Saturday, May 31, 2008

Psychiatrist: I didn't think patient would take murder plot 'literally'

Sounds like the Shrink is either lying, or is an idiot. As seen in NewsDay

[...] Karpf said he viewed White as a friend, and he said he was hurt when White turned him in to police in January 2003 after Karpf revealed a plot to kill people and dump their dismembered bodies in shark-infested waters.

"I didn't feel he would take me literally," Karpf said. "I felt he would take it as it was -- as a fantastic, concocted story. ... It was such a fantastic story, who would believe it?"

Karpf, 55, of Great Neck, testified for a second day Thursday in a medical malpractice suit brought against him by White, 43. White is seeking unspecified monetary compensation.

White was Karpf's patient for more than six years in December 2002, when Karpf said he began sharing details of a plot to commit murder. Talking about the plot was "just an excuse to have this relationship with him," Karpf said.

"I just thought that he would be impressed by the story, by the fact of the life he led," Karpf said, under questioning by White's attorney, Ruth Bernstein, of Manhattan.

"He was the kind of a guy people would be afraid to mess around with." Karpf said he created a list titled, "Motives for Murder," based on something he saw he in a television movie, "The General's Daughter."

Among the "motives" were profit, revenge, humiliation and "homicidal mania," he testified. He said he wrote the list because "I was having a mental breakdown at the time."

He said he did not remember whether he showed the list to White. After learning of the plot, White called police and cooperated with their investigation.

Karpf acknowledged that he asked White for help to buy a gun, a silencer, ammunition, an axe, cleaning supplies and a van. He said he drove with White on Jan. 8, 2003, to a bank to withdraw money. Later that day, they met with an undercover officer posing as a gun dealer, Karpf said. Police said Karpf was arrested after paying the officer $1,600 for a gun, silencer and ammunition.

Karpf pleaded guilty in 2004 to third-degree criminal possession of a weapon and was sentenced to three months in jail, time he already had served. He surrendered his medical license after his guilty plea. Karpf said he didn't need White's help to purchase a weapon.

[...]

After his arrest, Karpf said, he was hurt "by the fact that he [White] got the police involved."

Thursday, May 29, 2008

Psychiatrist indicted on two counts of statutory rape

From the Crossville Chronicle

A Cookeville psychiatrist who had an office in Crossville has been indicted by the Cumberland County Grand Jury on two counts of statutory rape by an authority figure, according to the Cumberland County Sheriff's Department.

Dr. Chip Hayward Fountain, 44, was indicted by the grand jury on May 6 after "a thorough investigation" by the Department of Children's Services, District Attorney General's Office and the sheriff's department. Fountain surrendered to authorities at the Justice Center on May 27.

A press release states that Fountain, who in addition to Cookeville and Crossville, had an office in Livingston, is accused of "being sexually involved with a former juvenile female patient."

Bond was set at $15,000 and Fountain is scheduled to appear for arraignment in Cumberland County Criminal Court on June 2, according to Investigator Jeff Slayton's release.

Fountain graduated from Texas Tech University Health Service Center School for Medicine in the late 1990s.

Since two-year-old children are naturally calm and attentive, the playful and unruly ones are starting to receive ADHD drugs

We have this report from Australia

Toddlers as young as two are being diagnosed with ADHD and prescribed drugs including Ritalin.

Figures obtained by The Daily Telegraph reveal 311 children in NSW aged five and under depend on controversial medication, including 58 four-year-olds and 13 three-year-olds.

Health Department figures show that, nationally, doctors have prescribed ADHD drugs to five toddlers aged only two, despite possible side effects.

The mother of one four-year-old who has been on Ritalin since the age of three said she knew there could be long-term effects but the change in her son's behaviour was worth the risk.

"At first I was hoping he didn't have ADHD and I didn't want to put him on medication but I thought I should give it a go and there has been a big improvement," the single mother of two told The Daily Telegraph.

But the disturbing figures tell only part of the story.

They cover scripts subsidised under the Pharmaceutical Benefits Scheme - only a proportion of the young children on ADHD drugs.

With Australia's ADHD rates among the highest in the world, the federal Department of Health said prescriptions paid for without PBS subsidies "are a significant portion of the total scripts".

It has no corresponding data for them.

The most widely prescribed drugs for the youngest children, according to the figures to March this year, continue to be Ritalin and the longer-lasting associated drug, Concerta, which was added to the PBS last year.

Dexamphetamine is the next most popular while Strattera, a longer-lasting non-stimulant, is less popular and prescribed mainly for children aged six and older.

As well as the three and four-year-olds, there are 240 five-year-olds on subsidised ADHD drugs in NSW. There are 6692 6- to 10-year-olds, 9006 11- to 15-year-old and 2584 16- to 18-year-olds.

The figures follow the State Government's ADHD review which found there was no overprescribing of drugs.

But child psychiatrist Jon Jureidini said he was disappointed at the number of preschoolers on the list.

"I would be confident that they (the drugs) are being inappropriately used in most cases of preschool children," Dr Jureidini said.

"ADHD is not a good explanation for putting these children on drugs.

"I have seen children of that age displaying very disturbed behaviour but it is usually a medical problem or significant family circumstances that are undermining their well-being."

However paediatrician Dr Michael Kohn, the treating doctor for the four-year-old, said he was not surprised at the number of children on ADHD medication.

Dr Kohn, a senior staff specialist in paediatrics at The Children's Hospital at Westmead, said the prescribing of ADHD drugs to children aged four and less was strictly controlled in NSW.

Specialists needed the permission of the state's Stimulant's Committee with the committee having to meet on each individual case.

Attorney: Ex-patient feels threatened by psychiatrist

A report out of New York State, as seen in Newsday

Richard Karpf was bullied as a child and kicked out of his apartment by roommates while attending a Mexican medical school.

Dennis White started having panic attacks when he was 6 and suffered from sleep disorders and depression as an adult.

Their lives crossed in 1996 when Karpf became White's psychiatrist. Six years later, White called police and said Karpf had revealed a plot to kill people and feed their dismembered bodies to sharks.

Yesterday, the two men met again as White's medical malpractice trial against Karpf opened in State Supreme Court in Mineola.

In opening arguments, lawyers debated whether White remains psychologically damaged after, he told police, Karpf asked him to help purchase a gun with a silencer. White, 43, suffers from post-traumatic stress disorder from the incident and is still afraid of Karpf, said his attorney, Ruth Bernstein of Manhattan.

"Dennis believes every day of his life that the defendant is still coming after him," Bernstein said.

Karpf, 55, pleaded guilty to third-degree criminal possession of a weapon in 2004 and was sentenced to three months in jail, time he already had served. He is on probation through next year.

After White contacted police, they arranged for Karpf to meet an undercover officer, whom Karpf paid $1,600 for a .22-caliber semi-automatic handgun, a silencer and boxes of ammunition in the parking lot of the Westbury Home Depot.

Karpf, who surrendered his medical license after pleading guilty, insisted that the plot was a fantasy and he had no intention of carrying it out.

Karpf's attorney, CaraMia Hart of Manhattan, conceded that he told White of a "completely inappropriate plan" to commit murder and he was "appropriately" prosecuted. But she questioned whether White suffers more now than he did six years ago. "Was Dennis White hospitalized at any point? Rendered incapable of working?" Hart said.

Since Karpf's arrest, White has married and become a father, she said.

Bernstein said Karpf's patients did not know he suffered a "lifelong mental illness" while he continued to practice at his Garden City office.

"This very sick man had a license to practice medicine," she said. "How would anyone know that he was spiraling downward?"

On Dec. 26, 2002, she said, White walked into Karpf's office and found him "disheveled." Karpf asked White, a mechanic, to help him buy a car and a boat. Later, Karpf asked White about buying a gun and finding shark-infested waters. "Dennis was starting to think there was something very wrong," she said.

Tuesday, May 27, 2008

New And Improved Drugs? No Thanks

As seen on CNN Money

New York psychiatrist Jeffrey Lieberman has heard Johnson & Johnson's (JNJ) sales pitch for the new anti-schizophrenia drug Invega, but he's not too impressed.

Problem is, Invega isn't much different than one of J&J's best-selling drugs, the antipsychotic Risperdal. In late June, Risperdal is scheduled to lose its U.S. patent protection, clearing the way for competing generic copies that are cheaper than Invega, which could further diminish Invega sales, already characterized as a disappointment by J&J.

"I don't think they have a strong case to make," says Lieberman, chairman of the psychiatry department at Columbia University's medical school. "It's basically a me-too drug, and the company hasn't done the studies that would be required to really distinguish it."

Lieberman's skepticism is shared by health insurers and points to a rising challenge for drug makers: a tougher market for so-called follow-on drugs. As a result, some companies - including Wyeth (WYE) and Shire PLC (SHPGY) - are setting prices lower or emphasizing improved dosing for the newer drugs to help overcome any skepticism that they're not much more effective than the older drugs set to lose patent protection.

The growing disdain for follow-on drugs also should reinforce the need for drug makers to come up with truly innovative products, not just marginally better ones, industry watchers say.

Drug companies have used follow-on drugs to try to offset some of the revenue lost when older, top-selling drugs lose patent protection and become exposed to generic knockoffs. The goal is to convince patients, doctors and drug plans to switch to the newer drug that carries a brand-name price and patent protection for years.

A successful example was AstraZeneca PLC's (AZN) promotion of the Nexium heartburn pill when its older drug, Prilosec, became exposed to U.S. generic competition in 2002. Nexium went on to become a huge blockbuster despite being chemically similar to Prilosec, which became available as both a cheaper generic and over-the-counter product.

