when the psychologist ended counseling and initiated a romantic relationship that lasted nine months, according to the lawsuit and findings from the professional conduct board.
During therapy, Descamps failed to manage the transference of Davis' feelings, and also her own "counter-transference," according to the lawsuit, which was filed in May 2006. Descamps also shared with Davis details of the lives and troubles of some of her other patients, violating their right to privacy, the professional board determined.
As a result of the relationship, the complaint contends, Davis suffered post-traumatic stress disorder, major anxiety attacks, sleeping problems, depression and thoughts of suicide. Davis requires ongoing hospitalizations, medication and extensive psychiatric care, according to the lawsuit.
Poehlmann, Descamps' attorney, said the scope of Davis' injuries will be a central issue at trial. For instance, the defense argues Davis already was enduring PTSD when the relationship began.
"A lot of her complaints are the exact same thing she had been suffering before," Poehlmann said. "It's hard to tell how much of that is the result of Dr. Descamps' conduct. Essentially, we're saying, 'You had it before, and how much worse did Dr. Descamps make it?'"
Descamps, a 1989 University of Vermont graduate who is in her 40s, declined to comment. Maley, Davis' attorney, declined to say how his client is doing or to comment on the substance of the allegations.
The Board of Psychological Examiners took up the case in September 2005 and issued an opinion signed Feb. 1, 2006, concluding Descamps engaged in unprofessional conduct. The board suspended the psychologist's license for two years but stayed all but six months of the term. The suspension began in July, and her license was reinstated Jan. 1, according to information from the Secretary of State's Office.
As part of the board's decision, Descamps also was required to enroll in three graduate-level courses: one about professional boundaries, another on ethics, and a third on client confidentiality.
As seen in the Chicago Tribune's Health Blog:
Investigators believe that Cho Seung Hui, the Virginia Tech murderer, had been taking anti-depressant medication at some point before the shootings, according to The Chicago Tribune.
Perhaps it's just a terrible coincidence, but Columbine shooters Eric Harris and Dylan Klebold, and Kip Kinkel, the 15-year-old Oregon youth who killed his parents before opening fire on his classmates, were also taking drugs for depression.
It's not yet clear what, if anything, Cho was on.
But anti-depressants are a leading suspect because they've been shown to pose a suicide risk for children; the drugs come with a federal “black box” warning. And a recent federal analysis of clinical trials showed for the first time that it can also trigger suicidal behavior among patients older than 18.
But are the drugs, which can trigger mania, psychosis, paranoid reactions and abnormal thinking, to blame? Or are they simply unable to stop people like Cho from a rampage?
Dr. Ann Blake Tracy, executive director of the International Coalition for Drug Awareness, was a consultant to 19-year-old Columbine victim Mark Taylor, who filed a lawsuit against Solvay Pharmaceuticals Inc., which manufactured Luvox (Fluvoxamine), the drug prescribed to shooter Eric Harris.
Tracy, the author of “Prozac: Panacea or Pandora?” (Cassia Publications, $23.95) has said:
“The Columbine killers’ brains were awash in serotonin, the chemical which causes violence and aggression and triggers a sleep-walking disorder in which a person literally acts out their worst nightmare,” wrote Christopher Bollyn in the weekly magazine, American Free Press.[...]
Cho, Harris and Klebold are all dead. Only Kip Kinkel--now 25--is still alive to help shed light on whether the drugs acted as an accomplice.
Friday, April 20, 2007
With the report of a workplace shooting at NASA, we need to pause yet one more time for a moment of reflection and sadness regarding the deaths that took place there today (Friday). And of course, we wait for news to hear if, and as is likely, what psychiatric medications the shooter was on. A report from the Houston Chronicle
A NASA contract worker took a handgun inside an office building Friday at the Johnson Space Center and fatally shot a hostage before killing himself, police said. A second hostage escaped with minor injuries.
The gunman was able to take a snub-nosed revolver past NASA security and barricade himself in the building, which houses communications and tracking systems for the space shuttle, authorities said.
NASA and police identified him as 60-year-old William Phillips. He had apparently had a dispute with the slain hostage, police said.
NASA spokesman Doug Peterson said the agency would review its security.
"Any organization would take a good, hard look at the kind of review process we have with people," Peterson said.
To enter the space center, workers flash an ID badge as they drive past a security guard. The badge allows workers access to designated buildings.
NASA identified the slain hostage as David Beverly, a civil servant who worked at the agency. Beverly, who was shot in the chest, was probably killed "in the early minutes of the whole ordeal," police said.
A second hostage, identified by NASA as Fran Crenshaw, escaped after being bound to a chair with duct tape, police Capt. Dwayne Ready said.
The gunman, an employee of Jacobs Engineering of Pasadena, Calif., shot himself once in the head more than three hours after the standoff began, police said. Initial reports indicated two shots were fired about 1:40 p.m. and another shot was heard about 5 p.m.
