Friday, July 31, 2015

Notorious Psych Ward at Miami-Dade Jail Finally Shuttered

From this report in the Prison Legal News Website

In a historic culmination to decades of “horrific” living conditions and a pattern of constitutional violations, the Miami-Dade County Jail in Florida has finally closed the “Forgotten Floor” – the notorious ninth floor at the facility that was used to house mentally ill prisoners, often for months and years at a time, with levels of care so abysmal that prisoners routinely died.

“It is thrilling on one level but kind of sad that it has taken so long,” said Miami-Dade Judge Steve Leifman of the December 23, 2014 closure of the jail’s ninth floor. “A lot of people have been hurt or died up there.” Leifman, as chair of the 11th Circuit Mental Health Project, has been a long-time advocate for the mentally ill.

In 2013 alone, three mentally ill prisoners housed on the ninth floor died. On August 26, Joseph Wilner, 59, was found “unresponsive” in his cell; jailed for driving on a suspended license, he was in the unit reserved for the most acute mental cases.

In July 2013, Leifman was informed of the death of wheelchair-bound prisoner Joaquin Cairo. An employee with the jail’s diversion program told the court that Cairo said “someone propositioned him while in custody and when [he] declined they threw him against the bed and against the floor.” Cairo suffered a broken pelvis and died from internal bleeding.

“The neglect was despicable. Despicable,” Leifman said. “He should have been taken to a hospital immediately, and there is absolutely no excuse.”

Three months earlier another psych ward patient, Juan Matos-Flores, who was considered a suicide risk, died after jailers found him unresponsive on the floor of his cell. When staff tried to call 911 they were unable to do so because the phones on the ninth floor were programmed to block outgoing calls. Instead, employees were forced to call another floor to get help.

“It’s a floor that is specifically designed for people who are ill. It’s absurd,” Leifman said after learning of the telephone debacle.

When the ninth floor at the Miami-Dade County Jail closed, some 400 prisoners were transferred to six newly-refurbished wings at the Turner Guilford Knight Correctional Center, where the telephones allow 911 calls and cameras monitor prisoners in every cell.

[...]

The Miami-Dade County Jail, the nation’s eighth-largest, has been under federal monitoring since the U.S. Department of Justice concluded a three-year investigation in 2011 that found a “pattern and practice in constitutional violations” of prisoners’ rights due to deplorable living conditions.

Leifman was more blunt, calling conditions on the Forgotten Floor “horrific.”

“It was not built to be a psychiatric facility. It was built as a jail [with a cell] for one person, and here two and three people [were placed] in there that are very psychotic,” he said.

The public got its first glimpse of the infamous floor in 2006 when Leifman invited a television reporter and camera crew to document conditions as he guided a tour. “Human beings should not be treated like this. No blankets, no beds, no mattresses. We sleep on the floor,” one prisoner told CBS4 chief investigative reporter Michele Gillen, who found the faucets in cells were not working and prisoners were drinking water from the toilets. Leifman credited Gillen’s reporting with stirring public outrage which, in turn, prompted action.

“We have finally closed the ninth floor, thanks to you,” Leifman told Gillen in an interview. “I don’t think the public ever would have understood how horrendous the situation was, but for your reporting. And it led to where we are today.”

Thursday, July 30, 2015

Anchorage Doctor Sentenced to 3 ½ years for Fraudulently Billing Medicaid and Tampering with Physical Evidence

State of Alaska Press Release here

The Alaska Department of Law, Medicaid Fraud Control Unit, announced today that 40-year-old Dr. Shubhranjan Ghosh was sentenced to 3 ½ years of active incarceration. Dr. Ghosh pled guilty to Medical Assistance Fraud and Tampering With Physical Evidence, which he committed between 2010 and 2013 at his practice, Ghosh Psychiatric Services.

Judge Philip Volland also ordered Dr. Ghosh to repay $605,000 in restitution to Medicaid. After release, Dr. Ghosh will be on probation for 10 years, and there will be 3 ½ years jail time that the Court could impose if he violates probation. Dr. Ghosh was remanded to custody at sentencing today. The Medical Board will decide the future of Dr. Ghosh’s medical license.

In court papers, Assistant Attorney General Jonas Walker argued that Dr. Ghosh “is a con artist who happens to hold a medical license.” The State presented evidence at sentencing, including a video showing Dr. Ghosh urging an employee to sign false affidavits stating that medical services were provided when, in fact, they were not.

Judge Volland remarked the community should be “shocked” by Dr. Ghosh’s “unconscionable and unacceptable” crimes of “poaching” money from a program designed to provide medical care to a particularly vulnerable population.

The case was initiated by citizen complaint and jointly investigated by the Alaska Department of Law, Alaska State Troopers, Anchorage Police Department, Alaska Department of Health and Social Services, the U.S. Department of Health and Human Services, Office of Inspector General, Federal Bureau of Investigation, Immigration and Customs Enforcement Homeland Security Investigations. Mr. Walker emphasized that this case is a great example of how state and federal collaboration can work to combat fraud and abuse in the Medicaid system.

