Studies Show Link Between Child Abuse, PTSD & Drugs
Reuters News Service, 1/8/2002

W A S H I N G T O N— Repeated sexual abuse makes physical changes in the brain, changes that can explain why abused children often use illegal drugs later in life, researchers say. They found that children who were sexually abused had changes in the blood flow and function of a brain region called the cerebellar vermis, which is also known to change when people abuse drugs. "This part of the brain has been recently implicated in the coordination of emotional behavior, is strongly affected by alcohol, cocaine, and other drugs of abuse, and may help regulate dopamine, a neurotransmitter critically involved in addiction," McLean Hospital in Belmont, Mass., where the study was done, said in a statement last week.
    Writing in the January issue of the journal Psychoneuroendocrinology, Carl Anderson and colleagues said they used functional magnetic resonance imaging to look at the brains of 32 adults, aged 18 to 22. Half had been abused as children. They homed in on the cerebellar vermis because it develops slowly and can be affected easily by stress hormones. "Damage to this area of the brain may cause an individual to be particularly irritable, and to seek external means, such as drugs or alcohol, to quell this irritability," Anderson said in a statement.
    A second study published this week showed related results. A team at the University of Buffalo in New York found that post-traumatic stress disorder can increase the craving for drugs in abusers. Psychiatry professor Scott Coffey and colleagues at the Medical University of South Carolina tested 30 cocaine-dependent and 45 alcohol-dependent volunteers, all of whom also suffered from PTSD resulting from a physical or sexual attack. They made the volunteers describe their worst trauma on tape, and then played this back to them while presenting them with a drug or alcohol "cue" such as a crack pipe or a serving of alcohol. They then asked each volunteer how badly he or she wanted a drink or a dose of drugs.
    Writing in the journal Drug and Alcohol Dependence, they said craving increased significantly when participants heard the tape and were then shown cues related to their substance of choice. "From our research with trauma victims, we know that intrusive trauma memories are very upsetting to patients, and now we have shown that these trauma memory-induced negative emotions increase craving in substance abusers with PTSD," Coffey said in a statement. "These findings add support to our contention that we need to treat the two disorders at the same time."

Police Learn to Spot Depressed Officers
Eric Ferkenhoff and James Janega, Chicago Tribune- 1/8/2002

Most days, Jack Felker, a retired Chicago police officer who spent seven years as a counselor, can be found at roll calls, speaking to street cops as part of the Police Department's push to open a dialogue on suicide and depression in the ranks. His efforts gained poignancy after the Dec. 29 suicide of Delvin Williams, a 29-year-old South Side officer with two years on the job, who shot his wife seven times before pointing the gun at himself. It was the third suicide of a Chicago police officer reported last year.
    Felker recently told a morning roll call that in 2000 "60 police officers [nationally] died in gun battles or some kind of shooting incident. Three hundred eighteen police officers killed themselves." In 2001, the number was even higher: more than 400, according to the National Police Suicide Foundation. The numbers may be understated, experts say, because in many cities investigators try to make police suicides look like accidents to protect benefits for the dead officer's family. Even so, the numbers are startling, yet no one listening to Felker in the basement room of the North Side's Belmont District seemed too surprised.
    Felker explained that most cops, caught up in the macho police culture, won't talk about being sad or depressed despite plenty of studies warning that police officers are far more prone to depression and suicide than the general public. To change that, Chicago's department plans to train its 13,500 officers and supervisors to better spot suicidal tendencies in themselves and other cops. The department hired Felker to address roll calls full time, and it began sending all supervisors and field training officers to special seminars about depression and suicide. The department also is producing a video on the subject that will be shown at roll calls, which means that for the first time every officer in the department will undergo some training on the subject. The idea is to get cops on the streets, in the squad cars, to be able to spot trouble before it's too late.
    Although there are plenty of exceptions, police officers most likely to commit suicide tend to be males in their 30s who are having job-related, financial or legal problems or who are involved in troubled relationships. Some are on disability, and alcohol use often is a factor. The first and most difficult step in heading off potential suicides is getting officers to open up about their feelings. "Feelings are something in law enforcement that historically you never got involved with," said William Powers, the department's head of personnel. Powers, who also is a licensed clinical psychologist, said police departments have been silent for so long about the subject that even with the new efforts it likely will be years before the culture opens up.

Impact of 9/11
Although it may be too early to judge how the Sept. 11 terrorist attacks will affect the psyche of street cops, some experts believe it is even more important to get the message out now. "The pressures are already there, and they're high. With 9/11, it's added," said Robert Douglas, a police chaplain for the union serving Baltimore city cops and the head of the National Police Suicide Foundation.
    The National Institutes for Health set the general suicide rate in the United States at about 12 per 100,000 people, but several surveys in the 1990s indicated that the rate among police officers in the U.S. has been roughly twice that. Those statistics, and a greater understanding of the biochemical causes of depression, have led to a sharp change in how police departments are addressing the long-ignored issue. Among others, the Illinois State Police, New York Police Department and U.S. Air Force have added peer support efforts to their employee support programs in recent years.
    Douglas said Chicago is taking important steps, but he questions whether the message can get across in short roll-call sessions, which may last 15 minutes. He said he has submitted his own proposal to Chicago's department, including longer, more intense training. He is waiting for a response.

Message must be repeated
Powers said Chicago has decided that repeating the message over and over in roll calls is more effective than a one-time training session. "[Departments] can do everything right, and a guy can still kill himself because he's so determined," Powers said. "You have to get them before they grow comfortable with the decision to die."
    St. Michael's House, an independent counseling center designed for police officers, was set up in Chicago in 1997. It was among the first such efforts in the country. Although it is not officially affiliated with the department, it was considered the first big step for the city in addressing an issue that was getting greater attention in the news media and in scientific circles in the 1990s.
    A year later, in 1998, following four suicides by Chicago officers, Supt. Terry Hillard made a personal plea, taping an address that was broadcast to every officer in his department. Hillard discussed the most recent death and asked whether the department and its officers had the know-how to recognize when their colleagues are hurting to such a point. Hillard's candor about such a sensitive subject caught officers off guard. "It was the naked lady on the elevator," Powers said of the unusual address. "It jolted people, got their attention." From then, a series of initiatives began taking shape, including warnings and instruction at the Chicago Police Academy for recruits. The efforts are being stepped up this year to make it easier for cops to talk about the stresses and miseries of the job and the emotional problems they create.

Distrust of bosses
In the last year, Felker has visited every watch in every police district and specialized unit twice, carrying the same basic message: "Nobody will be fired for being suicidal, nobody will be fired for being depressed." It is a point that needs underscoring, he said. Many cops don't trust department bosses, and they doubt any counseling would be kept confidential, despite a general order on the books to protect their privacy.
    Not seeking help, Felker tells officers, can quickly lead to trouble: "Shooting your television, shooting your drywall, shooting through the floor of your condo into someone else's ceiling, pistol-whipping your wife or husband, shooting at the ex-girlfriend's car." The speech lasts about 10 minutes, and Felker knows not everyone pays attention. But he figures that at least the message is being sent.
    It used to be that cops who sought help were routinely stripped of their police powers and had to turn in their badges pending the outcome of mental evaluations. All this, Powers said, only deepened the stigma. Because Chicago cops own their guns, the department usually didn't take the officer's weapon. Now, Powers said, the department rarely strips officers of their badges. Rather, they are put on medical leave pending an evaluation--a leave that is typically given a cover, such as the officer having the flu. Guns still are only taken in the most extreme cases.
    In the video to be released in the next few months, officers are told that counseling is available and confidential. It will feature doctors and experts who explain the dangers in waiting too long to seek help and the folly in trying to cover up psychological problems for their partners or colleagues. "It is an occupational hazard of police," said Dr. Jan Fawcett, who is head of psychiatry at Rush-Presbyterian-St. Luke's Medical Center, a coordinator of the Chicago police anti-suicide efforts, who is featured in the video. "It's a military kind of attitude, and in a military kind of situation, you're not supposed to have any weaknesses."

