Treating Tourette Syndrome / Depression / ADHD
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New Treatments Combat Depression and Anxiety -- Web Column
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By Stephanie Watson, Ivanhoe Health Correspondent
(Ivanhoe Newswire) -- Millions of Americans suffer regular bouts of
depression or anxiety. Most never seek help, yet experts say new
treatments can effectively relieve symptoms and improve quality of
life.
Nearly 10 percent of American adults -- almost 19 million people --
are depressed, according to the National Institute of Mental Health
(NIMH). Depression can be inherited, or it can emerge following a
traumatic life event, such as a death in the family, childbirth, or a
serious illness.
Depression can vary in severity and duration. Patients with major
depression may experience overwhelming sadness, hopelessness, or
anger for two weeks or more. These uncontrollable feelings can get in
the way of work and relationships. A milder form of depression,
called dysthymia, is less life-altering, but symptoms can stick
around for two years or more.
Many people with depression also suffer from generalized anxiety
disorder (GAD), one of a family of anxiety disorders that includes
obsessive-compulsive and posttraumatic stress disorders. Almost
everyone worries from time to time, but people with GAD feel anxious
for six months or more at a time. As with depression, many GAD
sufferers never seek help.
"People don't know they have a real and treatable disorder," says
Jerilyn Ross, President and CEO of the Anxiety Disorders Association
of America. "A lot of health professionals don't recognize it, don't
know the symptoms, and don't know that it's treatable."
One effective way to treat anxiety and depression is with medication.
When researchers studied the brains of depressed people, they
discovered an imbalance in the neurotransmitters serotonin and
norepinephrine -- chemicals that facilitate communication between
nerve cells in the brain. Antidepressant medications called selective
serotonin reuptake inhibitors (SSRIs) restore balance to these
neurotransmitters. SSRIs are also used to treat generalized anxiety
disorder, along with antianxiety drugs like clonazepam (Klonopin),
Iorazepam (Ativan), and buspirone (BuSpar).
Older tricyclic antidepressants (TCAs) and monoamine oxidase
inhibitors (MAOIs) also balance out neurotransmitters, but they tend
to have unpleasant side effects. Researchers are investigating new
delivery systems, including a patch-release version of the MAOI
selegiline, that may eliminate some of these side effects.
Ongoing studies are focusing on several new medications to treat
anxiety and depression. Duloxetine, a serotonin and norepinephrine
inhibitor, appears to alleviate the symptoms of depression and put
patients into remission. A class of medications called corticotropin-
releasing factor (CRF) antagonists block the production of a chemical
in the brain that scientists believe triggers anxiety.
Medication may be used on its own, or in conjunction with
psychotherapy (also called "talk therapy"). Cognitive behavioral
therapy is a popular form of psychotherapy in which patients learn to
identify and control the negative thoughts and behaviors that trigger
their depression and anxiety.
"Both with depression and anxiety, often individuals have a
distortion in their thinking about what is going on in their life,"
explains Reg A. Williams, Ph.D., professor at the University of
Michigan School of Nursing, and adjunct clinical nurse specialist at
the school's Depression Center. "Helping them to readjust that
thinking can be very powerful."
About 80 percent of patients who don't respond to medication or
psychotherapy find relief in a controversial treatment called
electroconvulsive therapy (ECT). Electrodes attached to the patient's
head deliver electrical impulses that trigger a brain seizure. The
seizure works much like medication, releasing neurotransmitters in
the patient's brain. But experts caution that the procedure may cause
short-term memory loss.
For patients squeamish about undergoing shock therapy, magnetic
therapy is a new alternative. This still investigational treatment
sends powerful magnetic pulses to the brain. Unlike ECT, magnetic
therapy does not appear to cause memory loss.
An epilepsy treatment is also showing promise in depression therapy.
Vagal nerve stimulation (VNS) uses a pacemaker-like device to
stimulate the vagus nerve, which carries messages to and from the
brain. In early trials, VNS has shown good results in patients who
did not respond to standard treatments.
In recent years, researchers have turned their attention to
alternative therapies for depression. St. John's Wort, which has been
used by Europeans for centuries, is one of the most promising
candidates. Although a 2002 National Institutes of Health (NIH) study
found St. John's Wort no more effective than a placebo for treating
major depression, researchers say the herbal remedy still shows
promise.
"The jury is out on it, but we still feel that the data are
encouraging enough to not dismiss it yet," says Jonathan Alpert,
M.D., Ph.D., Associate Director of the Depression Clinical and
Research Program at Massachusetts General Hospital. But he cautions
that St. John's Wort can have adverse interactions when taken with
drugs used to treat AIDS and to stop organ rejection.
Researchers are also looking at a naturally-occurring compound in the
body called S-adenosylmethione (SAMe), which builds
neurotransmitters. In 1998, SAMe was released as an over-the-counter
dietary supplement. Studies thus far have presented compelling
evidence that SAMe has antidepressant properties.
The first step to treating depression, anxiety, or any other mental
health problem, is to consult with a primary care physician or
psychologist, says Alpert. A psychological evaluation can rule out a
medical condition, and identify the most appropriate course of
treatment.
This article was reported by Ivanhoe.com, who offers Medical Alerts
by e-mail every day of the week. To subscribe, go to:
http://www.ivanhoe.com/newsalert/.
If you would like more information on depression and anxiety
disorders, please contact:
Anxiety Disorders Association of America
(240) 485-1001
http://www.adaa.org
The Center for Mental Health Services
http://www.mentalhealth.org/cmhs/
Depression and Bipolar Support Alliance
(800) 826-3632
http://www.dbsalliance.org/
National Alliance for the Mentally Ill
(800) 950-NAMI
http://ocd.nami.org/
National Mental Health Association
(800) 969-6642
http://www.nmha.org
Further reading on depression and anxiety disorders:
Bassett, Lucinda. From Panic to Power: Proven Techniques to Calm Your
Anxieties, Conquer Your Fears, and Put You in Control of Your Life.
New York: HarperCollins, 1995.
Bourne, Edmund J. Healing Fear: New Approaches to Overcoming Anxiety.
Oakland, California: New Harbinger Publications, 1998.
DePaulo, J. Raymond. Understanding Depression: What We Know and What
You Can do About It. New York: Wiley, 2002.
O'Connor, Richard. Undoing Depression: What Therapy Doesn't Teach You
and Medication Can't Give You. New York: Berkley Publishing Group,
1999.
Solomon, Andrew. Noonday Demon: An Atlas of Depression. New York:
Simon & Schuster, 2001.
Reported April 7, 2003
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Study Confirms Concerta (methylphenidate HCl) Effective, Safe
Treatment For Attention Deficit Hyperactivity Disorder

