Another Psychologist Caught in Drug Fraud

Here we have an odd case of a medical doctor who is also a psychologist, not a psychiatrist. In any case, he got caught with his hand in the cookie jar. As reported in the Pocono Record

East Stroudsburg doctor Harold Pascal pushed prescription drugs using “criminal patterns” and disregarding the health needs of his patients, state narcotics investigators charge.

Authorities allege Pascal was providing prescriptions for whatever drugs “patients” said they wanted, and police described an assembly-line process in which patients even went so far as to write down what drugs they wanted to save time during office visits that took as little as 2½ minutes.

Affidavits from police also list testimony from a citizen who claims Pascal billed area school districts for counseling services that were never performed. Statements in the affidavit also suggest Medicare fraud, saying Pascal took cash from patients and then billed Medicare.

The affidavits, filed Tuesday at the Monroe County Courthouse, include 30 detailed pages listing 27 undercover purchases of prescriptions narcotics agents said they made through Pascal.

By filing details of Pascal’s alleged crimes at the Monroe County Courthouse, the Pennsylvania Attorney General office reinstated its claim to seize Pascal’s building and offices on 223 Brown Street.

Pascal’s attorney, James Swetz, said by phone Thursday, “I have not seen it yet, but when I return I shall read, investigate it and attack it.”

According to the affidavits, Troy G. Serfass, a narcotics agent for the Pennsylvania Attorney General’s office, said the investigation began when a local student, who was sent to Pascal for help, found the doctor was dispensing prescription drugs regardless of need. “All she had to do was ask.”

The student also claimed Pascal would take cash from patients and bill Medicaid, according to the affidavit.

Two drug agents wearing recording devices subsequently posed as patients and reported that there was a line of patients outside Pascal’s offices. Each patient visit took from two to three minutes and each patient would leave with a prescription.

At one point a drug agent witnessed Pascal telling a patient to “bring a shopping bag” to hold all the drugs she was asking for.

Pascal is a psychologist and a medical doctor. He appears to have closed his practice, leaving some 400 patients without coverage.
Pascal holds a doctorate in psychology, a medical degree and license and a masters in divinity.

State law enforcement officials searched Pascal’s home and office on Nov. 7 and froze his bank accounts.

This week the state attorney general’s office tried again to take the Brown Street property, filing long affidivits claiming illegal drug activity at the building.

The state alleges Pascal’s building is subject to the terms of Pennsylvania’s Controlled Substances Act, which exposes for seizure “all property which is used as a container” for manufacture, sale or distribution of illegal drugs.

Meanwhile, a state grand jury continues to investigate Pascal.

School scam claimed

According to the affidavits filed in support of the state’s claim that it can seize the property, the first young complainant told Agent Serfass that Pascal “receives payment for counseling services from many area school districts but does not perform the services.” The state’s affidavit further claims that Pascal would issue fake invoices to school districts for counseling never received.

The first time an undercover agent went into Pascal’s office was Aug. 3, 2005. The visits from undercover agents continued through the fall of 2006.

On later visits an undercover agent asked for a prescription for Xanax, an anti-anxiety drug. Pascal handed it over. The agent gave Pascal $60. Narcotic agent Robert Bruce entered Pascal’s office and left with Xanax pills after a brief talk.

At one point, the affidavit states, Pascal asked an agent, “Is the whole family addicted?” He wrote the prescriptions anyway.

On the same day Agent Serfass said he saw 70 patients enter and leave Pascal’s office from between 2:30 p.m. and 5:30 p.m., averaging 2½ minutes per patient.

On another occasion an undercover agent went to see Pascal. According to the affidavit, the agent just said she needed Xanax. Pascal gave her a prescription.

Psychiatrist gets prison, fine in wheelchair scam

Via the Houston Chronicle

A Houston psychiatrist was sentenced to more than six years in prison and ordered to pay $20.6 million in restitution for defrauding the federal government in a scheme to sell unneeded motorized wheelchairs.

U.S. District Court Judge Lee Rosenthal also ordered Tuesday that Dr. Lewis Gottlieb forfeit $19 million in proceeds or property derived from a scheme to defraud Medicare and Medicaid.

Gottlieb was indicted in September 2003 with six others accused of involvement in a separate group operating the same fraud scheme.

He was among the first to be targeted in a federal crackdown on a widespread scheme that, at the time, was centered in Houston.

Since his arrest, two doctors who worked with Gottlieb and three medical equipment suppliers involved in the scheme have been convicted by a jury and are awaiting sentencing.

Gottlieb admitted accepting $200 kickbacks for each prescription he wrote for a motorized wheelchair, most of which were unneeded. The kickbacks were paid by recruiters working for medical supply companies, prosecutors said.

He also admitted that he refused to sign prescriptions unless patients also agreed to sign a form showing they needed his psychiatric services, for which Gottlieb billed the government.

Medical supply companies used the prescriptions to bill Medicare and Medicaid for motorized wheelchairs costing more than $4,000, then substituted motorized scooters costing about $1,600 and pocketed the difference, prosecutors said.

Womanising Psychiatrist 'struck off'

Another psychiatrist has had their license suspended or "struck off" in Queensland, Australia. As seen here

A doctor who had affairs with two patients and acted inappropriately with a string of others has been struck off for two years and ordered to undergo counselling.

Eric Quan, a GP based in Mackay in central Queensland, today admitted in the Health Practitioners Tribunal in Brisbane to unsatisfactory professional conduct by maintaining a sexual relationship with a patient.

