Sunday, August 30, 2009

Jaycee Dugard, transfixed by a monster - Includes past psych eval

Public revulsion will focus on Phillip Garrido, the delusional sex offender likely to spend the rest of his life in jail
by Karen Franklin, from the

In these harsh economic times, the saga of Jaycee Lee Dugard is especially riveting to the public imagination. Our horror and revulsion unite us. Who can we blame? How could this monster hide amongst us while committing unspeakable acts against innocent children?

Our collective furor and thirst for vengeance run counter to the principles of our justice system, under which a criminal defendant is presumed innocent until proven guilty. Psychiatric issues will make justice especially slow for Phillip Garrido, the registered sex offender who is accused of holding Dugard hostage for 18 years, after kidnapping her in June 1991 when she was just 11. (Garrido and his wife Nancy have both denied the charges.)

Initial evidence points toward a psychosis. In an interview from jail, Garrido called Dugard's story "heartwarming" and referenced secret documents and "hundreds and hundreds of thousands" of lawsuits. And that is just the tip of the iceberg. The wonders of the internet allow us to travel back in time and enter his mind, via rambling blog posts about voices in his head, mind control, and religious delusions of himself as the savior.

Ironically, more than a year ago Garrido referenced the potential for psychotic symptoms to cause violence against children. A woman who drowned her three children in the San Francisco Bay was, he wrote, "led by a powerful internal and external (hearing) process that places the human mind under a hypnotic siege that in time leads a person to build a delusional belief system that drives them to whatever course of action they take."

Defense attorneys in such cases would undoubtedly consider an insanity defense, inciting more public anger. High-profile cases skew public perceptions of this defence, which is rarely used and even more rarely successful. As one lawyer put it, "You can be extremely crazy without being legally insane. You can hear voices, you can operate under intermittent delusions, you can see rabbits in the road that aren't there and still be legally sane." Here, the prosecution could counter any insanity claim by pointing to Garrido's seemingly rational conduct, for example in running a printing business.

Another public misconception is that freedom follows a successful insanity defense. In reality, most insanity acquittees are sent to locked state hospitals that look very much like prisons. And, in the unlikely event that the 58-year-old Garrido was ever considered for discharge, he would be eligible for further detention under California's sexually violent predator law.

Competency to stand trial is another psycho-legal issue that may engender confusion in this case. While insanity pertains to an accused person's past state of mind, and whether he knew the difference between right and wrong at the time of his crime, competency pertains to his present ability to understand the legal proceedings and assist his attorney. As such, incompetency is not a permanent barrier to prosecution. A person who is found incompetent is treated until he becomes competent, at which time he stands trial.

After the dust settles and the legal manoeuvring ends, Garrido will likely spend the rest of his life behind bars if found guilty. Meanwhile, as with abduction survivors Elizabeth Smart of Utah, Natascha Kampusch in Austria, and fellow Californians Colleen Stan and Steven Stayner, the details of Jaycee Dugard's tragedy will gradually fade from our collective memory.

Until the next monster comes along and creates panic anew.

Fortunately, cases like this are so extraordinarily rare that they do not merit the public panic they engender. Although riveting, in the end the Dugard saga serves to distract us from the real dangers facing children in California today, including family child abuse and bankrupt schools preparing children for hopeless futures.

see also: A deluded man, certainly, but probably not America's Fritzl

Here's his 1976 Psych Eval.

Friday, August 28, 2009

County scrambling to fill the void

Officials try to find funds for inmate services after a state program was cut
By Rich Flowers News Editor

Henderson County is scrambling to overcome a loss of funds cut from a state program that provided inmate mental evaluations and other services.

The Texas Correctional Office on Offenders with Medical and Mental Impairments had funded the program which was administered in Henderson County through the Andrews Center. Last week, Henderson County Judge David Holstein’s office received notice the inmate evaluations had been terminated.

Tuesday, the Andrews Center board met to try to fill the gap left by TCOOMMI. Chief of Operations Cindy Grace said the meeting left the board still looking for answers.

“All we know is TCOOMMI is no longer funding that,” she said. “We’re awaiting direction from the Texas Department of State Health Services on how that is going to be funded. Right now we don’t have any direction on that.”

TCOOMMI was created by the Texas Legislature in 1989 to “reduce the time of additional imprisonment, reduce recidivism and divert offenders with mental illness, mental retardation and severe medical impairments to appropriate treatments instead of incarceration.”

Henderson County pays Andrews Center $30,000 each year for help with the mentally ill, mentally retarded, chemically dependent and mentally disabled. The center offers screenings to determine if the individual is in need of emergency services and provides the county with after-hour mental evaluation and commitment screenings.

Holstein said the county has only been involved with TCOOMMI for a few months. He was optimistic the program would be beneficial for the county.

Kay Dingler, with Holstein’s office, serves on the Andrews Center board.

