Tag Archives: mental-health

Started by a group of Kentucky Fried Chicken investors in the early 1980s, CCA quickly grew into the largest private prison operator in the world.


Colorado’s For-Profit Prisons a Bad Bet, Says Ex-Employee Turned Author

Thursday, May 18, 2017 at 8:26 a.m.

By Alan Prendergast

After it was taken over by a private-prison operator in 1996, the Bent County Correctional Facility soon doubled its capacity — and then doubled it again, to more than 1,400 inmates.

Sue Binder’s quarrel with the private-prison giant Corrections Corporation of America began shortly after she started to work at one of CCA’s cut-rate hoosegows in southeastern Colorado. It continued for thirteen years, right up until Binder resigned in 2015 from her job as a mental-health coordinator at the Bent County Correctional Facility — and got shorted on her last paycheck in a dispute over medical leave.

Started by a group of Kentucky Fried Chicken investors in the early 1980s, CCA quickly grew into the largest private prison operator in the world. But it’s also been dogged by bad press about poorly trained staff, inadequate medical care, outbursts of violence and riots, and studies that indicate turning to the private sector to manage inmate populations doesn’t really save money. The company recently changed its name to CoreCivic as part of a rebranding effort.

But whatever it calls itself now, it’s safe to say that working for CCA made an indelible impression on Binder, who became convinced that management at the Bent County lockup was more interested in keeping the place as full —and profitable — as possible than in helping inmates prepare for release or treating staff fairly. She decided to write a book that would encompass not just her experiences, but how the private corrections industry works. The result is Bodies in Beds: Why Business Should Stay Out of Prisons (Algora).

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“The longer I was there, especially the last four or five years, the more I became disillusioned,” says Binder, who now works at a community mental-health center in Lamar. “I can’t say I was burned out, but I was becoming more aware of what was happening behind the scenes at the company I worked for. At first I thought I would just do my personal story, but then I began researching more and more. It kind of ballooned on me.”

Part memoir, part overview, Bodies in Beds offers unsettling glimpses into what it’s like to work at a private prison — not just as a turnkey, but as someone who’s supposed to offer actual services to inmates. For a while, Binder managed to rationalize her position to herself, figuring that maybe she could make a difference to some of the mentally ill prisoners she saw. But as CCA’s cost-containment strategies kept multiplying the duties and thinning the staff, Binder found herself not only having to screen every new inmate, but divide with just one other mental-health specialist a caseload of more than 400 inmates diagnosed with some degree of mental illness. At the same time, she was asked to meticulously document every action she took — a request that was supposed to help her get more staff, but was actually used to justify the status quo. On a good day, she was lucky to spend a few minutes each with maybe ten or twelve inmates between mounds of paperwork.

“I felt like I’m not helping these guys very much,” she says. “We were pushing these inmates through like cattle. What could have been thirty or forty minutes with them, trying to help them, I saw that not happening. Some of them have opportunities and should be out of prison — but we need to give them help.”

After a 2004 riot at CCA’s badly understaffed Crowley County Correctional Facility, the Colorado Department of Corrections stepped up its monitoring of private-prison operators. But whistleblowers like Binder are not all that numerous; most staffers at the company’s facilities live in remote areas, with few economic opportunities, and need to hold on to their jobs. Once Binder realized that her job was more about providing the appearance of mental-health services rather than the services themselves, she began to prepare an exit strategy.

In her current position as a behavioral-health specialist at the High Plains Community Health Center, Binder occasionally runs across former Bent County inmates. “About half my caseload are people on probation, so I continue to work in the system,” she says. “Now and then you see somebody where you think, maybe you made a little difference. That makes it worthwhile.”

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An effort to get ecstasy FDA-approved is entering a key final test


Ecstasy tablets

After veteran Tony Macie came back from Iraq in 2007, he learned he had post-traumatic stress disorder.

Macie went to the VA “on and off” and tried the standard therapy.

“And then I kind of just fell off the radar, secluded, and did my own thing and got really dependent on a lot of the meds,” Macie explains in a video by the Multidisciplinary Association for Psychedelic Studies.

The retired sergeant then became part of a clinical trial organized by MAPS that was testing an unusual substance in an attempt to heal people who hadn’t responded to traditional therapies for PTSD.