Quan began his career as a GP in South Africa in 1982, and practised in Cape Town until he was sponsored to live in Australia on a work visa as a temporary resident in January, 2003.

He became a permanent resident in October the following year on condition that he work in areas of need until 2009.

Quan began working at the Hibiscus Medical Centre, in Mackay in January 2003, and had his first consultation with the woman who was the subject of the allegations in November of that year.

During that consultation, Quan told the married woman she had "beautiful boobs".

The relationship lasted until the end of 2005, continuing after her husband had reported the matter to the Health Rights Commission, and they had begun an investigation.

Quan also admitted to having a sexual relationship with another female patient between May 2004 and January this year, and that he had sex with her in his rooms, at her home, and at motels and caravan parks.

He also owned up to propositioning one other female patient, who reported him, and admitted acting inappropriately with three others.

Quan has also conceded that he had relationships with three patients in South Africa, each of 12 months standing, between 2000 and 2002.

Quan has been diagnosed by a psychiatrist as suffering from bipolar disorder, which meant he had mood and behaviour swings.

However, the psychiatrist said his behaviour in part also stemmed from personality traits of entitlement and narcissism.

Judge Julie Dick, who chaired the Health Practitioners Tribunal, said she was concerned by the number of patients involved, that the behaviour continued after an investigation had begun and about his psychiatric condition.

She also ordered that any resumption of his practice should be conditional on him having chaperones, supervision, continued psychiatric treatment and periodic independent reviews.

Update: The Continuing Wretched Saga of Psychiatrist Clint Tatchell

[Updated to connect to earlier posts on this site detailing the earlier wretched details.]

As reported in the Scotsman

See also this earlier report for more sordid details, as well as this one

A Psychiatrist has been found guilty of drunkenly writing a prescription for a flatmate at a party without consulting the man's GP.

Dr Clint Tatchell wrote a prescription for 28 diazepam tablets for Brian Hoolichan under the influence of alcohol.

The findings were released by the fitness to practise panel of the General Medical Council after a hearing in London.

David Steel, 30, was found dead in Dr Tatchell's home in Spiers Wharf, Glasgow, on 21 September, 2003 after taking drugs including heroin, cocaine, ecstasy and diazepam. He had died of an ecstasy overdose.

The GMC panel found Dr Tatchell guilty "dishonest" behaviour when he tidied his flat after it was discovered that Mr Steel was dead.

And now, hopefully the police will have their way with him. Don't people usually go to jail over things like this? I have seen reports that he has lost his license to practice, or "struck off" as the say in Britain. (which is at least a start).

Another Therapist Suspended in Sex Scandal

As seen here

A psychologist had an affair with a patient after he admitted having sexual fantasies about her, a hearing was told.

Gemma Bouwman began a relationship with the man despite knowing it could cost her her career.

And yesterday her fears were realised when she was suspended from practising for three years – the maximum period.

The patient, known only as Mr JG, was assessed by Bouwman in June 2003 when she worked for Leeds Mental Health NHS Trust.

He was said to have problems relating to physical and sexual abuse he suffered as a child, and also from being neglected by his mother.
A British Psychological Society conduct committee yesterday heard that, during one of their sessions, in April 2004, Mr J G told Bouwman that he wanted to have an affair with her.

She told the hearing that she tried to dissuade him, but eventually gave in – quitting the sessions so they could see each other non-professionally.

Mr Paul Epstein, for the BPS, said: "There was a discussion with JG about a potential relationship in which JG says he assumed Ms Bouwman was 'up for it'. Ms Bouwman said they would sack her.

"Therapy sessions were ended by Ms Bouwman in June 2004 in order that she might see JG outside a therapeutic setting. Ultimately, a sexual relationship developed between the two of them."

The affair lasted approximately five months, the hearing was told.
Bouwman, of Ilkley, admitted having a sexual relationship with her former client within two years of her ending her professional relationship with him. She also admitted bringing the profession into disrepute.

She told the hearing that she had raised her concerns about "professional boundaries" with JG after he admitted his feelings for her.

In her notes about JG read to the committee, she said: "He assumed I was up for it. I was his black lady.

"What if it turns out I am not? What if you are not my man? His eyes flickered anger, pain."

Bouwman also wrote: "If we had met outside this room it would have been different. We would have been free. I am not."

Ms Bouwman told the committee she later told him it was "completely impossible" to have a relationship, but she added: "I gave in to JG's pressure and agreed to discharge him and agreed to meet him without my professional hat."

BPS conduct committee chairman Dr Louis Kramer said: "The committee has taken into account all the mitigation, including her admission of the charges, the fact she has lost her employment, she was clearly under stress and there is no record of any previous complaints."

Jason Nash, defending, said Bouwman showed "honesty and remorse" about the inappropriate relationship with her former client. He added: "She had not tried to hide it."

The committee heard Bouwman was sacked by the NHS following an internal investigation. She has not worked as a psychologist since the incident because of her own health issues.

Man Accused Of Faking Retardation -- For 20 Years

This is a story that gets to the essential point, namely: Just how expert are these "experts" on the mind anyhow? As seen in this report.

For nearly 20 years -- ever since Pete Costello was 8 -- his mother has collected disability benefits on his behalf.

In meetings with Social Security officials and psychologists, he appeared mentally retarded and unable to communicate. His mother insisted he couldn't read or write, shower, take care of himself or drive a car.

But now prosecutors said it was all a huge fraud, and they have video of Costello contesting a traffic ticket to prove it.

