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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some Bay Area suicide prevention hotlines say they experienced an increase in calls following the election of Donald Trump as president last week.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.sfsuicide.org/\">San Francisco Suicide Prevention\u003c/a> hotline saw a 30 percent spike in calls in the five days after the vote.\u003c/p>\n\u003cp>Director Courtney Brown said she’s never seen anything like it.\u003c/p>\n\u003cp>“We don’t have the numbers, but the only comparable incidents have been 9/11 and the Loma Prieta earthquake,” she said.\u003c/p>\n\u003cp>Brown was taking calls at 7 a.m. on Nov. 9, the day after the election. She said many of the callers were wondering what their lives were going to look like for the next four years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Wondering if they’re going to have the same health care,” she said. “Some of them wondering if they’re going to still be in the country — still be allowed to be in the country.”\u003c/p>\n\u003cp>Brown started tracking these calls. In the five days after the election, around 20 percent of callers cited increased distress due to the election.\u003c/p>\n\u003cp>Brown’s data go back to 2007. After previous elections, the records generally show a small bump in calls. And after President Obama’s election in 2008, she says, there was even a slight decrease in the number of calls.\u003c/p>\n\u003cp>“It seems that there’s something about this election that is really affecting the most vulnerable people in our community,” Brown said.\u003c/p>\n\u003cp>Other suicide hotlines are reporting a similar pattern.\u003c/p>\n\u003cp>Joy Alexiou, public information officer for Santa Clara County’s \u003ca href=\"https://www.sccgov.org/sites/mhd/Services/CallCenter/Pages/default.aspx\">Behavioral Health Services\u003c/a>, said an informal survey of hotline staff found an increase in calls post-election.\u003c/p>\n\u003cp>“While most callers expressed disappointment and worry about what will happen now that Trump is elected president, none of the callers disclosed or shared that they wanted to engage in suicidal behaviors because of election results,” Alexiou wrote in an email.\u003c/p>\n\u003cp>Libby Craig, the Bay Area director of the national organization Crisis Text Line (80 percent of whose clientele are millennials), said the day after the election the service experienced four times the usual number of texters.\u003c/p>\n\u003cp>“The most common words we saw used by texters were ‘scared’ and ‘election.’ The word ‘scared’ was often associated with LGBTQ issues,” Craig wrote in an email.\u003c/p>\n\u003cp>While there have been upticks in mental health calls related to past events like the San Bernardino terrorist attack and Robin Williams’ suicide, according to Craig, this is the first time her organization has seen an increase related to politics.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you or someone that you know is experiencing post-election distress, here is some advice from the \u003ca href=\"http://suicidepreventionlifeline.org/\">National Suicide Prevention Lifeline\u003c/a>, which also received more calls than usual, both leading up to the election and in the aftermath.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Stick to routines.\u003c/strong> Even if you don’t feel like going to work or working out like you usually do, stick to going as much as possible. Routines ground us in the here and now, and remind us of things within our control that do not have to change.\u003c/li>\n\u003cli>\u003cstrong>Seek social supports.\u003c/strong> Talk about your thoughts and feelings with others, enjoy time to share experiences that can help you cope with the feelings, or distract you from them temporarily so you can take an “emotional breather.”\u003c/li>\n\u003cli>\u003cstrong>Limit your interaction\u003c/strong> with things that might aggravate your stress right now.\u003c/li>\n\u003cli>\u003cstrong>Take compassionate, caring actions\u003c/strong> to support others, where you can. Be the one to help a friend in crisis, or a stranger in need, or volunteer to assist others in a cause that you care about.\u003c/li>\n\u003cli>\u003cstrong>Call the Lifeline\u003c/strong> if you are in distress or would like to speak to someone. It’s available 24/7, and is free and confidential. You can call us at 1-800-273-TALK (8255).\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The staff of Clinica Sierra Vista, which has health centers throughout the Central Valley, screened its mostly low-income patients last year for mental health needs and determined that nearly 30 percent suffered from depression, anxiety or alcoholism.\u003c/p>\n\u003cp>Christopher Reilly, Sierra Vista’s chief of behavioral health services, said he was concerned about the high percentage of patients afflicted, but even more so about the clinic’s ability to treat them.\u003c/p>\n\u003cp>That’s in part because at health centers like Clinica Sierra Vista, a large group of mental health providers are excluded from reimbursement by Medi-Cal, the government program for low-income Californians. But that will soon change. Gov. Jerry Brown last week signed a law allowing federally funded health centers and rural clinics to bill Medi-Cal for the services of licensed marriage and family therapists.\u003c/p>\n\u003cp>“I am ecstatic that this passed,” Reilly said. “It means a lot more people are going to get attention for their behavioral health needs a lot earlier.”\u003c/p>\n\u003cp>The new law, which takes effect Jan. 1, is designed to address gaps in mental health care, particularly in rural areas where recruiting and retaining behavioral health providers is a challenge. Under the current law, clinics hire licensed clinical social workers and psychologists for their Medi-Cal patients, but they often can’t find enough to meet their needs. Many clinics don’t provide behavioral health services at all.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>About 40,000 marriage and family therapists are licensed in the state, compared to about 22,000 social workers and 21,000 psychologists, according to a \u003ca href=\"http://www.legtrack.com/bill.html?bill=201520160AB1863\" target=\"_blank\">state analysis\u003c/a> of the legislation, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB1863\" target=\"_blank\">Assembly Bill 1863\u003c/a>.\u003c/p>\n\u003cp>Sierra Vista’s Reilly, who himself is a marriage and family therapist, said he expects another benefit from the law: less reliance on medication. Instead of simply being referred to doctors for prescriptions, the patients will be able to have regular counseling. Often, Reilly noted, patients’ depression or anxiety stems from family problems, domestic violence or substance use. Marriage and family therapists can help with those situations, he said.\u003c/p>\n\u003cp>Access to mental health services has long been a challenge in California, especially for low-income residents. In 2014, millions more Californians became eligible for Medi-Cal and for mental health services under the Affordable Care Act. That put even more pressure on the system.\u003c/p>\n\u003cp>The new law signed by the governor affects nearly 1,000 federally-funded and rural health clinics, according to the state analysis. The clinics accept patients regardless of their ability to pay and rely heavily on Medi-Cal reimbursements.\u003c/p>\n\u003cp>One of them, OLE Health, treats about 25,000 patients each year in Napa. CEO Tanir Ami said it’s been a challenge to find enough social workers to treat patients, many of whom have depression and anxiety, often exacerbated by poverty and inadequate housing.\u003c/p>\n\u003cp>“Now we get to recruit from a whole other pool of qualified candidates,” Ami said. “I am hoping it will make it exponentially easier to find the workforce we need.”\u003c/p>\n\u003cp>Gov. Brown vetoed a similar bill last year. The bill’s author, Assemblyman Jim Wood, (D-Healdsburg), said the governor had been concerned about its cost. But this year, Wood said he and the bill’s supporters convinced Brown that providing more mental health services could actually reduce health care costs.\u003c/p>\n\u003cp>“If you get people the behavioral health they need, you potentially keep them out of emergency rooms, which is a huge savings,” Wood said.\u003c/p>\n\u003cp>The bill was sponsored by CaliforniaHealth+ Advocates, an arm of the California Primary Care Association, and the California Association of Marriage and Family Therapists. The California chapter of the National Association of Social Workers and the California Psychological Association opposed it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org\" target=\"_blank\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\" target=\"_blank\">Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The staff of Clinica Sierra Vista, which has health centers throughout the Central Valley, screened its mostly low-income patients last year for mental health needs and determined that nearly 30 percent suffered from depression, anxiety or alcoholism.\u003c/p>\n\u003cp>Christopher Reilly, Sierra Vista’s chief of behavioral health services, said he was concerned about the high percentage of patients afflicted, but even more so about the clinic’s ability to treat them.\u003c/p>\n\u003cp>That’s in part because at health centers like Clinica Sierra Vista, a large group of mental health providers are excluded from reimbursement by Medi-Cal, the government program for low-income Californians. But that will soon change. Gov. Jerry Brown last week signed a law allowing federally funded health centers and rural clinics to bill Medi-Cal for the services of licensed marriage and family therapists.\u003c/p>\n\u003cp>“I am ecstatic that this passed,” Reilly said. “It means a lot more people are going to get attention for their behavioral health needs a lot earlier.”\u003c/p>\n\u003cp>The new law, which takes effect Jan. 1, is designed to address gaps in mental health care, particularly in rural areas where recruiting and retaining behavioral health providers is a challenge. Under the current law, clinics hire licensed clinical social workers and psychologists for their Medi-Cal patients, but they often can’t find enough to meet their needs. Many clinics don’t provide behavioral health services at all.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>About 40,000 marriage and family therapists are licensed in the state, compared to about 22,000 social workers and 21,000 psychologists, according to a \u003ca href=\"http://www.legtrack.com/bill.html?bill=201520160AB1863\" target=\"_blank\">state analysis\u003c/a> of the legislation, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB1863\" target=\"_blank\">Assembly Bill 1863\u003c/a>.\u003c/p>\n\u003cp>Sierra Vista’s Reilly, who himself is a marriage and family therapist, said he expects another benefit from the law: less reliance on medication. Instead of simply being referred to doctors for prescriptions, the patients will be able to have regular counseling. Often, Reilly noted, patients’ depression or anxiety stems from family problems, domestic violence or substance use. Marriage and family therapists can help with those situations, he said.\u003c/p>\n\u003cp>Access to mental health services has long been a challenge in California, especially for low-income residents. In 2014, millions more Californians became eligible for Medi-Cal and for mental health services under the Affordable Care Act. That put even more pressure on the system.\u003c/p>\n\u003cp>The new law signed by the governor affects nearly 1,000 federally-funded and rural health clinics, according to the state analysis. The clinics accept patients regardless of their ability to pay and rely heavily on Medi-Cal reimbursements.\u003c/p>\n\u003cp>One of them, OLE Health, treats about 25,000 patients each year in Napa. CEO Tanir Ami said it’s been a challenge to find enough social workers to treat patients, many of whom have depression and anxiety, often exacerbated by poverty and inadequate housing.\u003c/p>\n\u003cp>“Now we get to recruit from a whole other pool of qualified candidates,” Ami said. “I am hoping it will make it exponentially easier to find the workforce we need.”\u003c/p>\n\u003cp>Gov. Brown vetoed a similar bill last year. The bill’s author, Assemblyman Jim Wood, (D-Healdsburg), said the governor had been concerned about its cost. But this year, Wood said he and the bill’s supporters convinced Brown that providing more mental health services could actually reduce health care costs.\u003c/p>\n\u003cp>“If you get people the behavioral health they need, you potentially keep them out of emergency rooms, which is a huge savings,” Wood said.\u003c/p>\n\u003cp>The bill was sponsored by CaliforniaHealth+ Advocates, an arm of the California Primary Care Association, and the California Association of Marriage and Family Therapists. The California chapter of the National Association of Social Workers and the California Psychological Association opposed it.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org\" target=\"_blank\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\" target=\"_blank\">Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Coping With Depression When Treatment Doesn't Work",
"title": "Coping With Depression When Treatment Doesn't Work",
"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>Rini Kramer-Carter has tried everything to pull herself out of her dark emotional hole: individual therapy, support groups, tai chi and numerous antidepressants.\u003c/p>\n\u003cp>The 73-year-old Los Angeles musician rattles off the list: Prozac, Cymbalta, Lexapro.\u003c/p>\n\u003cp>“I’ve been on a bunch,” she said. “I still cry all the time.”\u003c/p>\n\u003cp>She has what’s known as “treatment-resistant depression.” It’s commonly defined as depression that doesn’t respond to two different medications when taken one after the other, at the right dose and for the right amount of time.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-medium wp-image-224252\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/08/DepressedMan-800x453.jpg\" alt=\"DepressedMan\" width=\"800\" height=\"453\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-800x453.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-400x227.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-768x435.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-1180x669.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-960x544.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nearly 16 million adults have major depression, and up to \u003ca href=\"http://www.ajgponline.org/article/S1064-7481%2816%2930126-9/fulltext?rss=yes\">a third\u003c/a> do not respond to treatment. The disease afflicts people of all ages, but experts say that as many as half of older adults don’t get better with standard treatment.\u003c/p>\n\u003cp>Mental health experts expect treatment-resistant depression to become more widespread as baby boomers age. Boomers already have been identified as having \u003ca href=\"http://www.gallup.com/poll/181364/reports-depression-treatment-highest-among-baby-boomers.aspx\">higher rates\u003c/a> of depression than previous generations, and over time their depression may no longer respond to medication.\u003c/p>\n\u003cp>“We are seeing treatment-resistant depression more, and we are recognizing it more,” said Helen Lavretsky, a geriatric psychiatrist at UCLA. “And in older adults, the answer to understanding what it is and what to do about it is more complicated than in younger adults.”\u003c/p>\n\u003cp>The consequences among older adults can be devastating. Persistent depression can raise the risk of early death and suicide, expedite memory decline and lead to a loss of independence.\u003c/p>\n\u003cp>\u003cstrong>Why Antidepressants Aren't Enough\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The phenomenon isn’t well studied, but psychiatrists believe there are several reasons why depression in older adults may not respond to treatment. For one thing, if a person has been depressed and taken different medications for a long time, it can diminish their effectiveness. Patients also may neglect to take their medication as prescribed, because they have memory problems or they believe they no longer need it.