FORT WASHINGTON, PA -- April 1, 2003 -- A study of children with
Attention Deficit Hyperactivity Disorder (ADHD) who had previously
responded to treatment with methylphenidate demonstrates that once-a-
day Concerta(R) (methylphenidate HCl) CII effectively controls ADHD
symptoms and maintains a consistent safety profile over one year. The
study, an interim analysis of one of the longest studies to date of
continued use of a stimulant medication, indicates that children with
ADHD are likely to continue to respond to Concerta for up to 12
months. The findings were published in the April issue of the Journal
of the American Academy of Child & Adolescent Psychiatry.

The findings also add to the literature in countering some long-
standing beliefs about the effect of methylphenidate, the active
ingredient in Concerta, as a long-term ADHD treatment. Investigators
reported that Concerta did not adversely affect growth (weight and
height); did not appear to induce or worsen tics; did not adversely
affect vital signs (i.e., blood pressure, pulse); and had no
clinically meaningful effect on a wide range of blood tests (i.e.,
red and white blood cell count, liver function tests). Additionally,
despite its extended-release pharmacokinetic profile and long
duration of action, Concerta apparently had little impact on parental
perception of sleep quality.

"While it is generally agreed that pharmacological treatment of ADHD
may be needed for extended periods, few treatment studies of ADHD
extend beyond a few months," said study lead author Timothy Wilens,
M.D., Director of Substance Abuse Services in the Pediatric and Adult
Psychopharmacology Clinics at Massachusetts General Hospital. "This
12-month analysis of a longer-term study establishes the safety and
efficacy of Concerta over one year, and addresses some concerns about
the effects of long-term methylphenidate treatment on growth (height
and weight), tics, vital signs, and sleep quality. Given the chronic
nature of ADHD, it is comforting to know that medications such as
Concerta continue to work in reducing ADHD and associated impairment."

About the Study

The study was designed to evaluate the effectiveness and tolerability
of Concerta administered openly over a period of up to 24 months. It
involved one of the largest samples of stimulant-treated ADHD
children followed systematically for at least one year.

A total of 407 children, ages six through 13, who had participated in
one of the previous efficacy or pharmacokinetic studies for Concerta
participated in this multicenter, open-label nonrandomized study.

Subjects were initially assigned to one of three daily dosing levels
of once-a-day Concerta (18, 36, or 54 mg) based on their dose in the
previous study. Doses could be adjusted upward or downward in 18 mg
increments if considered appropriate by the investigator, and
participants were permitted to stop taking the medication for
weekends or non-school days, or to have medication holidays.

At the beginning of the study, 116 (28.5%) subjects were taking the
18 mg dose, 193 (47.4%) were taking the 36 mg dose, and 98 (24.1%)
were taking the 54 mg dose. At the end of treatment (last dose before
completing or withdrawing from study), 61 (15.0%), 163 (40.0%), and
183 (45.0%) subjects were taking the 18 mg, 36 mg, and 54 mg doses,
respectively. During this period, 39.8% of children had no dose
change, 19.7% had dose increases only, and 38.4% of subjects
experienced both increases and decreases.

"Increases in dosage of ADHD medications over time is not unusual,
and in line with the published literature," explained Dr.
Wilens. "The findings from this research suggest that a 20 percent
upward titration of Concerta may be appropriate for some children to
receive the full benefit of the medication," he added.