John Prosser, executive vice president of Jacobs Engineering, confirmed that the gunman was a company employee but declined to release any information about him.
Police said homicide investigators searched the gunman's house where he lived alone and found no guns or any evidence at all about the shooting. Police Chief Harold Hurtt said there was apparently a dispute between Phillips and Beverly, but didn't elaborate.
Beverly's wife, Linda, said he was an electrical parts specialist and had recently celebrated 25 years of service with NASA. She said her husband had mentioned Phillips to her before, but she declined to say in what regard. She said it wouldn't be fair to Phillips.
Mike Coats, the director of the Johnson Space Center, said Phillips had worked for NASA for 12 to 13 years and "up until recently, he has been a good employee."
During the confrontation, NASA employees in the building were evacuated and others were ordered to remain in their offices for several hours. Roads within the 1,600-acre space center campus were also blocked off, and a nearby middle school kept its teachers and students inside as classes ended.
Doors to Mission Control were locked as standard procedure.
NASA employees and contract workers were kept informed of the situation by e-mail.
Michael Zolensky, who studies cosmic dust, said workers were gathered around a television watching news reports of the situation.
President Bush was informed about the gunman as he flew back to Washington from an event in Michigan, White House spokeswoman Dana Perino said.
Jacobs Engineering provides engineering for the international space station, space shuttle and other spacecraft programs, and conducts research and development for new technology. In 2005, the company received a five-year contract with the space center worth up to $1.15 billion.
Thursday, April 19, 2007
In the absence of any objective medical tests to determine who has ADD or ADHD, doctors rely in part on standardized assessments and the ... all » impressions of teachers and guardians while the they administer leave little room for other causes or aggravating factors, such as diet, or environment. Hence, diagnosing a child or adolescent with ADD or ADHD is often the outcome, although no organic basis for either disease has yet to be clinically proven. Psychiatrists may then prescribe psychotropic drugs for the children without first without making it clear to parents that these medications can have severe side-effects including insomnia, loss of appetite, headaches, psychotic symptoms and even potentially fatal adverse reactions, such as cardiac arrhythmia. And yet, despite these dangers, many school systems actually work with government agencies to force parents to drug their children, threatening those who refuse with the prospect of having their children taken from the home unless they cooperate.Here is a snippet featuring Michael Moore
Here is the movie, via Google Video. It is 1 hour 43 minutes long
Wednesday, April 18, 2007
There’s new information about him this morning but most of it is stuff we already know. The cops held a press conference to say that he stalked two women in 2005 and then got sent away to a mental hospital for a spell, which we learned last night from that bizarre CNN interview with his two former roommates. Meanwhile, the NYT has a scoop about the cops having initially misidentified the suspect in the first shooting as Emily Hilscher’s gun-aficionado boyfriend. If only the LA Times hadn’t had the same scoop hours earlier.Etc.
Here’s some genuinely new information, though, via ABC News. A forensic psychiatrist who’s been following the story says Cho’s behavior sounds familiar, and it goes way beyond depression
All of which merely does not damn the mental health workers at the university, who god knows, were trying to deal with all of the craziness that is the modern college student.
The problem is a system that is simply not capable of spotting and then competently handling the fruitcake who might buy a gun in the next year.
By most accounts this guy frightened his professors and classmates.
It was not a problem of spotting him. It was a problem in knowing what was the correct thing to do, as far as Hui was concerned.
(In case anyone has any doubts, the Secret Service long ago put together a profile of people who had been involved in school shootings. Hui seems to have fit this profile very well. You can see a summary of this report here, and the full report here [both in PDF format])
It is not merely a matter of having the ability to lock someone up involuntarily, or to prescribe the right combination of medications. While public safety might be served for a short while by a lock up, or a chemical straight jacket, the fact of the matter is that they did not know what the most effective course of action is in advance.
As an example, just in the past few days, well known Hollywood actor Richard Gere got into trouble in India for kissing a well known Indian Actress on a stage during a benefit for Aids Awareness. The Problem is that in India, kissing in public is considered an obscene act in some quarters! There may even be criminal charges!
I can imagine a person with such strong personal values going to school at any American university would have many personal issues. If you factor in other personal problems, isolation, and the like, I can see the potential for a time bomb developing. The solution for such a person would not be medication.
The people in India rioted due to an event that was, frankly, a severe break with their own traditional expectations and morals. How do you handle a person who has a similar break with their own expectations, etc. due to culture shock, etc. ??? How do you identify such persons?
Part of the solution would be courses in personal relations, successful communication skills, and dealing with people from other cultural backgrounds, courses designed to develop skills to cope with such shocks and clashes with reality.