The Alaska MFCU is part of the Attorney General’s Office. The MFCU is responsible for investigating and prosecuting Medicaid fraud and abuse, neglect or financial exploitations of patients in any facility that accepts Medicaid funds.
The information filed in the Ghosh complaint can be found on the MFCU website.

Saturday, July 25, 2015

Timberlawn mental hospital cut off from federal funding over safety issues

From a much long report in the Dallas News

Federal regulators are taking the rare step of kicking one of North Texas’ largest psychiatric hospitals out of the Medicare and Medicaid programs for leaving patients in “immediate jeopardy” of injury or death.

[...]

Timberlawn flunked a make-or-break inspection, a final chance to prove it could fix an array of problems after promising improvements for months.

The U.S. Centers for Medicare & Medicaid Services found that unlicensed personnel were monitoring patients and some patients were going more than 12 hours without seeing a nurse. Electrical cords and other unsafe objects remained in rooms within reach of suicidal patients.

“These practices posed an immediate jeopardy to the health and safety of patients,” inspectors said in a report.

The state said it is moving quickly to evaluate its enforcement options.

“The issues have been egregious and incredibly disheartening. We are absolutely looking at the full range of penalties, including license revocation,” said Carrie Williams, a spokeswoman for the Texas Department of State Health Services. “Our inspectors have been in and out of the facility since February, citing issues and not seeing progress. It’s turned into a critical situation.”
Much more information at the link, which includes hand wringing over what they will do when a dangerous and unsafe facility is shut down.

Wednesday, July 22, 2015

Poor treatment at Lehigh Valley mental health clinics was evident, patients say

From a longer report in the Lehigh Valley Live website

Photo caption:Lehigh Valley Community Mental Health Centers Inc. at 226 Northampton St., Easton, is seen July 20, 2015. It is one of 10 mental health clinics sued July 20, 2015, by the U.S. Attorney's Office for the Eastern District of Pennsylvania, along with owner Melissa Chlebowski and Melchor Martinez. Martinez is alleged to have run the Medicare- and Medicaid-funded clinics in Easton, Bethlehem, Allentown, Philadelphia and Raleigh, North Carolina, despite a 2000 ruling excluding him from participating in these and any federally funded health care programs.

Director Allison E. Frantz said the department received complaints about the delivery of care at Lehigh Valley Community Mental Health Centers Inc., now the target of a federal whistleblower lawsuit. The department forwarded the complaints, prompting an investigation, she said.

"The Northampton County DHS has taken steps to ensure the county's citizens' behavioral health treatment would not be jeopardized: the provider network was enhanced to include additional bi-cultural, bilingual treatment professionals and regular and frequent on-site clinical reviews, including additional billing audits," Frantz wrote in an email Tuesday.

After the U.S. Attorney's Office for the Eastern District of Pennsylvania announced the lawsuit Monday, patients were left with myriad questions about the care they had received and whether the five local centers in Easton, Bethlehem and Allentown would remain open.

The suit also targets the centers' owner, Melissa Chlebowski, and her husband, Melchor Martinez, both of Allentown, as well as four sister mental health centers in Philadelphia and one in North Carolina.

[...]

The suit alleges the mental health clinics used unqualified stand-ins for psychiatrists and rushed patients through "medication management" visits. Federal prosecutors also say the centers were really run by Martinez, despite being prohibited since 2000 from participating in Medicaid, Medicare or any federally funded health care programs.

The civil action seeks damages and penalties.

[...]

Tuesday, July 21, 2015

Active Shooters and Psychotropic Drugs

Taken from the much larger article which is a book review of "Active Shooters and Psychotropic Drugs SSRI’s" by Chris Grollnek and Chris Magee. Without quoting the full review, all we really need to is to cite this list of deaths and "the coincidence" of all these shooting associated with psychiatric drugs.