Detroit Mental Health Care Is Cut
Wendy Wendland-Bowyer, Detroit Free Press- 1/8/2002

Wayne County's largest community psychiatric hospital can no longer provide treatment to patients in the public mental health system, after losing its contract with the Detroit-Wayne County Community Mental Health Agency.  The contract with Aurora Healthcare Inc., a 140-bed hospital, ended Dec. 31. As of Monday, the hospital had about 20 patients, said Ervin Johnson, its president and chief executive officer, and is operating with about 100 staff members after laying off 171. "We asked for reconsideration," Johnson said Monday, referring to the county contract. "We're hoping the board will go back through and look at the facts and say whether or not the materials . . . warranted closing down these beds."  Aurora was the only community hospital in Wayne County treating children and adolescents with mental illnesses. A state-run hospital in Northville Township also treats children. The public mental health system treats the state's indigent and most chronically mentally ill patients, about 32,000 of whom are in Wayne County.
    Karen Schrock, executive director of the Detroit-Wayne County agency, said it is working with other hospitals in Wayne and surrounding counties to take the patients that would have gone to Aurora. Schrock said she was limited in what she could say about the reasons for ending the contract with Aurora because the hospital sued her agency in late December. "We were concerned about the quality of care," said Schrock, who stepped into her position Jan. 1. "That is the big picture here."
    The federal Centers for Medicare and Medicaid Services, which certifies hospitals, has had Aurora on notice for quality issues for several months. In December the federal agency accepted Aurora's correction plan, said Robert Daly, a manager in the U.S. agency's regional office in Chicago. Because of the federal acceptance, Johnson said, Aurora's board was surprised at the county's decision to end the contract. The Detroit-Wayne agency's board voted in November to discontinue the contract at the end of December unless something was done to make the board change its mind, Schrock said. The board then decided in December to let the contract expire.
    Some of the problems Aurora recently was cited for include at least two patient deaths, reports of patients having sex with each other, insufficient staffing and dirty facilities. A 20-year-old man died shortly after his discharge in June. State inspectors found he had an inadequate discharge plan and his family was not properly informed about his care. He was found dead in an alley near a family member's home. Another patient died after he was not given his seizure medication for two days at the hospital, the inspectors found.
    Johnson disagreed with some of the findings and said he was working toward improving others. He said the hospital was hampered by a lack of funding. At one point, the county owed Aurora $4.5 million for patient care, Johnson said. And he said the $381 per patient per day the hospital received had not increased in about five years. The decision to end Aurora's contract came as the Detroit Medical Center prepares to trim psychiatric beds and outpatient services. Schrock said a group of DMC physicians is interested in providing outpatient services to patients once treated at the DMC. Aurora still has a contract to provide service to Wayne County Jail inmates, Johnson said.

A Diagnosis Not Exactly in the Book
Anna Fels, M.D., New York Times- 1/8/2002

Several years ago, a man came to me for a psychiatric consultation after he had lost his job. He explained that he had recently been fired--or, in the pyrotechnic language of Wall Street that he used, his "desk had been blown up." The company had shut down his investment group's computers with no warning and, after permitting the executives to gather up a few personal possessions, security officers had marched them to the door. The company called it a "business restructuring," but it sounded more like a police raid to me.
    Hearing the story, I assumed that the event, in and of itself, had been traumatic for the patient and precipitated the consultation. But amazingly, this was not an issue for him. In fact, he saw it as standard operating procedure in his profession and casually noted that there was nothing personal about its brutality. What did disturb him was that several years earlier he had gone through a similar "downsizing." He was worried now that he might somehow have brought these firings upon himself; after all, it was two firings in a six-year period. Perhaps, he suggested, he was unconsciously self-destructive or had a problem with interpersonal relations of which he was unaware.
    "It makes me feel like a loser," he said miserably, flashing me the L sign, thumb and forefinger spread wide apart. As he held up the telltale L, I found myself reflecting back on the infamous letter A, the Scarlet Letter, and pondering our newer alphabet of social shame. "I felt humiliated telling my children," he said, "or even my friends. I know it makes them think of me in a different way, and maybe they're right and I blew it."
    I was struck by my patient's sense of culpability--but not altogether surprised. I had seen enough similar cases to realize that the assumption of personal responsibility for ill fortune is endemic in our culture. I see women who blame themselves for "picking" a partner who later betrays them; patients with serious, often hereditary, mental illnesses who are convinced that it is a personal failing not to be able to cure their symptoms by willpower alone. And there are the legions of parents who believe that their children's every wrongdoing must reflect poor parenting--ignoring the effect of peers, teachers and the child's natural endowments or lack of them.
    These people, and many of the rest of us, seem to have a hard time with the idea of fate or, to put it less grandly, with acknowledging that many life events are beyond our control. We celebrate people who overcome obstacles, and we make success the arbiter of personal worth. Bad outcomes, in such a system, bespeak personal inadequacy. And when things go wrong--as they inevitably do--the credo of self-determinism leaves us in a fix. Often, at this juncture, people turn to psychotherapists in hope that "self-knowledge" will remedy things. The virtues associated with accepting fate--endurance, dignity, discipline, perseverance--are barely in our cultural lexicon.
    As the new patient and I began reviewing his personal history, we searched for problematic patterns. We went over his attitude toward his work and relationships with his bosses and co-workers. Listening to his narrative, I was acutely aware that retroactively assigning cause is a slippery business. You can always find something suspicious "through the retrospectoscope," as they say in medicine. Inevitably, some issues will emerge from anyone's life story.
    The tasks for the psychotherapist lies in assigning a weight to such problems. It involves separating pathology from normal variation. In addition, and often more difficult, it requires separating pathology that patients are comfortable with from that which is distorting their lives in painful ways. But in my patient's story there was nothing strongly pointing to self-sabotage or even run-of-the-mill social ineptitude. In fact, the main question in my mind was why he had come to see me at all. I listened closely, wondering if there was some hidden agenda that had brought him to my office. None emerged. At the end of the consultation, I delivered what seemed to me good news--the closest thing a psychotherapist comes to giving someone a "clean bill of health."
    He sat still, looking anxious. "So you think that I'm not doing this to myself; you think it just happened to me?" I nodded. He reflected silently on this unexpected turn of events. Finally, he drew himself up and said, "I'm not sure if that's better or worse." I laughed. "Maybe both?" After a pause, he began to look relieved. "So I should just continue looking for another job?" I nodded.

Pairing Serotonin Enhancers May Boost Risk of Stroke
Melinda Willis, ABC News- 1/8/2002

People who combine different types of serotonin-enhancing medications, such as certain antidepressants and migraine medications, may be increasing their risk of stroke, a new study says. The study, appearing in the journal Neurology, reports on three patients who developed ischemic strokes related to the use of serotonin-enhancing medications, which include certain antidepressants, anti-migraine drugs, decongestants and diet pills.
    Ischemic strokes occur when a blockage or extreme narrowing of an artery cuts off part of the brain's blood supply. The reports' authors speculate that too many serotonin drugs could cause restricted blood flow to the brain. "Serotonin is a neurotransmitter that is released onto blood vessels by the nerves and can cause the vessels to contract," said Dr. Walter J. Koroshetz, associate chief of neurology at Massachusetts General Hospital in Boston and co-author of the study. "It's our hypothesis that the serotonin is important and if you get too much serotonin activity, you get narrowing of the blood vessels that could lead to stroke." Antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, increase levels of serotonin in the blood by preventing the neurons from "reabsorbing" serotonin it has already released. Commonly prescribed SSRIs include Prozac, Zoloft, Paxil and Wellbutrin.
    Other types of medications also increase serotonin levels, although they act through different mechanisms. When combined, these effects could be dangerous. Patients who have migraines may need to exercise particular caution because they may be taking a double-dose of serotonin-enhancing drugs on a regular basis. Frequently used migraine medications that enhance serotonin belong to a group of drugs known as triptans. These include Imitrex and Zomig.
    According to the National Institute of Neurological Disorders and Stroke, 28 million Americans are afflicted by migraines and almost 20 million suffer from depressive disorder. "The problem is that antidepressant drugs work very well and the serotonergic migraine medicines are the best we have for migraine," said Dr. Joseph Broderick, chairman of the department of neurology at the University of Cincinnati. Broderick said he has many patients who take both classes of drugs and while most people do very well, certain migraine sufferers with symptoms such as vision or language problems should take special care if using both medications.
    The research also has implications for people who experience sudden-onset, "thunderclap" headaches, as these could indicate narrowing of the blood vessels that may lead to stroke or serious hemorrhages. All three of the subjects in the study presented with such a headache. "If someone gets these sudden onset headaches, they probably need to stop and talk to their doctor," said Koroshetz. Experts caution that the association indicated in the new report is based on only a few patients and needs more research before a solid public health message can be defined. Yet experts say that this association may indicate that people who use SSRIs and stimulants should do so cautiously, and be aware that there may be risk for drug interaction.