“As it stands right now there are two options. The Texas Department of State Health Services would supplement it and provide services. They could either fund what they’ve taken away, or provide a different program,” Dingler said. “Another possibility is for the Andrews Center to offer the services. Right now, it’s a hurry up and wait sort of thing — but there are not many options right now.”

Grace said her office has been in contact with Dingler concerning the issue.

“I don’t think we’ve come to any agreement yet,” Grace said. “It’s still in the process of planning. I can‘t really tell you what the result is going to be.”

TCOOMMI provided several services in addition to mental evaluations for local county jail inmates. The program also offered assistance for parolees and probationers residing within Henderson County, Dingler said.

If the county has to pick up the bill for inmate evaluations, the funds will have to be found in an already tight 2010 budget.

Thursday, August 27, 2009

Not Guilty by Reason of Insanity (NGRI) Treatment and Monitoring - New Hampshire

This policy covers the provision of "confinement, security and treatment for persons committed" to the Secure Psychiatric Unit (SPU) due to their being deemed by the court not guilty by reason of insanity (NGRI). Procedures explained are: admission procedures in addition to general rules; discharge from SPU; discharge from New Hampshire Hospital (NHH) to another unit; and transitional services after SPU discharge. Also attached are "Guidelines for NGRI Transfer Process from SPU," the sample from "Request to Initiate NGRI Transfer," and "Facilitating Conditional Discharge for Not Guilty by Reason of Insanity (NGRI)."

Download document.

Inmate Behavior Management: The Key to a Safe and Secure Jail

This guide “presents six key elements that, in combination, will help jails reduce a wide array of negative, destructive, and dangerous inmate behavior” (p. v). These elements are: assessing risk and needs; assigning inmates to housing; meeting inmates’ basic needs; defining and conveying expectations for inmate behavior; supervising inmates; and keeping inmates productively occupied.

Download the guide.

Tuesday, August 25, 2009

Mental Health Symptoms of Incarcerated Juvenile Offenders: Change and Continuity During the First Three Months in a Secure Facility

Click here for the study.
The changes in juvenile offenders' mental health symptoms over the first 11 weeks of their incarceration and the relationship of these adjustments to violent behavior are examined. Sections of this Bulletin include: highlights; introduction; methodology using MAYSI-2 (Massachusetts Youth Screening Instrument, Version 2); mental health at baseline; mental health symptoms over time -- alcohol/drug use, angry-irritable, depressed-anxious, somatic complaints, suicide ideation, and mental health symptoms and violent behavior; and summary/implications. Variable patterns of mental health change exist.

Saturday, August 22, 2009

Jail Suicide / Mental Health Update Newsletter

From the Newsletter:
The Tragic and Preventable Death of David Thomas:

David Thomas1 was born into a life of turmoil and discord in
Atlanta, Georgia on November 3, 1987. His mother, Anne,
gave birth to her son at age 18 after many years of institutionalization
for incorrigibility and mental illness. She was reportedly raped at
age 13 in one of many institutional placements. David’s father left
the family early on in his life, but not before sexually and physically
abusing both he and his younger sister. Anne Thomas was in and
out of her son’s life for much of the early years, debilitated by both
substance abuse and mental illness. As a troubled young adult,
she was self-described as an irresponsible parent. During this
time, David was cared for by his grandmother, Barbara Mitchell,
herself a victim of childhood sexual abuse. Ms. Mitchell tried to
become a stabilizing factor in his life. However, as a result of his
unsettled and dysfunctional early years, David experienced
learning difficulties at school that were associated with delinquent
behavior. (Click on the newsletter to read the rest)

Friday, August 21, 2009

Evaluation of the Jail Data Link Program

Click here for the full report.
address problems faced by "[m]entally jail inmates who were previously served by mental health centers" - treatment disruption, inadequate care in jail and failure to reconnect at community reentry - is assessed (p. 7). This report is divided into seventeen sections following an executive summary: introduction; background; JDL program model; methodology; identification and selection of project participants; characteristics; reliability and use of JDI; project implementation; referrals and linkages outcomes; JDL system sample -- JDL cases compared to non-JDL cases; Intensive Case Review (ICR) sample; Department of Mental Health (DMH) booking data and site interview data; summary of recidivism outcomes; administrative and community context and collaboration; information sharing; project design, costs, and sustainability; and conclusions and recommendations. Results show that JDL improves the connections between mental health agencies and jails.

Wednesday, August 19, 2009

Letter to County Sheriffs from the Texas Commission on Jail Standards

Upon the conclusion of the 81st Legislature, new laws were enacted that will require seven changes to Minimum Jail Standards. The seven proposed changes to Minimum Jail Standards are enclosed. The formal adoption of the amended minimum jail standards will progress through normal rulemaking procedures as outlined in Title 37 Part 9 Chapter 255 of the Texas Administrative Code and will likely be adopted in November. However, all new statutes will go into effect on September 1, 2009 and will require Texas jails to make necessary changes on that date. To assist in the transition, the following information outlines enacted legislation, changes to minimum jail standards, and required action of Texas counties.