  • Eric Harris age 17 (first on Zoloft then Luvox) and Dylan Klebold aged 18 (Columbine school shooting in Littleton, Colorado), killed 12 students and 1 teacher, and wounded 23 others, before killing themselves. Klebold’s medical records have never been made available to the public.
  • Jeff Weise, age 16, had been prescribed 60 mg/day of Prozac (three times the average starting dose for adults!) when he shot his grandfather, his grandfather’s girlfriend and many fellow students at Red Lake, Minnesota. He then shot himself. 10 dead, 12 wounded.
  • Cory Baadsgaard, age 16, Wahluke (Washington state) High School, was on Paxil (which caused him to have hallucinations) when he took a rifle to his high school and held 23 classmates hostage. He has no memory of the event.
  • Chris Fetters, age 13, killed his favorite aunt while taking Prozac.
  • Christopher Pittman, age 12, murdered both his grandparents while taking Zoloft.
  • Mathew Miller, age 13, hung himself in his bedroom closet after taking Zoloft for 6 days.
  • Kip Kinkel, age 15, (on Prozac and Ritalin) shot his parents while they slept then went to school and opened fire killing 2 classmates and injuring 22 shortly after beginning Prozac treatment.
  • Luke Woodham, age 16 (Prozac) killed his mother and then killed two students, wounding six others.
  • A boy in Pocatello, ID (Zoloft) in 1998 had a Zoloft-induced seizure that caused an armed stand off at his school.
  • Michael Carneal (Ritalin), age 14, opened fire on students at a high school prayer meeting in West Paducah, Kentucky. Three teenagers were killed, five others were wounded..
  • A young man in Huntsville, Alabama (Ritalin) went psychotic chopping up his parents with an ax and also killing one sibling and almost murdering another.
  • Andrew Golden, age 11, (Ritalin) and Mitchell Johnson, aged 14, (Ritalin) shot 15 people, killing four students, one teacher, and wounding 10 others.
  • TJ Solomon, age 15, (Ritalin) high school student in Conyers, Georgia opened fire on and wounded six of his class mates.
  • Rod Mathews, age 14, (Ritalin) beat a classmate to death with a bat.
  • James Wilson, age 19, (various psychiatric drugs) from Breenwood, South Carolina, took a .22 caliber revolver into an elementary school killing two young girls, and wounding seven other children and two teachers.
  • Elizabeth Bush, age 13, (Paxil) was responsible for a school shooting in Pennsylvania
  • Jason Hoffman (Effexor and Celexa) – school shooting in El Cajon, California
  • Jarred Viktor, age 15, (Paxil), after five days on Paxil he stabbed his grandmother 61 times.
  • Chris Shanahan, age 15 (Paxil) in Rigby, ID who out of the blue killed a woman.
  • Jeff Franklin (Prozac and Ritalin), Huntsville, AL, killed his parents as they came home from work using a sledge hammer, hatchet, butcher knife and mechanic’s file, then attacked his younger brothers and sister.
  • Neal Furrow (Prozac) in LA Jewish school shooting reported to have been court-ordered to be on Prozac along with several other medications.
  • Kevin Rider, age 14, was withdrawing from Prozac when he died from a gunshot wound to his head. Initially it was ruled a suicide, but two years later, the investigation into his death was opened as a possible homicide. The prime suspect, also age 14, had been taking Zoloft and other SSRI antidepressants.
  • Alex Kim, age 13, hung himself shortly after his Lexapro prescription had been doubled.
  • Diane Routhier was prescribed Welbutrin for gallstone problems. Six days later, after suffering many adverse effects of the drug, she shot herself.
  • Billy Willkomm, an accomplished wrestler and a University of Florida student, was prescribed Prozac at the age of 17. His family found him dead of suicide – hanging from a tall ladder at the family’s Gulf Shore Boulevard home in July 2002.
  • Kara Jaye Anne Fuller-Otter, age 12, was on Paxil when she hung herself from a hook in her closet. Kara’s parents said “…. the damn doctor wouldn’t take her off it and I asked him to when we went in on the second visit. I told him I thought she was having some sort of reaction to Paxil…”)
  • Gareth Christian, Vancouver, age 18, was on Paxil when he committed suicide in 2002, (Gareth’s father could not accept his son’s death and killed himself.)
  • Julie Woodward, age 17, was on Zoloft when she hung herself in her family’s detached garage.
  • Matthew Miller was 13 when he saw a psychiatrist because he was having difficulty at school. The psychiatrist gave him samples of Zoloft. Seven days later his mother found him dead, hanging by a belt from a laundry hook in his closet.
  • Kurt Danysh, age 18, and on Prozac, killed his father with a shotgun. He is now behind prison bars, and writes letters, trying to warn the world that SSRI drugs can kill.
  • Woody __, age 37, committed suicide while in his 5th week of taking Zoloft. Shortly before his death his physician suggested doubling the dose of the drug. He had seen his physician only for insomnia. He had never been depressed, nor did he have any history of any mental illness symptoms.
  • A boy from Houston, age 10, shot and killed his father after his Prozac dosage was increased.
  • Hammad Memon, age 15, shot and killed a fellow middle school student. He had been diagnosed with ADHD and depression and was taking Zoloft and “other drugs for the conditions.”
  • Matti Saari, a 22-year-old culinary student, shot and killed 9 students and a teacher, and wounded another student, before killing himself. Saari was taking an SSRI and a benzodiazapine.
  • Steven Kazmierczak, age 27, shot and killed five people and wounded 21 others before killing himself in a Northern Illinois University auditorium. According to his girlfriend, he had recently been taking Prozac, Xanax and Ambien. Toxicology results showed that he still had trace amounts of Xanax in his system.
  • Finnish gunman Pekka-Eric Auvinen, age 18, had been taking antidepressants before he killed eight people and wounded a dozen more at Jokela High School – then he committed suicide.
  • Asa Coon from Cleveland, age 14, shot and wounded four before taking his own life. Court records show Coon was on Trazodone.
  • Jon Romano, age 16, on medication for depression, fired a shotgun at a teacher in his New York high school.

Monday, July 20, 2015

Owners of local mental health clinics face fraud charges

As Reported in the Philadelphia Business Journal

The U.S. Attorney’s Office for the Eastern District of Pennsylvania filed a civil health care fraud lawsuit Monday, under the False Claims Act, against an Allentown husband and wife and their network of mental health centers funded largely by Medicaid and Medicare.