Such tactics, however, might not work as well in today's environment, in which drug-benefit plans are demanding steeper discounts and pushing use of generic drugs in order to lower costs and bolster profit margins.

"We don't think those opportunities are really going to fly," Deutsche Bank pharmaceutical analyst Barbara Ryan said. "I think managed-care sees them for what they are, extending the franchise."

The skepticism around Invega has contributed to a financial disappointment for J&J. The New Brunswick, N.J., healthcare giant hasn't broken out Invega sales but acknowledges they've been below expectations. Invega's share of U.S. antipsychotic prescriptions was only around 2% for the week ended May 9, according to Verispan, a drug-data marketer. In comparison, Risperdal, which had 2007 sales of more than $4 billion, held a 21% market share.

Insurer Pressure

Some insurers aren't putting certain follow-on drugs on their lists of preferred drugs, or they're requiring members to pay higher out-of-pocket costs for these drugs than for other branded and generics.

"It's a marketing scheme that is not looking at improving healthcare, it's looking at maintaining their revenues coming in," said Mirta Millares, in commenting on the industry's follow-on drug strategy.

Millares is manager of drug information services at Kaiser Permanente, a California health insurer that doesn't include Invega on its list of preferred drugs. The active ingredient of Invega is derived from that of Risperdal, Millares noted, though it was different enough to get a new patent and regulatory approval.

Minneapolis-based UnitedHealth Group Inc. (UNH), the nation's largest health insurer by revenue, has Invega on the "third tier" of its preferred drug list, which means members have to pay higher copays than if they were to use other schizophrenia drugs on the first and second tiers. The insurer deemed Invega clinically similar to other atypical antipsychotics.

Clinical studies supporting Invega's December 2006 Food and Drug Administration approval primarily compared it with a fake drug, or placebo, but not with Risperdal. In 2007, J&J released data showing Invega improved symptoms over AstraZeneca's Seroquel antipsychotic, which is the market leader for U.S. antipsychotic prescriptions. Also, J&J touts Invega's long-acting formulation and once-daily dosing.

J&J says it's not encouraging patients who are stable on Risperdal to switch to Invega. But it had hoped for Invega's performance to be better by now, making Risperdal's loss of U.S. market exclusivity next month less painful. "We need to do a better job at drawing a differentiation in a difficult-to-treat population, " David Norton, J&J's group chairman of pharmaceuticals, said earlier this month.

Norton said J&J should have ensured Invega had more favorable coverage by drug plans at the time of market launch. Still, he noted that new antipsychotics have historically taken a while to gain acceptance.

J&J has said it plans to seek FDA approval for Invega as a treatment for bipolar disorder, which could bolster sales. It also has applied for FDA approval of a long-acting, injectable version of Invega.

New Marketing Strategies

Despite the challenges, drug-company marketing remains a powerful tool, and it might be too early to write off follow-on campaigns such as that for Invega. The real test may come when Risperdal goes off patent, and J&J reduces its active promotion of Risperdal, leaving sales reps to focus on Invega.

"There are plenty of studies showing physicians are susceptible to marketing practices in their prescribing patterns," said Aaron Kesselheim, an instructor in medicine at Harvard Medical School who researches drug marketing. "My perception is that hasn't changed substantially."

A new marketing campaign that might be meeting with more success is underway at Shire, Basingstoke, U.K., which last year began selling a new drug for attention deficit hyperactivity disorder, Vyvanse. Shire's top drug, Adderall XR for ADHD, will face generic competition beginning next year.

So far, Vyvanse has captured about 7% of U.S. ADHD drug prescriptions, according to Verispan, which Chief Executive Matthew Emmens calls good progress. Although Shire recently said it expected 2008 Vyvanse sales to come in at the lower end of its forecast range of $350 million to $400 million, Emmens said in an interview he was confident that Vyvanse's market share will eventually surpass Adderall XR's peak market share of about 26%.

Emmens noted that Vyvanse is a different chemical entity than Adderall XR, and he thinks its pricing is attractive to health insurers. "In a general nature, the market has become more price sensitive in the last 10 years," he said. Not incidentally, in the 1990s, Emmens headed the AstraZeneca partnership with Merck & Co. (MRK) that marketed Prilosec and he was involved in the planning for Nexium's marketing.

The next test of the drug-switch campaign?

Wyeth, Madison, N.J., recently began selling Pristiq, an antidepressant that is chemically similar to Wyeth's older antidepressant Effexor XR, which is expected to face limited generic competition this year. Deutsche Bank's Ryan thinks the odds of Pristiq's success are slim because it appears to offer few benefits beyond those of Effexor.

Wyeth has said Pristiq is effective at treating depression, offers a convenient dose regimen for most patients, and is being priced at a 20% discount to Effexor.

Monday, May 26, 2008

State police seize documents from Massachusetts "shock" school

The Judge Rotenberg Educational Center in Canton, Massachusetts is an institution that has long earned our distaste and disdain. So news of a search with a search warrant is most welcome. As reported in the Boston Globe earlier this month

State Police seized documents late last week from the offices of the Judge Rotenberg Educational Center in Canton that are related to a prank phone call last summer that led two students to wrongfully receive dozens of punishing electrical shocks, according to two people with direct knowledge of the investigation.

The collection of evidence has to do with a yearlong grand jury investigation led by the office of Attorney General Martha Coakley, said Kenneth Mollins, a New York lawyer who has filed several lawsuits against the school and who said he spoke to a representative of Coakley's office about the Rotenberg investigation. Mollins said he was told the grand jury is also examining possible financial improprieties by the school.

The second source, who works for the state and asked to remain nameless because this person is not authorized to speak about grand jury proceedings, said State Police investigators came with a search warrant and left with boxes of documents. The source said the investigation had an ambitious scope and involves multiple government agencies.

Reached last night, Ernest Corrigan, a spokesman for the school, did not confirm that a seizure of documents had occurred last week. He said only that school officials have been cooperative with state and local police ever since they reported the prank phone call to police last summer.

"We've been supportive of the investigation," he said.

A spokesman for Coakley declined to comment, saying the office never confirms or denies an ongoing investigation.

The special-education school, which serves about 250 adults and children from across the country with emotional and behavioral problems, has been the target of numerous government investigations related to its unorthodox behavior-modification methods, including skin-shock treatments to deter inappropriate behavior. Rotenberg officials, who have weathered two attempts by Massachusetts officials to close the center, have defended its treatment methods as effective for some students.

School officials have also said they have instituted numerous safeguards to prevent a repeat of the Aug. 26 incident, in which two emotionally disturbed students wrongfully received dozens of electrical shocks based on instructions from a caller posing as a supervisor. The incident was caught on 24-hour surveillance tapes, which were shown to investigators last summer. The tapes were subsequently destroyed by school officials, even though investigators had instructed them to preserve the tapes.

After hearing about the destruction of the tapes, Senator Brian A. Joyce, a Democrat from Milton who has sought to ban shock therapy at the school, said he intended to ask the attorney general's office to look into the matter.

Psychiatrist Pleads Not Guilty To Murder

As covered widely in the Australian press, and as seen in the Australian

A FORMER NSW psychiatrist has pleaded not guilty to the shooting murder of South Australia's former mental health chief, Margaret Tobin, in 2002.
Appearing in the South Australian Supreme Court today, Jean Eric Gassy, 52, declared emphatically he was not guilty when asked to plead to the murder charge.

Dr Tobin was fatally shot as she walked from a lift on the eighth floor of an inner-city office building in Adelaide in October 2002.

She was 50 years old.

Justice Trish Kelly said the trial would be listed for hearing at the earliest opportunity.

Dr Tobin's widower, Don Scott, said outside court the day had been an emotional one for him.

Mr Scott said he would attend the trial, even though it might bring back “horrific” memories for him.

Representing himself, Mr Gassy was remanded in custody for a directions hearing in two weeks.

He flagged his intention to apply for a “suppression order” from the court, but Justice Trish Kelly suggested he raise it at the directions hearing.

Prosecutor Peter Brebner QC asked the court for more time to prepare the Crown case, because of the large number of witnesses expected to be called.

“Checking their availability will take quite some time,” Mr Brebner said.
As noted in this news item from Adelaide Now, this is a re-trial, due to the original conviction being overturned due to technical errors by the Judge in the case.
A Supreme Court judge has told prosecutors that the retrial of the man once convicted of the shooting murder of Dr Margaret Tobin should be held as soon as possible.

Justice Trish Kelly today said that a retrial for Jean Eric Gassy should be held as soon as possible.

"From the court's point of view, this matter should proceed in August," Justice Kelly said.

Gassy, 51, today pleaded not guilty to murder and plans to represent himself at trial.

The former Sydney psychiatrist was jailed for life with a 34-year non parole period for the shooting murder of Dr Tobin in October 2002.

Dr Tobin, then South Australia's mental health chief, was shot four times as she walked from a lift at her city office building.

Earlier this month, the High Court of Australia overturned Gassy's murder conviction and sentence.

The High Court found that Supreme Court Judge Ann Vanstone had erred in her directions to the jury during their deliberations in Gassy's original trial.

Prosecutor Peter Brebner QC said more than 160 witnesses were likely to be called when the matter again goes to trial.

Dr Tobin's widower Don Scott attended this morning's hearing, which lasted a little over two minutes.

Gassy will be back in court in June, when another judge will set a date for the trial.

Doctors charged with defrauding national insurance

We have this report from the Israeli newspaper Ha-aretz

Two physicians were indicted yesterday in the Rishon Letzion Magistrate's Court for repeatedly defrauding the National Insurance Institute between 2000 and 2007.