Read the rest here.

Monday, August 17, 2009

Mental Issues That Can Lead to Violence

Tarrant County’s tragic record of infant mortality


Infant mortality is often used to compare the health and well-being of nations, as well as population groups within nations. On this measure — defined as babies who die before their first birthday — our nation, state and county tragically perform poorly.

In 2004, the United States ranked 29th in the world, trailing developing nations such as Cuba and Hungary, at 6.3 deaths per 1,000 live births.
In 2005, the U.S. rate rose to 6.9 per 1,000, compared with 6.5 for Texas. Tarrant County’s performance comparatively is atrocious at 8.2 per 1,000 live births. Fort Worth has the highest rate for Texas cities with 10,000 or more births at 8.1, and Arlington is highest in cities with 5,000 or more births at 9.4.

Infant mortality is the ultimate racial health disparity. In Tarrant County in 2005, the rate for blacks was 19.5 per 1,000 births, compared with 6.0 for whites and 6.9 for Hispanics. More than 200 people carrying red-and-white umbrellas participated in a "Stop the Reign of Infant Mortality" silent march Wednesday in downtown Fort Worth to raise awareness.

Medically, the primary causes of infant mortality are low-birth-weight babies, especially those born prematurely; genetic deformities; and sudden infant death syndrome. Less than 2 percent of U.S. births — those babies born before 32 weeks of pregnancy — account for half of the deaths.

But those causes are closely linked to unhealthy mothers who struggle with economic and environmental disadvantages and cope by practicing unhealthy behaviors. Women who drink, smoke, eat poorly during pregnancy or suffer physical and mental abuse are much more likely to have low-birth-weight babies.

Location can be an enormous factor. Women often lack transportation to seek prenatal care and poor neighborhoods typically suffer healthcare provider shortages. These areas are also considered "food deserts," meaning the lack of available supermarkets with ample supplies of nutritious food.

In 2007, Fort Worth Women’s Health Initiative assessed the health of women 18-44 years old in four ZIP codes — 76104, 76105, 76112 and 76119 — using in-person interviews. Those codes are among the nation’s worst 25 in infant deaths. About 58 percent of the women were black and 33 percent were Hispanic. What they found:

Nearly 36 percent had less than a high school education; about 71 percent were not married. More than 69 percent were overweight or obese, about 25 percent reported feeling depressed or hopeless nearly every day and more than 8 percent had been physically abused in the past year.

An astounding 82 percent were uninsured, compared with about 37 percent of women 18-44 in Texas and about 21 percent nationally.

Few took advantage of safety-net programs. Although most native-born women were eligible for the JPS Health Network, only about 9 percent were enrolled. About 22 percent said they had no pregnancy-health coverage despite the fact that county and state programs cover all pregnant women in Fort Worth.

Prenatal care is an important component of ensuring a healthy pregnancy. But as the study’s authors point out, such care is often too late because it cannot undo years of damage to health. They emphasize the need for preconception health interventions and family planning, given that about 50 percent of pregnancies are unplanned.

Programs such as the Fort Worth/Dallas Birthing Project that match volunteers and pregnant girls to provide mentoring and emotional support are crucial. Such efforts can go a long way to help mitigate the disparities that foster heartbreaking loss of innocent lives.

Sunday, August 16, 2009

Prison spending hits a brick wall

In a season of deep deficits and alarming program cuts, why aren’t states more seriously focused on reducing their swelling prison populations?

The Vera Institute of Justice reports unusual progress–22 states, pressed by recession, reluctantly starting cutbacks. But with a world-leading 2.3 million people behind bars, the United States has a long, long ways to go.

California’s case is extreme–but illustrative. In the mid-1970s, it was jailing 20,000 offenders. Today the total is 168,000 inmates–an increase of 740 percent. In 1999, its prison system cost an already massive $4 billion to operate. Now, with more prisoners, more penitentiaries, more guards, more health costs, the budget figure has topped $10 billion–a big contributor to California’s $26 billion budget shortfall.

And the money’s producing more horrors than cures. After 14 years of lawsuits by inmates alleging cruel and unusual punishment, a three-judge federal court panel Aug. 4 ordered California to reduce its prisoner roll by 43,000 inmates over the next two years.

The state, the judges wrote shortly before a major riot at the state prison at Chino, has created a “criminogenic” system that actually pushes prisoners and parolees to more crimes through “appalling,” “horrific” prison conditions:

“Thousands of prisoners are assigned to ‘bad beds,’ such as triple-bunked beds placed in gymnasiums or day rooms, and some institutions have populations approaching 300 percent of their intended capacity. In these overcrowded conditions, inmate-on-inmate violence is almost impossible to prevent, infectious diseases spread more easily, and lockdowns are sometimes the only means by which to maintain control. In short, California’s prisons are bursting at the seams and are impossible to manage.”