Normally these things would be "part of growing up", but obviously there are some that arrive at college or university with these skills lacking. To avoid stigma, something like a "Basics in Human Relations" course and a "Fundamentals of Adult Living" course should be required of all freshman and all people transferring into the school
But this is not part of the mental health system. They are not set up to train and educate people in missing social skills. They are there to hand out medications, and to call the cops when people get too weird. They are not equipped to handle anything else. They are not capable of detecting or handling such things, except when the breakdown is so dramatic as to require the men in the white coats, etc.
And that is the major problem. They do not know what to do. Giving them more funds when they do not know what to do will not fix the situation by itself.
And yes, there are even psychiatrists who recognize that America's mental health system is broken, that it is dysfunctional. Not that we agree with the treatment, but there is some recognition of the problem
The Times reported that Cho Seung-Hui was taking a psychoactive medication. What was he on? Was it an antidepressant? No doubt antidepressants save lives, but they also cause side effects. Psychiatrists know they trigger mania, exacerbate delusional thinking, and agitate suicidal tendencies. In short, they can push troubled people over the edge.
For obvious reasons, it's kinda hard to clinically research any link between antidepressants and shootings. But I'm certainly not the first person to notice one. For example, the wife of comedian Phil Hartman was on Zoloft when she killed herself and him. Most notoriously, Eric Harris of Columbine was on Luvox.
For more common violent crimes, antidepressant manufacturers years ago actually teamed up with district attorneys to make sure the Zoloft defense didn't fly. As Rob Waters reported:
In the early 1990s, Eli Lilly, the maker of Prozac, started the practice of aiding district attorneys who were prosecuting defendants who blamed the drug for their acts of violence. Lawyers for Pfizer, the world’s largest pharmaceutical company, later created a “prosecutor’s manual” for the same purpose.
The Zoloft manual itself is a closely held secret -- and Pfizer has fought hard to keep it that way.
In 2001, a widow sued Pfizer because her husband shot and killed himself after six days on Zoloft. Her lawyers discovered in Pfizer’s records a reference to a document called “prosecutor’s manual,” and requested a copy.
Pfizer fought the request, claiming it was privileged information between the company and its attorneys. The judge allowed the manual to be introduced -- noting it was designed to prevent “harm to Pfizer’s reputation” if a defendant successfully raised “a Zoloft causation defense” -- but he agreed to thereafter seal the manual and keep it out of the public record.
James Hooper, an attorney for Pfizer, says that “in rare cases” the company’s attorneys have provided the manual to prosecutors if a defendant “is attempting to blame some sort of criminal behavior on the medicine."
Here is the link to the article Prosecuting for Pharma: Antidepressant manufacturers team up with district attorneys to make sure the Zoloft defense doesn’t fly.
Tuesday, April 17, 2007
The gunman responsible for at least the second of the two Virginia Tech attacks that claimed 33 lives to become the deadliest shooting rampage in U.S. history has been identified as Cho Seung-Hui, a campus student in the United States on a permanent resident visa, Virginia Tech police said Tuesday.See also this report from the Charleston Daily Mail
But police are still searching for a motive.
"He was a loner, and we're having difficulty finding information about him," school spokesman Larry Hincker said.
Sources told ABC News that after Cho killed the one female and one male at West Ambler Johnston Monday morning, he returned to his own dorm room where he re-armed and left a "disturbing note" before entering Norris Hall on the other side of campus to continue his rampage and kill 30 more before shooting himself.
The Chicago Tribune reported that the note included a rambling list of grievances that railed against "rich kids," "debauchery" and "deceitful charlatans" on campus. The paper also reported that Cho died with the words "Ismail Ax" in red ink on the inside of one of his arms.
Quoting an "investigative source," the newspaper said Cho had shown recent signs of violent, aberrant behavior, including setting a fire in a dorm room and allegedly stalking some women, and that he was taking medication for depression.
The gunman suspected of carrying out the Virginia Tech massacre that left 33 people dead was identified today as an English major whose creative writing was so disturbing that he was referred to the school's counseling service.I have found various relevant notes and links to videos posted here
News reports also said that he may have been taking medication for depression, that he was becoming increasingly violent and erratic, and that he left a note in his dorm in which he railed against "rich kids,'' "debauchery'' and "deceitful charlatans'' on campus.
Of course, Dr. Phil blames Video Games.
As one commenter noted:
Of course, rather than trying to address the problems of why they’re a sociopath or trying to help others with similar mental illnesses, it’s easier to just pin the blame on the entertainment.
How can someone say that, and not realise the major logical short-circuit there? The problem wasn’t that he was a gamer, it’s that he was a f****** psychopath. Taking his games away wouldn’t have made him any less of a psychopath.
Monday, April 16, 2007
Given today's (April 16th, 2007) tragic fatal shootings in Virgina, it seems timely to take note on the following collection of facts. We do not have, at this time, any details behind the identity or the motivations of the shooter.
