Pediatrician paranoia runs deep - what’s up with the snooping?

While this story is NOT about psychiatrists or psychologists, it is important because another medical specialty is abusing the rights and privacy of parents in the pursuit of their own agenda. As reported in an OpEd piece in the Boston Herald

They’re watching you right now.

They counted every beer you drank during last night’s Red Sox game.

They see you sneaking out to the garage for a smoke.

They know if you’ve got a gun, and where you keep it.

They’re your kids, and they’re the National Security Agency of the Nanny State.

I found this out after my 13-year-old daughter’s annual checkup. Her pediatrician grilled her about alcohol and drug abuse.

Not my daughter’s boozing. Mine.

“The doctor wanted to know how much you and mom drink, and if I think it’s too much,” my daughter told us afterward, rolling her eyes in that exasperated 13-year-old way. “She asked if you two did drugs, or if there are drugs in the house.”

“What!” I yelped. “Who told her about my stasher, I mean, ‘It’s an outrage!’ ”

I turned to my wife. “You took her to the doctor. Why didn’t you say something?”

She couldn’t, she told me, because she knew nothing about it. All these questions were asked in private, without my wife’s knowledge or consent.

“The doctor wanted to know how we get along,” my daughter continued. Then she paused. “And if, well, Daddy, if you made me feel uncomfortable.”

Great. I send my daughter to the pediatrician to find out if she’s fit to play lacrosse, and the doctor spends her time trying to find out if her mom and I are drunk, drug-addicted sex criminals.

We’re not alone, either. Thanks to guidelines issued by the American Academy of Pediatrics and supported by the commonwealth, doctors across Massachusetts are interrogating our kids about mom and dad’s “bad” behavior.

We used to be proud parents. Now, thanks to the AAP, we’re “persons of interest.”

The paranoia over parents is so strong that the AAP encourages doctors to ignore “legal barriers and deference to parental involvement” and shake the children down for all the inside information they can get.

And that information doesn’t stay with the doctor, either.

Debbie is a mom from Uxbridge who was in the examination room when the pediatrician asked her 5-year-old, “Does Daddy own a gun?”

When the little girl said yes, the doctor began grilling her and her mom about the number and type of guns, how they are stored, etc.

If the incident had ended there, it would have merely been annoying.

But when a friend in law enforcement let Debbie know that her doctor had filed a report with the police about her family’s (entirely legal) gun ownership, she got mad.

She also got a new doctor.

In fact, the problem of anti-gun advocacy in the examining room has become so widespread that some states are considering legislation to stop it.

Last year, my 7-year-old was asked about my guns during his physical examination. He promptly announced to the doctor that his father is the proud owner of a laser sighted plasma rifle perfect for destroying Throggs.

At least as of this writing, no police report has been filed.

“I still like my previous pediatrician,” Debbie told me. “She seemed embarrassed to ask the gun questions and apologized afterward. But she didn’t seem to have a choice.”

Of course doctors have a choice.

They could choose, for example, to ask me about my drunken revels, and not my children.

They could choose not to put my children in this terrible position.

They could choose, even here in Massachusetts, to leave their politics out of the office.

But the doctors aren’t asking us parents.

They’re asking our kids.

Worst of all, they’re asking all kids about sexual abuse without any provocation or probable cause.

The American Academy of Pediatrics has declared all parents guilty until proven innocent.

And then they wonder why we drink.

And it makes me wonder what they are guilty of, if they are going to all this trouble to snoop into everyone else's business.

Sharon Osbourne confesses that 11 years of Zolft did her no good.

Apparently Sharon Osbourne has a new tell all book out. To read about it in the Daily Mail, it is all a bit of a train wreck. But one snippet caught our attention. Paragraph 11 of the story has this:

But above and beyond the simply tasteless (Sharon is, apparently, convinced that the more shocking the book, the more it will sell), what really worries her friends is her astonishing admission that despite taking the anti-depressant Zoloft for the past 11 years, she remains, she confesses, prone to self-harming."

The rest of it is juicy hollywood gossip, none too surprising. But that Zoloft probably didn't help.

Misdiagnosing an Eye Condition as ADHD

Not that this hasn't been said before, but there is a growing list of very treatable medical conditions that are being miss diagnosed as ADHD. You would think that a decent and thorough medical exam would be routine to pick up things like this..... but no......

As reported on Canada.com

Before reaching for the Ritalin, parents of children who have difficulty paying attention in school should consider another option: getting their kids' eyes tested.

An estimated five per cent of school-age children suffer from an eye disorder called convergence insufficiency, or CI. People with the disorder, which is treatable, have difficulty seeing things at close range.

"Their eyes don't like turning in," said Lisa Christian, a lecturer at the University of Waterloo School of Optometry. "Often times, children will avoid reading or do poorly in comprehension because their eyes don't like turning in. They get headaches."

Other symptoms of the disorder include double vision, dizziness and nausea. In some cases, the brain will actually shut down one eye in an attempt to correct the problem, an occurrence known as suppression.

"You don't want that to happen," said Christian. "You lose depth perception."

Because CI makes reading difficult, some children with the disorder have trouble focusing in the classroom and are being misdiagnosed with attention-deficit hyperactivity disorder (ADHD). A 2005 University of California study of 266 people with CI found that almost 10 per cent had also been diagnosed with ADHD - triple the normal rate.

"The school thinks it's behavioural, the parents probably think it's behavioural, so the child is sent to a psychologist or somebody to take a look at and they get misdiagnosed," said Christian.

The disorder is easy to detect, says Christian, and easy to treat. She recommends vision therapy, which consists of working with an optometrist to teach the eyes to converge when looking at something at close range. The therapy involves performing exercises to strengthen eye muscles, such as looking at a pencil and bringing it to your nose.

"The problem is that there are very few children getting full eye exams done before starting school."

The Canadian Association of Optometrists recommends that children have their eyes examined before their first birthdays, but estimates that less than five per cent do. The association reports that only 15 to 20 per cent of children receive a comprehensive eye exam before entering school.

"Parents are not aware of the link between good vision and a child's learning ability," said Dorrie Morrow, an Alberta optometrist and chairwoman of the association's children's vision initiative. "We don't wait until our children's teeth fall out to take them to a dentist. We don't wait until they turn blue to make sure they're breathing properly. It just baffles me."

Morrow says many parents believe that if their children don't need glasses, their eyes are fine. But that's not always true; there are numerous eye disorders, including CI, someone can have while maintaining 20-20 vision.

According to a 2006 Canadian Journal of Optometry report, an estimated 25 per cent of children 18 years old or younger are affected by some form of vision impairment.

"Every day, there are instances when a child's visual skills are holding them back from their full potential," said Morrow.

CI can be particularly challenging for young students, says Morrow, because the inability to see things clearly at close range severely inhibits their ability to learn.

"Most of a child's learning takes place in that 12 to 13 inches range. That's a child's world when they start school."

During her residency years ago, Morrow gave eye exams to teenage boys who lived in a group home for children with social problems. She found that 75 to 80 per cent of the teenagers she examined had visual skill problems.

"Those boys never had a chance to succeed academically, so they looked for another outlet. That changed my life. It's not just academics; it's giving your child the best possible start."

In 2003, Morrow led a year-long pilot project in Alberta called Eye See, Eye Learn. Optometrists teamed with school boards in the province to educate parents on the importance of having their children's eyes tested. The percentage of children who received eye exams jumped from about 15 per cent to more than 50 per cent.

"We were not refused by one school board," said Morrow. "Now it's provincewide."

The next step, says Morrow, is to take the program national. Many provinces have already shown interest.

"Every child starting school should have at least one comprehensive eye exam. They deserve that."

Massachusetts finds 35 children on excessive psychiatric drugs, more to come

From a longer report in the Boston Globe

Following the death of a 4-year-old Hull girl from an overdose of psychiatric drugs last December, state officials have set up a unique early-warning system to spot preschoolers who may be getting excessive medication for mental illness. In just the first three months, the system has flagged the cases of at least 35 children for further investigation, and the number is sure to rise.

The state Medicaid program is analyzing records of 82,900 children under age 5, looking for those taking at least three psychiatric drugs or a single prescription of a powerful antipsychotic drug. Mental health professionals will review the care of these children and, if necessary, contact the prescribing doctor for an explanation, say officials of the state insurance program for lower-income families, known as MassHealth.

Although cases like the overdose of Rebecca Riley are rare, the prescription of psychiatric drugs to young children is not. Doctors last year prescribed Clonidine - a drug sometimes used to treat hyperactivity that was found in lethal quantities in the Hull girl's bloodstream - to 955 children under age 7 in MassHealth. Doctors also prescribed antipsychotic drugs, which raise the risk of diabetes and obesity, to 536 children under age 7, according to MassHealth records. MassHealth could not say how many of these cases involve children under age 5 and might be subject to review.