Mentally ill inmates are left without access to health care, said the judges, noting that in the last four years “a California inmate was dying needlessly every six or seven days.”

Click here for the rest.

See also: At least 26 states spend less on prisons

Saturday, August 15, 2009

FUNDING OPPORTUNITY - Sentencing and Incarceration Alternatives Project

The Open Society Institute is accepting letters of inquiry for grants under its Sentencing and Incarceration Alternatives Project, which supports groups working to eliminate racial and class disparities in sentencing and incarceration; limit the growth of prisons; mobilize communities affected by high rates of incarceration to call for changes in public policy; promote alternatives to imprisonment; and reduce the length of criminal sentences.

Advocacy groups, associations of elected officials, community organizations, government agencies, nonprofit business associations, and research or scholarly institutions may apply.

Application deadline is open. For more information, contact Christina Voight, OSI, 400 West 59th Street, New York, NY 10019; 212-548-0600, or e-mail

Friday, August 14, 2009

TDCJ Pay Raise Update - 81st Legislature

The 81st Texas Legislature funded a targeted pay increase for correctional officers. Beginning with their September 2009 pay (received October 1, 2009), these employees will see, on average, a 3.5% increase in their gross monthly pay. In addition, those same employees will see another 3.5% increase effective September 1, 2010.

Correctional Officer Salary Rates effective September 1, 2009

Title-----Months of Service-----Monthly Salary
CO I--------0-2-------------------$2,240.63
CO II-------3-8-------------------$2,371.88
CO III------9-14-----------------*$2,510.20
CO III------15-30-----------------$2,653.18
CO IV-------31-42-----------------$2,730.00
CO IV-------43-54-----------------$2,808.64
CO IV-------55-90-----------------$2,893.34
CO V--------91+-------------------$2,982.02
*Higher starting salary for Bachelor’s degree or two years active military service.

We can prevent tragedies from postpartum illness - Update

From the Houston Chronicle:

Every new mother is expected to feel joyous at the birth of a new child. After all, the creation of life is supposed to be the height of a mother's life experience. But if you're a mother living with postpartum mental illness, that's not always the case.

The recent reports of Otty Sanchez, the San Antonio mother diagnosed with postpartum psychosis prior to killing her baby, are troubling and tragic. Concern about this situation resonates with people in communities throughout our area because of Andrea Yates and her children, who experienced a similar tragedy.

Although the cases of Andrea Yates and Otty Sanchez are both extreme instances of postpartum psychosis, a serious mental illness that only occurs in about one in 1,000 mothers, the illness has once again become a topic of discussion, as well as a source of misunderstanding, in Houston, the U.S. and around the world.

Watching in shock and disbelief as the details of this recent tragedy unfold makes us all wonder how could this happen? Perhaps more importantly, we can ask ourselves, what can we do as individuals and as a community to prevent such tragedies?

Through years of research, we have been able to identify the risk factors associated with postpartum mental illnesses along with their most recognizable symptoms. Early identification of postpartum illnesses can lead to early treatment. In most cases, with treatment, mothers are able to fully recover. Postpartum mental illnesses are identifiable, treatable and in most cases, preventable. With education, we can all learn to identify the symptoms of postpartum mental illnesses, guide mothers to treatment and recovery and simultaneously protect their children.

Postpartum psychosis should not be confused with the much more common postpartum depression. Some of the symptoms of postpartum depression include: sadness and crying, problems sleeping, not wanting to hold or touch the baby (not enjoying the baby), feeling extremely tired or having changes in eating patterns.

On the other hand, some general symptoms of postpartum psychosis include: hearing voices, seeing things, shutting down or withdrawing from others, confused or disorganized thoughts and having thoughts about hurting herself or her baby.

While both postpartum depression and postpartum psychosis require the care and treatment of a mental health or health care professional, postpartum psychosis should be treated as an emergency and a medical professional should be contacted immediately. A mother diagnosed with postpartum psychosis usually requires hospitalization until she is in stable condition. Hospitalization is required to protect the mother and child. A mother who has postpartum psychosis should never be left alone with her child.

When a mother has postpartum psychosis, it is important that people take the signs seriously and understand that help means connecting with a health care professional quickly.

Building awareness and education about postpartum mental illnesses are steps that we have already begun in our community. Since the Yates case, Houston has created ways to reach out to mothers, families and health care professionals about postpartum mental illnesses.

With the foresight of Yates' attorney, George Parnham, Mental Health America of Greater Houston created the Yates Children Memorial Fund in 2002 to support educational efforts for health care professionals and the public about postpartum mental illnesses. Mental Health America of Greater Houston continues its work today by increasing awareness about postpartum mental illnesses and creating educational materials such as brochures and posters that are distributed to hospitals, clinics, social service agencies and others who come in contact with mothers. Free trainings on postpartum mental illnesses for health care professionals are also provided by local experts.

