For Some New Mothers, A Descent Into Darkness
Leef Smith, Washington Post- 12/9/2001

It was during her second pregnancy that Karen Peterson began to sense trouble. The joy and optimism she had felt with her first child were absent, replaced by growing lethargy and unexplained insomnia. Peterson's daughter was born three months later, without complication. The baby was healthy. Peterson was anything but. In the months that followed, the outgoing mother of two became increasingly afraid to leave home. Her emotions were erratic, vacillating between unexplained anger and tears. "I felt like I was descending into this darkness until suddenly I felt nothing at all," she said of that frightening period four years ago. "I didn't think I was capable of being helpful to anyone. I felt like the world would be a better place if I wasn't around."
    A psychiatrist's diagnosis was swift: postpartum depression, to be treated with therapy and antidepressants. Today, Peterson considers herself fortunate to have beaten a disorder that strikes 400,000 women in this country each year, experts say, and is the most common serious complication of childbirth. The emotional devastation of the disorder, especially in its most severe forms, became starkly clear in June with the drowning deaths of five Texas children, ages 6 months to 7 years, reportedly at the hands of their mother. Andrea Yates, 37, will be tried on capital murder charges next month in Houston.
    Then, two weeks ago, postpartum depression resurfaced in the news when a new mother in Fairfax County allegedly stabbed her husband to death before wounding herself at their home in Springfield. Relatives said Seema Rothstein began experiencing severe anxiety after giving birth Sept. 10, saw five psychiatrists in seven weeks and was taking a variety of drugs to treat the disorder. Rothstein, 32, has been charged with murder and is being held at a hospital for the mentally ill in Petersburg.
    The families of both women remain supportive, certain that the crimes of which they are accused resulted from mental illness and were largely out of their control. "I don't think she got the treatment she needed," Russell Yates said last week during a court hearing for his wife, who was diagnosed with severe postpartum depression in 1999 and had twice attempted suicide. Similarly, Haskell Rothstein wants charges against his daughter-in-law dropped, believing that she "was rendered unable to account for her actions" by her mental state.
    Despite its prevalence, many women suffer postpartum depression in silence, doctors say, preferring to endure the mood swings and anxiety -- even the worry of hurting their own children -- in private rather than face the stigma of a mental disorder and the fear of being labeled an inadequate mother. "This is major depression," affecting one in 10 new mothers, said Ralph Wittenberg, clinical professor of psychiatry at George Washington University. If not properly treated, the effect can be devastating not only to the woman but also to her family, he said. Postpartum depression generally strikes within the first year after a woman gives birth, doctors say. Symptoms typically include sleep disturbances, panic attacks, frequent crying, intense irritability, loss of everyday enjoyment and feelings of being overwhelmed. Women with a rare, more severe condition called postpartum psychosis may hallucinate, have delusional thoughts and lose contact with reality. Episodes of violence are rarer still.
    The exact cause of the disorder is unknown, but medical researchers believe that hormonal change and sensitivity are involved. "It's the $64,000 question," said Catherine Roca, principal investigator of a study underway at the National Institute of Mental Health. The illness is known to run in families, but neither economic background nor the number of children a woman has had is a factor, experts say. High-profile cases such as the one in Texas are double-edged, psychiatrists say -- pushing some women to seek help, but exacerbating worries for others already being treated that they could be headed into a similar downward spiral. "We've gotten feedback from therapists that they're getting more phone calls from patients saying, 'That might be me,' " said Jane I. Honikman, founding director of Postpartum Support International, a California-based nonprofit organization.
    Mary, a 40-year-old mother of three from Vienna, was one who took the news reports to heart. It was seven months ago, not long after giving birth to her son, that Mary, an at-home mom who spoke with the understanding that her last name would not be published, realized that things were different this time around. Her highs and lows were more acute. At times she felt overwhelmed and trapped, hardly able to function. But none of her friends talked about postpartum, so Mary told herself to hold it together because "who's going to want to send their kids to your house for a play date if you're a psychotic mom?" Her thinking changed after she heard about Seema Rothstein. "I started to wonder, is there something about me that would make me pick up a knife," she asked herself. "I don't feel like I'm going to harm myself or my husband, but [Rothstein] seemed like she was feeling overwhelmed," too. Last week, Mary went in search of psychological counseling and antidepressants that doctors say will not interfere with breast-feeding her son.
    Many women grow up believing that pregnancy and the first days of motherhood will be the happiest time of their lives. It is, for some. Others, though, are in for a shock. "All of a sudden, she's taking care of this baby," said Barry Rothman, chairman of the department of obstetrics and gynecology at Inova Alexandria Hospital. "The husbands generally go back to work, and . . . it can be a very fearful moment for her. Add to that the hormonal changes that fluctuate and personality swings, and it's usually a time where patients will just break down and start crying."
    Pregnancy was welcome for Naomi, 31, of Bethesda, then a marketing executive who agreed to an interview if her full identity was not disclosed. She looked forward to adding the role of "mom" to her busy life. But shortly after giving birth, she began to crash. When she was alone, she yearned for others. When she sought company, she craved solitude. Each morning as her husband left for work, she would be overcome with fear that her life was out of control. At "Mommy and Me" class one day, Naomi broke down and sobbed. "I looked around at all these other mothers and wondered why it was such a cakewalk for them and I'm having all these issues? I thought they thought I was such a loon, but after class many of them came up to me and said they felt the same way. It was a big eye-opener -- the fact is you never know what's going on behind closed doors."
    Family and friends -- those in closest contact with new mothers -- are seen as first and best at spotting symptoms of postpartum depression. "The onus is definitely on the family" to be alert for clues and get assistance, Honikman said. There is help out there. It's just very hard to find," said Karen Peterson, who draws on her own postpartum experience to help other mothers as the Washington contact for Postpartum Support International.
    Some in the field feel the United States could learn from countries such as Britain, which long ago established early and mandatory screening programs and set up treatment facilities. But with American women reluctant to talk about pregnancy-related depression, it's hard for caregivers to know something's wrong, experts say; often doctors are so busy they don't delve into a patient's emotional well-being unless a problem is obvious.
    "There's a reluctance on the part of the patient and a reluctance on the part of the doctor," said Wittenberg, who runs the Family Mental Health Foundation in the District. The group was selected this year for a$700,000 Healthy Start grant to establish routine screenings for postpartum depression in primary-care settings. The four-year program, one of the first in the nation, kicks off in March at three sites in the District: Georgetown University Hospital, George Washington Hospital Center and Mary's Center for Maternal and Child Care. "It's not something trivial," Wittenberg said of postpartum disorders. "Half the women, if they don't get treated, go on to have lifelong depressions. . . . It makes [them] absolutely miserable."
    Susan Sonde, of Crownsville, said she suffered years of depression and anxiety attacks because she was not treated for postpartum after her daughter's birth 33 years ago. From the start, Sonde, now 61, was terrified to be alone with the baby, worried she might harm her. She knew she needed help the day she smashed the child's bottle against the nursery wall. She went to see a psychiatrist at Georgetown, but he simply "told me to get with the program," she said. Now Sonde sees signs of the disorder in her daughter, who had her second baby five weeks ago and is on antidepressants. "She gets terrified when the sun goes down," said Sonde, who makes a point of driving to her daughter's home each day to be with her when it starts getting dark. "That's when she gets depressed and hopeless."

Colorado Sex Offender List Holds 7,000 Names
John Ingold, Denver Post- 12/9/2001

There are 24 crimes that can land someone on the sex offender list, from sexual assault to incest, enticement of a child to inducement of child prostitution. "This is a lifelong scar on a lot of people's lives, and sometimes they never recover from it," said police Lt. Gary Lauricella, commander of the Denver department's sex crimes unit. "This is a very bad crime."
    There are more than 7,000 people on Colorado's sex offender registry. And with more than 3,500 sex offenders currently in the state Department of Corrections system and more than 1,000 scheduled to be released over the next several years, the necessity of the sex offender list and the difficulty in maintaining it have never been clearer, Lauricella said.
    Once released from prison, sex offenders who are under some type of DOC supervision, such as parole or probation, are required to register within five days. Those released without DOC supervision have until the next business day to register. Convicted sex offenders must visit their local police stations and tell officers their name and where they live. They must re-register every time they move or change their name.
    Denver uses registration to gather genetic samples from sex offenders, to log detailed information about the offender's crime and to determine whether the offender has any signature pattern, Lauricella said. Before July 1, when new laws specified that offenders must register four times a year instead of once, Lauricella had only one detective assigned to work on the registry. Now he has added two more to handle an estimated 7,000 registrations a year, he said.
    Some sex offenders, those who have been convicted or pleaded guilty to the most serious felonies, must continue to register for the rest of their lives. Others, based on the crimes they committed, must continue to register for 20, 10 or five years. Offenders who received a deferred sentence do not have to register, and those younger than 16 at the time of their crimes can petition to be taken off the registry.
    While there are some inequities on the list - such as lumping violent sexual offenders in with people convicted of indecent exposure - it is a necessary tool in tracking potentially dangerous people in the community, Lauricella said.  "I personally do not know of one case where somebody has been convicted and put on the sex offender list in Denver for urinating in public," said Lauricella. "Could that person be listed as a sex offender? Yes. But somebody who is a flasher, somebody who gets some satisfaction out of exposing himself to someone, I want to know who that person is."

