Noteworthy News Articles on Mental Health Topics, July 10-15, 2001

Pathological Gambling Is Chronic Medical Condition, Say Researchers
Ascribe News Service, 7/10/2001

NEW HAVEN, Conn. -- Like drug and alcohol abuse, pathological gambling should be viewed as a chronic medical condition, Yale researchers assert in an article published in the July 11 issue of the Journal of the American Medical Association (JAMA). ''Pathological gambling should be conceptualized as a chronic medical illness so that we can gain better understanding of the biological, genetic and environmental factors that contribute to the problem, develop better treatment strategies and treat individuals with the disorder within a medical context,'' said principal investigator, Marc Potenza, M.D., assistant professor of psychiatry at Yale.
    Potenza, who is also director of the Problem Gambling Clinic and the Women and Addictive Disorders Core of Women's Health Research at Yale, said that as a nation, America has seen a robust increase in gambling. Studies show that with the rapid increase and availability of legalized gambling, there are a growing number of problem and pathological gamblers. In 1998, 86 percent of the general adult population was estimated to have gambled at some time in their lives, up from 68 percent in 1975. Traditional forms of gambling include wagering in casinos or on lotteries or horse racing. Potenza said new gambling forms, such as video poker and Internet gambling, may be more habit-forming than traditional gambling, given their greater rapidity of action and ability to be used in isolation.
    Potenza said less than 10 percent of adult gamblers develop a gambling problem. Problem gambling generally refers to gambling which interferes significantly with basic functioning in occupation, interpersonal relationships and finances. Pathological gambling is more severe and refers to a psychiatric disorder with specific diagnostic criteria.
    ''Gambling has gone from being considered a sin to being a vice to being just bad personal behavior and only recently has been conceptualized within a psychiatric or medical context,'' said Potenza. ''As with drug addiction, pathological gambling can have a devastating effect on family relationships, disrupting work, marriage and/or child care responsibilities. It is estimated that one of every five individuals with pathological gambling attempts suicide.''
    Potenza said two prominent theories on gambling classify the condition as either an impulse control disorder or a non-substance-related addictive disorder. Some treatments for impulsive/compulsive disorders, such as selective serotonin reuptake inhibitors, appear effective in the short-term treatment of pathological gambling. Treatments for substance dependence, such as the opioid antagonist naltrexone, also appear effective. ''Primary care physicians should make questions about a patient's gambling habits a routine part of a check-up, as are questions about alcohol and drug abuse,'' said Potenza.
    The article's co-authors included Thomas R. Kosten, M.D. and Bruce Rounsaville, M.D., professors in the Department of Psychiatry at Yale. The study was funded in part by the National Institute on Drug Abuse, American Psychiatric Association, National Alliance for Research on Schizophrenia and Depression, the National Center for Responsible Gaming and the VA-New England MIRECC.

Children As Young As Six Attempt Suicide in UK
Paul Majendie, Reuters News Service- 7/11/2001

LONDON -- Children as young as six are attempting suicide in Britain after suffering sex abuse, school bullying and exam stress, the counseling service ChildLine said on Wednesday. Its helpline receives up to 1,500 calls a year from suicidal children -- and some even ring while they are trying to kill themselves.
    "Some of these children have such painful lives filled with abuse that we can only wonder they found the courage to survive at all," ChildLine Chairwoman Esther Rantzen said. "Young death is always painful. Suicide is the most painful of all because it is preventable," she said, reflecting on a growing problem that confronts counselors around the world from Japan to the United States. ChildLine said the youngsters most often try to kill themselves by overdosing on pills or slashing their wrists. Telephone counselors try to keep the child on the line while an ambulance is called.
    According to a ChildLine report released on Wednesday, girls call more frequently than boys -- and their ability to talk freely about their problems could be saving their lives. Boys tend to hide their problems and try to cope alone.  Most of the callers to the helpline were aged 13 to 18, although the youngest were aged just six. Nearly half of the calls were from families without two parents. The report warned that up to half of youngsters who attempt suicide will try again. The greatest risk of a repeat is within a few months of the first attempt.
    Health Minister Jacqui Smith, commenting on the report, said: "It is harrowing that some children feel so desperate that they take their own lives and we must do all that we can to prevent this from happening." She said the government was now working with ChildLine to develop a national suicide prevention strategy "to address the needs of vulnerable young people."
    The report's selection of case histories showed that the reasons for suicide attempts among the young varied widely.  Fourteen-year-old Sarah took 20 of her mother's sleeping tablets after a family row about studying for exams.   Sixteen-year-old Tariq overdosed on paracetamol after his father died of a brain hemorrhage and his mother found a new boyfriend. Craig, unemployed for two years, called to say that he was going to hang himself the next day -- his 19th birthday. At the age of 13, Nikki swallowed a bottle of painkillers. She had been raped a year earlier by her father but had been too scared to tell anyone. She told ChildLine she didn't want an ambulance, she just wanted to talk to someone while she was dying.

Study: Desire for Cocaine Increases Over Time
Dan Childs, ABC News, 7/11/2001

Cocaine addicts’ drug cravings may increase, rather than decrease, over time after cocaine use has stopped, finds a study on rats by the National Institute on Drug Abuse published in the July 12 issue of Nature. Researchers say rats addicted to cocaine are about four times as persistent in trying to obtain a dose of the drug 60 days after quitting than they were after one drug-free day. Experts say this finding, if applicable to humans, could have huge implications for treatment of cocaine addiction. "It’s one of those things where absence makes the heart grow fonder," said Jeffrey Grimm, first author of the study, released today, and experimental psychologist with NIDA, which is based in Bethesda, Md. "The importance of this is that a lot of people have the idea that cravings get lower over time.  "We were kind of expecting to see cravings diminish over time and were surprised to see them progressively increase."
    In the experiment, researchers focused on "cues," or reminders of the drug. For the rats, the cue was a red light that turned on when researchers made the drug available. For humans, cues can range from seeing a bag of cocaine to something as simple as holding a rolled-up dollar bill. When addicts receive the cue, their cravings for cocaine intensify.
    Dr. Herbert Kleber, director of the division of substance abuse at the Columbia University College of Physicians and Surgeons in New York, said the new study reinforces findings drug craving from a study he authored in 1986, based on testing of humans. "[These studies] emphasize the need for intensive relapse training so addicts can cope and, equally important, the development of medications that will either decrease or block these feelings," Kleber said.  "This study emphasizes the importance of treatment that is intensive enough and long enough to deal with heightened craving, and it points out the fallacy of many managed-care programs that don’t permit patients to be in treatment long enough to get help with this." Grimm agreed. "In terms of implications for treatment, if someone goes into treatment for two months and comes out, they might be coming out when they are most sensitive to drug cues."

Arizona Boy's Death Revives Argument Over Boot Camp Effectiveness
Bryan Robinson, ABC News, 7/12/2001

Col. Phil Torres thinks boot camps get a bad rap. He doesn't even want the state-run military structured youth corrections program he helps operate in Kenbridge, Va., to be called a "boot camp." But with the death of a 14-year-old boy at an Arizona juvenile boot camp last week, he dreads the inevitable comparisons. "It's devastating," said Torres, director of Rebound Camp Kenbridge. "Anytime there's a serious incident, people do not differentiate from one program in another state to another program in another state. They like to lump us all in the same category."
    But the argument against boot camps seems to be mounting. On July 1, Anthony Haynes died following the first in a five-week stint at an Arizona boot camp operated by the America's Buffalo Soldiers Re-enactors Association. The investigation into his death is ongoing, but sources close to the camp said Haynes was forced to swallow mud, deprived of food and water and required to engage in strenuous activity in 100 degree heat during his week at the camp. In July 1999, a 14 year-old girl died after a forced run at a South Dakota state-run girls' boot camp. In 1998, a 16-year-old boy died of a heart attack at the privately run Arizona Boys Ranch near Oracle, Ariz.  In Florida that same year, a 16-year-old committed suicide after being assigned to a juvenile boot camp.
    Despite these deaths and allegations of abuse, some experts say parents should fear state-run or the private boot camps. "It [abuse] occurs very rarely, death even more rarely," said R. Dean Wright, professor of sociology at Drake University in Des Moines, Iowa. "Anytime you have a situation where there's any kind of procedure and heavy regiment involved, inevitably something is going to happen."

