Providentia

"Cruel and Unusual Abuse" Alleged in Prison Lawsuit

A former inmate at an Illinois super-maximum prison is alleging "cruel and unusual" punishment in his lawsuit against the prison and his former psychiatrist, Dr Rakesh Chandra.  In the case being heard before a federal jury, 35-year old Anthony Gay is claiming lingering trauma from the psychiatric treatment that he received from Dr. Chandra at Tamms Correctional Center.  The treatment often involved his being strapped naked to a metal bed frame for up to 32 hours at a time.  Gay is claiming that the abuse that he received is causing him to self-mutilate various parts of his body.  He maintains that he should have been treated with medication and therapy instead of the restrictive treatment that Dr. Chandra ordered.  Dr. Chandra and other staff have testified that Gay's clothing was removed to prevent him from hurting himself and that he often engaged in self-harm to manipulate staff members. 

Gay, who was initially sentenced in 1993 to seven years for robbery, later incurred nineteen other charges for various offenses including assaulting officers and possession of a weapon.  He is eligible for parole in 2095. 

Tamms Correctional Center is a 500-bed maximum security facility designed to house extremely violent and/or disruptive inmates. Opened in 1998, the prison was designed to meet constitutional challenges that have been faced in other jurisdictions, including the Federal Bureau of Prisons.   Inmates are locked down twenty-three hours a day, only move when shackled, and kept segregated from other inmates during recreation.  The use of solitary confinement in dealing with mentally ill prisoners has been cited as a human rights abuse by U.S. legislators such as Senator Dick Durbin.  In a recent meeting, Senator Durbin stated that, ""While in prison, many mentally ill prisoners have limited or no access to mental health services and their conditions deteriorate." 

The case is proceeding.  Governor Pat Quinn has ordered a review of the prison and its controversial restraint policy while state lawmakers are contemplating a prison reform bill.

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Dealing With Tinnitus

A paper published in the May 2009 issue of Rehabilitation Psychology examines explore the effects of a new tinnitus treatment program (tinnitus intensive therapy [TIT]) based on auditory perception principles and neural habituation. The researchers used a follow-up study with measurement of treatment effects every third month over a 2-year period in which the cases were their own controls. There were 25 participants with a mean age 50.1 years (SD = 16.1); 10 women (52.7 years; SD = 16.8) and 15 men (48.3 years; SD = 15.9). The participants were recruited from clinical population admitted to a polyclinic tinnitus treatment program in western Germany. Results showed that there was a significant reduction of tinnitus in the follow-up period. Mean baseline tinnitus scores (Tinnitus Fragebogen; Goebel & Hiller, 1998) at the start of the treatment were 50.9 (SD = 14.5) and the final scores were 14.2 (SD = 5.9). In total, the clinical improvement over the follow-up period was 72.1%. The authors concluded that the TIT program showed a significant clinical treatment effect and should be tested further in a multicenter treatment project. The findings support the Jastreboff habituation model of tinnitus, but social cognition factors should also be taken into account.

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Doctors call for 'Munchausen' blacklist

Whether dealing with medical services directly or through a proxy, cases of Munchausen Syndrome represent a major drain on time and resources needed for dealing with patients in need of medical services. First identified in 1951, Munchausen Syndrome (formally recognized as a form of factitious disorder) can lead to multiple hospital admissions by patients seeking attention and/or sympathy by doctors and nurses. A related syndrome, Munchausen Syndrome by Proxy (MSP)involves use of a second person (usually a child) to gain attention and treatment using false or exaggerated symptoms. Although child protective services have successfully prosecuted  cases of MSP on the grounds of child abuse, the true incidence of MSP and Munchausen Syndrome remains unknown.

Doctors in the Australian state of Victoria have called for an electronic "blacklist" to alert hospitals and private clinics about patients who repeatedly seek medical treatment for suspicious symptoms. Although emergency department physicians have dubbed these patients, "frequent flyers", medical ethicists are warning about the possible risks of the proposed blacklist. Patients who have been flagged as possible Munchausen cases may be deprived of necessary treatment despite actual need as well as concerns about lack of privacy. Doctors are also recommending psychiatric referrals for suspected cases as well as working with family members to ensure that proper care is maintained and to avoid the health risks resulting from repeated medical test and hospitalizations.