Dr. David Adivi, an orthopedist at Wolfson Medical Center in Holon, stands accused of taking bribes and breach of trust.

Dr. Mark Zeevin, the Health Ministry's district psychiatrist, is charged with providing false certificates and other counts of attempted fraud.

According to the charge sheet, Adivi, 64, from Rishon Letzion, received envelopes containing between NIS 500 and NIS 1,000 in cash, plus a coffee machine, from Yosef Tzemach. In exchange, he instructed various associates of Tzemach's on how to obtain disabled status from the NII. He also allegedly made sure that he sat on the disability committees before which Tzemach's associates appeared.

Zeevin allegedly took money from various people in exchange for fake psychiatric opinions that declared the recipients disabled. Tzemach was also indicted in January for advising people to increase their life insurance and disability policies and then staging accidents so they could receive the insurance money. He mediated between these individuals and five doctors, including Adivi and Zeevin, who produced false medical documents.

[...]

Sunday, May 25, 2008

More Psychiatrist Jokes

(Be sure to check out our full collection of Psychiatrist Jokes)

Some more jokes about Psychiatrists:



A psychiatrist met a friend and exclaimed, "I heard you died. "

"But you see I'm alive ," smiled the friend.

"Impossible," said the psychiatrist. "The man who told me is much more reliable than you. "
Two psychiatrists meet at their twentieth college reunion. One of them looks like he just graduated, while the other psychiatrist looks old, worried and withered.

The older looking one asks the other, "What's your secret? Listening to other people's problems every day, all day long, for years on end, has made an old man of me."

The younger looking one replies, "Who listens?"
A man who thinks he's George Washington has been seeing a psychiatrist.

He finishes up one session by telling him, "Tomorrow, we'll cross the Delaware and surprise them when they least expect it."

As soon as he's gone, the psychiatrist picks up the phone and says, "King George, this is Benedict Arnold. I have the plans."
Psychiatrist to his nurse: "Just say we're very busy. Don't keep saying 'It's a madhouse.'"
FBI agents conducted a "search and seizure" at the Southwood Psychiatric Hospital in San Diego, which was under investigation for medical insurance fraud. After hours of poring over many rooms of financial records, some sixty FBI agents worked up quite an appetite. The case agent in charge of the investigation called a local pizza parlor with delivery service to order a quick dinner for his colleagues. (verified true by Snopes)

The following telephone conversation took place:
Agent: Hello. I would like to order nineteen large pizzas and sixty-seven cans of soda.

Pizza man: And where would you like them delivered?

Agent: To the Southwood Psychiatric Hospital.

Pizza man: To the psychiatric hospital?

Agent: That's right. I'm an FBI agent.

Pizza man: You're an FBI agent?

Agent: That's correct. Just about everybody here is.

Pizza man: And you're at the psychiatric hospital?

Agent: That's correct. And make sure you don't go through the front doors. We have them locked. You'll have to go around to the back to the service entrance to deliver the pizzas.

Pizza man: And you say you're all FBI agents?

Agent: That's right. How soon can you have them here?

Pizza man: And you're over at Southwood?

Agent: That's right. How soon can you have them here?

Pizza man: And everyone at Southwood is an FBI agent?

Agent: That's right. We've been here all day and we're starving.

Pizza man: How are you going to pay for this?

Agent: I have my check book right here.

Pizza man: And you are all FBI agents?

Agent: That's right, everyone here is an FBI agent. Can you remember to bring the pizzas and sodas to the service entrance in the rear? We have the front doors locked.

Pizza man: I don't think so.
Click.

Child psychiatrist trial postponed

As reported in the Palo Alto Daily News

The upcoming trial of Dr. William Ayres, the prominent San Mateo child psychiatrist facing allegations he molested seven pre-adolescent patients, has once again been postponed.

The jury trial, which was scheduled for June 23, won't take place until at least the end of July, San Mateo County prosecutors said Friday.

The ongoing drama behind the delay revolves around a defense motion to suppress all evidence acquired by search warrants that gave investigators access to Ayres' patient files. A Superior Court judge heard arguments Friday on the motion from both the prosecution and the defense, but he postponed a final decision until July 23, Chief Deputy District Attorney Steve Wagstaffe said.

The motion potentially could handicap the prosecution's case, because each of the seven men who claim they were abused by the psychiatrist initially came to the attention of law enforcement through those patient records.

The defense motion calls on Judge Norman Gatzert to suppress evidence gathered from Ayres' patient files by charging that search warrants lacked probable cause and violated the state's psychotherapist-patient privilege.

The judge ultimately denied the defense contention that the warrants lacked probable cause but postponed ruling on whether the warrants violated the state's psychotherapist-patient privilege.

Defense attorney Doron Weinberg did not immediately return calls for comment Friday, but Wagstaffe said, "We are certainly very pleased that the court denied the first aspect of the motion, and we believe we put on sufficient evidence for him to deny the second part."

Should the judge sustain the second part of the motion, the prosecution could potentially lose the entire case against Ayres, Wagstaffe said.

The search warrant enabled authorities to confiscate files for some 800 of Ayres' former patients and contact those treated by Ayres since 1988 who were between the ages of 11 and 17 at the time. Investigators relied on the warrant to find seven men who claim they were abused by the psychiatrist.

Officials with the District Attorney's Office said they have spoken to several dozen men who claim they were abused by Ayres. But only seven fall within the state's statute of limitations on molestation crimes, which requires that charges be brought before the accuser turns 29 or that the alleged crime occurred after Jan. 1, 1988.

Many of Ayres' alleged victims appeared in court Friday to witness the hearing against the child psychiatrist, Wagstaffe said. Few victims were present during a December hearing when the defense first argued its motion before Superior Court Judge John Runde, the same magistrate who authorized the search warrant in 2006.

Runde summarily dismissed both defense arguments during that hearing, but a state appeals court ruled in March that the Superior Court judge didn't offer the defense a proper hearing and ordered him to hear the defense arguments in their entirety.

The court reassigned the case to Judge Gatzert on Friday, because Runde retired in December.

The judge is expected to rule on the second aspect of the defense motion and set a new trial date on July 23.

Thursday, May 22, 2008

Internet Addiction, Gaming, Porn, And Chat As The Mental Illnesses of the Future

A psychologist has an appropriately cynical view on the new world of Internet Addiction

Psychiatrists Do Not Know What Normal Sex Is.

Psychiatrists are trying to define what normal sex is for the next edition of the DSM, but will probably wind up making everything a for-profit treatable condition that be be treated with a pill.

As Seen on MSNBC

This month the American Psychiatric Association announced the names of “working group” members who will guide the development of the new Diagnostic and Statistical Manual of Mental Disorders, or DSM, the codex of American psychiatry.

Not surprisingly, given the DSM’s colorful history, particularly when it comes to sex, controversy erupted within days of the announcement, especially over membership of the Sexual and Gender Identity Disorders working group, which will wrestle with questions such as:
  • Are sadomasochism or pedophilia mental disorders?
  • Are dysfunctions like female hypoactive sexual desire disorder (low sex drive) psychiatric issues, or hormonal issues?
Perhaps the most important question is whether, when it comes to many sexual interests and issues, it’s even possible or desirable to create diagnostic criteria.

At least one petition, spearheaded by transgender activists, is being circulated to oppose the appointment of some members to the Sexual and Gender Identity Disorders work group and its chair, Kenneth Zucker, head of the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto, Canada. The petition accuses Zucker of having engaged in “junk science” and promoting “hurtful theories” during his career, especially advocating the idea that children who are unambiguously male or female anatomically, but seem confused about their gender identity, can be treated by encouraging gender expression in line with their anatomy.

Zucker rejects the junk-science charge, saying that there “has to be an empirical basis to modify anything” in the DSM. As for hurting people, “in my own career, my primary motivation in working with children, adolescents and families is to help them with the distress and suffering they are experiencing, whatever the reasons they are having these struggles. I want to help people feel better about themselves, not hurt them.”

That sex is controversial comes as no surprise to Dr. Darrel Regier, the vice-chair of the APA’s DSM-V Task Force, based in Arlington, Va.

Sex, he says, in an understatement, “is an area that obviously has lots of emotion attached to it.” But the APA, he says, is doing its best to put science and evidence first, both in who it appoints to working groups and in the process it will use to create the DSM-V (so called because it is the fifth complete version). Each working group will accept input from many experts with varying views, reach a consensus on DSM content, and then put that work group’s product before the board of trustees of the APA and the APA assembly.

All that may be true, but Regier does not expect such reassurances to quell the forces already swirling around the DSM-V as it moves toward a 2012 publication date. Currently, the DSM-IV includes sex-related activities as varied as paraphilias like voyeurism, klismaphilia (erotic use of enemas) and sadism, and functional disorders like dyspareunia (pain with intercourse), erectile disorders and premature ejaculation.

'A set of scientific hypotheses'

The first DSM was issued in 1952. The idea was to create a more standardized way of talking about psychiatric disorders. As psychiatrist Dr. Gail Saltz, a TODAY Show contributor who also practices in New York, explains, the DSM is best viewed as “a language we have chosen to speak, a talking point we mental health professionals have created to communicate as well as we can with each other and with other professions.”

It is not a final arbiter of who’s crazy and who’s not. Saltz, who says she thinks the DSM can be limiting in clinical practice, prefers to take a holistic approach and look at each patient’s collection of symptoms and concerns without being restricted by the DSM’s various criteria.

