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"content": "\u003cfigure id=\"attachment_20865\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11514_IMG_0176-hpf.jpg\">\u003cimg class=\"size-full wp-image-20865\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/08/RS11514_IMG_0176-hpf.jpg\" alt=\"A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11514_IMG_0176-hpf.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11514_IMG_0176-hpf-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2014/08/RS11514_IMG_0176-hpf-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Small\u003c/strong>\u003c/p>\n\u003cp>The number of inmates with mild to severe mental illness has grown to 37,000 in California, about a quarter of the prison population.\u003c/p>\n\u003cp>A series of lawsuits brought by inmates against the state over the last two decades has exposed a correctional system poorly equipped to handle their extraordinary needs.\u003c/p>\n\u003cp>Now California is trying to comply with a federal court order to change when and how correctional officers use pepper spray to force uncooperative inmates to leave their cells or follow orders.\u003c/p>\n\u003cp>Pepper spray may have contributed to three inmate deaths and an unknown number of injuries -- unknown because the California Department of Corrections and Rehabilitations doesn’t consider the effects of pepper spray an injury.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The issue was brought to light last year through graphic videos shown in court in a lawsuit that was begun in 1990, a lawsuit brought by inmates to improve psychiatric care.\u003c/p>\n\u003cp>Prisons record some use of force incidents, according to department policy.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/a-day-in-californias-psychiatric-prison-units/\" target=\"_blank\">A Day in California's Psychiatric Prison Units\u003c/a>]\u003c/p>\n\u003cp>One video showed custody staff at Corcoran State Prison struggling to remove an inmate who was hallucinating and refusing to leave his cell in order to receive medication.\u003c/p>\n\u003cp>The inmate had taken off his clothes and smeared feces on himself. When he refused to submit to handcuffs, guards in gas masks sprayed a potent pepper spray into the cell, causing the inmate to gasp for air.\u003c/p>\n\u003cp>The video showed that as the inmate screamed for help, an officer ordered him to “turn around and cuff up.”\u003c/p>\n\u003cp>The inmate screamed back, “Open the door!”\u003c/p>\n\u003cp>When the inmate still wouldn't “cuff up” the officers sprayed him again, repeatedly.\u003c/p>\n\u003cp>Later, the video showed guards rushing in and wrestling the inmate to the floor and into restraints.\u003c/p>\n\u003cp>“He has described this as making him feel like less than an animal,” said Lori Rifkin, an attorney for inmate Jermaine Padilla, who is suing the Department of Corrections.\u003c/p>\n\u003cp>Rifkin says two years on, her client still has flashbacks and nightmares from the process prison officials refer to as a “cell extraction.”\u003c/p>\n\u003cp>Padilla believes the experience at Corcoran worsened his schizophrenia and bi-polar disorder and has permanently damaged him.\u003c/p>\n\u003cp>“It changed something in him,” Rifkin says. “He’d never been treated that badly, and it broke something in him.”\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/163303802&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>The Padilla video, and five others shown last fall, were the latest revelation in a long history of problems with mental health care in California prisons that have prompted federal court intervention.\u003c/p>\n\u003cp>U.S. District Judge Lawrence Karlton called the video evidence “horrific.” In April, he ordered new restrictions on the use of force. He banned the use of pepper spray on mentally ill inmates in cells and psychiatric holding facilities with few exceptions. He instructed prison officials whenever possible to defer to clinicians about whether to use force.\u003c/p>\n\u003cp>On August 1st, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/01/california-prisons-to-restrict-pepper-spray-segregation-of-mentally-ill-inmates/\" target=\"_blank\">the judge signed of\u003c/a>f on the Department of Corrections’ reform plan.\u003c/p>\n\u003cp>Among the changes: prison staff will be trained to collaborate and to exhaust every reasonable alternative to force.\u003c/p>\n\u003cp>Craig Brown, a lobbyist for the California Correctional Peace Officers Association agrees with this approach. “The critical element is to appropriately train our members to recognize what they’re dealing with,” Brown said.\u003c/p>\n\u003cp>Brown says the union has been pushing for better training for years. He says additional training will help them interact with the growing percentage of mentally ill inmates.\u003c/p>\n\u003cp>“They’ll recognize what’s going on,\" Brown said. \"They’ll know when they need to talk to a mental health professional. They know when they don’t.\"\u003c/p>\n\u003cp>The state department of corrections declined to be interviewed for this story. They referred KQED to their plan filed with the court.\u003c/p>\n\u003cp>Under that plan a mental health clinician must be called in to evaluate an inmate’s mental status to determine whether they’re able to understand directions. This evaluation now must happen before officers can proceed with use of force. If a clinician decides force shouldn’t be used, correctional officers can no longer override that decision. Instead, the conflict will be referred to senior management to resolve.\u003c/p>\n\u003cp>Dr. Alan Abrams says the state’s plan reinforces the values and strategies he used when he was the chief psychiatrist at the California Medical Facility in Vacaville. Abrams, who left the post a couple years ago, says staff at most prisons already collaborate well.\u003c/p>\n\u003cp>Abrams believes the problem is that there have been a limited number of ways to handle violent inmates.\u003c/p>\n\u003cp>“One (inmate) is brutalizing another,\" he explained. \"Yes, they’re labeled mentally ill, but you need to stop the violence very quickly. It’s not a discussion.”\u003c/p>\n\u003cp>In his 12 years working in prisons Abrams says he ordered force numerous times to keep inmates from killing each other or themselves.\u003c/p>\n\u003cp>“What do you do about the inmate who’s in their cell with a t-shirt, in a noose, saying they’re going to kill themselves unless you release them from prison?” says Abrams, “You’re not going to watch him hang himself. You’re not going to release him from prison, and so you say to your custody co-workers ‘You better get them down!’”\u003c/p>\n\u003cp>But Terry Kupers, a national expert on correctional mental health believes the pepper-spraying incidents indicate inadequate mental health care in the prisons. He says prisons can and should mitigate conditions that exacerbate mental illness.\u003c/p>\n\u003cp>“The pepper spray, the cell extractions, the beatings, the violence among prisoners--all those constitute reenactments of trauma in people who were previously traumatized and make them more emotionally disabled,” Kupers said.\u003c/p>\n\u003cp>California prison officials believe they will have fully implemented the reforms by the end of this year. But they’re still negotiating another critical change to how mentally ill inmates are managed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Judge Karlton wants a proposal by next week that will restrict how often and for how long prisons can house inmates with mental disorders in segregation units -- where their illnesses can and do worsen.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The issue was brought to light last year through graphic videos shown in court in a lawsuit that was begun in 1990, a lawsuit brought by inmates to improve psychiatric care.\u003c/p>\n\u003cp>Prisons record some use of force incidents, according to department policy.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/08/18/a-day-in-californias-psychiatric-prison-units/\" target=\"_blank\">A Day in California's Psychiatric Prison Units\u003c/a>]\u003c/p>\n\u003cp>One video showed custody staff at Corcoran State Prison struggling to remove an inmate who was hallucinating and refusing to leave his cell in order to receive medication.\u003c/p>\n\u003cp>The inmate had taken off his clothes and smeared feces on himself. When he refused to submit to handcuffs, guards in gas masks sprayed a potent pepper spray into the cell, causing the inmate to gasp for air.\u003c/p>\n\u003cp>The video showed that as the inmate screamed for help, an officer ordered him to “turn around and cuff up.”\u003c/p>\n\u003cp>The inmate screamed back, “Open the door!”\u003c/p>\n\u003cp>When the inmate still wouldn't “cuff up” the officers sprayed him again, repeatedly.\u003c/p>\n\u003cp>Later, the video showed guards rushing in and wrestling the inmate to the floor and into restraints.\u003c/p>\n\u003cp>“He has described this as making him feel like less than an animal,” said Lori Rifkin, an attorney for inmate Jermaine Padilla, who is suing the Department of Corrections.\u003c/p>\n\u003cp>Rifkin says two years on, her client still has flashbacks and nightmares from the process prison officials refer to as a “cell extraction.”\u003c/p>\n\u003cp>Padilla believes the experience at Corcoran worsened his schizophrenia and bi-polar disorder and has permanently damaged him.\u003c/p>\n\u003cp>“It changed something in him,” Rifkin says. “He’d never been treated that badly, and it broke something in him.”\u003c/p>\n\u003cp>\u003ciframe width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/163303802&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\">\u003c/iframe>\u003c/p>\n\u003cp>The Padilla video, and five others shown last fall, were the latest revelation in a long history of problems with mental health care in California prisons that have prompted federal court intervention.\u003c/p>\n\u003cp>U.S. District Judge Lawrence Karlton called the video evidence “horrific.” In April, he ordered new restrictions on the use of force. 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"content": "\u003cfigure id=\"attachment_144561\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/08/RS11447_134732889-lpr-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-144561\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/08/RS11447_134732889-lpr-1-640x454.jpg\" alt=\"Robin Williams, pictured in 2004. (Ryan Pierse/Getty Images)\" width=\"640\" height=\"454\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Robin Williams, pictured in 2004. (Ryan Pierse/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>How much do you \u003cem>want\u003c/em> to know about how Robin Williams died? How much do you \u003cem>need\u003c/em> to know about it? What \u003cem>should\u003c/em> you know about it? When does releasing the details of a death, even a celebrity’s death, threaten to breach the boundaries of decency, violate privacy and even pose a public health risk?\u003c/p>\n\u003cp>I ask because of the reaction in the KQED newsroom Tuesday as Lt. Keith Boyd, Marin County’s assistant chief deputy coroner, delivered his description of Williams’ death in a nationally televised press conference. Boyd disclosed that Williams’ body was discovered in a bedroom of his Tiburon home by his personal assistant late Monday morning. Then he offered some explicit details about the condition of Williams’ body when it was found:\u003c/p>\n\u003cblockquote>\u003cp>… Mr. Williams [was] clothed in a seated position, unresponsive, and with a belt secured around his neck with the other end of the belt wedged between the closed closet door and door frame. His right shoulder area was touching the door with his body was perpendicular to the door and slightly suspended.\u003c/p>\n\u003cp>Mr. Williams was cool to the touch with rigor mortis present in all of his extremities and livor mortis positioned appropriately for the position he was located in. …\u003c/p>\u003c/blockquote>\n\u003cp>(\u003ca href=\"http://www.iupui.edu/~pathol/autopsy/main/10/10.htm\" target=\"_blank\" rel=\"noopener\">Rigor mortis\u003c/a> refers to a body’s temporary rigidity after death. \u003ca href=\"http://www.iupui.edu/~pathol/autopsy/main/11/11.htm\" target=\"_blank\" rel=\"noopener\">Livor mortis \u003c/a>describes the discoloration that occurs as blood pools in a body after death.)\u003c/p>\n\u003caside class=\"pullquote alignleft\">You can thank us, the media pursuing the public’s right to know, for disclosure of the circumstances surrounding the death of Robin Williams.\u003c/aside>\n\u003cp>After Boyd read his statement, some here in the newsroom (and far beyond, to judge from comments on Twitter) said they were disturbed, even shocked, to hear the graphic description of Wiliams’ postmortem physical condition. The general feeling from the comments I heard was that publicizing the details was a sort of violation. It was an intrusion into a personal tragedy that by right only those closest to the dead should share. And it exposed the awful particulars of the deceased’s last moments to a luridly curious media and public. Some raised the possibility that disclosing details of the death scene might lead to copycat suicides.\u003c/p>\n\u003cp>On the other side, a few folks said, first, that the information the coroner provided would come out in any case, and second, that the Marin County authorities might be trying to head off the inevitable sensational speculation about the circumstances of Williams’ death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>I called Boyd Wednesday to ask what factors guided the decision by the sheriff’s office to include what some have deemed graphic details of Williams’ death. His answer was simple: “We are just following the law.” The law in question is the \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=gov&group=06001-07000&file=6250-6270\" target=\"_blank\" rel=\"noopener\">California Public Records Act\u003c/a>, which requires local agencies to disclose most of the records they keep, including coroner’s records (One significant exception is photographs. It takes a court order to get pictures that medical examiners may have taken as part of their postmortem investigations).\u003c/p>\n\u003cp>I asked Boyd whether the details released Tuesday would be disclosed in any case his office handled. “Mr. Williams’ case is not like any other case,” Boyd said. “I wouldn’t have gotten the PRA requests I’ve gotten for this case.”\u003c/p>\n\u003cp>You can thank us, the media pursuing the public’s right to know, for all those requests. And you can thank us in advance, too, for the further details on Williams’ death that will emerge as the coroner’s office completes its forensic investigation. Among other things, media organizations have already requested recordings and transcripts of the 911 call that alerted authorities to Williams’ death late Monday morning.\u003c/p>\n\u003cp>[contextly_sidebar id=”jPbOvUtyUMdV34Raq5SbNhU5rNtPZGwP”]\u003c/p>\n\u003cp>For my part, I do indeed believe in the public’s right to know. I think in general we’re a little too ready to protect our audiences from what we judge to be the unpleasant details of the violence in which our culture sometimes seems to be immersed, whether that violence be our wars, violent crime or, yes, suicide. I believe in the value of the public discussion that may follow full and honest disclosure, even disclosure of someone else’s awful personal tragedy.\u003c/p>\n\u003cp>But how we handle such disclosures can make all the difference. It’s \u003ca href=\"http://www.nytimes.com/1987/03/18/nyregion/pattern-of-death-copycat-suicides-among-youths.html\" target=\"_blank\" rel=\"noopener\">long been accepted\u003c/a> among suicide researchers and social scientists that copycat suicides are a real thing. There’s \u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0007252\" target=\"_blank\" rel=\"noopener\">a growing body of evidence\u003c/a> that media reporting on suicides can prompt more suicides. \u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0055000\" target=\"_blank\" rel=\"noopener\">One recent study\u003c/a> looked at what happened when media reported on a novel method of suicide in Taiwan in the late 1990s: asphyxiation brought about by lighting a charcoal fire indoors. The findings suggest that intense media attention on such episodes triggered an immediate spike in similar suicide attempts. By 2010, “charcoal burning suicide” had became the second most common method of taking one’s life in Taiwan (after hanging).\u003c/p>\n\u003cp>In response to growing attention to news media’s potential role in sparking copycat suicide episodes, suicide researchers, mental health experts and media partners have come up with a set of guidelines on how to treat the subject: \u003ca href=\"http://reportingonsuicide.org/\" target=\"_blank\" rel=\"noopener\">Recommendations for Reporting on Suicide\u003c/a>.\u003c/p>\n\u003cp>The recommendations seek to get media to emphasize the mental health and public health implications of suicide and to remove sensationalism from suicide coverage. For instance.\u003c/p>\n\u003cblockquote>\u003cp>Instead of this: Big or sensationalistic headlines, or prominent placement (e.g., “Kurt Cobain Used Shotgun to Commit Suicide”), do this: Inform the audience without sensationalizing the suicide and minimize prominence (e.g., “Kurt Cobain Dead at 27”).\u003c/p>\u003c/blockquote>\n\u003cp>The specific mention of \u003ca href=\"http://www.biography.com/people/kurt-cobain-9542179#synopsis\" target=\"_blank\" rel=\"noopener\">Kurt Cobain\u003c/a> in the recommendations is kind of interesting. Cobain, the guitarist/singer/songwriter for Seattle’s Nirvana, used a shotgun to kill himself in 1994. David A. Jobes, a prominent suicide researcher, studied Cobain’s death and the popular reaction to it. As \u003ca href=\"http://www.seattleweekly.com/home/951542-129/happens-every-day-the-suicide-of\" target=\"_blank\" rel=\"noopener\">recounted by Cobain biographer Charles R. Cross\u003c/a> in the Seattle Weekly earlier this year, the aftermath was different from what Jobes anticipated:\u003c/p>\n\u003cblockquote>\u003cp>[Jobes] was actually attending an international convention of suicide researchers that week; he heard the news sitting in a bar discussing trends in the field when a breaking news report came across the television in the background. “It was the headline story,” Jobes told me, “and I was with a guy from the CDC, and our jaws just dropped. ‘This is going to be bad,’ we said. We thought there was going to be an epidemic.”\u003c/p>\n\u003cp>Jobes’ extensive study found the opposite occurred. The \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/8897665\" target=\"_blank\" rel=\"noopener\">paper he published\u003c/a> speculates several reasons: “The lack of an apparent copycat effect in Seattle may be due to various aspects of the media coverage, the method used in Cobain’s suicide, and the crisis center and community outreach interventions that occurred.” Jobes says another key was outreach by the medical community in the previous year to establish a protocol for suicide coverage, urging media outlets to include suicide resources in their reports. Kurt’s death “was the first time where articles appeared with little boxes that listed hotline numbers, signs of depression, and places to get help,” Jobes said. He says Kurt’s death was something of an “outlier of a celebrity suicide in that it arguably led to reporting that did some good.”\u003c/p>\u003c/blockquote>\n\u003cp>So, that’s the challenge — “reporting that will do some good,” despite the distressing details. One gesture in that direction, as mentioned by one of my colleagues: recognition that suicide is a national public health crisis.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdc.gov/nchs/data/dvs/2011_Final_Mortality_Data_Release.pdf\" target=\"_blank\" rel=\"noopener\">According to the federal Centers for Disease Control and Prevention\u003c/a>, 39,518 people took their lives in the United States in 2011, the most recent year for which data are available. That’s a toll 2½ times the number of homicides during the same year.\u003c/p>\n\u003cp>As stark as that number seems — nearly 109 suicides per day, on average, with the nationwide incidence of suicide growing each year — it conceals the actual dimensions of the crisis. The CDC also \u003ca href=\"http://www.cdc.gov/violenceprevention/pdf/suicide_datasheet-a.pdf\" target=\"_blank\" rel=\"noopener\">estimate\u003c/a>s that in 2010, there were 25 attempted suicides for every one that succeeded — 1 million attempts all across the United States in a single year. Two million people said they had made plans to kill themselves. Eight million said they had experienced suicidal thoughts.\u003c/p>\n\u003cp>It’s natural to look for a message in Robin Williams’ suicide. I’m not sure there is one beyond the staggering realization that even those who look like they have everything can experience such blinding despair that they are driven to take their own lives.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The message in the larger context: Realize the dimensions of the crisis that’s taking so many lives, and pay attention and be ready to help those in your life when they tell you they’re in crisis.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_144561\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/08/RS11447_134732889-lpr-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-144561\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/08/RS11447_134732889-lpr-1-640x454.jpg\" alt=\"Robin Williams, pictured in 2004. (Ryan Pierse/Getty Images)\" width=\"640\" height=\"454\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Robin Williams, pictured in 2004. (Ryan Pierse/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>How much do you \u003cem>want\u003c/em> to know about how Robin Williams died? How much do you \u003cem>need\u003c/em> to know about it? What \u003cem>should\u003c/em> you know about it? When does releasing the details of a death, even a celebrity’s death, threaten to breach the boundaries of decency, violate privacy and even pose a public health risk?\u003c/p>\n\u003cp>I ask because of the reaction in the KQED newsroom Tuesday as Lt. Keith Boyd, Marin County’s assistant chief deputy coroner, delivered his description of Williams’ death in a nationally televised press conference. Boyd disclosed that Williams’ body was discovered in a bedroom of his Tiburon home by his personal assistant late Monday morning. Then he offered some explicit details about the condition of Williams’ body when it was found:\u003c/p>\n\u003cblockquote>\u003cp>… Mr. Williams [was] clothed in a seated position, unresponsive, and with a belt secured around his neck with the other end of the belt wedged between the closed closet door and door frame. His right shoulder area was touching the door with his body was perpendicular to the door and slightly suspended.\u003c/p>\n\u003cp>Mr. Williams was cool to the touch with rigor mortis present in all of his extremities and livor mortis positioned appropriately for the position he was located in. …\u003c/p>\u003c/blockquote>\n\u003cp>(\u003ca href=\"http://www.iupui.edu/~pathol/autopsy/main/10/10.htm\" target=\"_blank\" rel=\"noopener\">Rigor mortis\u003c/a> refers to a body’s temporary rigidity after death. \u003ca href=\"http://www.iupui.edu/~pathol/autopsy/main/11/11.htm\" target=\"_blank\" rel=\"noopener\">Livor mortis \u003c/a>describes the discoloration that occurs as blood pools in a body after death.)\u003c/p>\n\u003caside class=\"pullquote alignleft\">You can thank us, the media pursuing the public’s right to know, for disclosure of the circumstances surrounding the death of Robin Williams.\u003c/aside>\n\u003cp>After Boyd read his statement, some here in the newsroom (and far beyond, to judge from comments on Twitter) said they were disturbed, even shocked, to hear the graphic description of Wiliams’ postmortem physical condition. The general feeling from the comments I heard was that publicizing the details was a sort of violation. It was an intrusion into a personal tragedy that by right only those closest to the dead should share. And it exposed the awful particulars of the deceased’s last moments to a luridly curious media and public. Some raised the possibility that disclosing details of the death scene might lead to copycat suicides.\u003c/p>\n\u003cp>On the other side, a few folks said, first, that the information the coroner provided would come out in any case, and second, that the Marin County authorities might be trying to head off the inevitable sensational speculation about the circumstances of Williams’ death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>I called Boyd Wednesday to ask what factors guided the decision by the sheriff’s office to include what some have deemed graphic details of Williams’ death. His answer was simple: “We are just following the law.” The law in question is the \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=gov&group=06001-07000&file=6250-6270\" target=\"_blank\" rel=\"noopener\">California Public Records Act\u003c/a>, which requires local agencies to disclose most of the records they keep, including coroner’s records (One significant exception is photographs. It takes a court order to get pictures that medical examiners may have taken as part of their postmortem investigations).\u003c/p>\n\u003cp>I asked Boyd whether the details released Tuesday would be disclosed in any case his office handled. “Mr. Williams’ case is not like any other case,” Boyd said. “I wouldn’t have gotten the PRA requests I’ve gotten for this case.”\u003c/p>\n\u003cp>You can thank us, the media pursuing the public’s right to know, for all those requests. And you can thank us in advance, too, for the further details on Williams’ death that will emerge as the coroner’s office completes its forensic investigation. Among other things, media organizations have already requested recordings and transcripts of the 911 call that alerted authorities to Williams’ death late Monday morning.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>For my part, I do indeed believe in the public’s right to know. I think in general we’re a little too ready to protect our audiences from what we judge to be the unpleasant details of the violence in which our culture sometimes seems to be immersed, whether that violence be our wars, violent crime or, yes, suicide. I believe in the value of the public discussion that may follow full and honest disclosure, even disclosure of someone else’s awful personal tragedy.