Iowa's Governor Terry Branstad seeks to close two mental institutes

From a much longer report at the Des Moines Register

Gov. Terry Branstad has proposed closing two of the state's four institutes for people with mental illnesses.

The proposal startled legislators of both parties, although the idea of closing at least one of the institutes has been debated off and on for decades, as their populations dwindled and costs soared.

[...]

Branstad suggested during a budget hearing last month that he wanted to consider consolidating some of the services at the institutions. "The facilities are obsolete, and it's extremely expensive" to use them the way the state now does, he said then. However, he said he had no immediate plans to do so.

According to his new budget, however, Branstad wants to zero out spending for the Mount Pleasant and Clarinda institutions. According to the budget, the state is spending nearly $7 million on the Mount Pleasant facility this budget year and $8.7 million on the Clarinda facility.

Local legislators were surprised by the Governor's budget proposals, and are in a panic over the proposed closings

The Iowa Court of Appeals has ruled that the state is not liable in a lawsuit filed by a former University of Iowa Hospitals and Clinics patient who had a sexual relationship with a psychiatrist.

As reported by the Iowa City Press Citizen

Given the regulations that were in place, it looks like the shrink is the only one responsible for his reprehensible conduct. More details at the link

The Iowa Court of Appeals has ruled that the state is not liable in a lawsuit filed by a former University of Iowa Hospitals and Clinics patient who had a sexual relationship with a psychiatrist.

In a ruling issued Wednesday, the appeals court reversed a previous decision by a Johnson County District Court judge denying the state's motion for summary judgment.

The civil suit stems from a 2010 relationship between Dr. Sergio Paradiso, then a psychiatrist at UIHC, and Sonni Giudicessi, who had been treated by Paradiso and others at the hospital in 2008 and 2009.

According to court records, the two secretly engaged in a sexual relationship from March to June 2010 — four months after Giudicessi had been discharged for treatment. Giudicessi's Des Moines-based psychiatrist reported the relationship to UIHC in July of that year, and Paradiso voluntarily surrendered his medical license in 2012 after the Iowa Board of Medicine found he violated the laws of medical practice.

Giudicessi sued Paradiso in July 2011 for medical negligence, battery, breach of contract and intentional infliction of emotional distress, among other charges. She also sued the hospital for breach of contract and negligent hiring.

The appeals court ruled this week that there is no evidence that Paridiso represented to Giudicessi that their sexual relationship was a continuation of their previous counseling relationship.

"Paradiso pursued the relationship for his own personal interest and not the interests of UIHC," Judge Thomas Bower wrote in the court's decision. "... Paradiso's acts were 'so far removed' from his employment duties the State could not be held liable."

Paradiso worked in the psychiatry department at UIHC as a staff doctor from 1997 through his departure in July 2010. According to the ruling, UIHC resident doctors are trained that it is inappropriate to have sexual relationships with patients.

In the ruling, Bower noted that the department's head of psychiatry has distributed a list of "commandments" to residents and fellows, with the first commandment being: "Though shalt not sleep with any UI Psychiatry Hospital patient unless it be thy spouse."

The American Psychiatric Association Code of Ethics prohibits relations between current and former patients, and UIHC policies prohibit sexual harassment, Bower wrote.

[...]

Psychiatrist shortage looms - Lack of popularity puzzles professionals

Now Formally: The decline of Psychiartry, Part 1

It looks like many people who could become psychiatrists are avoiding the job. This is puzzling to medical professionals, some of whom are starting to panic. Of course, we could speculate about the public reputation of psychiatrists as a contributing factor. (Just take a look at the stories published on this site) We will not speculate further in this regard, but can only note that if this trend keeps up, this decline can only lead to the eventual death of the profession as we know it. Snippets from this report out of Iowa

Russell Knight, president and chief executive officer of Mercy Medical Center-Dubuque, recently served on a task force studying Iowa's physician needs.

The group found 77 openings for psychiatrists in Iowa, yet an average of only 16 psychiatrists entering the state each year.