That substance, MDMA, commonly referred to as “Molly,” is the pure form of something commonly thought of as an illegal party drug — ecstasy. (Most nonresearch substances that are sold as ecstasy or Molly are not actually pure MDMA and can be significantly more dangerous.) The trial pairs MDMA with psychotherapy.

“One of the first things I said when it kicked in was, ‘This is what I’ve been looking for,'” Macie says in the video. “I reconnected with myself and did a lot of internal work, and afterwards it was like a huge weight was lifted off my shoulders.”

The trial Macie was involved in and other Phase 2 clinical studies conducted by MAPS have been so effective that the Food and Drug Administration on Tuesday agreed to allow large-scale Phase 3 clinical trials — the third and final in the three sets of human trials required before the FDA will consider a new drug for approval — to go forward, according to a report in The New York Times.

If those trials continue to show that MDMA effectively treats PTSD, ecstasy could enter clinical use as soon as 2021, fitting the timeline that MAPS has been working toward for some time now.

And so far, MDMA has consistently been very effective.

One of the early studies conducted by MAPS showed that 83% of the study participants no longer showed signs of PTSD two months after treatment, and long-term follow-ups conducted an average of four years later showed that most of those benefits stuck. That was a proof-of-concept study, with just 20 participants, all of whom had psychotherapy as well. (Twelve were given MDMA, and eight were given a placebo; 25% of those on the placebo improved, too.)

Though small and preliminary, the results were encouraging enough to help lead to Phase 2 clinical trials, which MAPS announced were coming to an end last March. These trials consisted of at least eight studies that Brad Burge, the director of communications for MAPS, recently told Inverse treated 136 people using MDMA-assisted psychotherapy for PTSD.

Those trials dealt with patients who were struggling with PTSD from a variety of sources. They included military veterans, people who had been sexually assaulted, firefighters, and police officers, all who had not responded to traditional treatments.

The data released from those studies so far is very promising, with a large percentage of patients not showing any signs of PTSD more than a year after completing the therapy.

“We can sometimes see this kind of remarkable improvement in traditional psychotherapy, but it can take years, if it happens at all,” Dr. Michael Mithoefer, a psychiatrist involved in the research, told The Times.

The final tests will involve hundreds of people and must be conducted before the FDA decides to approve a new medication. MAPS has applied for “breakthrough” therapy status, which could speed up the approval process.

“Phase 3 starts around 2017, and it will take four to five years to finish,” Burge has previously said. “So that will put it at early 2021 for FDA approval.”

MAPS is mostly raising money itself to fund what it describes as a roughly $20 million plan to complete these trials, which are largely not of interest to pharmaceutical companies since the patent on MDMA has expired. That will mean significant fundraising is required.

Last year the organization reported $9.1 million in assets, more than $5 million of which was a bequest from a longtime board member that has been earmarked specifically for those Phase 3 trials. In fiscal-year 2015, MAPS raised a combined $2.99 million from 2,500 donors. It said in its most recent annual report that “substantially increasing our donor base” would be necessary to move forward with Phase 3 trials.

It’s only after those trials wrap up that we’ll know for sure whether using MDMA to treat PTSD is safe and effective. MAPS calls making that happen its “top priority.”

The group is also conducting research testing the efficacy of MDMA-assisted therapy to treat social anxiety in autistic adults and to treat anxiety associated with life-threatening illnesses like cancer.

“It’s a really interesting and a very powerful new approach,” Thomas Insel, a former director of the National Institute of Mental Health, told the San Francisco Chronicle. “It’s not just taking MDMA. It’s taking it in the context of a treatment that involves improved insight and increased skills and using this in the broader context of psychotherapy.”

As Macie says in the MAPS video, “this tool, it may not be the end all, but it [could] be a tool that can help a lot of people drastically.”

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House passes medical cures bill


By Peter Sullivan – 11/30/16 06:40 PM EST

House passes medical cures bill

The House on Wednesday passed a medical innovation bill aimed at curing diseases, with the measure securing bipartisan support after months of negotiations.
The legislation, known as the 21st Century Cures Act, passed 392-26. It seeks to speed up the Food and Drug Administration’s approval of new drugs while investing new money in medical research. 