Treatment of Depression Rises Sharply
Shankar Vedantam Washington Post, 1/9/2002

The number of people being treated for depression has increased dramatically in the United States in the last decade, marking a profound shift in how Americans cope with the common emotional disorder, according to the most comprehensive study to date. Drugs like Prozac have become the mainstay for the vast majority of those being treated, even as doctors spend less time with patients and offer comparatively less psychotherapy, researchers said yesterday in reporting the results of the study.
    The sea-change is probably not due to an actual increase in depression, experts said. Instead, it is most likely connected to the destigmatization of mental health problems in general and depression in particular, the rise of managed care insurance plans, and the arrival of powerful drugs like Prozac, which have been accompanied by multimillion-dollar marketing campaigns.
    ''The increase in the treatment of depression cuts broadly across the population and extends to Hispanics and African-Americans, people who are unemployed and uninsured,'' said Mark Olfson, the lead author and an associate professor of clinical psychiatry at Columbia University and the New York State Psychiatric Institute. ''These changes reflect broader changes in attitudes toward the treatment of depression and a decrease in stigma.''
    Between 1987 and 1997, the number of patients being treated for depression more than tripled nationwide from 0.7 percent to 2.3 percent. Medicines, which were prescribed to about a third of patients in 1987, were given to almost three quarters a decade later. Simultaneously, patient visits to doctors for depression fell by a third, from about 12 to 8 visits per patient, with large numbers being treated by primary care physicians and other non-mental-health specialists.
    While the news almost certainly means that fewer people with depression are suffering in silence, the results also spur concern that some of the patients may not be getting the treatment they need, and that some might be getting misdiagnosed or overdiagnosed. ''What we don't know about is the quality of the care people are getting, but there are reasons to suggest there are problems with quality,'' said Harold Pincus, vice chairman for psychiatry at the University of Pittsburgh and one of the study's authors.
    Substantial numbers of patients receive a single prescription for medicines and don't refill it, he said. Since the drugs often take a month to have an effect, one prescription is unlikely to do very much. But overburdened primary care doctors have no incentive to do the kind of long-term follow-up that chronic conditions like depression demand - which means that many patients may not be getting the best treatment.
    Psychiatrists say that most depression - including major depression where patients may find it difficult to get out of bed in the morning or are suicidal - still goes untreated. While prevalence estimates vary, studies indicate 5 to 10 percent of Americans are affected by major depression each year, according to the researchers who published their study in today's issue of the Journal of the American Medical Association. ''There was such under-treatment of depression that the increase in treatment for depression almost certainly represents a good thing,'' said Benjamin Druss, an assistant professor of psychiatry and public health at Yale University and one of the study's authors.
    The study, which used data from surveys that interviewed tens of thousands of American families, started the same year that Prozac, introduced in 1987, began to change the treatment landscape. Part of a class of medicines that boost the levels of a neurotransmitter called serotonin, Prozac and its like quickly came to be prescribed for a vast array of conditions and disorders.

Two Seated As Yates Jurors
Lisa Teachey, Houston Chronicle- 1/9/2002

The first two jurors selected Tuesday in Andrea Pia Yates' capital murder trial are married women with psychology degrees, although neither uses the degree in her chosen profession. One of the women has a 3-year-old daughter. She works at a state-funded private foundation that places foster children. The other woman is an office administrator at the law firm Baker Botts, but she said she had no legal experience. She and her husband do not have children.
    Before jury selection began Tuesday, state District Judge Belinda Hill denied a request by Yates' lawyers to have equal time in the media after her husband and the district attorney appeared last month on a national television broadcast. Hill allowed defense lawyer George Parnham to read his statement into the court record. Arguing against Parnham's motion, prosecutor Joe Owmby said if Yates had accepted criminal responsibility for the crime, prosecutors would have considered supporting a life sentence. That is typical in most death-penalty cases. But because Yates had not pleaded guilty and because prosecutors were unable to decide for themselves whether there were mitigating circumstances, they decided to let a jury make the decision.
    So far, 21 potential jurors, including three who were questioned individually Tuesday, have been dismissed. Of those three, the prosecution struck two and the defense struck one. The others were excused either because of their answers to the judge's questions or by agreement between the lawyers. Because of the layout of the courtroom, the prospective jurors were blocked from spectators' view.
    Yates sat directly in their line of sight, however. She smiled at her lawyers as they greeted her in the morning but showed little emotion during questioning. During the proceeding she answered "yes" three times to questions from the judge about whether she was in agreement to dismiss the potential jurors who had not been called in for questioning.
    The woman with the daughter said she wanted to be on the panel, but she had reservations, including whether she would be hounded by reporters when she left the building that day. Hill assured her that she wouldn't and told her that she was not to discuss the case with anyone. The juror said she does not rely on her psychology degree from the University of Houston because she thought she would go to graduate school in another field. The woman said the death penalty and the insanity defense should be used "sparingly." She said she did not read the newspaper or watch the news on television, so the publicity surrounding the case had not affected her.
    The other woman seated on the panel did not appear to want to be a juror. She said the case was going to be tragic for everyone involved and the publicity would thrust jurors into the media spotlight. The woman said she earned her degree in psychology from West Georgia College in Carrollton, Ga., because she needed to graduate without having to take an accounting course.
    Most of the questions posed to the other three who were called in centered on understanding the insanity defense, views on capital punishment and whether they believed mental illness could be an excuse for committing a crime.  Under Texas law, insanity refers to whether Yates can be held criminally responsible for her actions. A jury can find Yates legally insane only if it believes she had a severe mental disorder and could not tell right from wrong during the commission of the crime.
    In the statement Hill allowed Parnham to read, he said the defense will show that the drowning of Yates' children was caused by "a mentally diseased and ill woman. "Andrea Yates was suffering from severe psychotic depression," Parnham said. "But for the psychosis, she would never have considered, much less acted upon, any thought to take the lives of the children she bore into this world and dearly loved as their mother." On the broadcast, Harris County District Attorney Chuck Rosenthal told CBS-TV's 60 Minutes he decided to seek death because there were five dead children and to hold Yates accountable for those deaths.

Emotionally Scarred for Life by Trauma
Stuart Pfeifer, Los Angeles Times- 1/9/2002

Lenore Alvillar-Aguilar marched into the Cal State Fullerton library an eager freshman, the first in her family to attend college. She emerged an hour later trembling and crying, a witness to one of the worst mass shootings in California history. Seven people died and two were wounded in the 1976 rampage by a university janitor named Edward Charles Allaway. Alvillar-Aguilar and dozens of others got out of the white concrete building without a scratch. But that does not mean they were unscathed. Alvillar-Aguilar eventually dropped out of college, unable to cope with the anxiety that rocked her anew each time she stepped onto campus. A library receptionist who survived that day said she developed alcoholism that tore her family apart and eventually led her to the welfare line and jail. One library employee, tormented by guilt over being off the day of the shooting, committed suicide eight months later.
    The violence at the university library doesn't approach the scale of more recent mass killings, let alone the losses experienced at the World Trade Center and the Pentagon. But because a quarter of a century has passed, these survivors' experiences provide a striking glimpse into the long-term effects of being a spectator to violence. Interviews with a group of people who found themselves in Allaway's direct path underscore the mysterious and highly individual ways in which trauma plays out. For many, the emotional wounds were immediately visible. Others coped for years until a "trigger" forced them to confront the trauma.
    The Sept. 11 terrorism was just one of the triggers that has made recent months difficult for Cal State Fullerton survivors. Allaway--who was found not guilty by reason of insanity--made an unsuccessful bid to be released from a state mental hospital. Backed by some the hospital's doctors, Allaway argued that his mental illness was in remission. But a judge last month ruled that Allaway remains a danger to society and should remain incarcerated.
    "We have big brains and good memories and they often are helpful to us," said Stanford psychiatrist David Spiegel, an expert in post-traumatic stress disorder who set up a Web site to help monitor survivors of the World Trade Center attacks. "But they also keep in our consciousness things that have been profoundly disturbing."

Karen Dwinell
Although most students were home for the summer, the basement of the Cal State Fullerton library was a busy place on July 12, even at 8:30 on a Monday morning. Graphic artists, counselors and janitors roamed in and out of tiny offices, their voices echoing in narrow hallways. In Room 40, receptionist Karen Dwinell was listening to her colleague Paul Herzberg talk about a recent European vacation when she spotted the janitor moving toward her. Allaway shoved the barrel of a .22-caliber rifle into her chest. Herzberg, who had been sitting on Dwinell's desk, stepped to his feet to defend her. Allaway turned and shot him in the heart. The janitor then shot a third employee in the office, Bruce Jacobson, who collapsed into Dwinell's arms. Allaway then moved to a different office and kept shooting.
    It must have been 15 minutes, maybe longer, before Dwinell built up the courage to step out of the office. She reached the hallway, looked into the graphic arts office and saw a pair of legs, motionless on the floor. She turned and tried to run, but stumbled, her platform shoes slipping on bullet shells. "They're dying all around me!" she remembers screaming as she climbed up the stairs that led to the university quad. After hours of questioning by police, Dwinell was allowed to go home. She stopped at a friend's home that night and opened a bottle of liquor. "I sat and I drank and I drank," Dwinell recalls.
    She did not get counseling. She worked at the Fullerton campus for the next 11 years. "Every time I walked down that hall, I could see myself fumbling for the keys and stumbling over the shells and wondering whether he was going to come from around the corner," Dwinell said. Dwinell developed a breathing exercise to deal with recurring panic attacks. She'd hold her breath and count slowly to 30. She also began to lose hope for the future. She said she started to despise herself. The only time she felt better was when she was drinking. "I ruined relationships. I ignored my children, the problems they were having. I was constantly drowning myself in my own sorrows. I blamed myself for not being killed that day." She thought about suicide.
    Dwinell, now 58, said she put her drinking problem behind her about six years ago, thanks in large part to a self-improvement group she said helped restore her confidence. "I like myself now," she said. But her fears and anxiety come flooding back whenever she thinks about that day. "Every time there's a school shooting, it brings it all back," she said. Then came Sept. 11. "I can relate," she said of the survivors. "The people that lived through it, they probably will have nightmares forever."