Children's ADHD-related behavior in school and at home were rated at
various intervals of the study by parents and teachers, using
established tools such as the IOWA Conners Ratings Scale. Researchers
reported that teacher and parent/caregiver monthly IOWA Conners
scores remained relatively consistent throughout the 12-month period.

"The results of this study coupled with results from short-term
clinical studies support the usefulness of this once-daily
preparation of OROS(r) MPH for ADHD," said Dr. Wilens. "Further
studies of Concerta in adolescents, adults, and subgroups of
individuals with ADHD, and with concurrent psychosocial treatments
are warranted to determine the impact of this long- acting stimulant
preparation on the long-term outcome of ADHD." The majority of
adverse events reported during the study were judged mild in severity
and consistent with the known safety profile of methylphenidate.
There were no unusual or unexpected adverse events.

Of the 407 subjects who received study medication, 289 (71 percent)
completed 12 months of treatment. Of the 118 subjects who
discontinued treatment prior to 12 months, 31 subjects (7.6%)
discontinued for lack of effectiveness, 30 of whom were taking the 54
mg dose. Other reasons for discontinuation included adverse events
(n=28), lost to follow-up (n=16), noncompliance or protocol violation
(n=14), personal reasons (n=11), female reaching menarche (n=6), and
other (n=12).

About Concerta

Concerta is an extended-release formulation of methylphenidate for
ADHD treatment that is designed to last through 12 hours, with just
one morning dose. Concerta uses an advanced OROS(R) extended-release
delivery system. The OROS(R) trilayer tablet is designed to release
the medication in Concerta in a controlled pattern providing symptom
management throughout the day.

Concerta should not be taken by patients who: have significant
anxiety, tension, or agitation, since Concerta may make these
conditions worse; are allergic to methylphenidate or any of the other
ingredients in Concerta; have glaucoma, an eye disease; have tics or
Tourette's syndrome, or a family history of Tourette's syndrome; are
taking a prescription monoamine oxidase inhibitor (MAOI). Concerta
should not be administered to patients with preexisting severe
gastrointestinal narrowing. Concerta should not be used in children
under six years, since safety and efficacy in this age group have not
been established. In the clinical studies with patients using
Concerta, the most common side effects were headache, stomach pain,
sleeplessness, and decreased appetite.

Concerta should be given cautiously to patients with a history of
drug dependence or alcoholism. Chronic abusive use can lead to marked
tolerance and psychological dependence. (See Boxed Warning in the
full U.S. Prescribing Information for Concerta).

Concerta was approved by the U.S. Food and Drug Administration in
2000. It is marketed in the United States by McNeil Consumer &
Specialty Pharmaceuticals. For more information about Concerta, call
1-888-440-7903 or visit http://www.concerta.net.


SOURCE: McNeil Consumer & Specialty Pharmaceuticals
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Alleged Beating and Tourette Syndrome.
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On stand, inmate recounts his alleged beating
There was nothing remarkable about Leonard Gibson as he walked into a
federal courtoom yesterday. Not at first. Dressed in track pants and
white sneakers, he looked like an ordinary 22-year-old, even if his
boyish face made him appear younger.
But as he settled into the witness chair in the US District Court
trial of three jail guards charged with beating inmates, Gibson
immediately began to show signs of the disorder he was diagnosed with
as a child -- the tics and sputtered slurs of Tourette's syndrome.
In 1999, when an arrest on stolen car charges left him awaiting trial
at Suffolk County's Nashua Street Jail, Gibson said the sounds and
movements he couldn't help making were met with taunts -- and
ultimately violence -- by the officers charged with his care.
To a jury captured as much by his outbursts as by the otherwise even
tones of his testimony, Gibson -- the youngest alleged victim of the
guards on trial -- recounted an assault he said left him bruised and
sleepless inside the jail's medical unit.
''My ears were throbbing,'' Gibson said of the alleged beating by
Officer William Benson and Lieutenant Eric Donnelly.
The pain from the punches to his ribs, Gibson said, made it hard to
go to the bathroom, to lie down on his side, even to breathe. ''My
sides were burning,'' he said.
Donnelly, the shift supervisor on the night of Gibson's alleged
beating, has already pleaded guilty to the charges against him.
Before the trial began this week, he and two other officers admitted
their roles in a number of inmate beatings and coverups. A fourth
officer is also expected to plead guilty.
The guilty pleas have left three officers facing trial on similar
civil rights charges. Of the three, only Benson is charged with the
1999 assault on Gibson.
All of the inmates allegedly beaten were awaiting trial, not serving
sentences. Still, defense lawyers have cast the inmates as aggressive
felons with histories of misconduct behind bars. Before Gibson took
the stand, defense attorney Stephen Pfaff attacked the credibility of
another alleged victim, Reginald Roscoe, ticking off a long list of
assault and drug convictions, as well as violent behavior inside the
jail where he said he was beaten.
But before his 1999 arrest, Gibson had never seen the inside of a
jail cell. He wound up at Nashua Street at 18, unable to make the
$500 bail ordered by a judge. Since his first arrest, Gibson
testified, he has had more problems with the law, but not major ones:
breaking into a boat to steal beer, shoplifting, and a repeat of the
crime that first landed him in jail, receiving a stolen car.
On the night of Oct. 16, 1999, Gibson said, he was eating dinner when
he got up to wash a piece of fruit. But he had not asked Benson for
permission, and that decision, he said, cost him dearly. Scolded by
Benson for leaving the table on his own, Gibson said he muttered
under his breath, ''What an attitude.'' But Benson heard something
much worse, and Gibson was taken back to his cell.
Inside the cell, Gibson said, the anger he felt at being forced back
inside fed his brain disorder, and he tried to expel all the nervous
energy from his system. He burst into jumping jacks and began lifting
his metal bed like a barbell. All the while, the twitches and
involuntary outbursts continued, he testified.
Moments later, Donnelly and Benson appeared at his cell, according to
Gibson. When he heard Donnelly shout the words, ''Crack 16,'' Gibson
said he backed up in his cell because he knew what it meant: the door
to his cell was about to open, and he feared Donnelly and Benson
would enter.
When they did, Gibson said, Donnelly grabbed him and put his knee
into Gibson's ribs. Standing behind Donnelly, Benson began hitting
Gibson's ears. When Gibson tried to cover his face with his hands, he
said Donnelly removed them. Benson then punched him in the forehead
before both men left his cell, Gibson said. He testified that he
watched the guards show the cuts they had suffered to the nurse on
duty.
As a group of new guards came to relieve the 3 p.m. to 11 p.m. shift,
Gibson said he heard the instructions Benson left for his colleagues
as they arrived.
''Watch 16,'' was what Gibson told the jury that Benson said. ''He's
a punk.''
Francie Latour can be reached at flatour@g...
This story ran on page B1 of the Boston Globe on 3/8/2003.
© Copyright 2003 Globe Newspaper Company.