Screening for postpartum depression is another area of prevention where we focus our attention. As an organization we also advocate for postpartum depression screenings at health care visits. Health care professionals can quickly and easily screen mothers for postpartum depression at well-woman and well-child visits. Screening is an affordable, efficient and effective means of identifying mothers who may be suffering from postpartum depression. Legislative support for screening, education and treatment for postpartum mental illnesses is also crucial to community efforts.

No one wants to see a baby or a small child die at the hands of his/her own mother. Rather than denying the reality of postpartum mental illnesses, we must work together to ensure that a tragedy like this never happens again.

Schwartz is president and CEO of Mental Health America of Greater Houston, the area's oldest mental health education and advocacy organization.

update: Baby Blues Explained to Moms

Juarez violence takes toll on mental health

EL PASO, Texas -- There is rarely a day when we don't report about the increasing brutality across the border.

From beheadings to bullet riddled bodies to extortion schemes that turn deadly, it seems the cartels in Juarez know no limits.

Now an El Paso psychologist says the emotional stress of the violence is taking a heavy toll on both sides of the border.

Achieving Better Outcomes for People with Mental Illnesses Involved in the Criminal Justice System In Tough Economic Times

A must read for any state agency involved in MH/CJ issues.
On July 15-17, 2009, the Council of State Governments Justice Center, in partnership with the Bureau of Justice Assistance (BJA), hosted a technical assistance and training event for nearly 500 representatives from state and local governments and community-based programs who have expressed interest in improving how the justice system responds to adults and juveniles with mental illnesses.

This was the largest training forum ever organized by BJA on this topic. Participation in the event was limited primarily to representatives from jurisdictions that received grants through BJA's Justice and Mental Health Collaboration Program (JMHCP), as well as jurisdictions that applied for but did not receive funding from JMHCP. Several other collaborative criminal justice/mental health teams were also in attendance.


all handouts and presentations

Monday, August 10, 2009

Texas Mental Health System is Underfunded

From my SA:
Mental health system is underfunded, flawed

The case of a reportedly schizophrenic woman with postpartum psychosis, arrested late last month in the brutal murder of her 4-week-old son, has once again brought the lack of funding for the treatment of mental illness into the public conversation.

There has been much public outrage that the young mother did not get the medical attention she needed before her baby died.

The tragedy has left many in the community wondering what can be done to resolve the problems and frustrated at the lack of services available.

Unfortunately, once the news headlines in extreme cases such as this fade, so does the public focus on the problems of those who suffer from mental illness and their families.

The lack of funding for mental health services is not new.

Texas ranks 49th out of the 50 states when it comes to per capita funding for mental health service and has earned a D from the National Alliance on Mental Illness for its mental health care, Express-News staff writer Melissa Fletcher Stoeltje reported.

The local mental health care office is overwhelmed and its services are stretched to the limit.

It is serving a thousand more patients than it gets funded to treat. That cannot be good for the staff or its patients.

Quality of care suffers when the system is overburdened.

Unfortunately, in many cases it often takes a brush with the law before mental health services become available.

The county operates a very good diversion program to keep mentally ill inmates out of jail and get them into treatment.

In recent years, county officials also created mental health courts for juveniles and adults who come in contact with the criminal justice system.

The courts are designed to keep mentally ill people out of jail when they don’t get the services they so desperately need.

These are all much better alternatives to incarceration but are not nearly enough.

Many mentally ill individuals never come in contact with law enforcement or the criminal justice system, and they are often in the same desperate need of help.

It should not take a crisis to get them the help they need.

Saturday, August 8, 2009

Mentally Ill Addict Prefers Jail to Shelters

Mentally ill addict prefers jail to shelters

02:34 PM CDT on Sunday, August 2, 2009

By KIM HORNER / The Dallas Morning News

Despite eight years in and out of Dallas hospitals, emergency rooms, jail and drug treatment centers, Robert Ceccarelli is still homeless and still addicted.

The former special education teacher, who has bipolar disorder and schizophrenia, said he has tried many times to get off crack cocaine.

"I don't have much control over the compulsion," said Ceccarelli, who sells plasma to fuel his dependency. "It's ruined my life."

The city helped him get a subsidized apartment last fall. But he relapsed, got arrested for theft and went to jail two weeks later. He said the place was in a neighborhood where he routinely bought drugs, and the temptation was too great.

"That's the problem – they put you in dope-infested areas," he said.

Ceccarelli spent nearly the first half of 2009 in the Dallas County jail, at a cost of more than $8,000. In the summer of 2008, he spent four months at the Salvation Army through a program paid by the county, at a cost of at least $1,200. He spent a couple of weeks at Terrell State Hospital, at a cost of $5,222. In addition, the public mental health care system has spent more than $30,862 on his care in the past five years.