Some psychiatrists have been concerned for years about the rise of psychiatric drug treatment of young children, largely because few preschoolers are old enough to show clear signs of mental illness and there are almost no studies on how the chemicals affect their developing brains. But until Riley's death from three drugs she was taking to treat bipolar disorder and hyperactivity, the state provided little oversight of doctors' prescribing practices.

Riley's death "was a wake up call," said Dr. John Straus, vice president for medical affairs at the Massachusetts Behavioral Health Partnership, one of the organizations that manage mental health care for children in MassHealth. He said MassHealth managers want to make sure that doctors have good reason for prescribing psychiatric drugs to such young patients and that they are not relying solely on the parents or guardians for information about each child's condition. Riley's parents have been charged with deliberately giving her a fatal overdose.

[...]


Riley's death focused attention on the growing use of drugs among preschoolers for another condition, bipolar disorder, which is characterized by wide mood swings and was once thought to begin in late adolescence. Her doctor, Kayoko Kifuji, diagnosed the girl with the condition when she was 2 1/2 years old. Kifuji has voluntarily given up her license to practice medicine while regulators investigate her treatment of Riley, and the girl's mother, Carolyn Riley, said on "60 Minutes" last Sunday that she no longer believes her daughter was bipolar. The parents blame Kifuji for their daughter's death, though she denies wrongdoing.

Despite unease over the amount of psychiatric drugs being prescribed to preschoolers, few states have tried to rein in prescriptions beyond drug educational programs for doctors or other forms of doctor assistance, such as Massachusetts' popular network of psychiatrists who are available for instant phone consultations concerning young patients.

[...]

New Orleans mental health agency diagnosed as unfit

From a much longer report in the Times Picayune. This is obviously just the tip of the iceberg.

For the past year, New Orleans leaders have pleaded for Gov. Blanco's help addressing a critical shortage of services for patients with chronic mental illness. With few places to go for care, these patients have crowded jails and jammed emergency rooms that have limited capacity to help them.

The state, it turns out, has made $74 million available in the past two years, but the money is under the control of an obscure public agency that has fumbled numerous chances to expand services since Hurricane Katrina and spends money with minimal oversight and accountability

Many fault the Metropolitan Human Services District, a state-financed agency governed by a board of directors appointed mostly by Mayor Ray Nagin. Health providers who work with the district say it is opaque, unresponsive and awash in internal problems that have crippled its ability to connect patients with services at a time when mental health across the region remains fragile.

In one example of such missed opportunities, Metropolitan has used only $430,000 of the $4 million in block grant money it received from the state to resurrect mental health services after Katrina -- even as Nagin was begging the governor to intercede in what he called a mental health crisis.

The only entity with the power to rein in the problems, its board of directors, sat half empty for almost a year. Nagin controls seven of the nine board appointments, but he failed for months to
appoint replacements for people who resigned their seats or were displaced by the storm and could not attend meetings. He finally filled all the board slots in late September.

With the board threadbare for so long, the executive director had almost unilateral control over contracting procedures. While most Metropolitan contracts have gone to nonprofits in the city, public records and interviews show a few were awarded to friends and business associates of executive director Jerome Gibbs.

What's more, patients have gone without services while Metropolitan remains mired in internal chaos. Scott Griffies, a psychiatrist who works at University Hospital, says he sees a large volume of patients in the emergency room who use drugs and alcohol to escape the stress of living in a stricken city. Meanwhile, numbers provided by the state show that Metropolitan is treating only a third as many patients with substance abuse problems as it was before the flood.

Metropolitan is supposed to provide services in the same fashion as United Way, by channeling money to nonprofit agencies with a track record of providing quality care. The agency also runs seven clinics in Orleans, Plaquemines and St. Bernard parishes. Data from the state shows the number of patients served at those clinics has dropped 46 percent since the storm.

When the state created Metropolitan four years ago, it ceded oversight of its operations to the board of directors. The state pumped $45 million into the agency last year and sent another $29 million its way this fiscal year, but the Department of Health and Hospitals does not have a detailed breakdown of how the agency spends the money.

A report released last year by the legislative auditor indicates that the agency has mismanaged some of that money. The auditor found that cash collected at the agency's clinics was not properly documented and that the hours listed on employee pay stubs did not always match the hours on their time sheets.

Bill Maher on Government Disease Mongering

"Diet and exercise don’t fail, a fact brought home last week by a new Duke University study that showed diet and exercise is just an effective a cure for depression as Paxil and Zoloft. So ask your doctor if getting off your ### is right for you."



Hat tip to BrandWeek NRx, eDrugSearch, ClinPsych, PharmaGossip and Pharmalot.

Rotenberg 'School of Shock' Doctor Defends Electric Shock for Kids, While Mother Jones Exposes His Lies Yet Again

Following the recent expose in Mother Jone's Magazine, Doctor Matthew Israel has been given the opportunity to defend himself and the psychiatric practices used at the Rotenburg School via a long and detailed letter published in Mother Jones itself. This is far too long to publish here, but suffice it to say the Doctor feels he was the victim of a smear job, dishonest journalism, etc.

Mother Jones has done him a great service in publishing his letter, but he has not gotten away scot free. They have responded to his letter by pointing out his own most damaging errors of fact, and standing their ground regarding continuous his moral lapses. You can see the Mother Jones editorial response below, as published online here

We applauded Mother Jones for the original expose, and continue in our own low opinion of the "Rotten-Berg" School of Electric Pain. We persist in our claim that the school should be labeled the Rotten-Berg School. Here are links to our own earlier reports on the story:

• Controversy resurfaces over use of electric shock treatment at Rotten-Berg school
  
• It really should be Rotten-Berg Center
  
• Dr. Matt Israel of the Rotenberg Center and his Electric Shock Program for Kids
  
• Shock treatment sought for autistic man
  
• Inspector general says school that uses shock therapy overcharged
  
• N.Y. report denounces school which punishes troubled and disabled students with electric shocks
  
• State investigates 7 at Canton, MA, school

Here is the Mother Jones Response to psychiatrist Israel's letter:

EDITORS' RESPONSE TO MATTHEW ISRAEL REGARDING "SCHOOL OF SHOCK"

THE USE OF SKIN SHOCK

In support of JRC's use of skin shock, Israel and his defenders stress the violent and self-abusive behavior of some students, and argue that those students have not benefited from other forms of treatment. Israel writes: "It is well documented in scientific articles and in court findings that some special needs children and adolescents have behaviors that are so self-abusive, aggressive or destructive as to be life-threatening and self-maiming."

The facts:

The use of skin shock is not restricted to such "low functioning" students. A report of an investigation by the New York State Education Department states: "JRC employs a general use of Level III aversive behavioral interventions [which include skin shock] to students with a broad range of disabilities, many without a clear history of self-injurious behaviors. JRC employs a general use of Level III aversive behavioral interventions to students for behaviors that are not aggressive, health dangerous or destructive.".…

THE DEATH OF A STUDENT

Israel writes:

"Ms. Gonnerman discusses California student Danny Aswad's death as though it had something to do with JRC or me. It did not. JRC had ceased its operations in California a year or two prior to his death which was from natural causes."

The facts:

According to the 1982 complaint filed by the State of California, this student was in the care of Behavior Research Institute at the time of his death. The complaint states that the student died while in restraints that kept him flat on his stomach in bed, and had been restrained on numerous occasions over the preceding seven months, despite the fact that such restraint was "contraindicated" because he suffered from a circulatory disorder.

Dr. Israel helped found Behavior Research Institute in California, which was a branch of the entity by the same name that he founded in Rhode Island (later renamed as JRC). Dr. Israel was a consultant to Behavior Research Institute at or at least shortly before the time the student died. Dr. Israel has previously defended the Behavior Research Institute, saying that the death was not the result of treatment.

DR. IWATA'S VISIT

Israel writes:

"Her statement that Dr. Iwata has visited the Rotenberg Center is false."

The facts:

Dr. Iwata visited the Rotenberg Center to review its practices at the request of Massachusetts officials. A copy of the report he wrote in 1995 was obtained by Mother Jones. At the time, the Rotenberg Center was still located in Rhode Island, but it already employed the skin shock aversive treatment that it still uses today.

SOCIALIZING AND ISOLATION

Israel writes:

"Ms. Gonnerman incorrectly states that the only time that JRC students can socialize freely is in the Big Reward Store. This is not true. There are many other places where students can socialize with each other such as on the playground, on field trips, at their residences, etc."

The facts:

In an interview with Jennifer Gonnerman, Dr. Israel stated: "We need to marshal every possible reward you can find to reward desired behavior. So even opportunities for some of the high functioning students to socialize with other students or staff, instead of those being routinely provided, those actually have to be earned. Everything you want has to be earned."