Fall From Grace
The first juvenile boot camp opened in Orleans Parish, La. in 1985, modeled after the first prison boot camp that had been established for adults in Georgia in 1983. It paved the way — and provided a model for — other camps that were opened nationwide over the next 10 years. At first, the camps had the full support of the public and state legislators. The image of juvenile offenders being rehabilitated and disciplined by barking drill sergeants gave the public evidence that juvenile crime (albeit non-violent offenders who had not been previously incarcerated) was being fought successfully, without the use of prisons.
    And legislators were encouraged by boot camps' cost effectiveness. According to the Koch Crime Institute, the majority of boot camps run programs lasting three-to-six months. A year of treating a juvenile costs $33,480 compared to $47,400 at a traditional facility. "Legislators were in favor of boot camps because it was a relatively cheap thing to do and the public liked it — they could see that something was being done about juvenile crime," said Mike Slusher, vice president of operations at the Koch Institute. "But when a few incidents occur, things can change."
    When allegations of abuse emerged and deaths were reported, boot camps began to lose favor. And then debate emerged over their effectiveness. Despite the rigors of the programs, there is a high recidivism rate among participants in boot camps. A 1998 report by the Kansas-based Koch Crime Institute found that between 64 percent and 75 percent of those who participated in juvenile boot camps committed crimes shortly after completing their programs.
    Children's advocates say the recidivism rates and abuse allegations prove that juvenile boot camps just don't work.  "It's a question of what you expect them to do," said Mark Soler, president of the Washington-based Youth Law Center. "If you expect them to reduce the recidivism rate, then by that criteria they do not work. The only thing I can see that they've done is provide that they've provided a supposedly more regulated program that puts a child through rigorous training in less time, making them cost effective." "But in terms of rehabilitating youngsters over the long term and making them into productive citizens, it has failed," Soler said. "It has only lent to excessive use of force and punishment on kids that has failed to do anyone any good. Unfortunate incidents like that in Arizona are not the first that we've heard about."

Force Does Not Equal Rehabilitation
Soler and other child advocates believe that boot camps are only a quick fix, across-the-board way of dealing with troubled teens that do not address their individual problems. Boot camps, he said, shows children that they cannot beat authority but it doesn't necessarily show them the benefits of doing the right thing or give them the choice to make right and wrong decisions. He also noted that many boot camps do not take violent child offenders or the most troubled children because they believe they are the most difficult to rehabilitate. "Often the rationale is to get them before they get to the state where they're violent offenders," said Soler. "But there have been studies that show that that doesn't work." Scandals and an apparent lack of effectiveness turned some legislators against state-run boot camps. Wisconsin and Florida nearly withdrew funding for their programs; Georgia and Arizona eliminated their state-run programs in 1999 and 1996 respectively.
    Soler believes small, community-based programs that do not isolate kids from the communities are the best way to rehabilitate troubled teens. "There's been a lot of research on what kind of programs work," Soler said. "They have small staffs, with a small staff-to-child ratio, and a program very focused individual case management. They [counselors] impose rules, but you also give kids the opportunity to make decisions. The child also gets competence in vocational training and have an extensive aftercare program so that they just don't go back to doing what they were doing."

Aftercare: The Key to Combating Recidivism?
Still, Mike Slusher believes the problems do not lie with boot camps in principal. He suggested that many boot camp graduates return to their old habits because several camps lack aftercare programs that monitor juveniles' progress and re-adjustment to society. He believes boot camps should be modeled after a program sponsored by the National Guard running in 27 states that focuses on troubled teens between ages 16 and 18. In this plan, juveniles who have not been convicted of violent crimes participate in a 5 1/2 month program and are monitored for a year in an aftercare program.
    Col. Torres' Camp Kenbridge seems to borrowed from the National Guard's program. In his program, which focuses on teens ages 12-17, juveniles address their superiors by military ranks and endure a strict military regimen over a four-month period. But Torres says his program is not a boot camp: there are no weapons on the grounds, and the program focuses on daily treatment for substance abuse, anger management, parenting and provides counseling for the teenagers' families.
    After their release, Camp Kenbridge graduates participate in a six-month aftercare program where they report weekly to a counselor and are supposed to obey a curfew. Aftercare counselors also try to help their graduates find a job or prepare for college. "We're trying to address bigger issues so that we can create a kid who will be a tax payer and not a tax burden," Torres said. "We have a 70 percent success rate — no other program in the state can make that claim. … Sure we address our kids in a stern, loud voice to encourage them to perform whatever they need to perform. As long as you're fair and consistent, you can make a program like this work."

Need For Boot Camp Screening and Checks and Balances
Run by the Virginia Department of Juvenile Justice, Camp Kenbridge, Torres said, undergoes unannounced inspections on a regular basis by state officials. Privately-run boot camps, he said should also be inspected by independent outside committees to prevent allegations of abuse. Other experts say better screening of camp counselors may also alleviate the problem. "Most of the allegations are situation-based. Certain kinds of people are drawn to law enforcement. Periodically, you'll get a person who has authority, and who doesn't back off," said R. Dean Wright. "I would suggest, especially with private institutions, more safeguards, more independent inspections, more oversight."
    "We can minimize the problems by hiring people who are well-trained," Wright continued. "I'm not an advocate of bringing in people to sensitize people but we constantly have to monitor [camp] staff members individually and have to more carefully screen those who oversee juveniles at these camps. You also need an independent agency outside of the camp to monitor its ongoings, just to keep the checks and balances ongoing."

What Parents Should Do
Parents looking for private camps for their troubled teens must also play an active role and carefully screen the programs. "I would ask for references and try to talk to some who were satisfied and not satisfied with it," said Slusher. "You'd think you'd want to know as much as you can with anything you're making an investment in."
"You have to remember these parents are desperate and may not even think or even know what questions to ask," said Wright. "But parents should really do a lot of referencing, ask a lot of questions and see what kind of programs and obstacle training and regimens the camps offer. Not all boot camps are the same and some parents think they are." "There's no reason to be scared of boot camps," Wright continued. "People have moved away from corporal punishment and parents complain that the laws are against them and they should be able to discipline their children the way they want to. There is a need for kids to be disciplined and have structure. … People shouldn't be scared because the ways camps offer that ranges in a variety of ways."

Massachusetts Plan Aims to Aid Mentally Ill Children
Alice Dembner, Boston Globe - 7/12/2001

Hoping to head off a class-action lawsuit over inadequate care for hundreds of mentally ill children, state officials are proposing an extensive program of individualized counseling and support that would treat more children at home. The initiative targets the poor and disabled children whose treatment is paid for by taxpayers through the Medicaid program and who have been forced into hospitals and often languished there for lack of coordinated outpatient treatment. ''This is an effort to keep kids out of institutional settings,'' said Wendy Warring, state commissioner of the Medicaid program. ''We're trying to put together a comprehensive plan for each child with a mix of traditional and less traditional care.''
    Advocates for mentally ill children have been threatening to sue the state since January, charging that the state is violating federal Medicaid law by failing to provide enough home-based care. Details of the new program, including the cost and the number of children who would be eligible, are still being negotiated, both with the advocates who have threatened to sue and the private firm that would provide the services.
    Although the program is expected to cost several million dollars, specialists say it may cut mental health costs in the long run. Similar programs in other states have reduced costly hospitalizations dramatically, according to the federal Center for Mental Health Services. As many as 10 states, including Vermont, provide similar home-based services.
    The advocates, who have notified the state of their intent to sue, said they were encouraged by the proposal, but were not yet willing to settle.  ''The proposal has the potential to be a dramatic change in the way the state serves the most needy children with mental illness,'' said Steven J. Schwartz, an attorney with the Center for Public Representation, one of three groups that joined to prepare the lawsuit. ''Even the most challenging children might be able to stay with their families.  ''But we remain prepared to file a lawsuit unless the details of eligibility, staffing, intensity of services, and funding are agreed upon quickly,'' he added. Schwartz said as many as 1,000 children may need access to the home-based services.
    Warring said the state hopes to avoid the suit, but plans to move forward with the new program anyway as the third prong of a campaign launched a year ago to strengthen the overburdened mental health system for Medicaid patients. The state has added hundreds of hospital and residential beds for children, but the increase has made only a dent in reducing the number of children ''stuck'' inappropriately in hospitals or group homes. As of July 3, 98 children were stuck statewide in locked hospital wards although they no longer needed hospital care.
    Under the outline the state provided to the advocates in a private meeting last week, the program will be built around specially trained ''care coordinators'' who will assess each child's needs and develop a flexible, individualized program of treatment including therapy, help in modifying troubling behavior, and afterschool programs for the child as well as support for the family. In some cases, the care will extend around the clock, while in others it may be limited to a few hours. Many of these services are already available, but most families have had trouble securing them and getting Medicaid to cover the cost. Schwartz said his clients feel strongly that ''the program must serve all the children who need intensive home-based services. This cannot be constrained by artificial funding limitations.'' Under Medicaid law, the state is required to provide all medically necessary services.
    In addition, Schwartz said his clients believe more workers are needed to provide the services. However, Warring said that the state won't know if the program requires more caregivers until the design is fleshed out. Even though many issues remain to be resolved, the proposal has the strong backing of the state's mental health commissioner, Marylou Sudders. ''The emphasis is on early identification and immediate access to superb clinical and support services for the child, and support for the family so the kids can remain in or return to their home,'' said Sudders.