The 53-year-old said he does not need more drug treatment after at least 15 times in rehab. Instead, he said, there should be more resources spent on housing that comes with services to help people stay stable. He said it's nearly impossible to stay clean on the streets.

Ceccarelli would rather stay anywhere than a shelter. He has shoplifted at a Dallas mall just so he could go to jail and, after that, he hoped, get into a housing program. At first, he said, police wanted to let him go.

He said, "I pleaded with them to arrest me."

Understanding and Ending the Cycle of Homelessness and Incarceration Through Permanent Supportive Housing

Click here for the ppt. Ending chronic homelessness is an achievable goal, but only if there is a strong commitment from local government leaders, federal and state policy makers, and the community at large.

Friday, August 7, 2009

Stanford Prison Experiment

Welcome to the Stanford Prison Experiment web site, which features an extensive slide show and information about this classic psychology experiment, including parallels with the abuse of prisoners at Abu Ghraib. What happens when you put good people in an evil place? Does humanity win over evil, or does evil triumph? These are some of the questions we posed in this dramatic simulation of prison life conducted in the summer of 1971 at Stanford University.

How we went about testing these questions and what we found may astound you. Our planned two-week investigation into the psychology of prison life had to be ended prematurely after only six days because of what the situation was doing to the college students who participated. In only a few days, our guards became sadistic and our prisoners became depressed and showed signs of extreme stress. Please join me on a slide tour describing this experiment and uncovering what it tells us about the nature of human nature.

Thursday, August 6, 2009

From Time Out to Hard Time: Young Children in the Adult Criminal Justice System

“This report provides the first-ever comprehensive look at how the nation treats young children who commit serious crimes, analyzes the available data with regard to the transfer of young children to adult criminal court, documents the extremely harsh and tragic consequences that follow when young children go into the adult criminal justice system, examines international practices, and offers policy recommendations to address this situation” (p. xiii). Chapters in addition to an executive summary are: introduction; children are different; pre-adolescents in adult court -- transfer policies and practices; sentencing policies and practices affecting young children in adult court; when transfer policies and adult sentencing statutes collide -- a focus on states with harsh outcomes for pre-adolescent offenders; problems associated with trying young children as adults; the juvenile justice system works; considering the global context -- an international consensus against treating pre-adolescent children as adults; and policy recommendations. An appendix provides information about international practices regarding the treatment of children as adults in a table showing the country, minimum age of criminal responsibility, other protections for children, and citation/law.

GAINS Center Seeking Input From Juvenile Mental Health Courts

The National Center for Mental Health and Juvenile Justice is seeking assistance in identifying juvenile mental health courts across the country.

Over the last few years, there has been a significant growth in the development of mental health courts for juveniles. In 2005, the National Center for Mental Health and Juvenile Justice, with support from the John D. and Catherine T. MacArthur Foundation, undertook a project designed to identify existing juvenile mental health courts and collect information on funding, organization and administration, court processes, services, and target populations of these courts. Information on the results of this effort can be found at NCMHJJ.

The Center is seeking to update its inventory of juvenile mental health courts information. If you currently operate a juvenile mental health court, or are aware of any juvenile mental health courts in your area, please take a minute to provide us with some basic information about the program using the following link:

Thank You.

Tuesday, August 4, 2009

So If We Balanced the Budget, Then What's Up With All the Program Cuts?

From Off the Kuff:
In addition to billions of stimulus dollars, the budget this year relied on some old tricks to get certified as balanced.

Nearly $3.7 billion in levies collected for everything from fighting air pollution to helping low-income people with their electric bills to funding trauma care will instead help balance the state’s upcoming two-year budget.

The money, for the most part, is collected through fees and fines that legally are dedicated for a particular purpose. If lawmakers do not spend the money on the dedicated purposes, however, the balances become available to spend on other programs.

“It’s kind of like having your (household) budget laid out and spending part of your food money on entertainment, or vice versa,” said Dale Craymer, chief economist of the Texas Taxpayers and Research Association, who has worked for a state comptroller, two governors and as the Texas House fiscal analyst. “It’s a backdoor way to undedicate the money.”

It’s pretty much the same thing every two years. We have a bunch of dedicated funds, which levy fees on certain things that are supposed to pay for certain specific items, then for a variety of reasons we decide to use some of that money for other things. It would be more honest to dedicate the money to general revenue, and it would be fairer to admit that we do this sort of thing because we refuse to adequately fund the things we want to pay for via the taxes we already collect and to deal with that, but we don’t. And so the shell game keeps getting played.

In some cases, unspent balances in dedicated accounts have grown to hundreds of millions of dollars over years.