The report by the New York State Education Department states: "During five observations involving a total of 59 students, there were no instances of students socializing with other students and only five instances observed of students socializing with staff. Social interactions between students reportedly occur in the Big Reward Store where students go to select a reward for keeping contracts. When questioned about friendships and social interactions among students, the students interviewed stated that they were unable to socialize in a natural way."

Israel writes:

"The title page contains the word 'Isolation.' Isolation is never used as a punishment at JRC."

The facts:

Again, Dr. Israel himself has confirmed that some students must earn the opportunity to socialize with other students or staff. A report of an investigation by the New York State Education Department says that students may be restrained on four-point restraint boards or in chairs "for extensive periods of time (e.g. hours or intermittently for days)." Students are sometimes confined to "conference rooms," which in some cases isolate them from everyone except a single staff member.

FOOD DEPRIVATION

Israel writes:

"The title page contains the phrase 'Food Deprivation.' Food deprivation is never used as a punishment at JRC."

The facts:

According to JRC, about 10 percent of the students are in a "Contingent Food Program" or a "Specialized Food Program." These programs require students to meet behavioral requirements in order to earn food. The New York State Education Department report says that students must "earn" meals by not displaying certain behaviors, and that if they do not they are "made to throw a predetermined caloric portion of their food into the garbage."

Students in the Contingent Food Program are given "make-up meals" at the end of each day, but according to JRC "make-up food is deliberately intended to be an unattractive option." Students in the Specialized Food Program do not receive "make-up food" unless they have eaten less than 26 percent of their normal daily caloric target. These programs are part of the court-approved treatment plans for the students, and students' weight is monitored. The program is altered or suspended if the student drops below a certain weight.

According to the New York State Education Department report, "The Contingent Food Program and Specialized Food Program may impose unnecessary risks affecting the normal growth and development and overall nutritional/health status of students subjected to this aversive behavior intervention."

USE OF OTHER THERAPIES BEFORE SHOCK TREATMENT

Israel writes:

"Before JRC uses aversives with any student, positive and educative procedures are tried for an average of 11 months to try to change serious problematic behaviors."

The facts:

The article does not assert that other treatments are not tried before aversives are used. However, according to the New York State Education Department report, "JRC may decide prior to a student's acceptance into the program that he/she requires aversive procedures based on historical and current behavioral information provided by parents, the CSE and other records/reports." In addition, in some cases, "the use of aversive procedures may be a condition of the student's acceptance and continued enrollment in the program." Letters from parents of students at JRC appear to support these findings.

SAFEGUARDS

Israel writes:

"There are many safeguards at JRC to make sure that the skin-shock procedure is used carefully, professionally and properly. They include prior parental consent, prior individualized court authorization (the judge appoints an attorney to represent the child's interests in this process), prior approval by a Human Rights Committee and a Peer Review Committee, clearance from a physician and a psychiatrist to insure that there are no medical contraindications, etc."

The facts:

The article discusses parental and court consent, and expressly reports that court approval is required in all cases. (Attorneys who have represented students in approval proceedings have told Mother Jones that court approval is routinely granted, sometimes over their objections.) The article doesn't suggest that other safeguards are not also employed in deciding to use or in monitoring the use of skin shock treatment.

However, some of the procedures are apparently required as the result of JRC's settlement with the State of Massachusetts, and according to the New York State Education Department report "the integrity of the behavioral programming at JRC is not sufficiently monitored by appropriate professionals at the school and in many cases the background and preparation of staff is not sufficient to oversee the intensive treatment of children with challenging emotional and behavioral problems."

FADING OUT SKIN SHOCK TREATMENT

Israel writes:

"As time goes on, many [students] are able to graduate completely from needing this ]skin shock] therapy."

The facts:

Data provided by Israel indicates that 43% of school-age students are receiving skin shocks, while only 3% percent have "graduated" or been "faded off" the shock devices. Among adult residents, 85% are attached to the shock device, while only 6% have been "faded off."

According to the New York State Education Department report, "JRC's policy states: ‘GED fading will not occur until the student has gone a minimum of one year with no major behaviors.' . . . The criterion of one year without a 'major disruptive behavior' is extremely long and is not determined based on the circumstances for each individual student. . . . Many NYS students remain on the GED for the entire time they attend the center."

Psychiatrist Reprimanded in 2002 Drug Intoxication Death

I have been wondering if cases similar to this, which result in the death of a patient due to a patient's treatment (and where there is no expected danger of death) should a least be subject to a charge of 'medical' man-slaughter. As seen in this report

A Lakeland psychiatrist brought before the Florida Board of Medicine on Friday after one of his patients died of "multiple drug intoxication" will get a reprimand, pay a $6,000 fine and attend classes intended to prevent similar situations.

The discipline package requires Dr. Charles Dack to complete "Prescribing Controlled Drugs: Critical Issues and Common Pitfalls of Misprescribing" or a board-approved equivalent. He must attend 16 hours of continuing medical education in drug medication and pain-management consultations. And he will pay administrative costs, up to $6,109.33, for investigation and preparation of his case.

He agreed to that discipline in a proposed settlement, negotiated with the Florida Department of Health, that was given to the Board of Medicine. He didn't comment before or after the board agreed to accept the agreement without debating its terms.

Dack, certified in psychiatry with subspecialty certification in addiction psychiatry, hasn't had previous discipline from the board, DOH said.

Dack treated a woman for seven years for depression and back pain. Before her death in March 2002, the state's administrative complaint said, she was on 1,300 milligrams of morphine a day and on 300 milligrams a day of Elavil, an antidepressant that also can be used to treat chronic pain. In addition to those drugs, Dack also prescribed other medicines.

Another psychiatrist recommended in 1997 he change the medication and suggested more conventional pain management.

Dack wrote a letter in which he agreed she might benefit from a pain management program, the state said, but "failed to take steps to make certain patient M.T. sought the help of pain management specialists."

The complaint said Dack failed to properly recognize her dependence and tolerance for controlled substances and didn't properly consider the possibility of her exaggerating her pain level. It said he inappropriately escalated the "quantity and dosage of the prescribed narcotics for patient M.T. without objectively justifying and adequately documenting changes in the patient's condition."

The settlement agreement doesn't require him to admit or deny allegations made against him in the state complaint.

Lilly Pumps Up Warnings on Psych Drug Zyprexa

The WSJ Health Blog is reporting that:

Eli Lilly has been dogged by concerns about the safety of its drug Zyprexa, which is approved to treat schizophrenia and bipolar disorder.

This morning the company said it’s beefing up the warnings on weight gain and increases in blood sugar, cholesterol and other fats associated with taking Zyprexa. The drug, Lilly’s biggest seller, already carried some warnings about these risks, but the new cautions go quite a bit further. The letter Lilly is sending to doctors to alert them to the changes in the instructions for the drug is here.

One key change may put Zyprexa at a disadvantage to other meds. The new labeling says that Zyprexa (generic name: olanzapine) may be more likely to drive up blood glucose levels than other atypical antipsychotics. Other drugs in this class include J&J’s Risperdal, AstraZeneca’s Seroquel, Bristol-Myers Squibb’s Abilify and Pfizer’s Geodon.

The labeling also includes information on weight gain, and increases in blood sugar and lipids in adolescents. The drug, unlike Risperdal, isn’t approved for use in patients under 18, but it is often prescribed off-label for adolescents.

As somebody else noted:

Isn't this move by Lilly 10 years and at least 1,000 deaths too late?

Florida suspends license of Vero psychiatrist incarcerated in New York

State officials issued the emergency suspension of a Vero Beach psychiatrist's medical license this week after learning the doctor pleaded "not responsible by reason of mental disease or defect" to charges that he tried to kidnap a 2-year-old in New York City from his mother. The doctor later told a court he thought she was from outer space.

Dr. William John Johns III, 35, has been incarcerated in New York since his arrest in July 2006.

Initially, Johns was charged with attempted second-degree murder in connection with a summer 2006 incident at a pier on the West Side of Manhattan, when he allegedly choked the mother unconscious. That charge, plus charges of second-degree assault and child endangerment, were dismissed by a New York judge at an April hearing.

On Aug. 30, Johns asked the court's permission to return to Florida and day treatment at a psychiatric facility.

Instead, the court found him "dangerously mentally ill" and committed Johns to a secure treatment facility in New York for six months, according to an order by Florida Surgeon General Dr. Ana M. Viamonte Ros.

The order relates New York court testimony in the case that indicated Johns was diagnosed in 2005 with bi-polar disorder and has a history of alcoholism, depression and attention deficit disorder.

Shortly before his 2006 arrest in New York, Johns stopped seeing local patients and fired his receptionist.

"He believed he was a character in a movie and that other people were actually actors observing him," the order reads.