Regier agrees that’s how doctors should use it, arguing that the DSM “really needs to be seen as a set of scientific hypotheses.” It is, he believes, “a living document” changeable with new research.

But if the DSM is a book of “hypotheses,” why the fuss? Does the DSM matter?

Yes. A lot.

The first reason why is prosaic. If you want your insurance to reimburse your visit to a mental health professional, you are probably going to need a DSM code signifying a diagnosis.

But the more profound reason is that it shapes how doctors, even the rest of rest of society, view sexuality.

“A psychiatric diagnosis is more than shorthand to facilitate communication among professionals or to standardize research parameters,” wrote Dr. Charles Moser and Peggy Kleinplatz in a 2005 paper published in the Journal of Psychology and Human Sexuality.
“Psychiatric diagnoses affect child custody decisions, self-esteem, whether individuals are hired or fired, receive security clearances, or have other rights and privileges curtailed. Criminals may find that their sentences are either mitigated or enhanced as a direct result of their diagnoses.

The equating of unusual sexual interests with psychiatric diagnoses has been used to justify the oppression of sexual minorities and to serve political agendas. A review of this area is not only a scientific issue, but also a human rights issue.”


A problem for whom?


There is no shortage of opinion on what ought to be changed, deleted or included in the new DSM-V. Sandra Leiblum, formerly a professor at New Jersey’s Robert Wood Johnson Medical School and an expert in female sexual health who is now in private practice in Bridgewater, N.J., says she wants to see a revision of diagnoses of female hypoactive sexual desire disorder, other female arousal disorders and sexual pain like dyspareunia. For example, she wants language that would separate arousal disorders into genital (more biological in origin) and subjective subtypes.

Carol Queen, a sexologist, sexual rights activist and co-founder of San Francisco’s Center for Sex and Culture, believes the new DSM should stress that sexual variances are only a problem “if they are problems in the life of the person showing up” in a psychiatrist’s office “so that when somebody is eroticizing something, or doing something in a consensual way, that’s not a problem” even if it may seem odd to most of us.

She also proposes an addition, a diagnosis of “absexual” (“ab” meaning “away from”). This would include those who appear to be “turned on by fulminating against it.” Examples could include state governors who crusade against prostitution even while paying hookers for sex, and religious leaders who wind up trying to explain engaging in the sex acts they preach against.

Moser, who is affiliated with the Institute for Advanced Study of Human Sexuality in San Francisco, and Kleinplatz, from the University of Ottawa, argue that all paraphilias, like sexual sadism, sexual masochism, transvestism, should be removed from the DSM, insisting that “the DSM criteria for diagnosis of unusual sexual interests as pathological rests on a series of unproven and more importantly, untested assumptions.”

This does not mean, as opponents of this idea have suggested, that they somehow approve of sex between adults and children. “We would argue that the removal of pedophilia from the DSM would focus attention on the criminal aspect of these acts, and not allow the perpetrators to claim mental illness as a defense or use it to mitigate responsibility for their crimes," they wrote. "Individuals convicted of these crimes should be punished as provided by the laws in the jurisdiction in which the crime occurred.”

Most of these suggestions are inherently political, as much as the APA and most psychiatrists would wish to avoid politics. Sex exists as part of the culture, and it cannot be separated from it.

The DSM has reflected cultural shifts through its revisions and new editions. The most famous example is homosexuality. When the first DSM was created in 1952, homosexuality was declared a mental illness. By 1973, and after much heated debate and over objections from religious conservatives, the DSM-II excluded homosexuality as a disorder with the exception of one variant, and that was soon dropped in an interim revision.

Once deviant, now desirable

“Definitely a change in culture affects diagnoses,” Leiblum says. “We used to think oral-genital sex was deviant and we have embraced that. Masturbation was evidence of out-of-control behavior, now we see it as not only normative but to be encouraged.”

So if enough people start to do it, or are more public about doing it, does that mean it is no longer a disorder? “I think it probably affects the degree to which people are willing to look at scientific evidence,” Regier says.

This fuzziness is why, starting in the 1980s, the field moved toward adding the notion of “distress” to the DSM.

“We do not consider something a disorder unless there is a clearly defined description of this entity and there is clearly some significant dysfunction and distress associated with it,” explains Regier. “I would say also if there is no victim involved … this behavior is not imposing a person’s will on another person, that is a critical component when one looks at conditions in this area.”

If you aren’t distressed, and everyone is a consenting grown-up, then there probably isn’t a disorder. But things won’t be that simple for the creators of the new DSM.

“How do you make a criteria that does not pathologize low desire?” Leiblum asks rhetorically. You add the need to be distressed about it. “But then whose distress should be looked at?” she asks, referring to a sexual partner. “You can have hypertension and not feel any distress because there is objective criteria for what is high blood pressure. But there is none of that for sexual diagnoses, even premature ejaculation. What constitutes premature?”

(At a press conference Monday, the International Society of Sexual Medicine made a stab at a definition, saying premature ejaculation is "a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.”)

This problematic lack of clarity, Leiblum argues, is especially acute for the paraphilias. Does the criteria amount to “If it’s mine it’s OK, but if it’s yours it’s kinky? These issues need to be grappled with.”

Tuesday, May 20, 2008

Patient's suicide raises questions about psychiatrist's ethics

As reported in the Pioneer Press

When people enter drug studies at the University of Minnesota, they're supposed to be protected by a safety net keeping watch that the vulnerable are not coerced, that standards of conduct are met and that researchers aren't tangled in conflicts that might influence their decision-making.

That system was supposed to protect Dan Markingson.

A schizophrenic, Markingson killed himself in 2004 while enrolled in a study at the U comparing anti-psychotic drugs. Documents surfacing the past year in a lawsuit over his death have raised questions about whether the U psychiatrist running the study followed university ethical guidelines. They also raise questions about why the Institutional Review Board, the internal group charged with protecting people in university studies, didn't intervene.

University officials say their nationally accredited review board — a volunteer panel of 57 experts in medicine and other disciplines — works well and rigorously reviews studies. They would not talk specifically about the Markingson case to the Pioneer Press. A judge ruled in February that as a state agency, the university and its IRB are immune from the lawsuit.

The legal ruling didn't allow questions to be explored about who's ultimately responsible for the safety of research subjects and whether the university did everything reasonable to protect Markingson from harm.

According to the U's human subjects protection guide, the IRB's first charge is "to protect human subjects involved in research at the university from inappropriate risk."

In reality, the IRB operates largely on trust. Trust that researchers will follow the rules. Trust that people will speak up when a safety plan is violated, even if they have professional or financial pressures to stay quiet.

"It's the people who implement the plan who are responsible for protecting the subjects," said Moira Keane, the U's director of research subjects protection programs.

The IRB approves all clinical research — modifying safety rules when necessary — and samples study records every year or so to make sure its conditions are met. It also has the power to shut down projects that aren't complying with safety requirements or have caused "unexpected serious harm" to subjects.

Keane recalled four studies out of thousands at the U over the past two decades that the IRB stopped.

The lawsuit by Markingson's mother, Mary Weiss, alleged that the IRB's trust was misplaced in the so-called CAFE study, led by Dr. Stephen Olson, a U psychiatrist.

A central allegation was whether Olson had too much power over Markingson, and too many conflicts that obscured his clinical judgment. Olson recruited Markingson into the study at the same time he served as Markingson's treating doctor and advised a Dakota County judge on whether Markingson should be committed to a psychiatric hospital.

Had the IRB followed its own guidelines, it would have discouraged Olson from recruiting his own patient. The IRB Web site states that "doctor-patient relationships between the investigator and participants should be avoided, when possible, to eliminate any power-based coercion."

It's impossible to know whether Markingson would have killed himself if he hadn't enrolled in the research study. He was in a sensitive early stage of his schizophrenia diagnosis, during which the suicide risk is greatest. Even so, the study's rigid guidelines meant that Markingson received only one anti-psychotic drug to help control his delusions.

Experts hired by Weiss' attorneys said in court depositions that the IRB missed opportunities to make the study safer.

Dr. Harrison Pope from Harvard Medical School called the IRB's role an "essential link in the chain of causation that improperly admitted Mr. Markingson into the CAFE study, improperly held Mr. Markingson within the CAFE study, prohibited effective treatment of Mr. Markingson, and thus became a substantial, proximate cause of Mr. Markingson's death."

The IRB could insist researchers turn over all complaints about their studies, which might have raised concerns in this case. Weiss had complained in letters to Olson and Dr. Charles Schulz, head of the U's Department of Psychiatry, that her son wasn't getting better and was at risk for harm. She had requested that the doctors try other treatments, even if he had to be withdrawn from the study.

The U hired its own national IRB expert to refute Pope's claims. The IRB had no legal obligation to require someone other than Olson to evaluate Markingson's competency or his ability to consent to research, said Ernest Prentice, associate vice chancellor at the University of Nebraska Medical Center.

Nor is there a requirement that complaints such as Weiss' letters be forwarded to the IRB unless there is some unanticipated risk. Had the IRB received complaints, it could have investigated, he said.

Weiss said she'd never heard of an IRB.

The CAFE study was fairly prominent, involving 26 academic institutions and 400 schizophrenic patients. Financed by the pharmaceutical company AstraZeneca, it was worth up to $327,000 to the U, with some of those funds going to Olson's salary and other study personnel.

U officials said the IRB acted ethically and within its obligations and federal regulations to protect human subjects in this study.

After the suicide, the IRB sought information from Olson on how Markingson consented to the study. But IRB officials said in depositions for the lawsuit that the review board never formally investigated Markingson's death.