"He's like any other person trying to get out of a traffic ticket," Assistant U.S. Attorney Norman Barbosa said Tuesday.

Pete and Rosie Marie Costello were indicted in September on charges of conspiracy to defraud the government and Social Security fraud, and the case was unsealed Tuesday. The Vancouver pair were scheduled to appear in federal court in Tacoma on Tuesday.

Barbosa said he planned to file with the court two videos of Pete Costello taken this year: In one, he allegedly feigns retardation during an interview with Social Security workers; the other is of him contesting the traffic ticket in a courtroom earlier this year.

The indictment accuses Costello of faking -- or at least exaggerating -- retardation since August 1997, because that is what prosecutors are confident they can prove, Barbosa said. But the pair first received benefits 10 years before that.

The benefits cited in the indictment totaled $111,000.

Barbosa said the government does not know whether Costello is retarded to some degree, but he clearly has been "exaggerating whatever he may have, if any."

"This person isn't being honest with the government about his condition," Barbosa said. "It makes it impossible to sort out."

It was not immediately known if the Costellos had obtained attorneys.

N.L. College investigating complaint of sexual relationship with patient

As seen in this report from the CBC news

A psychiatrist now working at a Canadian Forces base in New Brunswick gave up his medical licence in Newfoundland and Labrador after a patient complained that he had had sex with her.

James Hanley voluntarily closed his practice in St. John's in 2005, but did not tell his patients in advance. He moved to New Brunswick and is now practising at CFB Gagetown.

Despite Hanley's admission that he had had a sexual relationship with a patient he was treating, military officials says say they face a severe shortage of psychiatrists in Atlantic Canada.

"There's very limited psychiatric services in the Gagetown area," said Cmdr. David Wilcox, who is responsible for medical services for the military in Atlantic Canada.

"If his services were to be withdrawn, we would have a hard time filling that gap."

Patient attempted suicide

Kathleen Wiseman, 44, who lives on Bell Island near St. John's, became Hanley's patient in 1987.

In 2003, their relationship changed. Wiseman said she was depressed and abusing prescription drugs at the time.

"You know, I trusted him," Wiseman said in an interview.

"I was not in charge of myself.… I went to him and I said, 'I need you to help me,' and the next thing you know, I'm in bed with my psychiatrist."

At the time, Hanley was working part-time for the military in New Brunswick, where he still holds a licence.

The relationship between Hanley and Wiseman ended, and in late 2004 Wiseman made a suicide attempt.

Wiseman has registered a statement of claim against Hanley and the Eastern Health regional authority, his employer at the time, with the Newfoundland Supreme Court.

Could lose licence in other provinces

She has also filed a complaint with the Newfoundland and Labrador College of Physicians and Surgeons, which regulates the medical profession.

Dr. Robert Young, the college's registrar, said the issue is a serious one.

"If it's established that the physician has had sexual contact with a patient, that is inappropriate and may be professional misconduct," Young said.

Hanley does not want to speak publicly about the case. In a written response delivered to medical authorities, Hanley admitted that he and Wiseman had a sexual relationship.

The Canadian Forces did a risk assessment of Hanley. It concluded that, with troops returning from combat in Afghanistan, the Forces need Hanley too badly to let him go.

The Newfoundland and Labrador College of Physicians and Surgeons has not yet set a date for a hearing.

If a college panel finds Hanley guilty of professional misconduct, he could lose his licence to practise in other provinces, as well.

British Mental Health Tsar Resigns Over 'Scandal' of Black Patients

The death of 'Rocky' Bennett in 1998 sparked concerns over discrimination in Britain's psychiatric units. But little has changed since then, as seen in this report

The academic who designed the Government's race equality policy on mental health has resigned over fears that not enough is being done to protect ethnic minorities from mistreatment and discrimination.

Lord Patel of Bradford has told ministers he intends to step down as director of the Department of Health's ethnic minority mental health programme because the "scandal" of the treatment of black patients has not been dealt with.

The independent peer says the situation for ethnic-minority patients is " completely unacceptable", and says the Mental Health Bill should have greater "safeguards" to stop black people being mistreated.

In an interview with The Independent on Sunday, he said a national inquiry was needed into why a disproportionate number of black people were being diagnosed, or misdiagnosed, with serious mental health problems, and why their experience of the mental health system was so poor.

Research shows that black men tend to be given higher doses of medication than whites and are five times more likely to be detained on locked wards. Black people and people of mixed race are at least three times more likely to be admitted to hospital for mental health disorders than whites. They are also far more likely to be referred to mental health services by the police, courts or social services ­ and be diagnosed as psychotic and restrained or secluded in hospital.

Lord Patel's resignation will come as a blow to the Government. The peer, who has been in the post for three years, framed policy on tackling race inequalities and is highly regarded in government.

But Lord Patel said he was dismayed at the disproportionate use of control and seclusion orders and said the Government had yet to answer on why so many ethnic minorities were being detained. "I think there is a situation that is completely unacceptable. It's the last remaining care scandal. This is a major scandal," he said.

His resignation follows concerns that the Government has failed to properly conduct an assessment of the impact on race of its Mental Health Bill.

A census of mental health provision to be published in the coming weeks is expected to show that a disproportionate number of ethnic minorities are being detained. The academic, who is head of the Centre for Ethnicity and Health at the University of Central Lancashire, said he resigned to enable him to speak out against discrimination. Lord Patel, who is also chair-man of the Mental Health Commission, believes protections for ethnic minorities ­ and a duty to monitor the impact of the legislation on ethnic minorities ­ should be written into the Mental Health Bill before Parliament.