\u003c/p>\n\u003cp>“Sometimes people say, ‘I’m better. I don’t need this,’ and stop the medicine,” said Anthony P. Weiner, who directs outpatient geriatric psychiatry at Massachusetts General Hospital. “Then the symptoms recur … and if the person goes back on the medicine, it may not be fully effective.”\u003c/p>\n\u003cp>Seniors are also more likely to have chronic medical illnesses, which raises the risk of depression. Their illnesses may make it more difficult for them to recover from depression. And it can mask whether antidepressants are working, because symptoms of chronic illness can be mistaken for depression — and vice versa.\u003c/p>\n\u003cp>Poverty, isolation, pain, grief over the loss of a spouse, or being a caregiver can also lead to or intensify a senior’s depression. And no matter what medication the patients take, Lavretsky noted, those external factors don’t go away.\u003c/p>\n\u003cp>“Either they change their perspective or they change their circumstances, or the depression just persists,” she said.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-medium wp-image-225685\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/08/depressedwomanrain-800x473.jpg\" alt=\"depressedwomanrain\" width=\"800\" height=\"473\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-800x473.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-400x236.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-768x454.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-1180x698.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-960x568.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Antidepressants can help seniors gain some perspective. But Lavretsky and others agree that even if the medications are effective, they shouldn’t be used in isolation. “It’s an emotional experience,” Weiner said. “The whole answer isn’t just, ‘Oh, here take a pill.’ There is such a central role for psychotherapy.”\u003c/p>\n\u003cp>Kramer-Carter, who speaks slowly and hugs everyone she meets, has felt depressed for as long as she can remember. As a young adult, she worked as a secretary and a proofreader but got fired more than once because she had trouble getting out of bed and making it to work on time. She went to the emergency room many times and in her 30s, she was diagnosed with depression.\u003c/p>\n\u003cp>Now, she spends a few days each week driving her husband, Eugene Carter, to medical appointments. When she feels up to it, she volunteers delivering food to poor families.\u003c/p>\n\u003cp>Kramer-Carter checks all the boxes for being at high-risk of treatment-resistant depression. She is a long-time caregiver, first for her parents and now for her husband, a stroke survivor with short-term memory problems. Her own list of health problems is long: diabetes, high blood pressure, arthritis, fibromyalgia and gout.\u003c/p>\n\u003cp>“Who wants to be aching all the time?” she said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I can stay in bed all day, that’s what I do.'\u003ccite>Rini Kramer-Carter\u003c/cite>\u003c/aside>\n\u003cp>Money problems don’t help either. The couple depends financially on Social Security. If she had more money, she said she would go to the theater or see live concerts. She misses both.\u003c/p>\n\u003cp>“We wouldn’t be so stuck,” she said. As it is, they spend everything on food, rent and other bills.\u003c/p>\n\u003cp>“It’s a constant struggle,” she said. “You have to borrow from Peter to pay Paul.”\u003c/p>\n\u003cp>Despite the prevalence of treatment-resistant depression, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/\" target=\"_blank\">few resources\u003c/a> exist to help psychiatrists make treatment decisions. Clinical trials have been scant, and there are no universally accepted protocols for the condition. The risks and benefits of different medications for older adults are largely unknown.\u003c/p>\n\u003cp>Given a shortage of geriatric psychiatrists, decisions on treatment are often left to primary care providers, who may not have relevant training or might be reluctant to take on such complicated care.\u003c/p>\n\u003cp>Doctors with patients who don’t respond to traditional therapies frequently make ad hoc decisions about whether to change the dosage, add a medication or switch to a new one.\u003c/p>\n\u003cp>“The clinicians use their best experience and trial and error,” said Evelyn Whitlock, chief science officer at the Patient-Centered Outcomes Research Institute. “They try something, and if it doesn’t work, they try something else.”\u003c/p>\n\u003cp>Trial and error is not ideal, she said. Many of these people have been living with depression for so many years, and providers need to be able to provide them with effective treatment.\u003c/p>\n\u003cp>\u003cstrong>New Approaches\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In an effort to produce better medical outcomes for people with treatment-resistant depression, the Patient-Centered Outcomes Research Institute announced in July that it was funding \u003ca href=\"http://www.pcori.org/news-release/pcori-board-approves-40-million-improving-treatment-options-depression\" target=\"_blank\">three major studies\u003c/a> that will test different approaches to the illness. The goal of the research is to produce tangible evidence that can be used immediately to help patients and their doctors make more informed treatment decisions. [contextly_sidebar id=\"QvUjqDKFRFEtGPmtPTeoqpzPvYGJtv45\"]\u003c/p>\n\u003cp>The Washington, D.C. nonprofit, which finances health research, earmarked $40 million for the five-year studies, which it expects to begin this fall. They will include more than 2,500 patients at sites in California, Ohio, New York, Texas, Pennsylvania and elsewhere.\u003c/p>\n\u003cp>One of the studies will examine electroconvulsive therapy — its impact on quality of life and its potential for relieving the symptoms. Another will compare the effectiveness and safety of three strategies — using magnetic fields to stimulate nerve cells in the brain, adding an antipsychotic medication or switching to a specific antidepressant. The research will assess how these approaches affect the patients’ ability to function at home and work.\u003c/p>\n\u003cp>The third and largest study, with about 1,500 patients, will focus specifically on older adults, testing different drugs and studying how aging affects the risk and benefits of antidepressants. UCLA, where Kramer-Carter is being treated, is part of the third study, which will weigh life circumstances and disabilities in addition to depression.\u003c/p>\n\u003cp>The grants represent an “unprecedented opportunity to look at this population,” Lavretsky said.\u003c/p>\n\u003cp>“It will be a comprehensive look at the condition, why it happens and what are the ways of alleviating suffering,” she said. “Are there some similarities among all people with treatment-resistant depression? I suspect we will find some.”\u003c/p>\n\u003cp>On a recent afternoon, Rini Kramer-Carter visited Lavretsky at UCLA. She said the only time she truly escapes her sadness is when she plays percussion along with other musicians. But she hasn’t been playing lately, and she has been sleeping up to 20 hours a day.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-257360\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/10/Prozac-428x600.jpg\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/10/Prozac-428x600.jpg 428w, https://ww2.kqed.org/app/uploads/sites/13/2016/10/Prozac-400x560.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/10/Prozac.jpg 731w\" sizes=\"(max-width: 428px) 100vw, 428px\">\u003c/p>\n\u003cp>“If I can stay in bed all day, that’s what I do,” she said.\u003c/p>\n\u003cp>Sometimes she watches TV comedies to try to dissipate her black moods.\u003c/p>\n\u003cp>Kramer-Carter said she learned about Lavretsky after seeing a newspaper ad for another research study, of a drug typically used to treat early-stage dementia. During their appointment, Lavretsky went over a list of questions included in the study. “On a scale of zero to 10, where do you place yourself in terms of depression?” the doctor asked her. Nine, she responded.\u003c/p>\n\u003cp>She told Lavretsky she sometimes felt restless and anxious, but not suicidal.\u003c/p>\n\u003cp>“Do you feel full of energy?” Lavretsky asked.\u003c/p>\n\u003cp>“Do I look like I am full of energy?” she responded with a sigh.\u003c/p>\n\u003cp>Lavretsky told her that no pill will completely fix her problems, but medication might give her more energy and the ability to cope. Kramer-Carter said she knows a drug won’t produce any miracles. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Rini Kramer-Carter has tried everything to pull herself out of her dark emotional hole: individual therapy, support groups, tai chi and numerous antidepressants.\u003c/p>\n\u003cp>The 73-year-old Los Angeles musician rattles off the list: Prozac, Cymbalta, Lexapro.\u003c/p>\n\u003cp>“I’ve been on a bunch,” she said. “I still cry all the time.”\u003c/p>\n\u003cp>She has what’s known as “treatment-resistant depression.” It’s commonly defined as depression that doesn’t respond to two different medications when taken one after the other, at the right dose and for the right amount of time.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-medium wp-image-224252\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/08/DepressedMan-800x453.jpg\" alt=\"DepressedMan\" width=\"800\" height=\"453\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-800x453.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-400x227.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-768x435.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-1180x669.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/DepressedMan-960x544.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nearly 16 million adults have major depression, and up to \u003ca href=\"http://www.ajgponline.org/article/S1064-7481%2816%2930126-9/fulltext?rss=yes\">a third\u003c/a> do not respond to treatment. The disease afflicts people of all ages, but experts say that as many as half of older adults don’t get better with standard treatment.\u003c/p>\n\u003cp>Mental health experts expect treatment-resistant depression to become more widespread as baby boomers age. Boomers already have been identified as having \u003ca href=\"http://www.gallup.com/poll/181364/reports-depression-treatment-highest-among-baby-boomers.aspx\">higher rates\u003c/a> of depression than previous generations, and over time their depression may no longer respond to medication.\u003c/p>\n\u003cp>“We are seeing treatment-resistant depression more, and we are recognizing it more,” said Helen Lavretsky, a geriatric psychiatrist at UCLA. “And in older adults, the answer to understanding what it is and what to do about it is more complicated than in younger adults.”\u003c/p>\n\u003cp>The consequences among older adults can be devastating. Persistent depression can raise the risk of early death and suicide, expedite memory decline and lead to a loss of independence.\u003c/p>\n\u003cp>\u003cstrong>Why Antidepressants Aren't Enough\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The phenomenon isn’t well studied, but psychiatrists believe there are several reasons why depression in older adults may not respond to treatment. For one thing, if a person has been depressed and taken different medications for a long time, it can diminish their effectiveness. Patients also may neglect to take their medication as prescribed, because they have memory problems or they believe they no longer need it.\u003c/p>\n\u003cp>“Sometimes people say, ‘I’m better. I don’t need this,’ and stop the medicine,” said Anthony P. Weiner, who directs outpatient geriatric psychiatry at Massachusetts General Hospital. “Then the symptoms recur … and if the person goes back on the medicine, it may not be fully effective.”\u003c/p>\n\u003cp>Seniors are also more likely to have chronic medical illnesses, which raises the risk of depression. Their illnesses may make it more difficult for them to recover from depression. And it can mask whether antidepressants are working, because symptoms of chronic illness can be mistaken for depression — and vice versa.\u003c/p>\n\u003cp>Poverty, isolation, pain, grief over the loss of a spouse, or being a caregiver can also lead to or intensify a senior’s depression. And no matter what medication the patients take, Lavretsky noted, those external factors don’t go away.\u003c/p>\n\u003cp>“Either they change their perspective or they change their circumstances, or the depression just persists,” she said.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-medium wp-image-225685\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/08/depressedwomanrain-800x473.jpg\" alt=\"depressedwomanrain\" width=\"800\" height=\"473\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-800x473.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-400x236.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-768x454.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-1180x698.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/08/depressedwomanrain-960x568.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Antidepressants can help seniors gain some perspective. But Lavretsky and others agree that even if the medications are effective, they shouldn’t be used in isolation. “It’s an emotional experience,” Weiner said. “The whole answer isn’t just, ‘Oh, here take a pill.’ There is such a central role for psychotherapy.”\u003c/p>\n\u003cp>Kramer-Carter, who speaks slowly and hugs everyone she meets, has felt depressed for as long as she can remember. As a young adult, she worked as a secretary and a proofreader but got fired more than once because she had trouble getting out of bed and making it to work on time. She went to the emergency room many times and in her 30s, she was diagnosed with depression.\u003c/p>\n\u003cp>Now, she spends a few days each week driving her husband, Eugene Carter, to medical appointments. When she feels up to it, she volunteers delivering food to poor families.\u003c/p>\n\u003cp>Kramer-Carter checks all the boxes for being at high-risk of treatment-resistant depression. She is a long-time caregiver, first for her parents and now for her husband, a stroke survivor with short-term memory problems. Her own list of health problems is long: diabetes, high blood pressure, arthritis, fibromyalgia and gout.\u003c/p>\n\u003cp>“Who wants to be aching all the time?” she said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I can stay in bed all day, that’s what I do.'\u003ccite>Rini Kramer-Carter\u003c/cite>\u003c/aside>\n\u003cp>Money problems don’t help either. The couple depends financially on Social Security. If she had more money, she said she would go to the theater or see live concerts. She misses both.\u003c/p>\n\u003cp>“We wouldn’t be so stuck,” she said. As it is, they spend everything on food, rent and other bills.\u003c/p>\n\u003cp>“It’s a constant struggle,” she said. “You have to borrow from Peter to pay Paul.”\u003c/p>\n\u003cp>Despite the prevalence of treatment-resistant depression, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/\" target=\"_blank\">few resources\u003c/a> exist to help psychiatrists make treatment decisions. Clinical trials have been scant, and there are no universally accepted protocols for the condition. The risks and benefits of different medications for older adults are largely unknown.\u003c/p>\n\u003cp>Given a shortage of geriatric psychiatrists, decisions on treatment are often left to primary care providers, who may not have relevant training or might be reluctant to take on such complicated care.\u003c/p>\n\u003cp>Doctors with patients who don’t respond to traditional therapies frequently make ad hoc decisions about whether to change the dosage, add a medication or switch to a new one.\u003c/p>\n\u003cp>“The clinicians use their best experience and trial and error,” said Evelyn Whitlock, chief science officer at the Patient-Centered Outcomes Research Institute. “They try something, and if it doesn’t work, they try something else.”\u003c/p>\n\u003cp>Trial and error is not ideal, she said. Many of these people have been living with depression for so many years, and providers need to be able to provide them with effective treatment.