The lawsuit names Melchor Martinez and Melissa Chlebowski, both of Allentown, as defendants and their businesses: Northeast Community Mental Health Centers in Philadelphia; Lehigh Valley Community Mental Health Centers in Allentown, Easton and Bethlehem; and North Carolina Community Mental Health Centers in Raleigh, N.C.

The complaint notes Martinez was convicted of Medicaid fraud in 2000 and, as a result, was excluded from participating in all federally funded health care programs including Medicaid and Medicare. The exclusion prohibited Martinez from owning, managing or receiving payments from any federally funded health care provider.

The lawsuit alleges that in spite of the exclusion, Martinez, assisted by his wife Chlebowski, continued to own and operate the Northeast and Lehigh Valley clinics, and that, in 2009, while his exclusion was ongoing, he started up the North Carolina clinic in Raleigh.

The complaint also says the clinics billed Medicaid for psychiatrist visits “of very brief duration, sometimes as little as two to three minutes, while fraudulently representing that patients were being seen for a 15 minute visit.”

The Northeast and Lehigh Valley clinics allegedly billed Medicaid and Medicare for the services of “therapists” who were not qualified to provide mental health services, and fraudulently billed Medicare for therapy services allegedly provided without the required supervision.

The complaint did not specify the damages being sought by the government.

The matter was investigated by the U.S. Department of Health and Human Services’ Office of Inspector General and the U.S. Attorney’s Office for the Eastern District of Pennsylvania, with assistance from the Pennsylvania Office of Attorney General and the North Carolina Department of Justice.

Saturday, July 18, 2015

The Hoffman Report: The Investigation into the American Psychological Association (APA)

The Hoffman Report is the informal name for the 2015 investigation into the American Psychological Association’s (APA) practices regarding its relaxing of ethical standards for psychologists involved in torture interrogations. The full name for the report is, Independent Review Relating to APA Ethics Guidelines, National Security Interrogations, and Torture. It was authored by attorneys David Hoffman, Danielle Carter, Cara Viglucci Lopez, Heather Benzmiller, Ava Guo, Yasir Latifi and Daniel Craig of the law firm, Sidley Austin, LLP.

It was an extensive investigation spanning 6 months that reviewed over 50,000 documents and conducted over 200 interviews with 148 people.

The report notes that,

“Although most individuals were quite cooperative and willing to meet with us, that sentiment was not universal, and there were several individuals who declined to meet with us or did not respond to our requests.”

Also,

“This inquiry is made more difficult by the amount of time that has elapsed since the important events occurred. The key events relating to the APA task force report occurred 10 to 11 years ago, and the events relating to the ethics code revision occurred 13 to 19 years ago.”

The independent investigation resulted in a 542-page final report. It is available for download here

Independent Review Relating to APA Ethics Guidelines, National Security Interrogations, and Torture (PDF)

Thursday, July 16, 2015

Another ethics scandal for the University of Minnesota Dept. of Psychiatry

From a Report on Fox 9 News Video available at the link

The University of Minnesota has another ethics scandal on its hands. And once again it involves the Department of Psychiatry. This latest case of research misconduct involves falsifying records.

Dr. Ken Winters is a Psychologist who has worked at the U of M for 26 years. He was about to begin a new study for the National Institute on Drug Abuse on ways to stop teenagers from taking drugs, but before proceeding, a University review board wanted Winters to get something in writing from the federal government.

It would have been a legal document that would protect researchers from having to disclose confidential information about study participants should those participants ever get into trouble with the law. Winters told the Fox 9 Investigators he got tired of waiting for the paperwork to arrive so he falsified his own version and turned it in to the University so the study could begin.

He declined an on camera interview but agreed to have his voice recorded.

"Poor judgement on my part," Winters said. "It was a terrible thing I did, so I have no real explanation. I've got no defense. My own stupidity, poor judgement."

Winters also said within hours of turning in the phony documents, he fessed up after being approached by concerned staff members. His misconduct is yet another slam for the school's Department of Psychiatry.

Earlier this spring, a legislative audit, prompted by a Fox 9 Investigation, found serious ethical concerns and conflicts of interest relating to the death of a research participant in a Psych Department drug trial.

"It is a serious ethical breach. It is another indication that there are issues and problems in the drug trials at the University Department of Psychiatry that need attention," Legislative Auditor Jim Nobles said.

The National Institute on Drug Abuse told the Fox 9 Investigators "it takes allegations of research misconduct seriously." But wouldn't comment on what, if anything, it’s doing about this case.

Winters said he hasn't been disciplined by the University for falsifying the document. Instead, he was given the option to retire at the end of the month.

Wednesday, July 15, 2015

An abrupt end for Houston psychiatric hospital Cambridge facility gives up license and discharges its last patient

One of Houston's largest inpatient psychiatric hospitals closed suddenly last week, leaving a void in a city already underserved.

The 148-bed facility at 7601 Fannin had operated as Cambridge Hospital since 2012. On Monday the phone was disconnected and its website contained only the stark message: Cambridge Hospital is closed. Attempts to reach officials at the facility were unsuccessful.

