Noteworthy News Articles on Mental Health Topics, March 21-27, 2007 Julie Deardorff, Chicago Tribune- 3/21/2007 When Rich and Gertrude Lyons first admitted they were powerless, television was the first thing to go. Then they weaned themselves from mail-order catalogs, electronic gadgets and sugar. Today, the Chicago couple are still grappling with their "soft addictions," or ordinary behavior that, if overdone, can wreak havoc on your life. Unlike hard addictions, which are usually related to a chemical substance, you don’t die from soft addictions. "But you don’t really live, either," said self-help guru Judith Wright, who labeled the phenomenon more than a decade ago. Lee Romney & Scot Gold, Los Angles Times- 3/22/2007 Two Atascadero State Hospital patients have killed themselves and four others have attempted suicide since early February — an alarming surge in such incidents at the Central Coast psychiatric facility that comes as it is rapidly losing key staff to more lucrative jobs in the prison system. Until February, the facility had not had a suicide since August 2005, and the one before that occurred in 2001. Over the last six years, Atascadero has averaged less than one attempted suicide per month. The recent spate of deaths and injuries occurred in the weeks after hospital administrators severely curtailed admissions for the first time in the institution's history, concerned that staff shortages were jeopardizing patients' safety. Atascadero Executive Director Mel Hunter said he couldn't directly tie the suicides to the crisis. But he noted that acute staff shortages are clearly eroding care. To keep wards fully staffed, he said, the hospital has had to rely on overtaxed employees working large amounts of overtime. "The best way to prevent suicides is to spend time with the men, to develop good clinical relationships," Hunter said. "In an institution running shortages from 52% to 80% on our clinical staff, we are bound to start seeing some bad outcomes." The two men who died, Matthew Miller and Roland James, had been sent to Atascadero from the California prison system, where mental health care is so poor that a federal judge ruled it unconstitutional. The court ordered reforms, including steep pay raises for clinicians. But those reforms have contributed to what one legislator called a "death spiral" at Atascadero as psychiatrists and other clinicians have left the facility for much more lucrative prison jobs. Staff members had already been leaving the hospital, frustrated by relentless mandatory overtime, increasing assaults by patients and orders by the California Department of Mental Health to dramatically change the treatment philosophy. After the court-ordered prison raises, that trickle became a flood. On Jan. 18, Atascadero administrators closed the hospital to all but the most urgent admissions, saying that safety could not be guaranteed. The prison system only sends its most severely mentally ill inmates to Atascadero, which seeks to adjust their medication, stabilize them and keep them safe. But in the midst of its crisis, the hospital failed some of its patients. The recent cluster of suicide attempts began Feb. 4, when staffers discovered a gasping patient who had tried to hang himself from his bedroom locker. He survived without serious injury. Then on Feb. 15, Miller, 52, of Lynwood, killed himself using a similar method. He was deeply despondent, a cousin who grew up with him said, having learned the previous month that he would be kept at Atascadero rather than paroled. Ron Ward, who grew up watching out for his socially vulnerable cousin, wonders why the hospital was not able to prevent the suicide because it was evident from Miller's letters that he was distraught. "Maybe they should have watched him better once they told him that," Ward, 53, said. The next weekend, a patient overdosed on the antipsychotic drug Seroquel and was hospitalized. Another doused himself in baby oil, wrapped tissue around his body and set himself ablaze, suffering burns. On the night of March 2, in the same unit where Miller killed himself, James — a 43-year-old father of four — hanged himself from his locker with a bedsheet. A panicked staff member called his mother, Christine James, at her Redding home at 11:30 that night to report that her son had been found without a pulse. Then, concerned about privacy laws, she and other staffers refused to elaborate, leaving the family to call frantically through the night trying to get more information. Ten days later — after yet another patient in the same unit unsuccessfully attempted to hang himself — James was removed from a ventilator. He was brain-dead. In the weeks before his death, Christine James said, her son seemed to sink into deep despair. He told her he had been placed under intensive monitoring, and then, a few days before he hanged himself, he said the monitoring had been lifted. "It's hard to accept. Your kids are supposed to outlive you," said Christine James, 62. "It's a mental hospital. I would have thought they would have watched him since they know mental patients are capable of such things." Suicide attempts sometimes come in copycat clusters, and those determined to die can be difficult