\u003c/p>\n\u003cp>But how we handle such disclosures can make all the difference. It’s \u003ca href=\"http://www.nytimes.com/1987/03/18/nyregion/pattern-of-death-copycat-suicides-among-youths.html\" target=\"_blank\" rel=\"noopener\">long been accepted\u003c/a> among suicide researchers and social scientists that copycat suicides are a real thing. There’s \u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0007252\" target=\"_blank\" rel=\"noopener\">a growing body of evidence\u003c/a> that media reporting on suicides can prompt more suicides. \u003ca href=\"http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0055000\" target=\"_blank\" rel=\"noopener\">One recent study\u003c/a> looked at what happened when media reported on a novel method of suicide in Taiwan in the late 1990s: asphyxiation brought about by lighting a charcoal fire indoors. The findings suggest that intense media attention on such episodes triggered an immediate spike in similar suicide attempts. By 2010, “charcoal burning suicide” had became the second most common method of taking one’s life in Taiwan (after hanging).\u003c/p>\n\u003cp>In response to growing attention to news media’s potential role in sparking copycat suicide episodes, suicide researchers, mental health experts and media partners have come up with a set of guidelines on how to treat the subject: \u003ca href=\"http://reportingonsuicide.org/\" target=\"_blank\" rel=\"noopener\">Recommendations for Reporting on Suicide\u003c/a>.\u003c/p>\n\u003cp>The recommendations seek to get media to emphasize the mental health and public health implications of suicide and to remove sensationalism from suicide coverage. For instance.\u003c/p>\n\u003cblockquote>\u003cp>Instead of this: Big or sensationalistic headlines, or prominent placement (e.g., “Kurt Cobain Used Shotgun to Commit Suicide”), do this: Inform the audience without sensationalizing the suicide and minimize prominence (e.g., “Kurt Cobain Dead at 27”).\u003c/p>\u003c/blockquote>\n\u003cp>The specific mention of \u003ca href=\"http://www.biography.com/people/kurt-cobain-9542179#synopsis\" target=\"_blank\" rel=\"noopener\">Kurt Cobain\u003c/a> in the recommendations is kind of interesting. Cobain, the guitarist/singer/songwriter for Seattle’s Nirvana, used a shotgun to kill himself in 1994. David A. Jobes, a prominent suicide researcher, studied Cobain’s death and the popular reaction to it. As \u003ca href=\"http://www.seattleweekly.com/home/951542-129/happens-every-day-the-suicide-of\" target=\"_blank\" rel=\"noopener\">recounted by Cobain biographer Charles R. Cross\u003c/a> in the Seattle Weekly earlier this year, the aftermath was different from what Jobes anticipated:\u003c/p>\n\u003cblockquote>\u003cp>[Jobes] was actually attending an international convention of suicide researchers that week; he heard the news sitting in a bar discussing trends in the field when a breaking news report came across the television in the background. “It was the headline story,” Jobes told me, “and I was with a guy from the CDC, and our jaws just dropped. ‘This is going to be bad,’ we said. We thought there was going to be an epidemic.”\u003c/p>\n\u003cp>Jobes’ extensive study found the opposite occurred. The \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/8897665\" target=\"_blank\" rel=\"noopener\">paper he published\u003c/a> speculates several reasons: “The lack of an apparent copycat effect in Seattle may be due to various aspects of the media coverage, the method used in Cobain’s suicide, and the crisis center and community outreach interventions that occurred.” Jobes says another key was outreach by the medical community in the previous year to establish a protocol for suicide coverage, urging media outlets to include suicide resources in their reports. Kurt’s death “was the first time where articles appeared with little boxes that listed hotline numbers, signs of depression, and places to get help,” Jobes said. He says Kurt’s death was something of an “outlier of a celebrity suicide in that it arguably led to reporting that did some good.”\u003c/p>\u003c/blockquote>\n\u003cp>So, that’s the challenge — “reporting that will do some good,” despite the distressing details. One gesture in that direction, as mentioned by one of my colleagues: recognition that suicide is a national public health crisis.\u003c/p>\n\u003cp>\u003ca href=\"http://www.cdc.gov/nchs/data/dvs/2011_Final_Mortality_Data_Release.pdf\" target=\"_blank\" rel=\"noopener\">According to the federal Centers for Disease Control and Prevention\u003c/a>, 39,518 people took their lives in the United States in 2011, the most recent year for which data are available. That’s a toll 2½ times the number of homicides during the same year.\u003c/p>\n\u003cp>As stark as that number seems — nearly 109 suicides per day, on average, with the nationwide incidence of suicide growing each year — it conceals the actual dimensions of the crisis. The CDC also \u003ca href=\"http://www.cdc.gov/violenceprevention/pdf/suicide_datasheet-a.pdf\" target=\"_blank\" rel=\"noopener\">estimate\u003c/a>s that in 2010, there were 25 attempted suicides for every one that succeeded — 1 million attempts all across the United States in a single year. Two million people said they had made plans to kill themselves. Eight million said they had experienced suicidal thoughts.\u003c/p>\n\u003cp>It’s natural to look for a message in Robin Williams’ suicide. I’m not sure there is one beyond the staggering realization that even those who look like they have everything can experience such blinding despair that they are driven to take their own lives.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The message in the larger context: Realize the dimensions of the crisis that’s taking so many lives, and pay attention and be ready to help those in your life when they tell you they’re in crisis.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv class=\"audio-wrap\">\n\u003ch2>Listen:\u003c/h2>\n\u003cp>http://www.kqed.org/.stream/anon/radio/science/2014/08/20140804science.mp3\u003c/p>\n\u003c/div>\n\u003cp>The first sign of trouble, says Veronica, was when her daughter’s grades started to slip. At 15, Jasmin had been an honor roll student in her San Diego middle school. Suddenly, it was a strain even to sit through class.\u003c/p>\n\u003cp>“She would come home from school exhausted,” Veronica recalls. “She’d go to a corner in the living room and just sit there, away from everybody.” (Veronica asked us not to use her family’s last name, because Jasmin is still a minor.)\u003c/p>\n\u003cfigure id=\"attachment_20190\" class=\"wp-caption aligncenter\" style=\"max-width: 2721px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1068-e1406926256788.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20190\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1068-e1406926256788.jpg\" alt=\"Jasmin heads out to the beach in San Diego on a windy day, to fly a kite. (Marvi Lacar/KQED)\" width=\"2721\" height=\"2617\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">At 15, Jasmin was intensely sensitive to noise and light; her grades dropped. Some psychiatrists believe she was experiencing early symptoms of psychosis. (Marvi Lacar/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>What Jasmin remembers from that time is an acute sensitivity to sound and light. She wore dark sunglasses around the house and asked her family to turn the music down.\u003c/p>\n\u003cp>“It wasn’t a headache or anything, it would just bother me,” Jasmin recalls.\u003c/p>\n\u003cp>Within months, she had declined to the point where she couldn’t go to school, couldn’t eat without assistance.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘It feels like your child is not there. She’s looking at you, but she’s not comprehending who you are, where she is.’\u003c/aside>\n\u003cp>“It feels like your child is not there,” Veronica says. “She’s looking at you, but she’s not comprehending who you are, where she is.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Eventually, Jasmin recovered from her catatonic state, but only after things got much worse: a diagnosis of psychosis, a brief hospitalization and powerful anti-psychotic drugs that caused a 40-pound weight gain over three months.\u003c/p>\n\u003cp>Could the worst of it have been avoided had doctors paid closer attention to Jasmin’s earliest symptoms, particularly her sudden problems with schoolwork and her sensitivity to noise and bright lights?\u003c/p>\n\u003cp>A new generation of schizophrenia researchers believes these struggles may be some of the earliest symptoms of schizophrenia, symptoms of a cognitive decline that may precede, even cause the delusions and hallucinations the disease is famous for. \u003c/p>\n\u003cp>\u003cstrong>A Mysterious Disease\u003c/strong>\u003c/p>\n\u003cp>Schizophrenia is twice as common as Alzheimer’s disease, but almost nothing is known about how it works in the body. As with most other mental illnesses, there’s no blood test for schizophrenia, no scan that can diagnose it.\u003c/p>\n\u003cp>Instead, schizophrenia is defined by symptoms patients describe about themselves, particularly a blurring of the boundaries of reality.\u003c/p>\n\u003cp>A patient may hear strange, often threatening voices that no one else can hear. She may believe she is being spied on through her television, that she is telepathic, or that newspaper articles contain hidden messages directed at her alone.\u003c/p>\n\u003cp>These strange behaviors – hallucinations and delusions — have defined the disease since it was first formally described in 1950. The word “schizophrenia” means, literally, “split mind”: a division between what the patient believes is real and what most other people would agree is real.\u003c/p>\n\u003cp>Society’s preoccupation with hallucinations and delusions is easy to understand, says Sophia Vinogradov, a psychiatrist and researcher at the San Francisco VA hospital.\u003c/p>\n\u003cfigure id=\"attachment_20239\" class=\"wp-caption alignright\" style=\"max-width: 369px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/schiz-graphic.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-20239\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/schiz-graphic.png\" alt=\"(David Pierce/KQED)\" width=\"369\" height=\"790\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Pierce/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“They’re right there, in your face,” Vinogradov says. “And they’re frightening. They’re frightening for the person who has them and they’re frightening for society.”\u003c/p>\n\u003cp>She says that’s why anti-psychotic drugs, which were developed in the 1960s, seemed like such a breakthrough. Until then, nothing else had worked to help people with schizophrenia.“Up until that point we had wrapping them in wet towels, locking them in a padded cell,” Vinogradov says. “Frontal lobotomies if the behavior was really out of control. I mean, what did we have? So when antipsychotic medications did evolve, and they did reduce psychotic symptoms, it was like the heavens had opened.”\u003c/p>\n\u003cp>But the drugs came with powerful side effects. They left some people virtually comatose. Even the modern versions can cause serious weight gain. That’s one reason people with schizophrenia are at least twice as likely to die of cardiovascular disease.\u003c/p>\n\u003cp>And in recent years, scientists have begun asking whether the voices are better viewed as a symptom of something else, says Vikaas Sohal, a researcher at UCSF.\u003c/p>\n\u003cp>“If someone came to you with cancer and said, ‘My back is hurting, my gums bleed, I’m tired, I have headaches,'” Sohal says, “okay, there’s all these things, but that’s not what cancer is. Cancer is this group of cells that are dividing uncontrollably.”\u003c/p>\n\u003cp>In other words, giving antipsychotics to a person with schizophrenia may be like giving painkillers to someone with cancer. It might help, but it’s not getting at the cause.\u003c/p>\n\u003cp>\u003cstrong>Cognitive Decline as the First Sign of Disease \u003c/strong>\u003c/p>\n\u003cp>Basic cognitive problems may precede hallucinations and delusions by a decade or more.\u003c/p>\n\u003cp>Elaine Walker, a professor of psychology and neuroscience at Emory University, studied home movies of young children and \u003ca href=\"http://www.psycontent.com/content/9181225j68206743/\">noticed\u003c/a> that children who would later develop schizophrenia seemed to walk differently than the control group. Their gait seemed particularly abnormal on the left side of their bodies.\u003c/p>\n\u003caside class=\"alignright\">\u003cstrong>Schizophrenia: New Thinking, New Treatments\u003c/strong>This is the second story in a \u003ca href=\"http://ww2.kqed.org/science/series/schizophrenia-new-thinking-new-treatments/\">three-part series\u003c/a> looking at the changing science of schizophrenia and emerging treatments.\n\u003cul>\n\u003cli>Part One: \u003ca href=\"http://ww2.kqed.org/science/audio/new-clinics-in-california-seek-to-stop-schizophrenia-before-it-starts/\">New Clinics in California Seek to Stop Schizophrenia Before it Starts\u003c/a>\u003c/li>\n\u003cli>Part Three: \u003ca href=\"http://ww2.kqed.org/science/audio/schizophrenia-what-its-like-to-hear-voices/\">Schizophrenia: What It’s Like to Hear Voices\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>Other studies point to a \u003ca href=\"http://www.schizophreniaforum.org/new/detail.asp?id=1950\">decline in IQ\u003c/a> that happens over the time the disease develops.\u003c/p>\n\u003cp>People in the early stages of schizophrenia “seem to have problems focusing attention, planning, trouble with encoding and storing memories,” says Daniel Mathalon, a neuroscientist at UCSF. “Patients sometimes say they used to be able to read books, now they can’t read books. They can’t sustain focus. They used to build models, now they don’t. They used to be able to play the guitar well, now that’s deteriorated.”\u003c/p>\n\u003cp>Parents hope, he says, that the problems are “just a phase that an adolescent is going through. Sometimes it is, but sometimes it’s the predecessor to a full-blown psychotic illness.”\u003c/p>\n\u003cp>\u003cstrong>A Problem of Information Overload\u003c/strong>\u003c/p>\n\u003cp>In recent years, scientists have begun to talk about schizophrenia as a disease of “\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/12505794\">salience\u003c/a>,” in which the brain loses the ability to tune out information that isn’t useful or relevant.\u003c/p>\n\u003cp>“They are walking down the street trying to have a conversation and their brain is being flooded with the sound of the door slamming, the airplane going overhead,” says Vinogradov, of the San Francisco VA hospital. “The brain is starting to process all of that information as if it has meaning, and is something the brain needs to pay attention to and needs to do something about.”\u003c/p>\n\u003cp>Maybe, the theory goes, that’s what gives rise to hallucinations and delusions. The mind seeks explanations for the extra data coming in.\u003c/p>\n\u003cp>“If you pay attention to everything,” says UCSF’s Sohal, “you might start paying attention to coincidences, and you might get paranoid. Or you might pay even more attention to your own thoughts and start thinking, ‘These are other peoples thoughts.’”\u003c/p>\n\u003cfigure id=\"attachment_20217\" class=\"wp-caption aligncenter\" style=\"max-width: 3456px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1025.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20217\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1025.jpg\" alt=\"Young people taking part in a mental illness prevention program called Kickstart fly kites at San Diego's Seaport Village. Marvi/KQED)\" width=\"3456\" height=\"3456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Young people taking part in a mental illness prevention program called Kickstart fly kites at San Diego’s Seaport Village. (Marvi Lacar/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>New Treatments Emerge\u003c/strong>\u003c/p>\n\u003cp>When you change how you define a disease, you begin to change how you treat it.\u003c/p>\n\u003cp>Increasingly people in the early stages of schizophrenia are prescribed fish oil and exercise, to support basic brain functioning. Drug companies are \u003ca href=\"http://schizophrenia.com/?p=110\">working\u003c/a> on new medicines that could do the same.\u003c/p>\n\u003cp>At the Citywide Mental Health Center in San Francisco’s Tenderloin neighborhood, Vinogradov is leading \u003ca href=\"http://vinogradovlab.com/#/sectpage/4560739020\">a study\u003c/a> to see whether the brain can be, essentially, re-taught.\u003c/p>\n\u003cp>A middle-aged man named George, wearing a crisp short-sleeved shirt, sits at a computer. He’s wearing plastic gloves.\u003c/p>\n\u003cp>“Why the gloves?” I ask him. “Gloves?” he says. “So the cosmic dust doesn’t get on my hands.”\u003c/p>\n\u003cp>George can see my voice, he tells me. It looks “yellow, with light pinkish color.” He wants to know whether I’ve ever seen voices, or would like to.\u003c/p>\n\u003cp>“I don’t know,” I tell him. “Is it a good thing?”\u003c/p>\n\u003caside class=\"pullquote alignleft\">Giving antipsychotics to a person with schizophrenia may be like giving painkillers to someone with cancer. It might help, but it’s not getting at the cause.\u003c/aside>\n\u003cp>“Yes,” he answers. “You can understand life in general better.”\u003c/p>\n\u003cp>“You feel like you understand things other people don’t?” I ask.\u003c/p>\n\u003cp>“Of course,” George says. “It makes you superior.”\u003c/p>\n\u003cp>As we talk, George drags his cursor across the screen, following directions from a cognitive training exercise designed by the San Francisco software company Posit Science.\u003c/p>\n\u003cp>“Move the boy to the school,” the voice intones. George complies. He supplies his own commentary.\u003c/p>\n\u003cp>“OK, he’s going to school, see? Cutting, smoking cigarettes in the back.”\u003c/p>\n\u003cp>Researchers tend to avoid the term “video games.” These exercises are about as much fun as brushing your teeth. The idea here is to train George to tune out distractions and focus on simple instructions.\u003c/p>\n\u003cp>Another exercise repeats a word, like asking the user to click on the emotion that best describes how the word is said. They’re given four choices: happy, angry, sad and neutral.\u003c/p>\n\u003cp>\u003cstrong>For Some People, Not All. \u003c/strong>\u003c/p>\n\u003cp>The idea here isn’t to replace anti-psychotic drugs, at least not for everyone. Vinogradov says there are some people whose voices or delusions are so destructive, so violent, that they need to be turned off.\u003c/p>\n\u003cp>But for another group of people, doctors might be able to focus on a different set of questions, Vinogradov says.\u003c/p>\n\u003cp>“Is this person able to have the kind of life they want? Are they able to have friends, to have people who they can love, who can love them back? Are they able to keep food and shelter?”\u003c/p>\n\u003cp>Vinogradov, Mathalon and others point to studies showing that delusions and hallucinations aren’t always the factors that interfere with a person’s ability to lead a fulfilling life.\u003c/p>\n\u003cp>By focusing on cognitive problems, says Mathalon, “we might have greater impact on outcomes for patients. We might have a greater impact on whether they can successfully work, have relationships, than if we just quell their psychotic symptoms, keep the voices from intruding.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Silencing the voices with big doses of anti-psychotic drugs may, in some cases, do more harm than good.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/div>\n\u003cp>The first sign of trouble, says Veronica, was when her daughter’s grades started to slip. At 15, Jasmin had been an honor roll student in her San Diego middle school. Suddenly, it was a strain even to sit through class.\u003c/p>\n\u003cp>“She would come home from school exhausted,” Veronica recalls. “She’d go to a corner in the living room and just sit there, away from everybody.” (Veronica asked us not to use her family’s last name, because Jasmin is still a minor.)\u003c/p>\n\u003cfigure id=\"attachment_20190\" class=\"wp-caption aligncenter\" style=\"max-width: 2721px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1068-e1406926256788.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20190\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1068-e1406926256788.jpg\" alt=\"Jasmin heads out to the beach in San Diego on a windy day, to fly a kite. (Marvi Lacar/KQED)\" width=\"2721\" height=\"2617\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">At 15, Jasmin was intensely sensitive to noise and light; her grades dropped. Some psychiatrists believe she was experiencing early symptoms of psychosis. (Marvi Lacar/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>What Jasmin remembers from that time is an acute sensitivity to sound and light. She wore dark sunglasses around the house and asked her family to turn the music down.\u003c/p>\n\u003cp>“It wasn’t a headache or anything, it would just bother me,” Jasmin recalls.\u003c/p>\n\u003cp>Within months, she had declined to the point where she couldn’t go to school, couldn’t eat without assistance.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘It feels like your child is not there. She’s looking at you, but she’s not comprehending who you are, where she is.’\u003c/aside>\n\u003cp>“It feels like your child is not there,” Veronica says. “She’s looking at you, but she’s not comprehending who you are, where she is.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Eventually, Jasmin recovered from her catatonic state, but only after things got much worse: a diagnosis of psychosis, a brief hospitalization and powerful anti-psychotic drugs that caused a 40-pound weight gain over three months.\u003c/p>\n\u003cp>Could the worst of it have been avoided had doctors paid closer attention to Jasmin’s earliest symptoms, particularly her sudden problems with schoolwork and her sensitivity to noise and bright lights?\u003c/p>\n\u003cp>A new generation of schizophrenia researchers believes these struggles may be some of the earliest symptoms of schizophrenia, symptoms of a cognitive decline that may precede, even cause the delusions and hallucinations the disease is famous for. \u003c/p>\n\u003cp>\u003cstrong>A Mysterious Disease\u003c/strong>\u003c/p>\n\u003cp>Schizophrenia is twice as common as Alzheimer’s disease, but almost nothing is known about how it works in the body. As with most other mental illnesses, there’s no blood test for schizophrenia, no scan that can diagnose it.\u003c/p>\n\u003cp>Instead, schizophrenia is defined by symptoms patients describe about themselves, particularly a blurring of the boundaries of reality.\u003c/p>\n\u003cp>A patient may hear strange, often threatening voices that no one else can hear. She may believe she is being spied on through her television, that she is telepathic, or that newspaper articles contain hidden messages directed at her alone.\u003c/p>\n\u003cp>These strange behaviors – hallucinations and delusions — have defined the disease since it was first formally described in 1950. The word “schizophrenia” means, literally, “split mind”: a division between what the patient believes is real and what most other people would agree is real.\u003c/p>\n\u003cp>Society’s preoccupation with hallucinations and delusions is easy to understand, says Sophia Vinogradov, a psychiatrist and researcher at the San Francisco VA hospital.\u003c/p>\n\u003cfigure id=\"attachment_20239\" class=\"wp-caption alignright\" style=\"max-width: 369px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/schiz-graphic.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-20239\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/schiz-graphic.png\" alt=\"(David Pierce/KQED)\" width=\"369\" height=\"790\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David Pierce/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“They’re right there, in your face,” Vinogradov says. “And they’re frightening. They’re frightening for the person who has them and they’re frightening for society.”\u003c/p>\n\u003cp>She says that’s why anti-psychotic drugs, which were developed in the 1960s, seemed like such a breakthrough. Until then, nothing else had worked to help people with schizophrenia.“Up until that point we had wrapping them in wet towels, locking them in a padded cell,” Vinogradov says. “Frontal lobotomies if the behavior was really out of control. I mean, what did we have? So when antipsychotic medications did evolve, and they did reduce psychotic symptoms, it was like the heavens had opened.”\u003c/p>\n\u003cp>But the drugs came with powerful side effects. They left some people virtually comatose. Even the modern versions can cause serious weight gain. That’s one reason people with schizophrenia are at least twice as likely to die of cardiovascular disease.\u003c/p>\n\u003cp>And in recent years, scientists have begun asking whether the voices are better viewed as a symptom of something else, says Vikaas Sohal, a researcher at UCSF.\u003c/p>\n\u003cp>“If someone came to you with cancer and said, ‘My back is hurting, my gums bleed, I’m tired, I have headaches,'” Sohal says, “okay, there’s all these things, but that’s not what cancer is. Cancer is this group of cells that are dividing uncontrollably.”\u003c/p>\n\u003cp>In other words, giving antipsychotics to a person with schizophrenia may be like giving painkillers to someone with cancer. It might help, but it’s not getting at the cause.\u003c/p>\n\u003cp>\u003cstrong>Cognitive Decline as the First Sign of Disease \u003c/strong>\u003c/p>\n\u003cp>Basic cognitive problems may precede hallucinations and delusions by a decade or more.\u003c/p>\n\u003cp>Elaine Walker, a professor of psychology and neuroscience at Emory University, studied home movies of young children and \u003ca href=\"http://www.psycontent.com/content/9181225j68206743/\">noticed\u003c/a> that children who would later develop schizophrenia seemed to walk differently than the control group. Their gait seemed particularly abnormal on the left side of their bodies.\u003c/p>\n\u003caside class=\"alignright\">\u003cstrong>Schizophrenia: New Thinking, New Treatments\u003c/strong>This is the second story in a \u003ca href=\"http://ww2.kqed.org/science/series/schizophrenia-new-thinking-new-treatments/\">three-part series\u003c/a> looking at the changing science of schizophrenia and emerging treatments.