Arizona Court Favors Confining Sexually Violent Predators Indefinitely
Alisa Blackwood, Associated Press- 7/12/2001

P H O E N I X — The Arizona Supreme Court today upheld a law that allows the state to keep sexually violent predators confined indefinitely for treatment after they've served their criminal sentences. The Court of Appeals had ruled Feb. 15 that the law was unconstitutional because it did not require a finding that a person was unable to control urges to commit sex crimes. Arizona Attorney General Janet Napolitano argued in May that the law applied only to violent sexual predators. "I think the court correctly recognized that this is a narrowly drawn statute to deal with the worst of the worst," Napolitano said today.
    The 1995 law allows civil confinement of individuals judged to be sexual predators who would pose a danger to others if released. Confinement can occur even after the individuals finish prison terms on criminal convictions.  Arizona has approximately 135 men confined under the law. Judges had ordered two released because of the Court of Appeals ruling, but today's Supreme Court ruling allows both to remain confined. The case was similar to one in Kansas where an individual fought that state's sexually violent predator laws. The Kansas law was upheld by the U.S. Supreme Court.

Study: City Dwellers May Be More Prone to Psychotic Symptoms
ABC News, 7/13/2001

N E W Y O R K— Urban dwelling has never been known for its soothing effects, but new research suggests that people living in large cities are more likely than small-town residents to exhibit psychotic-like symptoms such as paranoia and delusions. In a study of more than 7,000 people in the Netherlands, investigators found that both full-blown psychotic disorders and milder psychosis-like symptoms were more common among those living in urbanized areas. The link was most apparent among people born and raised in densely populated areas, suggesting that childhood environment may create "enduring liabilities" for adult psychiatric health, according to the researchers.  Dr. Jim van Os of Maastricht University and colleagues report the findings in the July issue of the Archives of General Psychiatry.
    The researchers divided the study participants into groups living in one of five levels of urbanization, which were based on population density. Through interviews, van Os and his colleagues determined that the prevalence of psychiatric symptoms increased along with participants' level of urbanization. In the overall population, the prevalence of any type of psychotic symptoms over a lifetime was about 4 percent to 17 percent, depending on the definition of symptoms. The investigators looked at the number and severity of symptoms such as feelings of persecution or auditory hallucinations. Only about 1 percent suffered mental illnesses such as major depression, and even fewer had been affected by schizophrenia-like disorders.
    The fact that such symptoms were more common in urban settings could be partly explained by symptomatic individuals having "drifted" to these areas, the authors note. However, they add, their previous research has shown population stability in cities — that is, around 75 percent of city dwellers were born there. And a number of studies have demonstrated that psychotic illness is more prevalent in urban settings than in rural areas, the report indicates. "The high rates of psychotic illness in urban environments may be the result of the influence of environmental factors," van Os and colleagues write. "As the urban effect appears to have its impact during urban upbringing rather than during adult residence per se, developmental mechanisms ought to be considered."
    The fact that in this study, psychosis-like symptoms as well as full-blown illnesses were more common in cities suggests a greater "psychosis proneness" in urban settings, they add. Why this potential connection exists is unclear, but the researchers note that deprivation and social isolation in childhood neighborhoods have been shown to affect mental health.
    Another recent study in Denmark linked urban birth with an increased of developing schizophrenia. While family history was a far greater predictor of the risk, place of birth emerged as an environmental factor. Those researchers speculated that people born in urban areas are exposed to more infections during prenatal development and childhood. Some experts believe early exposure to infections may affect the developing brain in a way that makes it more vulnerable to schizophrenia.

Debate Over Methadone Overlooks Treatment's Presence in Vermont
Associated Press, 7/14/2001

BURLINGTON, Vt. -- The debate that's been raging for the past year about methadone treatment for heroin addicts in Vermont overlooks one small detail: It's already available. Gov. Howard Dean and lawmakers have been fighting over how, where and when heroin addicts should have access to methadone to help wean them from the drug. But state officials say the controversial treatment is already common in most Vermont hospitals. ''Methadone is probably in the lock safe of every hospital in the state as a pain killer,'' said Thomas Perras, director of the state Office of Alcohol and Drug Abuse.
    Any doctor can prescribe the synthetic narcotic as a pain medication, and many do. The state's Medicaid program, for example, paid for 532 methadone prescriptions to treat pain during the past 12 months. Methadone has also been prescribed to wean pregnant women from heroin until they give birth. ''We have done that with methadone,'' said Mike Noble, spokesman for Fletcher Allen Health Care, where there's been one case in the past two years. At Fletcher Allen, methadone is often prescribed as a pain medication, Noble said, and it's also used by doctors to detoxify heroin-addicted patients in-house. It isn't legal for Vermont doctors to prescribe methadone for addiction and hand a prescription to an addict to take to a pharmacy, said Madeleine Mongan, a lobbyist with the Vermont Medical Society. But physicians can prescribe methadone for pain.
    Zail Berry, medical director for the palliative care program at Fletcher Allen, said methadone is commonly used for pain in Canada. She said it's appropriate for any condition for which a doctor might prescribe another narcotic such as morphine. ''It takes more expertise to use methadone,'' Berry said, ''but used by somebody who knows how to do it, it is a very useful drug and it is a lot cheaper.''
    Vermont's Medicaid program, which uses state and federal dollars to pay for health care for low-income residents, has always covered methadone for pain management, said Eileen Elliott, commissioner of the Department of Prevention, Assistance, Transition and Health Access. Every year since 1998, she said, the state program has paid for roughly 500 methadone prescriptions. Medicaid also paid two claims from Vermonters who receive daily methadone doses from out-of-state clinics, Elliott said. The program is all set to cover in-state methadone therapy whenever a hospital opens a treatment program. Fletcher Allen, the Brattleboro Retreat, and the Rutland Regional Medical Center are all considering setting up methadone clinics.

How Well Are Police Trained to Cope With the Mentally Ill?
Ben Dobbin, Associated Press, 7/14/2001