to thwart. Still, staffers are dismayed by what some say is the worst series of patient tragedies in recent memory and believe that the staffing crisis contributed. Staff members say that licensed caregivers are in such demand that they are often required to shift to units where they don't know the patients. The problems, they say, are compounded by low morale. "When you have staff who feel defeated, how do you help patients who are basically criminals and feel defeated all the time?" one psychiatrist asked. Hunter said he is doing what he can to stabilize his hospital. Lockers have been redesigned to eliminate the risk of patients using them to hang themselves. And last week, what Hunter hopes will be the first of an influx of contract psychiatrists began working at the hospital to help plug the 80% vacancy rate. The temporary doctors will earn about $240 per hour — triple the rate of staff psychiatrists. Hunter has also been advocating pay parity with the California Department of Corrections and Rehabilitation. The judge in the prison mental health case — which includes the Department of Mental Health because the hospitals treat some prison inmates — recently ordered state officials to equalize salaries in the two systems or present an alternative plan in court by April 6. On Wednesday, after a meeting with Gov. Arnold Schwarzenegger, Department of Mental Health Director Stephen W. Mayberg announced a plan for temporary raises that will increase state pay for psychiatrists to within 5% of prison salaries and pay for other clinicians to within 18% of the prison rate. "The governor is very concerned about the impact of the exodus of staff on patient safety and staff safety," Mayberg said. Psychiatrists at Atascadero responded to the news with skepticism. "This will slow down the hemorrhage but the patient is still bleeding to death," said Dr. John Cannell, whose patient load surpasses 100. "The real question to me is whether doctors who have left for corrections will be willing to take a 5% pay cut for the privilege of working at Atascadero State Hospital in its current deteriorating state. I don't think so." Atascadero psychiatrist Michael Lisiak, the hospital's union steward, urged the federal judge to reject the plan, saying the "crisis will only continue" without pay parity. The deteriorating conditions at Atascadero and the state's other mental hospitals underscore how entangled the mental health and criminal justice systems have become. The hospitals increasingly serve mentally ill patients who are either too ill to be tried for crimes they are accused of committing, too sick for the prison system to handle or too dangerous to be paroled. Many received no mental health care at all until they found themselves in prison, where the care was lacking. Attorneys who pressed the class-action case that resulted in raises for prison clinicians say they now plan to seek an order from the judge to reopen Atascadero to mentally ill prisoners and to improve care there. "Even before the deaths, we felt that the situation at Atascadero was very dangerous and very likely to result in harm to patients," lawyer Michael Bien said. Assemblyman Sam Blakeslee (R-San Luis Obispo) has held numerous meetings with Atascadero staff members over the last year and faulted the governor for not taking action more promptly. "We've seen the implosion in corrections and what happens when a crisis is allowed to fester," he said. "There is the potential for a federal takeover, in which case you have no control. I would hope the state of California would have the foresight to appreciate that the same fate could await us in the Department of Mental Health if we don't prioritize this now."
In research published Friday in The Lancet magazine, Professor David Nutt of Britain's Bristol University and colleagues proposed a new framework for the classification of harmful substances, based on the actual risks posed to society. Their ranking listed alcohol and tobacco among the top 10 most dangerous substances. Nutt and colleagues used three factors to determine the harm associated with any drug: the physical harm to the user, the drug's potential for addiction, and the impact on society of drug use. The researchers asked two groups of experts -- psychiatrists specializing in addiction and legal or police officials with scientific or medical expertise -- to assign scores to 20 different drugs, including heroin, cocaine, Ecstasy, amphetamines, and LSD. Nutt and his colleagues then calculated the drugs' overall rankings. In the end, the experts agreed with each other -- but not with the existing British classification of dangerous substances. Heroin and cocaine were ranked most dangerous, followed by barbiturates and street methadone. Alcohol was the fifth-most harmful drug and tobacco the ninth most harmful. Cannabis came in 11th, and near the bottom of the list was Ecstasy. According to existing British and U.S. drug policy, alcohol and tobacco are legal, while cannabis and Ecstasy are both illegal. Previous reports, including a study from a parliamentary committee last year, have questioned the scientific rationale for Britain's drug classification system. ''The current drug system is