\u003c/p>\n\u003cp>\u003cstrong>New Approaches\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In an effort to produce better medical outcomes for people with treatment-resistant depression, the Patient-Centered Outcomes Research Institute announced in July that it was funding \u003ca href=\"http://www.pcori.org/news-release/pcori-board-approves-40-million-improving-treatment-options-depression\" target=\"_blank\">three major studies\u003c/a> that will test different approaches to the illness. The goal of the research is to produce tangible evidence that can be used immediately to help patients and their doctors make more informed treatment decisions. \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Washington, D.C. nonprofit, which finances health research, earmarked $40 million for the five-year studies, which it expects to begin this fall. They will include more than 2,500 patients at sites in California, Ohio, New York, Texas, Pennsylvania and elsewhere.\u003c/p>\n\u003cp>One of the studies will examine electroconvulsive therapy — its impact on quality of life and its potential for relieving the symptoms. Another will compare the effectiveness and safety of three strategies — using magnetic fields to stimulate nerve cells in the brain, adding an antipsychotic medication or switching to a specific antidepressant. The research will assess how these approaches affect the patients’ ability to function at home and work.\u003c/p>\n\u003cp>The third and largest study, with about 1,500 patients, will focus specifically on older adults, testing different drugs and studying how aging affects the risk and benefits of antidepressants. UCLA, where Kramer-Carter is being treated, is part of the third study, which will weigh life circumstances and disabilities in addition to depression.\u003c/p>\n\u003cp>The grants represent an “unprecedented opportunity to look at this population,” Lavretsky said.\u003c/p>\n\u003cp>“It will be a comprehensive look at the condition, why it happens and what are the ways of alleviating suffering,” she said. “Are there some similarities among all people with treatment-resistant depression? I suspect we will find some.”\u003c/p>\n\u003cp>On a recent afternoon, Rini Kramer-Carter visited Lavretsky at UCLA. She said the only time she truly escapes her sadness is when she plays percussion along with other musicians. But she hasn’t been playing lately, and she has been sleeping up to 20 hours a day.\u003c/p>\n\u003cp>\u003cimg class=\"size-medium wp-image-257360\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/10/Prozac-428x600.jpg\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/10/Prozac-428x600.jpg 428w, https://ww2.kqed.org/app/uploads/sites/13/2016/10/Prozac-400x560.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/10/Prozac.jpg 731w\" sizes=\"(max-width: 428px) 100vw, 428px\">\u003c/p>\n\u003cp>“If I can stay in bed all day, that’s what I do,” she said.\u003c/p>\n\u003cp>Sometimes she watches TV comedies to try to dissipate her black moods.\u003c/p>\n\u003cp>Kramer-Carter said she learned about Lavretsky after seeing a newspaper ad for another research study, of a drug typically used to treat early-stage dementia. During their appointment, Lavretsky went over a list of questions included in the study. “On a scale of zero to 10, where do you place yourself in terms of depression?” the doctor asked her. Nine, she responded.\u003c/p>\n\u003cp>She told Lavretsky she sometimes felt restless and anxious, but not suicidal.\u003c/p>\n\u003cp>“Do you feel full of energy?” Lavretsky asked.\u003c/p>\n\u003cp>“Do I look like I am full of energy?” she responded with a sigh.\u003c/p>\n\u003cp>Lavretsky told her that no pill will completely fix her problems, but medication might give her more energy and the ability to cope. Kramer-Carter said she knows a drug won’t produce any miracles. She just wants some relief.\u003c/p>\n\u003cp>“I just want to be able to live my life,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers\" target=\"_blank\">One in five\u003c/a> Americans is estimated to have a mental health condition at any given time. But getting treatment remains difficult — and it’s worse for children, especially those who identify as black or Hispanic.\u003c/p>\n\u003cp>That’s the major finding in \u003ca href=\"http://joh.sagepub.com/content/early/2016/08/11/0020731416662736.abstract\" target=\"_blank\">research published Friday\u003c/a> in the International Journal of Health Services. The study examines how often young adults and children were able to get needed mental health services, based on whether they were black, Hispanic or white. Using a nationally representative sample of federally collected \u003ca href=\"https://meps.ahrq.gov/mepsweb/\" target=\"_blank\">survey data\u003c/a> compiled between 2006 and 2012, researchers sought to determine how often people reported poor mental health and either saw a specialist or had a general practitioner bill for mental health services.\u003c/p>\n\u003cp>“No one is necessarily bigoted — and yet we have a system that creates the kind of discrimination we see in the paper,” said Steffie Woolhandler, a professor at City University of New York School of Public Health, and one of the study’s authors. “Kids are getting half as much mental health treatment — and they have the same level of mental health problems.”\u003c/p>\n\u003cp>Young people in general aren’t likely to see mental health specialists. But the numbers fell further when racial and ethnic backgrounds were factored in. About 5.7 percent of white children and young adults were likely to see a mental health specialist in a given year, compared with about 2.3 percent for black or Hispanic young people.\u003c/p>\n\u003cp>Put another way: Even when controlling for someone’s mental health status, insurance and income, black and Hispanic children saw someone for treatment far less often than did their white counterparts — about 130 fewer visits per thousand subjects. Black young adults visited a mental health specialist about 280 fewer visits per thousand; Hispanics had 244 fewer visits per thousand.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the data indicate that mental illness incidence rates are generally consistent across racial groups, according to the study. Of adults between the ages of 18 and 34, between 4 and 5 percent indicated having fair or poor mental health, regardless of racial background. For children, white and black subjects were reported to need care at about the same rate — between 11 percent and 12 percent — compared with about 7 percent of Hispanic children.\u003c/p>\n\u003cp>The paper outlines a few possible reasons for this disconnect. Different communities may attach greater stigma about mental health care, or they may place less trust in the doctors available. Plus, there is a shortage of child psychiatrists across the country, and black and Hispanic families often live in the most underserved areas.\u003c/p>\n\u003cp>“There are problems of access all around,” said Harold Pincus, vice chair of psychiatry at Columbia University’s College of Physicians and Surgeons. “We have to change the way we do things.”\u003c/p>\n\u003cp>The findings suggest that lawmakers have focused on trying to improve access to mental health care, but “we can’t rest on our laurels,” said Pincus, who wasn’t affiliated with the study. He also noted that treating white children’s level of access as the golden standard is probably unwise, since research suggests they also receive inadequate care.\u003c/p>\n\u003cp>One of the study’s clear messages, argued Woolhandler, is that racial minorities received markedly less care — regardless of socioeconomic or health status. The gap suggests a targeted intervention is needed.\u003c/p>\n\u003cp>The study highlights a need to ensure doctors know how to counsel patients of different racial backgrounds and will do so, said Benjamin Le Cook, an assistant professor of psychiatry at Harvard Medical School, who was also not affiliated with the study. Ending racial and cultural disparities in access to care is a more pressing concern than erasing the stigmas about mental illness in minority communities, he said.\u003c/p>\n\u003cp>That’s especially relevant given minorities are \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24178249\" target=\"_blank\">less likely to be treated\u003c/a> by doctors of their ethnicity. In addition, research suggests that mental health specialists sometimes discriminate based on race when seeing patients.\u003c/p>\n\u003cp>“It has to do with experiences people in the community have had that haven’t matched their expectations or aligned with problems they’re having,” LeCook said. “Cultural stigma is a factor, but not the main one.”\u003c/p>\n\u003cp>Beyond better training, more funds are needed for resources like community health centers, which often serve black and Hispanic patients, Woolhandler said.\u003c/p>\n\u003cp>“I see these great people trying to work in community mental health, but they need more resources to do their job,” she said.\u003c/p>\n\u003cp>But, the research doesn’t account for other areas where minorities may access mental health services, Pincus noted. Churches and social service agencies, for instance, may be filling some of the void and wouldn’t be accounted for by the survey data.\u003c/p>\n\u003cp>Researchers and policymakers should explore those sectors, he said, to see if they could be better leveraged to help people get connected to care they’ll actually trust. As experts try to bolster the mental health system — both to improve access across the board and also to close race-based gaps — they need to use a multipronged approach, pulling in different kinds of caregivers than those who might normally treat mental illness.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There’s all kinds of ways by which the mental health system doesn’t play a role in helping people,” he said. “Family and community supports, social services — they’re all part of the picture.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers\" target=\"_blank\">One in five\u003c/a> Americans is estimated to have a mental health condition at any given time. But getting treatment remains difficult — and it’s worse for children, especially those who identify as black or Hispanic.\u003c/p>\n\u003cp>That’s the major finding in \u003ca href=\"http://joh.sagepub.com/content/early/2016/08/11/0020731416662736.abstract\" target=\"_blank\">research published Friday\u003c/a> in the International Journal of Health Services. The study examines how often young adults and children were able to get needed mental health services, based on whether they were black, Hispanic or white. Using a nationally representative sample of federally collected \u003ca href=\"https://meps.ahrq.gov/mepsweb/\" target=\"_blank\">survey data\u003c/a> compiled between 2006 and 2012, researchers sought to determine how often people reported poor mental health and either saw a specialist or had a general practitioner bill for mental health services.\u003c/p>\n\u003cp>“No one is necessarily bigoted — and yet we have a system that creates the kind of discrimination we see in the paper,” said Steffie Woolhandler, a professor at City University of New York School of Public Health, and one of the study’s authors. “Kids are getting half as much mental health treatment — and they have the same level of mental health problems.”\u003c/p>\n\u003cp>Young people in general aren’t likely to see mental health specialists. But the numbers fell further when racial and ethnic backgrounds were factored in. About 5.7 percent of white children and young adults were likely to see a mental health specialist in a given year, compared with about 2.3 percent for black or Hispanic young people.\u003c/p>\n\u003cp>Put another way: Even when controlling for someone’s mental health status, insurance and income, black and Hispanic children saw someone for treatment far less often than did their white counterparts — about 130 fewer visits per thousand subjects. Black young adults visited a mental health specialist about 280 fewer visits per thousand; Hispanics had 244 fewer visits per thousand.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the data indicate that mental illness incidence rates are generally consistent across racial groups, according to the study. Of adults between the ages of 18 and 34, between 4 and 5 percent indicated having fair or poor mental health, regardless of racial background. For children, white and black subjects were reported to need care at about the same rate — between 11 percent and 12 percent — compared with about 7 percent of Hispanic children.\u003c/p>\n\u003cp>The paper outlines a few possible reasons for this disconnect. Different communities may attach greater stigma about mental health care, or they may place less trust in the doctors available. Plus, there is a shortage of child psychiatrists across the country, and black and Hispanic families often live in the most underserved areas.\u003c/p>\n\u003cp>“There are problems of access all around,” said Harold Pincus, vice chair of psychiatry at Columbia University’s College of Physicians and Surgeons. “We have to change the way we do things.”\u003c/p>\n\u003cp>The findings suggest that lawmakers have focused on trying to improve access to mental health care, but “we can’t rest on our laurels,” said Pincus, who wasn’t affiliated with the study. He also noted that treating white children’s level of access as the golden standard is probably unwise, since research suggests they also receive inadequate care.\u003c/p>\n\u003cp>One of the study’s clear messages, argued Woolhandler, is that racial minorities received markedly less care — regardless of socioeconomic or health status. The gap suggests a targeted intervention is needed.\u003c/p>\n\u003cp>The study highlights a need to ensure doctors know how to counsel patients of different racial backgrounds and will do so, said Benjamin Le Cook, an assistant professor of psychiatry at Harvard Medical School, who was also not affiliated with the study. Ending racial and cultural disparities in access to care is a more pressing concern than erasing the stigmas about mental illness in minority communities, he said.\u003c/p>\n\u003cp>That’s especially relevant given minorities are \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24178249\" target=\"_blank\">less likely to be treated\u003c/a> by doctors of their ethnicity. In addition, research suggests that mental health specialists sometimes discriminate based on race when seeing patients.\u003c/p>\n\u003cp>“It has to do with experiences people in the community have had that haven’t matched their expectations or aligned with problems they’re having,” LeCook said. “Cultural stigma is a factor, but not the main one.”\u003c/p>\n\u003cp>Beyond better training, more funds are needed for resources like community health centers, which often serve black and Hispanic patients, Woolhandler said.\u003c/p>\n\u003cp>“I see these great people trying to work in community mental health, but they need more resources to do their job,” she said.\u003c/p>\n\u003cp>But, the research doesn’t account for other areas where minorities may access mental health services, Pincus noted. Churches and social service agencies, for instance, may be filling some of the void and wouldn’t be accounted for by the survey data.\u003c/p>\n\u003cp>Researchers and policymakers should explore those sectors, he said, to see if they could be better leveraged to help people get connected to care they’ll actually trust. As experts try to bolster the mental health system — both to improve access across the board and also to close race-based gaps — they need to use a multipronged approach, pulling in different kinds of caregivers than those who might normally treat mental illness.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There’s all kinds of ways by which the mental health system doesn’t play a role in helping people,” he said. “Family and community supports, social services — they’re all part of the picture.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>For a group of mental health professionals in California, watching the Syrian refugee crisis unfold on television was not an option.