The IRB investigates when there is evidence of misconduct. There was no evidence of that in the Markingson case, said Dr. Richard Bianco, a U physician who oversaw the U's research subjects program at the time Markingson participated in the study.

Bianco declined a Pioneer Press interview request. But in a court deposition, he acknowledged that the U has some 8,000 studies involving humans — research he estimated was worth about $15 million — but that the IRB doesn't track the number of people enrolled in U research, only the number of projects approved.

Bianco agreed with Keane that the IRB system operates largely on self-disclosure by researchers.

The U's top research official says researchers and IRB reviewers "are aware and understand their ethical and moral obligations to do the right thing.

"If people write with concerns and issues, they will be reviewed," said Tim Mulcahy, the U's vice president of research. "If the IRB were to become aware of a suggestion of coercion or heavy handedness," he added, "we have an obligation to act promptly and very directly."

Olson declined to talk to the Pioneer Press about Markingson's care.

He said it would be difficult for any researcher to get away with violating research rules because they are observed by so many medical students, residents, nurses and others. However, a 2006 internal audit of the U's psychiatry department challenges the notion that those workers would speak up.

Nearly 40 percent of the psychiatry department staff responding to the auditor survey said they did not believe they would be protected from retaliation for blowing the whistle on a suspected violation in the department.

Some experts believe the nation's system of review boards is dysfunctional and in need of reform.

"We have a very haphazard way of overseeing (IRBs) and collecting data on adverse events," said Dr. Ezekiel Emanuel, bioethics chair at the Clinical Center of the National Institutes of Health and a national expert on institutional review boards.

"There's no one in America who can tell you how many people are enrolled in clinical research," he said. "No one can tell you how many people died in (ways) attributable to clinical research. No one can tell you how many people got injured, and no one can tell you over time whether the system is getting less safe."

Monday, May 19, 2008

First-ever government review shows fluoride may be toxic to the thyroid gland causing fatigue, weight gain, fuzzy thinking, depression, body pain, etc

Of course, our interest is in the psychiatric malfunctions, and the misdiagnosis of these conditions as actual psychiatric ailments.

As seen in this press release


There is clear evidence that small amounts of fluoride, at or near levels added to U.S. water supplies, present potential risks to the thyroid gland, according to the National Research Council's (NRC) first-ever published review of the fluoride/thyroid literature.(A)

Fluoride, in the form of silicofluorides, injected into 2/3 of U.S. public water supplies, ostensibly to reduce tooth decay, was never safety-tested.(B)

"Many Americans are exposed to fluoride in the ranges associated with thyroid effects, especially for people with iodine deficiency," says Kathleen Thiessen, PhD, co-author of the government-sponsored NRC report. "The recent decline in iodine intake in the U.S could contribute to increased toxicity of fluoride for some individuals," says Thiessen.

"A low level of thyroid hormone can increase the risk of cardiac disease, high cholesterol, depression and, in pregnant woman, decreased intelligence of offspring," said Thiessen.(C)

Common thyroid symptoms include fatigue, weight gain, constipation, fuzzy thinking, low blood pressure, fluid retention, depression, body pain, slow reflexes, and more. It's estimated that 59 million
Americans have thyroid conditions.(D)

Robert Carton, PhD, an environmental scientist who worked for over 30 years for the U.S. government including managing risk assessments on high priority toxic chemicals, says "fluoride has detrimental effects on the thyroid gland of healthy males at 3.5 mg a day. With iodine deficiency, the effect level drops to 0.7 milligrams/day for an average male."(E) (1.0 mg/L fluoride is in most water supplies)

Among many others, the NRC Report cites human studies which show

- fluoride concentrations in thyroids exceeding that found in other soft tissues except kidney

- an association between endemic goiter and fluoride exposure or enamel fluorosis in human populations

- fluoride adversely affects thyroid and parathyroid hormones, which affect bone health

"If you have a thyroid problem, avoiding fluoride may be a good preventive health measure for you," writes Drs' Richard and Karilee Shames in "Thyroid Power."(F).

Over, 1,700 Physicians, Dentists, Scientists, Academics and Environmentalists urge Congress to stop water fluoridation until Congressional hearings are conducted. They cite new scientific evidence that fluoridation is ineffective and has serious health risks. (www.fluorideaction.org/statement.august.2007.html)

Please sign the petition and Congressional letter to support these professionals

www.FluorideAction.Net

References:

(A) "Fluoride in Drinking Water: A Scientific Review of EPA's Standards," Committee on Fluoride in Drinking Water, Board on Environmental Studies and Toxicology, Division on Earth and Life Studies, National Research Council of the National Academies of Science. March 2006 Chapter 8 www.nap.edu/catalog.php?record_id=11571

"Thyroid Function: Fluoride exposure in humans is associated with elevated TSH concentrations, increased goiter prevalence, and altered T4 and T3 concentrations." (Page 262)

"(The thyroid effects are associated with average fluoride intakes that) will be reached by persons with average exposures at fluoride concentrations of 1-4 mg/L in drinking water, especially the children." (Page 260)

(B) Sodium Hexafluorosilicate and Fluorosilicic Acid Review of Toxicological Literature, October 2001
ntp.niehs.nih.gov/ntp/htdocs/Chem_Background/ExSumPDF/Fluorosili ..

(C) Chemical & Engineering News, "Fluoride Risks Are Still A Challenge," by Bette Hileman, September 4, 2006,
pubs.acs.org/cen/government/84/8436gov1.html

(D) Mary Shomon, About.com Thyroid editor, Patient Advocate -- Author of "The Thyroid Diet" and "Living Well With Hypothyroidism"
thyroid.about.com/

(E) Fluoride, "Review of the 2006 National Research Council Report: Fluoride in Drinking Water," July-September 2006, by Robert J. Carton
www.fluorideresearch.org/393/files/FJ2006_v39_n3_p163-172.pdf

(F) Thyroid Power and Feeling Fat Fuzzy or Frazzeled"by Richard Shames MD & Karilee Shames RN, PhD
www.thyroidpower.com
www.feelingfff.com/


Fluoride/Thyroid Health Effects
www.fluoridealert.org/health/thyroid/

Sources of Fluoride
www.fluoridealert.org/f-sources.htm

Sulfuryl Fluoride Pesticide Residues Allowed on Foods
www.fluoridealert.org/pesticides/sulfuryl.f.all.food.html

United States Department of Agriculture (USDA) National Fluoride Database of Selected Beverages and Foods
www.nal.usda.gov/fnic/foodcomp/Data/Fluoride/Fluoride.html




Kontaktinformation:

New York State Coalition Opposed to Fluoridation, Inc

PO Box 263
Old Bethpage, NY 11804

Kontakt-Person:

Phone:
E-mail: e-mail

Web: http://www.orgsites.com/ny/nyscof

Autor:

Nys Cof

e-mail
Web: http://www.orgsites.com/ny/nyscof
Telefon: 5165551212

Saturday, May 17, 2008

A Bit of Fry & Laurie - What Psychiatrists Actually Do

A bit of a Satire on Psychiatrist as seen on You Tube:



As someone said, "Ok... for reals... this is what Therapists actually do."

Friday, May 16, 2008

The psychiatric drug connection to Emo Kids

A report in the Guardian newspaper on the "emo" fad labels it as a cult, but of interest to our regular readers is the connection to psychiatric medications. Specifically, paragraphs 61 through 63 of the story read:

"'I was going through an unhappy period at school," she recalls. 'I grew up in the wealthy area of Cheshunt in Hertfordshire, and I was surrounded by spoilt rich kids. I felt that being an emo gave me a defined individuality.'"

"Looking back, she acknowledges that the 'cult', as she calls it, was heavily linked to self-harm and depression."

"Many of her friends were actually taking prescription antidepressants."
SSRI Stories believes 13 year old suicide victim Hannah Bond (featured in the story) may have ingested antidepressants given to her by her friends. This is a fairly common practice.

Psychiatric Medications Kill Schozphrenic

As reported in the North West Evening Mail

The cumulative effect of two drugs prescribed for schizophrenia killed a 34-year-old Millom man, a coroner has found.

Graham Date, of Trinity Road, died at his parents’ house in Festival Road on September 24 last year.

West Cumbria coroner John Taylor will now pass on concerns raised by Mr Date’s family to his doctor about the cumulative effect of taking Clozapine – an anti-psychotic – and Venlafaxine – an anti-depressant – asking him to let drug authorities know.

Mr Date’s father, Samuel, said at the end of the inquest in Millom: “These two drugs caused the problem and I am bothered that the same thing could happen again.”

At the inquest, Mr Taylor found no evidence that Mr Date, who was on medication to control paranoid schizophrenia, took his own life.

He recorded a verdict of accidental death caused by an overdose of the two drugs.

Samuel Date said in a statement that his son had been in psychiatric care three times in early adulthood following several attempts to take his own life, and was diagnosed with schizophrenia.

Mr Date also told the inquest that his son had back pain which started when he worked as a chef.

He had moved in with his parents in Millom in 2001, before getting his own house about three years ago, and was very close to his family and friends.

Mr Date junior was also excited because he was about to start teaching crafts to people with learning difficulties in Barrow.

He had been staying with his parents for a few days in September while his sister was visiting, and later complained of being constipated and feeling unwell.

On September 24 he was unwell and Mr Date senior told him to go for a lie down. When his mum, Bessie, went to change the bed she thought Mr Date junior looked very unwell and a doctor was called.

Mr Date senior said: “After a couple of minutes, he rolled on to his back and I knew he was dead.