\n\u003cul>\n\u003cli>Part One: \u003ca href=\"http://ww2.kqed.org/science/audio/new-clinics-in-california-seek-to-stop-schizophrenia-before-it-starts/\">New Clinics in California Seek to Stop Schizophrenia Before it Starts\u003c/a>\u003c/li>\n\u003cli>Part Three: \u003ca href=\"http://ww2.kqed.org/science/audio/schizophrenia-what-its-like-to-hear-voices/\">Schizophrenia: What It’s Like to Hear Voices\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>Other studies point to a \u003ca href=\"http://www.schizophreniaforum.org/new/detail.asp?id=1950\">decline in IQ\u003c/a> that happens over the time the disease develops.\u003c/p>\n\u003cp>People in the early stages of schizophrenia “seem to have problems focusing attention, planning, trouble with encoding and storing memories,” says Daniel Mathalon, a neuroscientist at UCSF. “Patients sometimes say they used to be able to read books, now they can’t read books. They can’t sustain focus. They used to build models, now they don’t. They used to be able to play the guitar well, now that’s deteriorated.”\u003c/p>\n\u003cp>Parents hope, he says, that the problems are “just a phase that an adolescent is going through. Sometimes it is, but sometimes it’s the predecessor to a full-blown psychotic illness.”\u003c/p>\n\u003cp>\u003cstrong>A Problem of Information Overload\u003c/strong>\u003c/p>\n\u003cp>In recent years, scientists have begun to talk about schizophrenia as a disease of “\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/12505794\">salience\u003c/a>,” in which the brain loses the ability to tune out information that isn’t useful or relevant.\u003c/p>\n\u003cp>“They are walking down the street trying to have a conversation and their brain is being flooded with the sound of the door slamming, the airplane going overhead,” says Vinogradov, of the San Francisco VA hospital. “The brain is starting to process all of that information as if it has meaning, and is something the brain needs to pay attention to and needs to do something about.”\u003c/p>\n\u003cp>Maybe, the theory goes, that’s what gives rise to hallucinations and delusions. The mind seeks explanations for the extra data coming in.\u003c/p>\n\u003cp>“If you pay attention to everything,” says UCSF’s Sohal, “you might start paying attention to coincidences, and you might get paranoid. Or you might pay even more attention to your own thoughts and start thinking, ‘These are other peoples thoughts.’”\u003c/p>\n\u003cfigure id=\"attachment_20217\" class=\"wp-caption aligncenter\" style=\"max-width: 3456px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1025.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-20217\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/08/20140618_Schizo_1025.jpg\" alt=\"Young people taking part in a mental illness prevention program called Kickstart fly kites at San Diego's Seaport Village. Marvi/KQED)\" width=\"3456\" height=\"3456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Young people taking part in a mental illness prevention program called Kickstart fly kites at San Diego’s Seaport Village. (Marvi Lacar/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>New Treatments Emerge\u003c/strong>\u003c/p>\n\u003cp>When you change how you define a disease, you begin to change how you treat it.\u003c/p>\n\u003cp>Increasingly people in the early stages of schizophrenia are prescribed fish oil and exercise, to support basic brain functioning. Drug companies are \u003ca href=\"http://schizophrenia.com/?p=110\">working\u003c/a> on new medicines that could do the same.\u003c/p>\n\u003cp>At the Citywide Mental Health Center in San Francisco’s Tenderloin neighborhood, Vinogradov is leading \u003ca href=\"http://vinogradovlab.com/#/sectpage/4560739020\">a study\u003c/a> to see whether the brain can be, essentially, re-taught.\u003c/p>\n\u003cp>A middle-aged man named George, wearing a crisp short-sleeved shirt, sits at a computer. He’s wearing plastic gloves.\u003c/p>\n\u003cp>“Why the gloves?” I ask him. “Gloves?” he says. “So the cosmic dust doesn’t get on my hands.”\u003c/p>\n\u003cp>George can see my voice, he tells me. It looks “yellow, with light pinkish color.” He wants to know whether I’ve ever seen voices, or would like to.\u003c/p>\n\u003cp>“I don’t know,” I tell him. “Is it a good thing?”\u003c/p>\n\u003caside class=\"pullquote alignleft\">Giving antipsychotics to a person with schizophrenia may be like giving painkillers to someone with cancer. It might help, but it’s not getting at the cause.\u003c/aside>\n\u003cp>“Yes,” he answers. “You can understand life in general better.”\u003c/p>\n\u003cp>“You feel like you understand things other people don’t?” I ask.\u003c/p>\n\u003cp>“Of course,” George says. “It makes you superior.”\u003c/p>\n\u003cp>As we talk, George drags his cursor across the screen, following directions from a cognitive training exercise designed by the San Francisco software company Posit Science.\u003c/p>\n\u003cp>“Move the boy to the school,” the voice intones. George complies. He supplies his own commentary.\u003c/p>\n\u003cp>“OK, he’s going to school, see? Cutting, smoking cigarettes in the back.”\u003c/p>\n\u003cp>Researchers tend to avoid the term “video games.” These exercises are about as much fun as brushing your teeth. The idea here is to train George to tune out distractions and focus on simple instructions.\u003c/p>\n\u003cp>Another exercise repeats a word, like asking the user to click on the emotion that best describes how the word is said. They’re given four choices: happy, angry, sad and neutral.\u003c/p>\n\u003cp>\u003cstrong>For Some People, Not All. \u003c/strong>\u003c/p>\n\u003cp>The idea here isn’t to replace anti-psychotic drugs, at least not for everyone. Vinogradov says there are some people whose voices or delusions are so destructive, so violent, that they need to be turned off.\u003c/p>\n\u003cp>But for another group of people, doctors might be able to focus on a different set of questions, Vinogradov says.\u003c/p>\n\u003cp>“Is this person able to have the kind of life they want? Are they able to have friends, to have people who they can love, who can love them back? Are they able to keep food and shelter?”\u003c/p>\n\u003cp>Vinogradov, Mathalon and others point to studies showing that delusions and hallucinations aren’t always the factors that interfere with a person’s ability to lead a fulfilling life.\u003c/p>\n\u003cp>By focusing on cognitive problems, says Mathalon, “we might have greater impact on outcomes for patients. We might have a greater impact on whether they can successfully work, have relationships, than if we just quell their psychotic symptoms, keep the voices from intruding.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_119704\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/2013/11/29/california-lawmakers-get-salary-increase/rs5102_56531571-scr/\" rel=\"attachment wp-att-119704\">\u003cimg class=\"size-medium wp-image-119704\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/12/RS5102_56531571-scr-640x426.jpg\" alt=\"State Capitol, Sacramento (David Paul Morris/Getty Images). \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">State Capitol, Sacramento (David Paul Morris/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>SACRAMENTO (AP) Governor Jerry Brown has signed a bill that deletes from most California laws outdated terms once used to describe mental health conditions.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1847\">AB1847\u003c/a> by Democratic Assemblyman Wesley Chesbro of Arcata replaces references to insane, mentally disordered or defective persons with references to mental health disorders, intellectual disability or developmental disability.\u003c/p>\n\u003cp>Chesbro says using such outdated terms increases the stigma against people who suffer from mental health issues and puts the focus on the disability rather than the person. Previous legislation already replaced references to imbeciles and lunatics in state laws.\u003c/p>\n\u003cp>The legislation that Brown announced signing Friday does not apply to penal codes used in legal proceedings. Terms such as insane have specific meanings in criminal law and are used in determining sentences.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_119704\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/2013/11/29/california-lawmakers-get-salary-increase/rs5102_56531571-scr/\" rel=\"attachment wp-att-119704\">\u003cimg class=\"size-medium wp-image-119704\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/12/RS5102_56531571-scr-640x426.jpg\" alt=\"State Capitol, Sacramento (David Paul Morris/Getty Images). \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">State Capitol, Sacramento (David Paul Morris/Getty Images).\u003c/figcaption>\u003c/figure>\n\u003cp>SACRAMENTO (AP) Governor Jerry Brown has signed a bill that deletes from most California laws outdated terms once used to describe mental health conditions.\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1847\">AB1847\u003c/a> by Democratic Assemblyman Wesley Chesbro of Arcata replaces references to insane, mentally disordered or defective persons with references to mental health disorders, intellectual disability or developmental disability.\u003c/p>\n\u003cp>Chesbro says using such outdated terms increases the stigma against people who suffer from mental health issues and puts the focus on the disability rather than the person. Previous legislation already replaced references to imbeciles and lunatics in state laws.\u003c/p>\n\u003cp>The legislation that Brown announced signing Friday does not apply to penal codes used in legal proceedings. Terms such as insane have specific meanings in criminal law and are used in determining sentences.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Therapists, Patients Criticize Kaiser Over Long Delays for Therapy",
"title": "Therapists, Patients Criticize Kaiser Over Long Delays for Therapy",
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"content": "\u003cfigure id=\"attachment_20235\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3.jpg\">\u003cimg class=\"size-large wp-image-20235\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3-640x480.jpg\" alt=\"Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>This is the second of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/01/sonoma-co-supervisor-presses-kaiser-on-mental-health-services/\" target=\"_blank\">two parts\u003c/a> about mental health services at Northern California Kaiser.\u003c/em>\u003c/p>\n\u003cp>In January 2013 a woman named “Nina” had a terrible falling out with her father. Soon after, she found out he had incurable cancer and was going to die. In the ensuing weeks, she tried to patch things up, but with the pressures inherent in the last months of a dying man, was unable to attain any form of closure. Some six months after their fight, he was gone.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"People are suffering, and I fear some of my patients will commit suicide for lack of ongoing treatment.\"\u003c/aside>\n\u003cp>\"Nina,\" who did not want us to use her real name for reasons of privacy, had been prone to depression. Zoloft had helped, but the now irreparable family rift left her severely depressed, with occasional thoughts of suicide. \"I was in a state of constant emotional pain and confusion,\" she says. “It was affecting all aspects of my life.\"\u003c/p>\n\u003cp>She went for an intake appointment at the psychiatric department at Kaiser Permanente’s Oakland Medical Center, with the expectation she'd be able to see a therapist for individual appointments during this severe emotional crisis. She requested those sessions, but the intake therapist told her Kaiser only offered group therapy.\u003c/p>\n\u003cp>“I said I'm not comfortable talking about my situation with a bunch of strangers,” Nina says. “She very kindly tried to make me aware of the value of group therapy. But I knew in my heart it wasn’t where I wanted to be.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nina left even more dispirited. Over the next year, she white-knuckled her depression on her own, before having the epiphany that maybe her medication needed adjustment. She went to see a Kaiser psychiatrist and mentioned she’d been told there was no individual therapy.\u003c/p>\n\u003cp>The psychiatrist seemed startled. She told Nina individual therapy was offered. “They probably just didn’t have the space,” the psychiatrist said.\u003c/p>\n\u003cp>Nina was shocked. “I could not believe that a professional therapist would lie to an obviously depressed patient who was sincerely seeking help.”\u003c/p>\n\u003cp>She finally did get to see a Kaiser therapist, whom she describes as “fantastic,” but who told her she could only book Nina maybe once every four weeks. At that point, Nina's expectations had been lowered to the point she was grateful to get any therapy at all. She also availed herself of a free Kaiser yoga class, which she considers to have been useful in her recovery.\u003c/p>\n\u003cp>Her therapist, she says, is really helping her with the depression.\u003c/p>\n\u003cp>Still, Nina's contact with Kaiser’s psychiatric department left her unnerved. “I started thinking maybe it’s my problem,” she says about her rejection of group therapy. \"It just added to my anxiety. But to share with other people what I was going through was just too much for me at that time. How depressed did this therapist need me to be in order to make room in the schedule for individual therapy?”\u003c/p>\n\u003cp>\u003cstrong>Kaiser Under Fire\u003c/strong>\u003c/p>\n\u003cp>Last year, Kaiser was\u003ca href=\"http://www.dmhc.ca.gov/Portals/0/AboutDMHC/PressReleases/2013/prkmhs.pdf\" target=\"_blank\"> fined $4 million\u003c/a> by the California Department of Managed Health Care for not accurately tracking patient waiting times for initial mental health appointments. And now the health plan is in the middle of another controversy over its mental health care: Some of its therapists and patients say there is a dangerous lack of access to individual therapy appointments and an over-reliance on group therapy.\u003c/p>\n\u003cp>Kaiser maintains that hiring in its psychiatric departments is up, and that patients do not have problems getting appropriate care. It points to its high rating in behavioral and mental health on the \u003ca href=\"http://reportcard.opa.ca.gov/rc2014/hmotopic.aspx?Category=HMOHEDIS&Topic=MentalHealthCare\" target=\"_blank\">2014 California Office of the Patient Advocate report card\u003c/a>. In addition, it has asserted that much of the controversy has been fueled by the union representing mental health clinicians, the National Union of Healthcare Workers (NUHW), which has been \u003ca href=\"http://www.californiahealthline.org/articles/2012/1/24/three-unions-announce-one-day-strike-at-kaiser-over-labor-negotiations\" target=\"_blank\">embroiled in contract negotiations\u003c/a> with Kaiser since 2010.\u003c/p>\n\u003cp>In reporting this story I talked to some two dozen current and former Kaiser clinicians and mental health patients as well as outside therapists. The vast majority express similar complaints: While health plans are required to provide medically necessary appointments within 10 business days, Kaiser patients have to wait long periods, sometimes months, between individual therapy appointments. These critics say Kaiser is referring patients to group therapy even in cases where ongoing individual sessions are clinically necessary. The reason, the union and clinicians say, is a serious staff shortage.\u003c/p>\n\u003cp>\u003cstrong>Therapists, Patients Speak Out\u003c/strong>\u003c/p>\n\u003cp>As \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/01/sonoma-co-supervisor-presses-kaiser-on-mental-health-services/\" target=\"_blank\">we've reported\u003c/a>, the issue came to a head this year when a \u003ca href=\"http://90daystochange.com/\" target=\"_blank\">behind-the-scenes blog \u003c/a>by Andy Weisskoff, a now-former therapist at the health plan’s Santa Rosa Medical Center, detailed long waiting times for therapy appointments and the deleterious effects on both patients and therapists.\u003c/p>\n\u003cp>“When I see someone today with suicidal thoughts ... I am often uncertain how well they’ll fare in the intervening weeks,” he \u003ca href=\"http://90daystochange.com/2014/03/04/even-if-youre-thinking-of-killing-yourself/\" target=\"_blank\">wrote\u003c/a>. “Did I miss something in our hour long interview?… Maybe I should have sent them to our intensive outpatient group instead of a skills group designed for people who are higher functioning. And then I wait, at least a month, to see if my intuition, one way or another, was correct.”\u003c/p>\n\u003cp>One Kaiser therapist from a Northern California facility described similar concerns. She wants to remain anonymous out of fear for her job. She is unnerved by the common practice of steering patients into groups instead of individual therapy sessions.\u003c/p>\n\u003cp>“I feel unethical when I go home at night, and feel really guilty,” she said. \"People are suffering, and I fear some of my patients will commit suicide for lack of ongoing treatment, but I’m powerless to treat them because I don’t have return visits available.”\u003c/p>\n\u003cp>Another therapist who worked at a South Bay Kaiser says she quit her position earlier this year because she considered the treatment of patients there \"unethical.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We believe these descriptions are not reflective of the millions of mental health visits we provide each year in Northern California.\"\u003c/aside>\n\u003cp>\"Patients that need individual therapy are not getting it,” she said. “We had to tell patients we offer group therapy. ... The patients that are the most severely mentally ill are the ones that can’t speak up for themselves, and the ones who get lost in the system. With the Affordable Care Act, we’re seeing more and more of those patients.\"\u003c/p>\n\u003cp>A number of Kaiser patients also reported similar dissatisfaction with the unavailability of individual sessions. Loran Watkins’ story was typical of the complaints many patients described to me.\u003c/p>\n\u003cp>Watkins, 53, said that in 2010 her husband was battling cancer and \"desperately needed therapy to get through this. They said he could go to a group. There was no way in God's green earth he would have gone to a group. He was already a social introvert, was on six different kinds of pain medications so his ability to focus was very limited.\"\u003c/p>\n\u003cp>After \"pushing and pushing and pushing,\" Watkins says, her husband was finally given the okay to see a therapist, but only once a month.\u003c/p>\n\u003cp>\"Here you have a man actively battling cancer, was relapsing,\" she said. \"After the seventh or eighth appointment, the therapist said he was retiring, and that there were no more appointments available.\"\u003c/p>\n\u003cp>Watkins added that when her own longtime therapist at Kaiser's Walnut Creek medical center retired, she told Watkins there was no replacement available.\u003c/p>\n\u003cp>\"I asked her for a referral. She said there's no one to refer you to. The only thing I can do is they will place me in a group type setting; there's no individual therapy appointments anymore.\"\u003c/p>\n\u003cp>Kaiser responded to an email outlining these accounts and disputed the allegations that individual therapy is not available:\u003c/p>\n\u003cp>\u003cem>We apologize if there are members who may have received incorrect information about the availability of services. All of our medical centers provide individual therapy as part of the wide range of mental health treatments available to Kaiser Permanente patients.\u003c/em>\u003c/p>\n\u003cp>\u003cem>We encourage our members and staff to share their concerns, and we investigate thoroughly and work to resolve any issues. We take the examples in your email very seriously. Out of respect for patient privacy, we cannot respond in the media about individual cases. Each patient’s concern is important to us and we will investigate with the information we have. We believe these descriptions are not reflective of the millions of mental health visits we provide each year in Northern California, but we recognize that we have opportunities to make our program even better and are committed to doing so.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Group Therapy vs. Individual Therapy\u003c/strong>\u003c/p>\n\u003cp>Dr. Mason Turner is Kaiser’s director of patient operations for regional mental health services in Northern California. He takes umbrage at the notion that individual therapy is the “gold standard,” as he puts it, and that group therapy is somehow inferior. “This is a disservice to the hundreds of thousands of Kaiser Permanente members -- and millions throughout the country -- who have benefited from this type of proven, effective treatment and to the mental health professionals, including our Kaiser Permanente therapists, who provide it.\u003c/p>\n\u003cp>“There is no evidence that individual psychotherapy is superior to group therapy.\"\u003c/p>\n\u003cp>I asked Dr. John Norcross, a psychology professor at the University of Scranton, if that was true. Norcross’ research is on treatment adaptations -- \"how to tailor therapy for individual patients,” he says.\u003c/p>\n\u003cp>Norcross is a “big supporter” of group therapy, but only when indicated. And group treatment is contraindicated, he said, if the patient has a strong preference for individual therapy. That can make a difference in both retention of the patient and effectiveness of the treatment.\u003c/p>\n\u003cp>“There are dozens of studies that show we should always begin with patients’ preferences if ethically or clinically possible,” he said.\u003c/p>\n\u003cp>I recounted to him the experience of Nina, the woman who had expressed a preference for individual therapy at Kaiser Oakland and was erroneously told it wasn’t offered. Norcross said in her case a group would not be effective.\u003c/p>\n\u003cp>“If this woman wants 50 minutes to express and resolve longstanding conflicts, you’re not going to get that kind of opportunity in a therapy group of 6-12 people,” he said.\u003c/p>\n\u003cp>Andy Weisskoff, the former Kaiser therapist who blogged about his experience at Kaiser Santa Rosa, wrote that only a quarter of those who were referred to groups attended one.\u003c/p>\n\u003cp>“The assertion that groups are better than individual therapy is a little bit beside the point if they don’t go to the groups in the first place,” he says.\u003c/p>\n\u003cp>Some patients who I spoke with amplified his concern. For example, a 60-year-old woman who uses Kaiser’s Roseville facility and suffers from panic disorder said the last time she had an appointment, the therapist told her she could be seen maybe once every three months.\u003c/p>\n\u003cp>Instead she was sent to a group, where she says the discussions triggered her anxiety attacks. She estimated the number of patients in another group at about two dozen -- “like cattle in there, how can anyone’s needs be met?” she said. So she quit.\u003c/p>\n\u003cp>On disability because of her anxiety, unable to tolerate medication, and with the cost of an outside therapist out of reach, she sees no available options. “There’s nowhere for me to go,” she said.\u003c/p>\n\u003cp>Corlene Van Sluizer described the same lack of options for her sister, 71. Her sister was ordered into an inpatient facility this year after telling her Kaiser Santa Rosa psychiatrist of plans to commit suicide, Van Sluizer says. Even with a diagnosis of major depression, after being released she was told she’d have to pay for any individual therapy on her own. Instead, she was sent to a group.\u003c/p>\n\u003cp>“It lasted 6 sessions. She got no benefit from it,” Van Sluizer says.\u003c/p>\n\u003cp>Many non-Kaiser therapists sent me emails asserting some of their patients have been forced to pay out-of-pocket because they cannot get individual therapy at Kaiser.\u003c/p>\n\u003cp>A typical response came from Karen Taylor, a therapist in Campbell: “(I) see a number of Kaiser clients. (Kaiser) tells them to go to a group or will only see them every six weeks for private therapy. Neither of these options have been appropriate or effective for my clients.”\u003c/p>\n\u003cp>A therapist who wanted to remain anonymous said that a patient was referred to her by Kaiser staff following his suicide attempt and hospitalization. “I considered him high risk for a second suicide. He attempted again soon after our intake. None of these incidents convinced Kaiser to provide individual therapy to him. … Kaiser continued to refer him to groups.”\u003c/p>\n\u003cp>In a statement, Kaiser said therapists have a responsibility to inform more senior staff of need for specific services:\u003c/p>\n\u003cp>\u003cem>The well-being of our patients is our primary concern. We would expect any therapist with concerns about a patient's urgent needs to immediately respond and escalate appropriately, and we support them in doing so.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Kaiser Disputes Shortage of Staff\u003c/strong>\u003c/p>\n\u003cp>Kaiser's Dr. Turner says any notion that a staff shortage is driving the choice of treatment options is untrue.\u003c/p>\n\u003cp>“We have nearly 14 percent more therapists in Northern California than three years ago, and we are continuing to recruit and hire,” he told me.\u003c/p>\n\u003cp>Some Kaiser mental health staff say any new hiring hasn’t kept up with the influx of patients due to Obamacare. But Turner disputes that. “Staffing increases (have) increased significantly ahead of membership growth,” he said. “Seventy percent of our therapy is individual psychotherapy.\" While that figure includes the intake sessions for new patients, Turner said the “bulk” of the 70 percent figure is for return visits.\u003c/p>\n\u003cp>“To say that 4-6 weeks is the time between visits is not accurate,” Turner said. “We encourage therapists to look at all the different contact modalities: telephone appointments, email visits, and individual visits, to understand how best to reach out.”\u003c/p>\n\u003cp>He called Kaiser’s system of care “multi-modal, highly integrated,” and listed medication management, crisis intervention, “evidence-based group programs,” and intensive outpatient and inpatient services among its services for mental health.