The hospital surrendered its state license on July 7 and discharged its last patient the same day, said Chris Van Deusen, a spokesman for the Texas Department of State Health Services.

Those in Houston's mental health community said the closing was not entirely unexpected.

"I was hearing that this was coming," said Steve Glazier, chief operating officer at Harris County Psychiatric Center, the area's largest facility with 250 beds. He said administrators acknowledged financial struggles to him more than a year ago.

[...]

Cambridge Hospital began operating in 2012 in the space that once housed IntraCare Medical Center, once the second-largest inpatient facility in the county.

IntraCare closed after losing its certification from the federal Centers for Medicare and Medicaid Services, which had declared it "an immediate and serious threat to patient health and safety."

Tuesday, July 14, 2015

California suspends license for Fairfield psychiatrist

From a much larger report in the Daily Republic

The state has temporarily suspended the license for Dr. William Munn after the Medical Board of California said the psychiatrist, in private practice since 1972 at his Travis Boulevard office, put public health at risk by excessively prescribing drugs to five patients.

Munn disputes any risk to public health and says his suspension is detrimental to his 250 patients, who can’t be absorbed by the limited number of psychiatrists in private practice in Solano County.

The Monday suspension follows a hearing in Oakland and the filing by the state Attorney General’s Office about Munn’s prescriptions for the five patients.

Munn referred to providing one patient “telephone psychotherapy,” said the state filing, which describes the therapy as consisting almost entirely of the psychiatrist refilling prescriptions for large quantities of hydrocodone, a semisynthetic narcotic analgesic, as well as amphetamines and alprazolam, often sold under the trade name Xanax.

Another patient was prescribed large doses of alprazolam even though the doctor saw the person only once and continued to prescribe the drug for almost two years, according to the state.

Treatment of the five patients includes numerous extreme departures from the standard of care, added the state, which sought the license suspension until the Medical Board can ensure Mann safely practices psychiatry.

Monday, July 13, 2015

Teens are prescribed more medications than ever, while teenage suicides are soaring.

One of the paradoxes of child and adolescent psychiatry is that, at a time when teens are prescribed more medications than ever, teenage suicides are soaring. Antidepressants and antipsychotics are supposed to decrease suicide, not increase it.

A report of the Centers for Disease Control (CDC) of March 6, 2015, says that suicides per 100,000 population among persons aged 10-24 increased from 1.8 in 1994 to 3.1 in 2012, an annual increase of 3.0 percent. This is almost doubling over that 18-year period.

See the report here

Male rates are far higher than female, and suicides among male adolescents rose annually by 2.2 percent. But here is the shocker: suicides among female adolescents rose from 0.5 per 100,000 in 1994 to 1.7 in 2012, an annual change of 6.7 percent.

Hanging (“suffocation”) has soared among young women, and the CDC report noted a grim landmark: “Suffocation surpassed firearm as the most common mechanism of suicide among females in 2001.”

Whatever medications these young men and women receive are not working. A truly alarming increase in the consumption of psychopharmaceuticals has taken place at the same time as the increase in suicide. For example, the prescription of antipsychotic medications for patients under 20 rose from 300 per 100,000 population in 1993-95 to almost 1500 in 2002. (New York Times, “Beyond Ritalin,” June 6, 2006, 18)

Could there possibly be a connection?

Or do you "double down" and insist that the problem is that what we need is more drugs?

Guess what this shrink says. Yep, more DRUGS. without figuring out the source.

American Kids are the Most Medicated in the World I would say this is very suggestive.

Saturday, July 11, 2015

Former Psychiatrist Sentenced for Child Sex Crimes

A Report from WNEP



Michael Kessler was sentenced to state prison Friday for trying to lure a 13-year-old boy to meet him for sex back in 2013.

“Michael, why did you tell the court you're sorry? Are you sorry you got caught? Or are you sorry you did it?" Newswatch 16 asked Kessler. He had no response.

Former psychiatrist Michael Kessler of Cresco is headed to a state prison after his sentencing in Monroe County Court. Kessler admits trying to lure a 13-year-old by to meet him and engage in sexual activity, sending him child porn and more. The boy’s mother says she’s glad Kessler will be behind bars.

"It caused a lot of anxiety not knowing and knowing that he knew where I lived and was my friend and he targeted my son,” said the boy’s mother Janet VanHorn.

That mother says she monitors her children’s phones and Facebook accounts. Two years ago she caught Kessler posing online as a 14-year old boy and turned the case over to Monroe County Detectives.

"She paid attention. She caught it early. She was on top of things and she took the right steps,” said Detective Brian Webbe of the Monroe County Detective Office.

Kessler worked at Pocono Psychiatric Associates near Marshalls Creek before his license was revoked in 2012. Prosecutors say Kessler was arrested four other times for sexual incidents in Massachusetts and New Jersey without facing jail time.

"It makes you angry because all these years he thought he was above the law. It made me want to fight even harder to make sure he faced punishment,” said VanHorn.