Monica Silbas
After shooting his first two victims, Allaway marched down the narrow, windowless hallway toward 16-year-old Monica Silbas, who was backed against a wall in the library basement. The man with the rifle turned toward her, but didn't fire. Instead, he shot into a graphic arts studio, striking artist Frank Teplansky twice in the back and once in the head. Silbas, who was on campus as part of a special program for high school students, dashed into an office, locked the door and began praying. After about 20 minutes of hearing nothing, Silbas climbed a stairwell and stepped out of the library. She could not speak. She would not move. Paramedics rushed her to a hospital, where she lay in a coma-like state for a week. After two weeks, she was released from the hospital and almost immediately taken by detectives back to the library basement to describe the day of the shootings. Her face started twitching. Her hands shook. A doctor who accompanied her on the visit ordered her to leave the campus at once.
    Silbas returned to Santa Ana Valley High School, went on to Sacramento State University, married and became an airline labor consultant. She believed she had put those moments at the Cal State Fullerton library behind her. Then, about 1991, some 15 years after the shootings, she returned to the Fullerton campus to visit a memorial the university erected for the seven slain victims. "As soon as I stepped foot on that campus I started to shake. I had no control over it. I just started crying," Silbas said. Fearing the onset of another panic attack, she climbed back in her car and drove away.
    Psychiatrists say Silbas experienced classic delayed post-traumatic stress. Researchers at the University of Minnesota and the Veteran Affairs Medical Center recently studied 244 World War II veterans and found that 84% of them suffered symptoms of post-traumatic stress disorder, including some who experienced their first symptoms decades after the war--such as at retirement. "If they stayed active they were OK," said Judith Herman, a Harvard psychiatry professor. "But when they got ill or had a lot of free time they had experiences of feeling hopeless." Silbas, 42, who now lives in Maryland, said she still hopes to return to the Fullerton campus again. "I keep saying I have to go back," Silbas said. "I have to close that part of it."

Kathy Morris
Kathy Morris was sorting library cards when she heard the gunfire. She suspected someone was lighting firecrackers, so she left her desk to investigate. What Morris saw next was Allaway shooting 32-year-old library employee Stephen Becker. Morris said she gathered as many employees as she could, dragged them into an office and locked the door. She hid under a desk and dialed campus police.
    The next few days were a blur. "I know I went to Steve's funeral," she said, "but I don't remember it." Like Karen Dwinell, Morris did not seek counseling before she returned to work. A single mother of three small children, Morris said she felt she had no choice but to keep working. "In retrospect, that wasn't real smart," she said.
    Morris, now 57 and living in Yorba Linda, said "to this day the Fourth of July is not my favorite holiday. Even though I enjoy fireworks, anything that sounds like gunshots is a little unnerving." All told, though, Morris feels she's gotten through it remarkably well. What enables some people to handle trauma as years pass better than others is a topic of much interest among trauma-stress experts. "As a psychiatrist I find it far more meaningful what the person brought to the trauma than how they were traumatized," said Frank Ochberg, a Michigan State University psychiatry professor.

Jason Fenton
By the time religious studies professor Jason Fenton saw Allaway, the janitor was out of bullets, running from the library toward a parked car. Fenton thought about trying to tackle the fleeing gunman, but instead ran to check on the victims. He saw library worker Becker in a pool of blood. Fenton soon learned that several of his friends had died.
    Looking back, Fenton, now 70, believes he was able to cope fairly well with the events of that day. Like Morris, he said he was able to quickly refocus on the rest of his life--something he attributes in large part to his combat experience with Israel's defense forces in 1948. When he thinks of that day in 1976, his thoughts often turn not to his own experiences but those of a colleague who suffered more profoundly.
    A few days after the shootings, a young library employee approached Fenton and talked about his grief. He had the day off on July 12 and was spared Allaway's bullets. He told the professor that he felt guilty he was not able to protect his friends. He said he could hear the victims' voices when he was alone in the university's audio-visual studio. "He said the voices were telling him he should have been with them," said co-worker Michael Casey. About 8 1/2 months after the shootings, the young employee handed his wristwatch to a co-worker. "I'm not going to need this anymore," he said. He climbed to the fifth floor of the campus Humanities Building and jumped off a balcony.
    Feelings of guilt and grief are common among survivors of tragedy, research has shown. Spiegel, the Stanford psychiatrist, said he noticed the same symptoms among survivors of a 1993 mass shooting at a San Francisco law office that left eight dead. "The thing that was most striking, everyone was affected, even the people who weren't there, who'd gone home early. They felt guilty," Spiegel said. "These people feel in retrospect they should have been there and they chickened out when there's no way in God's Earth they could have known."

Lenore Alvillar-Aguilar
Alvillar-Aguilar, the incoming freshman, was so excited about attending Cal State Fullerton that she arrived in a counselor's office more than an hour before a scheduled orientation. "He was telling me, 'You have a real bright future,' and then all of a sudden we heard shots," she said. For the next 15 minutes, she hid under a desk. The counselor eventually led her through the office, where she sidestepped bodies on her way out of the building. "The bullet holes were very small. They weren't breathing. I felt very bad because I couldn't help them," she said.
    About a month later, Alvillar-Aguilar began her freshman year. But whenever she set foot on campus, her heart would start racing and she'd feel sick to her stomach. If an assignment required a library visit, she'd either skip it or drive to her native East Los Angeles and use a community college library. In one semester, she'd had enough. And 25 years later, Alvillar-Aguilar still has no bachelor's degree.
    "People don't like to think of themselves as changed from these events or having a lifelong influence from something that was a few moments' duration, but that is what happens," said Dr. Lenore Terr, a San Francisco psychiatrist who studied the effects on Chowchilla schoolchildren who were buried alive during a 1976 kidnapping. "When you talk to kids who've been traumatized, they seem to believe they have no future. They give up on themselves."
    Alvillar-Aguilar, now 43, said that when she goes to work each day as a clerk at a large government building, she will sometimes plot out in her mind how she'll respond if there is some type of an attack. The terrorism of Sept. 11 has made things worse. "It's so depressing," she said. "So many victims--living and dead." At a psychologist's urging, she filled a journal with detailed memories of the shooting. This summer, she returned to the library basement for the first time in a quarter of a century. The drive took about 25 minutes from her home in Whittier. A recent remodeling dramatically changed the basement, but the feeling was still the same: narrow halls that wound like a maze, with offices stacked against each other. She tried to figure out where the office was. She pointed out where she saw the bodies. "Coming here was part of the healing process for me," she said. "I'm no longer afraid. I'm sad about it. But I'm glad I made it away." 'The people that lived through it, they probably will have nightmares forever.'

Use of Meth Skyrocketing Across Washington State
David Fisher, Seattle Post-Intelligencer- 1/9/2002