Knight said it will take five years to fill Iowa's psychiatrist vacancies if that rate continues. By comparison, obstetrician, cardiologist and general-surgeon vacancies take an average of two years to fill.

[...]

"But there is a shortage of psychiatrists all over the country," Curtis said.

The shortage in Iowa seems more pronounced than elsewhere, however. Knight's task-force research suggests Iowa has half as many psychiatrists per 100,000 residents compared to the national average -- 7.7 versus 15.8.

The statewide psychiatrist shortage has forced some Iowa hospitals to close their inpatient psychiatric units, Knight said, and it is no longer unusual for Mercy's unit to care for patients who have come from 100 miles away.

Families talk about 'worst nightmare' - man sentenced after murders, was on psych drugs.

From the Iowa City Press Citizen. A long and sand and tragic story, here are some of the essential points.

In a tearful and emotional sentencing Wednesday morning, Kyle Marin was sentenced to two consecutive life sentences without the possibility of parole for killing 18-year-old cousins Molly Edmondson and Katrina Hill in Edmondson's Cedar Rapids apartment on April 23, 2006.

Marin, 21, formerly of North Liberty, was convicted of two counts of first-degree murder Nov. 1. The mandatory penalty for first-degree murder in Iowa is life imprisonment without parole. Judge Robert Sosalla, who presided over the two-week long trial, ordered that the life terms be served consecutively rather than concurrently "because of the brutality of the offenses."

The sentencing also saw the only time Marin spoke out loud in the courtroom as he asked for forgiveness for his crimes.

"I will not forgive myself," Marin said. "I will do my time for the pain and suffering I have caused. I want Molly and Katrina, my friends, to know how sorry I am. ... I would like to ask for forgiveness, but I have no right."

Sometime in the early hours of April 23, 2006, Marin entered Edmondson's apartment, woke her and Hill and directed them to the bathroom, according to trial testimony. He had them strip before he brutally attacked them with knives, a hammer, a screwdriver and a pizza cutter.

Before and after the murders, Marin went to the top of a parking structure and contemplated suicide. His defense attorneys, Thomas Diehl and Dave Cmelik, argued that Marin's use of Zoloft and other prescription drugs drove him to experience suicidal and homicidal thoughts.

Marin's friendship with Edmondson and Hill was discussed at length throughout the trial. In a videotaped interview with police, Marin said the women were his best friends, and he did not know why he killed them. Marin attended two house parties with Edmondson and was staying at her apartment the night he killed the women.

[...]

In addition to the consecutive life sentences, Marin was ordered to pay $150,000 to the estates of both Edmondson and Hill, as well as court costs and attorney fees. He may seek an appeal within 30 days of his sentencing.

A number of victim impact statements are included in the original report. While the man who committed the crime deserves to go to jail, the psychiatrist who prescribed these dangerous drugs should also be held accountable.

Iowa to pay subjects $925K for stuttering study - 1930s experiment tried to cause speech issues by baiting, belittling orphans

Via this report on MSNBC - Sadly, not nearly enough for ruined lives.

The state [of Iowa] has agreed to pay $925,000 to unwitting subjects of an infamous 1930s stuttering experiment — orphans who were badgered and belittled as children by University of Iowa researchers trying to induce speech impediments.

Johnson County District Court Judge Denver Dillard issued an order approving the settlement Friday morning; it still must be ratified by the State Appeal Board, which next meets Sept. 4.

The six plaintiffs, who said the experiment left lifelong psychological and emotional scars, had originally sought $13.5 million.

“We believe this is a fair and appropriate settlement,” Attorney General Tom Miller said in a statement. “For the plaintiffs, we hope and believe it will help provide closure relating to experiences from long ago and to memories going back almost 70 years.”

He said it was a prudent outcome for the state because of the high costs of litigation and the difficulty of finding witnesses to events so long ago. He noted that the settlement provides a resolution for plaintiffs who are now in their 70s and 80s.

‘The Monster Study’

The 1939 experiment has come to be known as “The Monster Study” because of its methods and the theory researchers set out to prove — that stuttering is a learned behavior that can be induced in children.