Some time later, Johns reportedly drove to New York City. Along the way he tore a medication patch from his arm, heard voices and thought he was Jesus Christ, the order states.

At the Manhattan pier, Johns began watching families and children in a play area.

"He became fixated on a 2-year-old boy playing with his mother … Dr. Johns related that there were certain moments when he thought the child was an alien, or super-human, but later determined that the child was in danger of falling in the water or being hit by a bus and had to be saved from his mother, who was from outer space," the order states.

John then allegedly grabbed the child, then choked the mother until bystanders freed her and held him until police arrived.

Zyprexa: 'I couldn’t care less if I lived or died'

As seen in this report by Heidi Turner

Patients who are diagnosed with depression may feel a sense of shame about their diagnosis. That feeling may be compounded if they begin to feel suicidal, which can happen to people who take Zyprexa.

However, many people do not realize that they are not [alone], that other people taking Zyprexa have felt suicidal. The problem is with the drug, not with them.

"I am ashamed of taking Zyprexa," says Kendall Lewis. "In 1999, when I was 34 years old, I was diagnosed with clinical depression. I was losing my memory and was tired a lot and I didn't have the strength to do the job I normally did. My doctor suggested I quit work and go on social security. He immediately put me on Zyprexa. When he doubled the dosage it made me whacky and I told him I was hearing voices." But worse than that, Kendall's family said he was showing a violent side.

"Ask anyone and they will tell you -- I am a very passive person and I love my family," adds Kendall. "But on Zyprexa, it was like I was edgy all the time, I had zero tolerance and I didn't sleep.

"I didn't know how to handle confrontation with the kids. I would lose my temper; I'd yell and scream--this behavior was out of my control. During one of my visits to the doctor, the psychiatrist's assistant asked me if I felt like living. 'I couldn't care less if I died or not,' I said. I never felt suicidal until taking this drug.

My wife and I had a fight. I got into the car and I started speeding; I remember crying uncontrollably and felt my life was over; I wanted to crash the car and die. But I have always gone to church-- if it wasn't for God and if I had continued with Zyprexa, I would have been dead soon after that day. I woke up one morning in prayer, asking God what was wrong with me. I felt that God spoke to me and that I didn't have clinical depression—he told me to throw the pills away and come back to church to serve him. When I opened the bible I read the scripture about oppression: I had spiritual oppression, not clinical depression.

I lost 40 lbs within three months after throwing away Zyprexa. The years from 1999 until 2002 are a complete blur—I don't know where they went. I was having even worse memory problems and then suicidal tendencies on that drug; one night they even took me away in the ambulance. I don't know how to explain the pain of wanting to kill yourself; when you're not thinking clearly, there is nobody in their right mind who wants to commit suicide.

I am ashamed of saying that I was diagnosed with clinical depression. I was a happy person—everyone who knew me would say so. I was outgoing, a salesman. I owned a car lot and dealt with the public every day. I thought 'clinical depression' was just a term they used, but in reality, all that was wrong with me was that I didn't have any energy or strength.

And I had high blood pressure. The doctors told me that if I was stressed out, that could make my blood pressure go up. I wish I had gotten a second opinion, gone to another doctor. My treatment with Zyprexa made things worse, not better. Instead of shoving these pills onto me, I should have had alternate choices.

Now, my goal is to help someone not to take this drug - there are alternate routes. And maybe I can help save a life if someone reads my story."

Paxil implicated in another death

As seen in this report from New Zealand. In this cas a regular physician did not know about the risks, so it seems.

The family of a Nelson businessman who committed suicide has welcomed a coroner's recommendation that health professionals fully advise patients and their families of the risks of certain antidepressant drugs.

Nelson coroner Ian Smith has released his findings into the death of real estate agent Peter Michael Noonan, 53.

Mr Noonan was prescribed the selective serotonin re-uptake inhibitor (SSRI) anti-depressant drug Aropax days before his death on July 27 last year.

His wife Gaile Noonan told the Nelson Mail on Tuesday that she hoped Mr Smith's findings would be taken on board by the medical profession.

"We would like to think someone else could be protected from having these things happen."

She said she believed her husband could have concealed information about his condition and medication, to protect her.

"Perhaps caregivers should be there when they go to the doctor."

Mrs Noonan said the family had received an "enormous" amount of ongoing support, but her husband's death had left a big gap in the family's life.

Mr Smith last year began investigating a possible link between SSRIs and the effects on people suffering mental illness, particularly an increase in suicidal thinking and behaviour.

Mr Smith said Mr Noonan was a "respected businessman" but his life began to "go awry" after he decided to change jobs from property valuation to real estate.

He began withdrawing from normal social activities, and concerned family and friends urged him to seek help.

Mr Noonan visited general practitioner Hamish Neill on May 5, 2006 about his anxiety and depression, and was referred to psychotherapist Burke Hunter, whom he saw on May 9.

Mr Noonan saw Mr Hunter seven times, before Mr Hunter left on a six-week overseas trip.

Mr Smith said that while Mr Hunter had suggested the name of another counsellor who could be consulted in his absence, it appeared that no active steps were taken to set up an alternative therapist.

In July, Mr Smith recommended that Medsafe introduce a "black box"-type warning for SSRIs, with information about potential risks. Mr Smith said no information about Mr Noonan's thoughts of suicide or a referral to a psychiatrist was discussed with Mrs Noonan.

"It would appear that neither Mr Noonan nor his family was aware of the possible side effects of this medication."

Mr Smith said he was pleased to see that warning information was now available from Medsafe, but it was important that prescribers disclosed it to patients and caregivers where applicable.

Mr Smith said all people concerned with the care of someone, including family, should understand the process.

"Unfortunately, many doctors still think `Privacy Act - can't disclose', which is not correct," he said.

Man charged in bicyclist's death - was on toxic stew of anti-depressants

As seen in this report, original page also includes a video:

nvestigators with the Texas Department of Public Safety are counting on a driver who killed a south Austin cyclist in July to turn himself into authorities.

On Monday afternoon the D.P.S. issued an arrest warrant for 43-year old Richard Alan Lee. He's being charged with intoxication manslaughter, a 2nd degree felony.

Toxicology tests results listed in Lee's arrest warrant affidavit suggests he was under the influence of 5-different prescription drugs at the time of the accident, Xanax, Zoloft, Lamisil, Soma, and Equinil. Most of the drugs are anti-depressants and one is a muscle relaxant.

The affidavit also says that Lee had red, bloodshot eyes and slurred speech after the crash.

As of Monday evening D.P.S. investigators were having difficulty reaching Lee. They say his phone number has been disconnected and he is no longer at the address they had listed for him.

Intoxication manslaughter is a second degree felony that could mean two to 20-years in prison and a fine of up to $10,000.

"This kind of thing we have happen all the time on our streets and roadways when somebody makes mistakes, but when they make mistakes that involve violations of the law charges should be pressed" says Fred Meredith, a cycling instructor and riding partner of Vilhelm Hesness.

State files suit, levies fines over psychiatrist burning medical records

From this report

The state filed a lawsuit Wednesday and levied fines of $1 million against the owner of a Salem Township property where huge piles of burning medical records were found in August.

The seven-count complaint, filed by Attorney General Mike Cox for the state Department of Community Health, cites Dr. Soon K. Kim and his companies - Quality Health Plan and Signature Healthcare Services Inc. - for burning piles of records, some as large as a van, in violation of the public health code and privacy laws. Also named in as a co-defendant in the lawsuit was Dong Won (David) Kim.

The fines were imposed by the state Department of Community Health against Kim and Quality Health Plan for the improper disposal of health records.

The 415-acre property, at 6646 Six Mile Road, belongs to Soon Kim. He owned the bankrupt Greater Detroit Hospital, also known as North Detroit General Hospital. Officials said the records contained patient medical information, x-rays, and Social Security numbers.

Kim and his attorney, Laura Sanders, could not be reached for comment Wednesday. Kim has had a medical license as a psychiatrist in Michigan since 1973.

The suit alleges that on Aug. 29, David Kim was burning at least three large bonfires on the Salem Township property, and told police that Sanders told him to do it. The suit said David Kim had been dumping and burning on the Salem Township property since October or November 2006.

Some of the records, according to the suit, were blowing onto other properties.

The state is seeking a preliminary injunction against burning any other medical records, and an order asking for the address and owner of all locations from which the records were taken. The state also wants information about who created the records, how many were destroyed, how far back the records went, and a description of what was destroyed.

The lawsuit asks that Kim be ordered to hire a reputable disposal company to destroy the records, and to allow the Department of Environmental Quality to determine whether the site was contaminated by burning the x-rays.

A criminal investigation into the burning, which is illegal under both privacy and toxic waste laws, remains open, officials said.