\u003c/p>\n\u003cp>Turner says patients can get individual therapy at more frequent intervals if they, in consultation with their therapist, consider that is the best course of treatment. He also put the responsibility for arranging appropriate care on therapists.\u003c/p>\n\u003cp>“We would expect our therapists, if they thought (a patient) needed to be seen sooner, would elect to discuss it with their manager and look for alternative times. Or have a discussion with their colleagues how they’ve managed patients like that before. It’s really up to the patient and therapist to make sure that occurs. ...\u003c/p>\n\u003cp>“(But) we have ways of accommodating this when it comes up.“\u003c/p>\n\u003cp>\u003cstrong>Bringing Concerns to Management\u003c/strong>\u003c/p>\n\u003cp>Kaiser Oakland psychologist Melinda Ginne says she tried that, to no avail. She and other Kaiser clinicians eventually went to California's Department of Managed Health Care with their complaints.\u003c/p>\n\u003cp>“For the past two-and-a-half years I have (been) writing my management about … the dangerously long wait times for a return appointment,” she told me. “The response was literally nothing.”\u003c/p>\n\u003cp>Ginne works with seniors and patients who have serious physical ailments like cancer. She sent me the email she wrote to Kaiser managers last September.\u003c/p>\n\u003cp>“My patients have been waiting 3 months for a routine follow-up appointment,” she wrote. “This has been a dire situation with often adverse consequences for the patients. But now they must wait 5 months.”\u003c/p>\n\u003cp>“Believe me,” she continued. “I can’t tell a patient with 3-6 months to live that I’ll see them in 5 months.”\u003c/p>\n\u003cp>One former Kaiser therapist said she brought her concerns about patients not getting enough individual therapy to management “multiple times throughout the five years I was there, and they just don’t want to hear it.”\u003c/p>\n\u003cp>She said it was possible for a therapist to get approval to see a client individually, but only by “really insist(ing). And even if they feel the patient needs it, they don’t have room on their schedule because of the way Kaiser books them back to back.”\u003c/p>\n\u003cp>\u003cstrong>Kaiser’s Regulator Weighs In\u003c/strong>\u003c/p>\n\u003cp>Marta Green, the California Department of Managed Health Care’s (DMHC) deputy director of communications and planning, said whether Kaiser is in violation of regulations would depend on whether it displayed a pattern of steering patients to groups instead of medically necessary individual sessions.\u003c/p>\n\u003cp>\"If the medically necessary care to treat an enrollee's condition is an individual therapy session, then the plan must make that session available within a clinically appropriate timeframe and comply with the regulatory timeframes\" of 10 business days,” she wrote in an email.\u003c/p>\n\u003cp>However, if a physician or triage professional, using professionally recognized standards of practice, determines that a longer waiting time will not have a detrimental impact on a patient, that period between appointments may legally be extended.\u003c/p>\n\u003cp>Green said if Kaiser can't provide individual therapy to a patient that needs it, then Kaiser would be obligated to partially pay for outside therapy. Any Kaiser enrollees who think this situation may apply to them should file a claim with Kaiser at the same time they \u003ca href=\"http://www.dmhc.ca.gov/FileaComplaint/ConsumerIndependentMedicalReviewComplaint.aspx#.U8gtb41dWSM\" target=\"_blank\">ask the DHMC for a free independent medical review\u003c/a>.\u003c/p>\n\u003cp>Against this backdrop of reports of patient and therapist dissatisfaction, Kaiser maintains that staffing complaints are driven by its four-year-plus contract negotiation with the National Union of Healthcare Workers, which represents many of the therapists. In its statement to KQED, Kaiser said the union \"has not been cooperative in finding solutions that will enable us to meet our members' needs.\"\u003c/p>\n\u003cp>In particular, Kaiser has \"entered into an agreement with Value Options,\" a network of mental health providers, to \"make sure that our members have timely access to therapists when we need flexibility in staffing.\" But NUHW \"has so far not agreed to this solution -- despite the union making it clear that its members would not be able to take on the extra demand.\"\u003c/p>\n\u003cp>Fred Seavey of the NUHW responds that clinicians have requested to bargain with Kaiser “about the impact of these changes -- for example, how these changes in the acuity levels of their patients will affect clinicians' schedules, caseloads, etc and whether Kaiser should alter the productivity quotas under which clinicians currently operate.”\u003c/p>\n\u003cp>Seavey says Kaiser's clinicians have tried to get Kaiser to address staffing shortages for years. “Kaiser has simply turned a blind eye to them,” he says.\u003c/p>\n\u003cp>A follow-up DMHC report to the one that resulted in last year’s $4 million fine is due in the fall. The DMHC’s Marta Green said it will take into account any complaints about long waits for follow-up appointments to individual therapy.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20235\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3.jpg\">\u003cimg class=\"size-large wp-image-20235\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/photo-3-640x480.jpg\" alt=\"Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente's newly opened medical center in Oakland. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>This is the second of \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/01/sonoma-co-supervisor-presses-kaiser-on-mental-health-services/\" target=\"_blank\">two parts\u003c/a> about mental health services at Northern California Kaiser.\u003c/em>\u003c/p>\n\u003cp>In January 2013 a woman named “Nina” had a terrible falling out with her father. Soon after, she found out he had incurable cancer and was going to die. In the ensuing weeks, she tried to patch things up, but with the pressures inherent in the last months of a dying man, was unable to attain any form of closure. Some six months after their fight, he was gone.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"People are suffering, and I fear some of my patients will commit suicide for lack of ongoing treatment.\"\u003c/aside>\n\u003cp>\"Nina,\" who did not want us to use her real name for reasons of privacy, had been prone to depression. Zoloft had helped, but the now irreparable family rift left her severely depressed, with occasional thoughts of suicide. \"I was in a state of constant emotional pain and confusion,\" she says. “It was affecting all aspects of my life.\"\u003c/p>\n\u003cp>She went for an intake appointment at the psychiatric department at Kaiser Permanente’s Oakland Medical Center, with the expectation she'd be able to see a therapist for individual appointments during this severe emotional crisis. She requested those sessions, but the intake therapist told her Kaiser only offered group therapy.\u003c/p>\n\u003cp>“I said I'm not comfortable talking about my situation with a bunch of strangers,” Nina says. “She very kindly tried to make me aware of the value of group therapy. But I knew in my heart it wasn’t where I wanted to be.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nina left even more dispirited. Over the next year, she white-knuckled her depression on her own, before having the epiphany that maybe her medication needed adjustment. She went to see a Kaiser psychiatrist and mentioned she’d been told there was no individual therapy.\u003c/p>\n\u003cp>The psychiatrist seemed startled. She told Nina individual therapy was offered. “They probably just didn’t have the space,” the psychiatrist said.\u003c/p>\n\u003cp>Nina was shocked. “I could not believe that a professional therapist would lie to an obviously depressed patient who was sincerely seeking help.”\u003c/p>\n\u003cp>She finally did get to see a Kaiser therapist, whom she describes as “fantastic,” but who told her she could only book Nina maybe once every four weeks. At that point, Nina's expectations had been lowered to the point she was grateful to get any therapy at all. She also availed herself of a free Kaiser yoga class, which she considers to have been useful in her recovery.\u003c/p>\n\u003cp>Her therapist, she says, is really helping her with the depression.\u003c/p>\n\u003cp>Still, Nina's contact with Kaiser’s psychiatric department left her unnerved. “I started thinking maybe it’s my problem,” she says about her rejection of group therapy. \"It just added to my anxiety. But to share with other people what I was going through was just too much for me at that time. How depressed did this therapist need me to be in order to make room in the schedule for individual therapy?”\u003c/p>\n\u003cp>\u003cstrong>Kaiser Under Fire\u003c/strong>\u003c/p>\n\u003cp>Last year, Kaiser was\u003ca href=\"http://www.dmhc.ca.gov/Portals/0/AboutDMHC/PressReleases/2013/prkmhs.pdf\" target=\"_blank\"> fined $4 million\u003c/a> by the California Department of Managed Health Care for not accurately tracking patient waiting times for initial mental health appointments. And now the health plan is in the middle of another controversy over its mental health care: Some of its therapists and patients say there is a dangerous lack of access to individual therapy appointments and an over-reliance on group therapy.\u003c/p>\n\u003cp>Kaiser maintains that hiring in its psychiatric departments is up, and that patients do not have problems getting appropriate care. It points to its high rating in behavioral and mental health on the \u003ca href=\"http://reportcard.opa.ca.gov/rc2014/hmotopic.aspx?Category=HMOHEDIS&Topic=MentalHealthCare\" target=\"_blank\">2014 California Office of the Patient Advocate report card\u003c/a>. In addition, it has asserted that much of the controversy has been fueled by the union representing mental health clinicians, the National Union of Healthcare Workers (NUHW), which has been \u003ca href=\"http://www.californiahealthline.org/articles/2012/1/24/three-unions-announce-one-day-strike-at-kaiser-over-labor-negotiations\" target=\"_blank\">embroiled in contract negotiations\u003c/a> with Kaiser since 2010.\u003c/p>\n\u003cp>In reporting this story I talked to some two dozen current and former Kaiser clinicians and mental health patients as well as outside therapists. The vast majority express similar complaints: While health plans are required to provide medically necessary appointments within 10 business days, Kaiser patients have to wait long periods, sometimes months, between individual therapy appointments. These critics say Kaiser is referring patients to group therapy even in cases where ongoing individual sessions are clinically necessary. The reason, the union and clinicians say, is a serious staff shortage.\u003c/p>\n\u003cp>\u003cstrong>Therapists, Patients Speak Out\u003c/strong>\u003c/p>\n\u003cp>As \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/07/01/sonoma-co-supervisor-presses-kaiser-on-mental-health-services/\" target=\"_blank\">we've reported\u003c/a>, the issue came to a head this year when a \u003ca href=\"http://90daystochange.com/\" target=\"_blank\">behind-the-scenes blog \u003c/a>by Andy Weisskoff, a now-former therapist at the health plan’s Santa Rosa Medical Center, detailed long waiting times for therapy appointments and the deleterious effects on both patients and therapists.\u003c/p>\n\u003cp>“When I see someone today with suicidal thoughts ... I am often uncertain how well they’ll fare in the intervening weeks,” he \u003ca href=\"http://90daystochange.com/2014/03/04/even-if-youre-thinking-of-killing-yourself/\" target=\"_blank\">wrote\u003c/a>. “Did I miss something in our hour long interview?… Maybe I should have sent them to our intensive outpatient group instead of a skills group designed for people who are higher functioning. And then I wait, at least a month, to see if my intuition, one way or another, was correct.”\u003c/p>\n\u003cp>One Kaiser therapist from a Northern California facility described similar concerns. She wants to remain anonymous out of fear for her job. She is unnerved by the common practice of steering patients into groups instead of individual therapy sessions.\u003c/p>\n\u003cp>“I feel unethical when I go home at night, and feel really guilty,” she said. \"People are suffering, and I fear some of my patients will commit suicide for lack of ongoing treatment, but I’m powerless to treat them because I don’t have return visits available.”\u003c/p>\n\u003cp>Another therapist who worked at a South Bay Kaiser says she quit her position earlier this year because she considered the treatment of patients there \"unethical.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We believe these descriptions are not reflective of the millions of mental health visits we provide each year in Northern California.\"\u003c/aside>\n\u003cp>\"Patients that need individual therapy are not getting it,” she said. “We had to tell patients we offer group therapy. ... The patients that are the most severely mentally ill are the ones that can’t speak up for themselves, and the ones who get lost in the system. With the Affordable Care Act, we’re seeing more and more of those patients.\"\u003c/p>\n\u003cp>A number of Kaiser patients also reported similar dissatisfaction with the unavailability of individual sessions. Loran Watkins’ story was typical of the complaints many patients described to me.\u003c/p>\n\u003cp>Watkins, 53, said that in 2010 her husband was battling cancer and \"desperately needed therapy to get through this. They said he could go to a group. There was no way in God's green earth he would have gone to a group. He was already a social introvert, was on six different kinds of pain medications so his ability to focus was very limited.\"\u003c/p>\n\u003cp>After \"pushing and pushing and pushing,\" Watkins says, her husband was finally given the okay to see a therapist, but only once a month.\u003c/p>\n\u003cp>\"Here you have a man actively battling cancer, was relapsing,\" she said. \"After the seventh or eighth appointment, the therapist said he was retiring, and that there were no more appointments available.\"\u003c/p>\n\u003cp>Watkins added that when her own longtime therapist at Kaiser's Walnut Creek medical center retired, she told Watkins there was no replacement available.\u003c/p>\n\u003cp>\"I asked her for a referral. She said there's no one to refer you to. The only thing I can do is they will place me in a group type setting; there's no individual therapy appointments anymore.\"\u003c/p>\n\u003cp>Kaiser responded to an email outlining these accounts and disputed the allegations that individual therapy is not available:\u003c/p>\n\u003cp>\u003cem>We apologize if there are members who may have received incorrect information about the availability of services. All of our medical centers provide individual therapy as part of the wide range of mental health treatments available to Kaiser Permanente patients.\u003c/em>\u003c/p>\n\u003cp>\u003cem>We encourage our members and staff to share their concerns, and we investigate thoroughly and work to resolve any issues. We take the examples in your email very seriously. Out of respect for patient privacy, we cannot respond in the media about individual cases. Each patient’s concern is important to us and we will investigate with the information we have. We believe these descriptions are not reflective of the millions of mental health visits we provide each year in Northern California, but we recognize that we have opportunities to make our program even better and are committed to doing so.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Group Therapy vs. Individual Therapy\u003c/strong>\u003c/p>\n\u003cp>Dr. Mason Turner is Kaiser’s director of patient operations for regional mental health services in Northern California. He takes umbrage at the notion that individual therapy is the “gold standard,” as he puts it, and that group therapy is somehow inferior. “This is a disservice to the hundreds of thousands of Kaiser Permanente members -- and millions throughout the country -- who have benefited from this type of proven, effective treatment and to the mental health professionals, including our Kaiser Permanente therapists, who provide it.\u003c/p>\n\u003cp>“There is no evidence that individual psychotherapy is superior to group therapy.\"\u003c/p>\n\u003cp>I asked Dr. John Norcross, a psychology professor at the University of Scranton, if that was true. Norcross’ research is on treatment adaptations -- \"how to tailor therapy for individual patients,” he says.\u003c/p>\n\u003cp>Norcross is a “big supporter” of group therapy, but only when indicated. And group treatment is contraindicated, he said, if the patient has a strong preference for individual therapy. That can make a difference in both retention of the patient and effectiveness of the treatment.\u003c/p>\n\u003cp>“There are dozens of studies that show we should always begin with patients’ preferences if ethically or clinically possible,” he said.\u003c/p>\n\u003cp>I recounted to him the experience of Nina, the woman who had expressed a preference for individual therapy at Kaiser Oakland and was erroneously told it wasn’t offered. Norcross said in her case a group would not be effective.\u003c/p>\n\u003cp>“If this woman wants 50 minutes to express and resolve longstanding conflicts, you’re not going to get that kind of opportunity in a therapy group of 6-12 people,” he said.\u003c/p>\n\u003cp>Andy Weisskoff, the former Kaiser therapist who blogged about his experience at Kaiser Santa Rosa, wrote that only a quarter of those who were referred to groups attended one.\u003c/p>\n\u003cp>“The assertion that groups are better than individual therapy is a little bit beside the point if they don’t go to the groups in the first place,” he says.\u003c/p>\n\u003cp>Some patients who I spoke with amplified his concern. For example, a 60-year-old woman who uses Kaiser’s Roseville facility and suffers from panic disorder said the last time she had an appointment, the therapist told her she could be seen maybe once every three months.\u003c/p>\n\u003cp>Instead she was sent to a group, where she says the discussions triggered her anxiety attacks. She estimated the number of patients in another group at about two dozen -- “like cattle in there, how can anyone’s needs be met?” she said. So she quit.\u003c/p>\n\u003cp>On disability because of her anxiety, unable to tolerate medication, and with the cost of an outside therapist out of reach, she sees no available options. “There’s nowhere for me to go,” she said.\u003c/p>\n\u003cp>Corlene Van Sluizer described the same lack of options for her sister, 71. Her sister was ordered into an inpatient facility this year after telling her Kaiser Santa Rosa psychiatrist of plans to commit suicide, Van Sluizer says. Even with a diagnosis of major depression, after being released she was told she’d have to pay for any individual therapy on her own. Instead, she was sent to a group.\u003c/p>\n\u003cp>“It lasted 6 sessions. She got no benefit from it,” Van Sluizer says.\u003c/p>\n\u003cp>Many non-Kaiser therapists sent me emails asserting some of their patients have been forced to pay out-of-pocket because they cannot get individual therapy at Kaiser.\u003c/p>\n\u003cp>A typical response came from Karen Taylor, a therapist in Campbell: “(I) see a number of Kaiser clients. (Kaiser) tells them to go to a group or will only see them every six weeks for private therapy. Neither of these options have been appropriate or effective for my clients.”\u003c/p>\n\u003cp>A therapist who wanted to remain anonymous said that a patient was referred to her by Kaiser staff following his suicide attempt and hospitalization. “I considered him high risk for a second suicide. He attempted again soon after our intake. None of these incidents convinced Kaiser to provide individual therapy to him. … Kaiser continued to refer him to groups.”\u003c/p>\n\u003cp>In a statement, Kaiser said therapists have a responsibility to inform more senior staff of need for specific services:\u003c/p>\n\u003cp>\u003cem>The well-being of our patients is our primary concern. We would expect any therapist with concerns about a patient's urgent needs to immediately respond and escalate appropriately, and we support them in doing so.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>Kaiser Disputes Shortage of Staff\u003c/strong>\u003c/p>\n\u003cp>Kaiser's Dr. Turner says any notion that a staff shortage is driving the choice of treatment options is untrue.\u003c/p>\n\u003cp>“We have nearly 14 percent more therapists in Northern California than three years ago, and we are continuing to recruit and hire,” he told me.\u003c/p>\n\u003cp>Some Kaiser mental health staff say any new hiring hasn’t kept up with the influx of patients due to Obamacare. But Turner disputes that. “Staffing increases (have) increased significantly ahead of membership growth,” he said. “Seventy percent of our therapy is individual psychotherapy.\" While that figure includes the intake sessions for new patients, Turner said the “bulk” of the 70 percent figure is for return visits.\u003c/p>\n\u003cp>“To say that 4-6 weeks is the time between visits is not accurate,” Turner said. “We encourage therapists to look at all the different contact modalities: telephone appointments, email visits, and individual visits, to understand how best to reach out.”\u003c/p>\n\u003cp>He called Kaiser’s system of care “multi-modal, highly integrated,” and listed medication management, crisis intervention, “evidence-based group programs,” and intensive outpatient and inpatient services among its services for mental health.\u003c/p>\n\u003cp>Turner says patients can get individual therapy at more frequent intervals if they, in consultation with their therapist, consider that is the best course of treatment. He also put the responsibility for arranging appropriate care on therapists.\u003c/p>\n\u003cp>“We would expect our therapists, if they thought (a patient) needed to be seen sooner, would elect to discuss it with their manager and look for alternative times. Or have a discussion with their colleagues how they’ve managed patients like that before. It’s really up to the patient and therapist to make sure that occurs. ...\u003c/p>\n\u003cp>“(But) we have ways of accommodating this when it comes up.“\u003c/p>\n\u003cp>\u003cstrong>Bringing Concerns to Management\u003c/strong>\u003c/p>\n\u003cp>Kaiser Oakland psychologist Melinda Ginne says she tried that, to no avail. She and other Kaiser clinicians eventually went to California's Department of Managed Health Care with their complaints.\u003c/p>\n\u003cp>“For the past two-and-a-half years I have (been) writing my management about … the dangerously long wait times for a return appointment,” she told me. “The response was literally nothing.”\u003c/p>\n\u003cp>Ginne works with seniors and patients who have serious physical ailments like cancer. She sent me the email she wrote to Kaiser managers last September.\u003c/p>\n\u003cp>“My patients have been waiting 3 months for a routine follow-up appointment,” she wrote. “This has been a dire situation with often adverse consequences for the patients. But now they must wait 5 months.”\u003c/p>\n\u003cp>“Believe me,” she continued. “I can’t tell a patient with 3-6 months to live that I’ll see them in 5 months.”\u003c/p>\n\u003cp>One former Kaiser therapist said she brought her concerns about patients not getting enough individual therapy to management “multiple times throughout the five years I was there, and they just don’t want to hear it.”\u003c/p>\n\u003cp>She said it was possible for a therapist to get approval to see a client individually, but only by “really insist(ing). And even if they feel the patient needs it, they don’t have room on their schedule because of the way Kaiser books them back to back.”\u003c/p>\n\u003cp>\u003cstrong>Kaiser’s Regulator Weighs In\u003c/strong>\u003c/p>\n\u003cp>Marta Green, the California Department of Managed Health Care’s (DMHC) deputy director of communications and planning, said whether Kaiser is in violation of regulations would depend on whether it displayed a pattern of steering patients to groups instead of medically necessary individual sessions.\u003c/p>\n\u003cp>\"If the medically necessary care to treat an enrollee's condition is an individual therapy session, then the plan must make that session available within a clinically appropriate timeframe and comply with the regulatory timeframes\" of 10 business days,” she wrote in an email.\u003c/p>\n\u003cp>However, if a physician or triage professional, using professionally recognized standards of practice, determines that a longer waiting time will not have a detrimental impact on a patient, that period between appointments may legally be extended.\u003c/p>\n\u003cp>Green said if Kaiser can't provide individual therapy to a patient that needs it, then Kaiser would be obligated to partially pay for outside therapy. Any Kaiser enrollees who think this situation may apply to them should file a claim with Kaiser at the same time they \u003ca href=\"http://www.dmhc.ca.gov/FileaComplaint/ConsumerIndependentMedicalReviewComplaint.aspx#.U8gtb41dWSM\" target=\"_blank\">ask the DHMC for a free independent medical review\u003c/a>.\u003c/p>\n\u003cp>Against this backdrop of reports of patient and therapist dissatisfaction, Kaiser maintains that staffing complaints are driven by its four-year-plus contract negotiation with the National Union of Healthcare Workers, which represents many of the therapists. In its statement to KQED, Kaiser said the union \"has not been cooperative in finding solutions that will enable us to meet our members' needs.\"\u003c/p>\n\u003cp>In particular, Kaiser has \"entered into an agreement with Value Options,\" a network of mental health providers, to \"make sure that our members have timely access to therapists when we need flexibility in staffing.\" But NUHW \"has so far not agreed to this solution -- despite the union making it clear that its members would not be able to take on the extra demand.\"\u003c/p>\n\u003cp>Fred Seavey of the NUHW responds that clinicians have requested to bargain with Kaiser “about the impact of these changes -- for example, how these changes in the acuity levels of their patients will affect clinicians' schedules, caseloads, etc and whether Kaiser should alter the productivity quotas under which clinicians currently operate.”\u003c/p>\n\u003cp>Seavey says Kaiser's clinicians have tried to get Kaiser to address staffing shortages for years. “Kaiser has simply turned a blind eye to them,” he says.\u003c/p>\n\u003cp>A follow-up DMHC report to the one that resulted in last year’s $4 million fine is due in the fall. The DMHC’s Marta Green said it will take into account any complaints about long waits for follow-up appointments to individual therapy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_111725\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/09/supremecourt-640.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-111725\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/09/supremecourt-640.jpg\" alt=\"The Supreme Court of the United States. (Karen Bleier/AFP/Getty Images)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Supreme Court of the United States. (Karen Bleier/AFP/Getty Images) \u003ccite>((Karen Bleier/AFP/Getty Images))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Associated Press\u003c/strong>\u003c/p>\n\u003cp>WASHINGTON — The Supreme Court has rejected a challenge to California’s law that bars mental counseling aimed at turning gay minors straight.\u003c/p>\n\u003cp>The justices on Monday let stand without comment \u003ca href=\"http://www.lc.org/media/9980/attachments/pr_9th_pickup_v_brown_opinion_082913.pdf\" target=\"_blank\" rel=\"noopener\">a 2013 appeals court\u003c/a> ruling that said the state’s ban on so-called conversion therapy for minors doesn’t violate the free speech rights of licensed counselors and patients seeking treatment.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120SB1172\" target=\"_blank\" rel=\"noopener\">The law, SB1172,\u003c/a> was sponsored by state Sen. Ted Lieu (D-Torrance) and enacted in 2012.\u003c/p>\n\u003cp>\u003ca href=\"http://www.lc.org/\" target=\"_blank\" rel=\"noopener\">Liberty Counsel\u003c/a>, a Christian legal aid group, had challenged the law along with other supporters of the therapy. They argue that lawmakers have no scientific proof the therapy does harm.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The 9th U.S. Circuit Court of Appeals ruled last year that California lawmakers properly showed that efforts to change sexual orientation were outside the scientific mainstream and have been rejected for good reason.\u003c/p>\n\n",