For example, the System Benefit Fund has accrued more than $670 million. The program imposes a fee on electricity customers in competitive retail markets, including Houston, Dallas-Fort Worth and most of the Rio Grande Valley, to provide a May-September discount for low-income customers.


“We’re generating funds for a good purpose. We’re diverting the funds, without telling people, for general purposes. And then we say we’re not taxing. Well, government is lying,” said Rep. Sylvester Turner, D-Houston, who called such levies amount to “a tax by misrepresentation.”

Turner is a big advocate of the System Benefit Fund, which he tried but failed to restore full funding to in 2007. Especially in a summer like this one, it would have been nice for there to be help available for folks who can’t afford their utility bills, but as has often been the case, it wasn’t a priority.

Senate Finance Committee Chairman Steve Ogden, R-Bryan, said he understands the argument, but “if you are going to criticize that, then go tell me what other parts of the budget I’m supposed to cut. … The choice to complain about it is just hot air.”

Alternatives, he said, would be raising general taxes or dipping into the state savings account known as the rainy day fund, which budget-writers expect to need in the future.

“The long and short of it is, we have to do this in order to balance the budget,” Ogden said. “I guess this was the least objectionable of the four alternatives.”

The situation points up a major public policy issue, he said.

“Our tax and revenue system is pretty messed up, and a case can certainly be made for a major overhaul of our tax structure,” Ogden said.

I would have argued that the rainy day fund was the right way to go, as I was arguing for the budget in general before the stimulus funds saved the day. But Sen. Ogden is correct that our system is broken and needs fixing. He’s not the guy I want fixing it, mind you, but he’s right about the problem. As with many other things, that isn’t going to happen until we get a change not just in leadership but in our philosophy of governing. I can’t say I see that happening any time soon.

So how is Texas supposedly spending the Stimulus Money? Click here to find out.

Monday, August 3, 2009

Mental health system leaves gaps

What can you do to prevent this from happening? Can you write a letter? send an email? Pick up the telephone? Click here to find out who your public officials are and how to get a hold of them. All you have to do is enter your zip code under "Find your officials" and your state and national officials will be listed.

For the full article: "Mental health system leaves gaps" click here

Sanchez had sought help a week before the slaying, checking herself into a hospital after hearing voices. But she soon checked herself out, something she could do because she'd entered the facility voluntarily, as opposed to an involuntary commitment.

In the hours before she is alleged to have decapitated the baby at a North Side home, her erratic behavior around the child caught the attention of relatives and sheriff's deputies, but she never was detained because her behavior, though odd, was not deemed violent.

Mental health experts express outrage that more isn't done to force mentally ill people into treatment that might prevent such tragedies as the Sanchez case from happening.

“The only way a family can get relief is for their son or daughter to commit a serious felony, where the legal system can have a legal hold on them for the remainder of their sentence — put them in a halfway house or forensic outpatient program,” said Dr. Roberto Jimenez, clinical professor of psychiatry at the University of Texas Health Science Center at San Antonio. “But the majority of mentally ill people only commit misdemeanors and they just drift.”

Nor, he added, can mentally ill people be compelled to take their medication, except in rare court-ordered circumstances.

The Sanchez case plays out in a state where the mental health system is seriously stressed — chiefly because of lack of money.

Texas ranks 49th out of the 50 states when it comes to per-capita funding for mental health services. The National Alliance on Mental Illness each year issues a report card delineating how states do in mental health care, and in 2008 Texas earned an ignominious D.

Saturday, August 1, 2009

Otty Sanchez Was Not a Threat to Herself or Others? (I. E. Who's Responsible for Baby Scotty's Death?)

"was not a threat to herself or others." - It is easier for a camel to walk through the eye of a needle than it is for a person to get into a psychiatric hospital. Otty Sanchez went to the ER in psychiatric crisis a few days prior to killing her baby. She was released the same day because she "was not a threat to herself or others." Is the hospital to blame? We obviously do not know all the facts, so it is not fair to criticize this hospital's crisis response. After all, they cannot predict the future. They just represent a dwindling resource - psychiatric bed days.

Our mental health care system is screwed up - not necessarily FUBAR, but definitely screwed up. The less money appropriated, the more expensive it becomes. It is toward the end of the fiscal year and money appropriated for indigent hospital bed days are gone except for the most critical crisis calls. Perhaps if this would have occurred in September, after the new fiscal year, then possibly Baby Scotty would still be alive today. Who's to say? If Otty Sanchez stayed in the hospital a few weeks it would have cost less than $5000, but now, taxpayers will be paying millions. Most importantly, though, you cannot put a dollar figure on a baby's life (but isn't that what we have done?).

Who is accountable for Baby Scotty's death? Is it Sanchez? Is it her family for not intervening more? Is it Buchholz for not doing more? Is it law enforcement? Is it the hospital for not admitting her? Is it you and me for not supporting mental health legislation more? So, before we criticize the ER staff / crisis response team, maybe we need to look in the mirror. Did you tell your legislator to support mental health?