"Surely any government would want to know why this is happening," Lord Patel said. "We need a committee of inquiry. The census shows they are 50 per cent more likely to receive restraint or seclusion. Nearly 30 per cent of the population in high-security psychiatric care are black. We have an obligation to ensure that any future legislation must mitigate this situation. We should be putting race equality principles on the face of the Bill," he said.

Race discrimination in the mental health services was highlighted by the case of David "Rocky" Bennett, pictured above, who died of asphyxia in 1998 after being restrained for almost half an hour by five members of staff while in a secure mental health unit. The 38-year-old former musician had had an altercation with a fellow patient.

An inquest in 2001 ruled that his death, at a Norvic secure unit in Norwich, had been aggravated by neglect. Mr Bennett became angry that he, not the white patient, was being moved off the ward. His family were not told about his death until two days later.

Psychiatrist, girlfriend suspected in identity theft case

This report from Gillette, Wyoming

Deputies arrested a former Campbell County Memorial Hospital psychiatrist and his girlfriend on suspicion of stealing someone’s identity, Sheriff Bill Pownall said.

Dr. Lyndon Keith Steinhaus, 46, and 41-year-old Darcy Jo Bogenrief came under suspicion after Ozaukee, Wis., investigators notified Campbell County deputies last week about an identity theft.

Deputies searched Steinhaus’ and Bogenrief’s Robin Drive home Thursday and discovered evidence that led to their arrest, Pownall said. The case has been forwarded to the County Attorney’s Office for review, and the two have not yet been formally charged.

Pownall said he did not have any more details about the case because the investigation report is not yet complete. He said he thinks the victim lives in Wisconsin.

“I’ll be right honest, I look for further charges,” Pownall said.

The court paperwork was not ready at press time because Steinhaus and Bogenrief were arrested based on the evidence at their home and investigators did not ask for warrants before the arrest.

The hospital terminated Steinhaus’ employment Tuesday, said Karen Clarke, a hospital spokeswoman. Clarke would not say why he was let go because it is a personnel issue.

Steinhaus and Bogenrief were scheduled to appear in Circuit Court for their initial appearance Friday afternoon.

Another Coincidence of a Horrible Death and Antidepressants

Another pesky coincidence, where anti-depressants were used by someone who is alledged to have committed a horrible crime. as reported here:

Just minutes before his mom smothered him to death with a pillow, a 9-year-old Brooklyn boy begged her to "go to the doctor and get help," according to court papers made public yesterday.

"Demom" Olivia Jnnoel, 27, interviewed by detectives in a hospital where she'd been taken after jumping in front of a subway train, told detectives about the last conversation she had with her son, Kanil, on Nov. 13, the papers say.

Following morning prayers in the family home on Brooklyn Avenue in Crown Heights, Jnnoel's fiancé left for work, and mother and son lay in front of the TV, discussing the nightmares they'd each had.

"Kanil tells her that he had a bad dream last night," the papers say. "Being on the Empire State Building and flying. Her son mentioned going to hell . . .

"She then decided that if she was going to kill herself, she was going to take her son with her. That's when Kanil told his mother, 'Mom, you need to go to the doctor and get help.' "

The chilling confession was made public following Jnnoel's arraignment yesterday in the psychiatric ward at Elmhurst Hospital in Queens.

An indictment unsealed yesterday charges Jnnoel with murder, manslaughter and child endangerment for suffocating the boy just a day after his ninth birthday.

Police Commissioner Ray Kelly said after the murder that the woman told investigators that "demons overtook her" - although that was not mentioned in the court papers.

The first interviews with Jnnoel took place at Lutheran Hospital, where she was being treated for injuries sustained when she leaped in front of an F train in Coney Island. "I killed my son," Jnnoel allegedly told them. "I have no conscience."

After finding the boy's body inside the family house, detectives questioned Jnnoel further.

She allegedly told them she'd been under treatment for depression for six months, seeking relief from thoughts of suicide by taking Ambien, Prozac and Neurontin, which is used to treat nerve pain and seizures.

But on the night of Nov. 12, the Prozac bottle was empty, and Jnnoel's sleep was plagued by dreams.

"She awoke with these horrible thoughts in her head to hurt herself and could not stop thinking about it," according to the court papers.

Jnnoel faces 25 years to life in prison if convicted of the most serious charge.

Her lawyer, Jonathan Sims, yesterday requested a mental evaluation. If she's found unfit for trial, she could face an indeterminate period in a psychiatric institution.

Pregnant Women Are Urged to Avoid Paxil

As seen here

Pregnant women and those who plan to become pregnant should avoid taking the antidepressant Paxil if possible because of the risk of birth defects, a group of obstetricians said Thursday.

The opinion issued by the obstetric practice committee of the American College of Obstetricians and Gynecologists comes nearly a year after the Food and Drug Administration and manufacturer GlaxoSmithKline reclassified the drug to reflect studies in pregnant women that showed the drug poses a risk to the fetus.

Two studies of pregnant women who were taking Paxil during their first trimester have shown that their babies have heart defects at a rate that is as much as twice the norm, the FDA said at the time.

The American College of Obstetricians and Gynecologists also said the decision whether to treat pregnant women with SSRIs, a class of antidepressants that includes Prozac, Zoloft and Lexapro as well as Paxil, should be considered on an individual basis.

Exposure to SSRIs late in pregnancy has been associated with short-term complications in newborns, the doctors said.

However, reproductive-age women have the highest prevalence of major depressive disorders. The benefit to the mother of treatment with any of the drugs may outweigh the risk to the fetus.