“I carried out mouth-to-mouth resuscitation but it was to no avail. The doctor said he had died of a massive heart attack.”

In a statement, GP Dr Richard Walker said Mr Date junior was in regular contact with the mental health team and the surgery. He was “markedly overweight” but his mental health was stable.

A toxicology report showed that the level of Clozapine in Mr Date’s blood was in excess of what would normally be seen during therapeutic use, while the level of Venlafaxine was “towards the upper range” of what would normally be seen.

Consultant pathologist at West Cumberland Hospital, Dr Mitali Gangopadhyay, concluded that the two drugs used together would have had an additive effect on the central nervous system and that the cause of death was a drugs overdose.


Mr Taylor said: “Everybody’s bodies process drugs differently and some people’s are more effective at getting rid of drugs in the system than others. Sometimes drugs can store in the system for longer than would perhaps be the case for someone else.”

He found that Mr Date’s mental health was relatively well controlled, he was strict about his drug regime and had not shown any thought of harming himself.

He said: “It is quite clear from the pathologist’s report that she didn’t find anything else wrong with him physically, and that in the absence of any other explanation and after taking into account the cumulative effect of the drugs and these drugs taken together, she gives the cause of death as being due to an overdose.

“On that evidence, I’m going to record a verdict of accidental death in that there is doubt that he did take the drugs. Whether or not he took too many, we don’t know, and we can’t be sure whether the drugs in his system had accumulated and were enough to take his life.”

Thursday, May 15, 2008

Board Revokes License for Child Psychologist

In a followup to a long and ongoing case, we have this news item:

The State of Ohio has revoked the medical license of local child psychologist. Doctor Leo D'Souza was indicted by a Hamilton County Grand Jury in February on charges of gross sexual imposition and sexual imposition involving his young patients.

Court documents state the psychiatrist repeatedly fondled one boy in at least six office visits. In another case he is accused of examining an eight-year-old for a sexually transmitted disease. The alleged incidents happened at D'Souza's offices in Milford and Westwood.

The Ohio Medical Board examiner found that Doctor D'Souza failed to conform to minimal standard of care.
See also these earlier stories on this case

Wednesday, May 14, 2008

Psychiatric Drugs are the New Opiate of the Masses.

We stumbled across an interesting post on the Intellectual Conservative political blog, entitled The Hard Truth about a Soft Science: Why Psychology Does More Harm Than Good, starting off with this sentence

If you convince people they’re not responsible for their actions, you’ve set the stage for great evil to occur, as they will be able to justify anything suiting their fancy.
It makes a number of interesting points. While we are not taking sides in terms of politics here, a lot of the observations are spot on, especially as they get to the conclusion of the article.
Yet the implications of this collective sense that we aren’t responsible for our actions and that they can’t be “wrong” anyway go far beyond the resulting social breakdown. They even go beyond the governmental response, which is to step in and control from without people who do not control themselves from within. For the truly scary implication under such a scenario is not just that people will not govern their impulses, but that they cannot do so.

After all, if we are merely organic robots, at the mercy of our genes (hardware), chemistry and upbringing (software), we have no free will. It then follows that we cannot choose among, well, call them what you will, God’s morals or man’s values, as we are directed by things beyond our control. This reduces us to animals. While Christianity teaches that the two things making us like God and separating us from the animal kingdom are intellect and free will – two qualities necessary to be fully human – this idea tells us that, bereft of the second quality, we are mere automatons.

Of course, if Freud et al. are correct, that is all we are, chemicals and water arranged in a most interesting fashion – with a good helping of illusion thrown in for good measure. Thus, insofar as psychology succeeds in convincing us that there is no accountability because there is no free will – no ability to choose sin because there is no sin, only disease – it dehumanizes us.

Perhaps this dehumanization is why psychiatry has quite a history of using humans as guinea pigs. There was Benjamin Rush (the father of American psychiatry) and his bloodletting; Nazi experiments; electric shock and lobotomies; our MK ULTRA mind-control program; and Canadian psychiatrist Heinz Lehmann, who illegally used Thorazine on subjects in the 1950s.
Etc.

Yet another in a number of articles showing the decline of psychiatry.

One last quote:
As to this, I recently read about psychiatrists who are labeling the desire to engage in excessive text messaging a mental disorder. Then there is “Muscle Dysmorphia,” or the obsessive belief that one isn’t muscular enough; “celebriphilia,” the strong desire for amorous relations with a celebrity; “Intermittent Explosive Disorder,” or road rage; “Sibling Rivalry Disorder;” “Mathematics Disorder;” “Caffeine Related Disorder;” and “Expressive Writing disorder,” to cite just a handful of the hundreds of made-up conditions in the DSM. And every time a new variety is conjured up, psychology’s market and earning potential increases. I have to wonder, though, what do they call the obsession with labeling behaviors mental disorders? Some might call it greed.

Yet, as ridiculous as this seems, it’s also very consistent and understandable. Whether a religionist or atheist, one can’t help but notice that these organic robots don’t operate the way most of us would like. The Christian explanation for this is that we’re all sinners, but this is religious terminology and quite inappropriate for a machine. So psychology says we’re all mentally ill; it’s just a malfunction in the CPU, you see. Then, because a machine cannot commit sins but can be “out of order,” it calls them disorders. Thus, a defiant child or employee isn’t ruled by pride but has “Oppositional Disorder,” a person with a lack of gratitude isn’t just that but one who suffers from “Chronic Complaint Disorder,” and a man who is shallow and vain isn’t just that but one plagued by “Muscle Dysmorphia.” So there is a limit to the number of disorders that can be “invented,” and it’s roughly equivalent to the numbers of ways in which people can sin.

This brings us to an irony. In a strange way, this “study of the soul” is aptly named, as in a great measure psychology has usurped the role of religion. It co-opts sins, renames them, and then takes credit for their discovery; you could call it spiritual plagiarism.

I also might say that mental health professionals have become the new priesthood. After all, whereas years ago people might have gone to a man of the cloth for guidance, now they are likely to lie on a therapist’s couch. The prescriptions they get are far different, too. A priest, minister or rabbi would usually render advice steeped in tradition and God-centered, but the psychologist is most likely to offer relativistic counsel, where the focus is on feelings and is thus self-centered.

And what happens when the matter of religion is raised? If you’re like many, including someone I know of, you may be told you’re taking your faith too seriously, that such devotion is akin to a mental illness. This isn’t surprising, I suppose. What future could a person have with an “illusion,” even the very attractive one that Freud seemed to believe was the opiate of the masses?

Yet, with over 20 million Americans, 40 percent of college students and 1 out of 9 schoolchildren on psychiatrist-prescribed psychoactive drugs, one is left to wonder what realm is truly most deserving of that title.
Ahhh yes, Psychiatric Drugs are the New Opiate of the Masses.

Tuesday, May 13, 2008

Women in mental wards face grave risk of abuse

From The Age (an Australian Newspaper), as seen on the Psych Observer Website

NEARLY two-thirds of female patients surveyed in psychiatric wards in Victoria have been sexually abused or harassed by male patients, new figures show.

A report by the Victorian Women and Mental Health Network has also revealed that 70% of mental health staff surveyed by the group knew the abuse and harassment was occurring in public hospital wards. A further 30% of the 42 staff surveyed said the abuse, usually perpetrated by sexually disinhibited male patients, happened frequently.

Network convener Heather Clarke said the report, Nowhere to be safe: Women's experiences of mixed-sex psychiatric wards, showed that 61% of the 75 female patients surveyed about their experiences in psychiatric wards had been abused or harassed in some way and did not feel safe.

"These women are being admitted to hospital to get well and then they are being subjected to harassment and abuse that has an adverse effect on their health," she said.

"The situation is most concerning in areas of wards where staff are not always present, or in cases where patients are heavily medicated, making them more vulnerable to abuse."

Ms Clarke said any form of abuse in psychiatric facilities had great potential to retraumatise women. "Evidence suggests that up to 70% of women admitted to psychiatric inpatients units have experienced past sexual abuse," she said. "These women are at risk of having that trauma retriggered in a place where they should be safe."

During inpatient meetings last year, some women said they had been sexually assaulted or had seen women engaging in sexual activity with men when they did not seem well enough to consent. One woman fled from a high-dependency unit after a male patient sexually assaulted her in her bedroom. When she returned to the unit days later, the offender was still there.

Monash University psychiatrist Jayashri Kulkarni said most of Victoria's public inpatient units became mixed wards in the 1960s, creating the potential for men to assault women.

"It's a system that is a recipe for problems," she said. "There are lots of minor incidents occurring all the time that can have quite an impact on vulnerable female inpatients. Unfortunately, there are major incidents occurring as well. The framework of the inpatient settings has allowed this to happen."

Professor Kulkarni said that while some units tried to separate men and women when they could, ward design often hindered their efforts.

"A lot of wards have very rabbit-warren-like structures so there are lots of pockets staff can't see. Some of the designs are better with smaller bedrooms now, but you can often still have common bathrooms, which means both sexes traipsing around from bathroom to bedroom and so on … It's a situation where women can be assaulted too."

She said she knew of two cases now before the courts involving a public and a private hospital.

Ms Clarke and Professor Kulkarni said Australia needed to follow British policy to segregate new wards for patient safety.

"What's happening at the moment is a dereliction of that duty (of care), which could lead to litigation if nothing is done about it," Professor Kulkarni said.

A spokesman for the Department of Human Services said the Government was looking at ways to increase women's safety in new hospitals, which "may involve creating spaces that are for women only".

The department gave some centres a $20,000 grant to promote gender sensitive practices last year, which included the development of separate outdoor garden areas, he said.