The package also includes a range of other healthcare priorities, including $1 billion over two years to fight the epidemic of opioid addiction and $1.8 billion for Vice President Biden’s cancer “moonshot.”
The opioid money releases some pressure from a long-running dispute between the parties. Congress passed a bipartisan opioid bill before the election, but Democrats criticized that measure for lacking funding.
The cures legislation also includes a mental health portion that seeks to reorganize and improve accountability for government mental health programs.
Republicans have portrayed the mental health bill, sponsored by Rep. Tim Murphy (R-Pa.), as their response to mass shootings, though that messaging has been emphasized less now that it is part of a larger package.

Democrats agree reforms are needed in mental health, though they note that the bill lacks funding. They say the bigger policy response to mass shootings should be gun control.
House leaders are hoping that the bipartisan vote Wednesday puts pressure on the Senate, which is expected to take up the cures bill sometime before leaving town next month.
The bill faces a bumpier path in the upper chamber, where Sens. Elizabeth Warren (D-Mass.) and Bernie Sanders (I-Vt.) have blasted it as a giveaway to pharmaceutical companies.
Still, enough Democrats are expected to support the measure to get it across the finish line.

“This bill, which expedites the approval of drugs and devices, includes literally billions of dollars in additional spending for health research so that we can find the cures and the answers to what patients are demanding today,” said House Energy and Commerce Chairman Fred Upton (R-Mich.), the measure’s main sponsor. 

The White House gave the measure a boost on Tuesday night by announcing that it “strongly” supports passage, pointing in particular to the opioid funding and the funding for the cancer moonshot.
The liberal detractors note that the new research funding, which is helping to bring some Democrats on board, is not mandatory funding, meaning it is not guaranteed.

Still, the $4.8 billion over 10 years is set aside in a separate fund and not subject to the usual budget caps.

Sanders and Warren have denounced the bill as helping out pharmaceutical companies, in part by lowering the FDA’s regulations for approving their new drugs, while doing nothing to deal with the hot-button issue of high drug prices.

Some consumer groups have also criticized the measure, fearing that in speeding up the FDA’s approval process, it would lower safety standards.
The measure allows for ideas like sometimes using “real world evidence,” rather than more rigorous and time-consuming clinical trials, in drug approvals.
Rep. Frank Pallone (D-N.J.), a lead negotiator on the bill in the House, rejected criticisms of the FDA changes.

“It’s just a way of trying to address these cures in a more effective way, the way the public has asked for, without sacrificing any safety,” Pallone said.

The mental health portion of the legislation establishes a new assistant secretary for mental health in the Department of Health and Human Services as well as a chief medical officer. Murphy argues that these positions will bring more accountability and medical knowledge to the Substance Abuse and Mental Health Services Administration, an agency he has criticized as ineffective.
The bill also authorizes grants for areas like suicide prevention.

The mental health measure is significantly scaled down from the more sweeping version originally proposed by Murphy, though. It does not lift restrictions on Medicaid paying for care at mental health facilities, which would have cost billions of dollars.

The measure also includes elements from a companion mental health bill in the Senate from Sens. Chris Murphy (D-Conn.) and Bill Cassidy (R-La.).
Both the Cures and mental health portions of the bill come after more than a year of bipartisan negotiations.

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RIA awarded five NIH grants totaling more than $6 million


RIA building

UB’s Research Institute on Addictions is located on Main Street in downtown Buffalo.

 

By SARA R. SALDI

Published August 22, 2013

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“Given the current funding climate, only the most outstanding research projects are being funded.”

Kenneth Leonard, director

Research Institute on Addictions

UB’s Research Institute on Addictions (RIA) recently was awarded more than $6 million in grants from the National Institutes of Health to fund five innovative studies that will expand knowledge on societal ramifications of drug and alcohol use.

The studies cover a wide range of alcohol- and drug-related topics. Three studies focus on youth issues, including bullying and its relationship to substance use, energy drinks mixed with alcohol and their connection to risky sexual practices, and the effects of parental drinking on children of alcoholics.

The remaining grants focus on marijuana-induced aggression and partner violence, and understanding physical craving in substance abuse recovery.

RIA Director Kenneth Leonard is extremely pleased that RIA has been recognized for its hard work and excellence in research.

“The number and size of these grants represent a remarkable achievement for RIA and our talented researchers,” Leonard says. “Given the current funding climate, only the most outstanding research projects are being funded.”