The opinion appears in the December issue of the journal Obstetrics & Gynecology.

On the Net:

American College of Obstetricians and Gynecologists: http://www.acog.org/

Exercise in Children Leads to better Sleep and more Focus, Study Says

Another Condition Misdiagnosed as ADHD. But make the kids exercise?

A new study shows definite results that exercise for overweight children can help reduce snoring, hence improving sleep quality, attention span and focus.

Snoring is associated with poor sleep quality, which can lead to learning and behavioral problems that are often mistaken for disorders such as ADHD, says Dr. Catherine L. Davis of the Medical College of Georgia in Augusta.

Furthermore, prescribing stimulant ADHD drugs, like Ritalin, to kids who aren’t sleeping well will only make matters worse, she added. She also noted the growing evidence that sleep disorders can lead to a great risk of being overweight.

To research whether exercise might reduce sleep-disordered breathing in overweight kids, Dr. Davis and her team randomly divided 100 overweight children in the 7-to-11 age group between three different control groups. For the 13 week study period, the “high-dose” exercise group were involved in 40 minutes of physical activity every school day, the “low-dose” group exercised for 20 minutes a day and the third control group did not perform additional exercise.

The workouts consisted of games like basketball and tag, but unlike traditional gym class, Davis noted, there was no standing around waiting to play or be picked — the children were on the move for the entire session.

At the beginning of the study, one quarter of the participants’ parents reported symptoms in their children, such as snoring and inattention, serious enough to indicate a problem. Currently, just 2 percent of all children are thought to have sleep-disordered breathing, Davis and her colleagues note in the current issue of the journal Obesity.

By the end of the study period, half of the children who snored and were assigned to one of the exercise groups had stopped snoring altogether. Greater improvements were seen among the high-dose exercisers. However, weight, fatigue and behavior did not change.

Exercise alone is generally not enough to help people lose weight, Davis noted, although it does help people become more fit, physically and mentally, in every aspect. It’s possible that the workouts helped reduce the fat surrounding the neck area that can lead to collapse of the airway during sleep, she added, while exercise may also have had metabolic or neurological effects that made the brain, nerves and muscles better able to maintain an open airway.

To get the same amount of exercise in the real world, the children would probably need to exercise for an hour each day, Davis said. She recommended that parents send their kids out for some exercise right after school. Allowing them to burn off pent up energy will likely improve their mental focus and ability to tackle homework afterwards, she said.

Attention woes addressed without use of medication

Several points:

1. It's wonderful that more people are looking at non drug options for this 'condition'
   
2. There is still a major issue to what is the actual condition that is being treated.
   
3. So much of this disease lies in the realm of being 'socially defined', in the sense that it is behavior that is not acceptable to the current run of the mill teacher, who does not have the time or energy to deal with these kids.
   
4. God forbid that the condition, like autism, should be found to be a side effect of some common aspect of modern life. Like Television.

As seen here.

"She's been having problems with staying focused," said her mom, Nancy Lewis of Marysville.

The school, Bible Baptist in Shiremanstown, didn't seem like an issue. It doesn't have a disruptive atmosphere.

So it came back to the 12-year-old and what is often described as Attention-Deficit Hyperactivity Disorder _ a persistent pattern of abnormally high levels of activity, impulsiveness or inattention. The answer is usually Ritalin.

Nancy Lewis thought there might be a better way.

So twice a week, Sierra straps on a bike helmet that measures brain waves, and she works with video games that challenge her to pay attention.

"Kids who really have attention problems, they don't know what it feels like to pay attention," said G. David Smith, psychologist and president of Riverside Associates on Green Street, where Sierra has been going since July. "We teach them self-awareness and self-management, and not to be dependent on medication or on other people."

Smith and behavior specialist Katie Manning use the video software to teach their clients focusing skills, which the children can then transfer to the classroom and elsewhere.

To be nice, they call the video software a game.

"Play Attention" is a virtual reality system with a helmet attached to a computer. It's a difficult reality. Some of the games don't start until the helmet registers the brain waves that indicate the child is paying attention.

"The system projects that on a screen so kids can see when they hit it, and then use that as a way to get themselves in gear," Smith said.

The training techniques were developed by researchers working with brain injuries, particularly those of the frontal lobe, which Smith says mimics ADHD.

"These injuries produce problems in what are called executive functions, which have to do with planning, understanding cause-and-effect relationships and withholding the impulse to act," he said.

The video training teaches the children to focus on a shape as it moves around the video screen, for instance. It also helps them control their impulses by requiring the child to respond with a click of a button to certain images.

During the video sessions, Manning notes disruptive behaviors on a checklist and programs them into the virtual reality system to show how fidgeting or looking around the room interferes with the ability to focus.

The skills are eventually applied to real situations such as doing homework.

"We try to incorporate the school as much as possible," Manning said.

They also imitate home situations, which will help the children apply the acquired skills when their parents give them instructions to do something

"We never ask a kid to do something we think he can't do. It's almost like lifting weights. You get the kid lifting comfortably, then you add a pound. Not 10," Smith said. "The idea is to teach the kids that they can do this and they can use these skills, and generalize these skills."

These days, Sierra Lewis is able to ignore the chatter of her classmates and ambient noise that used to bother her. Her report cards are improving.

"We thought we'd try this program and see if it would help her to concentrate," her mother said. "I think it has. She does very well with the program."

The Riverside training system is currently working with about eight children, and it has worked with 20 or so in the past six years.