EVERETT -- Kathy Vertrees took her first shot of methamphetamine 16 years ago, when her daughter was 1. Three years later, six months into a recovery program, she watched her 4-year-old blow bubbles on a sunny Granite Falls porch and saw something she had never seen before. A little girl's smile and a big giggle. Vertrees doesn't know to this day whether that was her daughter's first smile, or whether she just didn't notice before because she had lost three years to a typically vicious methamphetamine cycle -- either flying high, or crashing low. "Life on meth is hell," Vertrees said yesterday during a Snohomish County summit on the drug,
    Throughout the state, police, fire departments, health departments, social workers and environmental cleanup crews say they are dealing with a spiraling increase in methamphetamine addictions and related problems. Among the signs are: Department of Ecology crews helped remove dangerous chemicals from 1,887 methamphetamine labs or dump sites in 2001, up from 1,454 the year before. Just six years ago in 1995, the number was only 60. Treatment admissions for methamphetamine addiction jumped 600 percent from 1994 to 2000, according to the Department of Social and Health Services. Last year, Child Protective Services took in 228 children who were found living or staying in 831 methamphetamine labs statewide. Their mean age was 8.
    In some parts of the state, few neighborhoods or people have been immune from the effects. In Snohomish County, a meth lab was busted recently in the apartment next door to Sheriff Rick Bart, who said two of his family members, a younger brother and a nephew, are battling addictions to the drug. Counselors in county schools are dealing with 13- and 14-year-old users. Police and prosecutors have busted burglary rings, forgers and identity thieves who are stealing to pay for their habits.
    Congress has given the state $2 million this year and $4 million next year to help cover the costs of law enforcement, treatment and prevention. Officials held a statewide summit meeting in August to bring police, social-service people and environmental health agencies together to look for solutions. Yesterday, Snohomish County, the state's third largest, became the first to do the same thing on a local level. Its summit drew more than 400 people. The problem begins with the drug's attractions, Children and Protective Services area manager Gia Wesley said.
    Methamphetamine, a variant of old-style speed, stimulates the brain's centers of well-being and emotion. New users are infused with energy and feelings of invincibility. To an extent, the feelings are real. Youths who try the drug for the first time may suddenly get better grades, clean their rooms, lose weight and hold down jobs, school and social lives, Wesley said. Soon, however, the body's production of its own mood-leveling chemicals backs off to compensate for the overstimulation, leaving users with devastating crashes when the drug is withdrawn.
    Unlike cocaine and heroin, which must be imported, or marijuana, which requires sophisticated indoor growing equipment or dangerously detectable outdoor gardens, methamphetamine can be made from cheap but dangerous chemicals that are readily available. Cleaning a meth site requires visits from respirator-clad police, Department of Ecology cleanup crews and health agents. Labs have been found in everything from rented or stolen cars and trailers to houses and rural fields, said Jonelle Fenton-Wallace, Snohomish Health District environmental health specialist.
    Summit attendees came up with a variety of potential attacks, including public education programs, education in the schools, more treatment programs and a push for a new meth lab abatement ordinance to make it easier for neighbors to get rid of a site. Ultimately, the addiction itself can be beaten, state Department of Social and Health Services Division of Alcohol and Substance Abuse chief Doug Allen said. But of the 109,000 low-income meth users in Washington who need publicly-funded treatment, the state has room for only 22.6 percent, Allen said. Vertrees, now a chemical dependency counselor, said she has been drug-free for 13 years. Life as an addict "is not fun," she said. "It's terrifying and damaging."

A Journey Back From the Horror of Untreated Depression
David Wahlberg, Ann Arbor News- 1/9/2002

Ann Arbor, MI--Julie Harrison can barely believe her own story, a tale of a woman full of life who later wanted to die and ended up in a wheelchair. It's also a story of how treatment for depression is a serious matter, of how even doctors and a loving family might not notice the depths of the disease. Nearly a year ago, on Jan. 9, Harrison jumped off the six-story parking structure at William and Fourth streets in downtown Ann Arbor. She wanted to commit suicide. She landed in the hospital for two months, with broken legs, ribs and vertebrae; bleeding from her kidney, liver and spleen; a near loss of feeling below her navel and a complete loss below her left knee. A former runner who loved to dance, the 26-year-old now must use a wheelchair. As difficult as that is, Harrison said it doesn't come close to dealing with her depression before. "I'm happy with my life now because I'm not depressed," she says.
    A petite woman with shoulder-length black hair and a long, expressive face, Harrison was born and raised in Ann Arbor, the only child of parents who work at different branches of the bank now called TCF. She attended Lakewood Elementary and then moved with her parents to Grand Rapids for fifth through 10th grades. By 11th grade, the family was back in Ann Arbor, with Julie attending Pioneer High School. That's when her problems started, she says. She was shy and had trouble making friends. Even though she was in the National Honor Society, she doubted her abilities. She felt unprepared for the upcoming adult world. Nearly every day, she would come home and cry, sitting with her parents on a living room couch as they tried to figure out how to help. She started seeing a therapist, and a doctor prescribed Prozac. Once the medicine kicked in, her outlook improved. "Senior year was a thousand times better," she says.
    Harrison attended the University of Michigan, majoring in psychology. The summer after her sophomore year, she studied in France. After returning to Ann Arbor that year, she stopped taking Prozac, thinking maybe she was OK. But she became depressed and suicidal, so she went back on the drug. After graduation in 1998, Harrison moved to Colorado, not knowing anyone there, to enroll in the Boulder College of Massage Therapy. She had long been interested in alternative medicine, and the school enabled her to be around others who shared that passion. But she didn't quite fit in.
    After a meditation conference, where participants did not talk or make eye contact for 10 days, most people felt a catharsis, a release of emotions they never knew they had. Harrison didn't feel much. She wondered if the Prozac was inhibiting her. Meanwhile, someone told her acupuncture could treat depression. She went off Prozac again, this time carefully tapering off of it to make sure she would be all right. At first, she was irritable. She and a boyfriend she had met in Boulder took a camping trip in Montana and almost broke up because she was so often upset. "And then the fire turned to water," Harrison says. She became lethargic and sad. "My inner-critic voice started to get really loud again." She couldn't afford the acupuncture treatments anymore. Yet living among people who criticized Western medicine and its profit-driven drug companies, she didn't want to be a pawn to a pill.
    When her parents flew out for her massage school graduation in December 2000, they knew something was wrong. Their daughter, who had been so engaged in life in recent years, seemed lifeless and withdrawn. They encouraged her to come home for the holidays, which she did. But it was far from a happy season. Harrison was distracted, unable to remember phone numbers, too tired to play Scrabble. Her body started feeling cold and clammy. She stopped eating regularly, sleeping most of the day. Her parents took her to a family doctor, who suggested they go to the University of Michigan's emergency psychiatric service. A doctor there asked Harrison if she felt suicidal. She said no. The doctor told her to start Prozac again, which she did.
    But just a few days later, on Jan. 9, the drug apparently had not yet taken effect. Harrison asked to take her mother to work, saying she wanted the car to drive to Kerrytown. Her mother agreed, giving Harrison a cell phone and telling her to call if anything came up. Harrison, who had driven around the day before, looking at which of Ann Arbor's tallest buildings would be easiest for a jump, drove to the parking structure at Fourth and William, just one block off Main Street. She knew her thoughts of ending her life did not make sense. But she couldn't resist. "I felt like everything alive was gone and I was just this shell empty of a soul," she says. She sat in her mother's copper-colored Honda atop the parking structure for two hours. She got out once, looked down at the street and went back into the car. With a knife she had taken from the kitchen, she looked in the rear-view mirror and tried to find her jugular vein, but she couldn't get up the nerve. Then she wrote a quick note to her parents, climbed over a snow bank at the edge of the structure, hung by her hands for a few seconds, closed her eyes and jumped.
    She doesn't remember the impact. But she does recall lying on her back, opening her eyes and being unable to breathe or move her legs. A man in a nearby alley, who had been eating lunch in his delivery truck, rushed to her side and called 9-1-1. A woman put a coat over her. Harrison started breathing in fits, enough to tell someone to call her mother. "I knew exactly what had happened," says her mother, Sherry Harrison, recollecting that fateful call. She joined her daughter in the ambulance on the way to U-M Medical Center emergency room. Doctors inserted breathing tubes and feeding tubes and whisked Harrison off to the operating room for surgery on her back, legs and vital organs.
    She spent three weeks in intensive care and nearly two months in the hospital. The poking and prodding and surgical scars only made the depression worse at first, Harrison says. But then something happened when a friend brought paczki, the Polish donut-like treat, on Fat Tuesday, the day before Ash Wednesday. It may have been that the Prozac finally kicked in. It may have been that Harrison's body was recovering. It may have been that the friend kept saying her dark days would one day end. "Something clicked that day," Harrison says. "Suddenly I felt like Dorothy from the Wizard of Oz. I was home."
    Today, Harrison lives with her parents, though she hopes to get her own apartment soon. She sees a psychologist once a week and takes her depression medication religiously. "I've learned my lesson," she says. "I won't stop taking it now." She is learning reflexology, a method of massaging the feet and hands to relieve stress throughout the body, and hopes to help others with her skills. She is taking violin lessons and has resumed her love of oil painting. She is training her red Doberman mix, Blue, to be an in-house service dog.
    She pages through her angst-filled journals from last year as if she's reading the words of another person. "I can't imagine not wanting to live, that death would be any kind of escape," she says. Her psychologist, Kathleen Sullivan, says Harrison has made a remarkable recovery from long-term depression that turned psychotic a year ago as she slipped away from reality. "Her story shows that treating depression is not a whole lot different from a diabetic deciding to stop taking insulin," Sullivan says. "It's serious."
    Sherry Harrison still cries to herself over her daughter's suicidal leap. She wants to encourage her to become independent again, but she also wants to watch her every move. "People always say, 'There's a reason this happened,"' Sherry Harrison says. "I'm still saying, 'What is it? Would someone give me a clue?"' Julie Harrison is trying to shift the focus to the present. While her life may look to others like more of a struggle now, it's actually a lot easier, she says. She's looking forward to Wednesday, Jan. 9. "We're going to have a 'celebration of life' day instead of an 'I want to die day,"' she says.

