FACT SHEET ON CHILDREN IN RESIDENTIAL CENTERS FROM THE BAZELON CENTER FOR MENTAL HEALTH LAW

Fact Sheet: Children in Residential Treatment Centers
I. Tens of thousands of children with mental health needs are being placed in expensive, inappropriate and often dangerous institutions.
The number of children placed in residential treatment centers (or RTCs)[1] is growing exponentially.[2] These modern-day orphanages now house more than 50,000 children nationwide.[3] Children are packed off to RTCs, often sent by officials they have never met, who have probably never spoken to their parents, teachers or social workers.[4] Once placed, these kids may have no meaningful contact with their families or friends for up to two years.[5] And, despite many documented cases of neglect and physical and sexual abuse, monitoring is inadequate to ensure that children are safe, healthy and receiving proper services in RTCs.[6] By funneling children with mental illnesses into the RTC system, states fail—at enormous cost—to provide more effective community-based mental health services.[7]

A. RTC placements are often inappropriate.
RTCs are among the most restrictive mental health services and, as such, should be reserved for children whose dangerous behavior cannot be controlled except in a secure setting.[8] Too often, however, child-serving bureaucracies hastily place children in RTCs because they have not made more appropriate community-based services available.[9] Parents who are desperate to meet their kids’ needs often turn to RTCs because they lack viable alternatives.[10]


To make placement decisions, families in crisis and overburdened social workers rely on the institutions’ glossy flyers and professional websites with testimonials of saved children.[11] But all RTCs are not alike.[12] Local, state and national exposés and litigation “regarding the quality of care in residential treatment centers have shown that some programs promise high-quality treatment but deliver low-quality custodial care.”[13] As a result, parents and state officials play a dangerous game of Russian roulette as they decide where to place children, because little public information is available about the RTCs, which are under-regulated and under-supervised.


To make it worse, far too many children are placed at great distance from their homes. For example, most District of Columbia children in RTCs are placed outside the District—many as far away as Utah and Minnesota.[14] Many families, especially those with limited means, find it impossible to have any meaningful visitation with their children.


B. Evidence is limited on the effectiveness of RTCs.
Children frequently arrive at RTCs traumatized by the process that delivered them there. They are often forcibly removed from their homes in the middle of the night by “escort companies.”[15] Other times, children are placed in RTCs not by their parents or doctors, but by overburdened child-serving state agencies, who know little about the children’s individual needs.[16]


Even more appalling, many children’s conditions do not improve at all while at the RTC.[17] In fact, there is little evidence that placing children in RTCs has any positive impact at all on their mental health state[18] and any gains made during a stay in an RTC quickly disappear upon discharge, creating a cycle where children return again and again to RTCs.[19]


There are many reasons why RTCs fail to deliver the results they promise, but most center on the type of services provided, the environment they are provided in and the lack of family involvement.


First, the reality of what occurs within an RTC is often quite different from the highly individualized, highly structured programs that are advertised. The RTCs often provide less intense services and the staff are often under-trained.[20] Children spend much of their day with staff who are not much more qualified than the average parent and they spend less time face-to-face with psychiatrists than they would if they were being served in appropriate community settings.[21]


The environment is also problematic because children in RTCs enter a situation where their only peers are other troubled children—a major risk factor for later behavioral problems.[22] Research has demonstrated that some children learn antisocial or bizarre behavior from intensive exposure to other disturbed children.[23]


Children are usually far from home in RTCs, often out-of-state.[24] Removed from their families and natural support systems, they are unable to draw upon the strengths of their communities and their communities are unable to contribute to their treatment. Few children thrive when they are hundreds or thousands of miles from their parents, friends, grandparents and teachers. Few can flourish without the guidance of consistent parenting. Yet, we expect that our most vulnerable and troubled youth will miraculously turn around in just such a situation. Instead, this isolation further reduces the efficacy of treatment and increases its cost.[25]


The fact that children and their families are far from one another creates a host of problems. For one, it makes family therapy difficult or impossible. As a result, when children leave the RTC, they return to an environment that has not changed. Also, because the RTC environment is inherently artificial—children are not asked to negotiate the obstacles that occur within their family setting or deal with the difficulties that trigger their behaviors in their neighborhoods or schools—the child does not gain new skills to better negotiate life outside of an institution. As a result, neither the children nor their parents learn better ways to overcome the obstacles that led to the RTC placement. Without family involvement, successes are limited.[26]


Among the rare children who are able to overcome these obstacles, few can sustain the gains they have made. In one study, nearly 50% of children were readmitted to an RTC, and 75% were either renstitutionalized or arrested.[27]


C. Children suffer because there is no watchdog.
The RTC industry is largely unregulated.[28] RTCs need only report major unusual incidents (or MUIs), but the interpretation of what constitutes an MUI and the reporting requirements vary widely.[29] Some RTCs fail to report MUIs at all—with little consequence.[30] Vulnerable kids are placed far from home where parents, social workers, or the state can offer little oversight or protection. Worse, many of the facilities limit children’s ability to have contact with their parents for extended periods, further restricting the parents’ ability to monitor the facilities.[31]


D. Children are abused in RTCs.
Children placed in RTCs have been sexually and physically abused, restrained for hours, over-medicated and subject to militaristic punishments; some have died.[32] The following are just a few documented examples of tragic occurrences at RTCs:

Medication is often used (and overused) to control behavior.[33] Children have been permanently disfigured because of over-medication.[34]

In some programs, the children’s shoes are confiscated to keep them from running away.[35]

There have been reports of behavioral ‘therapies’ being misused. As one author noted, “Such therapies do little more than systematically punish children, all under the guise of treatment . . . .”[36]

Sexual abuse by staff members and other residents is all too frequent.[37] In one case, a 13-year old girl performed sexual favors for staff members in return for snacks and carryout food.[38] At one RTC, four boys were accused of trying to sodomize another with a cucumber.[39] At another, a 19-year-old woman was charged with sodomizing a 14-year-old girl.[40]

Physical abuse is also too frequent an occurrence. For example, a 13-year-old boy was forced against a wall and slammed to the floor by employees of an RTC.[41]

Children are often restrained—sometimes for hours on end. The overuse of restraint has resulted in child deaths.[42]


E. Tragic outcomes at great public expense.
RTCs have grown to a billion-dollar, largely private industry.[43] Residential treatment care is exorbitantly expensive—costing up to $700 per child per day.[44] Annual costs can exceed $120,000.[45] Most of the time, the public foots the bill for these services.[46] In fact, nearly one fourth of the national outlay on child mental health is spent on care in these settings.[47]

II. Other Interventions Work Better for Less
Home- and community-based services are much more therapeutically effective than institutional services, and are also markedly more cost-efficient. As the Surgeon General reported, “the most convincing evidence of effectiveness is for home-based services and therapeutic foster care” and not for RTCs.[48] A comprehensive system of care would dramatically reduce the number of children in RTCs.[49]

Community-based alternatives produce better short- and long-term results and are less disruptive to children and families. These alternatives provide intensive mental health treatment, mobilize community resources and help children and their families develop effective coping mechanisms. Some models endeavor to “wrap services around” the child, while others emphasize multi-systemic therapy and crisis intervention. Randomized clinical trials found greater declines in delinquency and behavioral problems, greater increases in functioning, greater stability in housing placements and greater likelihood of permanent placement.[50] In Milwaukee, a wraparound project that has served over 700 youth involved in juvenile justice has shown similar promise; use of residential treatment has declined 60%, use of psychiatric hospitalization has declined 80%, and average overall care costs for target youth have dropped by one third.[51]

Notes
[1] According to the Surgeon General, a RTC is a “licensed 24-hour facility (although not licensed as a hospital), which offers mental health treatment.” U.S. Department of Health and Human Services. 1999. Mental Health: A Report of the Surgeon General. Washington, DC: Author. Available at: http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec7.html#treatment.

[2] In 1982, when Jane Knitzer wrote the seminal book, Unclaimed Children, the growth in the RTC industry was only beginning. Ms. Knitzer wrote that: “In contrast to the minimal efforts to create nonresidential services, 18 of the 44 states responding to our survey were working to increase residential care.” Knitzer, J., Unclaimed Children: The Failure of Public Responsibility to Children and Adolescents in Need of Mental Health Care, Children’s Defense Fund, 1982, at 45. By 1986, the number of children in RTCs had grown to 25,334, an increase of more than 30% over a three-year period. Rivera, V.R. & Kutash, K. (1994), Components of a System of Care. What Does the Research Say?, Residential Services: Psychiatric Hospitals and Residential Treatment Centers, at 8, Tampa , FL: University of South Florida, Florida Mental Health Institute: The Research and Training Center for Children’s Mental Health. This growth in continuing. See infra, at note 3.

[3] Latest Findings in Children’s Mental Health, Nearly 66,000 Youth Live in U.S, Mental Health Programs, Vo1. 2, No. 1 (Summer 2003). In 1997, the year in which the most recent data was available, more than 42,000 children were living in RTCs. Given the expansion of children living in RTCs, see supra note 2, this figure is likely well over 50,000 now.

[4] Reports to staff attorneys at the Bazelon Center for Mental Health Law. For example, in Washington, D.C., children are certified to go to RTCs by a “Multi-Agency Planning Team” process (or MAPT process). The MAPT meetings often do not include the voices of the people who know the child and family best.

[5] Ohio Rights Service Review of Fifteen Children’s Mental Health Facilities (October 2004) (on file with the Bazelon Center)

[6] See infra at sections I(C) and I(D).

[7] This development of long-term residential care occurred at the expense of community-based alternatives. Jane Knitzer, as far back as 1982, noted that: “In general, funds were used to develop long-term residential care, with few efforts to support or create emergency shelters, respite care programs, or specialized foster care for disturbed children and adolescents.” Unclaimed Children, supra note 2, at 46. Further, the Surgeon General noted that one of the primary reasons that RTCs are considered to be justified is because community-based alternatives are lacking. See Mental Health: A Report of the Surgeon General, supra note 1.

[8] Duchnowski, A.J., Hall, K. S., Kutash, K, and Friedman, R. (1998) The Alternatives to Residential Treatment Study, in Outcomes for Child and Youth with Behavioral and Emotional Disorders and Their Families. See also Mental Health: A Report of the Surgeon General, supra note 1.