ill thought-out and arbitrary,'' said Nutt, referring to the United Kingdom's practice of assigning drugs to three distinct divisions, ostensibly based on the drugs' potential for harm. ''The exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary,'' write Nutt and his colleagues in The Lancet. Tobacco causes 40 percent of all hospital illnesses, while alcohol is blamed for more than half of all visits to hospital emergency rooms. The substances also harm society in other ways, damaging families and occupying police services. Nutt hopes that the research will provoke debate within the UK and beyond about how drugs -- including socially acceptable drugs such as alcohol -- should be regulated. While different countries use different markers to classify dangerous drugs, none use a system like the one proposed by Nutt's study, which he hopes could serve as a framework for international authorities. ''This is a landmark paper,'' said Dr. Leslie Iversen, professor of pharmacology at Oxford University. Iversen was not connected to the research. ''It is the first real step towards an evidence-based classification of drugs.'' He added that based on the paper's results, alcohol and tobacco could not reasonably be excluded. ''The rankings also suggest the need for better regulation of the more harmful drugs that are currently legal, i.e. tobacco and alcohol,'' wrote Wayne Hall, of the University of Queensland in Brisbane, Australia, in an accompanying Lancet commentary. Hall was not involved with Nutt's paper. While experts agreed that criminalizing alcohol and tobacco would be challenging, they said that governments should review the penalties imposed for drug abuse and try to make them more reflective of the actual risks and damages involved. Nutt called for more education so that people were aware of the risks of various drugs. ''All drugs are dangerous,'' he said. ''Even the ones people know and love and use every day.''
Rebecca -- who had been diagnosed with attention deficit hyperactivity and bipolar disorder, or what used to be called manic depression -- died Dec. 13 of an overdose of prescribed drugs, and her parents have been arrested on murder charges, accused of intentionally overmedicating their daughter to keep her quiet and out of their hair. Interviews and a review of court documents by The Associated Press make it clear that many of those who were supposed to protect Rebecca -- teachers, social workers, other professionals -- suspected something was wrong, but never went quite far enough. But the tragic case is more than a story about one child. It raises troubling, larger questions about the state of child psychiatry, namely: Can children as young as Rebecca be accurately diagnosed with mental illnesses? Are rambunctious youngsters being medicated for their parents' convenience? And should children so young be prescribed powerful psychotropic drugs meant for adults? Dispensing drugs to children diagnosed with mood or behavior problems is ''the easiest thing to do, but it's not always the best thing to do,'' said Dr. Jon McClellan, medical director of the Child Study and Treatment Center in Lakewood, Wash. ''At some level, I would hope that you'd also be teaching kids ways to control their behavior.'' According to the medical examiner, Rebecca died of a combination of Clonidine, a blood pressure medication Rebecca had been prescribed for ADHD; Depakote, an antiseizure and mood-stabilizing drug prescribed for the little girl's bipolar disorder; a cough suppressant; and an antihistamine. The amount of Clonidine alone in Rebecca's system was enough to be fatal, the medical examiner said. The two brand-name prescription drugs are approved by the Food and Drug Administration for use in adults only, though doctors can legally prescribe them to youngsters and do so frequently. Rebecca's parents, Michael and Carolyn Riley, say they were only following doctor's orders. Rebecca, they told police, had been diagnosed when she was just 2 1/2, and Rebecca's psychiatrist prescribed the same potent drugs that had been prescribed for her older brother and sister when she diagnosed them with the same illnesses several years earlier. But Rebecca's teachers, the school nurse and her therapist all told police they never saw behavior in Rebecca that fit her diagnoses, such as aggression, sharp mood swings or hyperactivity. Prosecutors say the Rileys intentionally tried to quiet their daughter with high doses of Clonidine. Relatives told police the Rileys called Clonidine the ''happy medicine'' and the ''sleep medicine.'' Through their attorneys, Michael Riley, 34, and Carolyn Riley, 32, have accused Rebecca's psychiatrist, Dr. Kayoko Kifuji, of over-prescribing medication. Kifuji did not return calls for comment and declined to be interviewed. But Kifuji has vehemently denied any role in Rebecca's death. She has agreed to a suspension of her license while the state's medical board investigates. Kifuji told police Rebecca had been her patient since August 2004, when she was 2. She said she based her diagnoses of ADHD and bipolar disorder on the family's mental health history, as described by Carolyn Riley, and Rebecca's behavior, as described by Carolyn and briefly