Smith is authorized to provide the treatment to children on Medicaid. Otherwise, the program costs $55 a session or $2,600 for the course.

"Insurance companies won't pay," Smith said. "They'd rather pay for medication."

Mental Health Abuse and Neglect in Missouri

A St. Louis Post-Dispatch investigation has found abuse and neglect of mentally retarded and mentally ill residents in state centers and in private facilities the state supervises. Since 2000, there have been more than 2,000 confirmed cases of abuse and neglect with 665 injuries and 21 deaths. This investigation was published over a 4 day period, with many graphics, interviews, and additional information documenting the horror story. And it is all available online here

Missouri Task Force Recommends Investigating Abuse, Neglect, and Deaths in State Mental Health Facilities

From the Springfield News Leader

The state should establish a board to review the deaths of adults in state mental-health facilities, a task force recommended Wednesday in a report that made no mention of improving fire safety.

The report comes days after a fatal fire at the privately run Anderson Guest House, a residential care facility licensed by the state Department of Mental Health.

The task force focused many of its 25 recommendations on improving the procedures for reporting abuse and neglect in state- operated facilities after a newspaper series detailed abuse problems in these facilities.

The eight-member panel crafted its recommendations upon gathering public testimony at hearings across the state, including one this summer in Springfield.

"We never heard one word from any of the 271 witnesses about fire safety," said Lt. Gov. Peter Kinder, task force chairman.

The panel calls on the Department of Mental Health to:

- Pursue accreditation of its six habilitation centers and community providers that serve people with developmental disabilities

- Ensure staff are trained on identifying and reporting abuse and neglect

- Increase penalties for failure to report abuse and neglect

- Establish a mental-health fatality review board

- Allow access to nonconfidential information in substantiated abuse and neglect investigations

Gov. Matt Blunt formed the task force in June. In August, the panel heard southwest Missourians voice concerns about the safety of family members in state mental-health centers.

"These recommendations represent what Missourians told us they wanted for the state's mental-health system," Ron Dittemore, interim director of the Department of Mental Health and task force co-chairman, said in a statement.

Earlier this year, the St. Louis Post-Dispatch reported 21 deaths were linked to abuse and neglect at state-affiliated centers. The series revealed a flawed system of reporting and oversight.

State Auditor and U.S. Sen.-elect Claire McCaskill has called for more oversight for these facilities in a handful of state audits.

Though the Anderson Guest House holds a Department of Mental Health license, the state Department of Health and Social Services performs routine inspections.

That agency is supposed to inspect twice a year, but budget cuts have allowed for only annual reviews, a spokeswoman said.

Kinder said he expects the legislature will review the department's budget in the upcoming legislative session to restore funding for inspections.

Reviews of the Anderson Guest House in March 2006 and December 2004 revealed no deficiencies in fire safety. The nonprofit Joplin River of Life Ministries operates the center.

"This facility, as far as we know, was compliant with existing fire safety regulations," Kinder said. "We along with everyone else in state government will be looking and looking again at measures to improve fire safety."

One measure that took effect in August mandates an automatic sprinkler system for assisted living facilities. As a residential care facility, the Anderson Guest House does not fall under these regulations.

Advocacy groups have called for sprinklers to be installed in long-term care facilities. The one-story home had a fire alarm system but no sprinklers, which was not required by the state.

"The costs are enormous to install sprinklers in older buildings," Kinder said. "I'm not saying I'm against it. That's why it has not been done to date. As we learn more about the cause of this fire and how it spread, we can all review."

Drug death party psychiatrist admits substance misuse

As seen here, a followup from this earlier report on this site.

The psychiatrist who hosted a party where a man died from an overdose has admitted that he also used class A drugs.

Dr Clint Tatchell, who specialised in addiction therapy, has denied inappropriately supplying pills to his friends at the Roman-themed event at his luxury Glasgow flat.

The General Medical Council has been told that David Steel, 30, overdosed on ecstasy at the toga party.

Dr Tatchell, 37, who worked for NHS Greater Glasgow, also denied claims that he lied to police and hurriedly tidied the flat before detectives arrived to investigate his friend's death in September 2003.

Officers later discovered Mr Steel had taken a cocktail of drugs including diazepam, ecstasy, heroin and cocaine.

Dr Tatchell claimed there were no illegal drugs in his Spiers Wharf flat on the night of the party, but admitted he had taken ketamine, a horse tranquilliser, on nights out with Mr Steel before his death.

Dr Tatchell said: "Obviously one of the topics which did come up with us getting to know each other was about our drug experiences. We spoke openly and freely about it.

"In narrating these stories and experiences with mind altering substances, David Steel did tell me about ketamine and its use as a recreational drug.

"I remember explaining the medicinal uses and he did explain the recreational use and the effect one gets from it.

"From what he described, the effect of the ketamine sounded very much like the euphoria that I had experienced when I had experimented with ecstasy, but it did not seem to have the same side effects."

Dr Tatchell admitted he became "curious" about trying ketamine and even researched it on the internet. "I do admit that I did use it on a few occasions with David Steel. On all occasions when we used it was usually in a clubbing environment because that was the only avenue David Steel had.

"He told me how to purchase it, there was one club in particular in Glasgow where you could get it if you wanted to use it."

Dr Tatchell admitted to the panel that he had taken ecstasy and cocaine while working as a model in the Netherlands for 18 months in the early 1990s.

He claimed he stopped because it gave him a sore tongue and anxiety attacks.