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When Children See Abuse

A study published in the August 2009 issue of the Journal of Consulting and Clinical Psychology examines a randomized clinical trial of Project Support, an intervention designed to reduce conduct problems among children exposed to intimate partner violence.  The study participants were 66 families (mothers and children) with at least 1 child exhibiting clinical levels of conduct problems. Families were recruited from domestic violence shelters. The Project Support intervention involves (a) teaching mothers child management skills and (b) providing instrumental and emotional support to mothers. Families were randomly assigned to the Project Support intervention condition or to an existing services comparison condition. They were assessed on 6 occasions over 20 months, following their departure from the shelter. Children in families in the Project Support condition, compared with those in the comparison condition, exhibited greater reductions in conduct problems. Mothers in the Project Support condition, compared with those in the comparison condition, displayed greater reductions in inconsistent and harsh parenting behaviors and psychiatric symptoms. Changes in mothers’ parenting and psychiatric symptoms accounted for a sizable proportion of Project Support’s effects on child conduct problems at the end of treatment. Clinical and policy implications are discussed.

PsycNET - Display Record.

Guilty Plea in Drowning Fetish Case

An 47-year old Uniontown, Ohio man has pleaded guilty to attempting to solicit two young girls to satisfy a bizarre drowning fetish. Jeffrey Doland, a former public school employee, was arrested after traveling to Miami in 2007 to meet a woman he had chatted with on the Internet. The woman, actually an undercover Secret Service agent, had purportedly met Doland to allow him to "dunk both of her preteen daughters underwater until the bubbles stop rising". During Doland's trial, jurors had been shown transcripts of his Internet chat conversations in which he stated that, "I love long hair floating underwater. Cannot wait to see them drowning". The transcripts of Doland's online sessions at the Yahoo chat room fetishes14 also described his intention of wearing "skimpy trunks" while drowning the girls and even of handcuffing them to the bottom of a pool.

According to prosecutors, Doland made arrangements to travel to Miami after telling his wife that he was going diving with a friend. On meeting with the agent in Miami, he slipped her money and suggested buying Velcro straps as he had left his in Ohio due to fear of them being confiscated. While his defense attorneys described him as a "good man who simply went off the deep end" and that he had no intention of carrying out his plans, Doland issued a guilty plea to avoid the potential 90-year sentence that he would have been given if convicted. He agreed to a 20-year prison term with ten years of probation.

 

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September 10 is World Suicide Prevention Day

World Suicide Prevention Day is held on September 10th each year as an initiative of the International Association for Suicide Prevention (IASP), and is co-sponsored by the World Health Organization (WHO). The theme in 2009 is "Suicide Prevention in Different Cultures." Begun in 2003, the purpose of World Suicide Prevention Day is to improve education about suicide, disseminate information, decrease stigmatization and, most importantly, raise awareness that suicide is preventable.

World Suicide Prevention Day 2009, "Suicide Prevention in Different Cultures" provides an opportunity to remind people that suicide is influenced by cultural, religious, legal, historical, philosophical and traditional factors and that these contexts need to be taken into account in considering suicide prevention. Suicide needs to be understood in terms of its cultural background, and, to save lives, suicide prevention programs need to be tailored to different cultural contexts

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Politician's Son to Indian People: "Please Stop Killing Yourselves"

Following the death of an estimated 67 people in India's Andhra Pradesh province after learning of the death of a popular politician, the politician's son appeared on television asking viewers not to kill themselves. Chief Minister Y.S. Rajasekhara Reddy was killed on September 2 when the helicopter in which he was traveling crashed into a cliff 250 kilometers south of Hyderabad. His charred remains, along with the remains of four others traveling with him, were found by an air force helicopter 24 hours later.