[9] Mental Health: A Report of the Surgeon General, supra note 1, (“Concerns about residential care primarily relate to criteria for admission . . . .”).

[10] Lou Kilzer, Desperate Measures, Rocky Mountain News, July 2, 1999, available at: http://www.denver-rmn.com/desperate/site-desperate/front-pg.htm.

[11] Id.

[12] Mental Health: A Report of the Surgeon General, supra note 1, (“Settings range from structured ones, resembling psychiatric hospitals, to those that are more like group homes or halfway houses.”); Rivera, V.R. & Kutash, K. (1994), Components of a System of Care. What Does the Research Say?, Tampa , FL: University of South Florida, Florida Mental Health Institute: The Research and Training Center for Children’s Mental Health.

[13] Jane Knitzer noted this fact in 1982 in Unclaimed Children, supra note 2, at 46. The calls for reform have only increased as the population of children served in RTCs has grown. See infra at note 29 and accompanying text.

[14] Scott Higham and Sewell Chan, District Reexamines Out of Town Centers, The Washington Post, July 16, 2003, available at: http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&contentId=A61386-2003Jul15¬Found=true. See also, D.C. Department of Mental Health Data from 2003 Children in Residential Treatment Centers (on file at the Bazelon Center).

[15] Kilzer, supra note 10.

[16] Supra, note 4.

[17] Mental Health: A Report of the Surgeon General, supra note 1.

[18] Burns, B.J., Hoagwood, K. & Maultsby, L.T., Improving Outcomes for Children and Adolescents with Serious Emotional and Behavioral Disorders: Current and Future Directions. (“A dominant observation is that the least evidence of effectiveness exists for residential services, where the vast majority of dollars are spent.”); Chamberlain, P. , Treatment Foster Care, US Department of Justice, Office of Juvenile Justice and Delinquency Prevention, Juvenile Justice Bulletin, December, 1998.

[19] Brown, E.C. & Greenbaum, P.E., Reinstitutionalization After Discharge from Residential Mental Health Facilities: Competing Risks Survival Analysis.

[20] Kilzer, supra note 10.

[21] Client reports to Bazelon Center staff attorneys.

[22] Mental Health: A Report of the Surgeon General, supra note 1.

[23] Mental Health: A Report of the Surgeon General, supra note 1.

[24] See, e.g., supra note 14 and accompanying text.

[25] National Council on Crime and Delinquency, Focus Newsletter, July 16, 2002 (“[Residential treatment centers] are usually some distance from the youth’s community, alienating the youth from his or her known environment and adding communication and travel costs to the families and communities.”)

[26] Myrth Ogilvie, Transitioning From Residential Treatment: Family Involvement & Helpful Supports, in Focal Point (2001), available at: http://www.rtc.pdx.edu/FPinHTML/FocalPointSP01/pgFPsp01Transitioning.shtml.

[27] Supra note 25.

[28] Since their inception, RTCs have been under-monitored. As Jane Knitzer noted in Unclaimed Children, supra note 2 at 46: “States have not emphasized continued monitoring of children’s care once they are in residential treatment.” Many RTCs are not accredited at all. Further, the RTCs that are certified are accredited by the Joint Organization on Accreditation of Healthcare Organizations (JCAHO), an independent, nonprofit organization. But as many have pointed out “JCAHO’s standards are geared mainly toward monitoring surgical and pharmacological procedures. And so RTCs, which are more like boarding schools than traditional hospitals, can become accredited under standards that have little to do with the daily programs and activities practiced in them.” Meza-Wilson, A. & Harrison, C., Safe Choices for Troubled Teens: Residential treatment centers for troubled teens are plagued by allegations of abuse and ineffectiveness. But do anguished parents have an alternative?, August 12, 2004, available at: http://www.askquestions.org/articles/teens/.

[29] Ohio Rights Service Review, supra note 5.

[30] Id. Further, the Bazelon Center has been contacted by federally funded Protection and Advocacy organizations who never or rarely received MUIs from the RTCs serving children within their jurisdiction.

[31] Friesen, B.J., Kruzich, J.M., Robinson, A., Jivanjee, P., Pullmann, M. & Bowles, C., Straining the Ties that Bind: Limits on Parent-Child Contact in Out-Of-Home Care, in Focal Point (2001), available at: http://www.rtc.pdx.edu/FPinHTML/FocalPointSP01/pgFPsp01Straining.shtml.

[32] See e.g., Scott Higham and Sewell Chan, Poor Care, Abuses Alleged at Riverside, The Washington Post, July 15, 2003, available at: http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&contentId=A56180-2003Jul14¬Found=true; Kilzer, supra note 10; Associated Press, Death At Residential Treatment Center Ruled a Homicide, May 16, 2002, available at: http://www.geocities.com/ahobbit.geo/residential_treatment.html; Tim Weiner, Parents Divided Over Jamaica Disciplinary Academy, The New York Times, June 17, 2003; Ohio Rights Service Review, supra note 5; Tanya Eiserer, Death of teen at therapy facility investigated: Richardson 17-year-old died being restrained by staff in Hill Country, Dallas Morning News, October 17, 2002; Jorge Fitz-Gibbon, Leah Rae and Shawn Cohen, Treatment Often Hampered By Bureaucracy, The Journal News, June 23, 2002, available at: http://www.nyjournalnews.com/rtc/rtc062302_01.html.

[33] Higham and Chan, supra note 32.

[34] Reports to staff attorneys at the Bazelon Center for Mental Health Law.

[35] Kilzer, supra note 10.

[36] Unclaimed Children, supra note 2, at 46.

[37] Kilzer, supra note 10.

[38] Higham and Chan, supra note 32.

[39] Fitz-Gibbon, Rae and Cohen, supra note 32.

[40] Id.

[41] Higham and Chan, supra note 32.

[42] Associated Press, supra note 32.

[43] Fitz-Gibbon, Rae and Cohen, supra note 32.

[44] Kilzer, supra note 10.

[44] Higham and Chan, supra note 32.

[45] Fitz-Gibbon, Rae and Cohen, supra note 32.

[46] Id.

[47] Mental Health: Report of the Surgeon General, supra note 1.

[48] Id.

[49] Id. The Surgeon General suggests that RTCs are often utilized because of the under-availability of community-based alternatives.

[50] Bruns, E.J., Serving Youths with Emotional and Behavioral Problems in Maryland: Opportunities for the Use of the Wraparound Approach, University of Maryland School of Medicine, Department of Psychiatry, September 17, 2003 (on file at the Bazelon Center).

[51] Id. at 2.

SSRI ANTIDEPRESSANT DRUGS LEAD TO VIOLENCE AND SUICIDAL IDEATION

http://www.kurtdanysh.com

Bill Would Help Children Undergoing Psychiatric Abuse in Residential Facilities

http://www.mindfreedom.org/kb/youth-mental-health/teen-residential-psychiatric-abuse

This link to the site of the advocacy organization, Mind Freedom also contains link to the Government Accountability Office's report which details concerns about abuses and deaths in residential facilities for juveniles.

SPIRITUAL REFLECTIONS

"Desire and anger are born of unrest. The former has limitless appetite; the latter is the greatest of all sinners. Know that they are the real enemies."
-Bhagavad Gita 3:37

"A person not committed to higher good is mindless- he lacks right thinking, he is bound to be restless. How can a restless person be happy." -Bhagavad Gita 2:66

"The good and the pleasant are two different things- they motivate a person to pursue different goals. The one who embraces the good meets with auspiciousness, but the one who chooses the pleasant is lost." Katha Upanishad 2:1

CHANGING OUR THINKING, CHANGING OUR SOCIETY

"Because our society has become so focused on greed and what is best for the individual rather than for others, because we have focused only on what we desire rather than looking for the good of all, that we have effectively begun a campaign of destruction of an entire generation of children. We have abandoned them, left them with no guidance, no acceptance. All we have provided them is the aftermath of our own fauly decisions. We have made our children frustrated and angry. This anger has become rage. It is no wonder that we see a rise in anti-social behaviors, for they are the product of this rage which we have created ourselves. In early childhood, children think little of whether one is black or white, Jew or Christian, or whatever. Over time, they learn to establish barriers between others, because they have learned this from us. Sadly, I would say by the age of 10, we have indoctrinated our children. If what we have modeled is faulty, it will be very hard for them to unlearn. Vicious cycles will sadly continue. Hope often appears dim in a society as we have, but I do believe that buried within in of us lies potential, a potential for benevolence, a potential for change, a potential to re-create ourselves, re-create our world, and ultimately to turn away from the destructive course we are choosing to head at present."

-Dan L. Edmunds, Ed.D., B.C.S.A.
www.DrDanEdmunds.com
International Center for Humane Psychiatry

MODELFAMILY.ORG- TACKLING ABUSES IN THE CPS/FOSTER CARE SYSTEMS AND ISSUES OF JUDICIAL MISCONDUCT

http://www.modelfamily.org

This is a wonderful organization tackling issues of CPS/foster care abuses, judicial and public defender misconduct, and taking a stand for the rights of children and families.

JUVENILE DETENTION/ RESIDENTIAL TREATMENT CENTERS- FOCUS SHOULD BE SHIFTED TO TRUE REHABILITATION- SCRANTON TIMES TRIBUNE

Editor: It is a positive development that Luzerne County Judges Mark A. Ciavarella and Michael T. Conahan are being brought to justice for their actions in profiting from placing youth in detention facilities.

However, it is necessary for us to examine the problems inherent with residential and detention facilities themselves. In these settings, youth are placed often under conditions that lead them to further emotional distress. The decisions to place children is often not based on a genuine interest in the child’s best interests, but what will be profitable and the easiest way out of having to actually rehabilitate youth and meet their emotional needs.

It is no wonder that the socio-economically disadvantaged youth are the ones that are so frequently seen in this system. How does placing a child into a detention center or residential facility, which often is geared toward the concept of staff forcing conformity through rewards, punishments and often deprivation, teach a child who seeks to use power inappropriately that this is wrong?

How does a militaristic system teach anything but that children must submit to someone stronger than themselves? It only reinforces wrong ideas about power and domination.

These facilities are bound to create new emotional problems for these children. But the system profits here, as well, because then they are able to label and drug the children and make money in the process of billing for this injustice.