Now Kessler faces a year and a half to five years behind bars. And this mother of two has a message for other parents after a long tough two years waiting for justice.

“Parents need to be aware that they need to keep up on your social media you need to check your kids' phones and their Facebook. You need to be on top of it all because if you're not, Lord knows what could have happened,” said VanHorn.

Friday, July 10, 2015

State of Conneticut Reaches False Claims Act Settlement with Providers at Children's Behavioral Health Clinic

From this Conneticut Attorney General Press Release.

A social worker and a doctor will pay a total of $120,000 to Connecticut's Medical Assistance Program (CMAP) through settlement agreements that resolve civil allegations involving the filing of false and fraudulent claims for payments at a Branford-based outpatient behavioral health clinic for children, Attorney General George Jepsen said today.

The state alleged that David M. Meyers, a licensed clinical social worker and former president of Cornerstones P.C., located in Branford, hired Dr. W. Blake Taggart to be the medical director of Cornerstones through an independent contractor agreement. Cornerstones' provider agreement with the state Department of Social Services (DSS) for participation in CMAP – which is the state's Medicaid program – required that the clinic comply with all applicable regulations. The state Department of Children and Families (DCF), which licenses and regulates outpatient psychiatric clinics for children, required Cornerstones to have a medical director. As part of Meyers' effort to maintain his clinic's enrollment in the CMAP beginning in January 2010, the DSS required an updated letter representing that Cornerstones continued to have a medical director overseeing care.

The state alleged that Dr. Taggart resigned as the clinic's medical director in September 2009, but two months later Meyers falsely stated in the letter to DSS that Dr. Taggart remained as the clinic's medical director. The state alleged that Dr. Taggart facilitated this misrepresentation by signing the false, back dated letter to DSS.

[...]

Wednesday, July 08, 2015

Woman tells of 'hell on earth' at Limerick psychiatric unit

A Sad story of a woman trying to get help, and the failure of the psychiatric system in here city to help.

Snippet from a much longer story

The HSE has said it is to investigate concerns raised by a well-known Limerick businesswoman after she experienced "hell on earth" in a psychiatric hospital unit in Limerick.

Last November, Leona O'Callaghan, 35, spent two months at the 5B Psychiatric Ward in University Hospital Limerick, which she described as a "violent" and "uncaring" place.

"The HSE need to hear the voice of the service users," the mother of three said.

Ms O'Callaghan said she was forced to speak out publicly about her experience, because she got "no reply" to letters she sent to the Minister for Health, Leo Varadkar, and his Junior Health Minister, Kathleen Lynch.

In a searingly honest interview she described how after approaching a nurse in 5B, she was told she should kill herself if she really wanted to.

[...]

"There's an epidemic in suicide in Limerick. Obviously something is going wrong."

Tuesday, July 07, 2015

Recruitment for Psychiatric Treatment Trials: An Ethical Investigation

Abstract of the Report (Paid Access for full article)

This article is about ethics, specifically, the myriad of unethical practices characterizing recruitment for psychiatric trials.

Using a case study approach, honing on recruitment material, and examining the typical, the author explores recruitment in two studies—one involving electroconvulsive therapy, the other, a psychiatric drug. The bulk of the article is on these trials.

The ethical problems which surface include
  • minimization of risk;
  • euphemism;
  • lack of transparency;
  • false and misleading claims,
  • unfair inducement;
  • failure to mention most of the common and serious negative effects;
  • and a predatory quality.
The author also identifies some worrisome new trends. Of special interest to the humanistic counselor is the attempt to implicate people’s own counselors and therapists in recruitment.

The article ends with reflections on the onus that such practices place on all practitioners striving to be ethical.

The author concludes that it is critical that counselors and therapists not be complicit and beyond that they take it on themselves to confront and expose. Concrete practice suggestions include adopting an explicit policy against such referrals, alerting any clients who may be considering such trials of the danger, and countering false claims.

Monday, July 06, 2015

My Trip Through the Polypharmacy Blender

A long story by Rory Tennes on the Risx website, describing his descent into psychiatric hell.

We only present a few snippets, and recommend reading the full article.

I was asked by David Healy to write my own story after he read my comment on another RxISK story. I agreed but have been surprised how hard it was to sit down and do it. I knew the story, the words were in my head. Yet I avoided getting started. Perhaps it was because of the painful emotions I knew it would bring to the surface. Or maybe because it reminds me of the pain and suffering my family had to endure, how much we lost and the fact that I may not be able to do anything about it. Or it could be my frustration from the cognitive difficulties I still have, making writing a difficult task that drains what little energy I have.

My trip started this way: I was ill, injured and in pain. I went to my doctors for help, and they proceeded to drug me into oblivion. My PCP or “family doctor” diagnosed me with fibromyalgia. I don’t think he really knew what I had, but once he put a name on my symptoms, he started throwing drugs at them. I was in constant pain, chronically fatigued and began to have severe bouts of anxiety. For four years I saw doctor after doctor but none of them could tell me what was wrong, or why I was getting worse not better despite all the drugs. It turns out I had autoimmune arthritis. I’d had it for 30 years, and since it was misdiagnosed and untreated for so long, my spine was a total wreck.