Dr Tatchell said he decided to give up ketamine completely because of a "moral dilemma" he faced when he was offered a post with NHS Greater Glasgow. He added: "I did have a dilemma with regard to using a mind-altering substance and working in a field where I was actually dealing with a group of society that was abusing it."

Before working for the trust, Dr Tatchell worked at the exclusive Priory rehab clinic in Glasgow. He told the panel there were no drugs at his flat during the party, which started out as a night out in a Glasgow gay bar and turned into a three-day bender.

He said: "I was not aware of any drug-taking in my flat."

The psychiatrist trained in Johannesburg, South Africa, and practised in addiction psychiatry for NHS Greater Glasgow between 6 May, 2003, and 31 July, 2004.

Dr Tatchell denies his fitness to practise is impaired.

The hearing continues.

'We want real doctors not spin doctors’

As seen in this report

An NHS body is offering to pay more than £90,000 a year to a PR guru - despite the threat of 500 job losses in Times Territory.

The East of England Strategic Health Authority is offering a salary range of £80,000 to £90,000 for a director of communications, with "more available for exceptional candidates".

This figure is nearly FIVE times the starting salary of a newly-qualified nurse, who can expect to earn a little over £19,000 a year.

The SHA is one of 10 new bodies created in England earlier this year and oversees the work of primary care, hospital, ambulance and mental health trusts in the region

The news comes amid the threat of redundancy for hundreds of staff who work at the QE2 and Lister Hospitals.

A spokesman defended the salary, saying: "Communications is a vital task in the NHS.

"This is an important post, the role of which is to ensure good and effective communications between patients, public and the different parts of the NHS across the region.

"The salary for this post is in line with similar jobs in the public sector. Salary ranges are set according to a range of factors including responsibility levels and market forces."

But Welwyn Hatfield MP Grant Shapps hit out at the figure, branding it "absolutely outrageous".

He said: "People in Welwyn Hatfield will be appalled to hear of this. We want real doctors, not spin doctors.

"Because we've been betrayed over the pledge of the Hatfield superhospital, this money would be much better spent in keeping open maternity, A&E or any of the other departments under threat of closure at the QE2."

- North East Herts MP Oliver Heald was also critical.

He said: "At a time when 1,000 jobs in Hertfordshire in the NHS are threatened, it seems incredible that the priority of the strategic health authority is to bring in highly paid spin doctors."

- Labour MP Barbara Follett, whose Stevenage constituency includes Knebworth and Codicote, blamed the need for the post on the media.

She said: "Good, clear communication between the regional health service and the public is absolutely vital.

"Without it we get the kind of scare stories that have been appearing in our local press recently.

"Good communicators do not come cheaply but the salary for this post is in line with similar ones in the public sector.

"I wish such posts were not necessary. Perhaps if our press were more responsible they would not be.

Maybe they need someone to explain their screw-ups?

Eli Lilly, ZYPREXA, and Diabetes

As seen in this column

How does zyprexa cause diabetes?

What occurs is there is a TEN times greater incident of becoming a type 2 diabetic from zyprexa. The prevailing theory is because it causes weight gain which itself is a precursor for diabetes AND more sinister it may actually poison the pancreatic beta cells killing them off.

I took zyprexa starting in 1996 the year the FDA approved it, which was ineffective for my condition and gave me diabetes.

Zyprexa is the product name for Olanzapine, it is Lilly's top selling drug.It was approved by the FDA in 1996, an 'atypical' antipsychotic a newer class of drugs without the motor side effects of the older Thorazine. Zyprexa has been linked to causing diabetes and pancreatitis.

Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly's $14.6 billion revenue last year.

Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos, Humulin and Byetta?

Yes! They sell a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place!

I was prescribed Zyprexa from 1996 until 2000.

In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.

All the psychiatrist I've interviewed and the information on line presents zyprexa as a worse offender than the other Atypicals such as seroquel.My doctor has stopped prescribing zyprexa altogether.

The PDR classifies zyprexa as 'severe' for causing weight gain and diabetes and seroquel as 'moderate'.

Of course the 50 year old Thorazine didn't cause diabetes and is many times cheaper but it could cause tardive dyskinesia.

Where Eli Lilly's negligence comes in, is their KNOWING and not informing consumers (black box warning) until the FDA demanded it.

Lilly's incentive not to readily disclose is they had billions coming in from state medicaid scripts.

Criminal Probe Launched in Fire That Killed 10 in Missouri Mental Health Home

As seen on Fox News

State fire investigators were trying to determine Monday whether a fast-moving early morning blaze that killed 10 people and injured two dozen at a southwest Missouri group home for the elderly and mentally ill was deliberately set, Gov. Matt Blunt said.

"We're not saying it is definitely a crime scene, but we are treating it as if it is and trying to determine if the fire was set by somebody who had a nefarious motive," he said.

"It is being treated as a suspicious fire," he said, without elaborating about potential evidence.

Supervising Investigator Bill Zieres with the Missouri Fire Marshall's Office tells Fox News officials have pinpointed the ignition point in the northeastern part of the building. Zieres says they've found no physical evidence so far to indicate the fire was deliberately set. Zieres adds nothing has been ruled out and investigators are trying to keep an open mind to any possibility.

One thing investigators are checking out is a gas furnace and electrical wiring in the part of the building where the fire started.

Zieres says firefighters got on the scene very quickly but had a difficult time getting control of the fire, which quickly chewed through the wood roof of the building.

The home had fire alarms but no sprinklers, said Assistant State Fire Marshal Greg Carrell.