A youth is removed from the home, programmed, and when they conform to the expectations, released back to the setting that led to their distress and misbehavior to begin with. It becomes a vicious cycle.

These facilities are also very costly and their efficacy is questionable. The Bazelon Center for Mental Health Law noted the ineffectiveness of these facilities in treatment of youth as well as the many documented abuses that occur in such places.

Community-based options have proven effective and need to be more readily available and implemented.

We need to shift our focus to true rehabilitation and to addressing actual social problems, not locking our children away, drugging them into submission, and ignoring their needs.

DAN L. EDMUNDS, Ed.D.

Residential Treatment for Youth- Do No Harm- by Charles Huffine, M.D.

Residential Treatment for Youth: Do No Harm! Charles Huffine, MD
AACP Newsletter, Volume 15, Number 3, Summer 2001

A few months after the tragedy of 10 year old Candace Newmaker’s re-birthing death in Evergreen, Colorado, come reports of further brutality against our most vulnerable and troubled children.

In June 2001 in Fountain Hills Arizona, a 14-year-old boy was taken from a residential treatment facility dehydrated and delirious and was pronounced dead when he arrived at the hospital. Prior to staff calling 911 they had forced him, along with other residents, to stand in the Arizona sun in temperatures that were regularly over 100 degrees. They were forced to wear black sweats and were punished if they asked for food or water by being forced to eat mud. These teenagers were often beaten. The "sergeants," or staff members, stomped on the boys chests and arms with boots if they didn’t perform tasks required of them. On one occasion a staff held a knife to the throat of a boy.

Earlier, at a school for troubled teens in Prince Georges County Maryland, a 17-year-old boy died of asphyxia as a teacher cut off his airway in the act of restraining him.

More recently, at a Christian school for troubled youth in Newark Missouri, five staff members were arrested and charged with felony child abuse. Their punishment for youth who were deemed disrespectful was to stand in cow manure pits in depths of a few inches to chest high.

These incidents are the latest in a steady drum beat of reports of egregious behavior on the part of staff members of some residential programs for troubled youth. These facilities go by a variety of names: attitude adjustment schools, behavior modification camps, social service shelters, wilderness survival camps. Others present themselves as psychiatric residential treatment facilities.

These programs claim to help troubled youth, but they often operate with minimal, ineffectual or absent psychiatric oversight. Reports of abusive practices in these facilities come from all over the United States, but more often from states with weaker laws protecting the rights of adolescents.

How common are such incidents?

Do they occur in violation of an agency’s policies, or do they result from practices that should be considered child abuse but are seen by program leaders as valid treatments for behaviorally disordered youth?

Why do parents seek out such programs for their troubled sons and daughters?

What are our obligations to seek oversight and regulation of residential programs for troubled youth and to educate parents and the public about risks and questionable practices in these facilities?

These are a few of many unanswered questions that trouble advocates and professionals concerned about the humane treatment of children and youth with psychiatric disorders that manifest as troublesome behavior.

What we do know is that there are many programs for such youth around the country. Some have contracts within their home states for serving difficult to manage youth and others receive reimbursement from private insurance carriers. Oversight of these contracts appears to be inadequate in many cases.

Many such programs are responsible only to the parents for the way they serve children and youth. Many programs tell parents to stay out of contact with their children for a period of time and provide parents with explanations of the treatment that may not represent what their child experiences.

Too often, prior treatment is viewed as failed treatment. Records are not obtained and prior therapists are disrespected or shunned if they try to coordinate.

There is no one regulatory agency that has responsibility for such facilities in any state as programs fall outside of usual regulatory frameworks for psychiatric facilities or schools. Deaths, serious harm and frank abuse have been reported on by journalists, starting with the 1998 Hartford Currant article on death and injury from restraint and seclusion.

To date, the medical and nursing professions have had little to say about troubled facilities and the reports of tragic incidents arising from them. Our professions have not defined best practices for addressing behavioral symptomology in such programs.

A psychiatrist speaking on behalf of a program that had a recent death stated in a legal setting that such incidents are rare, but can be unfortunate side effects of restraint, and are unavoidable.

At the very least, states should develop regulatory policies defining the various forms of residential care and assuring that all residential programs in their state are covered by some regulatory system. Regulatory policies should be placed in law and should hold the program administration accountable for assuring the safety of each youth in their care. Regulations should define the boundary for staff between allowable physical interventions and behavior with youth that is frankly abusive.

Psychiatrists and nurses should be on the forefront of advocating for such reforms and assurances for our youth.

The issue of residential treatment should be looked at from the perspective of community psychiatric, or community nursing practice.

What have we learned from nearly twenty years of practicing values and principles articulated for the Children and Adolescent Service System Program (CASSP) and the System of Care (SOC) reform movement it spawned?

The core values of the SOC reforms were the following:

Services should be

1) family centered
2) child and adolescent focused
3) community based and well coordinated
4) culturally competent

Sending youth across the country to a residential program, or limiting parental access to their children in a local program, is the antithesis of a family centered practice. Parents must be included in the assessment of each child, involved in regular contact with their child and central to planning the child’s reentry into their life outside the institution.

Programs that offer rigid programming, or frankly misuse behavioral paradigms, are not providing individualized and tailored care as is becoming a standard "best practice" for ever more child care communities around the country.

To provide a quality service, psychiatrists, nurse practitioners and other mental health professionals should have a strong hand in overseeing the treatment process.

Children and youth taken out of their communities, when those communities have seemed unable to help a youth modify their behavior, are not optimally served. They are deprived of the opportunity to learn social adaptations in the context of family, culture and all that is familiar to them.

When care is placed in the hands of a single entity, when information is not obtained from prior providers, and when parents are excluded from meaningful participation in treatment, the power and control of the staff over a resident in the facility is extreme and unlike most other situations except prisons.

This gross inequity of power is, understandably, fertile ground for abusive practices. The facility becomes the new culture for the child. Treatment becomes for the child the game he or she needs to master in order to survive, or curry favor so as to get privileges.

This is the essence of institutionalization that was recognized as harmful by the movement toward community based and culturally competent care. Regulations based on best practices might include a definition of what specific circumstances demand residential placement. They might assure that this aspect of care is brief, limited only to a period when it meets standards of medical necessity, and is well integrated into community based services.

The CALOCUS would be an ideal tool for such a level of care determination process as it offers alternatives to residential placement when intensive treatment is indicated. Regulations based on best practices should assure that parents be full participants in the care of their child in a residential treatment facility.

Best practices based regulations would demand documentation of critical incidents and would create a certainty of outside investigation of incidents involving death or serious injury. They would create a quality assurance protocol for licensed agencies providing residential care that would address such issues as treatment effectiveness and individualization, resident rights and humane practices and acceptable interventions for troublesome behavior.

Clearly more examination of the network of residential treatment, schools and other programs is warranted by the AACP and the International Society of Psychiatric-Mental Health Nurses (ISPN).

On the heels of two more tragic deaths and police action against residential care staff we would hope that the discussion might look more broadly at the phenomenon of residential care for children and youth. We would encourage an examination of the role of residential care as a treatment option and social intervention, and its impact on the life of a developing youth.

Charley Huffine, MD, AACP Immediate Past-President
Wanda Mohr, RN, ISPN
Carol Bush, RN, ISPN

LUZERNE COUNTY JUDGES INDICTED IN CORRUPTION PROBE- PROFITING FROM SENDING JUVENILES TO DETENTION FACILITIES

These judges in Luzerne County, Pennsylvania violated the public trust and have harmed children. I had spoken in the past about these concerns, and it is very positive that action to bring these public officials to task. However- I have also noted that Luzerne County is not the only place where this sort of corruption appears to be occurring. We must continue to be diligent and expose these sort of situations and do what is right for our children! I will certainly be collaborating with a number of grassroots organizations and others on these issues throughout Pennsylvania and nationwide. I am pleased to say that in all of the situations I have been involved in that seemed grim and hopeless, with much determination and patience, justice was won. We must press on.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info





Update: Judges indicted in Luzerne corruption probe



The Luzerne County Courthouse.


By MICHAEL R. SISAK AND MICHAEL P. BUFFER
STAFF REPORT
Published: Monday, January 26, 2009
Updated: Monday, January 26, 2009 1:43 PM EST
Two Luzerne County judges were indicted this morning on charges relating to the operation of two juvenile detention centers.

President Judge Mark A. Ciavarella, 58, and former President Judge Michael T. Conahan are accused of collecting more than $2 million from the construction, expansion and operation of juvenile detention facilities, and for placing juveniles in those facilities in Luzerne County and Western Pennsylvania.

The indictment charges both judges with engaging in a scheme to defraud the public of their honest services and with conspiring to defraud the IRS.


Ciavarella and Conahan have filed a plea agreement, signed by both judges. The judges stipulated they will resign their judgeship and be disbarred. They will serve 87 months in federal prison and make restitution as stipulated by the court.


Earlier today, Judge Chester B. Muroski announced Ciavarella resigned as Luzerne County president judge.

Muroski's secretary, Sean Duesler, handed out copies of a one-line note Ciavarella sent to Gov. Rendell dated Jan. 23. It said, "Please accept this letter as my official notice to you that I am resigning effective immediately from my position as President Judge of the Eleventh District." (Read Ciavarella's resignation letter / Watch video of Muroski's press conference)

Ciavarella sent copies of the letter to the Administrative Office of Pennsylvania Courts and to his eight colleagues on the Luzerne County bench.

Muroski, the eldest member of the Luzerne County judiciary, will oversee the administration of the courts until an en banc meeting can be scheduled and a vote of the judges taken. State law requires the meeting be held after 72 hours notice is given.

"I am confident that the current members of this court are prepared to address the following priorities in an expedition manner," Muroski said at an 11:30 a.m. news conference in his court room on the third floor of the Luzerne County Courthouse.

"First, to maintain the function of this court by conducting the business of our court on a timely basis.

"Second, to make every effort to restore public trust and confidence in the judiciary. And third, to make a concerted effort to resolve the county-court budget impasse and the related litigation."

U.S. Attorney Martin Carlson scheduled a 1:30 p.m. press conference at the federal courthouse to discuss an ongoing probe into the Luzerne County Courthouse.