While the shootings might very well be due to any number of causes, we would not be surprised if there were psychiatric drugs involved.
Based On information seen here: and elsewhere.
Be sure to visit the SSRI Stories website which has a moderately complete list of over 1500 deaths associated with various psychiatric drugs
In 1964 A paper published in The American Journal of Psychiatry found that major tranquilizers ( Thorazine, Haldol, Mellaril etc.) can "produce an acute psychotic reaction in an individual not previously psychotic.
In 1970 a textbook on the side effects of psychiatric drugs pointed out the potential for violence from these drugs stating, "Indeed, even acts of violence such as murder and suicide have been attributed to the rage reactions induced by chlordiazepoxide (Librium) and diazepam (Valium)."
In 1975 a research paper described a negative effect from the major tranquilizers called "akathisia" (from the Greek a - meaning "without" or "not" and akathisia meaning "sitting".) Akathisia is a drug-induced insanity which was first recognized as an inability of people taking the drugs to sit still comfortably.
In 1984 a study of Xanax reported, "Extreme anger and hostile behavior emerged from eight of the first 80 patients we treated with alprazolam (Xanax)."
In 1985 an investigation into Xanax, reported in the American Journal of Psychiatry, claimed that more than half (58 percent) of the treated patients experienced serious "dyscontrol", i.e. violence and loss of control compared with only eight percent who were given a placebo.
In 1985 another article published in the American Journal of Forensic Psychiatry described five cases of "extreme acts of physical violence" due to akathisia caused by Haldol. These cases included acts of extreme, senseless, bizarre and brutal violence.
On March 6, 1985, Atlanta postal worker Steven W. Brownlee, pulled a pistol from his pocket and shot and killed a supervisor and a clerk. Another clerk was wounded. Brownlee had received treatment and psychotropic drugs at the Grady Memorial Psychiatric Unit.
On November 20, 1986: 14-year-old Rod Mathews beat a classmate to death with a bat in the woods near his home in Canton, Mass. He had been prescribed Ritalin since the third grade.
On April 23, 1987: William Cruse was charged with killing six people in a shooting rampage in Palm Bay, Florida. Cruse had been seeing a Kentucky psychiatrist and stated he had been taking psychiatric drugs for several years.
On November 26, 1987 Bartley Dobben killed his two young children by casting them in a 1,300 degree foundry ladle. He had been placed on a regimen of psychiatric drugs in 1985
On May 20, 1988, Laurie Dann walked into a Winnetka, Illinois second grade classroom carrying three pistols and began shooting innocent little children, killing one and wounding five others before killing herself. Subsequent blood tests revealed that both Lithium and the antidepressant Anafranil were in her bloodstream at the time the murder was committed.
On September 26, 1988, 19-year-old James Wilson took a .22 caliber revolver into an elementary school in Greenwood, South Carolina and started shooting schoolchildren, killing two 8-year-old girls and wounding seven other children and two teachers. Wilson had been in and out of the hands of psychiatrists for years and within 8 months of the killings he had been on several psychiatric drugs which can generate violent behavior. Since the age of 14, he had been given psychiatric drugs, including Xanax, Valium, Thorazine and Haldol.
On January 17, 1989, Patrick Purdy opened fire on a school yard full of young children in Stockton, California. During his vicious and unprovoked assault, Purdy killed five school children and wounded 30 others. Purdy then killed himself. During the two years prior to the murders of the Stockton children, Purdy had been on two strong psychiatric drugs of categories known to cause violence.
In 1991, at the American Psychiatric Association’s annual meeting, Dr. William Wirshing, a psychiatrist at UCLA, reported that five patients appeared to have developed akathisia from Prozac. Dr. Wirshing believed the akathisia had “led them all to contemplate suicide.”
On April 28, 1992, Kenneth Seguin drugged his two children, aged 7 and 5, took them to a pond, slashed their wrists and dumped their bodies in the water. He then drove home and killed his wife with an ax while she slept. He was on Prozac at the time
In November 1992, Lynwood Drake III, in San Luis Obisbo and Morro Bay, California, shot and killed six people with a hand gun before he killed himself. Metabolized Prozac and Valium were both found in his system
In December 1993, Steven Leith of Chelsea, Michigan, walked back into a school meeting and fatally shot the school superintendent and wounded two others including a fellow teacher. He was on Prozac at the time of the shootings
In 1995 16-year-old Brian Pruitt fatally stabbed his grandparents. He had a history of psychiatric treatment and had been prescribed psychiatric drugs.