Third Juror Selected to Help Decide Outcome of Yates Trial
Lisa Teachey, Houston Chronicle- 1/10/2002

A third juror was chosen Wednesday to help decide the fate of Andrea Pia Yates, the Clear Lake mother who confessed to drowning her five children in the family bathtub last year. The juror, a divorced mother of two adult children, works as a director of plant operations. She is the third juror selected, all of whom are women. Eight more potential jurors are scheduled to be questioned today. The names of the jurors are not being made public. Ten other potential jurors were questioned and rejected Wednesday. So far, 31 potential jurors have been dismissed. The first two jurors were selected Tuesday. Both are married women with psychology degrees, although neither uses the degree in her profession. One has a small child.  Jury selection is expected to last several weeks. In addition to the 12-member panel, prosecutors and defense lawyers may select two alternates. Jurors will first have to decide whether Yates was legally sane at the time of the killings. If they decide she was and vote to convict her, they will then decide whether to sentence her to life in prison or death by lethal injection.
    The woman selected as a juror Wednesday said she believes psychologists can help people and that she and her ex-husband had consulted one for about a year of marriage counseling before their divorce. The woman said she believes the death penalty is appropriate in certain cases and that she understands the legal definition of insanity. The juror, who grew up on a farm in South Dakota and earned a degree in business there, said her initial reaction to the case was disbelief. "I suppose I was angry that it could happen to five innocent children," the woman said.
    Yates, dressed in a dark gray jumper and long-sleeved white shirt, smiled when her mother, Jutta Karin Kennedy, entered the courtroom Wednesday.  Under Texas law, Yates cannot be held criminally responsible for her actions if found insane. Jurors can find her legally insane only if they believe she had a severe mental disorder and could not tell right from wrong at the time of the killings.

Boy Pilot's Parents, as Teens, Tried Suicide
Associated Press- 1/10/2002

ST. PETERSBURG, Fla. -- The parents of a 15-year-old pilot who crashed a small plane into a Tampa skyscraper had attempted suicide as teen-agers, according to newspaper reports at the time. Charles Bishop's mother, Julia, and father, Charles Bishara, entered into a suicide pact after they were denied a marriage license because they lacked the proper paperwork, the Malden (Mass.) Evening News reported in 1984. "Basically it was a Romeo-and-Juliet type of suicide pact," Julia Bishop's attorney, Pam Campbell, told the St. Petersburg Times for Thursday's editions. "They were both very depressed. ... And they were very young." Their son died Saturday when he crashed a stolen Cessna into Tampa's Bank of America building. Investigators said he had a suicide note expressing support for Osama bin Laden and the Sept. 11 attacks.
    Charles Bishop's mother, the former Julia Detore, tried to marry Bishara when she was 17 and he was 19, but the couple was denied a marriage license in Rhode Island because of the paperwork problem. The couple stuffed rags into the tailpipe of Detore's car and tried to fill it with carbon monoxide to kill them both, according to the 1984 newspaper accounts. When that failed, they allegedly agreed Detore would stab Bishara with a butcher knife, and he would slash her wrists with the same knife, the newspaper said. After Bishara was stabbed, he asked Detore to call an ambulance, according to the newspaper. Paramedics found him on a sofa bleeding heavily with a lacerated liver. Bishara denied that the pair had attempted suicide, though Detore insisted that was the case. Detore was charged with assault with a dangerous weapon with intent to commit murder. She was ordered to undergo a 20-day evaluation at a state hospital in Waltham, Mass. Bishara's sister Dawn said her brother refused to cooperate with prosecutors, and the charge against Detore was dropped. Campbell, Bishop's attorney, said she was told that the court file was sealed.
    The couple married after their son was born in 1986 but divorced when he was a baby. The boy's father had little if any contact with him, and his other family members had no idea why he crashed the plane, Campbell said. "There was no warning. There was no thought he would ever commit suicide," said Campbell, who also represents Charles Bishop's grandmother. "This is an honor student with goals and aspirations."
    Julia Bishop, who changed her name and her son's from Bishara, has declined interviews since Saturday. She told Pinellas County officials she changed her name because Bishara is an Arabic name and the United States was at war with Iraq at the time. Police have not been able to contact Bishara. The Times reported that Bishara's parents learned of their grandson's death through news reports. "It's just a tragedy to find your grandson in this way," Robert Bishara said. "We lost someone we didn't even know."

Mental Illness Not Cause for Revoking Handgun Permit in Alaska
Mary Pemberton, Associated Press, 1/11/2002

ANCHORAGE, Alaska -- Judge Natalie Finn took away Timothy Wagner's gun permit after he claimed someone had implanted a computer chip in his head and injected him with deadly chemicals. A state appeals court, though, ruled that Finn erred, saying Alaska's concealed-carry law does not allow general concerns about mental illness to play a role in deciding whether someone should have a gun.  Gun control advocates say the episode illustrates a dangerous accommodation to the gun lobby by Alaska's Legislature. Gun owners, however, argue that Alaska's law safeguards their Second Amendment rights and that the public is adequately protected.
    The Department of Public Safety has issued more than 18,000 such permits since 1995, when Alaskans were allowed to carry concealed handguns under restrictions that include an age limit and a gun-safety course. In 1998, the law was amended so that applicants did not have to prove they actually needed to carry a concealed weapon. Also, whether someone was mentally ill or had been treated for mental illness in the preceding five years was taken off the list of questions applicants were asked a change cited by the appeals court last year in Wagner's case. The Alaska law requires applicants to disclose only whether they have ever been committed to a mental hospital or found mentally incompetent by a court. ''Yes'' answers are grounds for denying a permit. ''We wanted to remove the potential for arbitrary and capricious decision making on the part of the issuing agency,'' said Brian Judy, Alaska liaison for the National Rifle Association. But Nancy Hwa, spokeswoman for the Brady Campaign to Prevent Gun Violence, complained: ''They are taking away the discretion of local law enforcement to make these decisions in the best interest of public safety.''
    Other gun-friendly states, including Texas, Montana and North Carolina, have much stricter standards when it comes to mental instability and concealed-carry permits, said Luis Tolley, the Brady Campaign's state legislative director. In Montana, the law says a sheriff can deny a permit if there is reasonable cause to believe ''the applicant is mentally ill, mentally defective or mentally disabled.'' North Carolina applicants with a ''physical or mental infirmity that prevent the safe handling of a handgun'' can be denied a permit. Even Texas has a long, broad list under mental health, Tolley said. The restrictions include anyone that has been diagnosed with ''a psychiatric disorder or condition'' that is likely to cause impairment in judgment, mood, perception or intellectual ability. ''Alaska seems more likely than many states to allow mentally ill people to carry guns in public,'' Tolley said. ''By establishing such a narrow definition, that is allowing an awful lot of people who are mentally ill to carry guns in public.''
    Wagner's case began in 1998, when he entered the Alaska Mining and Diving store in Anchorage, dripping wet, and told a clerk he was trying to soak away chemicals in his body before they killed him. He also said a computer chip had been implanted in his head. Another employee overheard the conversation and called police. A background check revealed he had a permit to carry a concealed gun. When an officer asked Wagner if he had a gun with him, Wagner pointed to a briefcase next to him. In it was a loaded .357 and several bags of bullets. Alaska law requires permit holders who come in contact with police to tell officers immediately if they are carrying a concealed gun. Wagner was convicted of failing to do so.
    Finn sentenced Wagner to three years' probation and ordered him not to possess guns during that period. She also ordered him to forfeit his concealed-gun permit until his mental illness was ''either cured or improved.'' The Department of Public Safety later revoked Wagner's permit based on Finn's decision. Efforts to reach Wagner were unsuccessful. He has no telephone listing in Anchorage. He told the court he was an ''inventor'' and designed guns and ammunition. The public defender's office said it had not recently heard from him. Wagner had no prior convictions, according to court documents. After his arrest, police took him to a state mental hospital. Wagner testified that he was released after being interviewed.
    The amended law was enacted over the veto of Gov. Tony Knowles, who warned at the time that the measure could allow dangerous people to carry concealed weapons. The Department of Public Safety has taken a wait-and-see attitude in Wagner's case. He has not again asked for his permit back and no court has ordered it returned, said Del Smith, deputy commissioner. ''I think Finn was concerned about his behavior, and rightly so,'' Smith said. ''He made some pretty bizarre claims.''
    On the Net: Brady Campaign: http://www.bradycampaign.org

Woman Accused of Shooting Son In Psychiatric Ward
Associated Press, 1/11/2002

GADSDEN, Ala. -- A woman opened fire inside a hospital psychiatric ward where her son was being treated, hitting him once, then tried to kill herself, police said Thursday. Eviless White, 56, had fired all five of her bullets by the time she turned the gun on herself, Lt. Faye Gary said. He said she was arrested and will be charged with attempted murder. Her son, Brian White, 26, was listed in critical condition Thursday.
    Police believe White shot her son out of fear and anger that he was about to be transferred to a mental health facility in Decatur, about 80 miles away. ''She didn't want him to be put in a place like that. She wanted to end both of their lives,'' Gary said. The shooting happened in a hall outside a patient area at Gadsden Regional Medical Center. About 20 patients were in the ward at the time, but no one else was injured.
    White told police she had signed her son into the psychiatric ward in November for treatment but that he was scheduled to be transferred to the other facility Thursday morning for a five-month stay, Gary said. It was unclear how the gun got into the ward, which officials described as a secure area. While the hospital does not have metal detectors, chief executive Jim O'Loughlin said doors to the psychiatric ward are routinely locked. Visitors must leave handbags and other items at the front desk, he said. Gary said the woman might have slipped through with the gun without notice because she had been visiting her son since November without any problem.