COMMUNITY ALLIANCE FOR THE ETHICAL TREATMENT OF YOUTH

I was very delighted yesterday to have a telephone conversation with Dr. Charles Huffine, M.D., a psychiatrist in Seattle, Washington who has been a dedicated advocate for children and has written extensively on reisdential treatment centers, particularly the abuses that occur in these facilities as well as their being costly and ineffective. I was also pleased to learn of his work with CAFETY (Community Alliance for the Ethical Treatment of Youth) and the winderful work this organization is doing towards advocating for the true needs of our young people.
http://www.cafety.org
I believe that the more we work together, the greater difference we can make. I know many (including myself) feel disillusioned at times by the enormous problems within the system, but if we can work together, and each make our contribution as people of ethics and goodness, the difference will be seen in time, we must be patient.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

SUPPORT HR6358- THE STOP CHILD ABUSE IN RESIDENTIAL PROGRAMS FOR TEENS ACT

This important legislation has been passed in the House and will be introduced in the Senate in 2009. Please contact your Senators to support this legislation!

RD LAING AND THE NATURE OF EVIL

http://laingsociety.org/colloquia/peaceconflict/natureofevil.jgm.htm

THINKING ABOUT MYSTIFICATION

RD Laing had often discussed the conception of mystification, of how individuals can justify enormous evils by saying that are doing the action for someone's own good. It appears that the psychiatric establishment and the systems intimately connected to it (child protective services, justice system, educational system) are often involved in mystification. The Nazi era is one of the most tragic examples of mystification, and such examples today as the Abu Ghraib prison scandal are a more graphic example. In these situations, mystification involves dehumanization, of erasing the person's experience, and making them something other than a person. And so we see this occur in psychiatric hospitals, detention centers, residential treatment facilities, etc.

LIES AND VESTED INTERESTS- THE CORRUPTION INHERENT IN THE JUVENILE JUSTICE AND CPS SYSTEMS

In one of my more heartbreaking situations, I had worked with a 14 year old young man in Wyoming County, Pennsylvania for some time. This young man had encountered domestic violence, physical and sexual abuse, and witnessed the drug use of his father and a suicide attempt of his mother. His situation was very complicated, yet through this I was able to develop a strong relationship with this often very distrustful young person. Through this alliance, he was able to share with me much of the darkness of his world, many things he found difficult to share with his family members, and until an incident last year, he had been progressing to the point where the psychologist and treatment team were recommending his discharge. However, after this incident, I noticed a gradual change and unfortunate decline, and he began association with a number of negative peers. I knew things were bound for trouble and warned him of this. I knew as well that his deep need for attention, affection, and validation were becoming confused in the midst of his awakening sexuality and in light of the past trauma and abuse he experienced. I noticed that as the new school year began, he began putting up distance with me, and it was shortly thereafter that 'all hell broke loose' with him becoming involved in the juvenile justice system. He was charged in regards to an incident where he had thoughts in regards to sexual abuse, but did not actually follow through with this action. The juvenile system as well as the Wyoming County Human Services Agency handled this young man's situation in a means that was far from compassionate, far from rehabilitative, and actually detrimental to his emotional well being. After investigation and obtaining information from colleagues, I determined that a number of youth with similar charges had received far less harsh treatment by the system. I also found that while the system wrangled over who paid for what, they allowed this child to be ripped from his family (causing trauma for his young siblings as well who remain confused as to this circumstance) and to languish with no connections to anyone and his prior therapeutic alliance completely cut off and no help provided. He was 'evaluated' but never was any information in regards to his past victimization or prior treatment considered. He has been recommended for a residential treatment facility in Erie, PA. Curious enough, this facility (which is 6 hours away) houses another youth from the same area. In light of the recent charges brought against Luzerne County Judges Conahan and Ciavarella in regards to taking kickbacks for sending youth to detention facilities, one could easily suspect a similar situation occurring here. According to F.E. Zimring (2004) of the University of Chicago, 90% of juvenile sex offenses are a one time event that do not recur. The NCSBY indicates that the vast majority of these youth can be helped in community based programs. However, this information was obviously ignored. According to a report from the Judge Bazelon Center for Mental Health Law, residential facilities have often had low rates of success, are highly costly, and abuses have occurred (overuse of psychiatric drugs, injuries involving restraint, and seclusion).
See: http://www.bazelon.org/issues/children/factsheets/rtcs.htm
In addition, the residential treatment facility that was recommended was asked to provide a plan of correction in 2007 because of inappropriate incidents that occurred at the facility. This information is publicly available from the Department of Public Welfare. In addition, after dialoguing with a person previouslt affiliated with the managed care company which often provided funding fot this residential treatment facility in Erie, Pennsylvania, I was informed that there have been a number of incidents of abuses, particularly improper restraints, and children have been hurt by inappropriate staff. But this did not prevent the Wyoming County caseworker from trying to sell this facility as it were a 'godsend'.
In spite of this information as well, the system continues its agenda as it appears evident that there are vested interests.
I am sadly quite sure that this is not the first of many incidents of distressed and disadvantaged youth whose needs are not truly being met by a corrupt system claiming to help but only concerned for their own interests. It is a travesty, and it is necessary for those truly concerned for the well being of our youth to continue the struggle to insure that our children's voices are truly heard, and that we address the needs of troubled youth in a rehabilitative and compassionate manner.
I so greatly appreciate the efforts of those who have stood with me in this important struggle. We will NEVER give up, no matter what games are played, what corruption we must tackle. Our kids are too important.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

REHABILITATION OF JUVENILES- MEETING THEIR TRUE NEEDS AND ENDING THE SYSTEM'S CYCLE OF GREED

When parents are not adequate often Child Protective Services steps in. But is the State to be deemed a better parent? Who do we report to when the State is abusive, possibly more so than the natural parents of the child? We see youth placed in detention facilities and residential facilities. In these settings, they are placed often under conditions that lead them to further emotional distress. It appears that this is the game. The decisions to place children is often not based on a genuine interest in the child's best interests, but what will be profitable and the easiest way out of having to actually rehabilitate a youth and meet their emotional needs. It is no wonder that the socio-economically disadvantaged youth are the ones that are so frequently seen in this system. Some of these children have been taught through their family dynamics to be aggressive and to seek to dominate others. How does placing a child into a detention center or residential facility which often is geared towards the concept of staff forcing conformity through rewards and punishments and often by deprivation teach a child who seeks to use power inappropriately that this is wrong? How does a militaristic system teach anything but that the child must submit to someone stronger than themselves? It only reinforces wrong ideas about power and domination. These facilities are bound to create new emotional problems for these children. But the system profits here as well, because then they are able to label and drug the children and make money in the process of billing for this injustice. These settings set youth up for failure, but that is part of the game as well. A youth is removed from the home, programmed, and when they conform to the expectations, released back to the setting that led to their madness and misbehavior to begin with. It becomes a vicious cycle. But there is money to be made. $70,000 a year for these type of placements, and if things go badly and they must return, well, here is more money to be made. If we spent $70,000 towards providing to the real needs of children and their families, we would be in a much better situation. We need to shift our focus to true rehabilitation and to addressing actual social problems, not locking our children away, drugging them into submission, and ignoring their needs. This may be a dream as long as money and greed remain the focus of those controlling this sick system.
In October 2008, I wrote to Governor Ed Rendell of Pennsylvania sharing some of the concerns I have outlined above as well as a specific situation. It was not until the end of November that I received a response from the Office of Children and Families which expressed "niceties" of how concerned they are for the welfare of the children of the Commonwealth and how the issue related would be looked into. It appears that because this family had a history of challenges, was disadvantaged (thus lacking representation and a real voice in the system), that Child Protective Services and others were able to push forward an agenda. To date, absolutely no action has been taken. This came to me as no surprise as it has been apparent that there are too many vested interests for any reforms to occur in the near future. However, I believe it is necessary for citizens and organizations committed to social justice and children to continue to fight the good fight. I believe that detention and residential centers should become a rarity if non-existent as it has been seen that there do exist community based programming that is far more effective and far more humane. Sadly, I have witnessed how disadvantaged children and particularly minority children are the ones more frequently subjected to these abuses I have mentioned. It is a travesty. We must look at juvenile offenders not merely as 'monsters' or 'troublemakers" but we must look at the underlying roots of why they become anti-social. Anti-social behavior arises as a result of the social, political, and familial processs at work. If society was not as ill as it is, if there existed equality, human rights, etc., it would be obvious that we would see a vast decline in emotional problems, crime, anti-social behaviors, etc.
We must re-examine our priorities. But as long as greed is at work and the desire to take the so-called 'easy way out', these abuses of our children will continue.
It is almost as if the system creates perpetually distressed or anti-social individuals as to keep everyone in their place. Rehabilitation is sadly far from the focus. The State officials can write all the niceties they want about how concerned they are for the children, but the words are empty without real action. And are we to assume that any of these high paid bureaucrats actualy are losing any sleep over the conditions that youth are subjected to? Definitely not.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

-Dan L. Edmunds, Ed.D.
www.DrDanEdmunds.com

THE POWER OF LISTENING AND UNDERSTANDING

Sadly, in my work with children and adolescents I have come to the awareness of the fact that there are often many dysfunctional family dynamics and oppressive societal structures that impact these kids that I as one person cannot possibly change though If I could I would. This does not mean that I do not continue to challenge and resist those things that lead to distress and oppression. But, I must realize that many of these young people are placed in situations that are almost like a prison sentence. They cannot escape it, and many times these dynamics tear them apart and often lead them to self-destruction. But, if it can be instilled that this prison sentence could be over in time, that self-destruction is not necessary, but that the person can overcome and be free. I realize that though I cannot change many of these things (largely because those perpetuating it do not want to change), what I can do is to provide these young people a time of respite, a time where they can feel safe and free from the burdens, and know that they have someone who will listen and respect their experience. This in itself is a great gift, and very powerful. It means so much to me when I hear from former clients who tell me what the time I spent with them, often just listening, meant to them. I cannot say that every client had the most wonderful outcome, some overcame, and some persisted in difficulties. But even the ones whose choices were poor and persisted in difficulties, when I spoke to them or corresponded with them, they would remind me of how much it meant to them to have someone on their side, someone who would listen and seek to understand.