IRONDEQUOIT, N.Y. -- Ron Kessler walked along the suburban highway in the summer haze, clutching a bunch of wildflowers in one hand and a claw hammer in the other. As he came down an exit ramp, a car pulled up alongside. The young driver wondered if he needed a ride. Waving the hammer, Kessler barked out a warning: ''Get away from me!'' Soon afterward, alerted to this encounter, a patrol car crawled up alongside him. Kessler, 42, who had recently stopped taking drugs to treat paranoid schizophrenia, at first ignored two police officers' orders and kept walking. But within two minutes of their arrival, he lay dead on a front lawn with five bullets in his chest, leg and wrist.
    It was the first-ever fatal shooting by the 56-member force in this Rochester suburb next to Lake Ontario. The circumstances raised thorny questions about how well police nationwide are trained to cope when mentally ill people break the law. ''I saw his body before we had him cremated,'' said Kessler's sister, Marlene Zazzara. ''I saw the bullet holes, how close they were. They didn't have to shoot him so many times. ''When they saw he was despondent, why didn't they Mace him? Why didn't they net him or call for backup? They didn't know he was trying to go get help.'' Tears flooded her eyes as she sat in her kitchen recalling that Friday morning in 1998, the day before the Fourth of July. ''It was like losing a child,'' she said. ''I was his lifeline, through good, bad and indifferent. I was always there for him.''
    Once psychiatric institutions began shrinking or shutting down in the latter half of the 20th century the result of new, anti-psychotic drugs and a switch in emphasis to community care police found themselves dispatched more than ever to mental health care's front lines. Encounters with people behaving in bizarre ways brought on by depression, delusions, intense anger or anxiety or other psychiatric conditions usually end peacefully. But hundreds of times in cities across the country, police find no other way to deal with what they see as a public threat and the consequences are lethal.
    ''Police departments are recognizing that they need to be more effective in their dealings with the mentally ill because these shootings have become all too common,'' said Terry Garahan, a mental health clinic supervisor who helped bring about a radical change in police tactics in Ithaca, N.Y., in defusing crises involving the mentally ill.  Led by a signature program in Memphis begun in 1988, at least 15 cities from Houston to Roanoke, Va., to Waterloo, Iowa, have ''crisis intervention'' officers trained intensively to handle emergency calls about emotionally disturbed people.
    In places like Los Angeles, Knoxville, Tenn., and Birmingham, Ala., alternative approaches pair up mental-health specialists with mobile police units. In Ithaca, Garahan and police Lt. John Beau Saul set up a distinctive collaborative program aimed at pre-empting violent clashes after a deranged woman fatally stabbed a police inspector in 1996. Police departments typically rely on academy training, usually an eight-hour regimen complete with role-playing scenarios. To many police, the notion of specialized officers or teams seems an indulgence.
    ''Should we train all our officers to be psychiatrists?'' asked an exasperated Capt. Mark Bonsignore, the Irondequoit police training officer. ''Hey, I'd love to. Have you got $30,000 for each officer to send him back to college? We have a huge Italian population, a Greek Orthodox population, a huge deaf population should we speak all those languages? ''We train our people to deal with crises in a general manner and they do a tremendous job at that. We did a great of soul-searching after Mr. Kessler's death. Our training worked exactly as it was supposed to work.''
    Lt. Sam Cochran, who coordinates the Memphis program, has heard those arguments before. He's convinced that police everywhere, in communities big and small, can handle mental-illness complaints far better at little or no extra overall cost, and dramatically reduce injury rates to both officers and the public. Some 200 of the 900-plus patrol officers in Memphis have undergone at least a week's training: meeting mentally ill residents, getting familiar with medications and symptoms, learning how to adjust their voice tone or stance or expectations during standoffs. The first step is recognizing the hidebound stigma that falsely labels the mentally ill as ''always violent, out of control and always going to kill you,'' Cochran said.
    But Memphis goes much further. It opened an emergency clinic where unstable people can be quickly dropped off, saving police the usual long hours of waiting in hospitals. They're steered toward ''medicalizing'' problems rather than dumping sick people in jail. ''It's much more than just training,'' Cochran said. ''It's an infrastructure. It's about changing attitudes and behavior. It's about getting the right people to do the right thing.''
    Zazzara's telephone picked up a message from her younger brother around 9 a.m. He said his car was missing when he awoke. He sounded frightened. Whenever ''Ronnie'' was in trouble, he'd go in search of her. Two hours after the call, he'd walked 10 miles from his studio apartment in the adjoining suburb of Webster and was three blocks from her home when he ran into the police. Zazzara thinks he picked the wildflowers for her. And just as he'd done two days before, he was probably bringing his hammer to help repair her husband's broken-down pickup.
    When Ron and Marlene were toddlers, their mother deserted the family. Their father later remarried and also moved out, leaving behind grandparents to raise them. They first knew something was wrong when, at 19, Kessler began kicking his elder brother's German shepherd over and over. Years later, he whirled around in a church pew and punched an elderly man in the nose, thinking he was a vampire. After both outbursts, gentle intervention seemed to calm him immediately and he willingly went off in an ambulance. While physically imposing with a muscular build from swimming and lifting weights, this was a laid-back, upbeat man who rarely lost his temper.
    ''He was like a puppy. The family was so complete with him,'' said Zazzara, who has two children, Christine, now 20, and Ronald Jr., 16. ''Every time we would burp, he would say `Hi!''' Christine interjected. ''He would make us laugh all the time. He said he was going to take me to my senior ball.'' Kessler taught her to swim in their aboveground pool. He was unbeatable at dead-man's float and stubborn at Monopoly. Although he knew Three Stooges episodes by heart, he'd laugh at them until tears ran down his face.
    He also complained often of hearing voices. He saw his name written in the snow. He believed doctors put an implant behind his ear to monitor his thoughts. Medicine kept the demons at bay but left him prone to bouts of lethargy and dread. So for years, whenever he felt better, Kessler routinely stopped taking his pills. The black moods would always return. Only by his early 30s did Zazzara persuade him to switch to monthly, time-release injections. That worked well. But Kessler was now dabbling in cocaine, leading to petty thefts, driving infractions and brief spells in jail.
    By 1998, he seemed finally to have broken his addiction. He'd started a painting-and-drywall business, moved out to Webster and begun dating. It was his new girlfriend who persuaded him to go back on pills in an apparent bid to break his fatigue, Zazzara said. Before long, he stopped taking them. The effects were percolating. Within two weeks, Kessler had a noisy row with a supermarket cashier, pushed aside a customer's cart carrying a little boy, then ran his car at a store manager in the parking lot. Webster police found the car outside his apartment complex and towed it, but couldn't locate him. They visited Zazzara but wouldn't say why they needed to talk to him.
    Officer Carl Saporito, alerted the next morning to ''a suspect menacing motorists,'' arrived first, and Officer Todd Fitzsimmons pulled up moments later. Saporito, a 20-year veteran who like his colleague had never fired his gun on duty, told investigators he quietly asked Kessler to drop the hammer. Kessler gave him ''a disgusted look'' and walked past him. Kessler then bolted down Culver Road, a traffic artery through a mostly residential section. A dozen witnesses, many in cars, watched as the officers hemmed him in by standing on each side. Kessler now appeared highly agitated and suddenly raised the hammer. The officers shouted loudly and repeatedly, ''Put the hammer down!''
    Police said Kessler lunged at Fitzsimmons with the hammer, forcing him backward. Alerted by Saporito's screams, Kessler then turned around and advanced. Four of the bullets came from Saporito's .45-caliber gun. ''The way he was swinging the thing, it looked like he was blind,'' said Chris Gress, 33, a gas station manager watching from across the street. ''I don't think it's the officers' fault and I don't believe a man should have died over something like that. He should have been in the hospital.''
    The officers didn't know about his personal history, nor that Webster police were searching for him. In perceiving him as a deadly threat to themselves or bystanders, that freed them to shoot to kill. ''What if he goes around the corner and there's a little boy or girl sitting on the sidewalk?'' asked prosecutor Ken Hyland. ''The officers couldn't allow him to move on without evaluating the situation,'' said Bonsignore, their trainer, adding that ''if Carl had not shot, he would have been seriously injured or dead because Kessler would have buried that hammer in his head.'' The officers, who remain on patrol, both declined to be interviewed. They were exonerated by a grand jury. A lawsuit alleging excessive use of force was dismissed.
    If she'd been warned the night before, Zazzara thinks she might have gotten her brother to a doctor. She blamed Saporito for ''not perceiving that he was ill.'' ''You thought there was nothing else you could have done, and you panicked,'' she said. ''He wasn't holding up a bank, he didn't have hostages, he wasn't doing anything to harm anybody. My problem with the law is they have a right to do whatever their gut feeling tells them to.''
    While reluctant to second-guess individual cases, some mental-health advocates suggested the officers might have backed off and waited for reinforcements while keeping close enough to protect others. ''Why not walk in front? I mean, they can always shoot him,'' Garahan said. Ron Honberg, legal director at the National Alliance for the Mentally Ill, said ''the police response frequently is `Oh, we know what we're doing, we really don't need to change.' ''I've developed an immense respect for the police over the years,'' he said, ''but if they deal with this as a confrontation, if they act in a threatening, loud way, close in on or circle the person, frequently that will feed right into the symptoms. The person may be very paranoid and may believe the police are agents of the devil or whatever.  ''In Memphis, they seem to know how to deescalate a situation. They will spend an hour or two talking a person down if they need to.''   Zazzara keeps her brother's ashes in her bedroom. ''I went through a very difficult time, saying the one time you needed me I wasn't there,'' she said. ''I have him here now I can protect him.''

His Brother's Keeper: David Kaczynski
Serge F. Kovaleski, Washington Post- 7/15/2001