\u003c/p>\n\u003cp>“We were very, very concerned that there (was) a lot of need, and little available for professional services -- particularly mental health services,” says psychiatrist Dr. Saad Shakir.\u003c/p>\n\u003caside class=\"pullquote alignright\">Seeing all the devastation going on, I want to have an impact in a positive way. \u003ccite> Dr. Saad Shakir, Alalusi Foundation \u003c/cite>\u003c/aside>\n\u003cp>Shakir yearned to do more, and he zeroed in on Jordan. Amman, the country’s capital, is on the front lines of the Syrian refugee crisis, with nearly 1.5 million refugees now living in the country. Many are suffering deeply, but there aren’t nearly enough mental health professionals to serve them. A study from the \u003ca href=\"http://www.who.int/mental_health/evidence/mh_aims_report_jordan_jan_2011_en.pdf\" target=\"_blank\">World Health Organization\u003c/a> says fewer than 100 psychiatrists live in Jordan.\u003c/p>\n\u003cp>In the face of overwhelming need came a creative response from the Alalusi Foundation, a Hayward-based nonprofit focusing on refugee relief and humanitarian projects around the world. The foundation developed the Care Program for Refugees -- or CPR -- to train professionals who work with refugees to provide mental health care.\u003c/p>\n\u003cp>“Being a physician, I'm a humanitarian,” says Shakir. “So seeing all the devastation going on, it's like I want to have an impact in a positive way. We decided the best way we can help is by training the individuals here who provide care for refugees.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Earlier this summer, the group traveled to Amman to hold a weeklong training for Middle Eastern professionals who work with refugees.\u003c/p>\n\u003cp>Shakir and his colleagues prepared intensive trainings on a range of subjects including post-traumatic stress disorder, therapeutic interventions, ethics, and self-care for therapists.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/276000214\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Saadia Hameed is a school psychologist from Sunnyvale who first heard about CPR after a meeting of the Bay Area Muslim Mental Health Professionals. The group was looking for someone with a background working with children, and she jumped at the chance to get involved.\u003c/p>\n\u003cp>“It’s really important for someone who does want to help to look within themselves to see what skills they have to offer,” says Hameed, while on a break from leading a workshop for 30 people on caring for children who have experienced trauma. The room buzzes with energy, and the discussion alternates between English and Arabic.\u003c/p>\n\u003cp>The workshop is intended for medical professionals, as well as social workers, volunteers, and educators. One of the attendees, Nisreen Katbi is a displaced refugee herself. Now she runs a residential rehabilitation center in Amman called\u003ca href=\"http://souriyat-across-borders.org/\" target=\"_blank\"> Souriyat Across Borders\u003c/a> that cares for Syrian refugees who were injured in the war.\u003c/p>\n\u003cp>“We found ourselves, all of a sudden, in the middle of this crisis,\" she says. \"Those people around us need help, they need help very quickly.\" Because of limited resources, people like Katbi sometimes find themselves given large responsibilities. She is grateful for today’s training.\u003c/p>\n\u003cp>“It’s a critical situation when they came from a war zone,” Katbi says. “So I have to be qualified to deal with them.”\u003c/p>\n\u003cp>The problem is vast. Care Program for Refugees hopes to expand its efforts by holding more trainings and offering webinars to reach other people who work with refugees. And Hameed, the school psychologist, says working with professionals like Katbi has in turn inspired her to dig deeper into treating trauma.\u003c/p>\n\u003cp>“One thing I feel is very motivated,\" she says. \"I want to learn more about how to support children who’ve not just faced trauma but war trauma, and torture and grief and loss.\"\u003c/p>\n\u003cp>Hameed plans to return to Amman for next spring’s training.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Luisa Conlon and Hanna Miller contributed to this story.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For a group of mental health professionals in California, watching the Syrian refugee crisis unfold on television was not an option.\u003c/p>\n\u003cp>“We were very, very concerned that there (was) a lot of need, and little available for professional services -- particularly mental health services,” says psychiatrist Dr. Saad Shakir.\u003c/p>\n\u003caside class=\"pullquote alignright\">Seeing all the devastation going on, I want to have an impact in a positive way. \u003ccite> Dr. Saad Shakir, Alalusi Foundation \u003c/cite>\u003c/aside>\n\u003cp>Shakir yearned to do more, and he zeroed in on Jordan. Amman, the country’s capital, is on the front lines of the Syrian refugee crisis, with nearly 1.5 million refugees now living in the country. Many are suffering deeply, but there aren’t nearly enough mental health professionals to serve them. A study from the \u003ca href=\"http://www.who.int/mental_health/evidence/mh_aims_report_jordan_jan_2011_en.pdf\" target=\"_blank\">World Health Organization\u003c/a> says fewer than 100 psychiatrists live in Jordan.\u003c/p>\n\u003cp>In the face of overwhelming need came a creative response from the Alalusi Foundation, a Hayward-based nonprofit focusing on refugee relief and humanitarian projects around the world. The foundation developed the Care Program for Refugees -- or CPR -- to train professionals who work with refugees to provide mental health care.\u003c/p>\n\u003cp>“Being a physician, I'm a humanitarian,” says Shakir. “So seeing all the devastation going on, it's like I want to have an impact in a positive way. We decided the best way we can help is by training the individuals here who provide care for refugees.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Earlier this summer, the group traveled to Amman to hold a weeklong training for Middle Eastern professionals who work with refugees.\u003c/p>\n\u003cp>Shakir and his colleagues prepared intensive trainings on a range of subjects including post-traumatic stress disorder, therapeutic interventions, ethics, and self-care for therapists.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/276000214&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/276000214'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Saadia Hameed is a school psychologist from Sunnyvale who first heard about CPR after a meeting of the Bay Area Muslim Mental Health Professionals. The group was looking for someone with a background working with children, and she jumped at the chance to get involved.\u003c/p>\n\u003cp>“It’s really important for someone who does want to help to look within themselves to see what skills they have to offer,” says Hameed, while on a break from leading a workshop for 30 people on caring for children who have experienced trauma. The room buzzes with energy, and the discussion alternates between English and Arabic.\u003c/p>\n\u003cp>The workshop is intended for medical professionals, as well as social workers, volunteers, and educators. One of the attendees, Nisreen Katbi is a displaced refugee herself. Now she runs a residential rehabilitation center in Amman called\u003ca href=\"http://souriyat-across-borders.org/\" target=\"_blank\"> Souriyat Across Borders\u003c/a> that cares for Syrian refugees who were injured in the war.\u003c/p>\n\u003cp>“We found ourselves, all of a sudden, in the middle of this crisis,\" she says. \"Those people around us need help, they need help very quickly.\" Because of limited resources, people like Katbi sometimes find themselves given large responsibilities. She is grateful for today’s training.\u003c/p>\n\u003cp>“It’s a critical situation when they came from a war zone,” Katbi says. “So I have to be qualified to deal with them.”\u003c/p>\n\u003cp>The problem is vast. Care Program for Refugees hopes to expand its efforts by holding more trainings and offering webinars to reach other people who work with refugees. And Hameed, the school psychologist, says working with professionals like Katbi has in turn inspired her to dig deeper into treating trauma.\u003c/p>\n\u003cp>“One thing I feel is very motivated,\" she says. \"I want to learn more about how to support children who’ve not just faced trauma but war trauma, and torture and grief and loss.\"\u003c/p>\n\u003cp>Hameed plans to return to Amman for next spring’s training.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Luisa Conlon and Hanna Miller contributed to this story.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>New research finds that young transgender children who have “socially transitioned” — living their lives under the gender they identify with — had positive mental health outcomes.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Crucially important’ research\u003ccite>Dr. Ilana Sherer, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Until now, studies had shown significantly higher rates for depression and anxiety in transgender children. \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf\" target=\"_blank\" rel=\"noopener\">Nearly half attempt suicide \u003c/a>by age 24.\u003c/p>\n\u003cp>Researchers at the University of Washington looked at 73 children ages 3-12 living as their identified gender and compared those children against two control groups — their own siblings and another group. They found average scores for depression and only slightly elevated anxiety rates.\u003c/p>\n\u003cp>“It puts out the possibility that being a transgender child doesn’t have to be associated with negative mental health outcomes in the way that to date the research has suggested,” said \u003ca href=\"https://depts.washington.edu/transyp/people/\" target=\"_blank\" rel=\"noopener\">Kristina Olson\u003c/a>, Ph.D., lead author of the study and director of the university’s TransYouth Project. She hopes to follow these children for 20 years.\u003c/p>\n\u003cp>It is the first analysis of mental health outcomes in a group of socially transitioned transgender children. The study was published in the journal Pediatrics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Parents who had suspected their children might be transgender and began research on their own would find depressing mental health outcomes, until now.\u003c/p>\n\u003cp>“Those felt like terrifying statistics to hold as a parent,” said one mother (who did not want to be identified by name out of concern for her child’s privacy), 42, of Oakland, one of the families in the study. She and her partner have two children, an older girl and a second child, now 6, born as a boy.\u003c/p>\n\u003cp>By age 3 and a half “it became increasingly clear,” she said said, “that there was something going on … that was pulling him into the realm of traditional girliness, and as it continued, it grew in intensity and grew in its consistency.”\u003c/p>\n\u003cp>The intensity of gender identity was true of most kids in the study, “These are kids who are very persistent and insistent about their gender identity,” said Olson, “and those are the only kids that experts working in this area have advised that these social transitions might be useful for.”\u003c/p>\n\u003cp>The mother and her partner began researching on their own and later with experts. While she knew adults who had transitioned, “I had never heard of transgender children. I didn’t know it had the capability of dating back to such early childhood.”\u003c/p>\n\u003cp>Just before his 5th birthday her son asked to be called a girl. The Oakland mother and her partner supported their child’s choice to live as girl. She already had a gender neutral name and began dressing as a girl.\u003c/p>\n\u003cp>“Now having a child who has lived in their identified gender for a year and a half, I have no doubt that we’re making the right decision,” she said, adding that her daughter is well-adjusted at school and is accepted as a girl by her peers.\u003c/p>\n\u003cp>None of the children in the study had any medical or surgical treatments. “No one in the country does medical or surgical interventions with kids this young,” said Olson. Estimates of the rate of transgender children range from 0.3 to 0.8 percent of the population.\u003c/p>\n\u003cp>The group of children Olson is studying, initially 73, has now grown to 153. None has transitioned back. She said her project \u003ca href=\"https://depts.washington.edu/transyp/participate/\" target=\"_blank\" rel=\"noopener\">welcomes additional participants\u003c/a>.\u003c/p>\n\u003cp>In an accompanying editorial, Ilana Sherer a pediatrician and assistant medical director of UC San Francisco’s \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/child_and_adolescent_gender_center/\" target=\"_blank\" rel=\"noopener\">Child and Adolescent Gender Center\u003c/a> called the research “crucially important.”\u003c/p>\n\u003cblockquote>\u003cp>“Olson and her colleagues give supporters of social transition evidence of what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety … up to 3 times higher for non-socially transitioned children.”\u003c/p>\u003c/blockquote>\n\u003cp>For the children in this study, family support appears to be key. But Olson pointed out that it’s a big decision for a family to take the step of supporting a socially-transitioned child, and not all families today are likely to make this decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Probably there are some attributes about the families who have done this that are unique to them,” Olson said. She stressed the need for more research to illuminate whether it’s those “other qualities” or the social transition itself that promotes the positive mental health outcomes seen in this analysis.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>New research finds that young transgender children who have “socially transitioned” — living their lives under the gender they identify with — had positive mental health outcomes.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Crucially important’ research\u003ccite>Dr. Ilana Sherer, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Until now, studies had shown significantly higher rates for depression and anxiety in transgender children. \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf\" target=\"_blank\" rel=\"noopener\">Nearly half attempt suicide \u003c/a>by age 24.\u003c/p>\n\u003cp>Researchers at the University of Washington looked at 73 children ages 3-12 living as their identified gender and compared those children against two control groups — their own siblings and another group. They found average scores for depression and only slightly elevated anxiety rates.\u003c/p>\n\u003cp>“It puts out the possibility that being a transgender child doesn’t have to be associated with negative mental health outcomes in the way that to date the research has suggested,” said \u003ca href=\"https://depts.washington.edu/transyp/people/\" target=\"_blank\" rel=\"noopener\">Kristina Olson\u003c/a>, Ph.D., lead author of the study and director of the university’s TransYouth Project. She hopes to follow these children for 20 years.\u003c/p>\n\u003cp>It is the first analysis of mental health outcomes in a group of socially transitioned transgender children. The study was published in the journal Pediatrics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Parents who had suspected their children might be transgender and began research on their own would find depressing mental health outcomes, until now.\u003c/p>\n\u003cp>“Those felt like terrifying statistics to hold as a parent,” said one mother (who did not want to be identified by name out of concern for her child’s privacy), 42, of Oakland, one of the families in the study. She and her partner have two children, an older girl and a second child, now 6, born as a boy.\u003c/p>\n\u003cp>By age 3 and a half “it became increasingly clear,” she said said, “that there was something going on … that was pulling him into the realm of traditional girliness, and as it continued, it grew in intensity and grew in its consistency.”