-Dan L. Edmunds, Ed.D.
www.DrDanEdmunds.com

ADDICTION

When we examine the actual root of drug addiction, we find that simply put the root is unhappiness, discontent. If individuals lived in a society that was just, where equality and opportunity was present and there did not exist oppression and the current class divisions and economic hardships, there would be little desire for individuals to alter their state of consciousness as they would exist in a high level of contentment. Incarceration of people undergoing addiction does not resolve any issue, it does not provide them with new skills, it does not resolve the issues which led them to addiction. If we are truly to wage a 'war on drugs', then we must wage war against poverty, social injustice, and every means of oppression. We must radically change our attitudes and the ways society operates.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

INVOLUNTARY COMMITMENT

Oftentimes individuals are involuntarily committed to psychiatric facilities, deprived of their liberty based on the supposed premise that they are a threat either to themselves or to others. However, there are many individuals who are threats to themselves or others who we do not deprive of their liberty. Therefore, who we deem as dangerous is a subjective call. Unless a person has actually committed a criminal act, and has gone through due process, and been convicted, this should be the only time that a person's rights and liberty should be limited. This concept of 'dangerousness' is merely a means of social control, it is to separate from society those who we subjectively deem undesirable. If these persons actually have committed a dangerous act which has infringed on the rights of others, then this should be handled by criminal law procedures. This conception has been argued vehemently by those such as Thomas Szasz.


-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

SOCIAL INJUSTICE AND INEQUALITY- PEOPLE BEFORE PROFITS

We are seeing the collapse of our economic system based on the greed that has been inherent in this system. It is a disgrace that some individuals are able to accumulate wealth individually that is greater than that of some small nations while children are starving, and the middle class continues to shrink and struggle for their survival. It is the barriers of class, religion, race, and so forth that leads to conflict and ultimately our downfall. Our society has lost its sense of community and connectedness, and the desire for profit has caused us to lose sight of the humanity of others. All of these barriers lead to our isolation and alienation. We are each day become more and more alienated from each other, so absorbed into selfish interests. And even the so-called 'helping professions' have become more about the profits that can be gained that the true desire to be with others and to come to their aid. In the age of managed care organizations, the needs of distressed persons are limited by the elite's need to earn profit. The downtrodden are dehumanized, they are looked upon as lesser, and ultimately as a source of profit. They must be kept in their place. If they actually 'got better', where would the profits come from? So, it is easier to drug them into compliance and conformity. It is easier just to 'maintain them', as then we know that our profits are not in jeopardy. Is it possible for us to come to a point where we will place people before profits? What will it take? What must we do?

-Dan L. Edmunds, Ed.D.
www.DrDanEdmunds.com

FREEDOM FOR CHILDREN

Children have been seen as property, with few rights, and subject to the domination of others who may not always have their best interests in mind. Children are viewed as slaves, as dependent. If adults treat them badly, they have little recourse. When the reach the arbitrary age of 18, they are then expected tom assume the role and responsibilities of an adult. What if we gave children the rights of adults and taught them responsibility from the beginning? Adult society has been involved in numerous wars, conflicts, attrocities, why do we think we know what is best for children, why do we think we know better than children themselves? Holt (1973) suggested that children should hasve equal treatment under the law. They should be able to participate in the political process, to be legally responsible for their choices and acts; to have privacy; to manage their education; and to decide who is to be their guardian. If we taught children the concept of freedom combined with responsibility, we would certainly see the lessening of many of the troubling scenarios facing young people today. Instead, adult society seeks to control children, and does not provide them with the proper guidance and support, it creates children who are oppressed and neglected, who then rebel against the adults who have hurt them in often unproductive and self destructive ways. If all human beings, children and adults, were accorded the same basic humanity, society could be much for the better.
We spend thousands on residential treatment facilities, detention centers, treatment programs, etc. for youth, but what if we could be pro-active, what if we could instead take these funds and invest them into what our children truly need? The money spent on residential treatment which has dubious outcomes is enormous. And at times a child is placed in such facility from a troubled family life, it makes them more of a conformist to the facilities expectations, and then returns them back to the troubled family dynamics, only to create a vicious cycle. If the children were allowed the ability to live on their own or to choose their guardian from those who may actually care for them, just think what funds which are now funneled to the psychiatric establishment could do for the advancement of children. We are speaking of around $70-100,000 per year, the child could have the best education, travel and explore, and be out of situations of poverty and oppression. But instead, the establishment would rather have its hands on these funds and it needs to keep the vicious cycle going as this is its source of profit. Keep people distressed, keep them labeled, make them "ill' and we will constantly have a flow of profits.

-Dan L. Edmunds, Ed.D.
www.DrDanEdmunds.com

The medical model misses the entire picture

A father recently came to me for a consultation in regards to his seven year old son. He began to tell me of the child's oppositionality and decline at school and left things pretty much at that. Let's say (as seems to be common practice under a medicalized model) that I left things at that and identified the child as the 'problem'. Instead, I met individually with the child who told me of his sadness that his parents fought daily and dad had destroyed objects in fits of rage. Fortunately, the father was willing to acknowledge concerns and asked for help for his entire family. But what if we chose to ignore this child's experience and the social context, only looking at the child's behavior, and this behavior as reported by one source. What outcome would be derived? What 'treatment' would be delineated?
-Dan L.Edmunds,Ed.D.
www.DrDanEdmunds.com

WHAT ARE WE DOING TO OUR CHILDREN?

What we become is a product of our thought and a product of how we choose to respond to the social and political processes at work daily in our lives, from our very birth. The young child begins to learn what responses to give that will gain him or her attention, affection, or approval. The family is the cauldron of our being. Often what we see, we become. Aggression breeds aggression. Lies creates liars. Lack of regard for the child leads to the child have a lack of empathy for others. Poor familial boundaries leads to the child haivng poor boundaries in regards to others. How do some families evoke such violence upon their own children? We live in a society where children are committing the crimes of adults, where children are rapidly entering the world of adults but lack the growth and maturity to be fully responsible and understanding. Because of societal pressures, adults are abandoning their children, and children are thrown into a brutal quest for survival. They are exposed to the corrupt world of adults. Parental egoism and desire for self gratification become passed down to the children. Families shrouded in secrecy and denial are often the most destructive upon the minds of children. This becomes the breeding ground for the most vile of thought and action. These are the families who make lofe about control- 'do as I say but not as I do, do this because I love you". The child has no clear direction. They then begin to seek to break from their painful reality. They are fearful, possibly mre fearful of living than of death. These children because of what they have seen and heard become persons as well who seek to use power, domination, and manipulation upon others. These are the children who become offenders. The mechanical world we exist within, where those who are not of the elite must struggle day by day leads to children being cast aside. The mechanical mentality has infected all institutions. Schools are no longer about learning but conformity, where students produce desired results for their teachers. We are creating frustrated families and frustrated children. This frustration has now built to the level of rage. This rage is destroying the minds of our children. This rage leads to violence and conflict. Is there a way out? Is there another way? It requires us to evaluate our responses. Life is suffering, all are presented with problems, this we cannot escape. But we can chose how to address our problems. If persons begin to lay aside the pain and hurt, and can build resiliency against the violence said to be 'love', if we can become survivors rather than victims, we stand a chance. If society and families can re-evaluate its values and principles, there is a chance. Many times a child is helped by having a helping person journey with them. We cannot do this alone, we must have others to journey with us. We need the restoration of a sense of community, of our inter-connectedness. There are no easy solutions. Sadly, the battle for the 'soul' of our children will mean some will be saved, and some will remain lost. But if even one child can be saved from the pit of self destruction, the efforts of time, compassion, and wisdom will be well worth it. In a world so rife with despair, it is so easy for us to fall into the same traps. Let us guard our minds, let us strive for social justice, and not give up hope that even in our small way, we can make a difference.

-Dan L. Edmunds, Ed.D.
www.DrDanEdmunds.com

disintegration of community

One of the significant problems in today's society is our lack of realizing our interconnectedness, our lack of community. We become so hurried, so engrossed in our activity, that we do not know or acknowledge or neighbor. We have become alienated and absorbed into ourselves and our own interests and objectives. No longer do we come together for common purposes, rarely do we share in common interests and vision. This is to our own destruction.

Sometimes caring is not enough

I have realized that showing caring and compassion are sometimes not enough. As I mentioned in my article on True Friendship, there must be a test to see if the friendship will endure and in my article Journey Through Madness, I commented on the fact that many who are so emotionally hurt trust noone and sincerity is questioned. I recall a therapeutic alliance with a 14 year old man. Though we built a strong connection, because of his immense hurts, familial turmoil, and victimization, he had difficulty trusting. He had moments of progress, but then would continue in self loathing and self destructive behavior. It was hard for him to accept that anyone might actually love him. It was easier to make others fear him, he had to dominate to feel any security. Unfortunately, he encountered the juvenile justice system, a painful experience for him, his family, and myself. But it was at this point that he came to the realization of my sincerity and that I did really care. Before, he had put his energy into superficial relationships. What is unfortunate, that none of these individuals have any concern for him now or even speak of him. He was blind to see where caring could be really found. It is unfortunate that it has taken extreme crisis for him to realize who his friends really are. It is my hope that this realization will carry him through the difficult path that lies ahead.
-Dan L.Edmunds,Ed.D.
www.humanepsychiatry.info

REACHING OUR TROUBLED CHILDREN

A society can be judged by how it treats its children, even those most troubled and disturbed. Many choose to 'throw away' those children who are deemed delinquent. But how did they become that way? It is not just their choices but it is also the failure of adults in their lives to truly reach out and guide these children. Court systems, Child Protective services, and our educational systems fail these children time and time again. They are shuffled off to placements and through psychiatric ceremonials only to become more bitter, more hardened, more distressed, and more disturbed. They sentence them to a spiritual death. We should be investing our time to teach new skills, to change the frame of reference, to show compassion and wisdom. We must have patience and journey with these children, to know that someone truly cares and that their pains and hurts need not be self destructive. But the issue remains greed. It is profitable to keep the status quo, the psychiatric establishment profits and so do others. No one wants to take the time to bother with these children, few are interested in social justice, few want to give the things that would truly rehabilitate.
I hope that there will be those who will wage a non violent resistance and to once again make our children a priority. We live in a society where there must always be winners and losers, it impacts every aspect of how we conduct ourselves, in courts, in politics, in business. If only we can regain a sense of our common humanity, and be able to develop concern for others, even the most troubled. We are creating the monsters by our failure to meet the true needs of our children, we are contributing to their demise. Hopefully we will soon awaken to this and make the important changes.