It's a cold morning in February when social worker David Kaczynski arrives at the home of a 15-year-old boy -- one of his "clients." The boy, his grandmother and uncle climb into Kaczynski's tan Chevrolet Prizm. He's taking them to a graduation ceremony of sorts. The boy's mother has successfully completed her time in a drug rehabilitation program, and is coming home, so everyone is in a festive mood. As the group heads west on Interstate 90 in Upstate New York, they chat about the grandmother's church work, and about the mother's crack addiction and her decision seven months before to finally try and kick it. After a while the conversation slows. The passengers doze a little. Cars and huge trucks blaze by. Finally the uncle begins edging around the subject that everyone edges around with David Kaczynski. When you're a black man in America, he begins, it's easy to feel victimized. To get really angry at society. So angry, in fact, that there have been times when he has wanted to hurt someone. Wanted to get some sort of revenge. He understands that impulse. The uncle is looking at Kaczynski in the rearview mirror. He's waiting for a response. Kaczynski, a tall 51-year-old man with salt-and-pepper hair and a gentle demeanor, has been listening quietly. He knows exactly where the uncle is heading with his careful words. But before he can say anything, another voice pipes in. It's the 15-year-old in the back seat. And he gets to the real issue at hand. "Dave?" the boy asks the brother of the anti-technology terrorist known as the Unabomber. "Why'd you turn him in?"
    So why did he do it? Why does a brother betray a brother? Violate memories of childhood camping trips, board games at the kitchen table and even the deeply personal alienation that came later, to tell the FBI: I think my older brother is a murderer, the mentally ill bomber you have been searching for, take him. And how do you live with the consequences of this one act: with the FBI hunting down your brother in Montana and parading him, handcuffed, before the world as a vicious psychopath? With the prosecutors seeking to put him to death? With Ted, who craved wilderness and isolation, locked up and regimented for life in a tiny prison cell? For almost 18 years, Theodore Kaczynski managed to escape detection, and mail his bombs to those he deemed responsible for the technology age -- computer store owners, engineering professors, businessmen. Until David, along with his wife, Linda Patrik, eventually read the Unabomber's rambling 35,000-word manifesto and felt a chill. He noticed an eerie similarity to language in his brother's angry and rambling letters home. And decided he had to do something.
    David goes to work every day, listens to country music, participates in a poetry group, plays baseball in a summer league and takes vacations with his wife at their Texas cabin -- and never quite forgets that his older brother sits in a Florence, Colo., federal maximum security prison, doing who knows what. Thinking who knows what. Ted hasn't communicated with him, or anyone in the family, since the FBI agents appeared at his remote Montana shack, told him, "Ted, we need to talk," and dragged him off to prison.
    It's evening and David's flat Midwestern voice is low after hours of talking about Ted and his arrest and the last six years. His Schenectady, N.Y., house is dim now, the only illumination from an occasional car going by. His is a tale of two brothers in conflict, not like Cain and Abel, whose relationship was overtaken by envy, anger and eventually murder. But two brothers whose relationship grew and then splintered in a more modern story of psychiatrists, mental illness, philosophical bents and mail bombs.
    They were two brothers so close, as they grew up in the Chicago suburb of Evergreen Park, Ill., that their mother recalls their relationship as "beautiful." Wanda Kaczynski, a widow now, lives alone in a sparsely decorated apartment in Scotia, not far from David's house. In the front hall on a table are a few photographs of her two sons. Wanda, a small, roundish woman with short gray hair, has spent many hours -- years, really -- puzzling over what went wrong with her older son. But she knows for sure that Ted had a powerful devotion to David.
    Ted was 71/2 years old when David was born and already a loner, uncomfortable with kids his own age. Wanda recalls bringing the new baby home from the hospital: "I put David in Ted's arms and said, 'You know, we three, you, your daddy and I, have to take care of him so that he'll grow up to be as big and nice as you are.' And he was hooked from that time on." David was often the only human Ted seemed to care about, Wanda says. And David looked up to him in turn, impressed by how smart and independent he seemed. Ted was hugely protective of his little brother. When Ted had nightmares they were sometimes about his inability to protect David. Once, Wanda remembers, Ted dreamed about starving children in poor countries (a topic in the news then) and saw his younger brother withering away with Ted unable to get to him to help. Later, he dreamed that he had to defend David from members of an evil cult.
    The boys grew to be so different: Ted a moody loner, brilliant, intolerant, rigid; David more outgoing, compassionate, easy to be around. As they grew they differed in their beliefs, too. Ted tried to mentor David in the "correct" ways of thinking about things, taking issue with David's decision to remain a vegetarian, his aversion to guns, even arguing about the degree to which logic alone can reveal "the truth." David and his parents often felt they had to be very careful around Ted, or risk upsetting what seemed like a delicately balanced psyche.
    Both Ted and David loved the wilderness, and one summer they traveled around British Columbia together, looking to buy a remote parcel of land. They found a place, but before they could buy it, Ted suddenly shut down, refusing to speak. He never explained, and David sensed he shouldn't push. In 1971, the two did buy some land together outside Lincoln, Mont., and Ted put up a primitive 10-by-12-foot shack, with no running water or electricity and homemade furniture, a cast-iron stove and just two small windows. He settled there that year, far from the nearest human, occasionally writing to the family.
    In the mid-1970s, Ted sent a letter to his mother and father, unleashing a torrent of hostility and abuse for failing him as parents, and for his nearly paralyzing uneasiness with people. Wanda recalls that when David defended them in a letter to Ted, Ted threatened to cut off all contact with him as well. Their relationship recovered, eventually, but it remained prickly when certain subjects were raised.
    In May 1978 the first bomb attributed to the Unabomber exploded at Northwestern University outside Chicago, injuring a security guard. As far as the Kaczynskis knew, Ted was in Montana, eking out a sparse existence. A few months later Ted returned home to the Chicago area, and began working at a foam rubber factory where his father, Ted Sr., was a manager and David also worked, at times as a fill-in supervisor. After a female co-worker refused to go out with Ted on a third date, he posted insulting limericks about her around the building. David, in what he now sees as a foreshadowing, was the one who fired him. Ted angrily locked himself in his room for days. Several months later he moved back to Montana, this time for good. He eventually began forbidding family visits, and his letters home became less and less frequent and more angry. By 1990, 11 more bombs attributed to the Unabomber had detonated around the country, killing one person and injuring 20 others. Ted's communication with David and his parents had all but ceased. He begged David to stop his mother from writing to him. "Every time I get a letter from a family member, my heart pounds and I'm going to die," he wrote.
    That year, David wrote Ted to say their father was terminally sick; Ted acknowledged receiving the letter, but nothing more. Later in the year, when he could no longer bear the pain of the lung cancer that had spread to his spine, Ted Sr. committed suicide. Ted Jr. did not return home for the memorial service -- though he spoke briefly by telephone with his mother but hung up abruptly when he got too emotional. David and his wife, a philosophy professor who had never met Ted but read some of his letters, were worried about Ted's mental condition. And then on a trip to Paris in 1995, Linda read a newspaper article in the International Herald Tribune about the elusive bomber, who by then had killed two more people and maimed two others. The paper reported that the FBI believed the Unabomber (its code name) held a strong anti-technology and pro-environment philosophy, may have been born in the Chicago area and was probably adept at woodwork, given the intricately carved boxes into which some of bombs had been built. It was Linda (who declined to be interviewed for this article) who first noticed the similarities to her brother-in-law.
    In September of that year, The Washington Post and the New York Times jointly published the manifesto the Unabomber had sent, along with his demand that it be printed in exchange for an end to his bombing campaign. David and Linda spent more than a month poring over each word, looking for clues in the massive diatribe that might lead back to Ted -- or exonerate him. They began to see patterns. The manifesto contained phrases and ideas that were similar to things Ted had penned over the years. "Cool-headed logicians" -- David remembered that phrase from one of Ted's letters.
    David loved his brother, but he knew he was sick and needed help. And yet, David believed, if Ted was the Unabomber, he might strike again. In November 1995, David wrote Ted one more time. David was worried about him. Could he come to Montana for a visit? The response was frigid: "I am not suffering, sick or discouraged, and I don't know what indication you think you have that I am so. Get this straight . . . I DON'T EVER WANT TO SEE YOU OR HEAR FROM YOU . . . AGAIN."
    And so they called a private investigator, a childhood friend of Linda's, and asked for help. I think my brother might have some connection to this Unabomber, David told Susan Swanson, the investigator, during one of their phone conversations in late December 1995. David and Linda gave her some of Ted's letters and other writings and asked her to find an expert to evaluate them against the manifesto. David was haggard and exhausted from worry. Swanson called Clint Van Zandt, a former FBI behavioral science expert she knew, and gave him typed copies of two handwritten letters David had given her. At David's insistence, she didn't tell Van Zandt who had written the letters or how she had come by them. She just wanted him to analyze what he read and compare it to the Unabomber manifesto.
    Van Zandt pulled together two teams of analysts and set to work. A few weeks later he called Swanson. His words were urgent: Whoever gave her the letters needed to contact the FBI immediately. David was devastated -- and frightened. What if his brother struck again? "My primary interest, all along, was to protect lives," David says softly as the evening darkness seeps further into the living room. He takes a sip of soda and continues. He knew his brother was sick, really sick, and needed to be protected. David couldn't bear the idea of the police cornering and trapping Ted like some wild animal, and he didn't want Ted hurt. He also didn't want Ted to know that it was David who had given him up.
    Acting anonymously through a Washington lawyer, Anthony P. Bisceglie, David began a careful dance with the FBI. After extensive negotiations, the FBI promised to keep David's identity a secret and to give the family at least a day's notice before it moved in on Ted. It was now time for David to break the news to his mother. In March 1996, after the two had breakfast together, David began pacing the floor of her apartment, not sure how to begin. Tears were streaming down his cheeks. Wanda watched in bewilderment. "David, what's the matter?" she asked him. "Well, it's about Ted . . . " he replied, and then told her the whole story, ending with, "I have notified the FBI . . . They are waiting to talk to you." Wanda wouldn't believe it. Ted? He couldn't hurt anyone. She remembers looking at David, who was clearly in torment, and reaching over and hugging him. "Oh dear, what you have been going through," she said, and then told him, "You'll see, you'll see. He couldn't have done it. When this is fully investigated Ted will be exonerated."