Russell Yates Speaks Out in TV Interview
Lisa Teachey, Houston Chronicle- 12/9/2001

The husband of Andrea Pia Yates, the Clear Lake mother accused of drowning her five children, said he does not believe his appearance Sunday night on a nationally televised news program violated a gag order imposed on all witnesses, lawyers and investigators in the case. Russell Yates told the Houston Chronicle he had a legal opinion that cleared the way for him to publicly speak about his children and his wife's treatment for severe depression with psychosis in the months before the children were killed. Yates said the opinion was not from his personal lawyer, Edward Mallett, but he would not disclose who had advised him. "I respect the court's order, and I tried to follow it," Yates told the Chronicle. "Otherwise, I would have said more." Yates would not say why he chose to speak only to CBS' 60 Minutes.
    Harris County District Attorney Chuck Rosenthal also appeared on the news show and explained why he thought seeking the death penalty is appropriate in this case. A lawyer not connected to the case said it appeared both Russell Yates and Rosenthal violated the gag order. "All Russell Yates is doing is tainting the jury pool," said Brian Wice. "It is absolutely a violation." Wice said the order precludes witnesses from discussing any substantial legal issue a jury would likely have to decide, including Andrea Yates' mental stability and her ability to distinguish right from wrong. Some of that would be based on her medical history, which Russell Yates talked about in detail on the program.  Wice said Rosenthal essentially presented his argument for why Yates should receive the death penalty. "He got to make perhaps the most compelling part of the prosecution's punishment argument on national television," Wice said.  Wice said if state District Judge Belinda Hill finds that either violated the gag order, she could sentence both to jail time or fine them. The maximum punishment is up to six months in the Harris County Jail and up to a $500 fine.  However, the judge could find that perhaps one's violation was more egregious than the other's and tailor the punishment accordingly, Wice said. "It's ultimately a question of degree," Wice said. "I don't think Chuck ought to be doing six months. I think the judge has to draw a line in the sand with Russell and maybe Russell ought to see what the inside of a jail cell looks like." So far, the judge has not formally addressed the matter.
    In the interview with Ed Bradley that was broadcast Sunday night on 60 Minutes, Yates said he blames the doctors and hospitals for not properly treating his wife. "I don't blame her a bit. And that's, I mean, people find that just outrageous, I know. But I don't, I don't blame her one bit, you know," Yates told Bradley. " ... If she received the medical treatment that she deserved, then the kids would be alive and well. And Andrea would be well on her way to recovery. And we'd be unknown. "A family cannot protect themselves from a psychotic person. A doctor can be putting the psychotic patient in the hospital."
    Andrea Yates had been treated off and on for depression and two suicide attempts after the birth of their fourth child. Her husband said she always seemed to get better when she took the anti-psychotic drug Haldol. After the birth of their fifth child, her condition seemed to worsen. She was hospitalized twice at Devereux Texas Treatment Network in League City in the spring. Her husband said she was put on a new anti-psychotic drug and made to attend substance-abuse classes even though she did not drink alcohol, take recreational drugs or smoke. Her last admittance there was in May after she filled up the bathtub but refused to tell anyone why. She was discharged, Russell Yates said, even though her medical chart indicated she still exhibited paranoid thought patterns and impaired judgment.  "I mean there's not, there's absolutely no reason she should have been let out of that hospital," Yates told Bradley. "It was just incomprehensible."
    Andrea Yates continued seeing a psychiatrist there as an outpatient. Her last visit with Dr. Mohammed Saeed was June 18. Two weeks before, had taken her off the anti-psychotic drug he had earlier prescribed. On that day, Russell Yates said, he wanted the doctor to readmit his wife. "I didn't actually come out and say it. But yeah, we were desperate. She was so sick. And I was at my wits' end," Yates said. "I mean, I'm just like, she's been sick for this long. Help us. And he ended the meeting ... by giving her a pep talk. And he kind of looks at Andrea, and he gets in her face and says, `Andrea, you need to think positive thoughts, not negative thoughts. Not negative thoughts. You need to think more positively.' "
    Last week during a hearing to suppress his wife's confession, Yates testified that on June 20, the day of the killings, he knew his wife was not herself. But he testified he thought it would be OK to leave her alone with the children when he went to work that morning. He said his mother, who was helping to care for the children, was scheduled to be at the house by 10 a.m. Russell Yates left for work shortly before 9 a.m. but was called home by his wife about an hour later after she had drowned the children.
    On the news program, Russell Yates also defended himself against criticism that he did not help his wife enough, especially after a previous doctor told them after the birth of their fourth child that having more children could worsen his wife's condition. "What we were told was that there was a 50 percent chance that she would be depressed again if we had another, and, and if she got depressed again, she would have the same symptoms as she had in '99, and, and that the same treatment that, that worked for her in '99 would work again," Yates said in the interview. Throughout the broadcast, Yates showed home videos of the children and their seemingly happy mother as well as video of their last child after her birth.
    Rosenthal's comments were not as lengthy regarding his decision to seek the death penalty. "If the question is why this case as opposed to other cases and, and all other things being equal -- five dead children," Rosenthal said on the program. "Five dead children who were, who were, we allege, killed by the person that they loved most in this world." Rosenthal said there may be other cases in which a mentally ill parent kills his or her children and the death penalty would not apply. He said it did in this case because the mother should be held accountable. "I want to hold her accountable for the death of those children," Rosenthal said. "That's my job ... to hold people accountable for what they do."
    Hill imposed the gag order June 26, six days after Andrea Yates called police to the family's home in the 900 block of Beachcomber and admitted she methodically drowned the children in the family bathtub. The order specifically forbids witnesses from talking to the media if they have given statements to law enforcement personnel or representatives of the District Attorney's Office or if they have testified in investigative or adjudicative proceedings. Russell Yates gave a statement to police the day his wife was arrested and a few days after that talked to prosecutors. He was subpoenaed in late August to testify at his wife's competency hearing, originally scheduled for Sept. 11. The CBS interview was conducted the week before the scheduled hearing. The hearing eventually was postponed to Sept. 18, but Yates was not called to testify.
    Andrea Yates, 37, has pleaded not guilty by reason of insanity to two charges of capital murder in the deaths of Noah, 7; John, 5; and Mary, 6 months. In September, a jury found her competent to stand trial. Prosecutors have said evidence regarding the deaths of siblings Paul, 3, and Luke, 2, will be presented at her trial, which is scheduled for Jan. 7.