Jennifer Livingston

Jennifer Livingston

Jennifer Livingston, RIA senior research scientist, was awarded $1.8 million over five years from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to study “Peer Victimization as a Pathway to Adolescent Substance Use.”

Livingston says that although there is clearly the potential of peer victimization (PV) (bullying and sexual harassment) to cause harm, not all adolescents suffer serious effects from such experiences. Little is known about the conditions under which PV causes harm.

“This study aims to discover the conditions under which PV contributes to emotional distress and substance use among adolescents, both immediately and over time” says Livingston. “We’re also seeking to identify the circumstances that might curb the long-term effects of PV, particularly as they relate to the development of emotional distress and substance-use problems.”

Kathleen Miller

Kathleen Miller

The NIAAA also awarded $1.37 million to Kathleen Miller, RIA senior research scientist, to fund her study, “Alcohol and Energy Drink Use, Expectancies and Sexual Risk Taking.”

Miller, a nationally renowned expert on the subject of alcohol mixed with energy drinks, says that although energy drinks have been widely available in the U.S. for more than a decade, their effects remain significantly understudied.

“This study will collect the first detailed, nationally representative data on the prevalence of energy drinks (ED) and alcohol mixed with energy drink (AED) use by youth,” says Miller, “and will map the differences in use across gender, race/ethnicity, age, college-enrollment status and sports involvement, as well as examine the links between AED use and sexual risk taking. We will then seek to understand how gender differences affect these relationships.”

Rina Das Eiden

Rina Das Eiden

Rina Das Eiden, RIA senior research scientist, received more than $400,000 from the NIAAA for a two-year study, “Early Childhood Predictors of Adolescent Substance Use in a High Risk Sample.”

Eiden, an expert on the prenatal effects of substance use, says that though children of alcoholics (COAs) are a large and critical component of the underage drinking population, little is known about how alcohol affects parenting and what the predictive risks are for underage drinking and substance use among COAs.

“Knowledge about predictors of substance use—beginning in infancy—is crucial for determining and developing early intervention to address substance-use risk among COAs,” she says.

Maria Testa

Maria Testa

A $1.86 million grant was made by the National Institute on Drug Addiction (NIDA) to Maria Testa, RIA senior research scientist, for her study titled “Proximal Effects of Marijuana in Understanding Intimate Partner Violence.” The study will take place over four years.

Testa says that despite the commonly held belief that marijuana suppresses aggression, many studies have found a positive association between marijuana use and intimate-partner violence.

“Although marijuana is the most commonly used illicit drug in the United States—with increases in rates of usage over the past few years—there is a lack of research regarding marijuana use and aggression,” says Testa. “Understanding the contribution of marijuana to the occurrence of domestic violence has important public health implications.”

Her research will address this gap in knowledge by examining the effects of marijuana use in couples and the consequences for their relationships.

Robert Schlauch

Robert Schlauch

Robert Schlauch, senior research scientist, received nearly $600,000 from the NIAAA for his project, “Ambivalence Model of Craving: Re-Examining the Craving-Drinking Relationship.”

This five-year study aims to improve understanding of the ways in which craving impacts positive treatment outcomes. The research specifically will examine how craving processes change over the course of recovery, including their influence on starting and maintaining treatment.

“Greater understanding of craving processes during the course of recovery has the potential to inform current treatment strategies,” he says. “Craving is a complex experience requiring consideration of many factors, including both desires to use (approach) and desires not to use (avoidance).”

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Schapelle Corby: Time to let go of our obsession


Michael Bachelard

Michael Bachelard
Indonesia correspondent for Fairfax Media

Schapelle Corby waits in her cell before her trial in 2005.

CORBY: THE FACTS

 

Another nuance of activity occurred in Bali on Tuesday, as the parole process for Schapelle Corby inched forward once again. Representatives of an agency of the Indonesian Justice Department visited the house where she would be required to live if she were let out of jail early.

Even though she has not yet applied for parole, as with all things Corby, the "news" drove some of the frothier parts of the Australian media into habitual overdrive.

Schapelle Corby  is escorted by police to a courtroom in Denpasar in 2006.

Schapelle Corby is escorted by police to a courtroom in Denpasar in 2006. Photo: AFP

Some outlets have even put a date on her release – October 30.