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Jail Officer Convicted in Beating Case

BOSTON - A federal jury convicted a former jail officer Monday of
beating inmates and trying to cover up the assaults, but acquitted
two co-defendants in a case that has been one of a series of
embarrassments for the sheriff's department in Boston.
Brian Bailey, 31, of Boston, was found guilty of criminal civil
rights violations, conspiracy to obstruct justice, obstruction of
justice and perjury, but was acquitted of another conspiracy charge.
Bailey was among seven Nashua Street Jail corrections officers
indicted in the alleged beatings of five pretrial detainees between
June 1998 and October 1999.
One former inmate, who has Tourette's syndrome, testified that prison
guards beat him after they accused him of insulting them under his
breath. Another former inmate said he was beaten for hiding a
sandwich in a laundry bag.
The case was one of several problems for the Suffolk County Sheriff's
Department, which has been buffeted by claims of mismanagement,
criminal activity, institutional violence and sexual abuse.
Jurors acquitted Officer William R. Benson, 51, of Kingston, and
Deputy Sheriff Thomas M. Bethune Jr., 51, of West Peabody, of all
charges. The other defendants have entered guilty pleas or are
expected to do so.
"Today's verdict should send a strong message that an individual's
rights do not stop at the jail cell door," U.S. Attorney Michael
Sullivan said in a statement.
Bailey's attorney, Evan Slavitt, said his client "was disappointed
with the jury's verdict, and he stands by what was said on the
stand." They were considering an appeal.
Bethune, reached at his home, said he was "ecstatic" over his
acquittal, and looked forward to his reinstatement.
Bailey is scheduled to be sentenced July 7. The conspiracy count
carries a maximum five-year sentence, and the other three counts
carry 10-year maximums.
Lt. Eric J. Donnelly, 36, of Boston, Deputy Sheriff Anthony Nuzzo,
32, of Boston, and Deputy Sheriff Melvin J. Massucco III, 39, of
Revere, have pleaded guilty in the case. Lt. Randall R. Sutherland,
45, of Randolph, is scheduled to plead guilty on April 15.
In a dramatic end to a four-year investigation of the state's largest
county corrections system, a federal jury yesterday cleared two of
three Suffolk County jail guards who were charged with beating
inmates and covering up the episodes.
Two years after the men were indicted, the jury acquitted veteran
officers Thomas Bethune Jr. and William Benson, both 51, of all
charges.
Benson was cleared in a case that brought forth one of the
prosecution's most dramatic witnesses: Leonard Gibson, who suffers
from Tourette's syndrome and testified that he was beaten by Benson
and another guard inside the medical unit of the Nashua Street Jail.
The jury, which deliberated for two days, returned guilty verdicts
against Brian Bailey, 31. Bailey was convicted of using excessive
force, obstructing justice, perjury, and conspiracy in the beating of
Nikolas Dais, a suicidal pretrial detainee.
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Two guards acquitted in beatings
In a dramatic end to a four-year investigation of the state's largest
county corrections system, a federal jury yesterday cleared two of
three Suffolk County jail guards who were charged with beating
inmates and covering up the episodes.
Two years after the men were indicted, the jury acquitted veteran
officers Thomas Bethune Jr. and William Benson, both 51, of all
charges.
Benson was cleared in a case that brought forth one of the
prosecution's most dramatic witnesses: Leonard Gibson, who suffers
from Tourette's syndrome and testified that he was beaten by Benson
and another guard inside the medical unit of the Nashua Street Jail.
The jury, which deliberated for two days, returned guilty verdicts
against Brian Bailey, 31. Bailey was convicted of using excessive
force, obstructing justice, perjury, and conspiracy in the beating of
Nikolas Dais, a suicidal pretrial detainee. Bailey was acquitted of
one conspiracy charge.
Dais was the only one of three alleged victims not to take the stand.
Bailey's sentencing was set for July 7.
In a trial that encompassed three defendants and 15 counts, more than
a minute elapsed before US District Court Judge Reginald C. Lindsay
read off the second of Benson's two not-guilty verdicts. When it
came, Benson lowered his head and he began to tremble, wiping tears
from his eyes.
''After four long years, it's gratifying they finally got the
truth,'' Benson said outside the courtroom. In the moments between