\u003c/p>\n\u003cp>The intensity of gender identity was true of most kids in the study, “These are kids who are very persistent and insistent about their gender identity,” said Olson, “and those are the only kids that experts working in this area have advised that these social transitions might be useful for.”\u003c/p>\n\u003cp>The mother and her partner began researching on their own and later with experts. While she knew adults who had transitioned, “I had never heard of transgender children. I didn’t know it had the capability of dating back to such early childhood.”\u003c/p>\n\u003cp>Just before his 5th birthday her son asked to be called a girl. The Oakland mother and her partner supported their child’s choice to live as girl. She already had a gender neutral name and began dressing as a girl.\u003c/p>\n\u003cp>“Now having a child who has lived in their identified gender for a year and a half, I have no doubt that we’re making the right decision,” she said, adding that her daughter is well-adjusted at school and is accepted as a girl by her peers.\u003c/p>\n\u003cp>None of the children in the study had any medical or surgical treatments. “No one in the country does medical or surgical interventions with kids this young,” said Olson. Estimates of the rate of transgender children range from 0.3 to 0.8 percent of the population.\u003c/p>\n\u003cp>The group of children Olson is studying, initially 73, has now grown to 153. None has transitioned back. She said her project \u003ca href=\"https://depts.washington.edu/transyp/participate/\" target=\"_blank\" rel=\"noopener\">welcomes additional participants\u003c/a>.\u003c/p>\n\u003cp>In an accompanying editorial, Ilana Sherer a pediatrician and assistant medical director of UC San Francisco’s \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/child_and_adolescent_gender_center/\" target=\"_blank\" rel=\"noopener\">Child and Adolescent Gender Center\u003c/a> called the research “crucially important.”\u003c/p>\n\u003cblockquote>\u003cp>“Olson and her colleagues give supporters of social transition evidence of what we have suspected all along: that socially transitioned children are doing fine, or at least as well as their age-matched peers and siblings. This finding is truly stunning in light of the numerous studies that show depression and anxiety … up to 3 times higher for non-socially transitioned children.”\u003c/p>\u003c/blockquote>\n\u003cp>For the children in this study, family support appears to be key. But Olson pointed out that it’s a big decision for a family to take the step of supporting a socially-transitioned child, and not all families today are likely to make this decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Probably there are some attributes about the families who have done this that are unique to them,” Olson said. She stressed the need for more research to illuminate whether it’s those “other qualities” or the social transition itself that promotes the positive mental health outcomes seen in this analysis.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Rick Doblin on Making Psychedelics Legal and Mainstream",
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"content": "\u003cp>From Silicon Valley to Hollywood, Californians lead the world with big ideas. For the latest installment of our \"\u003ca href=\"http://ww2.kqed.org/news/series/big-think\">Big Think\u003c/a>\" series, we meet Rick Doblin. He heads a nonprofit that sponsors research into the use of LSD and MDMA to treat mental illness. His Big Think?\u003c/p>\n\u003cp>“There should be thousands of psychedelic psychotherapy clinics all over the world.”\u003c/p>\n\u003cp>In the future, Doblin believes anybody with anxiety, depression, marital problems or a fear of snakes could be treated with a drug trip\u003c/p>\n\u003cp>Doblin came of age in the early '70s, right when President Richard Nixon declared America’s war on drugs.\u003c/p>\n\u003cp>“Marijuana! The burning weed with its roots in hell,” says the ominous voiceover in the much-parodied 1930s film, \"Reefer Madness.\" “Smoking the soul-destroying reefer, they find a moment’s pleasure. But at a terrible price: Divorcery! Violence! Murder! Suicide! And the ultimate end of the marijuana addict -- hopeless insanity.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Doblin remembers watching the film as a joke when he was a teenager. But some of the same messages meant to scare young people away from pot in the '30s were recycled in the '70s to create fear around psychedelics.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=sbjHOBJzhb0\u003c/p>\n\u003cp>“In high school I remember thinking drugs like LSD were terribly dangerous and that they would make you crazy,” Doblin says. “The education that I got was that if you took LSD more than a few times, you were going to be certifiably insane.”\u003c/p>\n\u003cp>When Doblin got to college, he tried LSD. A lot of it. And it changed his life. He dropped out of school.\u003c/p>\n\u003cp>“I was way out of balance, overdeveloped intellectually, underdeveloped emotionally and spiritually,” he says.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/235407650\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>He embarked on a crusade to make psychedelics legal in the U.S., and in the mid-1980s started a nonprofit called the \u003ca href=\"http://www.maps.org/\" target=\"_blank\">Multidisciplinary Association of Psychedelic Studies\u003c/a> (MAPS), now based in Santa Cruz, to further research into the benefits of psychedelics.\u003c/p>\n\u003cp>“When I started feeling like this was a tool that could bring me into balance, I realized this was a tool that could bring society back into balance,” he says.\u003c/p>\n\u003cp>Today, his group has permission from the FDA to research new treatments for mental disorders using LSD, a hallucinogenic, and MDMA, commonly known as Ecstacy, or E, which induces feelings of euphoria and empathy. \u003c/p>\n\u003cp>Doblin's group is currently studying the use of MDMA to treat post-traumatic stress disorder (PTSD) among war veterans and social anxiety in autistic adults. It's also studying how LSD can help ease the dying process for the terminally ill.\u003c/p>\n\u003cp>[contextly_sidebar id=\"SBuKcFfcFUl10eaE3jLxypudVQBRJHE9\"]\u003c/p>\n\u003cp>The treatment protocol is highly structured and, Doblin believes, replicable.\u003c/p>\n\u003cp>“It’s a male-female co-therapist team. People are receiving MDMA around 10 in the morning. It goes till 6 at night or so,” he says. “Then people are required to spend the night in the treatment center.”\u003c/p>\n\u003cp>The next day, the patient and therapist talk for hours about the drug trip. They check in every day over the phone for the next month. Doblin says this post-trip therapy is key.\u003c/p>\n\u003cp>“If you don't do that integrative work, then -- like dreams you don't pay attention to -- they fade away and you don't benefit from really learning and growing from them,” he says.\u003c/p>\n\u003cp>Doblin says one that day there will be a network of these psychedelic psychotherapy clinics around the world. And LSD and MDMA will be used to treat a range of anxieties and phobias, even a fear of spiders or fear of flying. Eventually, he says people with no formal diagnosis will be able to try them.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=xmXJo8xeb5c\u003c/p>\n\u003cp>“I believe that these clinics will eventually expand to treat people that have just an interest in personal growth or spiritual experiences or couples therapies,” he says. “Couples therapy is one of the best uses for MDMA.”\u003c/p>\n\u003cp>Plenty of other cultures use psychedelics to promote personal growth. People in Brazil and Peru use ayuhuasca, a plant-based psychedelic brew, for spiritual quests and healing rituals. Native Americans use peyote in religious ceremonies. Doblin says kids and adolescents are sometimes involved. He remembers going to a Navajo wedding where a 9-year-old boy participated.\u003c/p>\n\u003cp>“He stayed up all night. They gave him small doses of peyote,” he says. “These are cultures that have successfully integrated psychedelics. They are good examples of what we can do in a Western culture. They don’t have young people going off and abusing peyote and abusing ayuhuasca.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We need honest drug education, not crude propaganda that kids these days can easily see through.'\u003c/aside>\n\u003cp>That is precisely what critics of Doblin’s work say would happen if he succeeds in opening a network of psychedelic clinics. That would only encourage kids to do drugs and tune out of society, critics say.\u003c/p>\n\u003cp>But Doblin disagrees. He says the prohibition mentality of today’s anti-drug campaigns doesn’t work. He calls public service announcements implying teenagers will end up in the hospital from half a hit of Ecstasy (MDMA), or decline into utter mental instability after trying LSD, exaggerated and dishonest.\u003c/p>\n\u003cp>“These are ridiculous attempts at creating fear. They exaggerate the negative and deny the positive,” he says. “We need honest drug education, not crude propaganda that kids these days can easily see through.”\u003c/p>\n\u003cp>It’s not that Doblin thinks it should be a free-for-all. He says the way kids usually take drugs \u003cem>is\u003c/em> dangerous. Drugs are often impure and people are taking them in unsupportive environments, like dance clubs, surrounded by other people who are high.\u003c/p>\n\u003cp>“If they think they’re doing it only for fun and only for recreational purposes, and something serious comes up, then they’re unprepared for it,” Doblin says.\u003c/p>\n\u003cp>Doblin has three kids, ages 20, 19, and 17. Watching them go through extensive driver's education training has inspired another big idea.\u003c/p>\n\u003cp>“You have to take a course, you have to pass a test. They have to do 10 hours of driving with their parents in the car, all different things,” he says. “So the question is, should there be some similar model like that for young people, for anybody who wants to have legal access to psychedelics.”\u003c/p>\n\u003cp>He says his clinics will be the ideal place where people can get training in how to take psychedelics responsibly.\u003c/p>\n\u003cp>“I would feel more comfortable if people had their first psychedelic experience under supervision, and then they could get a license and buy it and do it on their own,” he says.\u003c/p>\n\u003cp>Under Doblin’s clinical protocol, a three-month course of psychedelic-assisted therapy would include three drug trips and cost about $10,000. He says by the time the therapy gets legalized -- 2021 is the goal -- he believes he will have convinced health insurance companies to pay for it.\u003c/p>\n\u003cp>“Part of the clinical trials is looking not just at the influence of MDMA on PTSD, but we also want to look at health care utilization,” he says. People with PTSD are shown to have more heart attacks and other costly physical health conditions. Doblin believes those costs could be alleviated by effective psychotherapy. And that logic could spill over into off-label uses of the drugs as well.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“A very good economic case can be made that psychedelic-assisted therapy for people looking for personal growth or spiritual experiences, that it’s a part of preventive medicine,” he says. “And insurance companies may start covering that as well.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Doblin remembers watching the film as a joke when he was a teenager. But some of the same messages meant to scare young people away from pot in the '30s were recycled in the '70s to create fear around psychedelics.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/sbjHOBJzhb0'\n title='//www.youtube.com/embed/sbjHOBJzhb0'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>“In high school I remember thinking drugs like LSD were terribly dangerous and that they would make you crazy,” Doblin says. “The education that I got was that if you took LSD more than a few times, you were going to be certifiably insane.”\u003c/p>\n\u003cp>When Doblin got to college, he tried LSD. A lot of it. And it changed his life. He dropped out of school.\u003c/p>\n\u003cp>“I was way out of balance, overdeveloped intellectually, underdeveloped emotionally and spiritually,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/235407650&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/235407650'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He embarked on a crusade to make psychedelics legal in the U.S., and in the mid-1980s started a nonprofit called the \u003ca href=\"http://www.maps.org/\" target=\"_blank\">Multidisciplinary Association of Psychedelic Studies\u003c/a> (MAPS), now based in Santa Cruz, to further research into the benefits of psychedelics.\u003c/p>\n\u003cp>“When I started feeling like this was a tool that could bring me into balance, I realized this was a tool that could bring society back into balance,” he says.\u003c/p>\n\u003cp>Today, his group has permission from the FDA to research new treatments for mental disorders using LSD, a hallucinogenic, and MDMA, commonly known as Ecstacy, or E, which induces feelings of euphoria and empathy. \u003c/p>\n\u003cp>Doblin's group is currently studying the use of MDMA to treat post-traumatic stress disorder (PTSD) among war veterans and social anxiety in autistic adults. It's also studying how LSD can help ease the dying process for the terminally ill.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The treatment protocol is highly structured and, Doblin believes, replicable.\u003c/p>\n\u003cp>“It’s a male-female co-therapist team. People are receiving MDMA around 10 in the morning. It goes till 6 at night or so,” he says. “Then people are required to spend the night in the treatment center.”\u003c/p>\n\u003cp>The next day, the patient and therapist talk for hours about the drug trip. They check in every day over the phone for the next month. Doblin says this post-trip therapy is key.\u003c/p>\n\u003cp>“If you don't do that integrative work, then -- like dreams you don't pay attention to -- they fade away and you don't benefit from really learning and growing from them,” he says.\u003c/p>\n\u003cp>Doblin says one that day there will be a network of these psychedelic psychotherapy clinics around the world. And LSD and MDMA will be used to treat a range of anxieties and phobias, even a fear of spiders or fear of flying. Eventually, he says people with no formal diagnosis will be able to try them.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/xmXJo8xeb5c'\n title='//www.youtube.com/embed/xmXJo8xeb5c'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>“I believe that these clinics will eventually expand to treat people that have just an interest in personal growth or spiritual experiences or couples therapies,” he says. “Couples therapy is one of the best uses for MDMA.”\u003c/p>\n\u003cp>Plenty of other cultures use psychedelics to promote personal growth. People in Brazil and Peru use ayuhuasca, a plant-based psychedelic brew, for spiritual quests and healing rituals. Native Americans use peyote in religious ceremonies. Doblin says kids and adolescents are sometimes involved. He remembers going to a Navajo wedding where a 9-year-old boy participated.\u003c/p>\n\u003cp>“He stayed up all night. They gave him small doses of peyote,” he says. “These are cultures that have successfully integrated psychedelics. They are good examples of what we can do in a Western culture. They don’t have young people going off and abusing peyote and abusing ayuhuasca.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We need honest drug education, not crude propaganda that kids these days can easily see through.'\u003c/aside>\n\u003cp>That is precisely what critics of Doblin’s work say would happen if he succeeds in opening a network of psychedelic clinics. That would only encourage kids to do drugs and tune out of society, critics say.\u003c/p>\n\u003cp>But Doblin disagrees. He says the prohibition mentality of today’s anti-drug campaigns doesn’t work. He calls public service announcements implying teenagers will end up in the hospital from half a hit of Ecstasy (MDMA), or decline into utter mental instability after trying LSD, exaggerated and dishonest.\u003c/p>\n\u003cp>“These are ridiculous attempts at creating fear. They exaggerate the negative and deny the positive,” he says. “We need honest drug education, not crude propaganda that kids these days can easily see through.”