-Dan L.Edmunds,Ed.D.
www.DrDanEdmunds.com

I placed my hope in you, I sought your liberation. Shattered. Broken. Lost. You could not respond. I loved you. I still do. But you did not know until it was too late. I embrace you and the tears flow. I know you, but you do not know youself. You wanted control. How out of control things are. Let go. Let go of the pain, the rage, I am with you, know this, if it be your only solace. The torment to me and to you. It will pass, don't give up.I believe in you, you will overcome. Namaste.

The Gift of Trust, Love, and Hope

I had the privilege of working with a young man who had experienced much turmoil in his life. From early on, we connected, and over time this bond became stronger. Family sessions were often difficult and challenging, but one on one he would share with me his pain, his dark secrets, his sorrows. He had been abandoned by his father, sexually abused by a peer at age 7, witness to a suicide attempt of his mother, and having a conflictual relationship with his step-father. He had little love in his life to the point where he had no love for himself either. He began to loathe himself and be filled with rage. I sought to be loving but firm, and to steer him towards finding meaning and of resolving conflicts in his life. We had a strong relationship, we could joke together but also share more serious reflections. However, I knew that because he had been so hurt and broken, that he was not fully trusting anyone and he was constantly being sucked into the vortex of negative peer associations and familial dysfunction. I'm spite of this, he progressed, even to the point discharge was discussed by the psychologist. But then came the series of unfortunate events. I noticed him struggling again and isolating. He then had an incident where he was caught unclothed with his younger sibling. I suspected he had been abused again by a peer, but he was not able to develop the courage to relate this until much later. He persisted in some negative actions at school, using domination of others as a way to regain control and his feelings of worth. There was another incident of sexual acting out and this brought charges. I hjad predicted sadly that if better choices were not made that legal ramifications would come and there would be a day where all decisions would be out of his hands, out of his parents, and out of mine. The State became involved. Not understanding my connection to the young man, and wanting everything sterile and clinical, as well as having political machinations, they chastised me for being real and genuine and actually treating this young man as a human being. They had their agenda and decided to proceed. It was not that I did not understand that he needed additional support and help, it was that I was concerned if he felt alone and had no spiritual connection, he would only become more hardened and fall into despair. The young man pleaded with me not to abandon him, and I said I would not. He told me that he wished he would have followed what I said, but he could never trust anyone, but now he knows that I truly cared about him, but he felt it was too late. I had given him a word that means 'I see the love, truth, and divine in you.' He said this word to me as he remembered it. When I exained it meaning, he wept. Now I am left to only hope for the best in an absurd situation, to hope for the best in a system not knowing compassion, not knowing persons, so filled with ego. His mother's words were very meaningful to me in that she said- 'you did not fail, you gave him more than anyone ever did- you gave him trust, hope, and love.' This I did and would do again and again even though the pain has been great. And if any dare say that what I gifted this child with was 'unprofessional', then I must question their heart. It is indeed a great misfortune that those who claim to be in the field of protecting children are so beguiled by greed and corruption, that they lose sight of how to truly reach our children, even the most troubled ones, and deal with them in compassionate, rehabilitative means.

-Dan L. Edmunds,Ed.D.
www.humanepsychiatry.info

PATIENT ACCEPTANCE, UNCONDITIONAL LOVE, AND COMPASSION

Sometimes it is difficult to accept things as they are, to come to a patient acceptance. I have looked at the role of the 'bodhisattva', one who postpones their own enlightenment and happiness, to compassionately help liberate others. I am convinced that providing unconditional love and compassion heals much. It is the opening to the door of liberation from distress and deluded minds. Pain and turmoil can only cease by knowing unconditional love, of feeling that someone understands, that no matter how bad things are or have been, we can overcome. I think of the term 'namaste', that we are all inter-connected, and we can join our hearts together, and that there exists within all beings the potential, the seed of goodness and light. It is this unconditional love and compassion that waters this seed and helps it to grow. I think of the lotus, a beautiful flower blossoming from the muck, such a symbol of our world, that from despair, hopelessness, and sufferings, can blossom forth goodness and inner peace.

-Dan L. Edmunds, Ed.D.
www.DrDanEdmunds.com

Left powerless, son, who protected you? Who has nourished your soul? When you cried, did anyone hear? Broken and hurt, torn and shattered, where was your solace? Rage and confusion destroyed your peace. They created the monstrous desire for revenge. I have been hurt, I seek revenge. My pain shall be their pain! My hurt shall be their hurt! They do not know me, I am lost, I do not know myself. They destroyed my soul, and I cannot find it. They shattered my trust, I can trust no one, and I cannot be trusted. I inflict my pain on them and those that are with them. My anger has consummed me. I cannot find my soul, I am void, there is nothing there, yet I need something. I fill this void with more rage. I plead that someone will hear me. I plead that someone will understand. I wait alone. I wait afraid. Will I recognize the one who hears my cry or will I turn away thinking they are one of them? I wait for the one who will hear my cry, yet I remain afraid.

If I opened the door of paradise...

If I opened the door to Paradise, would you choose to remain in Hell? If I gave you my heart, would you notice? Can you respond to that you never knew or had? Surrounded by the demons, yet truly alone. You recognize not your friends. Engulfed in delusions, seeking pleasure in that which but leads to more suffering. How I sought to change the wretched mind. A deafening silence, but then an echo, a constant echo. Are you too far away to hear it? Your hurt is now the hurt of others. You inflict your pain on many. Covered in stinking filfth, they say you are foul. Yet I saw what was within. I saw what was possible. You glorify the one who hurt you. You have indeed become him. A sick cycle. The wheel must be broken. Who are you? What do you see? A mirage. A false image, not you, but that which the demons say you must be to join their legion. You think they laugh and revel with you, they laugh at you, they scorn you. And now in the darkness, they flee, leaving you truly alone. If I open the door to Paradise to you now, will you choose to remain in Hell?

-Dan L.Edmunds,Ed.D
www.humanepsychiatry.info

BBC NEWS- ADHD DRUGS NOT THE ANSWER

Treating children who have Attention Deficit Hyperactivity Disorder (ADHD) with drugs is not effective in the long-term, research has shown.
A study obtained by the BBC's Panorama programme says drugs such as Ritalin and Concerta work no better than therapy after three years of treatment.

The findings by an influential US study also suggested long-term use of the drugs could stunt children's growth.

It said that the benefits of drugs had previously been exaggerated.

The Multimodal Treatment Study of Children with ADHD has been monitoring the treatment of 600 children across the US since the 1990s.

'Exaggerated impact'

Most of the estimated 500,000 children in Britain with ADHD receive no treatment at all.

DH STATEMENT


The Department of Health has issued a statement on the treatment of ADHD

But of those that do, most - about 55,000 last year - are prescribed stimulants like Ritalin and Concerta.

The cost of these drugs to the NHS is about £28m.

In 1999, the American study concluded that after one year medication worked better than behavioural therapy for ADHD.

This finding influenced medical practice on both sides of the Atlantic, and prescription rates in the UK have since tripled.


But now after longer-term analysis, the report's co-author, Professor William Pelham of the University of Buffalo, said: "I think that we exaggerated the beneficial impact of medication in the first study.

"We had thought that children medicated longer would have better outcomes. That didn't happen to be the case.

"There's no indication that medication's better than nothing in the long run."

Prof Pelham said there were "no beneficial effects" of medication and the impact was seemingly negative instead.

"The children had a substantial decrease in their rate of growth so they weren't growing as much as other kids both in terms of their height and in terms of their weight," he said.

American society is now filled with the concepts of self interest, entitlement, and playing victim. The downward spiral of our economy should be no surprise, our attitudes have only led to this eventual result. As I have mentioned previously, the education system does not value or reward initiative or creativity, it is rather focused on the self interest of the educators and administrators who seek to have children conform to standards based on tests and gain their compliance so that the administrators can appear as if they have fulfilled their duty while the children actually languish. We are a society that expects others to 'fix' our errors and provide for our relief. We are a society of shifting blame. We are a society that does not seek to take ownership and responsibility. We are a society that knows not how to think critcally but only to possess and consume. The American dream can be now said to be the American nightmare. We do not think of others, but we focus on our own survival, and our political leaders and the elite have placed persons in this uncomfortable position of intense worry for their own survival. When this occurs, the concern for others lessens, and we focus solely on our own needs, our own desires. Society itself is sick, yet it seeks to pathologize those who would react to this sick society, and it offers them its technologies, it offers them its drugs, to numb them into accepting things as they are rather than to actively protest and change the injustices that exist. American society has become apathetic and numb, and if such persists, our further decline is only inevitable. Let us hope that some will awaken from their stupor before it is too late.