his two verdicts, Benson said, ''My whole life was in front of me.''
Stephen Pfaff, the lawyer for Bethune, said, ''It's been a long, long
time,'' referring to the investigation that began in 1999. ''I was
nervous, like everyone else, but confident that the jury would do the
right thing.''
Following Benson's firing in 1999, a private arbitrator ordered the
Sheriff's Department to reinstate him with back pay. Bethune, who was
suspended without pay following the 2001 indictment, may also return
to the department.
But a sheriff's spokesman said yesterday that neither Benson nor
Bethune will return until department lawyers review their trial
testimony.
Gibson expressed shock at Benson's acquittal. ''Surprised? Of course
I'm surprised. He's guilty,'' he said. ''He's one of the ones who
beat me. ... If he can get away with that, what's to stop him from
doing it again?''
Bailey, Benson, and Bethune each took the stand in their own defense,
denying the charges and telling jurors that they never witnessed any
beatings while employed as guards at the jail.
Three other veteran guards, who were named in the original
indictment, Eric J. Donnelly, Anthony Nuzzo, and Melvin Massucco III
pleaded guilty to all of the brutality and conspiracy charges against
them before the case went to trial and are scheduled to be sentenced
in June.
Another indicted officer and former lieutenant, Randall Sutherland,
is expected to plead guilty in April.
US Attorney Michael Sullivan said that the two acquittals did not
undermine the basis of the lengthy investigation.
''I don't see it as a serious blow at all,'' Sullivan said. ''Proof
beyond a reasonable doubt is an extremely high standard, and the
defendants were members of a law enforcement agency. ... Looking back
on it, I'm not sure there's anything we could've or would've done
differently.''
Sullivan would not comment on the prosecution's most controversial
witness, Michael Ross, a former guard who kept his badge for two
years despite failing the department's training academy and its use-
of-force exam.
Ross was the only witness whose testimony implicated all three
officers on trial. In exchange for his testimony and for pleading
guilty to a misdemeanor, prosecutors agreed to ignore any other
crimes Ross may have committed while he was a guard, and to recommend
a one-year sentence.
But in two days of withering cross-examination by defense attorneys,
Ross repeatedly contradicted himself and often said he could not
remember testimony he had given the previous day.
This story ran on page B1 of the Boston Globe on 4/1/2003.
© Copyright 2003 Globe Newspaper Company.

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Other Articles With Tourette Syndrome
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'I'M DISABLED, I WAS NOT DRUNK,' MAN TELLS CITY COURT
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BY ECHO REPORTER

12:00 - 07 April 2003
A disabled man landed in court after police mistook his handicaps for
disorderly behaviour. Officers thought Adrian Elvis Presley Chambers
was behaving drunkenly and being abusive outside his girlfriend's
block of flats in Exeter.

But Chambers was shaking because he moves unsteadily due to cerebral
palsy and an amputated arm.

He was swearing at officers because he suffers from fits similar to
Tourette's syndrome, which causes uncontrollable verbal outbursts.

The incident occurred when he was trying to get back into the block
of flats to help his disabled girlfriend who had fallen over.

Chambers, of Eaton Drive, Exeter, agreed at Exeter magistrates court
to be bound over in the sum of £20 to keep the peace for a month.
Magistrates agreed to withdraw a charge of causing a public order
offence by using threatening, abusive or insulting words or behaviour.

Prosecutor Derek Frame said: "Mr Chambers was outside a residential
block trying to gain entry to see a friend. He couldn't get in and he
pushed past police.

"His actions may have been misinterpreted. He has a previous good
character and no past convictions." Caroline Salvatore, in
mitigation, said police had made a genuine mistake.

"Mr Chamber's fiancee has cerebral palsy, is wheelchair-bound and has
a speech impediment so she cannot make herself easily understood,"
she said.

"When she falls, legislation means her warden is not allowed to raise
her and an ambulance has to be called.

"The police and an ambulance attended after the fall and Mr Chambers
was anxious to help.

"He knew the ambulance crew would need to ask her questions and might
not be able to understand her.