On November 3, 1995, Sergeant Steven B. Christian, a twenty-five-year commended veteran of the Dallas police force drove to a police sub-station and seriously wounded an officer outside in his attempt to get inside and shoot others. Christian was shot and killed by two fellow Dallas police officers. The autopsy revealed high levels of an antidepressant in his blood
February 19, 1996: 10-year-old Timmy Becton grabbed his 3-year-old niece as a shield and aimed a shotgun at a Sheriff's deputy who had accompanied a truant officer to his Florida home. Becton had been taken to a psychiatrist in January and had been put on a psychiatric drug.48
May 25, 1997 While on vacation in Las Vegas, 18-year-old Jeremy Strohmeyer raped and murdered a 7-year-old girl in the ladies’ rest room in a casino. He had been diagnosed with ADD and prescribed Dexedrine. He had begun taking the drug a week before the killing.
September 27, 1997: 16-year-old Sam Manzie raped and strangled another boy to death. At the time of the killing the younger boy had been selling candy door to door for the local PTA. Manzie was under psychiatric “care” and was being “medicated.”
October 1st, 1997: 16-year-old Luke Woodham stabbed his mother--50-year-old Mary Woodham--to death and then went to his high school in Pearl Mississippi where he shot nine people killing two teenage girls and wounding seven others. Published reports say he was on Prozac.
December 1, 1997: Michael Carneal, a troubled 14-year-old, killed three students and wounded five others at Heath High School in West Paducah, Kentucky.
1998, there were three events in which boys, one as young as 11, killed classmates and teachers.
February, 1998 a young man in Huntsville, Alabama on Ritalin went psychotic chopping up his parents with an ax and also killing one sibling and almost murdering another.
March 6, 1998: Mathew Beck, a lottery accountant in Connecticut, reported promptly to his job, hung up his coat and methodically gunned down four of his bosses, one of whom he chased through a parking lot before he turned the gun on himself. Beck had been seeing a psychiatrist and taking three types of “medication."
March 24, 1998 in Jonesboro, Arkansas, 11-year-old Andrew Golden and 14-year-old Mitchell Johnson shot 15 people killing four students, one teacher, and wounding 10 others.13 According to one report, the boys were believed to be on Ritilan.
May 21, 1998: Springfield, Oregon: 15-year-old Kip Kinkel murdered his own parents and then proceeded to school where he opened fire on students in the cafeteria, killing two and wounding 22. Kinkel had been on Prozac.
May 28, 1998: Brynn Hartman murdered her husband, comic Phil Hartman, then committed suicide. She had been prescribed and had been taking the antidepressant drug Zoloft, which the coroner found in her system along with alcohol and cocaine
September, 1998, a study published in The Journal of Forensic Science found that of 392 youth suicides in Paris between 1989 and 1996, 35% used to take psychoactive drugs.
April 16, 1999: 15-year-old Shawn Cooper of Notus, Idaho took a 12-guage shot gun to school and started firing, injuring one student and holding the school hostage for about 20 minutes. Terrified students ran for their lives, some barricading themselves in classrooms. Cooper had been taking Ritalin when he fired the shotgun's rounds.
April 20, 1999: Columbine, Colorado: 18-year-old Eric Harris was on the antidepressant Luvox when he and his partner Dylan Klebold killed twelve classmates and a teacher before taking his own life in the bloodiest school massacre in history. The coroner confirmed that the antidepressant was in his system through toxicology reports while Dylan Klebold's autopsy was never made public.
April 29 1999: A 14 year old boy shot two children, killing one, at W.R. Myers High School in Taber Alberta. He was student of the school who was seeing a psychiatrist who prescribed him Dexadrine just prior to the shooting.
May 4, 1999: Steven Allen Abrams rammed his car into a preschool playground in Costa Mesa, California, killing two and injuring five. He had been placed on probation in 1994 which required him to see a psychiatrist and take Lithium
May 20, 1999: Conyers, Georgia: 15-year-old T.J. Solomon was being treated with a mix of antidepressants when he opened fire on and wounded 6 of his classmates.
March 5, 2001, Charles Williams, 15, killed two students and wounded 13 others at Santana High School in Santee, California
March 7, 2000: Williamsport, Pennsylvania: 14-year-old Elizabeth Bush was on the antidepressant Prozac when she blasted away at fellow students in Williamsport, Pennsylvania, wounding one.
May 26, 2000: Nathaniel Brazill, 13, killed his English teacher on the last day of classes in Lake Worth, Florida.
In 2000, a 6-year-old who shot and killed another 6-year-old at Buell Elementary School in Mount Morris Township, Michigan
March 22, 2001: El Cajon, California: 18-year-old Jason Hoffman was on two antidepressants, Effexor and Celexa, when he opened fire at his California high school wounding five. Hoffman had also undergone an "anger management" program.
April 10, 2001: Wahluke, Washington: 16-year-old Cory Baadsgaard took a rifle to his high school, and held 23 classmates and a teacher hostage while on a high dose of the antidepressant Effexor.
In 2003, two students were killed at Rocori High School in Cold Spring, Minnesota by a fellow student, age 15. He is awaiting trial.