'60 Minutes' Transcript of Russell Yates Interview
CBS News- 12/9/2001

ED BRADLEY:
It is hard to comprehend that this 37-year-old woman, a former nurse and high school valedictorian, who has been described by everyone who knew her as a devoted and loving mother, is the same person who is charged with capital murder. The person who has the hardest time comprehending all of this is her husband.
RUSTY YATES:
She's a terrific mother, loved the children. They're always climbin' up in her lap and she'd read books to 'em. And just all kinds of stuff. She loved them. I mean there's just no way that she, she, she would ever do anything like what happened.
ED BRADLEY:
But she did.
RUSTY YATES:
No, no, but it's it's 'cause her mind was sick, you know. I mean that's, that's it.
ED BRADLEY:
Although there were indications that her mind was sick, Andrea Yates never gave any signs that she intended to harm her children, but after her arrest she told authorities that on and off for the past two years she'd heard voices telling her that the devil was after the kids and that she needed to save them. She said they were quote "hopelessly damaged," and on the morning of June 20th, Andrea Yates waited to act until after her husband left their home to go to his job at NASA's Johnson Space Center in Houston, where he is a civil engineer.
RUSTY YATES:
I got a phone call from my wife at five till ten. And she said "You need to come home." And she sounded really like very stern, very cold. I said, "What, what's wrong Andrea?" And she said, "You need to come home," and she hung up. And I was really getting nervous because of her tone, you know. And I called Andrea back at the house and she picked up the phone. And I said, "Andrea, what's wrong?" I said, "Is anyone hurt?" And she said, "Yes." And I said, "Who?" And she said, "The kids." And I said, "Which one?" She said, "All of 'em." And I mean I was just, I was just devastated.
ED BRADLEY:
According to what she told police, Andrea Yates had filled the family bathtub and methodically drowned her five children. Then she dialed 911.
RUSTY YATES:
I drove home, lucky I didn't have an accident on the way home. You know, I mean I'm a nervous wreck. And I came in, police cars are everywhere. And they told me, and I just bawled, you know, for quite some time. They wouldn't let me in the house. Andrea was in the house. And all I could do was sit there in the yard and just say, "How could you do this? I don't understand. How could you do this? I don't understand." I did that for, for hours.
ED BRADLEY:
When you came home that day and said you were just sitting in the yard crying, did you see her?
RUSTY YATES:
I could see her through the window, and this is, right, probably within an hour after I found out, and I was banging on the windows. And she just sat there, she didn't even look at me. She just sat there and just stared straight ahead, you know. She had this just real stern look on her face and she was just starin' ahead.
ED BRADLEY:
Andrea Yates was booked on first degree murder charges and held without bail at the Harris County Jail. Seven days later, the five children were eulogized by their father at the funeral service. For nearly an hour, Rusty Yates told fond stories about each of his children and then placed their favorite blankets in their open caskets, and bid them farewell.  At the funeral you described John as having a contagious smile?
RUSTY YATES:
Yeah, you can see it. I mean he would smile real big and just made everybody smile.
ED BRADLEY:
You described him at the funeral as "perfect Paul," the, the perfect child.
RUSTY YATES:
Well, he was. Just a super attitude. He was good to everybody so everybody liked him. He's a good kid.
ED BRADLEY:
He told me about Noah -- his first-born -- and how he shared his son's love of rockets. He told me about how thankful he was to have Mary, his only girl. And Luke, who loved to have his picture taken.
RUSTY YATES:
He always liked the camera. He'd always smile but he, he, he always squint his eyes and...you know, say, "Cheese" real, real big.
ED BRADLEY:
And looking at all of these pictures, I mean, it looks like a normal, happy family.
RUSTY YATES:
Right.
ED BRADLEY:
By all appearances, the Yates' were a normal, happy family until two years ago. Soon after the birth of their fourth son Luke, Andrea began showing signs of depression. Twice in 1999, she tried to kill herself, first from an overdose of sleeping pills. And then a month later she took a knife into her bathroom.
RUSTY YATES:
I cracked the door open, and saw Andrea inside. And she, she had a knife, held up to her neck, you know, like this. And she was just staring at herself in the mirror. You know. She's got it against her neck, and it's like she's looking at her neck trying to figure out how to cut herself, so that she could successfully kill herself. And I said, "Give me that knife." And she said, "Let me do this." And I said "No, give me the knife." You know. And she said, and she, she wouldn't do it. She just stood there like this, with her, the knife against her neck, I grabbed her arm and pulled it down and I, I pried the knife out of her hand.
ED BRADLEY:
The next day Andrea Yates was admitted to a psychiatric hospital. She was there almost three weeks, and diagnosed with postpartum depression with psychosis. About 75% of new mothers experience some form of postpartum depression. It's commonly known as the "baby blues," and it usually fades away in a few weeks. But Andrea Yates fits into a much more severe category that affects less than one percent of women. Psychologist Cheryl Meyer, who specializes in postpartum depression, has done extensive research on women who kill their children.
CHERYL MEYER:
What was astounding about that category was that people described them by and large as devoted mothers. Andrea Yates, perfect example. Devoted mothers, cared for their children, loved to be with their children.
ED BRADLEY:
Help me understand how this can affect a woman so much that she would kill her children.
CHERYL MEYER:
Women begin to become very insecure about who they are and their parenting ability. And they begin to have thoughts "You know, maybe I'm, I'm not as good of a parent as I thought I was. Maybe I can't do this." They begin to make those thoughts even more monumental and they grow larger and larger and larger and I think that's how it can shift from becoming just almost an obsessive thought to a delusion. And even more severe, you know, just slipping over into psychosis.
ED BRADLEY:
And generally speaking, what reasons do they give for killing their children?
CHERYL MEYER:
There's a lot of discussion of the child being inadequate or tainted somehow by their bad mothering. Sometimes if it's a full blown psychosis the child is the devil. And will be somehow rehabilitated or healed after they have, in fact, killed their child.
ED BRADLEY:
Andrea Yates seemed to fit that profile perfectly. There is no evidence that she abused her children, but during hospitalization she described being stressed trying to raise so many young kids, saying it was a "big responsibility...I don't want to fail." According to hospital reports she said she had "recurrent, obsessive thoughts" and that "most of them are over our children and how they'll turn out." She was treated with two anti-depressants and an injection of the anti-psychotic drug Haldol. Her husband Rusty says the response was remarkable.
RUSTY YATES:
Within a day Andrea was, she went from being completely catatonic to sitting on the couch with me in the visiting area, and we carried on what I refer to as the best conversation we've ever had. And it was wonderful. And the thing I learned from it is that she needed the right medicine. That's it. When I saw her respond to the medicine at that time, I'm like, wow, there's hope. You know, there's hope that, that Andrea will return.
ED BRADLEY:
After returning home, Andrea Yates was soon back to the job of being a full-time mom, which she appeared to enjoy. She photographed and narrated this home video of her children playing around the house.  Andrea Yates home-schooled her oldest children, even designing their sets and costumes for a lesson on medieval history. She also cooked and cleaned the house. Her doctors suggested she get some help taking care of the children, and that she devote some time for herself. But Rusty says she chose not to.
These were all things that she wanted to do?
RUSTY YATES:
Yes.
ED BRADLEY:
So this was never a situation where you thought she might be taking on too much, that this might be overwhelming for her?
RUSTY YATES:
Well, I talked about it to be sure that wasn't the case, I didn't want her to look back and say "I missed out on something in life," so I talked to her last year, and said, "Andrea, you know, if there's, you know, if you, if you'd like, I could go to part-time work and, and have you work part time." And then, that way, she has some activities outside of the home. And I know that being a nurse was rewarding for her. And Andrea, what she said, she said, "I'm a mother now." You know, and, and that's what her fulfillment, that's where she got her fulfillment is in teachin' the children and raisin' the children.
ED BRADLEY:
How do you respond to people who, who've said in some of these newspaper articles that you weren't giving her enough time alone, that you were a controlling husband. You weren't doing enough to try to ease her burden.
RUSTY YATES:
Well, they don't know anything. I mean they don't know us, you know. We had what I'd call a more traditional family. But to say that, to say those things is really, you know, unfair.
ED BRADLEY:
For more than a year after she got out of the hospital and was off all medications, by all accounts life in the Yates family was back to normal. They decided to have another child.   Ignoring a doctor's written warning, which said that doing so would "surely guarantee future psychotic depression."  That's a pretty ominous warning. Did you and Andrea, maybe given the circumstances, say maybe we've had enough kids, we shouldn't have any more?
RUSTY YATES:
Well, no. We looked at that and we said you know, well this was a very difficult time, but then we said well, would we rather have not had Luke? I mean of course we'd rather have Luke. And have gone through that. What we were told was that there was a 50% chance that she would be depressed again if we had another, and, and if she got depressed again, she would have the same symptoms as she had in '99, and, and that the same treatment that, that worked for her in '99 would work again.
ED BRADLEY:
Within months of Mary's birth, Andrea Yates's depression returned with a vengeance. It was a depression which her husband says led her to murder their children.  So for people who don't understand, I mean, you're supportive of her. You've talked to her, you've seen her, you go to visit her in jail?
RUSTY YATES:
Right.
ED BRADLEY:
And you support her today?
RUSTY YATES:
Absolutely.
ED BRADLEY:
There are people who don't understand, who would say "Wait a minute. She killed your children, five children, her children. How can you be supportive?" What do you say to them?