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"excerpt": "Without comment, justices decline to hear lawsuit that would overturn ban on 'reparative therapy.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_111725\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/09/supremecourt-640.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-111725\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/09/supremecourt-640.jpg\" alt=\"The Supreme Court of the United States. (Karen Bleier/AFP/Getty Images)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Supreme Court of the United States. (Karen Bleier/AFP/Getty Images) \u003ccite>((Karen Bleier/AFP/Getty Images))\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Associated Press\u003c/strong>\u003c/p>\n\u003cp>WASHINGTON — The Supreme Court has rejected a challenge to California’s law that bars mental counseling aimed at turning gay minors straight.\u003c/p>\n\u003cp>The justices on Monday let stand without comment \u003ca href=\"http://www.lc.org/media/9980/attachments/pr_9th_pickup_v_brown_opinion_082913.pdf\" target=\"_blank\" rel=\"noopener\">a 2013 appeals court\u003c/a> ruling that said the state’s ban on so-called conversion therapy for minors doesn’t violate the free speech rights of licensed counselors and patients seeking treatment.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120SB1172\" target=\"_blank\" rel=\"noopener\">The law, SB1172,\u003c/a> was sponsored by state Sen. Ted Lieu (D-Torrance) and enacted in 2012.\u003c/p>\n\u003cp>\u003ca href=\"http://www.lc.org/\" target=\"_blank\" rel=\"noopener\">Liberty Counsel\u003c/a>, a Christian legal aid group, had challenged the law along with other supporters of the therapy. They argue that lawmakers have no scientific proof the therapy does harm.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "can-legislation-prevent-mass-shootings",
"title": "Isla Vista Aftermath: Can Legislation Prevent Mass Shootings?",
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"content": "\u003cp>\u003cstrong>By Lisa Pickoff-White, Mina Kim and Rachel Dornhelm\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_137311\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/493651175.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-137311\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/493651175-640x421.jpg\" alt=\"Bullet holes in the IV Deli Mart, one of several crime scenes Saturday, May 24, 2014. (Spencer Weiner/Getty Images)\" width=\"640\" height=\"421\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bullet holes in the IV Deli Mart, one of several crime scenes Saturday, May 24, 2014. (Spencer Weiner/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The UC Santa Barbara community is mourning the victims of a violent rampage Friday night that left seven dead, including the alleged killer. Three of the dead were \u003ca href=\"http://ww2.kqed.org/news/2014/05/26/stabbing-victims-in-isla-vista-killings-were-from-san-jose-fremont/\" target=\"_blank\" rel=\"noopener\">from the Bay Area\u003c/a>.\u003c/p>\n\u003cp>Authorities say 22-year-old Elliot Rodger stabbed to death three men in his apartment, and then shot three people and injured 13 others before shooting himself.\u003c/p>\n\u003cp>Rodger’s parents reportedly \u003ca href=\"http://ww2.kqed.org/news/2014/05/26/amid-multiple-warning-signs-alleged-isla-vista-killer-slipped-through-system/\" target=\"_blank\" rel=\"noopener\">alerted police last month\u003c/a> about concerns they had about their son. But police did not search his room, where he was stowing weapons.\u003c/p>\n\u003cp>Without probable cause to believe a crime was being committed, the police wouldn’t have had authority to go search his apartment. Also, while Rodger legally possessed three firearms, possession of a firearm is not in and of itself evidence of a criminal act or criminal intent.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Senate President pro Tem Darrell Steinberg (D-Sacramento) suggested that authorities should be required, as part of such welfare visits, to go beyond just talking and to check whether a person has purchased weapons.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘All we can do is take a public health approach to this and try to lower the number of gun victims every single day.’\u003c/aside>\n\u003cp>Additional steps could include searching the individual’s surroundings and talking to roommates, neighbors and relatives, he said.\u003c/p>\n\u003cp>“There need to be the protocols in place, training, and culture, which says when you see these kinds of warning signs you’re going to take consistent steps to double-check and make sure this person isn’t someone who might be prone to violence,” Steinberg said.\u003c/p>\n\u003cp>Currently, therapists can tell authorities when they fear a client is at risk of committing a violent act. However, there is no prohibition on firearms ownership unless someone has been involuntarily committed for mental health treatment.\u003c/p>\n\u003cp>Police could also use social media to help determine someone’s mental state, recommends \u003ca href=\"https://www.law.ucla.edu/faculty/faculty-profiles/adam-winkler\" target=\"_blank\" rel=\"noopener\">Adam Winkler\u003c/a>, a law professor at UCLA and a gun law expert.\u003c/p>\n\u003cp>“Sending seven deputies to someone’s home is not the best way to find out if someone is mentally ill or not,” Winkler said. “Perhaps we have to start taking seriously online threats and people’s social media presence as well. I don’t know if that digital footprint would have been enough to give police probably cause to search that home, but maybe something could have been found.”\u003c/p>\n\u003cp>The deputies found Rodger to be shy but polite and left without walking through the apartment or talking to anyone else. Rodger later wrote in his manifesto that deputies would have found his weapons and foiled his plot if only they had done a bit more checking.\u003c/p>\n\u003cp>Today, Assembly members Nancy Skinner (D-Berkeley) and Das Williams (D-Santa Barbara) announced legislation that would create a gun violence restraining order: Concerned family members, intimate partners or friends could notify law enforcement of someone who is demonstrating a propensity to commit violence toward themselves or others, and potentially prohibit the purchase of firearms or remove firearms already in possession.\u003c/p>\n\u003cp>“When someone is in crisis, the people closest to them are often the first to spot the warning signs, but almost nothing can now be done to get back their guns or prevent them from buying more,” said Skinner.\u003c/p>\n\u003cp>Winkler is not sure that legislation can make a difference, though.\u003c/p>\n\u003cp>“If we think about two of the main elements of President Obama’s gun proposals, limiting high-capacity magazines and background checks on every gun purchase, those are already the law in California and they certainly didn’t prevent this horrible tragedy,” Winkler said. “All we can do is take a public health approach to this and try to lower the number of gun victims every single day.”\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/151592397&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Don Thompson from the Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Lisa Pickoff-White, Mina Kim and Rachel Dornhelm\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_137311\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/493651175.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-137311\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/493651175-640x421.jpg\" alt=\"Bullet holes in the IV Deli Mart, one of several crime scenes Saturday, May 24, 2014. (Spencer Weiner/Getty Images)\" width=\"640\" height=\"421\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Bullet holes in the IV Deli Mart, one of several crime scenes Saturday, May 24, 2014. (Spencer Weiner/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The UC Santa Barbara community is mourning the victims of a violent rampage Friday night that left seven dead, including the alleged killer. Three of the dead were \u003ca href=\"http://ww2.kqed.org/news/2014/05/26/stabbing-victims-in-isla-vista-killings-were-from-san-jose-fremont/\" target=\"_blank\" rel=\"noopener\">from the Bay Area\u003c/a>.\u003c/p>\n\u003cp>Authorities say 22-year-old Elliot Rodger stabbed to death three men in his apartment, and then shot three people and injured 13 others before shooting himself.\u003c/p>\n\u003cp>Rodger’s parents reportedly \u003ca href=\"http://ww2.kqed.org/news/2014/05/26/amid-multiple-warning-signs-alleged-isla-vista-killer-slipped-through-system/\" target=\"_blank\" rel=\"noopener\">alerted police last month\u003c/a> about concerns they had about their son. But police did not search his room, where he was stowing weapons.\u003c/p>\n\u003cp>Without probable cause to believe a crime was being committed, the police wouldn’t have had authority to go search his apartment. Also, while Rodger legally possessed three firearms, possession of a firearm is not in and of itself evidence of a criminal act or criminal intent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Senate President pro Tem Darrell Steinberg (D-Sacramento) suggested that authorities should be required, as part of such welfare visits, to go beyond just talking and to check whether a person has purchased weapons.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘All we can do is take a public health approach to this and try to lower the number of gun victims every single day.’\u003c/aside>\n\u003cp>Additional steps could include searching the individual’s surroundings and talking to roommates, neighbors and relatives, he said.\u003c/p>\n\u003cp>“There need to be the protocols in place, training, and culture, which says when you see these kinds of warning signs you’re going to take consistent steps to double-check and make sure this person isn’t someone who might be prone to violence,” Steinberg said.\u003c/p>\n\u003cp>Currently, therapists can tell authorities when they fear a client is at risk of committing a violent act. However, there is no prohibition on firearms ownership unless someone has been involuntarily committed for mental health treatment.\u003c/p>\n\u003cp>Police could also use social media to help determine someone’s mental state, recommends \u003ca href=\"https://www.law.ucla.edu/faculty/faculty-profiles/adam-winkler\" target=\"_blank\" rel=\"noopener\">Adam Winkler\u003c/a>, a law professor at UCLA and a gun law expert.\u003c/p>\n\u003cp>“Sending seven deputies to someone’s home is not the best way to find out if someone is mentally ill or not,” Winkler said. “Perhaps we have to start taking seriously online threats and people’s social media presence as well. I don’t know if that digital footprint would have been enough to give police probably cause to search that home, but maybe something could have been found.”\u003c/p>\n\u003cp>The deputies found Rodger to be shy but polite and left without walking through the apartment or talking to anyone else. Rodger later wrote in his manifesto that deputies would have found his weapons and foiled his plot if only they had done a bit more checking.\u003c/p>\n\u003cp>Today, Assembly members Nancy Skinner (D-Berkeley) and Das Williams (D-Santa Barbara) announced legislation that would create a gun violence restraining order: Concerned family members, intimate partners or friends could notify law enforcement of someone who is demonstrating a propensity to commit violence toward themselves or others, and potentially prohibit the purchase of firearms or remove firearms already in possession.\u003c/p>\n\u003cp>“When someone is in crisis, the people closest to them are often the first to spot the warning signs, but almost nothing can now be done to get back their guns or prevent them from buying more,” said Skinner.\u003c/p>\n\u003cp>Winkler is not sure that legislation can make a difference, though.\u003c/p>\n\u003cp>“If we think about two of the main elements of President Obama’s gun proposals, limiting high-capacity magazines and background checks on every gun purchase, those are already the law in California and they certainly didn’t prevent this horrible tragedy,” Winkler said. “All we can do is take a public health approach to this and try to lower the number of gun victims every single day.”\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" width=\"100%\" height=\"166\" scrolling=\"no\" frameborder=\"no\" src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/151592397&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Don Thompson from the Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_137156\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/islavistavigil-640.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-137156 size-full\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/islavistavigil-640.jpg\" alt=\"A student lights a candle at a memorial for one of the victims of Elliot Rodger during a series of attacks near the UC Santa Barbara campus. (Robyn Beck/AFP-Getty Images)\" width=\"640\" height=\"400\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A student lights a candle at a memorial for one of the victims of Elliot Rodger during a series of attacks near the UC Santa Barbara campus. (Robyn Beck/AFP-Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Amid the horrific accounts of the Isla Vista mass murders and the ugly misogynistic resentments expressed by alleged killer Elliot Rodger, one of the startling facts to emerge in the incident is that Santa Barbara sheriff’s deputies met with Rodger on April 30 to determine if he posed a threat.\u003c/p>\n\u003cp>The officers checked on Rodger at his apartment “at the request of state mental health officials, acting on an expression of concern by his mother,” says the New York Times. “They left after a calm and polite Mr. Rodger assured them that there was nothing to worry about. The officers reported that Mr. Rodger was shy and had told them that he was having difficulties in his social life.”\u003c/p>\n\u003cp>The encounter with the deputies is described by Rodger in the 134-page autobiographical \u003ca href=\"http://www.nytimes.com/interactive/2014/05/25/us/shooting-document.html\" target=\"_blank\" rel=\"noopener\">manifesto\u003c/a> he sent out shortly before the attack. The document, which lays out the plans for a killing spree, is a bitter recounting of his life and the deep resentments he had built up, especially toward the women who continuously rejected him, he said. Here’s an excerpt about the meeting with the deputies, which occurred after he had posted disturbingly bitter \u003ca href=\"https://www.youtube.com/channel/UCgsBey7KX53-0qm-FSGTOyQ\" target=\"_blank\" rel=\"noopener\">videos\u003c/a> online:\u003c/p>\n\u003cblockquote>\u003cp>After only a week passed since I uploaded those videos on YouTube, I heard a knock on my apartment door. I opened it to see about seven police officers asking for me. As soon as I saw those cops, the biggest fear I had ever felt in my life overcame me. I had the striking and devastating fear that someone had somehow discovered what [I] was planning to do, and reported me for it.\u003c/p>\n\u003cp>If that was the case, the police would have searched my room, found all of my guns and weapons, along with my writings about what I plan to do with them. I would have been thrown in jail, denied of the chance to exact revenge on my enemies. I can’t imagine a hell darker than that. Thankfully, that wasn’t the case, but it was so close.\u003c/p>\n\u003cp>Apparently, someone saw my videos and became instantly suspicious of me. They called some sort of health agency, who called the police to check up on me. The police told me it was my mother who called them, but my mother told me it was the health agency. My mother had watched the videos and was very disturbed by them. I don’t suppose I’ll ever know the full truth of who called the police on me. The police interrogated me outside for a few minutes, asking me if I had suicidal thoughts. I tactfully told them that it was all a misunderstanding, and they finally left. If they had demanded to search my room … That would have ended everything. For a few horrible seconds I thought it was all over. When they left, the biggest wave of relief swept over me. It was so scary.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong style=\"color: #2b2b2b;font-size: 16px\">Rodger Visited by Sheriff’s Deputies in April\u003c/strong>\u003c/p>\n\u003cp>Santa Barbara County Sheriff Bill Brown discussed the visit by his deputies on CBS’s “Face The Nation.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We were asked by the mental health department to conduct a welfare check with Elliot Rodger to determine if he was a danger to himself or anyone else. This was prompted by a call by a third party; the mental health department contacted one of his relatives who had expressed some concern about his well-being.\u003c/p>\n\u003cp>“Our deputies went to check on (him) and contacted him outside his residence. They found him to be rather quiet, timid. He was polite and courteous. He was able to convince the deputies that this was all a misunderstanding. That although he was having some social problems, he was probably not going to be staying in school and returning home. He was able to make a very convincing story that there was no problem, that he wasn’t going to hurt himself or anyone else. And that he just didn’t meet the criteria for any further intervention at that point. Obviously looking back on this, it’s a very tragic situation, and we certainly wish we could turn the clock back and change some things….\u003c/p>\n\u003cp>Brown said that after reading Rodger’s manifesto, he believed the youth was able to “fly under the radar” in terms of his “likelihood of propensity to hurt anyone else.”\u003c/p>\n\u003cp>“When you read his autobiography and manifesto that he wrote,” Brown said, “it’s very apparent that he was able to convince many people for many years that he didn’t have this deep underlying obvious mental illness that manifested itself in this terrible tragedy.”\u003c/p>\n\u003cp>Brown said Rodger had purchased three handguns in the year before the incident, and because he had never been “institutionalized or committed for an involuntary hold,” the weapon sales were not flagged. When asked if anything in the visit should have prompted a check of Rodger’s weapons purchases, Brown said, “I think they actually, probably spoke to him about weapons, but I’m not sure a weapons check was conducted.”\u003c/p>\n\u003cp>Southern California Public Radio KPCC \u003ca href=\"http://www.scpr.org/news/2014/05/26/44370/isla-vista-massacre-did-sheriffs-deputies-miss-opp/\" target=\"_blank\" rel=\"noopener\">spoke to a pair of mental health experts\u003c/a> about \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=wic&group=05001-06000&file=5150-5155\" target=\"_blank\" rel=\"noopener\">Section 5150\u003c/a> of California’s Welfare and Institutions Code, which potentially could have allowed for authorities to detain Rodger involuntarily.\u003c/p>\n\u003cp>“They’re looking for body language, they’re looking for how you look at the officer,” said CarolAnn Peterson, who teaches at the USC School of Social Work. “[Taking note] if I’m kinda looking down or I’m looking at other directions. But if I’m looking directly at you — I’m answering the questions, I seem very calm, nothing seems out of the ordinary — law enforcement may not think that there’s a problem.”\u003c/p>\n\u003cp>Carla Jacobs, board member at the Virginia-based Treatment Advocacy Center, told KPCC that “waiting for danger means the danger can lead to horrendous tragedy as we have seen over and over again.” Doris Fuller, executive director of the center, told \u003ca href=\"http://www.cbsnews.com/news/elliot-rodgers-family-was-en-route-to-intervene-at-time-of-rampage/\" target=\"_blank\" rel=\"noopener\">CBS News\u003c/a>: “Once again, we are grieving over deaths and devastation caused by a young man who was sending up red flags for danger that failed to produce intervention in time to avert tragedy.”\u003c/p>\n\u003cp>KPCC said the sheriff’s office did not respond to a request to discuss any training on mental health issues the department receives.\u003c/p>\n\u003cp>\u003cstrong>Rodger’s Mental State\u003c/strong>\u003c/p>\n\u003cp>An attorney for Peter Rodger, Elliot’s father, told news organizations that the younger Elliot was highly functioning but had been diagnosed with \u003ca href=\"http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm\" target=\"_blank\" rel=\"noopener\">Asperger’s syndrome\u003c/a>, an autism spectrum disorder. The \u003ca href=\"http://www.nytimes.com/2014/05/26/us/parents-nightmare-failed-race-to-stop-killings.html\" target=\"_blank\" rel=\"noopener\">New York Times\u003c/a> and the \u003ca href=\"http://www.latimes.com/local/la-me-isla-vista-main-20140526-story.html#page=1\" target=\"_blank\" rel=\"noopener\">L.A. Times\u003c/a> spoke to neighbors and friends of Rodger’s and his family, most of whom described a sense of isolation and depression in Elliot. Both papers describe an incident at a party last summer resulting in one of the three contacts Rodger had with police. Rodger “tried to shove women off a ledge where they had been sitting,” according to the L.A. paper. “Several men intervened and pushed him off the ledge instead, and he injured his ankle.” Police interviewed him afterward, but no action was taken.\u003c/p>\n\u003cp>The paper sums up any warning signs of potential violence in Rodgers this way:\u003c/p>\n\u003cblockquote>\u003cp>It’s tempting, now that the finale has been written, to think that someone could have stepped in before Rodger killed six people and wounded 13 Friday before apparently killing himself, that the law could have been crafted to raise a red flag, to compel someone to act.\u003c/p>\n\u003cp>But according to interviews with Rodger’s acquaintances, law enforcement officials and mental health professionals, all that was known about the 22-year-old college student was that he was terribly sad. And being sad is not a crime, nor the sort of mental state that would, alone, cross a legal threshold requiring official response.\u003c/p>\u003c/blockquote>\n\u003cp>George Woods, a San Francisco psychiatrist, told the paper that Rodger was in an early stage of pre-psychosis, in which the patient can commonly mask symptoms. “They aren’t telling people their business,” he said.\u003c/p>\n\u003cp>In his 134-page screed, Rodger mentioned he had been under the care of \u003ca href=\"https://www.google.com/webhp?tab=ww&ei=B5aDU4DUDrGziAKvr4AY&ved=0CBcQ1S4#q=dr.+charles+sophy\" target=\"_blank\" rel=\"noopener\">Dr. Charles Sophy \u003c/a>of Beverly Hills. Sophy had prescribed Risperidone, Rodger wrote, an anti-psychotic drug that the \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694015.html\" target=\"_blank\" rel=\"noopener\">National Institutes of Health \u003c/a>describes as treating “mania (frenzied, abnormally excited or irritated mood) or mixed episodes (symptoms of mania and depression that happen together).”\u003c/p>\n\u003cp>Rodger wrote that he would not take the drug and that he never saw Sophy again.\u003c/p>\n\u003cp>The Southern Poverty Law Center, which monitors hate groups, \u003ca href=\"http://www.splcenter.org/blog/2014/05/24/shooting-suspect-elliot-rodgers-misogynistic-posts-point-to-motive/\">writes\u003c/a> that an online trail of Rodger’s posts on the Internet “suggests an ideology behind his lust for revenge.” The center \u003ca href=\"http://splcenter.org/blog/2014/05/24/elliot-rodger-isla-vista-shooting-suspect-posted-racist-messages-on-misogynistic-website/\">details\u003c/a> racist comments Rodger made on PuaHate.com, which the SPLC describes as “an online forum known for its misogyny.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>A friend of Rodger’s mother told the\u003ca href=\"http://www.nytimes.com/2014/05/26/us/parents-nightmare-failed-race-to-stop-killings.html\" target=\"_blank\" rel=\"noopener\"> New York Times\u003c/a> that Rodger’s mother read the manifesto detailing his murderous plans just 10 minutes before it began. She called her ex-husband, Rodger’s father, and then 911. Both parents raced separately to Isla Vista, but when they arrived it was too late.