I have worked in construction for 38 years, as a skilled tilesetter with my own business. I love the work but it can be rough on the back. I am now on disability due to a combination of my disease and the multiple toxic “treatments” I was put on.

[...]

Before my trip through the Pharma looking glass began, I had quit drinking altogether. I had been sober for five years, solidly sober and liked it. In October 2010 I was on Trazodone and Wellbutrin. When Flexeril and Naprelan were added, within weeks I suddenly had strong urges to drink, which had been totally absent until that point. I now know that Flexeril (cyclo-benzaprine) acts just like a tricyclic antidepressant and should never be mixed with trazodone or Wellbutrin. The urge and the thoughts of drinking came on suddenly and very strong.

I made two trips to alcohol rehab, attended AA regularly but could not stay sober to save my life. I had numerous run-ins with the law as well. My behavior had become so bizarre, unpredictable, unstable and dangerous that I thought I had lost my mind and myself completely. I had no control over my thoughts, emotions or behavior, no matter what I did or how hard I tried. I watched my family suffer horribly in fear and confusion at what was happening.

Now I know why. Drugs can drive people to drink for relief from the agonizing akathisia that they cause. Couple that with the disinhibiting effect of the drugs, and it’s a recipe for alcoholism. That’s not just true for the antidepressants, but Lyrica too. The warning on Lyrica says that “People who have had a drinking problem in the past may be prone to abuse Lyrica.” It really should say: “If you take Lyrica you may have strong, uncontrollable urges to drink.” Lyrica can cause alcohol abuse, I have no doubt. So can Cymbalta, Zoloft and several other drugs I was on. I didn’t have a chance in hell to stay sober on those drugs.

[...]

Psychiatric Drugs Are False Prophets With Big Profits - Psychiatry has been hijacked

From a column in Psychiatry Today by Robert Berezin M.D. While I do not think that psychotherapy is very workable, his criticism of psychiatry is spot on.

Once again, I just finished another consultation with someone from out of state who was desperate to find a therapist who he could talk to. He didn’t want to be pigeon holed into some DSM-5 reductionistic diagnosis. He didn’t want psychiatric drugs. He was desperate to find a psychiatrist who would understand him, who he could relate to, and could treat him with real psychotherapy. There should never have been a reason for me to consult with anyone from out of state. Unfortunately, the cynical and fraudulent takeover of psychiatry is all but complete. How many real psychiatrists are left?

How did this happen? Over the course of my career, I kept my head down and devoted myself to my craft, psychotherapy. I was certainly aware of the collusion between the APA and the drug companies. But as recently as ten years ago, I honestly did not know that things had really deteriorated this far.

Apparently, Dr. Jeffrey Lieberman and other like-minded psychiatrists, decided that psychoanalysis had too much power, and they wanted to transform the APA once again to the tenets of somatic psychiatry. The underling theory of somatic psychiatry is that the source of human struggle is considered to be the brain itself, rather than the person.
Treatments that follow from this simplistic, mechanistic, and reductionist notion have been to act directly on the brain, always with violating and destructive outcomes.
Somatic psychiatry originated with seizure therapy, or its first modern incarnation, insulin shock therapy (IST). It actually had its roots in the sixteenth century and was used psychiatrically around the time of the American Revolution. It was refined in 1927 into insulin shock therapy, when insulin was used to induce seizures as a treatment for drug addiction, psychopathy, and schizophrenia, with claims of a 50 percent remission rate. Papers were published in the American Journal of Psychiatry, starting in 1937. IST was widely used through the 1940s and 1950s. Its founding etiological principle was the (false) idea that seizures were the opposite of schizophrenia. Induce a seizure, and you balance out psychosis. In the 1930s, a more refined scientific explanation was developed for the (phantom) curative power of seizures. Its science proclaimed that psychiatric problems came from the autonomic nervous system. IST was said to work by blocking the nerve cells of the parasympathetic nervous system, thereby intensifying their tonus and strengthening their anabolic force. This restored the nerve cell, and the patient recovered. The corollary theory was that patients were jolted out of their psychiatric condition.

Next, we have lobotomies, originally called leucotomies. Lobotomies came onto the scene in the 1930s, having been invented and promoted by Antonio Egas Moniz. When I was a psychiatric resident, lobotomies were still fresh in psychiatric memory. The practice had only ceased in the early 1960s, after over twenty thousand people received this “treatment.” Let’s see … what was the science? The source of psychiatric problems was located in the brain, specifically the prefrontal cortex. The treatment of choice, then, was to ream out the prefrontal cortex with an ice pick. Respected MDs had a miracle cure and were the vanguard of the field. Science proved that lobotomies cured not only schizophrenia but anxiety, depression, low self-esteem, obsessive/compulsive disorder, and the unwanted behavioral problems associated with mental retardation (this is code for sexual behaviors). It was respected and celebrated in the psychiatric literature and validated in journals with documented studies and peer-reviewed scientific evidence. Lest you think this is an exaggeration, Moniz won a Nobel Prize in 1949 for his great and wonderful discovery.