RUSTY YATES:
The person that drowned those children is not, not Andrea, you know, and if your brain is sick, you can think things that aren't real.
ED BRADLEY:
So because of that, because of that mental illness, you, you don't, you're not angry with her, you don't blame her for what happened?
RUSTY YATES:
I don't blame her a bit. And that's, I mean people find that just outrageous, I know. But I don't, I don't blame her one bit, you know.
ED BRADLEY:
Rusty Yates does blame the doctors and the psychiatric hospital that treated his wife for the deaths of his children. When we come back, a close look at that hospital, which has come under attack from former patients, employees and Health Department regulators for placing the public at risk. But the State of Texas blames one person - Andrea Yates, and we'll talk to the prosecutor who is seeking the death penalty.
ED BRADLEY:
In four weeks, Andrea Yates is scheduled to go on trial for murdering her five children. If convicted she could face execution by lethal injection. Could the Yates family tragedy have been prevented? Over the past five months, we have been looking into the treatment Yates and other patients have received at Devereux Hospital outside Houston, part of a nationwide chain of psychiatric facilities. What we found raises serious questions about her care...care that her husband Rusty claims led to the deaths of his children.
RUSTY YATES:
If she received the medical treatment that she deserved, then the kids would be alive and well. And Andrea would be well on her way to recovery. And we'd be unknown.
ED BRADLEY:
Rusty Yates says after the birth of their fifth child, Mary, Andrea's postpartum depression came back as had been predicted, and was more severe than it had been after their fourth son, Luke, was born. Four months after the arrival of the new baby, Rusty told staff members at Devereux Hospital -- where Andrea had not been before -- that he was afraid his wife could not survive another night at home. She was admitted there in March of this year for the first of two stays.
RUSTY YATES:
Her first day at Devereux she became completely catatonic again. I mean she was in her bed all day. She was just completely, completely out of it. Not talking, not eating, not sleeping well, not drinking. Not anything.
ED BRADLEY:
Her new psychiatrist, Dr. Mohammed Saeed, prescribed a combination of drugs different than the ones that had been effective for her before. He replaced the anti-psychotic medicine Haldol with a newer drug which reportedly has fewer side effects. She was also placed in group therapy sessions for substance abuse, even though she was never diagnosed as a substance abuser.  She didn't use drugs or drink alcohol?
RUSTY YATES:
That's what's funny is that she never drinks, she never has. Smoked, any drugs, nothing. Never even tried it, you know. She's like the cleanest person in town. And here she is seein' films on substance abuse, you know. Which is, not, not, what she needed.
ED BRADLEY:
Andrea Yates spent twelve days at Devereux Hospital. Two days before her discharge, hospital records say she was "somber, sad, withdrawn, delusional with possible hallucinations, and suffering from impaired judgment." Two days later she was sent home. While she said she was feeling much better, hospital records show she had improved but still exhibited "paranoid thought patterns, impaired judgment, and was described as 'somber, flat, and withdrawn.'"
RUSTY YATES:
I mean there's not, there's absolutely no reason she should have been let out of that hospital. It was just incomprehensible.
ED BRADLEY:
So you, you had no idea she was going to be discharged?
RUSTY YATES:
Absolutely none.
ED BRADLEY:
Her hospital records show that the day she was admitted before she was ever treated -- the hospital staff had already listed her expected discharge date as April 12th. And in fact they did discharge her that day, although the record indicates that she still had significant symptoms. And that was not unusual, according to Jaqueline Pruden, who had been a supervising nurse at Devereux.
JACKIE PRUDEN:
I have seen patients discharged whether they are really ready to go back out into the world and face reality, and face the real world, or not.
ED BRADLEY:
Pruden worked at Devereux before Andrea Yates was there. She left after an on-the-job injury and is now on disability.  You said that when you read that she had been treated at Devereux before she killed her children, you weren't surprised?
JACKIE PRUDEN:
I wasn't.
ED BRADLEY:
Because?
JACKIE PRUDEN:
Because I have seen patients released before they were ready to go.
ED BRADLEY:
So they were discharged as being well, being okay, when in fact, they weren't.
JACKIE PRUDEN:
Stabilized on their medications. And in fact, they had no coping skills. They weren't getting the counseling, and the education, and the behavior modification. And they were being released before they learned the coping mechanisms they needed on the outside world.
ED BRADLEY:
Life in the outside world was an emotional roller coaster for Andrea Yates after her release from Devereux, even though she was still on medication. By this time Rusty had asked his mother to stay with Andrea and help out while he was at work. One afternoon in early May, in an ominous sign of what was to come, Andrea filled her bathtub with water. She could not explain why she did it, and that alarmed her husband, who brought her back to Devereux. Officials at Devereux Hospital - citing patient confidentiality - won't talk about her case, but recently released hospital records that show the last time she was admitted, on May 4th, she was in a near catatonic state. The entire time she was there, she was kept on suicide watch - checked every fifteen minutes, day and night. On the day she was discharged her psychiatrist, Dr. Mohammed Saeed, described her as improved but "still appearing depressed." And the hospital records indicate she was "somber, flat, isolated, withdrawn, and showed impaired judgment." A little more than a month later, Andrea Yates drowned her five children.  After she left the hospital, she continued to see Dr. Saeed as an out patient, and two weeks before the murders he stopped her anti-psychotic medication, indicating that she was developing serious side effects. She stayed on anti-depressants.
RUSTY YATES:
The doctor took her off her anti-psychotic medicine, when she'd, had psychosis. I mean, he diagnosed her himself. Postpartum depression with psychosis. He took her off anti-psychotic medicine.
ED BRADLEY: Rusty Yates says, and medical records confirm, that just two days before she killed the children he took Andrea to see Dr. Saeed at his office and told him her condition was deteriorating. He adjusted the dosage and her anti-depressants.  Were you hoping that he would hospitalize her that day?
RUSTY YATES:
I didn't actually come out and say it. But yeah, we were desperate. I mean, we were desperate. She was so sick. And I was at my wits' end. I mean, I, I'm just like, she's been sick for this long. Help us. And he ended the meeting with, by giving her a pep talk. And he kind of looks at Andrea and he gets in her face and says: "Andrea you need to think positive thoughts. Not negative thoughts. You need to think more positively."
ED BRADLEY:
We tried to ask Dr. Saeed about his treatment of Andrea Yates, but he declined to speak with us. This is not the first time that Dr. Mohammed Saeed and Devereux Hospital have been accused of malpractice. They've been sued for wrongful death and for improper monitoring of patients. One case is pending and the other was settled. Between 1993 and 1999 the Texas Health Department substantiated nearly 100 complaints against Devereux, including inadequate care and abuse of patients. The hospital has corrected the problems. But last year, state regulators placed Devereux on an intensified monitoring and inspection plan.  Whether or not Andrea Yates received proper medical care is of little concern to Harris County District Attorney Chuck Rosenthal, who charged her with capital murder and is seeking the death penalty, in a county and a state that has executed more people than anywhere else in America.  Why did you charge her with capital murder?
CHUCK ROSENTHAL:
If the question is why this case as opposed to other cases and, and all other things being equal? Five dead children.
ED BRADLEY:
Simple as that. Clear and straightforward.
CHUCK ROSENTHAL:
Five dead children who were, who were, we allege, killed by the person that they loved most in this world.
ED BRADLEY:
Andrea Yates had pleaded not guilty by reason of insanity, and while both sides agree that she is mentally ill, that in itself is not enough to find her legally insane. Her lawyers must prove that Andrea Yates did not know that what she was doing was wrong at the time she killed her children.  Can you imagine a case, where a person would be so mentally ill, that she would take the lives of her own children, and you wouldn't seek the death penalty? Is that conceivable to you?
CHUCK ROSENTHAL:
Yes.
ED BRADLEY:
But she doesn't fit that category?
CHUCK ROSENTHAL:
No.
ED BRADLEY:
Why not try to get her help in a mental hospital, instead of charging her with the crime, no less the crime of capital murder?
CHUCK ROSENTHAL:
I want to hold her accountable for the death of those children. That's my job, is to hold people accountable for what they do.
ED BRADLEY:
As you know, there have been a number of newspaper articles that have been written saying that attributing your wife's actions to mental illness, to, to postpartum depression is essentially an attempt to absolve her of any responsibility. One person wrote that it's, quote, "letting Mommy Dearest off the hook." Well, how do you respond to those people, Rusty?
RUSTY YATES:
Well, they don't know Andrea, you know, first of all. And I think that a, a person's heart can be good while their mind is, is sick.
ED BRADLEY:
Another person wrote "He is just as guilty. He did not protect his children against a very dangerous woman."
RUSTY YATES:
Yeah, a family cannot protect themselves from a psychotic person. A doctor can be putting the psychotic patient in the hospital.
ED BRADLEY:
Rusty Yates still lives in the same house. The pictures of his family hang on the walls, the children's toys are still in their rooms.
RUSTY YATES:
(WITH KIDS TOYS)...He'd bounce all over the house with this thing with just a big smile on his face. He loved it.  I wanted to fight for my kids. You know? I mean, it's like...(CRYING)...what, what father, you know, wouldn't fight for his children. You know? And, but it was too late. They were gone. I did everything I could, you know, to see that Andrea got well. And...(SIGHS)...you know, the medical community failed us. I mean, that's the bottom line.
ED BRADLEY:
Since she's been in prison, Andrea Yates has been put back on anti-psychotic medication, and her condition has improved significantly. She is reported to be no longer delusional. A jury recently found her mentally competent to assist in her own defense, and her trial is set to begin on January 7th.