RETURNING THE ZEAL FOR LEARNING AND UNDERSTANDING WHAT EDUCATION REALLY SHOULD BE

Today I spent some time conducting observations in a school. One of the students I noticed had significant reading challenges and appeared to be enormously frustrated with academics because of this. He appeared somewhat distractible and not engaged. The teacher came to me and stated that if 'he had meds he would do better." I saw this as an ignorant and self serving response. She was plainly not understanding how this child cannot read well and this is at the root of the problem and that the dilemma is not an issue of his brain but how SHE can reach him and provide him a REAL education. I explained the recent study that showed no academic improvement or improvement in pro-social skills with kids on stimulant drugs and shared some of my own research. The response was only a blank stare. New York State Teacher of the year and author of "Dumbing Us Down" John Taylor Gatto remarked, "Curiosity has no important place in my work, only conformity." And this is what I sadly saw, these children had no outlets to explore their curiosity. A token system exists to bribe them into conformity and to make them dependent and unable to develop skills for the real world for the real world does not operate this way. I noticed that there seemed to be as many adults in the room as children. It seems we are doing much schooling, but not educating. Education comes through creativity, exploration. Children who are truly being educated have a zeal for learning. One of the students stated to me, "I hate school, I wish the school would be blasted off by a rocket into space." I did not respond to this, but to some degree in my mind have to admit, I agree. This statement received the response of "well, we don't speak that way", but I am more curious to know this child is so unhappy with the school he is in. Did anyone of the school staff consider that? Probably not. It will remain status quo. And who benefits? Not the children. I share a few other qoutes from John Taylor Gatto:
"...‘How will they learn to read?’ you ask, and my answer is ‘Remember the lessons of Massachusetts.’ When children are given whole lives instead of age-graded ones in cellblocks, they learn to read, write, and do arithmetic with ease, if those things make sense in the kind of life that unfolds around them."
"It’s absurd and anti-life to be part of a system that compels you to sit in confinement with people of exactly the same age and social class. That system effectively cuts you off from the immense diversity of life and the synergy of variety; indeed it cuts you off from your own past and future, sealing you in a continuous present much the same way television does..."
I have argued for a more humane mental health system as well as for democratic education and an educational system that encoruages our spirited children rather than stifles them. Gatto describes clearly the education system we should all be striving for- "Whatever an education is, it should make you a unique individual, not a conformist; it should furnish you with an original spirit with which to tackle the big challenges; it should allow you to find values which will be your road map through life; it should make you spiritually rich, a person who loves whatever you are doing, wherever you are, whomever you are with; it should teach you what is important, how to live and how to die."

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

A STORY FROM MY THERAPEUTIC WORK

I was contacted by a special education department because they had a teenager, who I will refer to as Bob who was having frequent aggressive incidents at school, had poor motivation, and whose attention was said to be fleeting. Bob struggled academically and had little interest in school. This is what was initially presented to me. So, I met Bob and his family. I first wanted to know something about Bob as a person and the world he was living in. Bob expressed to me that his family was disadvantaged and he often felt 'lost' among his siblings. Bob lacked confidence and felt that because he was not a good reader that school was basically pointless. He spoke alot about conflicts at home that he was exposed to and many times feeling belittled if he did not meet certain standards. My sessions revolved around first understanding his experience. From this, I worked with Bob in being able to come to a realization that all people encounter problems and they have no choice in this but we do have a choice in how we seek to think. I worked with Bob on non-violent communication and posed various scenarios as to how he might be able to work through conflicts with others. I allowed Bob to share his thoughts openly and honestly. I do not believe he had this opportunity before. In prior therapeutic programs that Bob had been involved in he was often taught programmed responses. I noticed this from the beginning as he often had answers to various dilemmas that appeared as if they came from a textbook. I encouraged Bob to be a critical thinker, to develop a higher level of independent thought. I explored with him some of his strengths and interests and began to encourage him to channel this into building confidence. I worked with Bob on a 'life map' to explore short term and long term attainable goals. We also made use of decision trees whereby we would evlauate his decisions and go through on explore the ramifications. He began to read books based on his interests, and this combined with some reading support arranged for him, led him to have more desire to read. As his confidence built, his reading gradually improved as well as his motivation. I spent some time in the community with Bob seeking to provide him positive validation and the opportunity to communicate this thoughts and feelings in a non-judgmental atmosphere as he appeared to feel somewhat unheard and repressed before. I encouraged the family to begin to do likewise. I established a discipline plan with the family based on social reinforcement and provided some additional opportunities for outings provided that Bob was willing to follow through on a basic contract addressing what he would accomplish at home and school. The school staff noted marked improvement and the parents stated that the aggressive incidents were eliminated and that Bob appeared to have a more positive attitude. What went from a period of daily calls from the school over various dilemmas, now has become calls from the school to discuss what Bob has accomplished. I saw that Bob was a young person who had been hurt and did not feel a sense of worth. This is what led to him to react in ways that were at times destructive. School did not appear important because he could not grasp many areas, so previously had decided to shut down and give up. At the root of the problem was the desire for attention and validation and the concept of assumed disability that he had adopted. What if Bob had been told he had a chemical imbalance? That he was disordered and could not control his actions because of this so called disorder? Would this have resolved any inner conflicts for him? Would it have built his confidence? or would it have only perpetuated the problem? And so it seems in the education and mental health systems today. We are creating 'disability', we are allowing our children to languish, we are not meeting their true needs. We are forcing their conformity to a broken system.
_______________________________________________________________________________
Dan L. Edmunds, Ed.D.

JUDGING BEHAVIOR- SOCIAL CONTROL OR MEDICINE?

When we seek to judge behavior, we come upon some great difficulties. Let us say that we have identified a person as 'aggressive'. What exactly is an aggressive act? A person who hunts an animal? Is that an aggressive act? Johnny punches Sally in the nose, is that an aggressive act? A nation invades another nation. Is that an aggressive act? Mr. Smith invests a lot into the stock market. Is he an aggressive investor? George rises to the top of his company. Is he aggressive? How we answer this is based on our values. However, psychiatry would like us to think that judging and categorizing behavior is a science, that it is medicine. So, understanding that these are value judgments, we could say that 'well, a behavior that infringes on the rights of others is a problem'. Indeed, he may be, but to state this means we are dealing with legality, not medicine. Therefore, psychiatry can be said to be an arm of the law, a means of social control and defining who are the offenders of the social 'norms'. From this arises the question as to whether this position should be afforded to psychiatrists to be the arbitrators of values and what society 'should look like'.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

breaking free

As human beings, we all seek to be free from suffering. We all seek to be free from oppression. We all react to what we experience. Some react in unconventional ways. Not all reactions are effective means, yet we react. We all are seeking to create order, a sense of purpose to our lives, though there are varying constructs of what life is, of what it means to be human. Some retreat from suffering or seek higher levels of consciousness through use of substances, but this often becomes destructive, much like a plane soaring to high altitudes only to crash and burn upon landing. Those who become labeled as mentally ill are often seeking to break free from severe oppression and suffering. Yet society seeks to stifle their experience. How dare they break free! How dare they act in ways we do not approve! So we drug and shock them hoping they 'come to their senses' or at least not be a 'bother' to us anymore. If we could only come to realize the transformative process, and support their liberation. If society could but realize its illness rather than ascribing so called illness to persons.

Experience and reactions.

We all react to what we experience. We all seek at some point to create order in life and at times control those events which are uncontrollable. We each have our stories of joys and sorrows, blessed memories and traumas. For some individuals, the way they experience the world has led them to despair, or led them to obsessive behavior as a reaction to the extreme chaos they have internalized. Those we label as mentally ill are those whose reactions to their experience society judges to be without value or problematic. This creates stigma, but if we understood these reactions, if we sought to understand the experience, we would find that these reactions may be the person's only way of dealing with the intense emotions, oppression, or other experiences they have had. As Laing stated, that what is termed insanity may be a sane response to an insane world. We lock people up for behaving in ways we do not like. We argue it is for their own good, and we claim that we can predict their behavior or judge them to be a harm to themselves or others when in reality we do not truly possess this capability, we can only hypothesize based on our own limited perceptions. We believe falsely that those labeled mentally ill are more prone to violence while our 'sane' ones continue to involve themselves in wars and conflicts.
-Dan L.Edmunds,Ed.D.
www.humanepsychiatry.info

Impact of Abuse

I have always had particular interest in the works of Dr. Alice Miller who discussed the role of childhood abuse and the development later of emotional disturbance, criminality, addiction, and further cycles of violence perpetuated on their children and others. I have argued that aggression breeds aggression.My article "Trauma Model of Psychological Distress" provided a timeline of when trauma occurs in childhood and the resulting impact in the teen years and into adulthood. The mental health establishment often ignores these important factors instead attributing emotional distress to solely chemical processes. Miller discussed the role of the enlightened witness which lessened the impact of the trauma. I strongly believe that this role is crucial and a buffer to the destructive social and familial forces that impact some children. This is a key part of the person developing resiliency. Even in the most serious emotional disturbances the potential for recovery (and discovery) is possible. It is not an easy process, but a possible one. It is sad that in our age we do not provide long term psychotherapy but focus on numbing people's minds and feelings. This is not recovery, it is repression which often leads to oppression.
-D.L.Edmunds,Ed.D.
www.humanepsychiatry.info

Oppressive Society

For the disadvantaged youth, what are the choices that the ruling oligarchy allows them? Go into military service and fight the wars for the rich so they can possibly receive the 'blessings' of the rich to pursue an education? Or become a slave to them by amassing student loan debt while the wealthy ones path is paved. There is no real opportunity.Efforts are rarely rewarded, but the good conformists are rewarded. Is it any wonder that many poor kids turn to the sale of drugs and crime? When we do not reward effort, the elite oppress, and opportunities are glim, some are willing to assume the risk and danger if only for a moment to be apart from poverty and struggle. And so it is with our homeless and those we often label mentally ill. They seek to be free from oppression, and thus many depart from the reality and standards of corrupt society. As Laing stated, madness may very well be a normal response to a society gone mad. For these persons, the elite drug them into submission, their experience is of no importance, and so they often wander the streets with little chance of recovery as first, no one seems to care, second, they are damaged by psychiatric drugs, and lastly, society refuses to change.
Where is our sense of humanity? Where is our compassion? Can equality truly exist? We are taught not to worry about such things, there is a pill for these worries. No need to change anything, its all in your brain. You have the money, you can be part of the game, and maybe win. If you don't have money, you lose. Whether this be education, health care, or other basic human rights.
-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

THE STATE OF AMERICAN SOCIETY

Through capitalistic greed and corporate power, the United States is slowly being sold out to foreign interests and powers. We are allowing our nation's assets to be given away. Our freedoms and rights are being eroded often under the guise that 'it is for our own good and protection." We lack choices in government, we are controlled by an oligarchic system, a rulin elite, where the very wealthy are the only players. Third party candidates stand no chance, for example in Pennsylvania, The McCain camp knows that the Libertarian candidate Bob Barr could take votes away and lead to an Obama win in Pennsylvania. However, rather than allowing choice, the Mccain camp is fighting for the removal of Barr from the ballot. So as it is in most political equations today, we are not given any real choices, and the politicians hold all the cards, and seek to keep it that way. With the current dynamics and a generation of apathy, we must seriously look at our future. The current institutions are decaying and eroding, and they are driving people mad. It is not that the systems will admit failure. If you do not like the system, too bad, we will force your conformity, hence a large proportion of American children labeled and drugged.
We must change our minds, and we must do it quickly.