observed by her during office visits. Kifuji told police she became alarmed in October 2005 when Carolyn Riley told her she had increased Rebecca's nighttime dose of Clonidine from 2 to 2 1/2 tablets, and warned Carolyn the increased dose could kill Rebecca. But Carolyn told investigators Kifuji told her she could give Rebecca and her sister extra Clonidine at night to help them sleep. Tufts-New England Medical Center, where Kifuji worked, issued a statement supporting Kifuji, saying her care of Rebecca ''was appropriate and within responsible professional standards.'' In the months leading up to Rebecca's death, others noticed there was something wrong. Teachers and staff members at the Johnson Early Childhood Center in Weymouth, about 20 miles south of Boston, say they called Rebecca's mother repeatedly to tell her that Rebecca was ''out of it,'' but her mother said the girl was tired because she wasn't sleeping well. A neighbor who lived next door to the family in the last month of Rebecca's life said Rebecca and her siblings seemed listless. ''They looked like little robots. They looked very lethargic,'' Phyllis Lipton said. ''I said, `Wow, they don't look right,' but who knew?'' Pharmacists at Walgreens in Weymouth called Kifuji twice to complain that Carolyn Riley was asking for more Clonidine, even though her prescription was not due to be refilled yet, according to state police. Once, Riley said she had lost a bottle of pills, and another time, she said water had gotten into her prescription bottle and ruined the pills, according to police. Kifuji authorized refills, but after the second incident, she began prescribing Clonidine in 10-day refills instead of 30-day supplies, investigators said. On Aug. 16, a prescription for 35 Clonidine tablets -- a 10-day supply -- was filled at Walgreens, even though the Rileys had obtained a 10-day refill only the day before, investigators said. Walgreens spokeswoman Tiffani Bruce said: ''The scrip was filled as written, as it was prescribed by the doctor, and all the appropriate information on the medications was given to the family.'' After Rebecca's death, police found only seven Clonidine tablets in the family's medicine tray; the pharmacist said there should have been 75. All together, prosecutors say, Carolyn Riley got 200 more pills in one year than she should have. The Rileys' lawyers call them unsophisticated people who did not question their children's doctors. Both were unemployed; they collected welfare and disabilty benefits and lived in subsidized housing. Michael Riley, who is also awaiting trial on charges of molesting a stepdaughter in 2005, claimed to suffer from bipolar disorder and a rage disorder; his wife told police she suffered from depression and anxiety. ''They are not the sort of people who go on the Internet and look on WebMD. These are the sort of people who, when they go to a doctor, the doctor is God and they do what the doctor says,'' said John Darrell, Michael's lawyer. Carolyn's lawyer, Michael Bourbeau, said that because the Rileys' three children were all taking Clonidine, Rebecca's prescription may have come up short at times when her siblings were given some of her pills. And some of the pills may have been lost when they were split in half, he said. In July, after a therapist filed a complaint with the state Department of Social Services, social workers met with the family's doctors and other medical professionals and were assured that the medications Rebecca was taking were within medical guidelines. ''There were lots of medical eyes on this case and none of them seemed to say there was an issue of over-medication in this case,'' said Social Services Commissioner Harry Spence, who has come under fire for the agency's handling of the case. Still, there were lingering concerns. When social workers tried to make a home visit in November, Carolyn ''resisted and evaded,'' Spence said. Weeks later, workers resolved to make a surprise check, but Rebecca died the very next day, before they could visit. Rebecca was found dead on the floor of her parents' bedroom wearing only a pink pull-up diaper and gold-stud earrings, on top of a pile of clothes, magazines and a stuffed brown bear. Rebecca's uncle, James McGonnell, and his girlfriend, Kelly Williams, who lived with the Rileys, told police that the Rileys would put their kids to bed as early as 5 p.m. Rebecca, they said, often slept through the day and got up only to eat. When Michael Riley decided the kids were ''acting up,'' he told Carolyn to give them pills, McGonnell and Williams told police. According to McGonnell and Williams, Rebecca spent the last days of her life wandering around the house, sick and disoriented. But the Rileys told police they were not alarmed. ''It was just a cold,'' Carolyn repeatedly said during police interviews. The medical examiner said Rebecca died a slow and painful death. She said the overdose of Clonidine caused her organs to shut down, filling her lungs with fluid and causing congestive heart failure. Williams told police that the night before she died, Rebecca was pale and seemed ''out of it.'' At one point, the little girl knocked weakly on her parents' bedroom door and softly called for her