Mental Health Benefits Face Opposition From Lawmakers
Los Angeles Times, 12/9/2001

WASHINGTON -- At first glance, the legislation appears unstoppable: More than half the House members and two-thirds of those in the Senate back a proposal to broaden mental health insurance coverage. But the juggernaut has been slowed -- and soon might be halted altogether -- by a powerful alliance of big business, the insurance industry and House Republican leaders. The measure, which the Senate approved in October as part of a routine appropriation bill, aims to end the practice of group health insurance plans imposing tighter restrictions on mental health benefits than on what they provide for physical ailments.
    Spearheading the bid to help families defray the direct costs of treating schizophrenia, depression and other mental illnesses are Sens. Paul Wellstone, D-Minn., one of Congress' most liberal members, and Pete V. Domenici of New Mexico, a respected GOP leader best known for his expertise on budget issues. But big employers and insurance companies have been fighting the proposal, saying it would drive up the cost of providing health insurance just as corporate profits are suffering. The measure, they say, could result in less, not more, health benefits for employees.
    The House version of the appropriation bill did not contain the mental health provisions. A House-Senate conference committee began looking for a compromise last week that would allow a significant expansion of mental health coverage but limit the cost to employers. House GOP leaders, however, have urged negotiators to drop the proposal from the spending bill entirely. In a discouraging development for the measure's sponsors, White House officials said late in the week that the administration would rather postpone action on the issue until next year. "The White House has not been helpful," Wellstone said. "It's really an uphill battle."
    The measure's fate is likely to be decided later this week, as Congress nears adjournment for the year. If the drive to block the mental health proposal succeeds, it will mark the latest in a string of victories for the insurance lobby. In late November, insurance companies won House passage of legislation to aid the industry in the event of another terrorist attack. (Senate approval might follow soon.) And before that, health insurance companies bitterly fought legislation to impose new regulations on managed health care plans; the bill stalled and has been eclipsed by post-Sept. 11 concerns.
    That the mental health measure has gotten as far as it has in Congress is attributable in part to the transformation of the legislative agenda following the terrorist attacks. The sense of national crisis buried some once-prominent issues, such as campaign finance reform, and gave new prominence to others, such as concern about tending to the nation's mental health. "At a time when mental health care is of unprecedented importance, many will discover that their health plans hinder rather than help them receive treatment," said Rep. Marge Roukema, R-N.J., a leading House supporter of the legislation.
    According to a report by the U.S. surgeon general, about 20 percent of all Americans are affected by mental disorders. But many who seek treatment face steeper co-payments and deductibles than they pay for treatment of physical illness -- as well as strict limits on the number of office visits or days in the hospital that will be covered.
    Congress passed a law in 1996 that tried to address the disparity in coverage. That law prohibited private insurance companies from setting annual and lifetime limits on mental health benefits -- unless the same limits applied to other illnesses. But insurance companies found other ways to curb benefits for the mentally ill, such as limiting the number of visits a year that could be covered.
    The proposal by Domenici and Wellstone would require parity not just in overall benefit limits but in terms of what costs are covered and the access provided to services. Like the '96 law, the new measure would not require any plan to cover mental health; it would apply only to plans that already provide coverage for mental treatment. The legislation also exempts businesses with 50 or fewer employees. Proponents say the measure is essential to ensure fair and effective treatment for mental illnesses, some of which have biological causes. They argue that the discrepancy in coverage reflects the continuing stigma attached to mental illness. "We made progress with the 1996 law, but we need to pass this new ... legislation to have policies befitting the 21st century and not the dark past," Domenici said.
    But employers and insurance companies have peppered key lawmakers with phone calls and letters imploring them to block the measure. They are worried that the cost of expanded mental health benefits would be prohibitive, especially if coverage is provided for what critics say are vaguely defined or bogus psychological conditions. The measure's foes also argue that increased insurance costs are unwelcome now, at a time when the economy is in a recession and health insurance costs are skyrocketing.
    To address that concern, House and Senate negotiators are considering a compromise by Rep. Nancy L. Johnson, R-Conn., that would allow an exemption from the parity requirement for employers who demonstrate that their insurance costs would increase by 1 percent or more as a result. Proponents of the legislation are open to allowing such an exemption but want to set the bar higher, at 2.5 percent.
    Johnson also is urging that the measure's scope be narrowed so that it covers only the most serious mental illnesses, not every condition. Paul Dennett, vice president of American Benefits Council, a coalition of Fortune 500 companies opposed to the legislation, said allowing a cost-based exemption was an improvement. But he said businesses still oppose the measure because it would impose new limits on employers' ability to design their own benefit programs.
    Domenici and Wellstone, both of whom have close relatives with mental disorders, are backed by a broad coalition of advocates for the needs of the mentally ill. They held a news conference recently at which former first lady Rosalynn Carter and television newsman Mike Wallace were among those who endorsed the measure. The National Alliance for the Mentally Ill noted in a recent ad that as governor of Texas, President Bush signed a state law prohibiting discrimination against mental illness in health insurance. The Texas bill, however, was more narrowly focused than the congressional measure.

Michigan's Registry of Youthful Sex Offenders Coming Under Scrutiny
Dee-Ann Durbin, Associated Press- 12/10/2001

LANSING, Mich. -- The boy was only 10 when a slightly older neighbor in his northeastern Michigan town asked him to play. The two climbed into a tree house with the neighbor's 9-year-old sister. There, he said, the neighbor told the boy to have sex with the girl. ''I didn't know what I was doing,'' said the boy, now 18, who asked that his name not be used because of fear of harassment. ''It was kind of like me and a girl playing doctor.'' After a similar incident later that summer, the boy was convicted as a juvenile of criminal sexual conduct. He was sentenced to a year of probation and fined $80.
    But for him and hundreds of other youthful sex offenders, their sentence continues. Under Michigan law, the teen's name will be on Michigan's registry of sex offenders for 25 years. That means his name appears when potential employers, landlords or neighbors search the state's registry. He and other young offenders say the state is sending confusing signals to juveniles, who are generally considered easier to rehabilitate than adults and can have their convictions erased once they turn 21.
    Every state has a sex offender registry. Michigan is one of 28 states that requires juvenile sex offenders to register once they have completed their sentences, according to the Washington-based Center for Sex Offender Management. Of the 28, only about one-third have limits on releasing those names to the public, according to the center. Michigan publicly releases the names of juvenile sex offenders who have been tried as adults. The names of offenders who were tried as juveniles and convicted of the most serious sex crimes including rape of a child are posted once they turn 18. In Texas and South Carolina, juveniles' names are posted publicly. In Mississippi, only juveniles who are twice convicted must register. Indiana requires those older than 14 to register. In South Dakota, the cutoff is 15.
    Many supporters of sex offender registries say there's nothing wrong with including teen-agers on the lists. Many of the laws are inspired by Megan's Law, a 1996 federal law that required states to register sex offenders. It was named for a 7-year-old girl who was raped and murdered by a twice-convicted sex offender. Laura Ahearn, the executive director of Parents for Megan's Law, a New York-based group that supports registries, backs registering juveniles as long as they're being treated. ''A broad law that gives you release from the registry is a mistake,'' she said.
    But others say the laws are unfair because they don't take into account whether the teens are a danger to society.  ''At the minimum, if you're going to stigmatize people, there should be a showing by the government that they pose a danger to society,'' said Michael Steinberg of the American Civil Liberties Union. In New Jersey, where the original Megan's Law was passed, a judge ruled earlier this month that posting sex offenders' addresses violates their privacy, undercutting a constitutional amendment overwhelmingly passed last year.
    Attorney Nichol Palumbo, who is representing the Michigan boy convicted of raping his neighbor, said that even the victim's father asked the judge not to make the boy register as a sex offender. The victim in that case could not be reached. The county's current prosecutor, Gary Rapp, said he wasn't familiar with the case and wouldn't comment.
    In a separate action, three Michigan men are appealing a court's decision that their names be posted on the registry, arguing they were sentenced under a law that erased their convictions when they turned 21. Palumbo says the state has gone too far by not allowing judges to decide who should be on the registry. Oakland County Judge Gene Schnelz, who recently had to sentence a 16-year-old to the registry for touching a girl's breast, agrees. ''It's an excessive punishment for a minor, to stain them for 25 years. It could preclude them from a normal, happy existence,'' Schnelz said. Schnelz is concerned that teen-agers having consensual sex could wind up on the registry.
    Meanwhile, the boy convicted of raping his neighbor lives with constant worry. He left his hometown because of harassment after his conviction. Now that he's 18 and his name and address have been posted on the Internet, the harassment is beginning again. ''I've had calls at my house, saying, `You're a pervert. You're a disgusting pig,''' he said. ''I can't deal with it anymore. It just feels like my old life is coming back to me again.'' His girlfriend of three years broke up with him when he worked up the courage to tell her about the registry. He wanted to join the Navy but he's unsure the military will take him. ''I want to tell everyone, don't judge a book by its cover,'' he said.
    On the Net:
Parents for Megan's Law: http://www.parentsformeganslaw.com
Center for Sex Offender Management: http://www.csom.org