From the Houston Chronicle:

Mother accused of murder no stranger to authorities

In the days before Otty Sanchez killed her 4-week-old son and mutilated his body, there were at least two major incidents where her behavior triggered a crisis response by doctors and police.

Yet, in each case, Sanchez slipped through the cracks and returned to her baby Scott W. Buchholz Sanchez at a near North Side home, where police said she killed the infant Sunday morning while her mother, sister, and two other young children apparently slept.

Mental health experts said there's no way to know whether the slaying of Scott Wesley Buchholz Sanchez could have been avoided.

But family, doctors and police certainly had opportunities to intervene as when the tragic series of events began unfolding in the week before Sanchez allegedly decapitated "baby Scotty" and ate parts of his body.

On July 20, after doctors at a local clinic determined Sanchez, 33, was having a severe mental breakdown, she was transported to the Metropolitan Methodist Hospital emergency room, but released the same day.

"I can't confirm details of her treatment or what happened," said JoAnn King, a hospital spokeswoman.

A source familiar with the investigation but unauthorized to speak to the media said she should have remained hospitalized, but the ER staff thought she "was not a threat to herself or others."

"A lot of people are still wondering why they let her go," the source said.

Should Postpartum Screening for Depression or Psychosis be Mandatory?

Mom Accused of Beheading Baby Points to Need for Mandatory Postpartum Depression Screening
The savage dismembering of a Texas baby allegedly by his own mother this past Sunday is the most recent example of why new mothers need to be carefully monitored by their physicians during and after their pregnancies, doctors say.

Although it only makes the news when a new mother harms her child or children — think Andrea Yates — due to postpartum depression, the truth is, said one doctor, there are also many cases where new mothers harm, even kill, themselves in the months after giving birth to a child.

“All obstetrical doctors that deliver babies need to do pre- and post-natal assessments of new mothers,” said Dr. Manny Alvarez, managing editor of health for “This is a real disease. It affects 15-20 percent of all pregnant women. And it’s not only dangerous for the child, but also for the mother.”
. . . .
Having a history of mental illness puts women at an increased risk for postpartum depression. The reported events surrounding the Sanchez case, if proven true, could point to an even more severe form of postpartum depression called postpartum psychosis in which women hallucinate, hearing voices that aren't there.

“Postpartum depression is common enough that any obstetrician or pediatrician should be alert to the signs of that condition developing in new mothers, particularly in any new mother with a history of affective illness including major depression or bipolar disorder, said Dr. Keith Ablow, a psychiatrist and FOX News Channel contributor. “One of the reasons is that people with depression or bipolar disorder become delusional and come to have fixed beliefs about the world around them, which can include bizarre thoughts about their babies.”

Currently, a number of states require doctors to screen mothers for postpartum depression, including the state of New Jersey, where Alvarez is chairman of the Department of Obstetrics & Gynecology at Hackensack University Medical Center.

“In New Jersey, if you’re not assessing mothers both during and after pregnancy for postpartum depression, then you’re breaking the law,” he said. “And there’s a group, Postpartum Support International, that’s working to get Congress to pass legislation to make it a national law.”

Ablow said it wouldn’t be a bad idea for maternity wards to give new mothers a diagnostic test before they are discharged to assess whether they are starting to feel the effects of postpartum depression. However, the condition can set in at any point after giving birth, said Ablow, adding that some women don’t feel depressed until several months after their baby is born.

Ablow said it is important for women who have a history of depression – or women experiencing it for the first time – not to dismiss medication just because they are pregnant or breast-feeding.

“There are several helpful medicines you can take while you are pregnant and breast-feeding for depression, including some of the antidepressants,” Ablow said. “Not every woman needs to be taken off medication if she is depressed and pregnant.”

Alvarez, who recorded a government public service announcement in Spanish on the dangers of postpartum depression, said the signs of this disease can be subtle, which is why doctors should be aware of patients’ risk factors for the disease including previous mental health problems.

Other risk factors include having previously suffered postpartum depression, being pregnant with multiples, having medical problems such as hypertension and diabetes, and having suffered the previous loss of a child including miscarriages.”

Ablow said the following questions should be asked:

— Have you experienced a change in mood?

— Has your sleep or appetite changed?

— Do you have suicidal thoughts?

— Do you have peculiar thoughts about the baby?

— Have you become hopeless or lost interest in your daily activities?

Alvarez added, “You need to ask questions like ‘Do you feel sad?’ ‘Are you having difficulties?’ And if you’re patient says, ‘Yes I’m having a terrible time,’ you need to intervene.”

Alvarez said intervention can include putting moms in touch with psychologists and psychiatrists that specialize in postpartum depression, giving them information on support groups and emergency call centers and using medication to control symptoms when necessary.