Within hours of the popular politician's death, there has been an outsurge of public grief along with reports of suicides and others simply "dying of shock". Reddy's son, Jaganmohan, in a bid for public calm gave a televised message to prevent further suicides. In his message, he stated that: ""I request you not to commit suicide. I appeal to all of you to be patient and be brave in this hour of tragedy. He wanted to see a smile on the faces of all and if you resort to such things, this will hurt him." Jaganmohan is believed by many to be a leading candidate to succeed his father as chief minister.

While suicides following the suicide of a public figure is a well documented phenomenon, suicides following an accidental death is far more unusual. Whether Jaganmohan's message will be successful in preventing further deaths remains to be seen.

TheStar.com | World | India state 'in deep mourning'.

The Psychopathic Stalker

Although the psychological factors that lead to stalking behaviour has been the focus of numerous research studies, the role that psychopathy can play has not been as well examined. A study published in June 2009 issue of Law and Human Behavior examines the the association between psychopathy and stalking in 61 men convicted of stalking-related offenses. These offenses included criminal harassment, loitering, and uttering threats. All participants were assessed using standard psychopathy measures including a screening version of the Psychopathy Checklist based on a review of clinical files. Information was also collected regarding relationship between perpetrator and victim and various other stalking-related factors (i.e., escalating behaviour, vulnerability of victim). Psychopathic symptoms were rare, but their presence-especially that of affective deficit symptoms-was associated with victimization of casual acquaintances and with several risk factors from the Guidelines for Stalking Assessment and Management (SAM) (Kropp et al., Guidelines for stalking assessment and management, including stalking in violation of supervision orders, degree of preoccupation with victims, and targeting of victims with limited access to external resources. The findings suggest that in spite of their rarity, psychopathic traits may be important in the assessment and management of stalking risk. 

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New Orleans Mental Health System Still In Crisis 4 Years after Katrina

Despite ongoing efforts to restore emergency services to a city devastated by Hurricane Katrina in 2005, available resources for survivors dealing with serious mental illness remain at an all-time low. According to one recent report published in Psychiatric Annals, the number of inpatient psychiatric hospital beds has dropped from 487 pre-Katrina to 190. Since most of these remaining beds are reserved for psychiatric patients unable to live independently, only a fraction of those 190 beds are available for acute care.

The only state-operated mental health facility in New Orleans, the New Orleans Adolescent Hospital, is now scheduled for closing after Louisiana governor Bobby Jindal vetoed the 14 million dollars of funding needed to keep the hospital open. The hospital's closure on September 1 is expected to reduce the available number of beds to 133 leaving the city jail as New Orleans' largest psychiatric facility with 50 beds. Although state funding for mental health services has been rising, those funds have been earmarked for community-based services. Inpatient care services for the mentally ill continue to decline despite a rise in suicide rates and a sharp increase in the number of people with mental health problems, many who had been left homeless post-Katrina.

According to a World Health Organization study, the number of residents with serious mental health problems has risen from 6.1 percent pre-Katrina to 19.9 percent today due to the incidence of post-traumatic issues. The number with mild to moderate problems has risen from 9.7 to 19.9 percent. When the Federal Emergency Management Agency surveyed displaced families living in trailers and hotel rooms in February, 2006, it found that 44 percent of displaced persons suffered from some form of psychological distress. Since 2006, there have been 101 suicides and 726 suicide attempts in a population ranging from 200000 to 300000. In 2009 alone, there have been at least 24 suicides and 82 attempts.

Cecile Tebo, administrator of the New Orleans Police Department Crisis Unit that responds to 911 calls involving the mentally ill, has been outspoken in warning of the critical health care problems city has faced since Katrina.  "I've told people for so long, just don't come back [to New Orleans] right now. Don't come back if you have any kind of special needs; this is not the place to be if you have elderly that are really sick, if you have children with special needs or people in the family with mental illness or mental retardation; this is just not a good place to be right now." Mrs. Tebo added that her own staff of volunteers is just a little more than half the size it was before Katrina.

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