\u003c/p>\n\u003cp>It’s not that Doblin thinks it should be a free-for-all. He says the way kids usually take drugs \u003cem>is\u003c/em> dangerous. Drugs are often impure and people are taking them in unsupportive environments, like dance clubs, surrounded by other people who are high.\u003c/p>\n\u003cp>“If they think they’re doing it only for fun and only for recreational purposes, and something serious comes up, then they’re unprepared for it,” Doblin says.\u003c/p>\n\u003cp>Doblin has three kids, ages 20, 19, and 17. Watching them go through extensive driver's education training has inspired another big idea.\u003c/p>\n\u003cp>“You have to take a course, you have to pass a test. They have to do 10 hours of driving with their parents in the car, all different things,” he says. “So the question is, should there be some similar model like that for young people, for anybody who wants to have legal access to psychedelics.”\u003c/p>\n\u003cp>He says his clinics will be the ideal place where people can get training in how to take psychedelics responsibly.\u003c/p>\n\u003cp>“I would feel more comfortable if people had their first psychedelic experience under supervision, and then they could get a license and buy it and do it on their own,” he says.\u003c/p>\n\u003cp>Under Doblin’s clinical protocol, a three-month course of psychedelic-assisted therapy would include three drug trips and cost about $10,000. He says by the time the therapy gets legalized -- 2021 is the goal -- he believes he will have convinced health insurance companies to pay for it.\u003c/p>\n\u003cp>“Part of the clinical trials is looking not just at the influence of MDMA on PTSD, but we also want to look at health care utilization,” he says. People with PTSD are shown to have more heart attacks and other costly physical health conditions. Doblin believes those costs could be alleviated by effective psychotherapy. And that logic could spill over into off-label uses of the drugs as well.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“A very good economic case can be made that psychedelic-assisted therapy for people looking for personal growth or spiritual experiences, that it’s a part of preventive medicine,” he says. “And insurance companies may start covering that as well.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Nevada to Pay San Francisco $400,000 Over Psychiatric 'Patient Dumping'",
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"content": "\u003cp>San Francisco supervisors accepted a $400,000 payment from Nevada on Tuesday, settling a two-year dispute over allegations that psychiatric patients were wrongly shipped to California upon discharge.\u003c/p>\n\u003cp>The settlement approved by the board also requires Nevada to provide transport back to California only for patients who are returning to a home address or a treatment facility in the state. San Francisco's city attorney released details of the confidential settlement shortly after the vote.\u003c/p>\n\u003cp>The city sued Nevada in September 2013 after the \u003ca href=\"http://ww2.kqed.org/news/2013/04/24/the-hunt-is-on-for-1500-psychiatric-patients-a-nev/\" target=\"_blank\">Sacramento Bee published accounts\u003c/a> of patients who were discharged from the state-run Rawson-Neal Psychiatric Hospital in Las Vegas, and given bus tickets to California cities for further care.\u003c/p>\n\u003cp>San Francisco City Attorney Dennis Herrera said two dozen people with no prior connection to the city had been bused here over a five-year period, and 20 needed medical care shortly after they arrived. In many cases, they were sent to California without sufficient food, water or medication.\u003c/p>\n\u003cp>[contextly_sidebar id=\"c4div4KcG23twFpQnVFMXW6xiCx9QbF2\"]\u003c/p>\n\u003cp>He said at the time that the practice \"punishes jurisdictions for providing health and human services that others won't provide.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a statement Tuesday, Herrera said he was pleased his office had reached an agreement with Nevada.\u003c/p>\n\u003cp>The Nevada Board of Examiners approved the settlement earlier this month.\u003c/p>\n\u003cp>In the months immediately after the newspaper's investigation, Nevada health officials said they improved policies to better care for discharged patients at their destination. Several employees were fired.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The agreement requires a second board vote, which is expected, as well as court approval.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco supervisors accepted a $400,000 payment from Nevada on Tuesday, settling a two-year dispute over allegations that psychiatric patients were wrongly shipped to California upon discharge.\u003c/p>\n\u003cp>The settlement approved by the board also requires Nevada to provide transport back to California only for patients who are returning to a home address or a treatment facility in the state. San Francisco's city attorney released details of the confidential settlement shortly after the vote.\u003c/p>\n\u003cp>The city sued Nevada in September 2013 after the \u003ca href=\"http://ww2.kqed.org/news/2013/04/24/the-hunt-is-on-for-1500-psychiatric-patients-a-nev/\" target=\"_blank\">Sacramento Bee published accounts\u003c/a> of patients who were discharged from the state-run Rawson-Neal Psychiatric Hospital in Las Vegas, and given bus tickets to California cities for further care.\u003c/p>\n\u003cp>San Francisco City Attorney Dennis Herrera said two dozen people with no prior connection to the city had been bused here over a five-year period, and 20 needed medical care shortly after they arrived. In many cases, they were sent to California without sufficient food, water or medication.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He said at the time that the practice \"punishes jurisdictions for providing health and human services that others won't provide.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a statement Tuesday, Herrera said he was pleased his office had reached an agreement with Nevada.\u003c/p>\n\u003cp>The Nevada Board of Examiners approved the settlement earlier this month.\u003c/p>\n\u003cp>In the months immediately after the newspaper's investigation, Nevada health officials said they improved policies to better care for discharged patients at their destination. Several employees were fired.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The agreement requires a second board vote, which is expected, as well as court approval.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Violence and Healing at Napa State Hospital: A Tale of 2 Families",
"title": "Violence and Healing at Napa State Hospital: A Tale of 2 Families",
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"content": "\u003cp>At California's five state psychiatric hospitals, patients are mostly criminal defendants found not guilty by reason of insanity or incompetent to stand trial. They've been sent to these institutions for psychiatric care. But sometimes the patients can be violent.\u003c/p>\n\u003cp>Five years ago this week, a \u003ca href=\"http://napavalleyregister.com/news/local/police-employee-at-psychiatric-hospital-killed-patient-arrested/article_c6428892-dfac-11df-805a-001cc4c03286.html\" target=\"_blank\">staff member was murdered\u003c/a> by a patient at Napa State Hospital. In the time since, the hospital has tried to improve safety. While the majority of patients are not violent, sometimes those who are target not just staff, but other patients as well.\u003c/p>\n\u003cp>Although it's rare for members of the media to gain access to the hospital, I was invited by Frank and Barbara Brackin to join them in visiting their 45-year-old son, Shawn, who has been a patient at Napa State for nearly 20 years. I met up with Shawn's parents in the parking lot.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/229804825\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>\"Sometimes he says he can't sleep when he's expecting a visit because he's so excited,\" Barbara Brackin tells me as we walk to the hospital's front door.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Our main concern now is for Shawn's safety,\" her husband says. \"He was not given the death sentence, (but) he's almost had it twice in the past three years,\" Frank adds, in reference to assaults Shawn has suffered at the hospital.\u003c/p>\n\u003cfigure id=\"attachment_96504\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-96504\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/ShawnWithDog-800x643.jpg\" alt=\"Shawn Brackin during junior high school in 1983.\" width=\"800\" height=\"643\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWithDog.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWithDog-400x322.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Shawn Brackin during junior high school in 1983. \u003ccite>(Courtesy Brackin Family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After passing through a number of locked gates and surrendering our driver's licenses, we pass through several locked doors and then a metal detector, where we also surrender our cellphones and wallets.\u003c/p>\n\u003cp>At last, we're ushered into a tiny room to visit with Shawn Brackin.\u003c/p>\n\u003cp>\"I'm glad to see you,\" he says, shuffling toward us with difficulty. He's wearing a blue helmet to protect his head in case he falls -- which happens somewhat frequently -- or is pushed.\u003c/p>\n\u003cp>Shawn wasn't always in this condition, his parents had explained to me earlier. His life took a bad turn at age 6, when he was struck by a car and had a severe head injury. That accident began a slow descent that ended in tragedy.\u003c/p>\n\u003cp>After graduating from high school, Shawn became increasingly depressed and withdrawn. In 1995, he took a small gun and walked into a local police station.\u003c/p>\n\u003cp>Frank Brackin says that was an attempt at \"suicide by cop.\"\u003c/p>\n\u003cp>\"He was wanting to die,\" Frank Brackin says. \"And so he put himself before the firing squad, and he had no idea the firing squad would turn on themselves.\"\u003c/p>\n\u003cp>On that day, when he was 25 years old, Shawn was shot by police but survived. In the mayhem, an officer shot and killed another cop.\u003c/p>\n\u003cp>Shawn Brackin was charged with six felonies. As part of a plea deal, he was found \"not guilty by reason of insanity.\" And that plea -- with its diagnosis of mental illness -- is what led him to Napa State Hospital.\u003c/p>\n\u003cp>\"We had no choice, really,\" Shawn's father says. \"We wanted to protect him and make sure he had a safe environment. We thought a hospital would be a safe environment.\"\u003c/p>\n\u003cfigure id=\"attachment_96499\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-96499 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/ShawnBrackinICU-800x757.jpg\" alt=\"Napa State Hospital patient Shawn Brackin spent 17 days in the ICU at UC San Francisco Medical Center after being severely beaten by a fellow patient in 2014.\" width=\"800\" height=\"757\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-800x757.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-400x378.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-1440x1362.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-1180x1116.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-960x908.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Napa State Hospital patient Shawn Brackin spent 17 days in the ICU at UCSF Medical Center after being severely beaten by a fellow patient in 2014. \u003ccite>(Courtesy Brackin Family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But over the years, Shawn Brackin has been assaulted by several patients. Last year he suffered a particularly brutal assault when a patient turned on him.\u003c/p>\n\u003cp>\"And he slammed Shawn into the wall so hard that it buried his head into the wall and left hair in the wall,\" Frank Brackin says. \"And then he hit him. And then Shawn hit that concrete floor.\"\u003c/p>\n\u003cp>Shawn needed emergency brain surgery. He was left with severe disabilities.\u003c/p>\n\u003cp>The day I visited Shawn, his hair was damp from sweat. It was a hot day in Napa, and the tiny room had no air conditioning or ventilation. I ask him if feels he's gotten well while at the hospital, if he thinks he's better off for having been sent there.\u003c/p>\n\u003cp>\"I'm better off,\" he says. \"I'm pretty good right now.\"\u003c/p>\n\u003cp>But his mother says things are not good. Before he entered the state hospital system, Shawn was able to drive and hold a job, Barbara Brackin says.\u003c/p>\n\u003cp>\"He interacted with the family, laughed and joked, played cards. And he was the Uno champ,\" she says, and laughs. \"Nobody else could usually beat him.\"\u003c/p>\n\u003cp>Toward the end of our 45-minute visit, Frank Brackin reads a Bible verse, and then they say their goodbyes.\u003c/p>\n\u003cfigure id=\"attachment_96507\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-96507\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/ShawnWFamily-800x568.jpg\" alt=\"Shawn Brackin (top middle) celebrating Christmas with his family at Napa State Hospital in December, 2011.\" width=\"800\" height=\"568\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWFamily.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWFamily-400x284.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Shawn Brackin (top middle) celebrating Christmas with his family at Napa State Hospital in December 2011. \u003ccite>(Courtesy Brackin Family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"We'll visit you again on Sunday, Shawn,\" Frank says. \"We'll have time to play some cards if you want. I love you. You're my main man, you know?\u003c/p>\n\u003cp>\"Yes sir,\" Shawn says.\u003c/p>\n\u003cp>The latest assault on Shawn Brackin was just one of 1,800 at Napa State Hospital last year. To be fair, most of those assaults are very minor.\u003c/p>\n\u003cp>While the Brackins don't dismiss what their son did 20 years ago in that police station, they feel he's had to pay too high a price and have filed a lawsuit against the hospital, alleging negligence in failing to keep their son safe.\u003c/p>\n\u003cp>Napa has made many changes since psychiatric technician \u003ca href=\"http://napavalleyregister.com/news/local/police-employee-at-psychiatric-hospital-killed-patient-arrested/article_c6428892-dfac-11df-805a-001cc4c03286.html\" target=\"_blank\">Donna Gross was murdered by a patient \u003c/a>five years ago, but mostly \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/19/five-years-after-brutal-murder-napa-hospital-seeks-to-balance-treatment-with-security/\" target=\"_blank\">those changes\u003c/a> are intended to protect staff. While a new law took effect in July that will allow the hospital to isolate the most dangerous patients, hospital Executive Director Dolly Matteucci says more needs to be done.\u003c/p>\n\u003cp>\"We have made tremendous progress in safety improvements and in mitigating violence at the hospital,\" she tells me. \"But sadly it continues to be a part of our environment and our shared experience as patients and employees. And it is unacceptable.\"\u003c/p>\n\u003cfigure id=\"attachment_96512\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-96512 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/DollyM-800x573.jpg\" alt=\"Dolly Matteucci became executive director of Napa State Hospital after Donna Gross's murder. She stands in a conference room decorated with paintings created by psychiatric patients.\" width=\"800\" height=\"573\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-800x573.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-400x286.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-1440x1031.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-1180x845.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-960x688.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dolly Matteucci became executive director of Napa State Hospital after the killing of Donna Gross. She stands in a conference room decorated with paintings created by psychiatric patients. \u003ccite>(Scott Shafer/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Not all families are critical of Napa. Many say they enjoy the visits with their loved ones -- who they say are finally getting the kind of treatment they should have gotten before the tragedy that sent them there happened.