mommy, but Michael Riley opened the door a crack and yelled at her to go back to her room, Williams said. Later that night, McGonnell told police, he heard someone struggling to breathe and found Rebecca gurgling as if something was stuck in her throat. McGonnell told police he wiped vomit from his niece's face, then kicked in the door to her parents' room and yelled at the Rileys to take Rebecca to the emergency room. Instead, Carolyn Riley said, she gave her daughter a half-tablet of Clonidine. Carolyn's mother, Valerie Berio, said that when she visited the kids the night of Dec. 11, Rebecca seemed congested but not seriously ill. In a photograph Berio said she took that night, Rebecca is smiling slightly as her mother holds a new green velvet dress in front of her. Berio said that shows that her daughter and son-in-law could not have known how sick Rebecca was. Rebecca's death has inflamed a long-running debate in psychiatry. Some psychiatrists believe bipolar disorder, which was traditionally diagnosed in adolescence or early adulthood, has become a trendy diagnosis in young children. ''As a clinician, I can tell you it's just very difficult to say whether someone is just throwing tantrums or has bipolar disorder,'' said Dr. Oscar B. Bukstein, a child psychiatrist and associate professor at the University of Pittsburgh. A study of mentally ill children discharged from community hospitals, published in January in the Archives of General Psychiatry, found the proportion of children diagnosed with bipolar disorders jumped from 2.9 percent in 1990 to 15.1 percent in 2000. A report released by the Centers for Disease Control and Prevention in 2002 estimated that about 7 percent of elementary school-age children -- or approximately 1.6 million youngsters ages 6 to 11 -- have been diagnosed with ADHD. The annual number of U.S. children prescribed anti-psychotic drugs jumped fivefold between 1995 and 2002, to an estimated 2.5 million, according to a study published last year by researchers at Vanderbilt Children's Hospital in Nashville, Tenn. Some child psychiatrists say bipolar disorder may have been under-diagnosed in children for years, partly because several key symptoms are also symptoms of ADHD, including hyperactivity, distractibility and talkativeness. Dr. Janet Wozniak, director of the Pediatric Bipolar Disorder Research Program at Massachusetts General Hospital, said early diagnosis and treatment are critical because the illness can cause social and academic problems, and lead to drug abuse, crime and suicide. ''What's commonly overlooked when considering diagnosing and treating children at such an early age is the risk of not treating and not intervening,'' Wozniak said.
Mo. Man Who Documented Meth Use Dies Jim Suhr, Associated Press- 3/25/2007 ST. LOUIS -- Wide-eyed and appearing catatonic, Shawn Bridges couldn't muster any talk from his hospital bed, his gaunt, tattooed body wracked by years of abusing the powerfully addictive witch's brew of chemicals that is methamphetamine. The footage from the documentary the 34-year-old trucker commissioned about his slow, agonizing decline does the talking for him. And he hopes the 29-minute film, shot by a southern Illinois television videographer, speaks volumes to children and others headed down a similar path to drug addiction. By his family's account, Bridges already died twice, his heart so ravaged by meth over the years that it stopped and had to be shocked back into beating. "The bottom half of his heart is dead," his dad laments on camera. As the documentary "No More Sunsets" shows, Bridges' life now isn't much. Largely bedridden, his constant companions are the catheter that funnels the urine out of his body and the feeding tube sticking from his stomach. When he does speak, it's in guttural slurs. "Ahmmmmmmm collllllllllllllllllllllld," Shawn, dressed in boxer shorts and sweat socks, said recently from a hospital-style bed wedged into his father's living room. His dad hustled to blanket him. "I'd say he's got a 34-year-old body on the outside with 70- to 80-year-old man on the inside," Jack Bridges says of his son. "You see what meth has done to my son and what my son has let it do to him. "If the documentary helps just one person stay away from this terrible poison, it's worth it." Bridges prays his son's story sways the young, including the 12 million people ages 12 and older the U.S. Department of Health and Human Services says reported in a 2002 national survey that they had used meth at least once in their lifetime. According to federal estimates, roughly 28,000 people sought treatment for meth addiction across the country in 1993, accounting for nearly 2 percent of admissions for drug-abuse care, according to the Substance Abuse and Mental Health Services Administration. But just a decade later, the meth-related admissions numbered nearly 136,000 _ more than 7 percent of the national total for drug-abuse treatment. The man who shot and narrates the film calls it a cautionary tale. "He's dying because of the decisions he's made," Chip Rossetti says in the film. "Long ago, he chose to give in to temptation. Long ago, he chose a life of drugs. But he wasn't always that way." Bridges' story