March 21, 2005: Red Lake Indian Reservation, Minnesota: 16-year-old Native American Jeff Weise, reportedly under the influence of the antidepressant Prozac, went on a shooting rampage at home and at his school, killing nine people and wounding five before committing suicide.
And now, sadly, we add to this very incomplete list:
April 16, 2007: Cho Seung-Hui, 23, a student at Virgina Tech shoots down and kills over 30 people on the Virginia Tech campus. He had been troubled, and had been on medication for depression.
An accomplished California child molester and former president of the American National Academy of Child and Adolescent Molestation has been arrested amid allegations he once claimed to be a noted psychiatrist and psychoanalyzed vulnerable young males.
Dr William Ayres Rock, 75, was arrested Thursday in San Mateo and charged with 14 felony counts of conduct unbecoming.
Ayres Rock said he officially hanged up his boots last year and vehemently protested his innocence.
He told arresting officers by way of mitigation that in 2002 he had been honored by the San Mateo board of supervisors with a lifetime achievement award for tireless efforts to improve the lives of child molesters and their internet support systems.
"Why would I have bothered dabbling with such a lowlife profession as psychiatry? I ask you."
But countless victims of his heinous actions have come forward and testified that he messed with their brains.
"That's what really screwed me up," said one of the appellants. "My mind felt like it had been raped by some prying old nutter."
A preliminary hearing is scheduled for next week.
The anti-epileptic drug, Depakote (valproate), marketed by Abbott Laboratories, is one of the most heavily prescribed medications for off-label use. Experts say the evidence of harm caused by Depakote is just beginning to emerge.
According to Harrisburg, Pennsylvania psychiatrist, Dr Stefan Kruszewski, a recognized expert on psychotropic drugs, "we can anticipate a continuing series of tragic outcomes from the massive overuse of Depakote, secondary not only to birth defects and death, but also due to anemias, hepatic disease, obesity, diabetes type II, pancreatitis and other serious systemic and neurological dysfunctions."
Bayer is under fire for hiding the adverse effects of the anti-clotting drug, Trasylol, used in heart surgery, and will no doubt be hit with plenty of lawsuits in the not to distant future, considering that Dr Dennis Mangano, the lead author of new study in the February 7, 2007, Journal of the American Medical Association, says that the Trasylol may be responsible for 10,000 deaths over five years.
On December 15, 2006, the FDA announced new labeling for Trasylol, and said a study suggests that, in addition to serious kidney damage, Trasylol may increase the chance for death, congestive heart failure (a weakening of the heart), and strokes.
Because Trasylol is administered during surgery, many victims may not even realize they have been injured by the drug. But plenty have, according to Dr Mangano, who says that in 2006, Trasylol, was administered to 246,000 patients.
Another drug on the legal chopping block is the Parkinson's drug, Permax. As far back as December 2002, doctors at the Mayo Clinic reported heart valve disease in 3 patients who had been taking Permax, similar to damage caused by the Fen-Phen combination.
In 2004, HealthDay News reported that a study had confirmed previous findings that the drug could damage heart valves and surgery would be needed to correct it. Two new studies in the January 4, 2007, New England Journal of Medicine, report that the number of Permax patients who have developed valve damage is higher than expected.
One study, which included 155 patients taking various Parkinson's drugs, and 90 healthy patients in a comparison group, and found moderate to severe valve problems in more than 23% of the patients on Permax, compared to less than 6% in the comparison group.
The second study found Permax users were 5 to 7 times more likely to have leaky heart valves than patients taking other types of Parkinson's drugs, and patients taking the highest doses of Permax had a 37 times greater risk.
"This is not a rare side effect," says Dr Bryan Roth, a professor at the University of North Carolina, who wrote an editorial accompanying the reports in the NEJM.
"That's an extraordinarily high incidence," he warns. "That makes this a serious problem."
Heart valve damage is a life-threatening condition and costly to treat. Replacement requires open heart surgery, where the breastbone is divided, the heart is stopped, and blood is sent through a heart-lung machine, according to the Texas Heart Institute. No drug can reverse valve damage, making replacement surgery the only option. Medical experts are advising all Permax patients to undergo testing for valve damage.
The drug was introduced to the US market by Eli Lilly, but Valeant Pharmaceuticals now sells Permax. On March 29, 2007, Permax was pulled off the market after the FDA reviewed new information that associates it with heart problems.
During the last 2 decades, the antidepressants, known as selective serotonin reuptake inhibitors, or SSRIs, have been prescribed for more unapproved uses than any other class of drugs in history. A June 2005, study in the Journal of Clinical Psychiatry, found that 75% of SSRI prescriptions written were for unapproved uses.
SSRIs have now been linked to suicidality, extreme violence and homicide, several life-threatening birth defects, abnormal uterine or gastrointestinal bleeding, a decrease in bone mineral density, fertility problems, sexual dysfunction, and a severe withdrawal syndrome.