\u003c/p>\n\u003cp>Candace and Hans -- they’ve asked that we just use their first names to protect their privacy -- say their son has been at Napa for 3½ years. At their request, we’re not using his name.\u003c/p>\n\u003cp>I met with them in their home in Alameda, where Hans showed me his son's high school trophies from basketball and football.\u003c/p>\n\u003cp>\"He loved fishing, so we have pictures of him catching a 32-pound salmon,\" says Hans.\u003c/p>\n\u003cp>[contextly_sidebar id=\"z3MoWy1s3a0uaqzle3WibjbVXxDDGFT2\"]\u003c/p>\n\u003cp>Candace says that when their son was in high school, he started changing.\u003c/p>\n\u003cp>\"He couldn't organize his homework. He couldn't turn in assignments,\" she says. \"And he was becoming very quiet around the house, and also talked about feeling spirits and things around him.\"\u003c/p>\n\u003cp>It was the early signs of schizophrenia. The symptoms got worse, and his behavior escalated. Hans and Candace were so worried their son would hurt himself or someone else that they had him confined against his will.\u003c/p>\n\u003cp>\"When police come into the house and handcuff your kid and take him out of the house, in the same house he grew up in sprawled across the floor, it's quite an experience,\" she says.\u003c/p>\n\u003cp>They called the police many times, but authorities could not hold him indefinitely, so he was always released. Candace and Hans tried repeatedly to get their son psychiatric help, but as an adult he had the right to refuse treatment.\u003c/p>\n\u003cp>Finally, in 2012 while suffering delusions, their son killed someone in the Berkeley Hills.\u003c/p>\n\u003cp>He was found not guilty by reason of insanity and sent to Napa State Hospital, where his mother says he is slowly getting better.\u003c/p>\n\u003cp>\"It has taken this long to see real results of recovery,\" she says, \"in little bits and pieces along the way. It was only because of the sustained treatment we had through Napa.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Despite the complaints and problems at California’s state mental hospitals, there’s\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/19/five-years-after-brutal-murder-napa-hospital-seeks-to-balance-treatment-with-security/\" target=\"_blank\"> a long waiting list \u003c/a>to get into them -- and many of those waiting spend their time in jail.\u003c/p>\n\n",
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"excerpt": "For one family, a son's safety was compromised in an attack at the psychiatric facility. For another, a son has begun recovering from violent schizophrenia.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>At California's five state psychiatric hospitals, patients are mostly criminal defendants found not guilty by reason of insanity or incompetent to stand trial. They've been sent to these institutions for psychiatric care. But sometimes the patients can be violent.\u003c/p>\n\u003cp>Five years ago this week, a \u003ca href=\"http://napavalleyregister.com/news/local/police-employee-at-psychiatric-hospital-killed-patient-arrested/article_c6428892-dfac-11df-805a-001cc4c03286.html\" target=\"_blank\">staff member was murdered\u003c/a> by a patient at Napa State Hospital. In the time since, the hospital has tried to improve safety. While the majority of patients are not violent, sometimes those who are target not just staff, but other patients as well.\u003c/p>\n\u003cp>Although it's rare for members of the media to gain access to the hospital, I was invited by Frank and Barbara Brackin to join them in visiting their 45-year-old son, Shawn, who has been a patient at Napa State for nearly 20 years. I met up with Shawn's parents in the parking lot.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/229804825&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/229804825'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Sometimes he says he can't sleep when he's expecting a visit because he's so excited,\" Barbara Brackin tells me as we walk to the hospital's front door.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Our main concern now is for Shawn's safety,\" her husband says. \"He was not given the death sentence, (but) he's almost had it twice in the past three years,\" Frank adds, in reference to assaults Shawn has suffered at the hospital.\u003c/p>\n\u003cfigure id=\"attachment_96504\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-96504\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/ShawnWithDog-800x643.jpg\" alt=\"Shawn Brackin during junior high school in 1983.\" width=\"800\" height=\"643\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWithDog.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWithDog-400x322.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Shawn Brackin during junior high school in 1983. \u003ccite>(Courtesy Brackin Family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After passing through a number of locked gates and surrendering our driver's licenses, we pass through several locked doors and then a metal detector, where we also surrender our cellphones and wallets.\u003c/p>\n\u003cp>At last, we're ushered into a tiny room to visit with Shawn Brackin.\u003c/p>\n\u003cp>\"I'm glad to see you,\" he says, shuffling toward us with difficulty. He's wearing a blue helmet to protect his head in case he falls -- which happens somewhat frequently -- or is pushed.\u003c/p>\n\u003cp>Shawn wasn't always in this condition, his parents had explained to me earlier. His life took a bad turn at age 6, when he was struck by a car and had a severe head injury. That accident began a slow descent that ended in tragedy.\u003c/p>\n\u003cp>After graduating from high school, Shawn became increasingly depressed and withdrawn. In 1995, he took a small gun and walked into a local police station.\u003c/p>\n\u003cp>Frank Brackin says that was an attempt at \"suicide by cop.\"\u003c/p>\n\u003cp>\"He was wanting to die,\" Frank Brackin says. \"And so he put himself before the firing squad, and he had no idea the firing squad would turn on themselves.\"\u003c/p>\n\u003cp>On that day, when he was 25 years old, Shawn was shot by police but survived. In the mayhem, an officer shot and killed another cop.\u003c/p>\n\u003cp>Shawn Brackin was charged with six felonies. As part of a plea deal, he was found \"not guilty by reason of insanity.\" And that plea -- with its diagnosis of mental illness -- is what led him to Napa State Hospital.\u003c/p>\n\u003cp>\"We had no choice, really,\" Shawn's father says. \"We wanted to protect him and make sure he had a safe environment. We thought a hospital would be a safe environment.\"\u003c/p>\n\u003cfigure id=\"attachment_96499\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-96499 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/ShawnBrackinICU-800x757.jpg\" alt=\"Napa State Hospital patient Shawn Brackin spent 17 days in the ICU at UC San Francisco Medical Center after being severely beaten by a fellow patient in 2014.\" width=\"800\" height=\"757\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-800x757.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-400x378.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-1440x1362.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-1180x1116.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnBrackinICU-960x908.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Napa State Hospital patient Shawn Brackin spent 17 days in the ICU at UCSF Medical Center after being severely beaten by a fellow patient in 2014. \u003ccite>(Courtesy Brackin Family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But over the years, Shawn Brackin has been assaulted by several patients. Last year he suffered a particularly brutal assault when a patient turned on him.\u003c/p>\n\u003cp>\"And he slammed Shawn into the wall so hard that it buried his head into the wall and left hair in the wall,\" Frank Brackin says. \"And then he hit him. And then Shawn hit that concrete floor.\"\u003c/p>\n\u003cp>Shawn needed emergency brain surgery. He was left with severe disabilities.\u003c/p>\n\u003cp>The day I visited Shawn, his hair was damp from sweat. It was a hot day in Napa, and the tiny room had no air conditioning or ventilation. I ask him if feels he's gotten well while at the hospital, if he thinks he's better off for having been sent there.\u003c/p>\n\u003cp>\"I'm better off,\" he says. \"I'm pretty good right now.\"\u003c/p>\n\u003cp>But his mother says things are not good. Before he entered the state hospital system, Shawn was able to drive and hold a job, Barbara Brackin says.\u003c/p>\n\u003cp>\"He interacted with the family, laughed and joked, played cards. And he was the Uno champ,\" she says, and laughs. \"Nobody else could usually beat him.\"\u003c/p>\n\u003cp>Toward the end of our 45-minute visit, Frank Brackin reads a Bible verse, and then they say their goodbyes.\u003c/p>\n\u003cfigure id=\"attachment_96507\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-96507\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/ShawnWFamily-800x568.jpg\" alt=\"Shawn Brackin (top middle) celebrating Christmas with his family at Napa State Hospital in December, 2011.\" width=\"800\" height=\"568\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWFamily.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/ShawnWFamily-400x284.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Shawn Brackin (top middle) celebrating Christmas with his family at Napa State Hospital in December 2011. \u003ccite>(Courtesy Brackin Family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"We'll visit you again on Sunday, Shawn,\" Frank says. \"We'll have time to play some cards if you want. I love you. You're my main man, you know?\u003c/p>\n\u003cp>\"Yes sir,\" Shawn says.\u003c/p>\n\u003cp>The latest assault on Shawn Brackin was just one of 1,800 at Napa State Hospital last year. To be fair, most of those assaults are very minor.\u003c/p>\n\u003cp>While the Brackins don't dismiss what their son did 20 years ago in that police station, they feel he's had to pay too high a price and have filed a lawsuit against the hospital, alleging negligence in failing to keep their son safe.\u003c/p>\n\u003cp>Napa has made many changes since psychiatric technician \u003ca href=\"http://napavalleyregister.com/news/local/police-employee-at-psychiatric-hospital-killed-patient-arrested/article_c6428892-dfac-11df-805a-001cc4c03286.html\" target=\"_blank\">Donna Gross was murdered by a patient \u003c/a>five years ago, but mostly \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/19/five-years-after-brutal-murder-napa-hospital-seeks-to-balance-treatment-with-security/\" target=\"_blank\">those changes\u003c/a> are intended to protect staff. While a new law took effect in July that will allow the hospital to isolate the most dangerous patients, hospital Executive Director Dolly Matteucci says more needs to be done.\u003c/p>\n\u003cp>\"We have made tremendous progress in safety improvements and in mitigating violence at the hospital,\" she tells me. \"But sadly it continues to be a part of our environment and our shared experience as patients and employees. And it is unacceptable.\"\u003c/p>\n\u003cfigure id=\"attachment_96512\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-96512 size-medium\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/DollyM-800x573.jpg\" alt=\"Dolly Matteucci became executive director of Napa State Hospital after Donna Gross's murder. She stands in a conference room decorated with paintings created by psychiatric patients.\" width=\"800\" height=\"573\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-800x573.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-400x286.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-1440x1031.jpg 1440w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-1180x845.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/DollyM-960x688.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dolly Matteucci became executive director of Napa State Hospital after the killing of Donna Gross. She stands in a conference room decorated with paintings created by psychiatric patients. \u003ccite>(Scott Shafer/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Not all families are critical of Napa. Many say they enjoy the visits with their loved ones -- who they say are finally getting the kind of treatment they should have gotten before the tragedy that sent them there happened.\u003c/p>\n\u003cp>Candace and Hans -- they’ve asked that we just use their first names to protect their privacy -- say their son has been at Napa for 3½ years. At their request, we’re not using his name.\u003c/p>\n\u003cp>I met with them in their home in Alameda, where Hans showed me his son's high school trophies from basketball and football.\u003c/p>\n\u003cp>\"He loved fishing, so we have pictures of him catching a 32-pound salmon,\" says Hans.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Candace says that when their son was in high school, he started changing.\u003c/p>\n\u003cp>\"He couldn't organize his homework. He couldn't turn in assignments,\" she says. \"And he was becoming very quiet around the house, and also talked about feeling spirits and things around him.\"\u003c/p>\n\u003cp>It was the early signs of schizophrenia. The symptoms got worse, and his behavior escalated. Hans and Candace were so worried their son would hurt himself or someone else that they had him confined against his will.\u003c/p>\n\u003cp>\"When police come into the house and handcuff your kid and take him out of the house, in the same house he grew up in sprawled across the floor, it's quite an experience,\" she says.\u003c/p>\n\u003cp>They called the police many times, but authorities could not hold him indefinitely, so he was always released. Candace and Hans tried repeatedly to get their son psychiatric help, but as an adult he had the right to refuse treatment.\u003c/p>\n\u003cp>Finally, in 2012 while suffering delusions, their son killed someone in the Berkeley Hills.\u003c/p>\n\u003cp>He was found not guilty by reason of insanity and sent to Napa State Hospital, where his mother says he is slowly getting better.\u003c/p>\n\u003cp>\"It has taken this long to see real results of recovery,\" she says, \"in little bits and pieces along the way. It was only because of the sustained treatment we had through Napa.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Despite the complaints and problems at California’s state mental hospitals, there’s\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/19/five-years-after-brutal-murder-napa-hospital-seeks-to-balance-treatment-with-security/\" target=\"_blank\"> a long waiting list \u003c/a>to get into them -- and many of those waiting spend their time in jail.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In 2010, Rodney Bock was arrested for carrying a loaded gun into a restaurant in Yuba City, north of Sacramento. Bock had severe mental illness and was later found incompetent to stand trial. He was released on bail, but was rearrested after he failed to appear at a court hearing.\u003c/p>\n\u003cp>Bock, 56, was placed in the Sutter County jail, awaiting transfer to a state hospital. While there, he began suffering hallucinations. After more than two weeks in jail, Bock hanged himself.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Jail is simply too dangerous a place for these most vulnerable defendants.'\u003cbr>\n\u003ccite>Micaela Davis, ACLU attorney\u003c/cite>\u003c/aside>\n\u003cp>Mentally ill defendants declared incompetent to stand trial, as Bock was, are supposed to be transferred to state mental hospitals for treatment within two or three months. But more than 300 of them statewide are languishing in county jails because there’s simply no bed space.\u003c/p>\n\u003cp>Bock's daughters are now plaintiffs in \u003ca href=\"https://www.aclunc.org/news/aclu-sues-state-hospital-system-failing-mentally-ill-developmentally-disabled-criminal\" target=\"_blank\">a lawsuit\u003c/a> filed by the American Civil Liberties Union, charging two state agencies, including the Department of State Hospitals, with denying mentally ill inmates their right to due process -- and the treatment they need.