The lawsuit can be downloaded from this link

Psychiatrist Faces Florida State Disciplinary Action

This report details actions against both a psychiatrist and by a surgeon. This site, being the way it is, will focus of the misconduct by the psychiatrist, even though both patient deaths are troubling. As seen in this report

Two Lakeland doctors accused of medication errors go before the Florida Board of Medicine on Friday in an effort to resolve complaints against them.

A patient died in each situation, but the circumstances vary greatly.

The proposed penalties would be similar - reprimands and additional training and fines, with a drug course for one of them.

The Florida Department of Health and the doctors, without admitting guilt, agreed to the proposed settlements. It's up to the board to decide whether the proposed discipline is acceptable.

The state's accusations involve treatments by Dr. Charles Dack and Dr. Anthony Jean-Jacques.

Dack, a psychiatrist, treated a woman for seven years for depression and back pain after an injury.

Before her death, she was on 1,300 milligrams of morphine a day and on 300 milligrams a day of Elavil, an antidepressant that also can be used to treat chronic pain. Dack also prescribed other antidepressants and didn't require her to seek pain-management treatment, according to the Department of Health complaint.

She was found dead March 13, 2002. The cause of death was listed as "multiple drug intoxication, namely opiates and tricyclic antidepressants," the complaint said.

The state said Dack inappropriately escalated the quantity and dosage of her prescribed narcotics, keeping her at a toxic level of morphine for more than two years; failed to get blood tests to measure the impact of one type of drug; and failed to recognize her dependence on and tolerance for controlled substances.

Dack said he didn't want to comment before the board hearing in Orlando.

[...]

Two new women allege fondling by Psychiatrist

From the Atlanta Journal Constitution

Two more women have told police that a Lawrenceville psychiatrist charged with sexually fondling patients touched them inappropriately, police said Tuesday.

The women contacted police after hearing about the case Monday. They bring to five the number of complaints filed against Dr. Mohammed Uzair Qureshi, according to Capt. Greg Vaughn, spokesman for the Lawrenceville Police Department.

No additional charges have been filed against Qureshi, 45, of Lawrenceville, since he was charged Friday with sexual assault by a practitioner of psychotherapy against a patient. In that incident, a 43-year-old woman told police that Qureshi asked her to disrobe during a psychiatric session and touched her breasts.

Police are investigating the latest accusations, Vaughn said.

Qureshi was released Saturday from the Gwinnett County jail on $33,200 bond.

When contacted by the AJC on Monday, he said "these are totally false allegations.

Qureshi had been working at the Gwinnett-Rockdale-Newton Community Services Board. He was fired after the criminal charges were filed, according to David Will, the attorney for the community services board.

Psychiatrist in court for 30-year-old rape

Via this report

A former psychiatrist has pleaded not guilty in Perth Magistrate's Court today to a number of sex offences that allegedly occurred in the 1970s.

Police allege Alan John Stubley was a practicing psychiatrist in Kings Park Road, West Perth at the time of the alleged offences and the victim was a woman who was receiving treatment.

It is alleged the offences, including one count of indecent assault and six counts of rape, occurred during the woman's therapy sessions.

Detective Sergeant Greg Balfour said at a press conference today that the woman had been a patient of Dr Stubley for some years.

Dr Stubley was granted bail and scheduled to re-appear in the same court in December.

The Death of Rebecca Riley: a Case of Psychiatry Gone Mad.

For those who have never heard of the Rebecca Riley case, except through the 60 Minutes report, here is a list of our stories covering the story:

• 60 Minutes Report: Who Killed Rebecca Riley?
• 60 Minutes on Rebecca Riley and Bipolar Prescriptions
• Symposium: Freud's legacy – does medication = healing?
• Is It Time To Sue Doctors Who Prescribe Drugs Off-Label ?(Part I )
• Misguided standards of care
• Bipolar madness?
• Backlash against psychiatric diagnoses of bipolar disorder in children
• Red flag on pediatric psychopharmacology
• 4-Year-Old's Fatal Overdose Raises Questions About Psychiatric Prescriptions For Kids
• Activists take on Eli Lilly over off-label sale of Zyprexa
• Defense blames Rebecca’s Riley death on her Psychiatrist; Calls prosecution’s likely argument a ‘sick theory’
• Pediatric Bipolar. Yeah. Right.
• Girl's death puts doctor at center of controversy
• At the center of the Storm, Psychiatrist Kayoko Kifuji (MD)
• Death puts focus on medication
• In Depth Reports on the Death of Rebecca Riley
• Public Health Commitee plans prescription medication oversight hearing
• Timeline: Rebecca Riley Murder Case
• Psychiatrist denies wrong doing in death of 4 year old girl
• COPS: MOM AND DAD KILLED GIRL, 4; Hull pair charged with giving daughter deliberate overdose of prescription pills

We also recommend the detailed coverage in this local newspaper, the Patriot Ledger

Psychiatrist Accused of Molesting Woman

From WXIA-TV 11 in Atlanta

A woman who sought medical help for "anxiety issues" was given an appointment with a psychiatrist who, she reported to police last week, sexually assaulted her during his consultation with her.

Now police are saying that the psychiatrist may have also molested additional patients, under the guise of performing physical exams.

Lawrenceville police arrested the psychiatrist, Dr. Mohammad Uzair Qureshi, on Friday, charging him with one count of sexual assault and one count of sexual battery.

Since then, "we've had two more victims come forward that were victimized by Dr. Qureshi," popularly known as "Dr. Q," said Lawrenceville Police Captain Greg Vaughn.

According to the police incident report, the 43 year old woman had gone to Gwinnett Rockdale Newton Community Service Board, or "GRN," on Gwinnett Drive near Scenic Highway in Lawrenceville, last Thursday, "to consult with a physician about anxiety issues."

The doctor who saw her was Dr. Qureshi who, she complained, "conducted what she felt was an unnecessary breast exam" during her first and only appointment with him.

The report says "Dr. Qureshi unexpectedly grabbed her left wrist for what she assumed was done to check her pulse. She then stated that Dr. Qureshi asked her to pull up her shirt" and "reveal her breast from her bra. At which point, Dr. Qureshi began touching both of her breast [sic]."

The woman immediately complained, and GRN called police.

"There's no reason in the world," Capt. Vaughn said Monday, "that a psychiatrist would need to take a female top off to do some type of examination."

Dr. Qureshi was released over the weekend on a bond of $33,200 as police intensified their investigation of him.

Capt. Vaughn said detectives are checking out the complaints of the two women who came forward following Dr. Qureshi's arrest, and that the doctor may face additional charges.

The address that Dr. Qureshi gave police when he was arrested is an apartment complex off of Lawrenceville Highway, just west of Lawrenceville. An employee of the complex said Dr. Qureshi has moved out. 11Alive News was unable to reach Dr. Qureshi by telephone for comment.

GRN released a statement Monday that Dr. Qureshi "was not an employee of GRN, but was an independent contractor supplied to GRN by a private company that provides psychiatric services" to GRN.

The statement goes on to say that the medical director of that company talked with Dr. Qureshi about the complaint and then fired him.

A check of the state medical board website shows that there have been no medical board investigations of Dr. Qureshi in Georgia and no disciplinary actions taken against him in Georgia.

But Lawrenceville police are asking women who believe "Dr. Q." had inappropriate physical contact with them during an appointment, but have remained silent about it, to call Lawrenceville police.

"This man is a doctor," said Capt. Vaughn. "And we all trust our doctors. And we all listen to them. So Dr. Qureshi was, obviously, he could convince these ladies that they needed some other type of exam" and they may not have realized, at first, Vaughn said, that the physical exam was not part of a psychiatrist's normal procedure.

New Federal Drug Safety Bill Signed Into Law

Some details not noted below - Among the many reforms, this new law gives the FDA the authority and money to monitor, investigate, report (and take action) on adverse side effects of drugs once they are on the market. It also requires all PRINT ads (Magazines, newspapers etc) to say: "You are encouraged to report side effects of prescription medication to the FDA's medwatch call 800# or log onto www.fda....." In six months the Secretary of Health and Human Services must make a report to Congress on how they can implement this in TV ads.

As seen in this report

The Food and Drug Administration on Thursday gained broad new powers to ensure the safety of prescription drugs used by millions of Americans under a bill President Bush signed into law.

At its core, the new law renews for five years programs to collect fees from drug and medical device manufacturers. The industry money accounts for about one-quarter of the FDA's overall budget, defraying the cost of reviewing products that need agency approval.

Members of Congress, acting in the wake of the withdrawal of the painkiller Vioxx three years ago, seized on the bipartisan legislation as a vehicle to reform the FDA's handling of drug safety.

In part, the legislation shifts more of the FDA's attention from experimental drugs pending approval to those already are on the market, and gives the agency more power to act when worrisome problems emerge.