"Police didn't realise and thought he was being a busybody. They
thought he was drunk."

Magistrates told Chambers there had been a misunderstanding and they
realised he had never intended to cause trouble.

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Bus ban
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A FIVE-year-old girl faces being banned from Sheffield's buses unless
she carries a letter proving she can't control her swearing.
Chelsea Aheran has Tourette's syndrome – a condition where children
unconsciously blurt out foul language – and is diagnosed with a
hyperactivity disorder.
She is at the centre of a row between her parents, Tracey and Peter,
and bus operator First, which wants her to carry a letter on their
buses to inform drivers of her condition.
The argument follows a bust-up between Tracey and a driver in the
street in Birley Moor Road, Birley, after Chelsea swore at him.
First is investigating the incident. But the company has told the
family its drivers must be told of Chelsea's condition as she boards
their buses, or she may "face problems" staying on board.
Tracey, of Newstead Grove, Birley, said: "I know her swearing causes
problems, and we have lost friends over it.
"But how can you try and impose rules on a little five-year-old girl
to use a bus?
"Whenever my husband gets on with her and she starts swearing, he
tells people 'my daughter's got problems'.
"People are usually all right about it. I don't see why children with
problems should be treated like this. It's disgusting."
There have been at least two other occasions when First drivers have
been offended by her bad language, Tracey said.
Chelsea is taught at Birley Primary School, but her parents say she
could be soon moved out of mainstream schooling.
Her three brothers, Joel, aged seven, Joshua, two, Jason, one, and
her six-year-old sister Courtney do not have her behavioural problems.
First's communications director Brandon Jones said its drivers are
instructed to ban passengers who abuse their drivers physically or
verbally.
He said: "It is a very delicate situation, and obviously it would be
wrong to ban this little girl from our buses because of her problems.
"The solution we are presenting is that we will issue her with a
letter from one of our senior managers which will then explain to our
drivers the problems this young lady has.
"We are in a situation where our customers and staff are being
confronted with expletives, through nobody's fault."
FACTFILE
Tourette's syndrome (TS) is a neurological disorder.
Sufferers experience sudden outbursts of bad language.
The condition is also shown up by making rapid, sudden movements,
repeatedly.
The outbursts can occur many times a day, or intermittently.
Symptoms can disappear for weeks or months at a time.
Some people with TS are able to hold back their outburst for up to
hours at a time, but this only leads to a stronger outburst later.
27 March 2003
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Support group helps families of children with severe mental illness
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Sunday, April 6, 2003
By STEVE SCHMADEKE, sdschmadeke@n...
For Janette L'Heureux and her family, the process often starts with a
surge as sudden and unexpected as weather, an electrical storm in a 9-
year-old brain that leaves her son violent, tearing apart his room at
home or attacking playmates.
In many ways, the L'Heureuxs are more fortunate than other families:
Not only was their son, Josh, diagnosed with early-onset bipolar
disorder and Tourette's syndrome at a young age, but both parents
have good jobs with good insurance.
Even so, as their son grows older and more difficult to control, the
L'Heureuxs may be faced with a gut-wrenching decision faced by some
families who have children with severe mental illness.
In order to get the residential treatment he needs, they may have to
give up custody of their son and turn him over to the state-funded
foster care system, though for now they have no intention of doing so.
"We've heard the horror stories," said Janette L'Heureux, who has
started a parent support group called Caring4Kids. "It's really,
really sad."
The state Department of Children and Families does not track how many
mentally ill children are committed to the foster care system, but
says there are programs in place to prevent that from happening.
But even Pam Baker, administrator for DCF's mental health programs in
the five-county district that includes Lee and Collier counties,
acknowledges that the system needs money.
Her budget last year provided $19 million for adult mental health
services and less than $3 million for children.
"We've got it backwards," said David Schimmel, director of the David
Lawrence Center in Naples. "It's kind of a sad system. They (parents)
have to wait for things to get so bad with their kids or they have to
give up custody in order for them to get services."
The numbers are straightforward.
There are only 20 residential treatment beds for children in the
area, all located at the David Lawrence Center, but only five for
families who do not qualify for Medicaid.
The foster care system, on the other hand, has many more available
beds and every child in it receives Medicaid benefits, but it was
never intended as a service for the mentally ill.
"Resources for children in the state outside of the welfare system
are really pretty scarce," said Jan Eustis, director of the Ruth
Cooper Center, a mental health facility in Fort Myers. "It is not a
well-funded system. We've heard a lot of parents say, 'I just don't
know where to go.'"
"The biggest frustration these families have is trying to access to
those services," said Stan Applebaum of the Florida Advocacy Council.
Families who try to pay for residential treatment programs, which
typically run a minimum of four months, are looking at tens of
thousands of dollars in medical bills.
"I don't know many families who make $50,000 who can afford that," he
said.
The L'Heureuxs have already spent time searching for a residential
treatment program in which they feel comfortable placing their son.
They found a center in Wisconsin they liked, but it cost $12,000 a
month and a six- to 12-month enrollment was encouraged.
"I could maybe pay that for one month, but that is not long enough to
help him," Janette L'Heureux said.
Parents and mental health leaders also are concerned that the state
Legislature will cut back on mental health money even more this year
at a time when the number of children diagnosed with mental illness
is rapidly increasing.
The six-bed emergency unit that serves about 750 children a year at
David Lawrence has been financed by a $280,000 special appropriation,
but local politicians have indicated there is a good chance the money
won't be there this year.
Officials at the Ruth Cooper Center are concerned that a grant for a
program that provides in-home counseling for about 130 mentally ill