is one of tragedy and torment. Family members say he forever was haunted by the dreary day in 1976 when younger brother Jason, barely a year old, died in a car wreck. Shawn was just 4 and nowhere near the wreck but inexplicably blamed himself, wanting to trade places with his dead sibling, his father says. Bridges' parents were lenient with Shawn, convinced their "wishy-washy" disciplining would ease the grieving, his father says. It backfired. "We didn't realize we were making a little monster of him," Jack Bridges says. By 16, Shawn was a high school dropout, a partier with little regard for authority. He struggled accepting his parents' divorce in 1996 and drifted in and out of his own relationships. Between two failed marriages and a girlfriend, he fathered three daughters. Jack Bridges insists he didn't suspect his son was doing drugs; if the boy was using, he artfully hid it. But Jonathan Bridges says in the documentary that he witnessed his brother's addiction and how it tormented him. Twice, Jonathan Bridges says, his brother tried to kill himself. When Shawn tried to hang himself from a tree, the rope snapped. When he purposely veered into an oncoming vehicle's path after a night of heavy partying, Jonathan was there to grab the wheel and avoid the wreck. At 26, Shawn had a heart attack his father blames on meth, a concoction that can include such toxic chemicals as battery acid, drain cleaner and fertilizer. When pressed by his dad, Shawn admitted using the drug. Several years ago, Shawn sought redemption from Buddy Walls, the former southern Illinois pastor to Shawn's grandparents. He told Walls of his struggles with drugs, talked of wanting to get clean from a drug he said made him feel bulletproof. "He was really struggling," recalls Walls, now living in Springfield, Mo. "I told him, 'Get your heart right with the Lord.' I just wanted him to feel comfort from that, if nothing else. He was truly sorry for what he'd done." Soon after that, what Shawn thought was pneumonia was diagnosed as congestive heart failure, his heart enlarged two or three times its normal size, his father says. The back of that vital muscle was stretched so thin doctors feared it would burst, Jack Bridges adds. Shawn insisted to relatives he had quit using meth, famous for fatally damaging a chronic user's heart and other internal organs because it puts the body in overdrive for prolonged periods. A little more than a year ago, Shawn was spitting up blood. When his heart quit, doctors brought him back. His weight continued diving because he couldn't keep food down. His epiphany came months later, when he told Walls he'd like to find someone to videotape him going through his "nightmare, so the kids can see the pain I'm feeling." "'I know I'm dying,'" Walls recalls Bridges saying. "But he had a real desire to live to get his story out. " Walls eventually contacted Rossetti, a videographer for WSIL-TV in Carterville, Ill. To Rossetti, the project wasn't "about just what drugs did to this guy. This is about what drugs did to his entire family and everyone he knows." For now, the documentary --available for $20 from the Web site of Rossetti's production company-- closes on the note that Shawn's fate is "yet to be determined." If he dies, that signoff will be updated. Mike Townsend, who heads the Partnership for a Drug-Free America's programs to curb meth demand, said any impact by the documentary would hinge on whether teens or others could relate to Bridges and "see themselves in that world" someday. Jonathan Bridges wouldn't wish that on anybody. "It just really hurts seeing him the way he is," he says in the documentary, wiping away tears. "As soon as he knows he's done good, he'll be able to go home." Psychologist Says Teen Competent for Trial Jonathan Saltzman, Boston Globe- 3/27/2007 CAMBRIDGE -- A state-hired psychologist has concluded that a Lincoln-Sudbury Regional High School student is competent to stand trial in the stabbing death of a schoolmate, but a judge put off ruling on competency yesterday after the teenager's lawyer challenged the diagnosis. John Odgren, 16, was evaluated for 20 days at Westborough State Hospital after his lawyer had argued that Odgren became suicidal following his arrest in January and incarceration at a maximum-security juvenile facility at the Plymouth House of Correction. When the judge announced yesterday that he was sending Odgren back to the Plymouth jail, the tall, bespectacled teenager from Princeton shouted an expletive in the Middlesex Superior courtroom and then said, "You send me back to Plymouth, I'm not coming back out." Odgren is charged with killing James Alenson, 15, in a school bathroom on Jan. 19, a slaying that has raised questions about school safety and prompted debate about mainstreaming special-needs students. Prosecutors say Odgren tried to slash Alenson's throat before repeatedly plunging a 13-inch carving knife into the freshman, a quiet student whom he had never met. Prosecutors say the slaying was premeditated, alleging that Odgren had visited numerous websites about knives the night before and played a violent video game at home before leaving for school the morning of the killing. His lawyer, Jonathan