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_137156\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/islavistavigil-640.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-137156 size-full\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/05/islavistavigil-640.jpg\" alt=\"A student lights a candle at a memorial for one of the victims of Elliot Rodger during a series of attacks near the UC Santa Barbara campus. (Robyn Beck/AFP-Getty Images)\" width=\"640\" height=\"400\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A student lights a candle at a memorial for one of the victims of Elliot Rodger during a series of attacks near the UC Santa Barbara campus. (Robyn Beck/AFP-Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Amid the horrific accounts of the Isla Vista mass murders and the ugly misogynistic resentments expressed by alleged killer Elliot Rodger, one of the startling facts to emerge in the incident is that Santa Barbara sheriff’s deputies met with Rodger on April 30 to determine if he posed a threat.\u003c/p>\n\u003cp>The officers checked on Rodger at his apartment “at the request of state mental health officials, acting on an expression of concern by his mother,” says the New York Times. “They left after a calm and polite Mr. Rodger assured them that there was nothing to worry about. The officers reported that Mr. Rodger was shy and had told them that he was having difficulties in his social life.”\u003c/p>\n\u003cp>The encounter with the deputies is described by Rodger in the 134-page autobiographical \u003ca href=\"http://www.nytimes.com/interactive/2014/05/25/us/shooting-document.html\" target=\"_blank\" rel=\"noopener\">manifesto\u003c/a> he sent out shortly before the attack. The document, which lays out the plans for a killing spree, is a bitter recounting of his life and the deep resentments he had built up, especially toward the women who continuously rejected him, he said. Here’s an excerpt about the meeting with the deputies, which occurred after he had posted disturbingly bitter \u003ca href=\"https://www.youtube.com/channel/UCgsBey7KX53-0qm-FSGTOyQ\" target=\"_blank\" rel=\"noopener\">videos\u003c/a> online:\u003c/p>\n\u003cblockquote>\u003cp>After only a week passed since I uploaded those videos on YouTube, I heard a knock on my apartment door. I opened it to see about seven police officers asking for me. As soon as I saw those cops, the biggest fear I had ever felt in my life overcame me. I had the striking and devastating fear that someone had somehow discovered what [I] was planning to do, and reported me for it.\u003c/p>\n\u003cp>If that was the case, the police would have searched my room, found all of my guns and weapons, along with my writings about what I plan to do with them. I would have been thrown in jail, denied of the chance to exact revenge on my enemies. I can’t imagine a hell darker than that. Thankfully, that wasn’t the case, but it was so close.\u003c/p>\n\u003cp>Apparently, someone saw my videos and became instantly suspicious of me. They called some sort of health agency, who called the police to check up on me. The police told me it was my mother who called them, but my mother told me it was the health agency. My mother had watched the videos and was very disturbed by them. I don’t suppose I’ll ever know the full truth of who called the police on me. The police interrogated me outside for a few minutes, asking me if I had suicidal thoughts. I tactfully told them that it was all a misunderstanding, and they finally left. If they had demanded to search my room … That would have ended everything. For a few horrible seconds I thought it was all over. When they left, the biggest wave of relief swept over me. It was so scary.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong style=\"color: #2b2b2b;font-size: 16px\">Rodger Visited by Sheriff’s Deputies in April\u003c/strong>\u003c/p>\n\u003cp>Santa Barbara County Sheriff Bill Brown discussed the visit by his deputies on CBS’s “Face The Nation.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We were asked by the mental health department to conduct a welfare check with Elliot Rodger to determine if he was a danger to himself or anyone else. This was prompted by a call by a third party; the mental health department contacted one of his relatives who had expressed some concern about his well-being.\u003c/p>\n\u003cp>“Our deputies went to check on (him) and contacted him outside his residence. They found him to be rather quiet, timid. He was polite and courteous. He was able to convince the deputies that this was all a misunderstanding. That although he was having some social problems, he was probably not going to be staying in school and returning home. He was able to make a very convincing story that there was no problem, that he wasn’t going to hurt himself or anyone else. And that he just didn’t meet the criteria for any further intervention at that point. Obviously looking back on this, it’s a very tragic situation, and we certainly wish we could turn the clock back and change some things….\u003c/p>\n\u003cp>Brown said that after reading Rodger’s manifesto, he believed the youth was able to “fly under the radar” in terms of his “likelihood of propensity to hurt anyone else.”\u003c/p>\n\u003cp>“When you read his autobiography and manifesto that he wrote,” Brown said, “it’s very apparent that he was able to convince many people for many years that he didn’t have this deep underlying obvious mental illness that manifested itself in this terrible tragedy.”\u003c/p>\n\u003cp>Brown said Rodger had purchased three handguns in the year before the incident, and because he had never been “institutionalized or committed for an involuntary hold,” the weapon sales were not flagged. When asked if anything in the visit should have prompted a check of Rodger’s weapons purchases, Brown said, “I think they actually, probably spoke to him about weapons, but I’m not sure a weapons check was conducted.”\u003c/p>\n\u003cp>Southern California Public Radio KPCC \u003ca href=\"http://www.scpr.org/news/2014/05/26/44370/isla-vista-massacre-did-sheriffs-deputies-miss-opp/\" target=\"_blank\" rel=\"noopener\">spoke to a pair of mental health experts\u003c/a> about \u003ca href=\"http://www.leginfo.ca.gov/cgi-bin/displaycode?section=wic&group=05001-06000&file=5150-5155\" target=\"_blank\" rel=\"noopener\">Section 5150\u003c/a> of California’s Welfare and Institutions Code, which potentially could have allowed for authorities to detain Rodger involuntarily.\u003c/p>\n\u003cp>“They’re looking for body language, they’re looking for how you look at the officer,” said CarolAnn Peterson, who teaches at the USC School of Social Work. “[Taking note] if I’m kinda looking down or I’m looking at other directions. But if I’m looking directly at you — I’m answering the questions, I seem very calm, nothing seems out of the ordinary — law enforcement may not think that there’s a problem.”\u003c/p>\n\u003cp>Carla Jacobs, board member at the Virginia-based Treatment Advocacy Center, told KPCC that “waiting for danger means the danger can lead to horrendous tragedy as we have seen over and over again.” Doris Fuller, executive director of the center, told \u003ca href=\"http://www.cbsnews.com/news/elliot-rodgers-family-was-en-route-to-intervene-at-time-of-rampage/\" target=\"_blank\" rel=\"noopener\">CBS News\u003c/a>: “Once again, we are grieving over deaths and devastation caused by a young man who was sending up red flags for danger that failed to produce intervention in time to avert tragedy.”\u003c/p>\n\u003cp>KPCC said the sheriff’s office did not respond to a request to discuss any training on mental health issues the department receives.\u003c/p>\n\u003cp>\u003cstrong>Rodger’s Mental State\u003c/strong>\u003c/p>\n\u003cp>An attorney for Peter Rodger, Elliot’s father, told news organizations that the younger Elliot was highly functioning but had been diagnosed with \u003ca href=\"http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm\" target=\"_blank\" rel=\"noopener\">Asperger’s syndrome\u003c/a>, an autism spectrum disorder. The \u003ca href=\"http://www.nytimes.com/2014/05/26/us/parents-nightmare-failed-race-to-stop-killings.html\" target=\"_blank\" rel=\"noopener\">New York Times\u003c/a> and the \u003ca href=\"http://www.latimes.com/local/la-me-isla-vista-main-20140526-story.html#page=1\" target=\"_blank\" rel=\"noopener\">L.A. Times\u003c/a> spoke to neighbors and friends of Rodger’s and his family, most of whom described a sense of isolation and depression in Elliot. Both papers describe an incident at a party last summer resulting in one of the three contacts Rodger had with police. Rodger “tried to shove women off a ledge where they had been sitting,” according to the L.A. paper. “Several men intervened and pushed him off the ledge instead, and he injured his ankle.” Police interviewed him afterward, but no action was taken.\u003c/p>\n\u003cp>The paper sums up any warning signs of potential violence in Rodgers this way:\u003c/p>\n\u003cblockquote>\u003cp>It’s tempting, now that the finale has been written, to think that someone could have stepped in before Rodger killed six people and wounded 13 Friday before apparently killing himself, that the law could have been crafted to raise a red flag, to compel someone to act.\u003c/p>\n\u003cp>But according to interviews with Rodger’s acquaintances, law enforcement officials and mental health professionals, all that was known about the 22-year-old college student was that he was terribly sad. And being sad is not a crime, nor the sort of mental state that would, alone, cross a legal threshold requiring official response.\u003c/p>\u003c/blockquote>\n\u003cp>George Woods, a San Francisco psychiatrist, told the paper that Rodger was in an early stage of pre-psychosis, in which the patient can commonly mask symptoms. “They aren’t telling people their business,” he said.\u003c/p>\n\u003cp>In his 134-page screed, Rodger mentioned he had been under the care of \u003ca href=\"https://www.google.com/webhp?tab=ww&ei=B5aDU4DUDrGziAKvr4AY&ved=0CBcQ1S4#q=dr.+charles+sophy\" target=\"_blank\" rel=\"noopener\">Dr. Charles Sophy \u003c/a>of Beverly Hills. Sophy had prescribed Risperidone, Rodger wrote, an anti-psychotic drug that the \u003ca href=\"http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694015.html\" target=\"_blank\" rel=\"noopener\">National Institutes of Health \u003c/a>describes as treating “mania (frenzied, abnormally excited or irritated mood) or mixed episodes (symptoms of mania and depression that happen together).”\u003c/p>\n\u003cp>Rodger wrote that he would not take the drug and that he never saw Sophy again.\u003c/p>\n\u003cp>The Southern Poverty Law Center, which monitors hate groups, \u003ca href=\"http://www.splcenter.org/blog/2014/05/24/shooting-suspect-elliot-rodgers-misogynistic-posts-point-to-motive/\">writes\u003c/a> that an online trail of Rodger’s posts on the Internet “suggests an ideology behind his lust for revenge.” The center \u003ca href=\"http://splcenter.org/blog/2014/05/24/elliot-rodger-isla-vista-shooting-suspect-posted-racist-messages-on-misogynistic-website/\">details\u003c/a> racist comments Rodger made on PuaHate.com, which the SPLC describes as “an online forum known for its misogyny.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A friend of Rodger’s mother told the\u003ca href=\"http://www.nytimes.com/2014/05/26/us/parents-nightmare-failed-race-to-stop-killings.html\" target=\"_blank\" rel=\"noopener\"> New York Times\u003c/a> that Rodger’s mother read the manifesto detailing his murderous plans just 10 minutes before it began. She called her ex-husband, Rodger’s father, and then 911. Both parents raced separately to Isla Vista, but when they arrived it was too late.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The Killing of Jeremiah Moore: Parents Want Answers in 2012 Vallejo Police Shooting",
"title": "The Killing of Jeremiah Moore: Parents Want Answers in 2012 Vallejo Police Shooting",
"headTitle": "News Fix | KQED News",
"content": "\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/143784928\" params=\"color=ff5500&inverse=false&auto_play=false&show_user=true\" width=\"100%\" height=\"200\" iframe=\"true\" /]\u003c/p>\n\u003cfigure id=\"attachment_132025\" class=\"wp-caption alignleft\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/jeremiah.jpg\">\u003cimg class=\"size-full wp-image-132025\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/jeremiah.jpg\" alt=\"Photo of Jeremiah Moore. (Courtesy of Lisa Moore, his mother)\" width=\"270\" height=\"509\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jeremiah Moore. (Courtesy of Lisa Moore, his mother)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">A\u003c/span> year and a half after a Vallejo police officer shot and killed 29-year-old Jeremiah Moore, the dead man's parents are struggling to understand how and why it happened. Police say Moore was shot after he threatened officers with a rifle — an account contradicted by a witness whom investigators have yet to interview.\u003c/p>\n\u003cp>The Vallejo Police Department and Solano County District Attorney's office still haven't disclosed basic details of their investigation, including Moore's autopsy and results of a toxicology report that could show whether he had drugs in his system when police shot him.\u003c/p>\n\u003cp>Eugene and Lisa Moore say, most of all, they want to understand why police found it necessary to shoot someone they say was kind, curious and trying to overcome the social isolation that went along with a diagnosis of an autism spectrum disorder.\u003c/p>\n\u003cp>\"They owe us the truth. They really do,\" Lisa Moore says. \"I want to know the truth. Why did you shoot my son? Be honest with us. Tell us what happened. Because I don't buy the story that he put a gun on you. I do not buy it.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"d4cf6531df2c11f7c3ead511a0a31b3c\"]\u003c/p>\n\u003cp>The events that led to Moore's killing began unfolding about 11:30 p.m. on Saturday, Oct. 20, 2012, when people on a quiet Vallejo street were awakened by loud banging and shouts. The noise was coming from 2504 Alameda Drive, the house next door to the home of Marvin Clouse. He grabbed a video camera and went outside to investigate.\u003c/p>\n\u003cp>Clouse says he saw his neighbors, Jason Jessie and Jeremiah Moore, smashing the windows of their own cars, parked in front of their house. The men were naked, and Jessie was calling out commands to Moore. Lisa Moore says her son's disorder gave him a tendency to follow commands.\u003c/p>\n\u003cp>“I hope this is right, I’m destroying everything. Destroy it, Jeremiah. I want you to destroy it,\" Jessie can be heard saying on Clouse's video. \"Windshields are the soul. Windshield is god, break it. Break through.”\u003c/p>\n\u003cp>\u003cem>Clouse's video is too dark to see more than occasional flashes of light. In the audio, however, you can hear Jason Jessie giving orders to Jeremiah Moore, and Moore responding.\u003c/em>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/143584765\" 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>The disturbance continued well after midnight, and Clouse eventually taped Moore telling Jessie, “You start the fire.” At this point, Clouse says, he ran inside to call the Fire Department. Police officers, responding to multiple calls from the public, arrived as smoke began pouring from the upstairs bedroom window of the house.\u003c/p>\n\u003cp>\u003ca href=\"http://www.ci.vallejo.ca.us/common/pages/DisplayFile.aspx?itemId=31056\" target=\"_blank\">A Vallejo Police Department press release\u003c/a> said officers arrived at the scene at 1:33 a.m. and confronted a naked man, who turned out to be Jason Jessie, inside the residence. Then, the release said, a second naked man — Moore — \"appeared from the back of the interior of the house with a rifle. The man with the rifle placed the barrel of the rifle directly against an officer’s stomach. Another officer saw this and fearing for his life and the life of his fellow officer, immediately discharged his firearm at the man with the rifle. The man with the rifle fell to the floor and was taken into custody.\"\u003c/p>\n\u003cp>Clouse by this time was back outside with his camera rolling. His recording captured the sound of gunshots, a 10-second pause, then an officer repeatedly ordering someone to \"show me your hands.\" Then two more shots ring out.\u003c/p>\n\u003cp>\u003cem>The content of this audio is graphic. These events happened at some point later than the first audio excerpt, after Clouse turned off the video camera and then turned it back on. We have made no internal edits in this excerpt.\u003c/em>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/143585887\" 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>Moore was pronounced dead at Kaiser Hospital in Vallejo, just blocks from his home, at 2:04 a.m.\u003c/p>\n\u003cp>Jessie was arrested, and charged with misdemeanor resisting arrest and battery on a peace officer. Those charges were later dropped. No arson charges were filed, despite fire investigators' conclusion that the blaze was intentionally set with gasoline.\u003c/p>\n\u003cp>\u003cstrong>Another Witness\u003c/strong>\u003c/p>\n\u003cp>Clouse wasn't the only neighbor watching the scene at 2504 Alameda Drive.\u003c/p>\n\u003cp>Jaime Alvarado lived across the street and says he was playing a computer game when he heard the commotion coming from the Moore-Jessie residence. Alvarado says he went to an upstairs window, where he had a clear view of Moore's and Jessie’s front yard and porch, and he saw police arrive.\u003c/p>\n\u003cp>Alvarado describes seeing a naked man standing in the doorway across the street when the man was shot by police positioned at the bottom of the porch.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'I know, this guy who got shot, he doesn’t have a rifle in his hands.'\u003cbr>\n\u003ccite>—Jaime Alvarado, neighbor\u003c/cite>\u003c/aside>\n\u003cp>He says the man was waving his arms strangely — a flailing that he couldn't seem to stop. He says he could clearly see the man's hands, and there was nothing in them.\u003c/p>\n\u003cp>“What I heard was the officers told him to stop moving, and he can’t stop moving,” Alvarado says. “He starts shaking. That’s when the officer gets, like, scared. He got the gun and shoots him.”\u003c/p>\n\u003cp>“I know, this guy who got shot, he doesn’t have a rifle in his hands,” Alvarado says. “The officer who was firing the shots, he was before the stairs, and the man who got shot, he was on top of the steps.” He estimated the officer was 8 to 10 feet away from the man he shot.\u003c/p>\n\u003cp>Alvarado says police then dragged Moore away from the house, “like a piece of garbage. They don’t even check if he was alive or anything.”\u003c/p>\n\u003cp>Alvarado says the next morning he tried to tell an officer what he had seen, but was told to go back inside his house. Since then, he has repeated his account to three separate private investigators working for Moore’s family, but says he has not been interviewed by district attorney's investigators or police detectives.\u003c/p>\n\u003cp>[contextly_sidebar id=\"5ac40e12cf857685f25285a8c42b025d\"]\u003c/p>\n\u003cp>Both the Vallejo Police Department and the Solano County District Attorney's office say it's a matter of policy to canvass a neighborhood for witnesses.\u003c/p>\n\u003cp>Solano County District Attorney Donald du Bain said late last month he’d be happy to take Alvarado's statement. The DA's office confirmed to KQED that while Alvarado and one of the DA's investigators have since spoken on the phone, no statement had been taken as of Tuesday afternoon, April 9.\u003c/p>\n\u003cp>Jason Jessie moved to Arizona in December 2012. He says now he doesn’t remember Moore having a gun when he was shot, but he doesn’t remember much about the shooting. He says his mind has “shut out” the traumatic incident.\u003c/p>\n\u003cp>“I had to watch it,” he says. “I was covered in blood.”\u003c/p>\n\u003cp>Jessie says he doesn’t remember and can’t explain the men's behavior leading up to the shooting, but he insists he and Moore used only marijuana, and he thinks Moore’s toxicology report will prove that.\u003c/p>\n\u003cp>Lisa Moore’s face contorts with grief when she hears Alvarado’s description of her son’s waving hands.\u003c/p>\n\u003cp>“That was Jeremiah, when he was nervous,” says Moore, who lives in Santa Rosa with her husband. She thinks her son’s autism spectrum disorder played a direct role in the shooting. His family always knew Moore to strictly follow rules and orders, like those given by Jessie and also by police. She says his nervous twitching or flailing could easily have been mistaken for a quick hand movement just before he was shot.\u003c/p>\n\u003cp>\u003cstrong>Who Was Jeremiah Moore?\u003c/strong>\u003c/p>\n\u003cp>Family photos show a young man with short hair and an easy, almost goofy smile. Lisa Moore says as an infant, her son was a wonderfully well-behaved baby who would sit quietly in a playpen for hours. It was years before the parents realized their first child was a little \u003cem>too\u003c/em> calm, and Lisa Moore says he was eventually diagnosed with an autism spectrum disorder.\u003c/p>\n\u003cp>As Jeremiah Moore grew, his different way of seeing the world isolated him from his peers. Lisa Moore said he began speaking late, and his difficulty communicating would frustrate him, but he was never violent. She choked up remembering a time her son asked her why he never got invited to parties.\u003c/p>\n\u003cp>But when Moore started attending community college, “all of a sudden he just blossomed,” says his father, Eugene Moore. He pursued his interest in working with his hands and was well on his way to becoming a journeyman plumber when he was shot. (His union made him a journeyman posthumously.)\u003c/p>\n\u003cfigure id=\"attachment_131847\" class=\"wp-caption alignright\" style=\"max-width: 368px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/IMG_9041.jpg\">\u003cimg class=\" wp-image-131847 \" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/IMG_9041-640x409.jpg\" alt='Marvin Clouse shows the video he shot the night of Oct. 20, 2012, when his neighbor Jeremiah Moore was shot and killed by Vallejo police. (Alex Emslie/KQED)\" ' width=\"368\" height=\"235\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Marvin Clouse shows the video he shot the night of Oct. 20, 2012, when his neighbor, Jeremiah Moore, was shot and killed by Vallejo police. (Alex Emslie/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>People who knew Jeremiah Moore remember his fascination with electronics and antique light bulbs. He made friends with people with similar interests in an online lighting community, his father says.\u003c/p>\n\u003cp>Clouse remembers Moore’s eyes sparkling when he saw an old fluorescent light bulb in his neighbor’s shed. “He said, ‘Ooooh, can I have that?’” Clouse says. He says Moore was always kind and had been helping him work on his truck in the days before he was shot.\u003c/p>\n\u003cp>\"Jeremiah was a good worker,\" Clouse says. \"He’d get up at 2 in the morning to drive down to San Jose and work as a plumber, and he was always fixing his cars and they were fixing computers. I could come over with any questions, and he was a really kind, caring person. And I really miss him.\"\u003c/p>\n\u003cp>Moore met Jason Jessie online and moved into Jessie's rented house on Alameda Drive less than a year before the shooting. His parents say it was Moore's first serious romantic relationship, and he kept it fairly private. Sometimes the couple would fight, and Moore would call his mother to talk it out, she says.\u003c/p>\n\u003cp>Jessie says the only gun in their house was an antique .22-caliber rifle from the 1920s.\u003c/p>\n\u003cp>Clouse says the police could have helped Moore. \"My feeling about the police is that I believe they murdered my neighbor Jeremiah,\" Clouse says, \"and they came in like a SWAT team attacking someone who was not a threat, someone who actually needed to be helped.\"\u003c/p>\n\u003cp>\u003cstrong>Investigating Officer-Involved Shootings\u003c/strong>\u003c/p>\n\u003cp>All police departments in Solano County have signed on to the district attorney’s “Officer Involved Fatal Incident Protocol,” which dictates a joint investigation by local police detectives and DA investigators. Of the 21 completed investigations since 2008, most were finished within a year. Only two have taken longer than Moore’s case.\u003c/p>\n\u003cp>More than half of those shootings were by Vallejo police, and six occurred in 2012, a year after the city emerged from \u003ca href=\"http://www.californiareport.org/archive/R201303221630/b\" target=\"_blank\">bankruptcy\u003c/a> following the recession. Perhaps the most \u003ca href=\"http://ww2.kqed.org/news/2012/09/21/pressure-mounting-in-vallejo-police-fatal-shooting/\" target=\"_blank\">notorious\u003c/a> incident occurred seven weeks before Moore's shooting. Witnesses say a police officer got up on the hood of a car and fired at Mario Romero and another man sitting inside the car, but the police and the DA investigation concluded the officer did not fire from the hood of the car. Romero died, and the DA and U.S. Attorney's office cleared the officer of any wrongdoing in the case.\u003c/p>\n\u003cp>Vallejo criminal defense attorney Dan Russo is familiar with the Moore shooting, and he says he has serious doubts about the police department’s story.\u003c/p>\n\u003cp>“Even if this shooting was a legitimate use of deadly force, that’s something that should have been figured out a year ago,” he says. “This is why people distrust public agencies, and more important than that, Vallejo is in a really stressful situation. The last thing you want to do is lose community support, and when an investigation into a shooting takes a year and a half, without any kind of pronouncement, without any kind of information to the parties, it’s corrupting to everything. It creates a bad environment in the city. It makes the cops’ job harder.”\u003c/p>\n\u003cp>Russo says he’s used to homicide cases that are filed within days of an incident, and that much of the information Moore’s parents are still seeking in order to understand what happened that night is normally made public.