Families of 4 Suicides Left with Doubts, Grief
John Ingold, Denver Post- 12/10/2001

It's been a month since 15-year-old Ben Williams' family found him dead one evening in their garage. That time has done little to lessen their grief. It hasn't made the tragedy any clearer, either. Lakewood police officially classify Williams' death as a suicide, the first in a string of four teen suicides in Jefferson County, including three by students at Green Mountain High School since early November. But Williams' family doesn't think he meant to kill himself.  And the one person who knows can't answer their unbearably painful questions.  "We just can't believe that" Ben killed himself, said Robert Williams, Ben's father. "There were no indicators we noticed. He wasn't depressed. He wasn't suicidal in any way. He was happy. "He had teenage problems, but nothing to indicate anything so severe." But then Williams pauses. "I don't know if we just don't want to face the fact that he committed suicide," he said.
    The most recent suicide victim attended Summit Ridge Middle School. He killed himself Thursday afternoon. He was 13. Like Ben Williams' family, much of the surrounding community has been asking answerless questions in the wake of the deaths. Such is the conundrum of teen suicide, that someone so full of energy and promise could also be filled with despair and pain.
    The four deaths in Jefferson County serve as vivid examples of a phenomenon that took 47 young lives in Colorado last year and annually more than 4,000 nationwide. If Ben Williams' death was a suicide, he was like many victims.  Almost 75 percent of kids who kill themselves are male and Caucasian. Many, like Ben, are well-liked at school.  "From his short period of time at Green Mountain, he made so many friends," Robert Williams said. But there may also be problems.
    A police report said Ben was unhappy about being moved to Green Mountain this year. The day he died, Ben was caught by his father with a pack of cigarettes. Robert Williams told his son that smoking was not allowed and then said they would talk more later. But, in many cases, there is no easily identifiable trigger. "I think we tend to look for a reason somebody has committed suicide," said Betty Fitzpatrick, director of health services for the Jefferson County School District. "I think it's much more than a reason."
    So-called suicide "clusters" account for only 1 percent to 5 percent of all suicides, studies show. But they are more common among young people. And although the idea of suicide "contagion" is controversial among researchers, many agree that teens already contemplating suicide may find some sort of courage in seeing others be successful at it.
    Most suicide prevention activists, though, think the best way to combat suicide is to talk about it, for parents and teachers to ask kids what they are thinking and how they are feeling. And for the kids to respond honestly.  The Williams family has been talking with friends and counselors about Ben's death. Robert Williams said the family cannot shake the thought they may have some responsibility in his son's death. If they had just known before what they know now, Robert Williams said, then maybe his son would still be bouncing on the trampoline behind the house today. But then he realizes it may not have mattered. "Right now, all we have are unanswered questions," he said. "We're not sure of anything."

Massachusetts Sex Offender Registry Gears Up
John Ellement, Boston Globe- 12/11/2001

Five years after Massachusetts decided to alert the public to sex offenders in its midst, a new state agency is finally targeting potentially dangerous predators among the 18,000 men and women convicted of sex crimes in the past 20 years. Since 1996, lengthy battles in court and in the Legislature have repeatedly reshaped - and stalled - the Sex Offender Registry Board. But now, after clearing its final legal hurdles, the board is up and running, although much more slowly than before because all convicted sex offenders are now guaranteed a hearing before they are classified as dangerous or not. Boston police, for example, currently have information on just 33 convicted sex offenders out of a potential pool of 6,000. Under an earlier version of the Sex Offender Registry law, police had information on 900 offenders.
    ''I think [the board] is creeping before they walk,'' said Marilynne E. Gaffey, who has run the Boston registry for five years. ''It would be very defeatist of us to really bang these out and maybe be a little bit sloppy ... and get shut down again.'' In 1999, as a result of a Superior Court judge's order, the registration of sex offenders was stopped. The order was overturned by the Supreme Judicial Court in June.   Nonetheless, Gaffey welcomes the revision granting everyone a hearing, saying the process separates the truly dangerous from those convicted of such relatively minor infractions as college pranks. ''It seems fairer,'' she said.
    In recent weeks, the board has held hearings for 258 men, 53 of whom it classified as Level 3 offenders - those whose past makes them potentially the most dangerous. (There is a fourth level, violent sexual predators, but that designation can only be made by a judge and none have done so thus far.) With Level 3 offenders, police are required to disseminate as widely as possible their photographs, home and work addresses, and criminal histories to day care centers, schools, youth leagues, and the general public.
    Public identification of sex offenders grew out of the 1994 murder of 7-year-old Megan Kanka by a sex offender living in her New Jersey neighborhood. Congress enacted Megan's Law, which required states to create registries with the home and work addresses of convicted offenders or lose federal funding. Massachusetts was the last state to create such a registry, in 1996. Under the law, police have instant access to a statewide database of all sex offenders. Information on offenders classified as Level 1, or those considered least likely to commit more sex crimes, is never shared with the public. Information on Level 2 offenders is available only at police stations.
    Carol A. Donovan, an attorney with the Committee for Public Counsel Services, which represents indigent sex offenders before the board, is challenging in court the designation of a client who has been classified a Level 3 offender. He has twice been convicted of aggravated rape. ''This man has been hounded by some people in his neighborhood,'' Donovan said. ''He feels like he has become a pariah. People don't greet him anymore on the street.''  Donovan said the Level 3 designation for her client highlights flaws in the revised law. To her, the board ignored the ''exemplary life'' he is leading, focusing instead on his past in concluding that he remains a danger to the public.  Although the man was convicted of raping two women within a few days, Donovan said the crimes occurred 15 years ago. Her client served his time in prison, has done everything asked of him by his probation officer, and has forged a positive relationship with the mother of his child, according to Donovan. He also has been working steadily.
    ''I think this whole approach is bankrupt,'' Donovan said. ''I think the [goal] should be to attempt to rehabilitate those who are identified as the most dangerous,'' she said. ''I think it's misleading to suggest, or maybe kind of Pollyannish to think, that [public dissemination] is going to prevent reoffenses.'' Once alerted to a sex offender living nearby, neighbors might well keep a close eye out, she said. ''But if your neighbors are watching you, you then go over to the next town,'' she added.
    Gaffey said the registry should be viewed as only one tool the public should use to guard against sexual predators. ''I may give you a list of 10 sex offenders, but that doesn't help you with the 20 that aren't known'' to police, she said. ''It's an added tool for parents and guardians to help protect children. But if you rely totally on a list being supplied to you, you might as well put blinders on the horse.'' Those classified so far do not fall into a specific profile, except that most are white men, according to Ann M. Dawley, chairwoman of the Sex Offender Registry Board. ''The demographics cut across all economic ranges,'' she said. ''We have doctors, lawyers, [people with] six-figure incomes, down to those who have never held a job in their lives.''

Study: Alcohol Abstinence Partially Heals Brain
Stacey Singer, Knight Ridder Newspapers- 12/11/2001

Scientists have long known that chronic alcohol abuse leads to serious brain damage. It disrupts blood flow and creates lesions in a small, inner part of the brain called the cerebellum, the part that processes balance, gait and motor control. Alcohol also damages the brain's frontal lobe, where decision-making and memory reside. "Alcohol is exquisitely toxic to brain tissue," said University of Miami neurologist Deborah Mash. "I have worked with many alcoholics and you see deficits in what we call executive functioning. The frontal lobe is where you figure out right from wrong, where you learn to judge situations."
    A study published last month in the scientific journal Alcoholism: Clinical & Experimental Research offers hope that at least some brain damage can be reversed, especially in the frontal lobe, if chronic heavy drinkers abstain long enough. Researchers working with alcoholic patients at the Veterans Affairs Medical Center in San Francisco compared brain images of drinking alcoholics with those of people who had gone through treatment and successfully abstained for an average of two years. Using a technology called proton magnetic resonance spectroscopic imaging, the scientists were able to see the patients' brains at work and to monitor their brains' metabolism and anatomy. They studied eight heavy drinkers and compared them with 12 recovering alcoholics.
    They found that some regions of the recovering brain showed greater signs of recovery than others. The volume of so-called white matter in the frontal lobes, the connective nerve fibers that transmit signals, was greater for the treated alcoholics, who also had fewer lesions. In addition, the volume of gray matter, the cellular tissue of the brain, was greater in many regions of their frontal lobes. "Even within three to four weeks, some recovery is evident," said Dr. Dieter Meyerhoff, a scientist with the VA Medical Center in San Francisco and an associate professor at the University of California San Francisco School of Medicine. He coauthored the study with two colleagues.