But Ms Clarke said it was not enough. "At the end of the day, this is about people's safety. If the UK can introduce segregation, we should at least be able to start talking about it here," she said. "The safety of vulnerable people in hospital should be paramount."

Site Changes

We are in the process of making some Design Changes to the site. Don't worry, many of the special links and other resources will return shortly are still there, but now along the left side. as soon as we figure out some of the new features.

One of the things we wanted was the list of labels, and a better way of showing the archives.

So hopefully this is all for the better

Drug Czar Plays Politics With Mental Illness, Suicide And Marijuana

Via Furious Seasons, a report from the White House Office of National Drug Control Policy. This comment at Furious Seasons hits the nail on the head:

Yes, pot makes people kill themselves. That's such a bizarre assertion that it's embarrassing--and, indeed, claiming pot causes anxiety and suicide while perfectly legal drugs such as Paxil, Zoloft, Effexor and so on have been linked to suicidality and suicides and to cases of very extreme agitation is the very height of hypocrisy. A 2001 study published in the Journal of Clinical Psychiatry found that 8.1 percent of admissions to one hospital's psych unit in a 14-month period were due to "antidepressant-associated mania or psychosis." In fact, a Whether you like or hate pot, you ought to be against the feds making such hypocritical claims or you ought to be in favor of Walters warning parents of teens about the dangers of anti-depressant-caused psychosis. I simply don't know of any studies proving that pot causes suicide. I'm not saying it's impossible, but it's highly unlikely that such a link is very strong.
Anti-depressants are much more of a suicide threat.

The Decline of Psychiatry, Part 4

While people are in shock and horror at the decline of psychiatric services, this is all part of a larger picture where

Of course, there have also been problems of compassion within the mental health industry as well, as evidenced by profiteering, etc.

From the Nanaimo Daily News
There may some logic, based on crunching numbers and bureaucratic mumbo jumbo, in the decision by the Vancouver Island Health Authority to close the psychiatric unit at West Coast General Hospital in Port Alberni, but the closure makes no sense.

VIHA said they had to shut the unit for as long as a year because they cannot find a replacement for a departing psychiatrist. It's hard to believe that VIHA has allowed itself to end up in this position.

In fact, Alberni-Qualicum MLA Scott Fraser is right when he says, "It's not acceptable . . . . It's not an option. You cannot shut down essential services."

To add to Fraser's incredulity, closing a mental health ward approaches irresponsible if not outright negligent.

VIHA might argue they have no control over the comings and goings of doctors, but it's pretty hard to believe that they did not or could not foresee this long enough ago to take appropriate action.

Either way, the fact that they could not negotiate to have the current psychiatrist remain until a replacement could be found, or that they were caught by surprise, indicates something is wrong within VIHA.

What this also seems to indicate is that the health authority has little regard for those in need of mental health care.

Imagine if VIHA allowed the same state of affairs to happen at an emergency ward. The province would have to step in, replacing the VIHA board of directors -- who may also be personally liable for any tragedy -- and take steps to make sure that mandated level of emergency care is in place.

It is pretty shocking when one considers how the VIHA brass in Victoria seem to think about the mentally ill. The need for a psychiatrist in any community has to be seen as crucial as an emergency ward.

What the health authority seems to be saying is that someone in Port Alberni, or anywhere in the VIHA jurisdiction for that matter, who arrives at a hospital with a psychiatric crisis counts less than someone with a broken arm.

Sure, an untreated broken arm can lead to gangrene and death. But untreated mental distress can lead to suicide. And just as time is crucial in treating a medical emergency, so it is with a person in crisis from a mental disorder. Leaving such a person without necessary help will lead to escalating behaviour which can be violent or self destructive.

One agency that will not be very happy with state of affairs will be the RCMP. They are the ones who will have to cope with violent or suicidal people until appropriate help can be found. What do the RCMP do? Drive them to Nanaimo Regional General Hospital? Keep them in jail and let the courts sort it out?

VIHA's plan is that mental health and addictions community office in Port Alberni will handle psychiatric patients. The folks in that office must be just thrilled that their bosses in Victoria, who appear to have no insight into the needs of a person in mental distress, have delegated them as the ad hoc psych unit for the city.

The other plan is that a community response team will also intervene for people in need of psychiatric care. One problem though is that the team has not been established.

It's rather puzzling that VIHA appears to be able to put together this idea of a community response team, but can't seem to hire a psychiatrist.

Since its inception in 2002 VIHA has failed to serve any community on the Island adequately. Hospitals have become dirtier and less efficient, staff are overworked like never before, health facilities are increasingly crowded and this episode in Port Alberni is evidence of gross mismanagement.

The one place to start for a solution is for the VIHA board to censure Howard Waldner and his management team. And given that the board is ultimately liable, it seems they need to send a message that this state of affairs cannot go on.

Monday, May 12, 2008

List of Complaints Against Mental Health Practitioners and Counselors In Washington State

In April 2006 the Seattle Times ran a series under the title "License to Harm" exposing sexual abuse in the field of medicine in the the State of Washington. Using their online database of offenders, we were able to generate a list of those practitioners who are/were involved in the field of mental health in some capacity.

Out of 443 original complaints in the database, 159 were from the field of mental health. This is more than one third of all complaints, which is more than their fair share of the offenses.

These we detail below. We have preserved the individual links to the online database for each person in the list below. These are sorted by Specialty first, then by Name