    Later that day FBI agents arrived and began sifting through Ted's letters home and other keepsakes. When the last agent finally left, it was dark. Mother and son sat alone in the living room and, as Wanda recalls, "we both wept. Yes, we wept." And then late on the afternoon of April 3, 1996, David was in a staff meeting at the nonprofit agency where he worked as a counselor when he got an urgent call from Bisceglie. The FBI was about to serve a search warrant on Ted's Montana hovel. Get your mother and Linda and go home now.
    What happened next is a blur. Wanda recalls that when David arrived at her apartment, he tried to call the FBI, irate that it hadn't given the promised advance warning, but could only reach answering machines. When an agent finally called back, she said there had been a leak to the media and the FBI now felt it had to move in on Ted with dispatch.
    About an hour later, as David, Wanda and Linda huddled together in Wanda's apartment watching the television news, they were stunned to hear Dan Rather say that the elusive Unabomber had been "fingered by relatives." And then: "The first tip in the case came from Chicago, from Kaczynski's own family. Through a Washington attorney, a brother told the FBI he had uncovered evidence suggesting his sibling might be a suspect," the reporter covering the story told Rather. The Kaczynskis were shattered. "We all felt so betrayed," recalls Wanda. "Linda was sitting there, I was sitting there and Dave was sitting there and we were all crying. Well, this is after we saw Dan Rather say this. I have never been able to watch Dan Rather since."
    As the family watched in disbelief, Wanda remembers thinking, " 'I hope to God that they don't hurt him. I hope they don't have a shootout.' I'm thinking of Ruby Ridge and Waco and all of that mess that went on before." And then it was over. Ted was in custody. The family went into seclusion to avoid the swarms of reporters and television cameras eager to pick over all details of their lives. They felt battered and alone. David wanted to help Ted and make contact. Ted, though, through public defenders representing him, made it clear he wanted nothing to do with the family. At court hearings, he wouldn't even look David's way.
    In May 1997, Attorney General Janet Reno announced that prosecutors would seek the death penalty for the Unabomber. David received the news by telephone from Bisceglie and started crying. Wanda was as terrified for David as she was for Ted. She told people that it would be impossible for David to live the rest of his life feeling that he was somehow responsible for his brother's death. "David had such a burden. Oh, how terrible it would be for David if that happened," Wanda recalls thinking at that time. "It was a horrible thing. I thought of Ted lying on that gurney and being injected. It was horrifying to us to think that they would put him through that." David knew he wouldn't be able to cope with that. "It would be very, very difficult to live with myself knowing that I had delivered my injured, disturbed brother over to be killed," he told people. For nearly the next year, David worked to persuade the Justice Department, and the public, that the death penalty was not justified for Ted -- he was mentally ill -- and that to pursue it would discourage other families from stepping forward as David had done. He traveled to Washington twice to appear before the Justice Department committee that decides which federal defendants should face the death penalty. He gave a speech and several media interviews to make the case that it would be unjust to give the death penalty to a man he portrayed not as an evil or malicious monster, but as a sick human being who needed help and who, underneath it all, had redeeming qualities.
    And then, during the trial in January 1998, Ted tried to commit suicide. Wanda and David were living in a rented apartment in Sacramento near the courthouse where Ted was being tried when they heard the news. Eventually, a government psychiatrist agreed with the findings of psychiatrists for the defense that Ted Kaczynski was suffering from paranoid schizophrenia. A deal was struck -- life without parole -- and Ted was spared, not in a way he would tolerate well perhaps, but he would live. David, who for days sat in a courtroom a mere 15 feet behind his older brother but was never graced with a word or even a glance from Ted, now had to begin picking up the pieces of his own life.
    In the autumn of 1998, David fell into a malaise. He'd felt terribly despondent before, during the trial and especially when Reno announced she would seek the death penalty. This time, "life felt completely tasteless. I was sleeping and lying around and moping. It was like nothing I had ever felt before," David says now. "Linda tried to cheer me up . . . [but] it was as if I was wrapped in gauze and she was a distant voice. I heard what she was saying, I knew cognitively what it meant, but I had difficulty responding emotionally to it. Everything felt very flat." Sometimes David found himself just imagining what it must be like for Ted in his cell. "There were moments when I pictured him caged like an animal in a system that he feared," he recalls. "But there was also the hope in my mind and heart that he was adjusting, receiving three meals a day and being treated with at least his essential human dignity intact."
    Wanda was worried about David. "I thought, 'Oh my God, what if he breaks down over this, what if he can't survive this.' " It's hard to pinpoint exactly when the post-trial depression began to lift, but at some point, after a few weeks, David the social worker, David the compassionate brother, realized that he had something more to do. Ted had hurt a lot of people. David felt a responsibility to make amends to the victims.
    The Justice Department had offered a $1 million reward for information leading to the arrest of the Unabomber, and in August 1998 it had released the money to David and Linda. For David, it was "blood money" and the couple immediately pledged to donate the funds to Ted's victims and their families. "It was really a no-brainer when you think of all the difficulty, the anguish that went into this conflicted decision to turn in Ted," David recalls. "There was no way that we could have kept the money." David and Linda sent out letters to the victims telling them that they could apply for the money. In the end, about half the Unabomber's victims responded. The funds began flowing out -- by the end of 1999, $680,000 had been paid out. David used some of the reward money to pay for the family's legal expenses, and some of it had to go to taxes.
    David lobbied hard to get Congress to exempt the reward money from taxes so that he could give more away to the victims. "I went down to Washington and literally walked the halls, and I remember calling people on the phone and saying I was Ted Kaczynski's brother and people thinking it was a practical joke or something," David recalls. With the support of then-Sen. Daniel Patrick Moynihan, the bill passed the Senate, but it died in the House. Giving away the money was an important step in his own healing, David now says. But when he thought about the maimed computer scientist, or the families of the dead advertising executive and the forestry lobbyist, he felt it wasn't enough. For his own peace of mind, David needed to do more.
    After Ted's arrest, David had written letters to all his brother's victims, expressing his sorrow and regret. A few responded, with some even expressing appreciation for David's painful decision. Most, though, remained silent. And one victim couldn't be found. There was no address for Gary Wright, a computer shop owner in Salt Lake City who was injured by shrapnel in 1987 when he picked up an explosive-filled package in the parking lot behind his business. Then one day in late 1996 an investigator helping the Kaczynskis gave David a telephone number for Wright's home. "He wasn't home so I left a message. It was very odd," David recalls. "You don't know what to say exactly." He left a brief message, saying he was Ted's brother, would like to talk and would call back. "It's intensely awkward, and you want to be respectful and somehow acknowledge the tragedy that in some strange way has joined and separated you, without saying the wrong thing, without increasing someone's pain."
    A few days later, David tried again. Wright was washing the dinner dishes when the phone rang. As Wright recalls: "He said that he was sorry on behalf of his family. He was really genuine and sounded nervous. He later told me he was prepared for a blast of anger, but it didn't come. I told him that he can't carry that emotional burden for what someone else has done." They talked for about 20 minutes. Wright was so kind and open and forgiving that when it was over David felt a deep sense of release. It was, as he puts it, "a real gift." David asked if it would be okay if he called again sometime, and Wright said, sure.
    There were more telephone calls, and then in 1998 the two met as David was on his way home from Sacramento from Ted's trial. They spent two hours in a diner, over a late breakfast, talking about the case, Ted's illness, David's work and the whole ordeal for David and his family and the impact on Wright and his family. It was just the beginning of what was to turn into a real friendship and regular telephone conversations. For Wright, the contact with David and his family has brought a certain peace: "The fact there was a great family there has brought back a sense of humanity for me and helped me put some finality to this. It brought almost a sense of calm to a situation that was so complex. I think that people like myself respect David for his ability to feel and understand their grief."  The relationship with Wright, though, was the only bond David was able to establish with a Unabomber victim, despite his efforts. While some responded graciously to David's efforts to reach out to them, none seemed interested in further contact. David would have to find some other way to make amends.
    In 1999, he received an invitation from Survivors of Homicide, a group of families of murdered children and other loved ones, to be the keynote speaker at its annual anti-violence conference. The group had approached David after its head, Samuel Rieger, whose daughter Melanie was murdered by a boyfriend, saw David on the "Today" show and was struck by how understanding he was toward the Unabomber's victims and their relatives. "I thought how unusual it was. You never hear perpetrators' families saying how much they care for the victims' families and expressing pain and suffering for them," Rieger recalls.
    David readily accepted the invitation. These people were not Ted's victims, but they were like them. "I was very nervous about going there to speak. It was an education for me . . . to realize the kind of terrible emotional impact that a killing has on a victim's family. So even though I was not talking or interacting with any of Ted's victims, I was in a sense, in that they were like surrogates for that. In other words, I knew it would have to open me in some ways to the horror of what Ted had done and there would be, in a sense, no escaping it." It was a full house when David arrived at the auditorium at Naugatuck Valley Community College, in Waterbury, Conn., for the conference. About 750 people had shown up to hear the brother of the Unabomber, the one who had turned him in. In the front row sat about 30 members of the homicide survivors group.
    David talked for about 45 minutes, about building "emotional bridges" between families on both sides of such tragedies, about how he still considered his mentally ill brother to be a valuable human being, about the commonality of his family's suffering with the torment of many of those at the conference. When he was done, he was greeted with applause. Several people came up and hugged him. "He is really one of us. He has a lot of pain and suffering and he is genuine, and given what we have suffered, we don't need any baloney stories," Rieger says. "He just comes and says, 'Let's help each other.' He comes with an open mind." David, too, felt the common thread. "There are losses involved that are never going to be healed entirely. These losses are going to be defining us for the rest of our lives."