Inquiry Is Likely After Yates TV Interview
Mary Flood & Lisa Teachey, Houston Chronicle- 12/11/2001

State District Judge Belinda Hill is considering appointing a special prosecutor to investigate whether Russell Yates and Harris County District Attorney Chuck Rosenthal violated a gag order in the capital murder case of Yates' wife, Andrea. Yates and Rosenthal appeared on CBS-TV's 60 Minutes Sunday and discussed the case involving Andrea Yates' confessed killing of her five children in June. They agreed to be interviewed despite Hill's order that no one who was a witness in the case or who had been interviewed by police or prosecutors discuss the case publicly.
    A special prosecutor is needed because of Rosenthal's involvement in the broadcast. Two sources familiar with the case and who requested anonymity told the Chronicle on Monday about Hill's desire to recruit a special prosecutor, who could be appointed as early as today. The judge's court coordinator, David Alsworth, said Hill would not comment Monday. But Rosenthal said Monday the judge could not use a special prosecutor unless Rosenthal recuses himself from investigating whether the gag order was violated. Rosenthal said he has not been asked to remove himself, and he has not met with Hill about this matter.
    When asked if he would step aside, Rosenthal said it would depend on the reasons he was asked to do so.  Rosenthal said he does not believe his appearance on the news program violated the order because in August the judge had given him permission to release a statement regarding the death penalty. "What I did was authorized by the judge," Rosenthal said, adding that he did the interview in early September. Lawyers for Andrea Yates met Monday with Hill and Assistant District Attorney Kaylynn Williford about the broadcast, but Hill took no action. Neither Russell Yates nor his lawyer, Edward Mallett, was in the courtroom.
    The judge imposed the gag order shortly after Andrea Yates called police to the family's Clear Lake-area house on June 20 and admitted she methodically drowned each of the five children in the family bathtub. The gag order prohibits all witnesses, lawyers and investigators involved in the case from discussing it with the media. A violation could mean up to six months in the Harris County Jail and/or up to a $500 fine.
    On television Sunday, Russell Yates contended that if his wife, who was found to be depressed and suffering from psychosis, had received competent psychiatric care she wouldn't have been in the mental state that caused her to kill their young children. "The medical community failed us," he said. Several lawyers said Monday it appeared Russell Yates was laying the groundwork for a civil lawsuit against his wife's medical caretakers for negligence or malpractice. "It's so obvious that there's a potential lawsuit that the big question is why one hasn't been filed yet," said Gerald Treece, a professor at South Texas College of Law. Treece said he would take such a case, filing on behalf of Yates and her husband, who accompanied her to her physician's visits. Treece said such a lawsuit could be filed within two years and it might make sense to wait until the criminal case has ended, so as not to entangle any questions about Andrea Yates' competency to be party to such a suit.
    Mallett said his client has "been approached by many lawyers" hoping to file a lawsuit against Yates' psychiatrist and the League City hospital that treated her. "It's not about money for him," Mallett said. "He has not engaged me or any other attorney for that purpose," though Mallett said he does not think his client has ruled out a civil lawsuit over his wife's treatment.
    Jim Perdue Jr., a malpractice lawyer, said he thinks a suit by Russell Yates would be difficult to win. He said suits on behalf of third parties harmed by a doctor's lack of care to another person are nearly impossible to win in Texas.
    In 1999, the Texas Supreme Court ruled against a woman who sued a psychiatrist who was told repeatedly by her son, a patient, that he wanted to kill her husband, the son's stepfather. Her son shot and killed his stepfather. The high court ruled the psychiatrist owed no duty to anyone but his patient. Plaintiffs lawyer Joe Jamail said this high court case is the reason he wouldn't take Russell Yates' case. "(Andrea Yates) would have an easier lawsuit alleging that a psychiatrist didn't treat her by the standards of the profession," Perdue said.
    Another reason Russell Yates might not sue on his own behalf is that if he argued in civil court that it was clear his wife should not have been home with their children, he could create some criminal liability for himself as a negligent parent. Andrea Yates' psychiatrist, Mohammed Saeed of Dickinson, had no comment Monday. Devereux Texas Treatment Network, which owns the League City hospital where she was treated for depression and psychosis, issued a news release Monday indicating it has no comment on the Yates case either.

Havens of Wellness for Addicted Women
John L. Mitchell, Los Angeles Times- 12/11/2001

Wanda Davis was young, but she never forgot the worn-out gazes on the faces of the women who stood outside the Ding Dong Motel, a 16-room flophouse on a busy stretch of South Figueroa Street where the prostitution and drug trades have flourished for decades. She was 11 when her family moved into a small wood-framed house next door and her bedroom window looked out on the nightly commotion. "I could hear women crying," she recalled. "If anything sticks out the most in my mind it's that sound, a wailing sound." Davis left home for UCLA in 1979 and swore she would never look back. She returned last year--not to live, but to help. She transformed that childhood home into a sober living house for women recovering from drug and alcohol abuse. The family house on Figueroa is the third group home that Davis' nonprofit organization, the House of Wellness, established in South Los Angeles.
    At UCLA, Davis majored in applied mathematics, leaving behind acting and basketball, her high school passions. After graduation, she worked as an adult school mathematics teacher and later picked up a real estate license.  Davis, a field engineer for the Los Angeles Department of Public Works, came up with the idea of operating a group home in 1997. She had purchased a $125,000 fixer-upper on Normandie Avenue and 46th Street and thought of a way to make money and provide a much needed community resource--affordable housing for people in desperate need of a second chance. She picked up another property at 66th Street and Main within two years. So far, she said, "The payoff is not as much financial as it is spiritual. Financially, it's a struggle making ends meet on what I receive in rent from the women--and sometimes they're not able to pay. But it's also rewarding in that I can help them turn their lives around and reunite with their children."
    The House of Wellness' two dozen adult tenants pay $200 to $400 a month for a room. They also must agree to share expenses and chores, seek employment and continue their treatment for substance abuse. Run as a cooperative, the organization has a board of directors but no employees. Its executive director's only compensation is free housing. Program participants are selected from residential treatment programs. "When they come from a treatment program they have tools to work with--a foundation," said Barbara Wade, the program's executive director. "It's not enough to sit at the table and expect to eat. You have to learn to sit and feed yourself." "I always wanted to come back and do something for people who were less fortunate," said Davis, a single mother, who lives in an apartment building she owns near West Adams.

Sober Living Houses Seek Prop. 36 Funds
Davis' investment may also pay off financially if sober living houses can tap into public funds. Since the implementation this year of Proposition 36, which mandates probation and drug treatment for nonviolent narcotics offenders, the supply of housing for recovering addicts has become scarce. But under Proposition 36, funding is earmarked for drug treatment programs, not sober living houses--an issue that group home operators, like Davis, would like to change. Proponents of the measure argue that such housing should be eligible for state funding if the homes can be monitored and licensed. "We believe that many of these people need safe places to live," said Whitney Taylor of the Lindesmith Center-Drug Policy Foundation in Sacramento and who is helping the state implement Proposition 36. "But halfway houses and sober living environments should be licensed and regulated."
    The expansion of group homes has been advocated along the Figueroa corridor by such community activist organizations as the Community Coalition, which has waged a campaign against the low-rent motels that dot the street. "We want to eliminate motels as a source of crime in the neighborhood," said Karen Bass, the Community Coalition's executive director. "If people are using the motel as office space to deal drugs and rent rooms out by the hour for prostitution, then that will negatively impact communities."
    In the shadows of the Coliseum, Figueroa shares a reputation for prostitution similar to Sunset Boulevard in Hollywood, said Capt. James Bowers of the 77th Street Division. Prostitution and other crime remain high along Figueroa, Bowers said, but have fallen since the peak of the crack epidemic a decade ago. "If you drive up and down Figueroa, you won't see the graffiti there was a couple of years ago, which means that area is cleaning up, and prostitution is not as conspicuous."
    Some credit a city and community campaign to force dozens of operating conditions on motel operators. Fanny Liu, whose mother owned the Ding Dong, said police harassment forced her family to sell the motel last year. "The police came and they parked outside," she recalled. "They wanted to look into every room and disturb the customers. My mother sold it because it just wasn't worth it." Before selling, the owners agreed to prohibit the renting of rooms for periods of less than 24 hours, to discourage prostitution, remove graffiti and prohibit the consumption of alcohol outside the rooms. A worker at the Ding Dong, now under new management, said all guests must pay the full $35-a-night rate.
    Coming of age next to the Ding Dong didn't leave much to the imagination. Davis remembers a childhood in which she hid in the closet at the crackle of gunfire. She recalls being bundled up and rushed outdoors at the smell of fire next door. Members of her family fell to the crack epidemic. Next door, in Davis' old bedroom, a 36-year-old mother of two named Brenda said she doesn't care what's going on inside the motel. "I'm just looking to put my life back together again," she said. Brenda experienced a double hardship recently beginning with the murder of her twin sister in April and the death of her mother in September. "It just hit me hard and I didn't think I would ever recover," she said. "I started using drugs and I didn't think I could stop, but I did."