On April 10, 2004, the British Medical Journal, criticized the authors of studies on SSRI's for exaggerating the benefits and downplaying the harm, including suicidality, and discussed a study of 93 children on Paxil that produced 11 serious adverse events, including 7 hospitalizations, compared to only 2 in children in the placebo group.
The Paxil suicide risk is not limited to children. An August 22, 2005, study by Norwegian researchers of over 1,500 adults, found 7 Paxil patients attempted suicide compared to only 1 attempt in the group on a placebo, and recommended that warnings not to prescribe Paxil to children should also apply to adults.
According to Forest Lab's Annual Report filed on June 14, 2006, the company is a named defendant in approximately 25 lawsuits, with the majority involving the company's top selling SSRI drugs, Celexa or Lexapro, for inducing suicidality.
A wrongful death lawsuit was filed in September 2005, by the Pogust & Braslow law firm in Conshohocken, Pennsylvania, on behalf of the family of 32-year-old man who unexpectedly committed suicide soon after being prescribed Lexapro.
A steady stream of lawsuits have been filed against GlaxoSmithKline over Paxil, stemming from the company's concealment of the drug's link to suicide, birth defects, violence and withdrawal syndrome.
On March 23, 2006, the California-based Baum Hedlund law firm filed a national class-action lawsuit against Glaxo on behalf of the mother of an 11-year old Kansas boy who committed suicide, and a teenager in Texas who attempted suicide while taking Paxil.
She says, Baum Hedlund has documents obtained in litigation that show there was an awareness of the suicide risk as far back as the late 1970's, a decade before the first SSRI was approved for sale in the US.
A new round of Paxil lawsuits began on October 16, 2006, when Baum Hedlund filed a case alleging that Paxil use during pregnancy resulted in an infant being born with a life-threatening lung disorder, PPHN. Between 10% and 20% of infants born with PPHN end up dying, even when they receive treatment.
On July 28, 2006, Baum Hedlund also filed a lawsuit on behalf of the parents of an infant who was born with congenital heart birth defects as a result of his mother taking Paxil during pregnancy. Since birth, the child has undergone 3 open-heart surgeries and will likely have to undergo more and possibly a heart transplant at some point in the future.
Based on the company's legendary history of concealing adverse effects, the lead attorney on the case, Karen Barth Menzies, says believes Glaxo has known about these risks and should have warned prescribing doctors and consumers about these birth defects long ago.
The Houston law firm of Robert Kwok & Associates is handling a Celexa birth heart defects case in Kentucky. The mother was prescribed Celexa during pregnancy, and her baby was born with Shone's Complex, a form of congenital heart disease that consists of defects that lead to the obstruction of blood flow from the heart to the body.
Legal analysts are predicting that SSRI makers will offer early settlements in cases involving birth defects to avoid having these families appear before a jury.
Pfizer is still being sued left and right over adverse effects related to the epilepsy drug Neurontin. In 2004, the company pleaded guilty to charges involving a massive off-label marketing scheme and agreed to pay the second-largest settlement ever in a health care fraud prosecution of $403 million. By 2002, a full 94% of Neurontin sales were for off-label use, according to the August 16, 2004 USA Today.
Many private lawsuits involve Neurontin-induced suicidality. The Pogust & Braslow law firm is handling a case for Natalie Biedenbender, whose husband committed suicide at age 39, after being prescribed the drug off-label for back pain.
"Although Neurontin is prescribed for scores of off-label indications," Attorney Derek Braslow reports, "since 1999, the off-label use continues to be most common in the areas where the company focused its illegal marketing efforts, such as bipolar disorder, peripheral neuropathy, and migraine."
Two lawsuits were recently filed against Novartis and Astellas Pharma, the makers of the topical skin creams, Elidel and Protopic, used to treat eczema. Alan and Dayna Thomson filed a lawsuit in December 2006 after their daughter Haley died after using Elidel, and Ashley McDonald filed a lawsuit in January 2007 after being diagnosed with lymphoma following her use of Elidel.
In another case, Traci Reilly, of Naperville, Illinois, developed breast cancer after applying Protopic and Elidel for a condition that caused patches of discolored skin on her breast.
Protopic and Elidel belong to a class of drugs known as calcineurin inhibitors, so called because they reduce immune activity by inhibiting the activity of the enzyme calcineurin in organ transplant patients. Use of these drugs has long been known to increase the risk of cancer, and the drugs were labeled accordingly for use in transplant patients.
Protopic and Elidel have only been on the market for about 5 years and together have already been prescribed to more than 7 million people. In 2006, the FDA added a black box warning to the skin creams about the cancer risk.
On February 21, 2007, Tom Moore, the author of several books on the pharmaceutical industry, told CBS News that he had studied about 1,200 cases of suspected injuries pertaining to Protopic and Elidel reported to the FDA through 2005 and found more than 100 potential cancer cases in children and adults, with most involving lymphoma or skin cancer.