"It really represents an important addition to the FDA's authority," said FDA commissioner Dr. Andrew von Eschenbach.

It gives the FDA the power both to require drug companies to do further study on the safety of medicines, if needed, and to mandate new label warnings when problems do appear. The FDA also gains the ability to fine companies to ensure compliance with those two new authorities. The legislation further requires companies to publicly release results of all clinical trials that show how well their approved drugs performed. Not yet approved drugs could be subject to the requirement later.

Still, how the Food and Drug Administration Amendments Act of 2007 will change the agency remained unclear, beyond the expected hiring of several hundred new employees.

The FDA was still reviewing the 156-page law and its roughly 200 specific provisions, many with timelines, before deciding how to implement them. The fine-print list of actions the FDA must take runs more than 10 pages, said Randall Lutter, the agency's deputy commissioner for policy. The FDA may have to draft new regulations or guidelines - a process that can take years - to implement some of those provisions, Lutter said.

The legislation does spell out that the FDA will be able to fine drug companies for not completing follow-up studies on their drugs after they've won government approval. Those studies frequently remain undone, often leaving important safety questions unanswered.

The bill calls for drug companies to pay $393 million, and medical device makers $48 million, in various fees next year.

"The increased fees will allow the agency to expand drug safety monitoring, hire additional staff for post-market surveillance, and modernize its information technology systems," said Billy Tauzin, head of the Pharmaceutical Research and Manufacturers of America.

It also requires the FDA to step up its active surveillance for new safety issues with drugs. That system traditionally has been largely passive.

"We welcome the ability to really engage in how those products perform once they are out on the market," said Dr. Janet Woodcock, the FDA's deputy commissioner and chief medical officer, citing the use of data-mining techniques to sift through electronic medical databases for hints of problems.

The manufacturers of certain new drugs will have to draft for each one a so-called "Risk Evaluation and Mitigation Strategy" that can include medication guides distributed with each prescription to ensure the medicine's safe use.

Under the legislation, the FDA will set up a registry to log incidents where adulterated food could pose a health risk. The agency also will have to establish pet food ingredient and processing standards - a provision born of the massive dog and cat food recalls earlier this year.

"It strengthens safety rules for the wave of new miracle drugs coming on the market that Americans count on to protect their health. It brings needed reassurance to families that the food they feed their pets is safe," said Sen. Edward Kennedy, D-Mass.

Shifting the Blame for the Effects of Combat Fatigue

As seen in this report

Thousands of U.S. soldiers in Iraq — as many as 10 a day — are being discharged by the military for mental health reasons. But the Pentagon isn't blaming the war. It says the soldiers had "pre-existing" conditions that disqualify them for treatment by the government.

Many soldiers and Marines being discharged on this basis actually suffer from combat-related problems, experts say. But by classifying them as having a condition unrelated to the war, the Defense Department is able to quickly get rid of troops having trouble doing their work while also saving the expense of caring for them.

The result appears to be that many actually suffering from combat-related problems such as post-traumatic stress disorder or traumatic brain injuries don't get the help they need.

Working behind the scenes, Sens. Christopher "Kit" Bond, R-Mo., and Barack Obama, D-Ill., have written and inserted into the defense authorization bill a provision that would make it harder for the Pentagon to discharge thousands of troops. The Post-Dispatch has learned that the measure has been accepted into the Senate defense bill and will probably become part of the Senate-House bill to be voted on this week.

The legislation sets a higher bar for the Pentagon to use the personality-disorder discharge, and also mandates a review of the policies by the Government Accountability Office. Bond said it also would "force the Pentagon to stop using this discharge until we can fix the problem."

Bond said he learned of the practice from returning Iraq veterans. He called it an "abuse" of the system and "inexcusable."

"They've kicked out about 22,000 troops who they say have pre-existing personality disorders. I don't believe that," Bond said in an interview Friday. "And when you kick them out, they don't get the assistance they need, they aren't entitled to DOD or Veterans Administration care for those problems."

Obama said the practice is "deeply disturbing" because "it means that those who have served this country aren't getting the care they need. …"

Pentagon spokesman Lt. Col. Todd Vician declined Friday to discuss the matter because it was related to current legislation.

Defense Department records show that 22,500 cases of personality-disorder discharges have been processed over the last six years.

Jon Soltz, an Iraq war combat veteran who founded the group VoteVets.org, said untreated psychological problems were contributing to the highest military suicide rate in a quarter-century and to growing homelessness among veterans, he said.

If such widespread mental problems really existed before people joined the military and saw combat, they would have been uncovered when the recruits were enlisting, Soltz said.

STRESS FACTORS

The issue of personality-disorder discharges is a window into the broader problem of psychological damage to Iraq veterans, which experts say has three main causes:

— Multiple and longer deployments.

— The stress of fighting an insurgency with no breaks and everyone always on the front line.

— Better and faster medical care that helps troops survive horrific physical injuries that often leave psychological scars.

"You land in Iraq, and you're on the battlefield, whether you're a quartermaster or a medic or a cook," said David Segal, director of the Center for Research on Military Organizations at the University of Maryland. "All you have to do is get on the highway to go somewhere from the airport."

The military and lawmakers are only slowly coming to grips with the consequences, Segal said.

"I think we have failed to recognize the extent of the problem," he said. "We've produced a problem that's going to be plaguing us for generations."

Past wars, through the Persian Gulf war, produced three casualties for every fatality, while now in Iraq "we're up to about 16-to-1," Segal said. Those killed are "really the tip of the iceberg" as far as the toll on soldiers, he added.

One Republican congressional staff member who works on military issues said the rationale behind the Pentagon's practice was: "We didn't break you, you were already broken. You're not our responsibility."

"One soldier I know received a diagnosis for a personality disorder after a 45-minute talk," said the staffer, who spoke on condition of anonymity. "He'd been in the military 10 years, had made it his career, and then he was told he was being shuffled out in a couple of weeks. We keep getting these stories."

In the House, Rep. Phil Hare, D-Ill., is leading the effort to get similar legislation approved.

"It defies logic to think that tens of thousands of our servicemen and women slipped through the cracks during the pre-screening process," Hare said. "We have a moral obligation to review the discharge process and ensure we are getting it right."

60 Minutes Report: Who Killed Rebecca Riley?

Last night 60 Minutes broadcast a report on the death of Rebecca Riley, and on the storm of controversy that has resulted when it was found out that the 4 year old died as a result of an overdose of psychiatric medication for bipolar disorder, the disease formerly known as Manic Depression.

Bipolar disorder in a 4 year? Are the psychs crazy? In my opinion, yes they are.

The full 15 minute report is available on the website, including streaming video through CBS's own Flash player and a transcript. It is too long to provide in full here. Instead, we can provide some snippets that we find interesting.

"According to the medical examiner, her heart and lungs were damaged, and this was due to prolonged abuse of these prescription drugs, rather than one incident. Prolonged abuse of these prescription drugs," Couric remarks.

"Yes. And the doctor had Rebecca on .35 milligrams, daily, for months. And I didn't know anything about dosages. How much was fatal," Riley says.

The medical examiner ruled that Rebecca died of a drug overdose from a mix of medications. And that the amount of Clonidine alone would have been fatal.

Today, awaiting trial, Carolyn Riley says she now knows more about bipolar disorder than she ever did when her daughter was alive.

Asked if she thinks Rebecca was really bipolar, Riley says, "Probably not."

"What do you think was wrong with her, now?" Couric asks.

"I don't know," she says. "Maybe she was just hyper for her age."

---

The prosecutor alleged at their arraignment in February that they were overdosing Rebecca by repeatedly giving her more medication than she was prescribed. "It was used on Rebecca, her sister and her brother for one simple purpose by these defendants: to knock them out and make them sleep," the prosecutor claimed.

But the Rileys claim that they were following doctor's orders. 60 Minutes wanted to talk to the psychiatrist, Dr. Kayoko Kifuji, but she declined. Instead 60 Minutes got a statement from her hospital: "The care we provided was appropriate and within responsible professional standards."

60 Minutes did obtain a copy of Rebecca's medical records. In them, Dr. Kifuji notes Rebecca's increased risk of mental illness because of her family history. She diagnosed Rebecca after Carolyn said her daughter was - quote - "driving me crazy" and her mood switches within a minute. She would eventually prescribe the preschooler more than ten pills a day.

Riley says she did feel that that was a lot of pills for a little girl, but she says she went ahead and gave Rebecca the prescriptions. "I trusted the doctor," she says.

Dr. Kifuji has stopped practicing, pending a ruling by the state medical board. But her lawyer has said she was just practicing mainstream psychiatry. It's now estimated that nearly one million children like Rebecca Riley have been diagnosed with bipolar disorder, or manic depression. And while some psychiatrists told 60 Minutes that early diagnosis is saving lives, a growing number of doctors say it is being over-diagnosed.