Mom, Sober for 3 Years, Reunited With Daughter
Sober for three years, Terri Smith, 39, has been able to reunite with her 15-year-old daughter, Telia Pruitt, who has lived in more foster homes than she can remember. "I'm balancing my checkbook and paying off old bills," Smith said, a sign of how much her life has changed since she was living on the streets. "I used to justify the fact that I didn't walk the streets, but I did many things I was not proud of for drugs. I lost a lot in my life."
    Another roommate, Francesca Woods, 39, also has been sober for three years. Her memories of the Ding Dong are firsthand. It was the last hotel she worked on the street before her arrest turned her to sobriety. "I was tired, just tired of the streets," she said. "The cops pulled me over, I had warrants for my arrest." From jail, she made her way into a program and sobered up. Woods said she had been on drugs for years, lost contact with family and friends, but somehow that night in 1998 she was ready to make a change and she hasn't thought about going back. "I can't think about it," she said. "I can run by any motel and think about the good old days, but in my mind and heart I know I'm different, different now. I think about the pain, despair and loneliness and it reminds me of me. It doesn't tempt me, but it does hurt."

Digging Up A Disorder From A Mess
Anna Fels, M.D., New York Times- 12/11/2001

Behaviors that we do not understand often become nearly invisible--even when, in retrospect, we see how truly strange they are. When I was a psychiatric resident, we had a faculty member who was famous for his messy office: Stacks of papers and old journals covered every chair and table as well as much of the floor. One day, as I walked past the open office door with one of my supervisors, he murmured mildly, "Odd duck." And that was as far as anyone seemed to reflect on this peculiar state of affairs within an institution staffed by psychiatrists. Eventually, the faculty member had to be given another office in which to see patients.
    Several years later, a patient told me that her boyfriend of nearly a year refused to let her see his apartment, claiming it was too messy. Despite her offers to help him organize the chaos, he seemed mysteriously paralyzed. She asked me whether I thought this was just immaturity or evasiveness (was there another woman?), or perhaps some bona fide psychiatric ailment. I was as mystified as she, but her story rang a bell--the pack rat faculty member.
    Not surprisingly, the psychiatric diagnostic manual does not list "messy room" in the index. But it does mention a tantalizing symptom: inability "to discard worn-out or worthless objects even when they have no sentimental value." It comes under the diagnosis obsessive-compulsive personality disorder, and obscure cousin of the more famous obsessive-compulsive disorder. I was barely aware of the diagnosis. Every era has mental disorders that for cultural or scientific reasons become popular. In Freud's day it was hysteria. Currently, depression has moved to center stage. But other ailments go relatively ignored, and this disorder was one. It came with a list of additional symptoms that appeared to be peculiar bedfellows: anxiety about spending money, excessive devotion to work to the exclusion of leisure activities, rigidity about following rules, perfectionism in doing tasks--at times to the point of interfering with finishing them.
    In moderation, the symptoms seemed to fit right in with our workaholic culture--perhaps explaining the low profile of the diagnosis. Relentless work orientation and perfectionism may even be assets in rule- and detail-oriented professions like accounting or law. But when the symptoms are too intense or pervasive, they become crippling. Beneath the seemingly adaptive behaviors lies a central disability. People with this diagnosis have enormous difficulty making decisions. They lack the internal sense of completion that most of us experience at the end of a choice or a task, even one as simple as throwing something out or making a purchase. In obsessive-compulsive personality disorder, this feeling occurs only after endless deliberation and revision, if at all. The need to come up with the "correct" answer, the best purchase or the perfect proposal leads to excess rumination over each decision. It can even lead to complete paralysis. For such people, rules of all kinds are a godsend--they represent pre-made decisions. Open-ended assignments, like writing papers, are nightmares.
    When I presented the grocery list of symptoms to my patient to see if they fit her boyfriend, she nodded at each new category and looked at me with such incredulity that I felt as if I ought to slip into a swami outfit. She began to enumerate behaviors of his that had caused increasing tensions between them: his indecision about choosing vacation spots or restaurants or even food from a menu; his habit of bargaining endlessly on eBay but never buying anything; of staying at work long beyond the time his colleagues left to make sure he got everything "right," often leaving her cooling her heels. She decided to talk to him about seeing a therapist.
    For such a patient or for a clinician, understanding a cluster of diagnostic symptoms can be a revelation. The picture leaps out from the previously disorganized background. Undoubtedly, at times we can become too reductionistic, seeing patterns where none exist: sometimes a messy room is just a messy room. But in other cases such new insights shed light on otherwise unfathomable behavior.
    Several months after our conversation, my patient announced that she was leaving her boyfriend. "Whatever happened about him seeing a therapist?" I asked her. "He agreed to pursue it, but then his internist gave him not one, but two referrals," she said. Looking at me as if she had answered by question. "And?" I said. "What happened?" She laughed. "She's still trying to decide which one to see."

Letting Bygones Be Bygones Is Often a Challenge
Eric Goode, New York Times- 12/11/2001

"To forgive is divine," noted the English poet Alexander Pope. And most Americans appear to agree. Almost 75 percent of the adults who participated in a national survey said they knew God had forgiven them for any past mistakes or wrongdoing. "Americans are very confident about a lot of things, and it seems this follows in line," said Dr. Loren L. Toussaint, the lead author of a study based on the survey, conducted at the University of Michigan's Institute of Social Research.
    On the other hand, Dr. Toussaint and his colleagues found, the survey participants were far less confident of their own human ability to let bygones be bygones. Only 52 percent reported that they had forgiven other people, and 57 percent said they had forgiven themselves for transgressions against others. The study, which appears in the current issue of the Journal of Adult Development, did not ask people to specify what transgressions they had in mind. As part of a larger telephone survey of consumer attitudes, 1,400 randomly selected adults were asked about their experience with forgiveness. The participants also answered questions about their religious beliefs and practices and their physical and mental health.
    "There's a lot of ways to interpret this," said Dr. Toussaint, an assistant professor at Idaho State University, who carried out the research while completing a postdoctoral fellowship at Michigan. He said he found it "a little surprising" that so many people were convinced of God's forgiveness. "I didn't expect people to be so overwhelmingly certain that that was the case," Dr. Toussaint said. "Part of that is personal reflection: there have been times in my own life when I think I'm pushing the envelope." But he added that perhaps the finding "speaks to the fact that we're taught that God forgives unendingly and we should, too, but we're not perfect and forgiveness is a hard thing to do."
    Middle-aged and older adults, the researchers found, were significantly more likely than younger participants to report that they had forgiven people who had harmed them. And though the percentage who believed that God had forgiven them was high in all age groups, it was highest among adults over 45. Women were more apt to forgive than men, the survey found. Fifty-four percent of women scored high on items measuring forgiveness of other people, compared with 49 percent of men. But religious affiliation made no difference in how likely someone was to forgive.
    Dr. Toussaint and his colleagues also found confirmation for previous studies, which have indicated that the ability to forgive--perhaps because it reduces the stress induced by holding grudges--may be associated with health benefits. Among survey participants older than 45, for example, those who said they had forgiven others were less likely to report symptoms of psychological distress, like feeling nervous, restless, hopeless, worthless or so sad that nothing could cheer them up.
    Good physical health was also linked to having forgiven others, but only in adults over 65--perhaps, the researchers speculated, because people in younger groups tended to rate their health as good. Among adults under 65, having forgiven oneself for transgressions was associated with better overall physical health. "The take-home message here is that forgiveness changes with age, and that the benefits for your health due to forgiveness increase as you get older," Dr. Toussaint said. But he added that it was not possible to tell from the survey whether older generations somehow differed in their approach to forgiveness, or whether the appreciation of the importance of forgiving oneself and others simply increased with age. "Perhaps it's only as you get older and have had time to work through these transgressions that you fully realize the concept of forgiveness," Dr. Toussaint said.
    Not all forms of forgiveness were tied to better health among survey participants. People of all ages who reported that they often asked forgiveness from others, or asked God to forgive them or to forgive another person who had hurt them, also reported feeling more psychological distress. The researchers suggested that the act of seeking forgiveness for oneself or for others might itself be stressful. "These individuals, whether transgressors or victims, are 'taking the first step' in the process of forgiveness--a task that may actually engender psychological distress and lowered life satisfaction," Dr. Toussaint and his colleagues wrote. On the other hand, the researchers noted, the people who said they often asked others for forgiveness or prayed for God to forgive others might simply have lower self-esteem or might not be acting out of pure motives, but to manipulate others. For instance, such "pseudoforgiveness" might really translate into "I have forgiven you, now you owe me one."