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Well, that may or may not be so. Like the last time a date was so confidently predicted (in May last year, August 2012 was said to be when she would return to Australia), it’s far enough away to be possible, yet not so close that anyone is held accountable if the date is missed.

So, assuming her release is coming up after almost nine years in jail, let’s take the opportunity to assess our attitude to Schapelle Corby.

Schapelle Corby and fellow convicted drug mule Renae Lawrence in Kerobokan Jail in 2010.

Schapelle Corby and fellow convicted drug mule Renae Lawrence in Kerobokan Jail in 2010. Photo: Jason Childs

Many people have spent a great deal of time and energy poring over this one woman’s case – the Australian consulate in Bali; authors; lawyers; dozens, if not hundreds of journalists; prison officials, professional internet conspiracy theorists, politicians in both Australia and Indonesia.

It’s not only the Australian media who go into a frenzy at the mention of her name. She has become a touchstone in the Indonesian press, too. There, though, it’s not about an innocent entrapped in a third-world system, it’s about the ugly habit of Westerners to aggressively demand special treatment.

The head of Bali’s Kerobokan jail, Gusti Ngurah Wiratna, remarked to the press in frustration recently: "I’ve got 1000 prisoners, why are you only interested in Schapelle?"

Hundreds of thousands, perhaps millions of dollars, have changed hands – for paid interviews with the family, internet ads, defamation actions and other civil court actions, royalties and lawyers fees.

Her 2004 arrest and imprisonment has turned into a Schapelle industry.

Sadly, for several years, the subject of that industry has suffered from severe mental health issues, and has largely removed herself from its centre. Even the Corby family-friendly journalists can only quote  "those who know and live with her" in their stories because Corby herself refuses any direct interaction with the press.

She does not even go to the visitor’s area of Kerobokan in case there might be journalists there. Her absence, for the same reason, from compulsory prison events, has potentially even harmed her cause.

For a long time  Fairfax Media readers have held the dual belief that Corby is guilty, but that she deserves a shortened sentence.

Views of her innocence in the broader public are likely to be higher, but substantially lower than at the height of the "Our Schapelle" frenzy of 2004 and 2005.

It’s her perceived innocence that initially drove the Corby story to the point of obsession, but even though this has changed, nine years later, we in the media remain closely focused on every detail of her incarceration and possible release.

Perhaps we assume people will be moved by the same impulses, or the echoes of the impulses, that moved them a decade ago.

But let’s consider what all this will mean when she is ultimately released, whether on parole or at the end of her sentence.

After 10 years in a bubble, Corby will be exposed to the world.

She’ll be walking the narrow streets of Kuta, living in a Balinese compound whose address is well known, with the world’s media – including a chaotic Indonesian press pack – on her doorstep.

The inevitable paid interviews will create an appetite among the unsuccessful bidders for exclusives of a different kind – for evidence of her poor mental state, for pictures of her drinking her first beer, wearing a bikini at the beach, hanging out with a man, throwing a tantrum.

In the open, she’ll lack the protection afforded by the Australian consulate from the tourists and stickybeaks who even now occasionally try to get into the jail to visit her.

The local police are unwilling and unequipped to provide any protection.

Whatever you think of her guilt or innocence, Corby has served a long sentence, and her adjustment to life on the outside – difficult as it will be already – can only be made immeasurably harder by such attention.

Perhaps it’s time to let go of our decade-long obsession and finally just leave Schapelle Corby alone.

CORBY: THE FACTS
• Corby has been eligible for parole for more than a year, since the Indonesian president granted her clemency with a five-year sentence reduction;
• She has not yet applied for parole, and the Indonesians have not started the process, because the Indonesian immigration department has not yet confirmed that she can get a visa to be able to serve out her sentence in Bali with her sister Mercedes and brother-in-law Wayan;
• All the other conditions for parole – including an unprecedented letter from the Australian government guaranteeing her good behaviour – are in place;
• With continued remission for good behaviour, she is likely to be out in 2015 even if she does not win parole.

Read more: http://www.smh.com.au/world/schapelle-corby-time-to-let-go-of-our-obsession-20130814-2rvuc.html#ixzz2cKeyqYu5

Schapelle Corby
From Wikipedia, the free encyclopedia