One of the dead was a worker in the home and the other nine were residents, Blunt said. Authorities had not yet released the names, pending notification of relatives.

"I saw the front door blow open with fire," said neighbor Steven Spears, 47, who was watching TV and saw the blaze erupt through security cameras stationed outside his home. "I know most of them (the residents). I've talked to all of them at one time or another. It still hasn't hit me."

The home is operated by Joplin River of Life Ministries Inc. A woman who answered the phone there said the firm would not immediately comment but might release a statement later Monday.

The dead ranged in age from early 20s to the elderly. Eighteen people were taken to area hospitals and six were treated at the scene. The home had 32 residents and two employees inside when the fire was reported around 1 a.m., Highway Patrol spokesman Kent Casey said.

Two people were in serious condition at a Springdale, Ark., hospital. Freeman Hospital West in Joplin would not release the conditions of four people sent there after the blaze. All the other survivors who went to area hospitals were either in good condition or had been treated and released.

Officials were refusing to say how the victims died or whether they had warning. Blunt also said authorities were still investigating whether the home's residents were in bed when the fire began.

Asked if two staff members were enough to look after 32 residents, Blunt said that was up to state health officials.

"Again, it was late at night," he said. "That would impact to some degree the amount of care that is necessary."

There also was no information to suggest any of the victims were originally from Anderson, a town of mostly small businesses and manufacturing and whose residents commute roughly an hour south to Wal-Mart headquarters in northwest Arkansas or the businesses that have sprung up around the retailing giant.

On Saturday, there was a mattress fire on the other side of the building. No one was injured in the first fire, which was still under investigation when the second blaze began. Investigators say there's nothing to indicate that the deadly blaze was a rekindling of the earlier fire.

Inspectors from the Missouri Department of Health and Senior Services, which licenses the facility, found some deficiencies at the home in March but none related to fire safety, agency spokeswoman Nanci Gonder said.

"This is a devastating situation and we express our sympathy to the families of those who were killed or injured in the fire," Gonder said in a news release.

The deaths were the most from a single blaze in Missouri in recent memory.

"It's terrible," Casey said. "I have never been involved in a fire in which 10 people lost their lives."

The home is a residential care center licensed by the Missouri Department of Health and Senior Services. The facility also has a license from the state Department of Mental Health that allowed mentally ill residents to live at the home and receive treatment elsewhere.

The facility was cited in March for grease buildup in the kitchen, uncovered fluorescent light fixtures, allowing meat to thaw on the kitchen counter instead of in a refrigerator, allowing a resident to take more than the prescribed dose of an inhaler and not requesting criminal background checks as quickly as required by law for new two new employees. All the deficiencies were corrected within three weeks, according to the health department.

In 2003, a patient suffering from dementia and multiple sclerosis, set fire to her bed and burned down the Greenwood Health Center in Hartford, Conn., killing 16 residents. Six months later, in September 2003, a fire killed 15 patients in Nashville, Tenn.

Psychiatrist banned for patient love affairs

From this Australian Report

A leading Melbourne psychiatrist who was suspended for an affair with a patient has been banned from practice again after he was found to have lied under oath to cover up a second sexual relationship.

Ian McColl Fitzgerald — once described as "one of Victoria's best psychiatrists" — was suspended for five years at a hearing of the Medical Practitioners Board yesterday after admitting a two-year sexual relationship with a severely depressed woman who was having suicidal thoughts and hearing voices.

The father of four had been disciplined by the board in 2001 for a relationship with another vulnerable patient that lasted nearly three years.

Giving evidence at the 2001 hearing, Fitzgerald vowed never to repeat his offences — but at the time he was almost one year into the relationship with the second patient.

At yesterday's hearing, the three-member panel found Fitzgerald guilty of unprofessional conduct of a serious nature, and infamous conduct in a professional respect.

Counsel assisting the board, Melanie Young, said the woman, who began the relationship with Fitzgerald in January 2001, was quite ill and suffering a sense of persecution and hopelessness about her life.

"She was severely depressed and had been diagnosed with borderline personality disorder," Ms Young said. "Her marriage had broken down, leaving her a single mother with a young child."

She said Fitzgerald ended the affair with the first patient in November 2000 and began a sexual relationship with the second woman in January 2001.

After suffering from depressive symptoms, he stopped working at his Melbourne practice in September 2001 and appeared at a hearing in December that year to answer allegations about the first affair.

Ms Young said Fitzgerald had told the board in 2001 that he was remorseful and "deeply distressed and humiliated" by his actions.

"He gave evidence on oath to the panel that he had never had a relationship with another patient and that he never would have a relationship with another patient," Ms Young said. "He also gave evidence that he knew this relationship with the first patient was wrong … but what he didn't tell the panel was that he was already involved in a second relationship with a patient on that very day."

Counsel for Fitzgerald, Fiona Ellis, said several factors leading to her client's first affair were also relevant to his second relationship. He was depressed at the time of starting the new affair and suffering the effects of an acrimonious marriage breakdown in 1997. He faced bankruptcy, was stressed at work and "completely cleaved by grief" at being separated from his four children.

Prior to ending the relationship in April 2003, he had been diagnosed with type 2 diabetes, stopped taking his antidepressant medication and enrolled in a postgraduate diploma in professional ethics.

Ms Ellis said her client's "pathological vulnerability" and "neediness for emotional relations" obscured his professional judgement.

In a letter Fitzgerald had sent his children, he said: "I've made horrible mistakes, not simple transgressions of ethicism but errors of judgement … I failed the test and I didn't even realise I was in the exam room."