Attorneys Pick Fourth Juror for Yates Trial
Lisa Teachey, Houston Chronicle- 1/11/2002

Prosecutors and defense lawyers selected a fourth woman Thursday to serve as a juror in the Andrea Pia Yates capital murder trial. Although the names of jurors are not being made public, the four selected thus far are all women. The juror selected Thursday is a 22-year-old student living with her parents and younger brother. She works as a receptionist while attending classes on computer networking. The woman said she feared she did not have enough experience to be on a jury but she thought she would be a good juror because she hadn't paid attention to publicity about the case and because she had formed no opinion about Yates' guilt.
    Prosecutors and defense lawyers are scheduled to question eight more potential jurors today. Court officials expect to seat 12 jurors and two alternates before beginning the trial next month. The first three jurors were selected earlier this week. Two of the four women now selected are mothers. So far, 39 of the 60 members of the jury pool have been dismissed. With four jurors selected and eight more prospects to be questioned today, the original pool will be down to no more than nine by Monday. Those are expected to be questioned Monday, and a new pool is expected to be called Tuesday. To convict Yates, jurors will have to decide that she was sane at the time of the killings. If she is convicted, they will be asked to decide whether she should spend life in prison or be executed.

Special Ed Teachers Feeling Unsafe in Class
Debera Carlton Harrell, Seattle Post-Intelligencer- 1/11/2002

When police charged a Seattle teenager with assaulting his special education teacher last month, it became the most recent example of a disturbing trend that has caused eight special education teachers or aides to file claims against their school districts in the past year. The educators, whose claims range from death threats to bites, claim they are not being adequately protected in the classroom. Their districts are spread across Western Washington and include Issaquah, Puyallup, Tacoma, Clover Park and Ferndale. "It's a serious problem. Special education teachers are like cannon fodder," said Hal Hodgins, a Seattle attorney who filed the lawsuits pending against the school districts.
    Next week, a 15-year-old Federal Way student, charged with second-degree assault for slamming his special education teacher's head onto a desk, will appear in juvenile court. While his teacher struggles to heal from her injuries, the incident has thrown a grenade into the state's special education system. The case is the most egregious publicized example of a problem that has been quiet for too long, say some special education teachers.
    The teachers, parents and legal experts emphasize that the vast majority of the state's 120,000 special ed students pose no harm. Kids with speech, vision or hearing problems, developmental delays, physical birth defects, or other disabilities deserve to be educated in the least restrictive environment possible, as federal and state laws require, they say. For most, this means mainstream classrooms or other suitable district programs during the school day.
    But some teachers say they are being hurt by a small minority of extremely troubled students who should not be in public schools. Worn out by being head-butted, kicked, punched and in some cases knocked out, teachers and teaching aides are leaving special education, already suffering an acute national and state shortage. "I was never trained to be a lion tamer," said Joyce Burtch, a former Puyallup School District special ed teacher who has sued the district for injuries suffered while trying to restrain kids who "went into rages." "You have to be on your guard all the time -- and even then they can hurt you," she said.
    Christie Perkins, past president of the Washington State Special Education Coalition, an advocacy organization for parents of special ed students, said she is worried about a backlash in the wake of the publicized cases. "Violence in schools is still more of a general education problem than a special ed problem," Perkins said. The organization has long pushed for including special education students in public education and time has shown this works, she said. But she believes the law does not require a district to put those students back into a regular or even special ed classroom if they are violent; they are required to reassess the student and modify his or her individual educational plan accordingly. "We are not saying it's OK for teachers to get hurt or for kids to hurt other students," Perkins said. "Our kids get victimized first if they're in a classroom with other non- or special ed kids with violent tendencies."
    But lately, compliance with federal and state special education laws has meant a delicate balancing act in light of teacher and student safety concerns, costly litigation, higher academic expectations of all students, and taxpayer accountability. The situation is aggravated by what many educators and special education experts consider an inadequate state system of alternative placements for the most violent kids -- and inadequate federal funding for special education.
    Meanwhile, teachers are grappling with the day-to-day reality of working with high-needs kids. Some of those who have filed civil lawsuits say they love working with most special education kids, but are leaving the profession because they have been hurt and unnerved by extreme students in their care. "Autistic kids are my first love, and most are extremely sweet, harmless," said Linda Roselle, who has sued the Issaquah School District after injuring herself while trying to catch a boy who suddenly bolted from the classroom. "But it hits you one day: Some kids are violent. They chase you with broomsticks and scissors. ... These kids cannot remain in the district. There has to be a place where they can get better treatment."
    Hodgins, the attorney, said he believes many districts are so afraid of being sued by parents that they are not adequately protecting their teachers and other students from students known to be dangerous. Some of his clients, he said, told superiors they were afraid to work with certain students for fear of being hurt by them, but were ignored. In the Seattle case, the district has said it did not receive documentation of the 15-year-old boy's violent tendencies from the California school he attended before transferring to Washington.
    Pat Steinberg of the Washington Education Association recalls teaching special education years ago and being kicked down the stairs by one student. Steinberg, like many of her colleagues, figured it was an "occupational hazard" she was duty-bound to accept -- and she was attached to kids who had no other place to go. She didn't report the incident. "But things are shifting," Steinberg said. "Teachers are calling now, asking for protection from some of these kids."
    Doug Gill, director of special education operations for the state Office of the Superintendent of Public Instruction, said the number of special education students has risen in past years while the number of teachers for them has decreased. That trend, coupled with what some consider inadequate teacher training and legal requirements, has led to clashing needs, Gill said. "Parents want inclusion; they want their children in the least restrictive environment," Gill said. "But special ed and the issue of individual entitlement needs to be looked at in a greater context. You don't want to punish someone for being disabled, but you don't want to jeopardize someone else because of another's disability. That's the quintessential dilemma districts face." And districts are troubled.
    Janet Barry, a 33-year educator and superintendent of the Issaquah School District, said that over the years the federal law has been expanded to include some forms of mental health and behavioral problems that schools must serve -- but can't. She cited a school district where one high school student is so violent, he is transported to school by police car every day, with a bodyguard. "Under IDEA (the federal Individuals with Disabilities in Education Act), schools do not have the right to decline services to anybody," Barry said. "You can't blame the kids or the parents, but some of these issues are beyond the capacity of a public school to meet. We don't have the training, the specialized services, the resources."
    Special education parents can -- and have -- sued to ensure their children receive maximum school services under IDEA. A court ordered Issaquah to pay $240,000 a year for one violent student to go to school in Texas when the parents refused a lower-cost, in-state placement. Last year, the Seattle Public Schools reached a $180,000 settlement with the mother of a violent special ed student who the district claimed it could no longer accommodate.
    Jeanette Vallandingham is a former teacher in the Clover Park School District who sued the district after being head-butted by a student. She said she was knocked backward and fell, hitting her head on the end of a counter and knocked unconscious. "This can happen to anybody; violent students just act out," said Vallandingham, echoing other teachers. "But part of my concern is for other students. One of our students was blind and in a wheelchair; the (violent) student shoved her wheelchair, nearly tipping it over."
    Concerns of the districts have heightened since the Federal Way case, but have been growing since a 1999 state Supreme Court ruling found in favor of two Stanwood special education aides who alleged the district was negligent in not protecting them from students known to be violent. They were awarded a total of $455,000. A departure from previous workers' compensation law, the ruling cleared the way for current civil litigation.
    Dan Steele, governmental relations director for the Washington State School Directors Association, which represents school boards, said the organization will ask the Legislature to pass a law offering immunity to districts sued by special education teachers. The organization also plans to seek more funding for special ed, Steele said.
    James Rosenfeld, visiting clinical professor of law at Seattle University and an expert in national special education law, said he is disturbed by what he fears is a national trend -- schools trying to expel or otherwise remove some special education students. Rosenfeld said the biggest needs in special education nationwide are more funding to provide better services for troubled youths and better special education training for teachers. "There's no doubt that some kids who misbehave need special services, but what good is throwing them out? The law says these kids must be served (by the schools)," Rosenfeld said. "Even if a student poses physical danger, he can be isolated, but it doesn't mean all services can be cut off."