\u003c/p>\n\u003cp>Russo also says he doesn’t see the Moore shooting as an isolated incident.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.google.com/fusiontables/embedviz?containerId=googft-gviz-canvas&q=select+col4%2C+count()+from+1qVUrvNfuc5-Mcg2FrED6ejTFYbMXPi5hUTL-hv60+group+by+col4+order+by+col4+asc+limit+10&viz=GVIZ&t=COLUMN&uiversion=2&gco_forceIFrame=true&gco_hasLabelsColumn=true&gco_vAxes=%5B%7B%22title%22%3Anull%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22logScale%22%3Afalse%7D%2C%7B%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22logScale%22%3Afalse%7D%5D&gco_useFirstColumnAsDomain=true&gco_isStacked=false&gco_booleanRole=certainty&gco_hAxis=%7B%22useFormatFromData%22%3Atrue%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22viewWindow%22%3Anull%2C+%22viewWindowMode%22%3Anull%2C+%22textStyle%22%3A%7B%22color%22%3A%22%23222%22%2C+%22fontSize%22%3A%229%22%2C+%22bold%22%3Atrue%7D%2C+%22slantedTextAngle%22%3A30%2C+%22slantedText%22%3Atrue%7D&gco_legend=none&gco_title=Investigations+of+Officer-Involved+Shootings+Completed+by+the+Solano+County+DA+since+2008&gco_series=%7B%220%22%3A%7B%22color%22%3A%22%230000ff%22%7D%7D&gco_titleTextStyle=%7B%22color%22%3A%22%23000%22%2C+%22fontSize%22%3A%2216%22%2C+%22bold%22%3Atrue%7D&gco_fontName=Arial&width=640&height=300\" frameborder=\"no\" scrolling=\"no\" width=\"640\" height=\"300\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“Somebody is going to have to take responsibility for the fact that because of cutbacks to the police department, police are less supported,” he says. That means there are fewer officers to cover each other, he says, and creates a situation where there's little accountability when it comes to shootings.\u003c/p>\n\u003cp>“This kind of all adds up to an environment where you’re not telling anybody what’s happening, and you have what I consider in my experience of being in this town for 37 years, a really unusual environment where you have a large number of police shootings.”\u003c/p>\n\u003cp>Vallejo Police Lt. Sid De Jesus says there are a lot of theories about the increase in officer-involved shootings in 2012. He says violent crime was up substantially, and the department was down to 84 sworn officers from 158 when the recession began in 2008. That puts Vallejo’s officer-to-population ratio at about half the national average.\u003c/p>\n\u003cp>“It creates a huge safety concern for officers,” he says. “But more importantly, it (the low police presence) creates a huge safety concern for citizens of this community.”\u003c/p>\n\u003cp>De Jesus says quality of life in Vallejo has suffered, and officers who elected to stay with the struggling department in the struggling city are concerned.\u003c/p>\n\u003cp>Solano District Attorney du Bain says his office’s review of the Moore shooting is close to completion. He says that sometimes the long investigations could strain public trust, but that the cases are taken very seriously.\u003c/p>\n\u003cp>“I’ve insisted these reviews be conducted by a chief deputy district attorney, not a line attorney, and that they be approved by me,” he says. “Our reviews are thorough, and I’ve tried to ensure that we handle these cases very carefully.”\u003c/p>\n\u003cp>De Jesus adds, \"I can certainly tell you that I would assume that all of the DA’s findings have all been completed, and now they’re just in the stage of putting their case together, along with ours, and ensuring that every aspect of the incident has been addressed. It’s not uncommon for cases such as this, especially a case such as this that is completely complex. A lot of people may say, 'What makes it so complex?' There’s a lot of moving parts to it. There’s a lot of extenuating issues that were involved in this. And for those that were involved with the case and read what was publicized in the paper. So it’s not uncommon for these cases to take a little bit longer to come to a conclusion.\"\u003c/p>\n\u003cp>\u003cstrong>Civil Lawsuit\u003c/strong>\u003c/p>\n\u003cp>Eugene and Lisa Moore say they haven’t been able to find an attorney to take their case, so they’re representing themselves in a wrongful death lawsuit against Vallejo and its police department. They both think the strange circumstances leading up to the shooting are scaring attorneys from taking the case.\u003c/p>\n\u003cp>“We’re learning as we’re going, and it’s going to be frustrating because what if we screw up and I can’t do anything about my son’s death?” Eugene Moore says. “That’s my biggest fear. If they’re in the wrong and I screw up, I can’t do anything about it.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The Vallejo city attorney recently filed a motion to dismiss the family’s claim on the grounds that their complaint is devoid of underlying facts about the shooting. The motion could be heard in early May.\u003c/p>\n\n",
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"title": "The Killing of Jeremiah Moore: Parents Want Answers in 2012 Vallejo Police Shooting | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='200'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/143784928&visual=true&color=ff5500&inverse=false&auto_play=false&show_user=true'\n title='https://api.soundcloud.com/tracks/143784928'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cfigure id=\"attachment_132025\" class=\"wp-caption alignleft\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/jeremiah.jpg\">\u003cimg class=\"size-full wp-image-132025\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/jeremiah.jpg\" alt=\"Photo of Jeremiah Moore. (Courtesy of Lisa Moore, his mother)\" width=\"270\" height=\"509\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Jeremiah Moore. (Courtesy of Lisa Moore, his mother)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">A\u003c/span> year and a half after a Vallejo police officer shot and killed 29-year-old Jeremiah Moore, the dead man's parents are struggling to understand how and why it happened. Police say Moore was shot after he threatened officers with a rifle — an account contradicted by a witness whom investigators have yet to interview.\u003c/p>\n\u003cp>The Vallejo Police Department and Solano County District Attorney's office still haven't disclosed basic details of their investigation, including Moore's autopsy and results of a toxicology report that could show whether he had drugs in his system when police shot him.\u003c/p>\n\u003cp>Eugene and Lisa Moore say, most of all, they want to understand why police found it necessary to shoot someone they say was kind, curious and trying to overcome the social isolation that went along with a diagnosis of an autism spectrum disorder.\u003c/p>\n\u003cp>\"They owe us the truth. They really do,\" Lisa Moore says. \"I want to know the truth. Why did you shoot my son? Be honest with us. Tell us what happened. Because I don't buy the story that he put a gun on you. I do not buy it.\"\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>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The events that led to Moore's killing began unfolding about 11:30 p.m. on Saturday, Oct. 20, 2012, when people on a quiet Vallejo street were awakened by loud banging and shouts. The noise was coming from 2504 Alameda Drive, the house next door to the home of Marvin Clouse. He grabbed a video camera and went outside to investigate.\u003c/p>\n\u003cp>Clouse says he saw his neighbors, Jason Jessie and Jeremiah Moore, smashing the windows of their own cars, parked in front of their house. The men were naked, and Jessie was calling out commands to Moore. Lisa Moore says her son's disorder gave him a tendency to follow commands.\u003c/p>\n\u003cp>“I hope this is right, I’m destroying everything. Destroy it, Jeremiah. I want you to destroy it,\" Jessie can be heard saying on Clouse's video. \"Windshields are the soul. Windshield is god, break it. Break through.”\u003c/p>\n\u003cp>\u003cem>Clouse's video is too dark to see more than occasional flashes of light. In the audio, however, you can hear Jason Jessie giving orders to Jeremiah Moore, and Moore responding.\u003c/em>\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/143584765&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/143584765'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The disturbance continued well after midnight, and Clouse eventually taped Moore telling Jessie, “You start the fire.” At this point, Clouse says, he ran inside to call the Fire Department. Police officers, responding to multiple calls from the public, arrived as smoke began pouring from the upstairs bedroom window of the house.\u003c/p>\n\u003cp>\u003ca href=\"http://www.ci.vallejo.ca.us/common/pages/DisplayFile.aspx?itemId=31056\" target=\"_blank\">A Vallejo Police Department press release\u003c/a> said officers arrived at the scene at 1:33 a.m. and confronted a naked man, who turned out to be Jason Jessie, inside the residence. Then, the release said, a second naked man — Moore — \"appeared from the back of the interior of the house with a rifle. The man with the rifle placed the barrel of the rifle directly against an officer’s stomach. Another officer saw this and fearing for his life and the life of his fellow officer, immediately discharged his firearm at the man with the rifle. The man with the rifle fell to the floor and was taken into custody.\"\u003c/p>\n\u003cp>Clouse by this time was back outside with his camera rolling. His recording captured the sound of gunshots, a 10-second pause, then an officer repeatedly ordering someone to \"show me your hands.\" Then two more shots ring out.\u003c/p>\n\u003cp>\u003cem>The content of this audio is graphic. These events happened at some point later than the first audio excerpt, after Clouse turned off the video camera and then turned it back on. We have made no internal edits in this excerpt.\u003c/em>\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/143585887&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/143585887'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Moore was pronounced dead at Kaiser Hospital in Vallejo, just blocks from his home, at 2:04 a.m.\u003c/p>\n\u003cp>Jessie was arrested, and charged with misdemeanor resisting arrest and battery on a peace officer. Those charges were later dropped. No arson charges were filed, despite fire investigators' conclusion that the blaze was intentionally set with gasoline.\u003c/p>\n\u003cp>\u003cstrong>Another Witness\u003c/strong>\u003c/p>\n\u003cp>Clouse wasn't the only neighbor watching the scene at 2504 Alameda Drive.\u003c/p>\n\u003cp>Jaime Alvarado lived across the street and says he was playing a computer game when he heard the commotion coming from the Moore-Jessie residence. Alvarado says he went to an upstairs window, where he had a clear view of Moore's and Jessie’s front yard and porch, and he saw police arrive.\u003c/p>\n\u003cp>Alvarado describes seeing a naked man standing in the doorway across the street when the man was shot by police positioned at the bottom of the porch.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'I know, this guy who got shot, he doesn’t have a rifle in his hands.'\u003cbr>\n\u003ccite>—Jaime Alvarado, neighbor\u003c/cite>\u003c/aside>\n\u003cp>He says the man was waving his arms strangely — a flailing that he couldn't seem to stop. He says he could clearly see the man's hands, and there was nothing in them.\u003c/p>\n\u003cp>“What I heard was the officers told him to stop moving, and he can’t stop moving,” Alvarado says. “He starts shaking. That’s when the officer gets, like, scared. He got the gun and shoots him.”\u003c/p>\n\u003cp>“I know, this guy who got shot, he doesn’t have a rifle in his hands,” Alvarado says. “The officer who was firing the shots, he was before the stairs, and the man who got shot, he was on top of the steps.” He estimated the officer was 8 to 10 feet away from the man he shot.\u003c/p>\n\u003cp>Alvarado says police then dragged Moore away from the house, “like a piece of garbage. They don’t even check if he was alive or anything.”\u003c/p>\n\u003cp>Alvarado says the next morning he tried to tell an officer what he had seen, but was told to go back inside his house. Since then, he has repeated his account to three separate private investigators working for Moore’s family, but says he has not been interviewed by district attorney's investigators or police detectives.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Both the Vallejo Police Department and the Solano County District Attorney's office say it's a matter of policy to canvass a neighborhood for witnesses.\u003c/p>\n\u003cp>Solano County District Attorney Donald du Bain said late last month he’d be happy to take Alvarado's statement. The DA's office confirmed to KQED that while Alvarado and one of the DA's investigators have since spoken on the phone, no statement had been taken as of Tuesday afternoon, April 9.\u003c/p>\n\u003cp>Jason Jessie moved to Arizona in December 2012. He says now he doesn’t remember Moore having a gun when he was shot, but he doesn’t remember much about the shooting. He says his mind has “shut out” the traumatic incident.\u003c/p>\n\u003cp>“I had to watch it,” he says. “I was covered in blood.”\u003c/p>\n\u003cp>Jessie says he doesn’t remember and can’t explain the men's behavior leading up to the shooting, but he insists he and Moore used only marijuana, and he thinks Moore’s toxicology report will prove that.\u003c/p>\n\u003cp>Lisa Moore’s face contorts with grief when she hears Alvarado’s description of her son’s waving hands.\u003c/p>\n\u003cp>“That was Jeremiah, when he was nervous,” says Moore, who lives in Santa Rosa with her husband. She thinks her son’s autism spectrum disorder played a direct role in the shooting. His family always knew Moore to strictly follow rules and orders, like those given by Jessie and also by police. She says his nervous twitching or flailing could easily have been mistaken for a quick hand movement just before he was shot.\u003c/p>\n\u003cp>\u003cstrong>Who Was Jeremiah Moore?\u003c/strong>\u003c/p>\n\u003cp>Family photos show a young man with short hair and an easy, almost goofy smile. Lisa Moore says as an infant, her son was a wonderfully well-behaved baby who would sit quietly in a playpen for hours. It was years before the parents realized their first child was a little \u003cem>too\u003c/em> calm, and Lisa Moore says he was eventually diagnosed with an autism spectrum disorder.\u003c/p>\n\u003cp>As Jeremiah Moore grew, his different way of seeing the world isolated him from his peers. Lisa Moore said he began speaking late, and his difficulty communicating would frustrate him, but he was never violent. She choked up remembering a time her son asked her why he never got invited to parties.\u003c/p>\n\u003cp>But when Moore started attending community college, “all of a sudden he just blossomed,” says his father, Eugene Moore. He pursued his interest in working with his hands and was well on his way to becoming a journeyman plumber when he was shot. (His union made him a journeyman posthumously.)\u003c/p>\n\u003cfigure id=\"attachment_131847\" class=\"wp-caption alignright\" style=\"max-width: 368px\">\u003ca href=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/IMG_9041.jpg\">\u003cimg class=\" wp-image-131847 \" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2014/04/IMG_9041-640x409.jpg\" alt='Marvin Clouse shows the video he shot the night of Oct. 20, 2012, when his neighbor Jeremiah Moore was shot and killed by Vallejo police. (Alex Emslie/KQED)\" ' width=\"368\" height=\"235\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Marvin Clouse shows the video he shot the night of Oct. 20, 2012, when his neighbor, Jeremiah Moore, was shot and killed by Vallejo police. (Alex Emslie/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>People who knew Jeremiah Moore remember his fascination with electronics and antique light bulbs. He made friends with people with similar interests in an online lighting community, his father says.\u003c/p>\n\u003cp>Clouse remembers Moore’s eyes sparkling when he saw an old fluorescent light bulb in his neighbor’s shed. “He said, ‘Ooooh, can I have that?’” Clouse says. He says Moore was always kind and had been helping him work on his truck in the days before he was shot.\u003c/p>\n\u003cp>\"Jeremiah was a good worker,\" Clouse says. \"He’d get up at 2 in the morning to drive down to San Jose and work as a plumber, and he was always fixing his cars and they were fixing computers. I could come over with any questions, and he was a really kind, caring person. And I really miss him.\"\u003c/p>\n\u003cp>Moore met Jason Jessie online and moved into Jessie's rented house on Alameda Drive less than a year before the shooting. His parents say it was Moore's first serious romantic relationship, and he kept it fairly private. Sometimes the couple would fight, and Moore would call his mother to talk it out, she says.\u003c/p>\n\u003cp>Jessie says the only gun in their house was an antique .22-caliber rifle from the 1920s.\u003c/p>\n\u003cp>Clouse says the police could have helped Moore. \"My feeling about the police is that I believe they murdered my neighbor Jeremiah,\" Clouse says, \"and they came in like a SWAT team attacking someone who was not a threat, someone who actually needed to be helped.\"\u003c/p>\n\u003cp>\u003cstrong>Investigating Officer-Involved Shootings\u003c/strong>\u003c/p>\n\u003cp>All police departments in Solano County have signed on to the district attorney’s “Officer Involved Fatal Incident Protocol,” which dictates a joint investigation by local police detectives and DA investigators. Of the 21 completed investigations since 2008, most were finished within a year. Only two have taken longer than Moore’s case.\u003c/p>\n\u003cp>More than half of those shootings were by Vallejo police, and six occurred in 2012, a year after the city emerged from \u003ca href=\"http://www.californiareport.org/archive/R201303221630/b\" target=\"_blank\">bankruptcy\u003c/a> following the recession. Perhaps the most \u003ca href=\"http://ww2.kqed.org/news/2012/09/21/pressure-mounting-in-vallejo-police-fatal-shooting/\" target=\"_blank\">notorious\u003c/a> incident occurred seven weeks before Moore's shooting. Witnesses say a police officer got up on the hood of a car and fired at Mario Romero and another man sitting inside the car, but the police and the DA investigation concluded the officer did not fire from the hood of the car. Romero died, and the DA and U.S. Attorney's office cleared the officer of any wrongdoing in the case.\u003c/p>\n\u003cp>Vallejo criminal defense attorney Dan Russo is familiar with the Moore shooting, and he says he has serious doubts about the police department’s story.\u003c/p>\n\u003cp>“Even if this shooting was a legitimate use of deadly force, that’s something that should have been figured out a year ago,” he says. “This is why people distrust public agencies, and more important than that, Vallejo is in a really stressful situation. The last thing you want to do is lose community support, and when an investigation into a shooting takes a year and a half, without any kind of pronouncement, without any kind of information to the parties, it’s corrupting to everything. It creates a bad environment in the city. It makes the cops’ job harder.”\u003c/p>\n\u003cp>Russo says he’s used to homicide cases that are filed within days of an incident, and that much of the information Moore’s parents are still seeking in order to understand what happened that night is normally made public.\u003c/p>\n\u003cp>Russo also says he doesn’t see the Moore shooting as an isolated incident.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.google.com/fusiontables/embedviz?containerId=googft-gviz-canvas&q=select+col4%2C+count()+from+1qVUrvNfuc5-Mcg2FrED6ejTFYbMXPi5hUTL-hv60+group+by+col4+order+by+col4+asc+limit+10&viz=GVIZ&t=COLUMN&uiversion=2&gco_forceIFrame=true&gco_hasLabelsColumn=true&gco_vAxes=%5B%7B%22title%22%3Anull%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22logScale%22%3Afalse%7D%2C%7B%22useFormatFromData%22%3Atrue%2C+%22viewWindow%22%3A%7B%22max%22%3Anull%2C+%22min%22%3Anull%7D%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22logScale%22%3Afalse%7D%5D&gco_useFirstColumnAsDomain=true&gco_isStacked=false&gco_booleanRole=certainty&gco_hAxis=%7B%22useFormatFromData%22%3Atrue%2C+%22minValue%22%3Anull%2C+%22maxValue%22%3Anull%2C+%22viewWindow%22%3Anull%2C+%22viewWindowMode%22%3Anull%2C+%22textStyle%22%3A%7B%22color%22%3A%22%23222%22%2C+%22fontSize%22%3A%229%22%2C+%22bold%22%3Atrue%7D%2C+%22slantedTextAngle%22%3A30%2C+%22slantedText%22%3Atrue%7D&gco_legend=none&gco_title=Investigations+of+Officer-Involved+Shootings+Completed+by+the+Solano+County+DA+since+2008&gco_series=%7B%220%22%3A%7B%22color%22%3A%22%230000ff%22%7D%7D&gco_titleTextStyle=%7B%22color%22%3A%22%23000%22%2C+%22fontSize%22%3A%2216%22%2C+%22bold%22%3Atrue%7D&gco_fontName=Arial&width=640&height=300\" frameborder=\"no\" scrolling=\"no\" width=\"640\" height=\"300\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>“Somebody is going to have to take responsibility for the fact that because of cutbacks to the police department, police are less supported,” he says. That means there are fewer officers to cover each other, he says, and creates a situation where there's little accountability when it comes to shootings.\u003c/p>\n\u003cp>“This kind of all adds up to an environment where you’re not telling anybody what’s happening, and you have what I consider in my experience of being in this town for 37 years, a really unusual environment where you have a large number of police shootings.”\u003c/p>\n\u003cp>Vallejo Police Lt. Sid De Jesus says there are a lot of theories about the increase in officer-involved shootings in 2012. He says violent crime was up substantially, and the department was down to 84 sworn officers from 158 when the recession began in 2008. That puts Vallejo’s officer-to-population ratio at about half the national average.\u003c/p>\n\u003cp>“It creates a huge safety concern for officers,” he says. “But more importantly, it (the low police presence) creates a huge safety concern for citizens of this community.”\u003c/p>\n\u003cp>De Jesus says quality of life in Vallejo has suffered, and officers who elected to stay with the struggling department in the struggling city are concerned.\u003c/p>\n\u003cp>Solano District Attorney du Bain says his office’s review of the Moore shooting is close to completion. He says that sometimes the long investigations could strain public trust, but that the cases are taken very seriously.\u003c/p>\n\u003cp>“I’ve insisted these reviews be conducted by a chief deputy district attorney, not a line attorney, and that they be approved by me,” he says. “Our reviews are thorough, and I’ve tried to ensure that we handle these cases very carefully.”\u003c/p>\n\u003cp>De Jesus adds, \"I can certainly tell you that I would assume that all of the DA’s findings have all been completed, and now they’re just in the stage of putting their case together, along with ours, and ensuring that every aspect of the incident has been addressed. It’s not uncommon for cases such as this, especially a case such as this that is completely complex. A lot of people may say, 'What makes it so complex?' There’s a lot of moving parts to it. There’s a lot of extenuating issues that were involved in this. And for those that were involved with the case and read what was publicized in the paper. So it’s not uncommon for these cases to take a little bit longer to come to a conclusion.\"\u003c/p>\n\u003cp>\u003cstrong>Civil Lawsuit\u003c/strong>\u003c/p>\n\u003cp>Eugene and Lisa Moore say they haven’t been able to find an attorney to take their case, so they’re representing themselves in a wrongful death lawsuit against Vallejo and its police department. They both think the strange circumstances leading up to the shooting are scaring attorneys from taking the case.\u003c/p>\n\u003cp>“We’re learning as we’re going, and it’s going to be frustrating because what if we screw up and I can’t do anything about my son’s death?” Eugene Moore says. “That’s my biggest fear. If they’re in the wrong and I screw up, I can’t do anything about it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Vallejo city attorney recently filed a motion to dismiss the family’s claim on the grounds that their complaint is devoid of underlying facts about the shooting. The motion could be heard in early May.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "how-twitters-neighbor-the-tenderloin-resists-an-upgrade",
"title": "How Twitter's Neighbor, the Tenderloin, Resists an Upgrade",
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"headTitle": "How Twitter’s Neighbor, the Tenderloin, Resists an Upgrade | KQED",