---

Dr. John McClellan [...] says the children's psychiatric hospital he runs in Washington state is filled with kids who have been misdiagnosed as bipolar. He says it has become a catchall for aggressive and troubled children.

"I think it's a problem to label kids with a major adult psychiatric disorder when they're five years old or when they're three years old," Dr. McClellan says. "Little kids are not adults. And little kids do things that if an adult did them, it would be evidence of a mental health problem."

"Having said that, if someone is bipolar and it presents later in life, doesn't it make sense that these issues exist really from birth?" Couric asks.

"No, that does make sense," McClellan says. "The problem is symptoms like irritability or recklessness or high energy when you're an eight-year-old don't necessarily predict in the long run developing bipolar disorder. Some might. Do you expose all those kids to medications to prevent the one kid that's going to get it?"

Maybe we need to ask if psychiatry kills. After all, the psychiatrist is not being investigated by law enforcement, and maybe psychiatrists should be, especially when there is a death involved. The death of a child.

AntiDepressant Side Effects During Pregnancy

A case where some mid-wives were not as aware of the side-effects of anti-depressants during pregnancy as they should have been. As seen in this report

The Health and Disability Commissioner has criticised the West Coast District Health Board after lack of care by three midwives left a newborn boy with permanent neurological problems.

Commissioner Ron Paterson also criticised the DHB over the subsequent delays and handling of the complaint into the case.

When the boy, known as Baby A, was born in 2004, he developed hypoglycaemia, or low blood sugar, after he stopped feeding normally in the two days after his birth.

Mr Paterson said the baby, at the lower end of the normal weight range, was vulnerable to hypoglycaemia as his mother, Ms A, was a heavy smoker and taking antidepressants during her pregnancy.

An independent adviser to Mr Paterson, midwife Nimisha Waller, said that as Baby A's weight was still inside the normal range he was not considered to be at risk of hypoglycaemia and did not get regular blood glucose monitoring.

She said all the midwives failed in developing a plan of care on a daily basis and did not recognise a change in Baby A's feeding pattern which resulted in the condition.

Mr Paterson said the combination of risk factors meant the midwives should have immediately monitored blood sugar levels and monitored feeding.

The three midwives have since reviewed their practice and written apologies to Ms A for the lack of care. The DHB has also written an apology to Ms A and is to audit its neonatal policies in regard to low-weight or at-risk babies.

Locked up and forgotten

A sad tale of why reform was needed, and likely still is. As seen in The Sun

A woman was locked up and “lost” for 70 years after being wrongly accused of stealing 13p.

Jean Gambell, 85, was “certified” indefinitely in 1937 over claims she had taken the cash while cleaning at a doctor’s surgery.

The money was found — but Jean still spent 70 years in a maze of care institutions.

She was “found” when brothers Alan, 66, and David, 63 — who thought she was dead — read a letter sent by a care home to their mother, who died 25 years ago.

David said: “I was about to throw it in the bin when I saw a name in the corner — Jean Gambell. I rang and they said our sister was there.”

The two brothers travelled from their homes in Liverpool to see Jean at the home in Macclesfield, Cheshire. Staff warned them she was deaf and may not remember them.

David said: “We were very nervous. We wrote on a piece of card ‘Hello Jean, we’re your brothers’. But she took one look at us and said, ‘Hello Alan, hello David’ — and flung her arms around us.”

He added: “Nowadays there are appeals — but back then a doctor could sign away a life with the stroke of a pen.

“They basically locked her up and threw away the key and she was stuck in the system.

“She just got moved from one institution to another.

“What a waste of a poor, innocent girl’s life.”

Jean had a stroke after meeting her brothers, believed to have been sparked by the shock of the reunion. She is said to be recovering.

The Failure of Quebec Governmental Mental Health Services for Children

Let's see, we have children in government controlled youth centers, where 80% are under the control of of a psychiatrist. About 67% are on prescription drugs, and 40% are on psychiatric drugs. Are we really surprised at these figures?

Granted, many are from broken homes, etc. and maybe the only practical method they have is to sort of warehouse them and drug them up. (Never mind the cycle of side effects that can drive people crazy)

But these kind of figures sound like the figures of a failed system to me. It's a surprise that the figures aren't worse. And of course, they don't make the connection between the psychiatrists and the high rate of psychiatric prescriptions. If you are hammer, everything looks like a nail.

Taken from this report in the Montreal Gazette.

Quebec children in youth protection services are extremely damaged, warned an author of a report showing nearly 40 per cent are prescribed drugs for psychiatric problems.

Children as young as six years old are medicated to control hyperactivity, aggression, depression and suicidal tendencies, said Pierre Charest, head professional services at Centre jeunesse de Montreal.

[...]

Made public earlier this week, Charest's report, however, strongly recommends finding alternatives to drug therapy, especially for young children.

Commissioned by the provincial health department, the working committee's study on the mental health of children under government care shows a disturbing trend of mental disorders.

The study tracking 3,600 youths in Quebec's youth protection network last year reveals that one in four suffers from multiple mental disorders. The majority are being treated for minor issues while 17 per cent are seriously ill.

Children ages six to 11 years old seem to have the most mental health issues, the report found. About 67 per cent are on prescription drugs.

"The rate of mental illness in group homes is very, very high. It's definitely higher than in the general population," Charest said.

Health professionals welcomed the report, a first of its kind for Quebec.

"For the first time we have a portrait of the Quebec reality," Douglas Hospital child psychiatrist Philippe Lageix said.

"But it's not something new that's popped up suddenly in Quebec."

Children in youth protection represent the most at-risk population for mental illness because of several factors, Lageix explained.

It's a predictable pattern:

"We meet one patient after another and realize that their parents have problems. They are exposed during pregnancy to (drugs, alcohol, cigarettes, malnutrition) and then neglected, then placed.

"They peak on all risks," he said. Those with severe mental health and behaviour problems cannot stay with their own families or be placed in foster care, he added.

But Quebec is not alone. Comparative studies show Ontario, Holland and the United States are dealing with similar issues, Lageix said.

"Very vulnerable youth are getting services from (youth protection) agencies and a lot of them are medicated," Lageix said. "But do we treat too much or not enough? That's a social debate."

Experts suggest health services to youths in centres has improved during the last decade.

In Quebec, nearly 80 per cent are under the supervision of a psychiatrist or other professional despite the shortage of physicians. But 20 per cent are fending for themselves, the report found.

[...]

Among the study's recommendations:

Better screening to evaluate and follow youth with multiple problems, special programs adapted to children with mental health issues, improved training for caregivers and professionals dealing with children at risk, multi-disciplinary teams in place in group homes and more studies to seek alternatives to medication therapy.

Quebec Health Minister Philippe Couillard has endorsed the study's recommendations saying funds are available in the 2007-2008 budget.

60 Minutes on Rebecca Riley and Bipolar Prescriptions

In a run up to their Sunday 60 Minutes show, Katie Couric had a news story to night on the tragic psychiatric drugging death of Rebecca Riley. As seen in this report/ press release We will have to see if this is an honest investigation, or free advertising for the drug companies. The online video seems to indicate that this is a damage control news item for the drug companies.

A mother charged with murder for what she claims was medicating a child diagnosed as bipolar, says her dead four-year-old daughter probably wasn't suffering from the disorder after all.

In her first interview, Carolyn Riley tells her story to Katie Couric for a report on the increase of bipolar diagnoses in children to be broadcast this Sunday, Sept. 29, at 7:30 p.m. ET, 7:00 p.m. PT, on 60 Minutes.

[...]

It's estimated today that one million youngsters in the U.S. have been diagnosed with bipolar disorder, which was once thought to affect only adults. Couric's story explores this phenomenon by talking to parents of diagnosed children and to doctors like Dr. Joseph Biederman, head of pediatric psychopharmacology at Boston’s Massachusetts General Hospital.

Bristol-Myers to pay $515,000,000,000 fine

Via the BBC and other news outlets

US drugmaker Bristol-Myers Squibb and a subsidiary have agreed to pay more than $515m (£251.7m) to settle allegations of marketing certain drugs illegally.

The fines issued by the US Department of Justice mark the end of a probe into the firm's drug pricing practices that began a number of years ago.

[...]

The US DoJ concluded on Friday that the company and a wholly-owned subsidiary called Apothecon had used incentive schemes to encourage doctors and wholesalers to stockpile their drugs and so help Bristol-Myers achieve its sales targets.

This included maintaining "fraudulent and inflated" prices for a wide range of cancer and generic drugs knowing that federal health care programmes established reimbursement rates based on those prices.

Bristol-Myers was also accused of knowingly misreporting its best price for the anti-depression drug Serzone to Medicaid, the government-backed health insurance scheme.