Mental Illness Is Focus Of Yates Jury Selection
Paul Duggan, Washington Post- 1/11/2002

HOUSTON -- The nation first saw Andrea Pia Yates last June in a TV news clip replayed countless times since -- a bedraggled, grim-faced woman being led from her home in handcuffs, her shirt still damp with water from the bathtub in which she told police she had drowned her five children. This week, a neatly dressed Yates has been sitting at the defendant's table in a downtown courtroom here, her expression hardly more animated than it was in that TV image. She listens quietly as defense attorneys and prosecutors work through a critical phase in her case -- choosing 12 jurors for whom the biggest issue will not be what Yates did to her children, but why she did it.
    As Yates's husband and lawyers sought sympathy for her last summer, publicly detailing her history of postpartum psychosis, the killings still seemed unfathomable and unforgivable to many people. Could a mother be so mentally deranged that she would systematically murder her five children, not knowing it was wrong? And if so, should she be spared punishment for such a horrendous crime? Her lawyers say she suffered a psychotic break with reality that morning of June 20; they say that she could not tell right from wrong when she killed her daughter and four sons, and that she should be acquitted by reason of insanity. Prosecutors, seeking a death sentence, dispute that reasoning, noting that after Yates, 37, drowned the children, she immediately called police.
    Jury selection, which began Monday, is expected to last four to six weeks, with both sides querying prospective panel members one by one. Lawyers in the trial are under a court order not to comment on the case publicly. But legal experts say that Yates's attorneys should seek jurors who appear open to the idea that a mental disorder can cause uncontrollable violence that does not warrant criminal punishment. The prosecution, on the other hand, likely will try to include as many jurors as possible who have no experience with psychiatric illnesses and appear to be skeptical of such a legal defense, the experts said.
    "I just think [the case is] tragic for everyone involved, regardless of the outcome," a prospective juror said as she was being questioned Tuesday. Because of limited seating in the small courtroom, Judge Belinda Hill has allowed only four journalists to attend the proceedings, and they must share their notes with other reporters waiting outside the building. The trial will move to a much larger courtroom when testimony begins, probably in mid-February. Yates, jailed since her arrest, has been greeting her attorneys with a slight smile in the courtroom each morning, according to the reporters in attendance. Then she sits, saying little or nothing, as lawyers question the potential jurors, whose identities have not been made public.
    The prospective juror who called the case "tragic" told the court she thinks the panel will have trouble deciding whether someone with Yates's mental problems should be punished or acquitted. If the jury agreed with her insanity defense, Yates would be confined to a secure mental hospital. Legal experts said she likely would spend many years in treatment before a judge would consider releasing her. "It's not going to be easy for anyone involved if they do their jobs correctly," the woman said of the jury's task. Asked about the possibility of a not-guilty verdict based on insanity, she said: "I understand in the state of Texas that is the law. In some cases, that is the right thing to do, and in others it's not."
    That woman remains in the jury pool, but several other prospective panel members have been sent home by the lawyers, including a man who promised he could decide the case fairly. "The notion that a mother would kill her children is an emotional one," the man said in court. "I just [want] to understand what made it transpire, because otherwise it's incomprehensible." The man was dismissed by the defense.
    Most of the prospective jurors have said they could be objective in the case. Legal experts said prosecutors and defense attorneys, when querying the potential panel members, must look for hints of which way they would lean in the case. Each prospective juror also has filled out a 14-page questionnaire, providing the lawyers with plenty of background information to study.
    "A whole hell of a lot of it is gut feeling," said longtime Houston defense attorney Michael Ramsey, who is not involved in the Yates case. "You're trying to determine, as you talk with them, whether they're people you can communicate with. Is this somebody I could have a beer with and enjoy the conversation?" Ramsey said that if he were defending Yates, "I'd be looking for someone who has firsthand experience with mental illness. That's the biggest thing. I want jurors who understand that mental illness is very real and palpable and concrete, and not just some pie-in-the-sky notion. I want people on that jury who understand that a broken mind is just as serious and painful as a broken leg."
    Former prosecutor Jim Leitner said the state will be looking for jurors who appear wary of the idea that mental illness can be a valid excuse for criminal behavior. "What you're doing is trying to get a sense, by their answers, whether [prospective jurors] are trying to let you know that they think the insanity defense is a lot of garbage," said Leitner, who ran unsuccessfully for district attorney here last year.
    On Tuesday, with no prospective jurors present, prosecutor Joe Owmby told the judge that if Yates agreed to give up her insanity defense and accept responsibility for the drownings, the state would consider dropping its request for the death penalty. That would mean a guilty plea to murder and a life sentence for Yates -- an apparent plea bargain that did not appear to interest the defense. "Andrea Yates was suffering from severe psychotic depression," one of her attorneys, George Parnham, said. "But for the psychosis, she would never have considered, much less acted upon, any thought to take the lives of the children she bore into this world and dearly loved as their mother." As Parnham spoke, Yates sat beside him in a dark-colored sweater-dress, listening impassively.

D.C. Teen Slain While Waiting for Drug Treatment
Scott Higham and Sari Horwitz, Washington Post- 1/11/2002

A D.C. Superior Court judge sharply criticized child protection officials yesterday for mishandling the case of a teenager in the months before his slaying and ridiculed their defense that they "substantially complied" with court orders that were not carried out. Judge Ann O'Regan Keary stopped short of holding officials with the D.C. Child and Family Services Agency in contempt for neglecting to comply with her orders to help Jessie Jackson, 18. Jackson was fatally shot Dec. 15, two days before agency officials were ordered to explain why they had not removed Jackson from a group home and placed him in drug treatment. With Jackson dead, Keary said, a contempt order would serve little purpose. She also decided against ordering the agency to take steps to ensure that the inability to quickly place teenage wards in drug treatment not be repeated. Still, the judge said she felt compelled to speak out. "I'm surprised and disturbed that it's the agency's position that they were in substantial compliance," Keary said during the confidential neglect hearing, which was opened at the request of The Washington Post. "I find it to be representative of poor compliance."
    Jackson was taken from his neglectful mother six years ago and placed under the agency's supervision. Keary issued four court orders since September instructing Child and Family Services to remove Jackson from a group home and find him help for his drug problem. But Jackson's social worker left the agency, a new one was not assigned, and his case fell to a supervisor who did not provide the judge with status reports in advance of several court hearings. The agency faces a critical shortage of social workers.
    Last month, Keary lost patience with the lack of progress and demanded that agency director Olivia A. Golden and the supervisor, Anntinette Williams, appear in her courtroom Dec. 17 to explain why she shouldn't hold them in contempt. Two days before the hearing, Jackson was killed. Lawyers for the agency said yesterday that workers were having trouble finding drug treatment for Jackson, partly because he refused to admit he had a problem.
    Jackson told the judge early last month that he wanted help, and agency officials found him a spot at Second Genesis, but the program was not available until January. Keary and Wilma Brier, Jackson's court-appointed attorney, said they were under the impression that the teenager could start right away, not a month later. It was during those intervening weeks that Jackson was slain in a still-unsolved shooting.
    Assistant Corporation Counsel Frances Foote told the judge that many programs had turned Jackson down because of his uncooperative past, and she contended that agency workers did their best to keep the judge informed and find Jackson treatment. "They worked very hard to find a placement," Foote said. She added that the agency was in "substantial compliance" with the judge's orders.
    Keary disagreed. She said Williams did not provide her with status reports, calling it a "surprising failure." She also questioned why it took so long for the agency to find Jackson drug treatment and get him into Second Genesis, not simply secure a commitment that he could attend. Initially, the judge considered ordering the agency to make structural changes to make sure Jackson's case would not be repeated.
    But Assistant Corporation Counsel Henning Vent and Golden asked the judge to reconsider. They said the agency was already making changes, hiring more social workers and lawyers to improve communications with judges overseeing foster care cases. Golden also said the Jackson case forced her to increase her efforts to find drug treatment programs for young adults, a problem that she said is common to child protection agencies across the country. "It's intensified my own focus on these issues," Golden said. Keary relented. In the end, she accepted a promise by the agency to provide her with copies of internal reviews of how Child and Family Services handled the Jackson case and proposals for improvements to prevent similar cases.