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"content": "\u003cp>\u003ciframe loading=\"lazy\" src=\"//www.youtube.com/embed/NE6PpolDjvQ?rel=0\" frameborder=\"0\" width=\"640\" height=\"360\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>By Spencer Michels\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">S\u003c/span>an Francisco’s seamy underbelly, the Tenderloin, sits in the heart of the city, flanked by glitzy Union Square hotels and the gleaming, gold-ornamented dome of City Hall. Though just steps away from Twitter’s new headquarters on Market Street, its dirty, crime-ridden 40 square blocks can feel like a world away from affluent San Francisco.\u003c/p>\n\u003cp>About 28,000 people call the Tenderloin home. Many are homeless, and dealing with mental illness or drug addiction. Some have criminal records or work in prostitution. Others are new immigrants, working to find their place in a new country.\u003c/p>\n\u003cp>To outsiders, it’s long been curious why such prime real estate is largely left alone in a city facing a massive housing shortage. Gary Kamiya, author of “Cool Gray City of Love,” has\u003cstrong> \u003ca href=\"http://www.modernluxury.com/san-francisco/story/arise-tenderloin\">written extensively\u003c/a>\u003c/strong> about why he believes the city and the nonprofits that serve the Tenderloin are not improving the neighborhood’s blighted state.\u003c/p>\n\u003cfigure id=\"attachment_123694\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/news/2014/01/15/123502/san-francisco-tenderloin-resists-change/rs549_104161743-scr-3/\" rel=\"attachment wp-att-123694\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-123694 \" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2078/01/RS549_104161743-scr-300x300.jpg\" alt=\"Volunteers prepare meals at St. Anthony's dining hall in the Tenderloin. (Justin Sullivan/Getty Images)\" width=\"300\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Volunteers prepare about 2,500 meals a day at St. Anthony’s Dining Room in the Tenderloin. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>“What the nonprofits want to do is maintain their stake here,” Kamiya told me during a “KQED Newsroom” interview. “This is where they have their structures. They’re being part of the solution, but ironically they are also part of the problem.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Housing advocates argue that conditions are gradually improving in the Tenderloin, but that the neighborhood should continue to serve low-income residents. Redeveloping it would leave thousands of low-income families unable to afford to live in San Francisco, they say.\u003c/p>\n\u003cp>“Buildings are in better condition than ever before,” says Randy Shaw, director of the \u003cstrong>\u003ca href=\"http://www.thclinic.org/\">Tenderloin Housing Clinic\u003c/a>\u003c/strong>, a nonprofit that operates housing in the neighborhood. “It’s become San Francisco’s last working-class neighborhood, and the last it will ever have.”\u003c/p>\n\u003cp>\u003cstrong>The City’s Role\u003c/strong>\u003c/p>\n\u003cp>And why don’t lawmakers step in to clean up the place? This could be one reason:\u003c/p>\n\u003cp>In the late 1940s, the city decided to redevelop another “troubled” section of town – \u003ca href=\"http://www.pbs.org/kqed/fillmore/\" target=\"_blank\" rel=\"noopener\">the Fillmore\u003c/a>. Thousands of businesses were forced to close as the city pushed through urban development plans. More than 800 Victorian homes were demolished to make way for new housing and retail – built quickly and cheaply.\u003c/p>\n\u003cp>Without access to goods, services or jobs, many African American families left the neighborhood, and never returned. It is an urban redevelopment horror story that still haunts the city’s psyche, leaving lawmakers reluctant to stir the pot in the Tenderloin. \u003c/p>\n\u003caside class=\"pullquote alignleft\"> Housing advocates say redeveloping it would leave thousands of low-income families unable to afford to live in the city. \u003c/aside>\n\u003cp>“The city is very loath to step in and say, ‘Let’s sweep all this away. Let’s move it somewhere else,’” says Kamiya. “To simply take an undesirable population and go warehouse them someplace, it’s extremely problematic.”\u003c/p>\n\u003cp>\u003cstrong>\u003cstrong>Is Change Inevitable?\u003c/strong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>While cities like London, New York and San Diego have been quick to redevelop similar neighborhoods, the Tenderloin has so far resisted.\u003c/p>\n\u003cp>Land-use protections, rent controls, zoning protections and a unique housing stock that has no single-family homes make it almost impossible to redevelop, says Shaw.\u003c/p>\n\u003cp>The neighborhood has about 100 single-room-cccupancy hotels – known as SROs – that house many of the city’s poor and disabled residents. These units in particular are shielded from being replaced with upscale apartments, as has happened in other neighborhoods like the Mission District.\u003c/p>\n\u003cp>Despite the legal protections, longtime resident Judy Young eyes the new high-tech neighbors with suspicion. She wonders if a day might come when the Tenderloin becomes out of reach.\u003c/p>\n\u003cp>“Families do live here because it is one of the most affordable places in the city,” she says. “If you can find a studio or one bedroom here for $1,200, that’s pretty affordable compared to other places.”\u003c/p>\n\u003cp>That is an understatement, as a recent city\u003cstrong>\u003ca href=\"http://www.npr.org/2013/12/03/247531636/as-rent-soars-longtime-san-francisco-tenants-fight-to-stay\"> report\u003c/a>\u003c/strong> found that the median rent in San Francisco has reached $3,400 a month.\u003c/p>\n\u003cp>\u003cem>Spencer Michels reported on this story for “KQED Newsroom,” which is a weekly news magazine program on television, radio and online. Watch Fridays at 8 p.m. on KQED Public Television 9, listen on Sundays at 6 p.m. on KQED Public Radio 88.5 FM and watch on demand \u003ca href=\"http://www.kqed.org/tv/programs/newsroom/\" target=\"_blank\" rel=\"noopener\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Olivia Hubert-Allen contributed to this article.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ciframe loading=\"lazy\" src=\"//www.youtube.com/embed/NE6PpolDjvQ?rel=0\" frameborder=\"0\" width=\"640\" height=\"360\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>By Spencer Michels\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">S\u003c/span>an Francisco’s seamy underbelly, the Tenderloin, sits in the heart of the city, flanked by glitzy Union Square hotels and the gleaming, gold-ornamented dome of City Hall. Though just steps away from Twitter’s new headquarters on Market Street, its dirty, crime-ridden 40 square blocks can feel like a world away from affluent San Francisco.\u003c/p>\n\u003cp>About 28,000 people call the Tenderloin home. Many are homeless, and dealing with mental illness or drug addiction. Some have criminal records or work in prostitution. Others are new immigrants, working to find their place in a new country.\u003c/p>\n\u003cp>To outsiders, it’s long been curious why such prime real estate is largely left alone in a city facing a massive housing shortage. Gary Kamiya, author of “Cool Gray City of Love,” has\u003cstrong> \u003ca href=\"http://www.modernluxury.com/san-francisco/story/arise-tenderloin\">written extensively\u003c/a>\u003c/strong> about why he believes the city and the nonprofits that serve the Tenderloin are not improving the neighborhood’s blighted state.\u003c/p>\n\u003cfigure id=\"attachment_123694\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/news/2014/01/15/123502/san-francisco-tenderloin-resists-change/rs549_104161743-scr-3/\" rel=\"attachment wp-att-123694\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-123694 \" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2078/01/RS549_104161743-scr-300x300.jpg\" alt=\"Volunteers prepare meals at St. Anthony's dining hall in the Tenderloin. (Justin Sullivan/Getty Images)\" width=\"300\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Volunteers prepare about 2,500 meals a day at St. Anthony’s Dining Room in the Tenderloin. (Justin Sullivan/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>“What the nonprofits want to do is maintain their stake here,” Kamiya told me during a “KQED Newsroom” interview. “This is where they have their structures. They’re being part of the solution, but ironically they are also part of the problem.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Housing advocates argue that conditions are gradually improving in the Tenderloin, but that the neighborhood should continue to serve low-income residents. Redeveloping it would leave thousands of low-income families unable to afford to live in San Francisco, they say.\u003c/p>\n\u003cp>“Buildings are in better condition than ever before,” says Randy Shaw, director of the \u003cstrong>\u003ca href=\"http://www.thclinic.org/\">Tenderloin Housing Clinic\u003c/a>\u003c/strong>, a nonprofit that operates housing in the neighborhood. “It’s become San Francisco’s last working-class neighborhood, and the last it will ever have.”\u003c/p>\n\u003cp>\u003cstrong>The City’s Role\u003c/strong>\u003c/p>\n\u003cp>And why don’t lawmakers step in to clean up the place? This could be one reason:\u003c/p>\n\u003cp>In the late 1940s, the city decided to redevelop another “troubled” section of town – \u003ca href=\"http://www.pbs.org/kqed/fillmore/\" target=\"_blank\" rel=\"noopener\">the Fillmore\u003c/a>. Thousands of businesses were forced to close as the city pushed through urban development plans. More than 800 Victorian homes were demolished to make way for new housing and retail – built quickly and cheaply.\u003c/p>\n\u003cp>Without access to goods, services or jobs, many African American families left the neighborhood, and never returned. It is an urban redevelopment horror story that still haunts the city’s psyche, leaving lawmakers reluctant to stir the pot in the Tenderloin. \u003c/p>\n\u003caside class=\"pullquote alignleft\"> Housing advocates say redeveloping it would leave thousands of low-income families unable to afford to live in the city. \u003c/aside>\n\u003cp>“The city is very loath to step in and say, ‘Let’s sweep all this away. Let’s move it somewhere else,’” says Kamiya. “To simply take an undesirable population and go warehouse them someplace, it’s extremely problematic.”\u003c/p>\n\u003cp>\u003cstrong>\u003cstrong>Is Change Inevitable?\u003c/strong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>While cities like London, New York and San Diego have been quick to redevelop similar neighborhoods, the Tenderloin has so far resisted.\u003c/p>\n\u003cp>Land-use protections, rent controls, zoning protections and a unique housing stock that has no single-family homes make it almost impossible to redevelop, says Shaw.\u003c/p>\n\u003cp>The neighborhood has about 100 single-room-cccupancy hotels – known as SROs – that house many of the city’s poor and disabled residents. These units in particular are shielded from being replaced with upscale apartments, as has happened in other neighborhoods like the Mission District.\u003c/p>\n\u003cp>Despite the legal protections, longtime resident Judy Young eyes the new high-tech neighbors with suspicion. She wonders if a day might come when the Tenderloin becomes out of reach.\u003c/p>\n\u003cp>“Families do live here because it is one of the most affordable places in the city,” she says. “If you can find a studio or one bedroom here for $1,200, that’s pretty affordable compared to other places.”\u003c/p>\n\u003cp>That is an understatement, as a recent city\u003cstrong>\u003ca href=\"http://www.npr.org/2013/12/03/247531636/as-rent-soars-longtime-san-francisco-tenants-fight-to-stay\"> report\u003c/a>\u003c/strong> found that the median rent in San Francisco has reached $3,400 a month.\u003c/p>\n\u003cp>\u003cem>Spencer Michels reported on this story for “KQED Newsroom,” which is a weekly news magazine program on television, radio and online. Watch Fridays at 8 p.m. on KQED Public Television 9, listen on Sundays at 6 p.m. on KQED Public Radio 88.5 FM and watch on demand \u003ca href=\"http://www.kqed.org/tv/programs/newsroom/\" target=\"_blank\" rel=\"noopener\">here\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Olivia Hubert-Allen contributed to this article.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>It’s too soon to say whether the story of James Flavy Coy Brown is an anomaly, as Nevada regulators claim, or if budget-stressed mental health service professionals are “dumping” disoriented, mentally ill people on the rest of the nation.\u003c/p>\n\u003cp>If one thing is certain, it’s that a lot of people are now actively engaged in answering that question. Among them: at the \u003ca href=\"http://www.sacbee.com/leavinglasvegas/\">Sacramento Bee\u003c/a>, city attorney’s offices in Los Angeles and San Francisco, the U.S. Centers for Medicare and Medicaid Services, and the \u003ca href=\"http://www.jointcommission.org/accreditation/hospitals.aspx\">commission\u003c/a> that certifies hospitals in the United States.\u003c/p>\n\u003cp>Let’s return to the beginning, to the story of a man who showed up at a Greyhound bus station in Sacramento on \u003ca href=\"http://www.sacbee.com/2013/04/07/5322199/cast-out-by-nevada-he-finds-kindness.html\">Feb. 12\u003c/a>. Brown suffers from \u003ca href=\"https://www.google.com/search?q=schizophrenia+definition&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a\">schizophrenia\u003c/a>, which among other things makes it difficult for a person to think clearly. Fortunately for him, Brown was thinking clearly enough that morning to head toward a local police station and ask for help.\u003c/p>\n\u003cp>The story made it to the Sacramento Bee through \u003ca href=\"http://www.sacloaves.org/\">Loaves & Fishes\u003c/a>, a local provider of services to the homeless. The compelling nature of Brown’s adventure raised questions that went well beyond how one man got put on a bus to a city where he’d never been.\u003c!--more-->\u003c/p>\n\u003cp>He had no friends or family there. He had only a few days’ worth of medication and a few bottles of Ensure. He had no plan for continuing medical treatment. It looked a lot like Las Vegas’ Rawson-Neal Psychiatric Hospital was trying to get rid of him.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Bee’s Phillip Reese sat down with the \u003ca href=\"http://www.californiareport.org/archive/R201304240850/b\">California Report\u003c/a> and explained where things went from there.\u003c/p>\n\u003cp>“He did not know anyone here. He did not have any plan for medical care set up,” Reese said.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“He did not know anyone here. He did not have any plan for medical care set up.”\u003c/aside>\n\u003cp>Brown eventually found a new home in North Carolina with his daughter, but in the meantime the Nevada legislature became interested in the story.\u003c/p>\n\u003cp>“In those hearings, they mentioned that they had sent around 100 people to California, just in the last seven or eight months,” Reese said. “And potentially many more to other states. So we had a feeling that this was not an isolated incident.”\u003c/p>\n\u003cp>Then the Bee began reviewing five years’ worth of Greyhound bus receipts that Nevada’s \u003ca href=\"http://mhds.state.nv.us/\">mental health division\u003c/a> had purchased. The reporters put together an interactive \u003ca href=\"http://www.sacbee.com/2013/04/12/5338196/interactive-map-where-las-vegas.html\">map\u003c/a> showing where patients ended up.\u003c/p>\n\u003cp>(Visit the Sacramento Bee for the \u003ca href=\"http://www.sacbee.com/2013/04/12/5338196/interactive-map-where-las-vegas.html\">interactive version\u003c/a>)\u003c/p>\n\u003cfigure id=\"attachment_95201\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/2013/04/24/the-hunt-is-on-for-1500-psychiatric-patients-a-nev/patientbusingmap-sacbee/\" rel=\"attachment wp-att-95201\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-95201\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/04/PatientBusingMap-SacBee-1024x785.png\" alt=\"PatientBusingMap-SacBee\" width=\"640\" height=\"490\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">\u003ca href=\"http://www.sacbee.com/2013/04/12/5338196/interactive-map-where-las-vegas.html\">Via the Sacramento Bee\u003c/a>. Source: Southern Nevada Adult Mental Health Services; data for-mid 2008 to early 2013; Analysis by Phillip Reese. Interactive by Nathaniel Levine.\u003c/figcaption>\u003c/figure>\n\u003cp>Officials at the main hospital in question, Rawson-Neal Psychiatric Hospital, said a lot of people come to Nevada from somewhere else. They said the Brown case was an anomaly and that in all other cases there was a close family member or friend waiting at the destination to receive the patient who gets put on a bus.\u003c/p>\n\u003cp>To confirm that assertion, the Bee called at least 10 mental health agencies in counties all over California. Most were completely surprised at Nevada officials’ assertions.\u003c/p>\n\u003cp>“San Francisco told us that they’ve had at least two patients in the last year alone come from this particular facility, Rawson-Neal, without a plan or family members,” Reese said. “[They] just showed up, in the way that Mr. Brown did.”\u003c/p>\n\u003cp>According to the Bee’s review of bus records, 36 patients took buses to San Francisco. Without talking to those people, it’s hard to know what happened once they got to the city. They might have sought help. They might not have. They might be in San Francisco now. They might be elsewhere.\u003c/p>\n\u003cp>Reese said he and his colleagues are trying to track down patients, as well as Rawson-Neal employees and former employees.\u003c/p>\n\u003cp>“We’re hampered a bit, and rightfully so, by patient privacy laws,” Reese said. “The Greyhound bus receipts had the names blacked out.”\u003c/p>\n\u003cp>Nevada regulators told the Bee they reviewed protocols and instituted new rules that include requiring high-level approval of a Greyhound trip and a clear plan in place at the other end of the line for the patient. They also said they have taken disciplinary action related to Brown’s case.\u003c/p>\n\u003cp>Cross-state busing of patients might not be considered a best practice in mental health care, but is it illegal? Reese said California’s Justice Department isn’t sure.\u003c/p>\n\u003cp>Los Angeles, though, has laws on the books explicitly prohibiting patient “dumping” of any kind, because it’s something its own local hospitals did in the past. The San Francisco city attorney’s office is checking local codes that might provide grounds for a civil action.\u003c/p>\n\u003cp>One-third of patients bused out of Nevada were shipped to California.\u003c/p>\n\u003cp>Reese points to “severe” budget cuts in Nevada. The bus trips began to spike in 2009, around the same time a recent round of budget cuts took place.\u003c/p>\n\u003cp>Plus, he said, “They never had an elaborate safety net for mentally ill patients to begin with.”\u003c/p>\n\u003cp>\u003cstrong>UPDATE [4/26/13]\u003c/strong>\u003c/p>\n\u003cp>CARSON CITY, Nev. (AP) _ The federal agency that oversees Medicaid and Medicare compliance has put Nevada on notice of “serious deficiencies” at a Las Vegas psychiatric hospital following reports of patients being improperly discharged.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>An April 25 letter from the Centers for Medicare & Medicaid Services, first reported by The Sacramento Bee and obtain Friday by The Associated Press, gave Nevada 10 days to correct problems in its mental health discharge policies at Rawson-Neal Psychiatric Hospital or risk loss of federal funding.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s too soon to say whether the story of James Flavy Coy Brown is an anomaly, as Nevada regulators claim, or if budget-stressed mental health service professionals are “dumping” disoriented, mentally ill people on the rest of the nation.\u003c/p>\n\u003cp>If one thing is certain, it’s that a lot of people are now actively engaged in answering that question. Among them: at the \u003ca href=\"http://www.sacbee.com/leavinglasvegas/\">Sacramento Bee\u003c/a>, city attorney’s offices in Los Angeles and San Francisco, the U.S. Centers for Medicare and Medicaid Services, and the \u003ca href=\"http://www.jointcommission.org/accreditation/hospitals.aspx\">commission\u003c/a> that certifies hospitals in the United States.\u003c/p>\n\u003cp>Let’s return to the beginning, to the story of a man who showed up at a Greyhound bus station in Sacramento on \u003ca href=\"http://www.sacbee.com/2013/04/07/5322199/cast-out-by-nevada-he-finds-kindness.html\">Feb. 12\u003c/a>. Brown suffers from \u003ca href=\"https://www.google.com/search?q=schizophrenia+definition&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a\">schizophrenia\u003c/a>, which among other things makes it difficult for a person to think clearly. Fortunately for him, Brown was thinking clearly enough that morning to head toward a local police station and ask for help.\u003c/p>\n\u003cp>The story made it to the Sacramento Bee through \u003ca href=\"http://www.sacloaves.org/\">Loaves & Fishes\u003c/a>, a local provider of services to the homeless. The compelling nature of Brown’s adventure raised questions that went well beyond how one man got put on a bus to a city where he’d never been.\u003c!--more-->\u003c/p>\n\u003cp>He had no friends or family there. He had only a few days’ worth of medication and a few bottles of Ensure. He had no plan for continuing medical treatment. It looked a lot like Las Vegas’ Rawson-Neal Psychiatric Hospital was trying to get rid of him.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Bee’s Phillip Reese sat down with the \u003ca href=\"http://www.californiareport.org/archive/R201304240850/b\">California Report\u003c/a> and explained where things went from there.\u003c/p>\n\u003cp>“He did not know anyone here. He did not have any plan for medical care set up,” Reese said.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“He did not know anyone here. He did not have any plan for medical care set up.”\u003c/aside>\n\u003cp>Brown eventually found a new home in North Carolina with his daughter, but in the meantime the Nevada legislature became interested in the story.\u003c/p>\n\u003cp>“In those hearings, they mentioned that they had sent around 100 people to California, just in the last seven or eight months,” Reese said. “And potentially many more to other states. So we had a feeling that this was not an isolated incident.”\u003c/p>\n\u003cp>Then the Bee began reviewing five years’ worth of Greyhound bus receipts that Nevada’s \u003ca href=\"http://mhds.state.nv.us/\">mental health division\u003c/a> had purchased. The reporters put together an interactive \u003ca href=\"http://www.sacbee.com/2013/04/12/5338196/interactive-map-where-las-vegas.html\">map\u003c/a> showing where patients ended up.\u003c/p>\n\u003cp>(Visit the Sacramento Bee for the \u003ca href=\"http://www.sacbee.com/2013/04/12/5338196/interactive-map-where-las-vegas.html\">interactive version\u003c/a>)\u003c/p>\n\u003cfigure id=\"attachment_95201\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/news/2013/04/24/the-hunt-is-on-for-1500-psychiatric-patients-a-nev/patientbusingmap-sacbee/\" rel=\"attachment wp-att-95201\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-95201\" src=\"http://ww2.kqed.org/news/wp-content/uploads/sites/10/2013/04/PatientBusingMap-SacBee-1024x785.png\" alt=\"PatientBusingMap-SacBee\" width=\"640\" height=\"490\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">\u003ca href=\"http://www.sacbee.com/2013/04/12/5338196/interactive-map-where-las-vegas.html\">Via the Sacramento Bee\u003c/a>. Source: Southern Nevada Adult Mental Health Services; data for-mid 2008 to early 2013; Analysis by Phillip Reese. Interactive by Nathaniel Levine.\u003c/figcaption>\u003c/figure>\n\u003cp>Officials at the main hospital in question, Rawson-Neal Psychiatric Hospital, said a lot of people come to Nevada from somewhere else. They said the Brown case was an anomaly and that in all other cases there was a close family member or friend waiting at the destination to receive the patient who gets put on a bus.\u003c/p>\n\u003cp>To confirm that assertion, the Bee called at least 10 mental health agencies in counties all over California. Most were completely surprised at Nevada officials’ assertions.\u003c/p>\n\u003cp>“San Francisco told us that they’ve had at least two patients in the last year alone come from this particular facility, Rawson-Neal, without a plan or family members,” Reese said. “[They] just showed up, in the way that Mr. Brown did.”\u003c/p>\n\u003cp>According to the Bee’s review of bus records, 36 patients took buses to San Francisco. Without talking to those people, it’s hard to know what happened once they got to the city. They might have sought help. They might not have. They might be in San Francisco now. They might be elsewhere.\u003c/p>\n\u003cp>Reese said he and his colleagues are trying to track down patients, as well as Rawson-Neal employees and former employees.\u003c/p>\n\u003cp>“We’re hampered a bit, and rightfully so, by patient privacy laws,” Reese said. “The Greyhound bus receipts had the names blacked out.”\u003c/p>\n\u003cp>Nevada regulators told the Bee they reviewed protocols and instituted new rules that include requiring high-level approval of a Greyhound trip and a clear plan in place at the other end of the line for the patient. They also said they have taken disciplinary action related to Brown’s case.\u003c/p>\n\u003cp>Cross-state busing of patients might not be considered a best practice in mental health care, but is it illegal? Reese said California’s Justice Department isn’t sure.\u003c/p>\n\u003cp>Los Angeles, though, has laws on the books explicitly prohibiting patient “dumping” of any kind, because it’s something its own local hospitals did in the past. The San Francisco city attorney’s office is checking local codes that might provide grounds for a civil action.\u003c/p>\n\u003cp>One-third of patients bused out of Nevada were shipped to California.\u003c/p>\n\u003cp>Reese points to “severe” budget cuts in Nevada. The bus trips began to spike in 2009, around the same time a recent round of budget cuts took place.\u003c/p>\n\u003cp>Plus, he said, “They never had an elaborate safety net for mentally ill patients to begin with.”\u003c/p>\n\u003cp>\u003cstrong>UPDATE [4/26/13]\u003c/strong>\u003c/p>\n\u003cp>CARSON CITY, Nev. (AP) _ The federal agency that oversees Medicaid and Medicare compliance has put Nevada on notice of “serious deficiencies” at a Las Vegas psychiatric hospital following reports of patients being improperly discharged.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>An April 25 letter from the Centers for Medicare & Medicaid Services, first reported by The Sacramento Bee and obtain Friday by The Associated Press, gave Nevada 10 days to correct problems in its mental health discharge policies at Rawson-Neal Psychiatric Hospital or risk loss of federal funding.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"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. ",
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"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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"marketplace": {
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"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.",
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"mindshift": {
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"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>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
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},
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},
"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/reveal300px.png",
"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"link": "/radio/program/reveal",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
},
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},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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