In addition, the DoJ claimed that the company had promoted the use of the treatment-specific anti-psychotic drug Abilify to a wider client base than recommended by the Food and Drug Administration.

"Patients are entitled to unbiased decision-making from their physicians and should not have to worry that financial inducements or lavish entertainment have influenced their physicians' prescribing choices," said Michael Sullivan, the US attorney in Boston.

As part of the settlement, Bristol-Myers said it had entered into a five-year "corporate integrity agreement" with the government healthcare regulator, the Office of the Inspector General of the Department of Health and Human Services.

The agreement is designed to ensure the company adheres to its compliance programs relating to its US pharmaceuticals business.

British Government Watchdog Patient Survey Rate North Lincolnshire the Worst in Country

From the Scunthorpe Telegraph

Psychiatrists in North Lincolnshire are some of the worst in the country, according to a Government watchdog patient survey.

Mental health service users ranked the region's psychiatrists at the very bottom of a national league table for trustworthiness, respect and listening.

The Healthcare Commission survey findings are in stark contrast with steadily improving national results.

North Lincolnshire Primary Care Trust (PCT) director of contracting Caroline Briggs, on behalf of the acting chief executive, said she was disappointed with the results.

She said: "It goes without saying that the psychiatrists feel badly our patients are generally dissatisfied with the service we offer and that we have done badly on a national scale."

They have promised a host of measures in an action plan to get the service back on track including keeping staff long term.

Half of North Lincolnshire PCT service users were unable to answer yes when asked if they had trust confidence in their psychiatrist.

Users also ranked psychiatrists at rock bottom when asked if they were treated with respect and dignity. One third did not answer yes.

And 45 per cent said their psychiatrist listened only 'somewhat carefully' or 'not at all carefully' to them.

The survey was carried out among patients at 69 NHS trusts around the country.

[...]

The Potential Political Uses of Psychiatry

Someone else has discovered the political advantages of using psychiatry, and has become a little disturbed by this. Of course, old time Soviet style psychiatry would never become prevalent in the USA, comrade.

Or would it? These folks seem to think so.



Of course, we are not particularly aligned with any political party.

Psychiatrist Loses Criminal Appeal

As seen in this report from the Capitol News Service

A Maryland court Wednesday upheld disciplinary action against the psychiatrist who leaked details about the sexual habits and mental health of convicted spy Robert Hanssen in 2001.

A three-judge panel of the Maryland Court of Special Appeals upheld lower court rulings against Alen J. Salerian, who had been hired by defense attorneys to evaluate Hanssen, a former FBI agent arrested for giving highly classified information to Russia.

The two met over the course of a week in April 2001, during which Hanssen admitted he had a "long history of sexual betrayal and exploitation" of his wife -- a fact that Salerian later shared with Hanssen's wife.

Court documents said Salerian was warned repeatedly by Hanssen's attorney, Plato Cacheris, not to disclose any details of his conversations with the former FBI agent. Salerian, along with most others involved in the case, had also signed a letter from the U.S. Attorney General promising not to disclose information about Hanssen due to "national security interests" involved.

In May 2001, within a week after telling Hanssen's wife about the sexual betrayals, Salerian was fired by Cacheris. Salerian also received a letter from Hanssen forbidding him from discussing their meetings with anyone other than defense attorneys, including family members and "certainly with anyone outside the family."

But in the following weeks, Salerian was quoted in numerous media outlets discussing Hanssen's mental state.

In a June 2001 CBS report, Salerian claimed that he had disclosed the information with Hanssen's permission. Salerian, who believed the FBI, the church and the medical system had failed Hanssen, said it was "a situation where there was life and death involved and I had to make a call as a physician to say what I think is right."

In a disciplinary hearing against Salerian, Hanssen testified via telephone that he had agreed to let Salerian tell his wife about the sexual exploits because Salerian convinced him that the media were about to publish it.

Hanssen pleaded guilty to espionage in July 2001 and is serving life in federal prison. The 2007 film "Breach" was based on his arrest.

Hanssen's attorneys and wife filed a complaint against Salerian in September 2001 with the Maryland State Board of Physicians, charging he disclosed confidential information. That same month, Salerian's license to practice medicine in Maryland expired.

He applied for reinstatement of his license in September 2002, only to be told the board was charging him with immoral and unprofessional conduct and violating attorney-client and physician-patient privilege. He attempted to withdraw his application in July 2003, but was told he could not do so while charges were pending.

An administrative law judge initially recommended that Salerian be fined $20,000, have his license revoked and be barred from applying for reinstatement for up to three years.

In January 2005, the board decided instead that Salerian be fined $5,000 and be placed on probation for two years, which would not end until he completed an ethics course.

Salerian challenged the action, but it was upheld by the Montgomery County Circuit Court. He raised 10 issues in his appeal to the Maryland Court of Special Appeals, which rejected all 10 Wednesday.

Messages left on his voicemail Wednesday at the Washington Center for Psychiatry were not returned. A woman who answered the phone at the address listed for Salerian in the state physicians board's records said he had not lived there for six years.

Cacheris called Wednesday's ruling accurate and said he agreed with the penalties against Salerian.

Redefining Depression as Everyday Common Headaches

An opinion piece we missed from earlier this year

Yesterday’s front-page splash in The Times (London) proclaimed that Britain is now ‘a Prozac nation’. ‘The number of Britons prescribed antidepressants is at a record high despite official warnings that many patients may not need them’, the paper reported.

Last year doctors wrote more than 31 million prescriptions for antidepressant drugs, and while ‘the exact number of people taking pills for depression is not known’, it is ‘thought to be several million, with many taking the medications over long periods on repeat prescriptions’. The cost to the National Health Service of antidepressants was £291.5 million. ‘Depression’, reported The Times, ‘is estimated to affect as many as one in five at some point during their lives. At any moment, 1.5 million people aged between 16 and 75 are suffering from depression, and 2.7 million from anxiety, although most cases are untreated’.

Yet is the problem here really antidepressants, some kind of ‘Prozac culture’? Shouldn’t we be more concerned about the question of why so many people seem to believe that regular doses of drugs provide solutions to their problems?

Commenting on these reports, Libby Purves, in a piece subtitled ‘Hurray for Prozac. But it’s prescribed too easily’, compared the news that ‘Britain is on antidepressants’ to ‘hearing that a crutch-and-splint factory has doubled its profits. You’re glad all those people are being helped to walk upright, but wonder why so many are getting hurt.’

She agrees with a Times blogger that ‘drastically reducing the hours that television is broadcast would be a good place to start’ in combating depression, hailing this sort of ‘turn off the TV and DO something’ ethic as ‘simplistic but bracing’: ‘You can’t help noticing that these worried news items about depression are generally surrounded, in all media, by a sea of gloom about house prices, terrorism and new diseases, and further decorated with ridiculous stuff about “must-have” handbags and how contemptible it is to be a bit fat and not yet famous.’

If sitting in front of 24-hour television news and watching endless bulletins on how the planet is dying of climate change, while eating a comfort donut that the government’s ‘war against obesity’ has made you feel guilty about, is enough to trigger depression, then the real question is why all of us aren’t scoffing down Prozac.

In 2005, the last time the nation flew into a panic about the overuse of antidepressant drugs in the UK, Dr Michael Fitzpatrick argued on spiked that the reason depression is now so prevalent is that the diagnostic term has been altered. The term depression was ‘formerly restricted to patients so severely afflicted by melancholy that they might require hospital admission’, but is now ‘adapted to cover a wide range of responses to existential distress, resulting from workplace dissatisfaction, marital disharmony, bereavement or other losses’.

The real motivating factor behind our ‘Prozac nation’ is not the existence of new drugs or the willingness of doctors to dish them out or 24-hour TV cycles – it is that people are continually educated these days to identify their human grief, feelings of loneliness, heartbreak or simply anxiety at their own personal foibles as ‘depression’.

Medicalising every problem and treating natural feelings as a form of mild psychosis has replaced the old framework of seeing problems as something to be overcome with the help of friends. In the past, individuals were encouraged to get through rough times in a pro-active way, through collectivity and community, whether by turning to their trade unions, churches, extended families or their mates in the local pub. As such institutions decline, and claims that everything we experience can be a cause of depression or mental illness are on the rise, it seems inevitable that people will turn to drugs for answers.

As Dr Fitzpatrick concluded: ‘Rather than now telling GPs to stop prescribing anti-depressants, it might be more constructive for doctors and psychiatrists to ask whether it is beneficial either to individuals or to society to label a quarter of the population as being mentally ill.’

Today’s ‘Prozac Nation’ is the outcome of the relentless medicalisation of everyday problems – and if we switched off these messages about everyone being screwed up (rather than our TVs) that might be a first step to helping people get off the antidepressant bandwagon.