Shapiro of Boston, has said Odgren had been diagnosed with Asperger's syndrome, a mild form of autism, and also with hyperactivity disorder and had been taking several medications. Odgren had no criminal record and had never acted violently before, Shapiro said. Yesterday, Superior Court Judge Isaac Borenstein considered the results of an evaluation of Odgren by Hilary Ziven, a psychologist retained by the state Department of Mental Health. Her 30-page report has not been made public, and she declined to comment last night. But Borenstein said Ziven had concluded that Odgren understands the charges and can assist in his defense. In addition, Ziven had determined that Odgren does not need further treatment at Westborough Hospital and can return to the Plymouth jail. Shapiro vigorously disputed the findings, as Odgren's parents, Paul and Dorothy Odgren, clutched hands in the courtroom. Shapiro said that Ziven herself had reported that Odgren cannot remember the slaying or his state of mind at the time, which, Shapiro argued, will make it impossible for the teenager to assist in his defense. "John essentially has amnesia, with respect to the incident," he said. The judge, however, said the psychologist had supplied a "clear-cut opinion" that Odgren is competent to stand trial. Shapiro also said that Odgren had improved dramatically while receiving treatment at Westborough and that it made no sense to return him to Plymouth if the judge might ultimately rule that the teenager is not competent. In brief remarks to the judge, Assistant District Attorney Daniel Bennett said he had just received the evaluation and that the psychologist's assessment that Odgren is competent to stand trial "should be the end of it." Borenstein said he will hold a hearing at which both sides can present evidence about competency. The next hearing is set for April 30, but the judge has not scheduled the competency hearing yet. He asked two lawyers from the Department of Youth Services and the Department of Mental Health to make sure that officials at Plymouth monitor Odgren's mental health, in case he needs to return to Westborough. Odgren's parents declined to comment after the hearing, as did the prosecutor. But Shapiro said he was disappointed and expected that his client would again be placed on a suicide watch. Odgren, he said, suffered from nightmares in the jail and had struggled to get along with other detainees. "He's petrified of going back there," he said. Before Odgren began classes last September at Lincoln-Sudbury, he had attended a small private school for special-needs students in rural Connecticut. Lincoln-Sudbury was at least his fifth school in five years. Psychiatrists say that children with Asperger's often struggle with school transitions and that a move to a large public school with 1,600 students would not be easy. At Lincoln-Sudbury, he was enrolled in a special-needs program called Great Opportunities. Prosecutors say that Odgren had threatened several students, and once chased a student down a hallway with a sharp object. Sudbury police have said that he brought a knife and toy gun to school on separate occasions last fall. Lincoln-Sudbury school officials, who have said they did not know of prior threatening behavior, are investigating the reports. Shapiro has said most of the allegations are not true. Police Sued in Fatal Shooting of Mentally Ill Man Michael Higgins, Chicago Tribune- 3/27/2007 Chicago police could have avoided fatally shooting a 21-year-old man last month if they had been better trained in how to deal with mentally ill suspects, the man's family alleged in a federal lawsuit filed Tuesday. Raul Barriera was shot Feb. 28 at his family's home in the Humboldt Park neighborhood after police said he threatened officers with a knife. Barriera died the next day. Barriera's mother, Lynette Wilson, contends in the lawsuit that she told police her son was mentally ill; he had barricaded himself in his bedroom with a knife; and he might be suicidal. Wilson had counted on police to defuse the situation, said her attorney, Standish Willis of Chicago. But he said that instead, police argued back and forth with Barriera and then eventually pushed open the door several inches and shot him. "There's a need to train officers to deal with people with mental illnesses," Willis said Tuesday at a news conference. "If you're not trained, their behaviors will appear to be threatening when in fact it's not threatening, but it's just because of the mental illness." Barriera was 18 when doctors diagnosed him with schizophrenia, Willis said. The lawsuit filed in U.S. District Court in Chicago seeks more than $5 million in damages. Defendants include the city and two police officers, who are not identified by name. Willis said Tuesday that the family was still trying to identify the officers involved. City officials declined to comment Tuesday. At the time of the incident, police officials said Barriera had a knife and refused orders to drop it. A police roundtable discussion, which included the officers involved, witnesses and prosecutors, determined the officers acted "in accordance with state law and departmental guidelines," a police spokeswoman said at the time.
|