License typeNameState complaint
Applicant - Registered CounselorCHARD, RALPH K.Failure to disclose criminal conviction
Applicant - Registered CounselorMERCER, MATTHEW G.Application denied for prior criminal sex conviction in Montanna
Applicant - Registered CounselorPLATT, VERNON W."After licensed, criminally convicted of 2nd degree rape of a child and 1st degree child molestation"
Applicant - Registered CounselorREYES, GABINO M."Prior to license, criminally convicted of 1st degree rape of a child"
Chemical Dependency ProfessionalABILD, GORDON W.Sexual contact with a patient
Chemical Dependency ProfessionalBANKS, NATALIE B.Sexual contact with a client
Chemical Dependency ProfessionalBROTHERTON, MICHAEL D.Sexual contact with a client
Chemical Dependency ProfessionalDISMORE, ROBERT D.Sexual contact with a client
Chemical Dependency ProfessionalGAMBER, JOHN B.Sexual contact with a client
Chemical Dependency ProfessionalHARRIS, STEVEN C."After licensed, criminally convicted of 1st degree child molestation"
Chemical Dependency ProfessionalLAYCOCK, KIMBERLY M.Sexual contact with a patient
Chemical Dependency ProfessionalLINS, LINDA C.Sexual contact with a client
Chemical Dependency ProfessionalMCDONALD, THOMAS E.Sexual misconduct
Chemical Dependency ProfessionalTRIPLETT, DOROTHY M.Sexual contact with a client
Counselor - Certified Marriage/Family TherapistDONNEN, MICHAEL L.Sexual contact with a client
Counselor - Certified Mental HealthDEVINCENT, JACQUELYNE A.Sexual contact with a patient
Counselor - Certified Mental HealthTURSKY, STUART P.Sexual contact with a client
Counselor - Certified Mental HealthWHITE, LAWRENCE N.Sexual contact with a patient
Counselor - Certified Mental HealthWOLFE, CONSTANCESexual contact with a client
Counselor - Licensed Marriage/Family TherapistCOWAN, A L.Sexual contact with a client
Counselor - Licensed Marriage/Family TherapistSHELTON, DAVID L.Sexual misconduct
Counselor - Licensed Mental HealthADAMS, HOMER S.Sexual contact with a client
Counselor - Licensed Mental HealthARAD, HEMDASexual contact with a patient
Counselor - Licensed Mental HealthCARBARY, PRESTON L.Sexual contact with a client
Counselor - Licensed Mental HealthCOLEMAN, PATRICK L.Sexual contact with a client
Counselor - Licensed Mental HealthDITTY, BYRON D.Inappropriate physical contact with a patient
Counselor - Licensed Mental HealthNEELY, ROBERT M.Sexual misconduct
Counselor - Licensed Mental HealthPEARSON, ROBERT P.Sexual contact with a client
Counselor - Licensed Mental HealthPRITCHETT, GREGORY E.Transmitted child pornography to patient via computer
Counselor - Licensed Mental HealthREYNOLDS, MICHELLE D.Sexual misconduct
Counselor - Licensed Mental HealthRUSCIGNO, VICKI L.Sexual misconduct with client
Counselor - RegisteredALEXANDER, RONALD W.Sexual contact with a client
Counselor - RegisteredBARRETT, OWEN V.Sexual contact with a client
Counselor - RegisteredBATES, JAMES L.Sexual contact with a client
Counselor - RegisteredBAUER, COREY M.Sexual contact with a client
Counselor - RegisteredBAUER, GWENDOLYN S.Sexual contact with a patient
Counselor - RegisteredBECKSTROM, DIMITY P.Sexual contact with a client
Counselor - RegisteredBLANK, DENNIS C.Sexual contact with a client
Counselor - RegisteredBOUTON, DEAN O.Sexual contact with a client
Counselor - RegisteredBRADY, LARRY G.Sexual contact with a patient
Counselor - RegisteredBROWN, JOHN W.Sexual contact with a client
Counselor - RegisteredBROWN, LAURA L.Sexual contact with a client
Counselor - RegisteredBURFORD, JAMIE L.Sexual contact with a client
Counselor - RegisteredBURR, KENNETH A.Sexual contact with a client
Counselor - RegisteredCARLSEN, LISA J.Sexual contact with a client
Counselor - RegisteredCLARK, JOHN E.Making sexual advances to a patient
Counselor - RegisteredCLINE, RICHARD T..Inappropriate physical contact with a patient
Counselor - RegisteredCOOK, JOHN R.Sexual contact with a client
Counselor - RegisteredCOVELL, LARRY C.Sexual contact with a client
Counselor - RegisteredDANIEL, TIMOTHY D.Sexual contact with a client
Counselor - RegisteredDAVISON, GORDON A.Sexual contact with a client
Counselor - RegisteredDELAGASSE, RENE C.Sexual contact with a client
Counselor - RegisteredDESHAZO, RICKIE L.Sexual contact with a client
Counselor - RegisteredDOWNEY, CYNTHIA J.Sexual contact with a client
Counselor - RegisteredDUNAWAY, DAVID M.Sexual contact with a client
Counselor - RegisteredDURHAM, JAMES F."After licensed, criminally convicted of lewd conduct involving juveniles"
Counselor - RegisteredDYER, THOMAS G.Sexual contact with a client
Counselor - RegisteredERICKSON, BEAUSexual contact with a client
Counselor - RegisteredFERGUSON, DANIEL S.Sexual misconduct
Counselor - RegisteredFISHBACK, MICHAEL A.Sexual contact with a client
Counselor - RegisteredFOX, DANNY E.Sexual contact with a client
Counselor - RegisteredGARDNER, KATHY D.Inappropriate physical contact with a patient
Counselor - RegisteredGIESE, JENNIFER L.Sexual contact with a client
Counselor - RegisteredGOFF, JAMES H.Sexual contact with a client
Counselor - RegisteredGOODMAN, PETER J.Sexual contact with a client
Counselor - RegisteredGORDON, KATHYSexual contact with a client
Counselor - RegisteredGRANT, ANTHONY W.Sexual contact with a client
Counselor - RegisteredGRAVES, KEVIN R.Sexual contact with a client
Counselor - RegisteredHADDAD, EMILE F.Inappropriate physical contact with a patient
Counselor - RegisteredHAMILTON, CHARITY A.Sexual contact with a client
Counselor - RegisteredHARRAH, NATALIE A.Sexual contact with a client
Counselor - RegisteredHAWLEY, STEVEN J.Sexual contact with a client
Counselor - RegisteredHAYTE, PAUL A."After licensed, criminally convicted of sexual contact with a minor"
Counselor - RegisteredHELLMANN, JAMES A.Sexual contact with a client
Counselor - RegisteredHOOKS, ANDREA L.Sexual contact with a client
Counselor - RegisteredIGEIN, GODWIN O.Sexual contact with a client
Counselor - RegisteredIRVING, WILLIAM S.Sexual contact with a client
Counselor - RegisteredJASSO, SERVANDOSexual contact with a client
Counselor - RegisteredJOEHNK, DANIEL W.Sexual contact with a patient
Counselor - RegisteredJONES, JUDITH E.Sexual contact with a client
Counselor - RegisteredKAVANAUGH, DONAL M.Sexual contact with a client
Counselor - RegisteredKELTY, JAMES G.Sexual contact with a client
Counselor - RegisteredKEOUGH, MICHAEL P.Sexual contact with a client
Counselor - RegisteredKESTER, CAROL A.Sexual contact with a client
Counselor - RegisteredKINSEY, OSCAR L.Sexual contact with a client
Counselor - RegisteredKLINK, WILLIAM R.Sexual contact with a client
Counselor - RegisteredKOCH, WILLIAM A.Sexual contact with a client
Counselor - RegisteredKORNELIS, CLARICE J.Sexual contact with a client
Counselor - RegisteredLEGGEE, RICHARD B.Investigated for prior criminal conviction
Counselor - RegisteredLOUDEN, JOHN R.Sexual misconduct
Counselor - RegisteredLUDLOW, KENNETH W.Inappropriately touching juvenile
Counselor - RegisteredMARVIN, TERRY A.Inappropriate physical contact with a patient
Counselor - RegisteredMASSEY, WILLIAM R.Sexual contact with a patient
Counselor - RegisteredMCBRIDE, GREGORY T.Sexual contact with a client
Counselor - RegisteredMEYER, EVELYN J.Sexual contact with a client
Counselor - RegisteredMILLER, ALLANSexual misconduct
Counselor - RegisteredMILLER, RICHARD A.Sexual contact with a client
Counselor - RegisteredNEFF, STEVEN G.Sexual misconduct
Counselor - RegisteredOLSON-HERNANDEZ, BECKY S.Sexual contact with a client
Counselor - RegisteredPARKS, FRED A.Sexual contact with a client
Counselor - RegisteredPARLOTZ, ROBERT D.Sexual contact with a client
Counselor - RegisteredPETERSON, STEVEN W.Kissed underage girl and sent sexualized messages
Counselor - RegisteredPICHETTE, WILLIAM J.Failure to disclose criminal conviction
Counselor - RegisteredPRICE, JOHN A.Sexual misconduct
Counselor - RegisteredRADECKI, JOHN C.Sexual misconduct
Counselor - RegisteredRAINERI, JOSEPH V.Sexual contact with a client
Counselor - RegisteredRICE, GREGORY R."After licensed, criminally convicted of possessing child pornography and sexual exploitation of a minor"
Counselor - RegisteredRIDOUT, TRACY M.Sexual contact with a client
Counselor - RegisteredRITCHIE, PAUL C.Sexual contact with a client
Counselor - RegisteredRODRIGUEZ, DAVID A.Sexual contact with a client
Counselor - RegisteredROSMARIN, EDWARD T.Sexual contact with a client
Counselor - RegisteredROSS, DONALD R."Failure to disclose numerous criminal convictions, including 2nd degree rape."
Counselor - RegisteredSALO, LINDA D.Sexual misconduct
Counselor - RegisteredSASET, MEHANSexual contact with a client
Counselor - RegisteredSCROGGIE, DANIEL C.Sexual contact with a client
Counselor - RegisteredSHELTON, LARRY E.Sexual contact with a client
Counselor - RegisteredSITEK, JEFFREY J.Sexual contact with client's mother
Counselor - RegisteredSKEATES, TERENCE R.Sexual abuse of a patient
Counselor - RegisteredSMITH, DREWSexual contact with a client
Counselor - RegisteredSMITH, ISAACSexual contact with a client
Counselor - RegisteredSMITH, TERRANCE L.Sexual contact with a patient
Counselor - RegisteredSORENSEN, RONDA M.Sexual contact with a client
Counselor - RegisteredSOSBEE, ROBERT E.Sexual contact with a client
Counselor - RegisteredSPEES, MARK A.Sexual contact with a client
Counselor - RegisteredSPENS, MICHAEL R.Failure to disclose prior discipline for sexual misconduct of a client in Oregon
Counselor - RegisteredSTACY, SHEILA M.Sexual contact with a client
Counselor - RegisteredSTEPP, MERVIN L."After licensed, criminally convicted of 1st degree child molestation"
Counselor - RegisteredSTRATTON, LAWRENCE G.Sexual contact with a client
Counselor - RegisteredSTURZENEGGER, DALE E.Sexual contact with a client
Counselor - RegisteredTRAVER, RAYMOND R.Sexual contact with a patient
Counselor - RegisteredTRAYLOR, JOHN M.Sexual contact with a client
Counselor - RegisteredTUCKER, PAUL D.Sexual contact with a client
Counselor - RegisteredVANDERGRIFF, CHARLES M.Inappropriate physical contact with client
Counselor - RegisteredVANVOORST, PHILIP K.Sexual misconduct
Counselor - RegisteredWILES, DUANE B.Failure to disclose previous criminal conviction for indecent liberties
Counselor - RegisteredWOOD, JOSHUA G.Sexual contact with a client
Counselor - RegisteredYARBROUGH, RICHELLE L.Sexual contact with a client
Counselor - RegisteredZAFERATOS, TAMARA S.Sexual contact with a client
Hypnotherapist - RegisteredANDERSON, ROSS E.Sexual contact with a client
Hypnotherapist - RegisteredHUGHES, PHILLIP S.Sexual contact with a client
Hypnotherapist - RegisteredPATCHELL, TEGWITH E.Failure to disclose criminal conviction
Hypnotherapist - RegisteredPRINGER, BYRON C.Sexual contact with a patient
Hypnotherapist - RegisteredSPEED, LANCE E.Sexual misconduct
PsychologistANDERSON, M. D..Sexual contact with a patient
PsychologistBROWN, NATHAN C.Sexual contact with a patient
PsychologistDESEVE, KENNETH L.Sexual contact with a client
PsychologistFORD, BRIAN L.Sexual contact with a client
PsychologistFRESE, GLEN A.Sexualized treatment sessions
PsychologistHOWLAND, CHRISTOPHER S.Inappropriate physical contact with client
PsychologistKUBACKI, STEVEN R.Sexual contact with a client
PsychologistLAZERE, RICHARDSexual contact with a client
PsychologistLEKSA, BRUCE J.Sexual contact with a patient
PsychologistMAST, PHYLLIS B.Sexual contact with a client
PsychologistO'DONNELL, PATRICK G.Sexual contact with a patient
PsychologistPESKIND, ARTHUR W.Sexual misconduct
PsychologistSCOTT, MONTE L.Sexual contact with a client
PsychologistSTALLONE, THOMAS M.Sexual contact with a client
Social Worker - LicensedCRANE, EDIESexual contact with a client
Social worker - LicensedVANDENBUSH, WILLIAMSexual contact with a client