children a month at risk of hospitalization will also be left by the
wayside.
And some parents find it ironic that, at a time when politicians,
physicians and community leaders say they are scrambling to keep Lee
Memorial Health System's trauma center open to prevent patients from
being sent to Tampa or Miami, that is exactly what happens to many
children with severe mental illness.
It has happened to the L'Heureux family twice — their son, Josh,
stayed at a Miami hospital for five days and a Sarasota children's
facility for nine days.
Still, DCF's Baker said she and others were lobbying the Legislature
to allow mentally ill children to be classified as a family of one,
which would let them qualify for Medicaid.
The process of privatizing the mental health and foster care system
started this month when Camelot Community Care, the organization
heading up the effort in this district, began a $1 million phase-in
and planning project.
The organization is scheduled to take over much of DCF's functions by
the end of the year.
Executive Director Lee Scherrer said he plans to remove redundancies
and add more responsibility to the system by changes such as
appointing a single case worker to follow each child.
"They (parents) will see a more streamlined agency with more
flexibility and choices," he said.
But mental health officials such as Schimmel say that, without more
money, these changes will not mean much.
"DCF gets battered all the time, but they are simply a product of the
state Legislature," he said.
Meanwhile stand-in parents like Liza Williams, a teaching assistant
at the David Lawrence-affiliated SunshinWe've heard the horror
stories," said Janette L'Heureux, who has started a parent support
group called Caring4Kids. "It's really, really sad."
The state Department of Children and Families does not track how many
mentally ill children are committed to the foster care system, but
says there are programs in place to prevent that from happening.
But even Pam Baker, administrator for DCF's mental health programs in
the five-county district that includes Lee and Collier counties,
acknowledges that the system needs money.
Her budget last year provided $19 million for adult mental health
services and less than $3 million for children.
"We've got it backwards," said David Schimmel, director of the David
Lawrence Center in Naples. "It's kind of a sad system. They (parents)
have to wait for things to get so bad with their kids or they have to
give up custody in order for them to get services."
The numbers are straightforward.
There are only 20 residential treatment beds for children in the
area, all located at the David Lawrence Center, but only five for
families who do not qualify for Medicaid.
The foster care system, on the other hand, has many more available
beds and every child in it receives Medicaid benefits, but it was
never intended as a service for the mentally ill.
"Resources for children in the state outside of the welfare system
are really pretty scarce," said Jan Eustis, director of the Ruth
Cooper Center, a mental health facility in Fort Myers. "It is not a
well-funded system. We've heard a lot of parents say, 'I just don't
know where to go.'"
"The biggest frustration these families have is trying to access to
those services," said Stan Applebaum of the Florida Advocacy Council.
Families who try to pay for residential treatment programs, which
typically run a minimum of four months, are looking at tens of
thousands of dollars in medical bills.
"I don't know many families who make $50,000 who can afford that," he
said.
The L'Heureuxs have already spent time searching for a residential
treatment program in which they feel comfortable placing their son.
They found a center in Wisconsin they liked, but it cost $12,000 a
month and a six- to 12-month enrollment was encouraged.
"I could maybe pay that for one month, but that is not long enough to
help him," Janette L'Heureux said.
Parents and mental health leaders also are concerned that the state
Legislature will cut back on mental health money even more this year
at a time when the number of children diagnosed with mental illness
is rapidly increasing.
The six-bed emergency unit that serves about 750 children a year at
David Lawrence has been financed by a $280,000 special appropriation,
but local politicians have indicated there is a good chance the money
won't be there this year.
Officials at the Ruth Cooper Center are concerned that a grant for a
program that provides in-home counseling for about 130 mentally ill
children a month at risk of hospitalization will also be left by the
wayside.
And some parents find it ironic that, at a time when politicians,
physicians and community leaders say they are scrambling to keep Lee
Memorial Health System's trauma center open to prevent patients from
being sent to Tampa or Miami, that is exactly what happens to many
children with severe mental illness.
It has happened to the L'Heureux family twice — their son, Josh,
stayed at a Miami hospital for five days and a Sarasota children's
facility for nine days.
Still, DCF's Baker said she and others were lobbying the Legislature
to allow mentally ill children to be classified as a family of one,
which would let them qualify for Medicaid.
The process of privatizing the mental health and foster care system
started this month when Camelot Community Care, the organization
heading up the effort in this district, began a $1 million phase-in
and planning project.
The organization is scheduled to take over much of DCF's functions by
the end of the year.
Executive Director Lee Scherrer said he plans to remove redundancies
and add more responsibility to the system by changes such as
appointing a single case worker to follow each child.
"They (parents) will see a more streamlined agency with more
flexibility and choices," he said.
But mental health officials such as Schimmel say that, without more
money, these changes will not mean much.
"DCF gets battered all the time, but they are simply a product of the
state Legislature," he said.
Meanwhile stand-in parents like Liza Williams, a teaching assistant
at the David Lawrence-affiliated Sunshine School, see firsthand the
scars left on mentally ill children who have gone through the foster
care system.
Williams, who hopes to adopt the 15-year-old schizophrenic girl she
has cared for for about a year, says that the girl still asks
permission to use the bathroom and also asks to be told what to do
with her free time.
"I just wish she could feel comfortable," Williams said.
e School, see firsthand the scars left on mentally ill children who
have gone through the foster care system.
Williams, who hopes to adopt the 15-year-old schizophrenic girl she
has cared for for about a year, says that the girl still asks
permission to use the bathroom and also asks to be told what to do
with her free time.
"I just wish she could feel comfortable," Williams said.