    Last year when David returned to the survivors group's conference, a man whose brother had been murdered pulled David aside and told him that his speech the year before had changed his life. The man had begun participating in a program to talk to violent inmates in an effort to understand them, and it had helped him feel compassion instead of just hatred. He'd begun to heal. That, David says, "is one of those things that makes me cry. I was moved by this sense, by seeing that there are these seeds in the world of good that can grow out of something bad."
    But there were more jarring moments. Through his anti-death-penalty work, David had gotten to know Bill Babbitt, who, like David, had a brother who was mentally ill. And he, too, turned his brother in when he suspected him of a murder. Babbitt's brother Manny was a decorated Vietnam veteran whose lawyers pleaded that he get life in prison because he was schizophrenic and suffering from post-traumatic stress syndrome. In the end he got the death penalty. And David, who along with Linda had campaigned hard for Manny's life to be spared, was one of the few outsiders standing at the grave in Wareham, Mass., to bury Manny after his execution. "For once I was standing on the periphery and I saw Bill's mother break down and beginning to wail and throw herself on the ground and Bill attempting to comfort her," says David, growing emotional while recounting the funeral. "I realized that was what I had feared to go through."
    David had come to believe more strongly than ever, as he talked more and more to families of murder victims, that taking a life to avenge a death did not bring healing to anyone. It just created more victims, more sorrow. And there was the whole question of its unfair application -- Manny Babbitt, who was black, killed one person and got death; Ted killed three, injured 23 and got life in prison. David began speaking out, not just about cases similar to his, like Bill and Manny Babbitt, but about all death penalty cases. Through the Survivors of Homicide group he met Marc Klaas, who had been catapulted into the forefront of death penalty advocates after the murder of his 12-year-old daughter, Polly. Not long ago, Klaas proposed that they do a speaking tour together, presenting both sides of the issue. The Unabomber's brother would be a big draw, Klaas thought. David accepted. He explains: "The passion I felt about how it was so wrong to execute Ted has led me to other questions about this criminal justice process that is shallow, that is bureaucratic, that is not humane and that turns a deaf ear to cries of pain and, even at times, the voice of truth."
    And so it was that one evening this March, David looked out at some 400 students packed inside a lecture hall at Creighton University in Omaha and told them, "We owe some consideration to how this affects other people. I don't think that we can ignore their pain." David added, "I think the truth is that we must dehumanize someone before we kill them. This is what the Nazis did in the Holocaust." He would never want to be seen as minimizing what his brother had done, he told them, but life in prison without the possibility of ever again being free could be seen as more severe than capital punishment because murderers would be forced to live with the consequences of their crimes for the rest of their lives. "The impulse for revenge is a serious problem for human beings," he said. "We are not God. We tend to confuse justice with revenge." Klaas was having none of it: "Nothing wrong with a little social vengeance . . . Ladies and gentlemen, evil exists. And when we find it exists, we have to eradicate evil, one way or another. It is a layer of protection between us and them."
    Since September 2000, the two men, now friends, have held three other capital punishment debates -- in Plattsburgh, N.Y., New Orleans and Orlando. They have also appeared together on "The Early Show" on CBS. David has also been a guest on the "Sally Jessy Raphael Show" and Court TV and given a number of speeches decrying the death penalty. He has talked to New Yorkers Against the Death Penalty, the National Coalition to Abolish the Death Penalty, Connecticut public defenders, the New York State Bar Association and the Bruderhoff Communities, an international faith-based movement that has taken a stand against capital punishment. "It seems like one thing has led to another, and that I want to bring some greater good out of something that was unimaginably bad," David says.
    In this way, David has made a peace of sorts with the fact that his relationship to Ted, and what David had to do, will color his life forever. It's no longer such an oppressive idea, David has found; it can sometimes be something positive. Like when the 15-year-old boy piped up from the back seat of the Prizm and asked, Dave, why'd you turn him in? He looked the boy in the eye and told him that sometimes you have to do the right thing, even if it's incredibly painful. Sometimes you have to realize that although the consequences of an act can be hard to live with, not acting would be even worse. "If Ted had gone out and killed another person, I would have felt personally responsible," he told the boy. "I would have felt that I could not live with myself anymore, that I would have blood on my hands."
    David writes to his brother three or four times a year, reminiscences sometimes, recountings of jokes he's heard, a gentle bemoaning of the loss of contact. The letters are never that long. Last Christmas, he sent Ted the book Ishmael about a gorilla who speaks telepathically, telling a philosophical tale about the fall of human beings from their natural state. David figured that the theme would be of interest to Ted. He has never tried to explain to his brother why or how he decided to turn him in to the FBI. "I guess it has to do with my past experience with Ted and an understanding of how his mind works," David says. "If I were attempting to justify myself it would trigger a sort of debate or an argumentativeness. And it's almost like he would analyze what I've said and try to show that it is insincere in some way or find the fallacy in it."
    A couple years ago, a Time magazine interview with Ted Kaczynski suggested just that. The jailed Unabomber said David had been motivated purely by sibling rivalry. David found Ted's interpretation of his action extremely upsetting. Wanda writes to Ted at least every other week and sends newspaper articles and magazines stories about the environment and other topics she thinks may interest him. She also sends him some money to buy provisions in the prison. "I write him short notes and tell him that I think about him all the time and that I hope he is well," Wanda says. "In one of the first letters, I said, 'I want you to know that I have always loved you and always will.' " Ted has not responded to any of the letters. They don't hold that against him. They just hope that one day he will pick up a pen or make a telephone call to get in touch. And they'll be waiting. "I don't let myself think about the possibility of never hearing from him or never seeing him again," his mother says.
    David, too, hopes one day to reconnect with Ted. "Time heals to some extent, but the bond I feel with Ted doesn't disappear. Sometimes I'll remember the good times -- a backpacking trip, a softball game, or talking at night in his cabin -- and my sense of loss is very poignant. Those times we shared mean a lot to me and so I hold on to them . . . Different as we may seem in some respects, Ted was a major influence in my life, and so, inevitably, he remains a part of me."
    In the meantime, David doesn't dwell on the whole thing like he used to. In fact, he and Linda have signed a contract for an undisclosed sum with Disney, which wants to do a movie about the Unabomber case. And the Unabomber ordeal has come to occupy a smaller space in his consciousness. "Gosh, Linda and I used to talk about 'it' like we had nothing else to talk about but 'it.' This went on until maybe even last year. It seemed like somehow it was dominant in our lives. It was tiresome but we both gravitated back to it. It wasn't just me. She would somehow come back to it. Certainly, that is less persistent now."
    He has become a Buddhist, like his wife. He says he finds truth and comfort in Buddhism's beliefs -- that all human beings are interconnected and that compassion and the sanctity of human life should be one's guiding principles. Buddhism has also, he says, brought him closer to Ted. He concludes each half-hour meditation by dedicating it to his brother, in what Buddhists call merit of practice. Linda does, too, when the couple meditate together. "He is distant and remote, but this makes him more present to me, a bit closer on some plane," David says. "This process of meditation is in a sense a very intimate process and I guess it makes me feel less helpless, too." These days he can even acknowledge that Ted was onto something in his manifesto. Technology can be dehumanizing. "There is a tremendous threat to the soul of human beings. And I think so much depends on some ability to resist it, to keep your life spiritually rich."
    And so life, slowly, is moving on. David and Wanda and Linda often have dinner together, or go out to an occasional movie. Every week or so David takes his mother shopping, since she no longer drives. They celebrate the holidays together, and David and Wanda mark Ted's birthday by talking about him and all that has happened to the family. Together, they attend meetings of a support group of people with mentally ill relatives. David says the group has been particularly helpful for Wanda, who often questions her parenting because of what happened to Ted. Was there something she did that turned him so cold, made him so strange? "These are people who have been through what she has, meaning that they question themselves and feel helpless, as well. I think most people in the group are aware that there is no rational basis for feeling guilty, although it is somewhat unavoidable. I think every parent of a mentally ill person carries some sense of responsibility, some sense of guilt."
    Wanda, sitting across from her younger son at the dinner table, adds, "One of the things that I have wondered about is whether there was anything that I did that was so different and so heinous that he could do this. What did I do? I keep going over and over this in my mind." David's own guilt is also complex. Could he have done more as a brother? Could he have helped prevent what happened? "There are times when I have looked back and thought obviously I could have been a better brother," David says. Wanda doesn't let him go there: "Oh, David, you were a very good brother."
    His job as a social worker at Equinox Inc., a youth shelter and outreach group in Albany, has been particularly therapeutic. Who knows what young Ted is out there in need of help? Who might change if someone takes the time to reach out? "If there is some desperate kid out there at risk of being violent and doing terrible things that will destroy their lives and the lives of other people, if I could help that kid, it would seem more meaningful to me than before, because I would see a chance to help that I missed with Ted," he says. He was working at Equinox before the Unabomber case took over his life six years ago. It took him a while to get back. He finds different ways to reach kids. Not long ago, he and a group of teenagers put on a program at a local mall stressing nonviolence and personal responsibility. The program, which included skits by the kids, kicked off two weeks promoting nonviolence in and around Albany in the face of a recent surge in gang-related shootings. Shoppers stopped to watch the show and the teenagers seemed to get a lot out of it.
    Sometimes, it is the kids who help David. One afternoon last spring as he was driving a 14-year-old boy home from the library, where David had been helping him with science homework, the boy began to talk about how down he was feeling about himself. Sitting next to David in the front seat, he said he was being unfairly singled out as a troublemaker at school. David couldn't let that go unanswered: Don't ever let anyone convince you that you're not a good kid, he told the boy. And the boy, who knew about David's role in the Unabomber case, looked at him and said, "Don't let anyone ever convince you that you did anything wrong."