\u003c/p>\n\u003cp>\"Jail is simply too dangerous a place for these most vulnerable defendants,\" said Micaela Davis, lead attorney in the lawsuit. \"We have inmates that are waiting eight, nine months and sometimes over a year before being transferred to a facility for treatment.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/229285297\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>California's new state budget includes more than $17 million to add beds for defendants declared incompetent to stand trial. But not everyone agrees that's the best approach.\u003c/p>\n\u003cp>Stephen Manley is a mental health court judge in Santa Clara County. His court helps defendants struggling with severe mental illnesses, including bipolar disorder or schizophrenia, find alternatives to incarceration.\u003c/p>\n\u003cp>Manley doesn't want more psychiatric hospital beds; he wants to reserve state hospitals for the most violent defendants.\u003c/p>\n\u003cp>\u003ci>\"\u003c/i>We send far too many people to state hospitals who do not pose a risk to public safety,\" he says. \"Because we don’t work with them to figure out if there isn’t a local alternative.\"\u003c/p>\n\u003cp>Manley believes the psychiatric hospitals are already overcrowded -- and understaffed. \"As long as we keep overcrowding the hospitals, all we do is feed the fire,\" he says, referring to violence within the hospitals.\u003c/p>\n\u003cp>There were more than 1,800 physical assaults at Napa State Hospital last year alone. Hospital officials say patients who are there to have their sanity restored for trial inflict the most serious injuries.\u003c/p>\n\u003cp>[contextly_sidebar id=\"666xBwWJElI4zsw4g0a4Y9yXz6yonNLT\"]Ryan Navarre, with the organization representing Napa Hospital police, says that even officers are at risk. He recalled one patient specifically who put rocks into his socks and then spun them around \"violently,\" he said.\u003c/p>\n\u003cp>State psychiatric hospitals continue \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/19/five-years-after-brutal-murder-napa-hospital-seeks-to-balance-treatment-with-security/\" target=\"_blank\">working to find a balance \u003c/a>between treatment and security for patients and staff.\u003c/p>\n\u003cp>Meanwhile, Manley thinks the best solution for nonviolent offenders is to create more community-based treatment facilities.\u003c/p>\n\u003cp>\"If we add another 500 beds people to a state hospital, all we do is make the problem worse,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But funding is already inadequate for mental health treatment. And creating more community-based programs raises new challenges -- including resistance from neighbors who don’t really want to live near facilities whose clients are mentally ill criminal defendants.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In 2010, Rodney Bock was arrested for carrying a loaded gun into a restaurant in Yuba City, north of Sacramento. Bock had severe mental illness and was later found incompetent to stand trial. He was released on bail, but was rearrested after he failed to appear at a court hearing.\u003c/p>\n\u003cp>Bock, 56, was placed in the Sutter County jail, awaiting transfer to a state hospital. While there, he began suffering hallucinations. After more than two weeks in jail, Bock hanged himself.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Jail is simply too dangerous a place for these most vulnerable defendants.'\u003cbr>\n\u003ccite>Micaela Davis, ACLU attorney\u003c/cite>\u003c/aside>\n\u003cp>Mentally ill defendants declared incompetent to stand trial, as Bock was, are supposed to be transferred to state mental hospitals for treatment within two or three months. But more than 300 of them statewide are languishing in county jails because there’s simply no bed space.\u003c/p>\n\u003cp>Bock's daughters are now plaintiffs in \u003ca href=\"https://www.aclunc.org/news/aclu-sues-state-hospital-system-failing-mentally-ill-developmentally-disabled-criminal\" target=\"_blank\">a lawsuit\u003c/a> filed by the American Civil Liberties Union, charging two state agencies, including the Department of State Hospitals, with denying mentally ill inmates their right to due process -- and the treatment they need.\u003c/p>\n\u003cp>\"Jail is simply too dangerous a place for these most vulnerable defendants,\" said Micaela Davis, lead attorney in the lawsuit. \"We have inmates that are waiting eight, nine months and sometimes over a year before being transferred to a facility for treatment.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/229285297&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/229285297'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>California's new state budget includes more than $17 million to add beds for defendants declared incompetent to stand trial. But not everyone agrees that's the best approach.\u003c/p>\n\u003cp>Stephen Manley is a mental health court judge in Santa Clara County. His court helps defendants struggling with severe mental illnesses, including bipolar disorder or schizophrenia, find alternatives to incarceration.\u003c/p>\n\u003cp>Manley doesn't want more psychiatric hospital beds; he wants to reserve state hospitals for the most violent defendants.\u003c/p>\n\u003cp>\u003ci>\"\u003c/i>We send far too many people to state hospitals who do not pose a risk to public safety,\" he says. \"Because we don’t work with them to figure out if there isn’t a local alternative.\"\u003c/p>\n\u003cp>Manley believes the psychiatric hospitals are already overcrowded -- and understaffed. \"As long as we keep overcrowding the hospitals, all we do is feed the fire,\" he says, referring to violence within the hospitals.\u003c/p>\n\u003cp>There were more than 1,800 physical assaults at Napa State Hospital last year alone. Hospital officials say patients who are there to have their sanity restored for trial inflict the most serious injuries.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Ryan Navarre, with the organization representing Napa Hospital police, says that even officers are at risk. He recalled one patient specifically who put rocks into his socks and then spun them around \"violently,\" he said.\u003c/p>\n\u003cp>State psychiatric hospitals continue \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/10/19/five-years-after-brutal-murder-napa-hospital-seeks-to-balance-treatment-with-security/\" target=\"_blank\">working to find a balance \u003c/a>between treatment and security for patients and staff.\u003c/p>\n\u003cp>Meanwhile, Manley thinks the best solution for nonviolent offenders is to create more community-based treatment facilities.\u003c/p>\n\u003cp>\"If we add another 500 beds people to a state hospital, all we do is make the problem worse,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But funding is already inadequate for mental health treatment. And creating more community-based programs raises new challenges -- including resistance from neighbors who don’t really want to live near facilities whose clients are mentally ill criminal defendants.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Hundreds of criminal defendants declared incompetent to stand trial are sitting in county jails around the state awaiting transfer to state facilities for mental health treatment. By law, these defendants must receive treatment within 35 days. But an ACLU lawsuit filed against the state says many vulnerable inmates languish in jail, sometimes for as long as a year.\u003c/p>\n\u003cp>“Jail is simply too dangerous a place for these most vulnerable defendants,\" says Micaela Davis, one of the ACLU’s lead attorneys in this \u003ca href=\"https://www.aclunc.org/sites/default/files/20150729-complaint.pdf\" target=\"_blank\">lawsuit\u003c/a>.\u003c/p>\n\u003cp>“Oftentimes these incompetent defendants don't have the ability to follow rules, they get confused,” Davis says. “This can result in them being subject to disciplinary sanctions, or result in them being confined to solitary confinement, which only exacerbates their mental health condition.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/218932430\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>And, Davis says inmates with developmental disabilities can become targets. That's what happened to the son of one plaintiff, Nancy Leiva. Mentally disabled, he was held in Los Angeles County jail for eight months, waiting for a court-ordered transfer to a state facility.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“During that time he was raped multiple times by another inmate,” Davis says. “Of course he suffered severe mental health consequences from that and still suffers today.”\u003c/p>\n\u003cp>Another inmate, Rodney Bock, committed suicide at Sutter County Jail before he could be transferred to \u003ca href=\"http://www.dsh.ca.gov/napa/\" target=\"_blank\">Napa State Hospital\u003c/a>. Sutter County paid his family $800,000 to settle a separate lawsuit. But his children joined the new suit in hopes of preventing other families from experiencing what they have.\u003c/p>\n\u003cp>The burden of these delays falls to local sheriffs, who run county jails. Cory Salzillo, legislative director of the \u003ca href=\"https://www.calsheriffs.org/\" target=\"_blank\">California State Sheriffs' Association\u003c/a>, says his group is working closely with the state to speed up the process so prisoners aren't stuck in jail.\u003c/p>\n\u003cfigure id=\"attachment_74314\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/08/CfakepathLAJailCellblock2085.jpg\">\u003cimg class=\"size-full wp-image-74314\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/08/CfakepathLAJailCellblock2085.jpg\" alt=\"Getty Images\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Getty Images\u003c/figcaption>\u003c/figure>\n\u003cp>“You know they take up bed space when they could be moving through the system,” Salzillo says. “It slows down proceedings, so it exacerbates court backups. While they're waiting for a bed they decompensate oftentimes, so their mental condition gets worse.”\u003c/p>\n\u003cp>The two state agencies sued by the ACLU declined KQED’s interview requests. But in written statements, the \u003ca href=\"http://www.dsh.ca.gov/\" target=\"_blank\">Department of State Hospitals\u003c/a> and the \u003ca href=\"http://www.dds.ca.gov/\" target=\"_blank\">Department of Developmental Services\u003c/a> wrote that hundreds of beds are being added for patients needing restoration of mental competency so they can stand trial. They also note the state budget included funding for mental health programs in county jails and in the community.\u003c/p>\n\u003cp>Dan Mistak of a \u003ca href=\"http://cochs.org/\" target=\"_blank\">nonprofit in Oakland\u003c/a> that works with jails to develop community-based health service says the lack of treatment beds dates back decades, to when California began deinstitutionalizing mentally ill people.\u003c/p>\n\u003cp>“There hasn't been a social safety net for these folks and what's happened is the jail has actually stepped in in order to make up for essentially what's been a lack of these services everywhere else,” Mistak noted.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The ACLU hopes this lawsuit will lead to quicker assessments and treatment so justice can be served in a more timely way.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Hundreds of criminal defendants declared incompetent to stand trial are sitting in county jails around the state awaiting transfer to state facilities for mental health treatment. By law, these defendants must receive treatment within 35 days. But an ACLU lawsuit filed against the state says many vulnerable inmates languish in jail, sometimes for as long as a year.\u003c/p>\n\u003cp>“Jail is simply too dangerous a place for these most vulnerable defendants,\" says Micaela Davis, one of the ACLU’s lead attorneys in this \u003ca href=\"https://www.aclunc.org/sites/default/files/20150729-complaint.pdf\" target=\"_blank\">lawsuit\u003c/a>.\u003c/p>\n\u003cp>“Oftentimes these incompetent defendants don't have the ability to follow rules, they get confused,” Davis says. “This can result in them being subject to disciplinary sanctions, or result in them being confined to solitary confinement, which only exacerbates their mental health condition.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/218932430&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/218932430'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And, Davis says inmates with developmental disabilities can become targets. That's what happened to the son of one plaintiff, Nancy Leiva. Mentally disabled, he was held in Los Angeles County jail for eight months, waiting for a court-ordered transfer to a state facility.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“During that time he was raped multiple times by another inmate,” Davis says. “Of course he suffered severe mental health consequences from that and still suffers today.”\u003c/p>\n\u003cp>Another inmate, Rodney Bock, committed suicide at Sutter County Jail before he could be transferred to \u003ca href=\"http://www.dsh.ca.gov/napa/\" target=\"_blank\">Napa State Hospital\u003c/a>. Sutter County paid his family $800,000 to settle a separate lawsuit. But his children joined the new suit in hopes of preventing other families from experiencing what they have.\u003c/p>\n\u003cp>The burden of these delays falls to local sheriffs, who run county jails. Cory Salzillo, legislative director of the \u003ca href=\"https://www.calsheriffs.org/\" target=\"_blank\">California State Sheriffs' Association\u003c/a>, says his group is working closely with the state to speed up the process so prisoners aren't stuck in jail.\u003c/p>\n\u003cfigure id=\"attachment_74314\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/08/CfakepathLAJailCellblock2085.jpg\">\u003cimg class=\"size-full wp-image-74314\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2012/08/CfakepathLAJailCellblock2085.jpg\" alt=\"Getty Images\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Getty Images\u003c/figcaption>\u003c/figure>\n\u003cp>“You know they take up bed space when they could be moving through the system,” Salzillo says. “It slows down proceedings, so it exacerbates court backups. While they're waiting for a bed they decompensate oftentimes, so their mental condition gets worse.”\u003c/p>\n\u003cp>The two state agencies sued by the ACLU declined KQED’s interview requests. But in written statements, the \u003ca href=\"http://www.dsh.ca.gov/\" target=\"_blank\">Department of State Hospitals\u003c/a> and the \u003ca href=\"http://www.dds.ca.gov/\" target=\"_blank\">Department of Developmental Services\u003c/a> wrote that hundreds of beds are being added for patients needing restoration of mental competency so they can stand trial. They also note the state budget included funding for mental health programs in county jails and in the community.\u003c/p>\n\u003cp>Dan Mistak of a \u003ca href=\"http://cochs.org/\" target=\"_blank\">nonprofit in Oakland\u003c/a> that works with jails to develop community-based health service says the lack of treatment beds dates back decades, to when California began deinstitutionalizing mentally ill people.\u003c/p>\n\u003cp>“There hasn't been a social safety net for these folks and what's happened is the jail has actually stepped in in order to make up for essentially what's been a lack of these services everywhere else,” Mistak noted.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The ACLU hopes this lawsuit will lead to quicker assessments and treatment so justice can be served in a more timely way.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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},
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
},
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"how-i-built-this": {
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"hyphenacion": {
"id": "hyphenacion",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
},
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
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