Over a six-month period, Dr. Wendell Johnson, a nationally renowned pioneer in the field of speech pathology, and his staff tested his theory on 22 children who were in the care of the state-run Iowa Soldiers’ Orphans’ Home. Some were subjected to steady harassment, badgering and other negative therapy in an attempt to get them to stutter; the rest served as a control group.

According to the study, none became stutterers, but some became reluctant to speak or self-conscious about their speech.

Hazel Potter Dornbush, 84, of Clinton, who was 15 when she was chosen for the study, said she is relieved the case is settled.

“It was awful stressful all these years. I’m just glad it’s over,” she said. “How would you like to have them turn over all your past for the last 80 years?”

Dornbush said she recalls 22 children being taken from the state-run Iowa Soldiers’ Orphans’ Home to be used in the research. She said many of the children were told they stuttered even if they didn’t, and the researchers said they were there to help them stop.

“I call that brainwashing. I don’t care what anybody else calls it, that’s my language. I was wise to it right away, but I cooperated. You know we weren’t in no position to argue with nobody. We had nobody to lean on to help us out.”

The university kept the experiment and its methods from the former subjects for decades. It was not until 2001 when the San Jose (Calif.) Mercury News published an investigative story about the study and its methods did the former subjects learn about the experiment’s true purpose. The newspaper based its story on statements made by Mary Tudor, one of Johnson’s former research assistants, who lived in California at the time the story was published.

The university apologized for the experiment in 2001; the plaintiffs sued in 2003.

The settlement pays $900,000 to five of the plaintiffs, Dornbush, Kathryn Meacham, the Betty Romp estate, the Clarence Fifer estate and the Phillip Spieker estate. The state also will pay $25,000 to the sixth plaintiff, Mary Nixon.

Psychiatrist seeks reinstatement of medical license

From the Muscatine Journal in Iowa

Muscatine psychiatrist James A. Yeltatzie is seeking reinstatement of his license that was pulled by the Iowa Board of Medical Examiners more than a year ago.

Yeltatzie’s license was suspended in December 2005 for allegedly engaging in professional incompetence and practice that was harmful or detrimental to the public. It was the most recent and severe of the Board’s disciplinary actions against him, beginning in 1991.

A hearing on his request for reinstatement was held Thursday afternoon at the Muscatine County courthouse.

According to officials at the courthouse, approximately a half dozen protesters held signs and chanted in support of Yeltatzie near the main entrance just prior to his court appearance.

Yeltatzie’s lawyer, John Wunder, Muscatine, said Friday the punishment was too harsh for the violations for which his client was cited.

“Despite the fact that he has now been twice before the Board, he is still a good psychiatrist,” Wunder said. “The request for judicial review is not that discipline was unwarranted — it (license revocation) was essentially a death penalty for his career.”

Judge Patrick Madden, who heard the reinstatement appeal Thursday, is reviewing the case.

Yeltatzie, 47, received a license to practice in Iowa in 1988.

Years of controversy have surrounded the actions of the psychiatrist, who is apparently liked by many of his patients, yet has been accused of multiple counts of misconduct by others.

According to state records:

• In 1991, Yeltatzie’s license was suspended after he was accused of making improper physical contact and advances to three patients. He also was cited for possession of marijuana and filing a false license application with the state Board.
  
  
• In 1994, his license was reinstated and he was placed on probation for five years.
  
  
• In 1999, Yeltatzie was charged with violating his probation. The Board accused him of practicing outside of psychiatry, improperly using controlled or prescription drugs and not filing required reports with the Board.
  
  He was fined $6,000 and required to submit to a psychiatric evaluation and treatment by a Board-approved psychiatrist.
  
  
• In 2002, the Board began receiving complaints about Yeltatzie, including his prescribing practices, practicing outside the scope of psychiatry and failure to return phone calls. Multiple investigations took place and the Board began a peer review in late 2005.
  
  That investigation resulted in the 2005 license revocation.