Eventually, the validating follow-ups were shown to be fabricated and deluded, with self-promoting lies and half truths. Only after a great deal of harm were they debunked. And the ice picks were thrown into the trash heap of psychiatric history. We need to add that after lobotomies gradually attenuated, no one stopped and said, “What in the world did we just do?” How could sticking an ice pick in someone’s brain ever have been even a remote consideration? What was going on that such a grotesque medieval mutilation was actually adopted as a good thing to do? And how could it have been publicly and professionally embraced? However, as always seems to happen, amnesia quickly set in, and we forgot the brutal inhumanity that was so recently celebrated. And the considerable body of discredited scientific validation was never scrutinized for its contribution to and for having promoted such harm. Instead, science moved on to support the next somatic treatment in exactly the same way.

Next, we have electroconvulsive therapy (ECT), which came along soon after IST, in 1938. ECT was still a part of the curriculum in my own psychiatric residency in 1971. Entire psychiatric hospitals, built exclusively for ECT, were still operating, with no empty beds. Scientific studies and respected journals provided documented validation for placing electrodes on patients’ heads and applying huge jolts of electricity to generate seizures. Apparently, the jolt theory had gained traction. So we shocked the brain, instead of reaming it out. How humane. In addition to everything else, ECT also was touted as a cure for depression. It was allegedly proved that ECT was a safe, effective cure, with few, if any, drawbacks. The resultant memory loss not only was initially downplayed but was trumpeted as being therapeutic. (By the way, drugs are being developed today to chemically erase memories with the idea that this is therapeutic for trauma—same thing.) Later, under public pressure, ECT was refined to cut down on memory loss. The history of electroconvulsive therapy followed the same trajectory as lobotomies. Eventually, ECT showed itself to be the ineffective and violating practice that it is. But don’t get overconfident. Incredibly, in recent years, ECT has made a comeback and is being promoted once again, when its progeny treatments, antidepressants, don’t work.
Finally, we come the current incarnation of somatic psychiatry - neurobiological psychiatry, and its so-called treatment—drugs. Psychiatric drugs are next in the lineage of “treatments” whose focus is to act upon the physical brain. History is repeating itself.
Our contemporary science has now apparently proven that human problems come from genetic or developmental neurobiological disorders of the physical, anatomical, biochemical brain. The somatic treatments for these neurobiological, genetic, synaptic hormonal neurotransmitter diseases are brain drugs—psychoactive drugs.
In one generation, the APA, in collusion with the drug companies have destroyed psychiatry. The American Public has been sold a bill of goods.
People actually believe that human struggle is a brain disease. It is now taken as fact that there is a chemical imbalance in the brain and psychoactive drugs is just what the doctor ordered. We can now cure biological depression with antidepressants; biological anxiety with benzodiazepines; the fictitious ADHD with, of all things, amphetamines; insomnia with benzodiazepines, and other bizarre psychoactive drugs; Likewise the belief is that schizophrenia and manic-depression should be treated with drugs [...]

Friday, July 03, 2015

Houston Hospital Leaders Sentenced to 45 Years in Prison for Alarming Psychiatric Fraud Scheme

Details of the fraud allegations against Riverside General Hospital executives

The bulk of the Medicare and Medicaid fraud allegations against Gibson, et al. center around Riverside’s psychiatric facilities, which are classified by the government as a “partial hospitalization program” (PHP) A PHP is technically an outpatient treatment facility, but is geared toward the round-the-clock care required for patients enduring a severe mental illness. Under government guidelines, mental health patients receiving care at a PHP must be routinely seen by a psychiatrist, guided through a care plan, and carefully monitored throughout the course of treatment.

According to the allegations, Riverside collected more than $158 million in funds from Medicare and Medicaid on behalf of PHP patients who rarely, if ever, saw a psychiatrist for their illnesses. Moreover, Riverside regularly billed the government for psychiatric services that were never rendered, mostly because the patients were in the advanced stages of dementia and unable to participate in the treatment.

Patient care aside, Riverside is also accused of offering kickbacks and financial incentives to executives group homes, as well as recruiters tasked with increasing referrals of mental health patients to Riverside’s facilities.

In addition to the three main participants listed above, six other individuals recently pled guilty to conspiring with Gibson to bring in the maximum number of Medicare and Medicaid clientele.

According to a statement by the U.S. Attorney General’s Office, “The former President of Houston’s Riverside hospital, his son, and their co-conspirators saw mentally ill, elderly, and disabled Medicare beneficiaries as commodities to be turned into profit centers – not as vulnerable individuals in need of health care….Rather than providing needed medical care to a historically underserved community, the defendants ran a longstanding hospital into the ground through their greed and fraud. According to the evidence presented at trial, the defendants had patients sit around the facility watching movies while they received no treatment. Meanwhile, the defendants billed Medicare more than $158 million for care that was never provided. This brazen fraud cannot and will not be tolerated.”
See Also

Department of Justice Press Release, “Former President of Riverside General Hospital Sentenced to 45 Years in Prison in $158 Million Medicare Fraud.” June 9, 2015.