We've heard the horror stories," said Janette L'Heureux, who has
started a parent support group called Caring4Kids. "It's really,
really sad."
The state Department of Children and Families does not track how many
mentally ill children are committed to the foster care system, but
says there are programs in place to prevent that from happening.
But even Pam Baker, administrator for DCF's mental health programs in
the five-county district that includes Lee and Collier counties,
acknowledges that the system needs money.
Her budget last year provided $19 million for adult mental health
services and less than $3 million for children.
"We've got it backwards," said David Schimmel, director of the David
Lawrence Center in Naples. "It's kind of a sad system. They (parents)
have to wait for things to get so bad with their kids or they have to
give up custody in order for them to get services."
The numbers are straightforward.
There are only 20 residential treatment beds for children in the
area, all located at the David Lawrence Center, but only five for
families who do not qualify for Medicaid.
The foster care system, on the other hand, has many more available
beds and every child in it receives Medicaid benefits, but it was
never intended as a service for the mentally ill.
"Resources for children in the state outside of the welfare system
are really pretty scarce," said Jan Eustis, director of the Ruth
Cooper Center, a mental health facility in Fort Myers. "It is not a
well-funded system. We've heard a lot of parents say, 'I just don't
know where to go.'"
"The biggest frustration these families have is trying to access to
those services," said Stan Applebaum of the Florida Advocacy Council.
Families who try to pay for residential treatment programs, which
typically run a minimum of four months, are looking at tens of
thousands of dollars in medical bills.
"I don't know many families who make $50,000 who can afford that," he
said.
The L'Heureuxs have already spent time searching for a residential
treatment program in which they feel comfortable placing their son.
They found a center in Wisconsin they liked, but it cost $12,000 a
month and a six- to 12-month enrollment was encouraged.
"I could maybe pay that for one month, but that is not long enough to
help him," Janette L'Heureux said.
Parents and mental health leaders also are concerned that the state
Legislature will cut back on mental health money even more this year
at a time when the number of children diagnosed with mental illness
is rapidly increasing.
The six-bed emergency unit that serves about 750 children a year at
David Lawrence has been financed by a $280,000 special appropriation,
but local politicians have indicated there is a good chance the money
won't be there this year.
Officials at the Ruth Cooper Center are concerned that a grant for a
program that provides in-home counseling for about 130 mentally ill
children a month at risk of hospitalization will also be left by the
wayside.
And some parents find it ironic that, at a time when politicians,
physicians and community leaders say they are scrambling to keep Lee
Memorial Health System's trauma center open to prevent patients from
being sent to Tampa or Miami, that is exactly what happens to many
children with severe mental illness.
It has happened to the L'Heureux family twice — their son, Josh,
stayed at a Miami hospital for five days and a Sarasota children's
facility for nine days.
Still, DCF's Baker said she and others were lobbying the Legislature
to allow mentally ill children to be classified as a family of one,
which would let them qualify for Medicaid.
The process of privatizing the mental health and foster care system
started this month when Camelot Community Care, the organization
heading up the effort in this district, began a $1 million phase-in
and planning project.
The organization is scheduled to take over much of DCF's functions by
the end of the year.
Executive Director Lee Scherrer said he plans to remove redundancies
and add more responsibility to the system by changes such as
appointing a single case worker to follow each child.
"They (parents) will see a more streamlined agency with more
flexibility and choices," he said.
But mental health officials such as Schimmel say that, without more
money, these changes will not mean much.
"DCF gets battered all the time, but they are simply a product of the
state Legislature," he said.
Meanwhile stand-in parents like Liza Williams, a teaching assistant
at the David Lawrence-affiliated Sunshine School, see firsthand the
scars left on mentally ill children who have gone through the foster
care system.
Williams, who hopes to adopt the 15-year-old schizophrenic girl she
has cared for for about a year, says that the girl still asks
permission to use the bathroom and also asks to be told what to do
with her free time.
"I just wish she could feel comfortable," Williams said.


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