The Reality of Recovery, Unadorned
Andy Meisler, New York Times, 7/15/2001

If you've ever encountered Bob Dey while channel surfing, you may have had cause to rethink your definition of reality television. His on-screen world--one without tribal warfare, $1 million prizes or more-than-minimal production values--is about as real as it gets. Mr. Dey has battled addictions and emotional disorders most of his adult life. He is not an actor, but, speaking without a script, he manages to eloquently describe his overwhelming cravings, his delirium tremens, his depressions--and the insights he has gained along the path to sobriety.
    "My bottom came when I couldn't even make it to work," he says on "Testimony," an aptly named half-hour series which consists of one person talking, without visible prompting, about some of the most personal issues imaginable. "I kept the curtains closed in my bedroom because it hurt to have the sunlight streaming in. Every now and then I'd peek out through a crack and take a look at the world outside. I'd think to myself: 'That's life that's going on out there. And you're missing it.'"
    Mr. Dey, along with dozens of other everyday people embroiled in the webs of substance abuse and emotional disorders, is an on-screen participant in an unusual, little-seen television entity called the Recovery Network. Unlike the dramas, comedies and news magazines elsewhere on TV, which use topics like alcoholism, drug use and depression as grace notes in their depictions of life, the Recovery Network's programming concentrates almost entirely on the first-person struggles of people like Mr. Dey and their friends and family members.
    "No, watching television isn't a substitute for going to a self-help meeting," said Mr. Dey, a retired feature writer and handicapper for The Daily Racing Form, over lunch near his Hollywood-area home recently. "But there's something about watching a peer-led meeting that's so much more effective than having a professional tell you what to do. If you see, say, an alcoholic talking to another alcoholic who's still using and abusing--and telling him, I know exactly what you're going through because I went through it too, and this is what I did, and this is what I do today to stay clean and sober--it has so much more meaning.
    The four-year-old network, based in Irvine, Calif., and available on cable in close to 15 million households nationwide, runs occasional documentaries on addiction and subjects related to emotional illness, a "wellness" show whose host is the author Gary Null and a program called "Overcoming Overeating." But its signature series are "Testimony" and "Full Circle"-- simple programs in which recovering individuals, singly and in groups of 10 or 12, ignore the camera while starkly recounting their successes and failures. Most episodes were filmed in 1997, and--this is low-budget television, just a step above public access--have been rerunning constantly since then.
    Under the "Full Circle" rubric, groups of adults battling problems like alcoholism, drug addiction, eating disorders, spousal abuse and mental illness--and coping with how their problems affect their loved ones--sit on couches in nondescript meeting room and speak at the behest of an unobtrusive moderator. The "Full Circle" groups "meet" for 13 one-hour episodes. The group members give up at least part of their anonymity, although no last names are used. The participants come from all economic strata and range from alcoholics who have been sober for decades to drug addicts shuttling from residential treatment centers. They were recruited by Share, a Los Angeles-based nonprofit organization that serves as an umbrella for self-help groups, and were given $25 a day for expenses. In "Testimony" and "Full Circle" participants are given a half-hour to tell their stories uninterrupted.
    Regular viewers of the Recovery Network eventually get to know the "regulars." These include people like Diane, a professional woman and recovering bulimic who recalls being molested as a child and becoming a straight-A college student with an encyclopedic knowledge of her campus's least-frequented bathrooms--where she went to throw up after her periodic eating binges; Steve, a musician who began taking drugs at 11, burned out his nose with cocaine use, has "been to jail quite often" and whose proudest accomplishment to date is being trusted to answer the telephone at his current rehabilitation facility; Mike, the son of an abusive "rageaholic" whose wife had broken her promise not to abandon him to tend to her two addicted adult children from a previous marriage; and Mr. Dey, who faced disapproval from longtime members of his alcoholism 12-step group for his use of antidepressants--and found solace in a more tolerant group of 12-step "double trudgers" (addicts with emotional disorders who trust both in a higher power and in psychiatric medication).
    Although an on-screen disclaimer at the beginning of "Full Circle" states that "it is not intended to be a 12-step meeting," and no mention is made of Alcoholics Anonymous, any of its offshoots or tools like "The Big Book" or "The Twelve Traditions," it's obvious that the organization's techniques and philosophies are being enthusiastically embraced. Another parallel to Alcoholics Anonymous, albeit an unintentional one, is the Recovery Network's low public profile. The network does not have cable channels of its own. Instead it is carried at odd intervals, usually for several hours late at night, on public and governmental access channels.
    The availability of the network would probably be news to most of the households that receive it, since its programming is rarely if ever listed in TV Guide or local newspapers. Still, it receives hundreds of letters of thanks, most often from relatives of people with addictions or emotional problems. They write that after watching the programs, they are better able to understand the problems they and their loved ones may or many not have come around to acknowledging.
    Local cable operators report a positive and unexpectedly vigorous reaction to the channel. "All of the area support groups whose phone numbers we list on the channel are very happy that we run it," said Joyce Gallagher, the cable television administrator for the city of Chicago. "As for me personally, I believe it's a life-giving service." Steven Grace, president of Channel 36 in Los Angeles, said: "I don't have any hard ratings figures, but just talking with friends and people I meet with during the day, it seems we're satisfying a huge need and inspiring hopeful solutions. In fact, when I told the woman who runs the coffee shop I stop at every morning that I worked at Channel 36, she said: 'Oh, sure. I know it. That's the Recovery Network.'"
    Bob Dey, who has been an active volunteer staffer for several self-help groups, had no qualms about being named in an article. Despite having just received the $25 a day for his appearances on "Full Circle" and "Testimony," he states: "I think networks and programs like these can have a tremendous effect," he said. "one of the biggest assets to those kinds of shows is just the single fact that it gets out the message: I am not alone. So many people who have an addiction or mental illness suffer both from their symptoms and sensations and from feeling so alone and inadequate to life. What these shows do is say: you're not alone. Look at this body of people here who have suffered, maybe for years, from what you're suffering from. And yes, there is hope."