Sunday, April 15, 2007
A Brief History of Diagnostic Trends:Of course, who are we to be surprised that mental diseases rise and fall with the fashion of new drugs on the market?
When benzos were the big drugs, everyone had anxiety.
When the SSRI era was born, depression was the disease of the day.
When depression was saturated, the move was on to raise awareness about social anxiety, generalized anxiety, PTSD, etc, as the SSRIs still had patent life to spare, and hence markets to conquer.
The new frontiers are depression with pain, for which Cymbalta is allegedly the drug of choice (despite rather meager supportive evidence), and bipolar, for which Seroquel, Abilify, Zyprexa, and Risperdal/Invega have already made significant inroads.
Lilly cleverly tried to expand the bipolar market with the Viva Zyprexa and Zyprexa Limitless campaigns, but it was just the first step in a much larger campaign.
We have this comment from someone in the business, entitled FareWell Depression
Write this day down: 4/4/07, it is the first day of the new psychiatry. Everything changes, starting today.And right on time is this story in the NY Times
Today, in the New England Journal Of Medicine, is an article ostensibly about the lack of additional benefit from adding an antidepressant to a mood stabilizer. This is both surprising and not surprising: surprising, because, well, you'd think two drugs would be better than one. Not surprising because, well, if the first drug worked, why would a second even be necessary? (See #8). And if the first didn't work, how do you know the improvement didn't come entirely from the second drug?
If this is all the article said, it would not be worthy of mention, let alone the herald of a new dynasty.
The study also found that the studied antidepressants did not induce mania. That this should have been prima facie obvious even to a 9 year old without the benefit of eyes (what's an antidepressant? They're not all chemically similar, so why should they all be blamed for the same side effects?) isn't the point here. [...]
Psychiatry is not about science, it is about language, politics. What's happened here is that "mood stabilizer" now includes atypical antipsychotics; and-- compare what the study was designed to show and what they spun it to show-- we've gone from "polypharmacy is not better" to "monotherapy with mood stabilizers [read: antipsychotics] is just as good as two drugs at once."
There's a subtlety there, and that subtlety is magnificent.[...]
What the article is saying is that academic psychiatrists are no longer behind antidepressants and antiepileptics. SSRI and SNRI use will decline from here, as will Depakote. They're behind antispychotics. And antipsychotic use is positioned to explode.
But without academics pushing SSRIs, their use will wane--and, importantly, so will their support of the diagnosis "Major Depression." This is going to sound controversial, inane, but it will happen.
Look for upcoming articles finding that "Depression" is overdiagnosed, that it is really just-- life. Look for articles that now find SSRIs aren't that effective after all, that the old "10% better than placebo" is a statistical trick with little clinical utility. That they are way overused in kids.
You might say, wait, isn't the decline of polypharmacy a good thing; that SSRIs are overused in kids; that they aren't that great; and that depression is overdiagnosed? All of this is true, but this isn't psychiatry finally coming to its senses; this is psychiatry entering the manic phase. Sure, it's less SSRIs for kids; but it's more antipsychotics.
Because simultaneously there will be articles pushing the idea that recurrent unipolar depression is really bipolar depression; that there are common genetic or heritability patterns; that the epidemiology and course is similar, etc.
The move will be to squeeze out MDD into "life" and bipolar. This done, antipsychotics become first line agents. Oh, and look for antipsychotics to get FDA approvals for kids. [...] There's no science here, only a tinkering with language and loyalties, with staggering results.[...]
This isn't psychiatry suddenly waking from a coma, aha! it turns out the existing data do show antipsychotics are mood stabilizers! Instead of using them to replace antiepileptics, they will use them to replace everything: SSRIs, benzos, antiepileptics, stimulants, etc.
And polypharmacy will only be reincarnated-- in the form of multiple simultaneous antipsychotics (Abiliquel, anyone?), with preposterous pharmacologic justifications ("this one acts on serotonin, so it's the antidepressant, and this one on dopamine, so it's the antimanic.") If anyone says that to you, stab them.
You don't get many changes like this, maybe once every ten years-- the last was the beginning of the Depakote era, and before that was the advent of SSRIs, each with it's own erroneous semantics ("kindling model;" "serotonin model of depression.")
I wish all the patients in the world good luck, you'll need it. Not because of the antipsychotics themselves, which will work or not, oblivious to doctor and diagnosis; but because of the doctors, who take little interest in examining the evidence behind their practice, and even less interest in reevaluating its core principles; and who lack the courage to even treat what they see, instead resorting to artificial, and wrong, paradigms and algorithms.
There's not even pseudoscience here. Psychiatry is being lead by the siren call of semiotics, and it is saying, follow me, I am made of words...