-D.L. Edmunds, Ed.D.
www.humanepsychiatry.info

I recall a story of Buddha Shakyamuni where one of his monks desired to go forth to teach to a cruel and harsh people. The Buddha tested him with various questions as to what he would do if various cruelty came upon him. The monk described how he would seek the good in them and be patient no matter the ways they sought to treat him. The Buddha eventually blessed him to proceed stating that maybe hw would reach a few. This is the true work of the therapist. The therapist must be strengths based, focusing on the potential of benevolence in all beings, to realize the delusions we all possess, and to patiently join with another, but to respect their autonomy.
-Dr. D.L. Edmunds,Ed.D.
www.humanepsychiatry.info

The Mental Health Edge Radio Program

Dr.D.L.Edmunds will be speaking on the program THE MENTAL HEALTH EDGE on the topic of the impact of current psychiatric practice on children. The program will air Wednesday August 20 from 8 to 9pm EST on WTAN1340AM in Clearwater, Florida and can be heard on the internet at www.tantalk1340.com

Autonomy and Responsibility

If therapists are to truly respect the autonomy of persons they must allow the person to make decisions on their own, even if these are poor decisions. The therapist should focus the person on seeking their own solutions, taking responsibility for their own actions and choices. The therapist should not allow for overdependence and should not feel 'guilt' if the decisions of their client do not meet to their own or societal approval. If we think this way, then we are not respecting autonomy.
We must also consider that we cannot change the minds of others, only they can do that. -D.L. Edmunds, Ed.D.
www.humanepsychiatry.info

THEORETICAL INFLUENCES IN MY WORK

Boszormenyi-Nagy developed contextual therapy and as a part of this was the concept of destructive entitlement. He felt that many patterns of thought that were problematic and strains in relationship had to do with issues of justice and that people felt a sense of entitlement. This does not mean that feelings of entitlement means that the person is entitled. However, from this destructive entitlement came patterns of revenge. He saw this concept in conduct problems, substance abuse, and as far reaching as world political conflicts. Nagy focused on building conceptions of fairness and believed that ethical conceptions formed a part of the therapeutic process. I have to some degree been influenced by the work of Boszoremenyi-Nagi, particularly this concept of the impact of destructive entitlement.
In my practice, I have sought to develop a synthesis of Nagy's ideas of the needs for ethical principles to be a part of the therapeutic process, while incorporating the ideas of Laing in that extreme states of mind can be understood. In addition, I have brought into practice the thought of existentialism having realized that many distressed person's dilemmas are often problems of meaning and purpose. I am also in agreement with Adlerian ideas on feelings of inferiority being a motivating factor of the development of some destructive behaviors. My friend and colleague, psychologist Jorg Dao from Germany brought forward to me a different way of looking at therapy. His idea is that the therapist does not seek to analyze or 'fix' the problem but to guide the person to identifying the problem clearly and finding their own answers. I believe that all persons have innate strengths and the potential to come to resolution of their own dilemmas. We need to respect the autonomy of the individual and realize the great resiliency that exists within human beings.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

Our society does not reward effort and determination, rather we have often developed an idea of entitlement. Our universities are failing because of this. Professors are chosen based on issues of connections and political correctness. The education of our children as well because of this contagion of entitlement. Taxes skyrocket because of this idea. How far do we go to help those who have no desire to help themselves? Should we pay for the medical treatment of one who given knowledge of making poor health choices persists in them? We are a society that feels entitled, wishes not to take responsibility, and prefers to stay numb. Psychiatry provides the concepts to exonerate persons and society of responsibility, and gives them the drugs to escape and be numb, to never have to really address any dilemma. Is it possible we are headed in the direction of the Soviet era where any critical thought was suppressed, often through psychiatric means? Will our society awaken and take responsibility and ownership for its choices and actions? God only knows.

-D.L.Edmunds,Ed.D.
www.humanepsychiatry.info

Speaking Engagements and Consultation to School Districts- Special Education Departments

Dr.D.L Edmunds has received numerous requests for media interviews and speaking engagements. Dr. Edmunds has presented at professional conferences, school districts, parent organizations, and other organizations addressing mental health reform, existential approaches, relational approaches, spirituality, self transformation, ethics in practice, diversity, comparative religion, child development and other topics. Fees for speaking engagements within Pennsylvania and New York is $650. The fee for events in other locations within the US is $1000. Please see the website of ICHP for more information and to arrange a speaking engagement.
www.humanepsychiatry.info

In addition, Dr.Edmunds has provided consult to school districts in regards to behavioral assessments, individualized education plans, autism and developmental differences, drug free relational approaches for distressed children. To arrange a consultation, please contact via e-mail at:
DoctorEdmunds@DrDanEdmunds.com

HOW DID I COME TO CHALLENGE THE PSYCHIATRIC ESTABLISHMENT?

When I first began academic training as a counselor, I was not exposed to any critical works at all. Part of the training was to accept that mental illness was cased by biological processes, basically chemical imbalances, and that psychiatric drugs were the main avenue of treatment combined with psychotherapy which was seen to be of lesser importance. I did not initially challenge any of this. I like most of my colleagues fell into this pattern of thought. However, it was my experiences visting children's psychiatric facilities, seeing situations of children being abused by staff and staff seeking to cover it up, as well as seeing the devastating effects of some psychiatric drugs (such as a 9 year old with tardive dyskinesia), that many questions were raised in my mind and conscience. From this point, I became exposed to some critical works and began to do thorough research on psychiatric drug effects. Later, I began working with a number of children, some given serious psychiatric labels, and I soon realized that the system really was not listening to their experience, it was not even treating them as human beings. As I began to listen and learn of the experience of many of my clients, I developed a sense of great compassion and vowed that I would take a stand from within the system. This has often been at great cost, but I know that it is my duty to stand up for the vulnerable and to promote social justice and humane treatment.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

PSYCHIATRISTS PRESCRIBE PILLS, DO NOT MAK USE OF PSYCHOTHERAPY

CHICAGO - Cartoons about the psychiatrist’s couch were recently the subject of a museum exhibition. Now, the couch itself may be headed for a museum.

A new study finds a significant decline in psychotherapy practiced by U.S. psychiatrists.

The expanded use of pills and insurance policies that favor short office visits are among the reasons, said lead author Dr. Ramin Mojtabai of Johns Hopkins Bloomberg School of Public Health in Baltimore.



“The ’couch,’ or, more generally, long-term psychoanalytic psychotherapy, was for so long a hallmark of the practice of psychiatry. It no longer is,” Mojtabai said.

Today’s psychiatrists get reimbursed by insurance companies at a lower rate for a 45-minute psychotherapy visit than for three 15-minute medication visits, he explained.

His study found that the percentage of patients’ visits to psychiatrists for psychotherapy, or talk therapy, fell from 44 percent in 1996-97 to 29 percent in 2004-05. The percentage of psychiatrists using psychotherapy with all their patients also dropped, from about 19 percent to 11 percent.

Psychiatrists who provided talk therapy to everyone had more patients who paid out of pocket compared to those doctors who provided talk therapy less often. And they prescribed fewer pills.

'Aura of invincibility' around meds
As talk therapy declined, TV ads contributed to an “aura of invincibility” around drugs for depression and anxiety, said Charles Barber, a lecturer in psychiatry at Yale University and author of “Comfortably Numb: How Psychiatry is Medicating a Nation.”

“By contrast, there’s almost no marketing for psychotherapy, which has comparable if not better outcomes,” said Barber, who was not involved in the study.

The findings, published in Monday’s Archives of General Psychiatry, are based on an annual survey of office visits to U.S. doctors. Of more than 246,000 visits sampled during the 10 years, more than 14,000 were to psychiatrists. The researchers analyzed those psychiatrist visits.

Autism and Developmental Differences

Dr.D.L.Edmunds has developed one of few drug free relational programs for autistic and developmentally different children. Dr.Edmunds provides consultation to children, families, and school districts in Northeastern Pennsylvania and is available for phone consultation to those residing in other areas. Dr. Edmunds has worked with over 80 children with developmental challenges, developed a support group, was involved with a therapeutic equestrian program, and has delivered numerous lectures and seminars. His approach encourages autonomy, development of increased independent skills, the forging of emotional connections, and self advocacy. The program is not coercive and respects the dignity of the child. For more information, please see:
www.humanepsychiatry.info

WE ARE WHAT WE THINK

Problems in life are inevitable, we cannot escape them, we do have no choice in this. What we do have a choice in is how we wish to address these problems. We have the choice to decide to allow these problems to make us anger, bitter, depressed, anxious, etc. Our other choice is to become patient, to transform our minds towards total acceptance. When problems befall us we can also think of the causes that we may have created or misguided deeds or actions that may have led to our present experience. We must realize that birth, death, aging, and sickness are events we cannot escape. So many people indulge in various distractions and temporary pleasures to not have to think of these events. However, all pleasures lead to suffering. For instance, we may have one drink that is pleasant and relaxing, but multiple can cause us to become ill or hungover. We must begin to examine our minds. Even if we are not raging, we must examine the angry minds we possess. Simply being impatient is an angry mind, it is a mind based on not being able to come to acceptance, of seeking to change that which cannot be changed. One of my clients, age 14, commented that he felt he has always had 'anger problems' and that he feels that he has always 'had problems in my life." I discussed with him the root of his anger, patience, and the concept of total acceptance. I told him that he can change his mind to not look upon himself as the 'kid with problems' but realize that we all undergo problems, it is the human condition, and that he can transform his mind to accept this fact and develop patience and total acceptance.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

TROUBLED TEENS AND ISSUES OF MEANING

In many of the instances of troubled teens I have encountered in my work, I have noticed that a common theme is that they are lacking meaning and purpose. This does not imply that they must have a particular religiosity. What I am referring to is that they have become lost along the way, somewhat apathetic, and their zeal for life has been squashed. Many of these kids are solely of the attitude that 'whatever happens, happens." Because current psychiatric practice is focused on the medicalization of experience, it may be missing a key component to the resiliency and recovery of these troubled teens. Many of them I have worked with have been involved in numerous psychiatric programs, they go through the motions, or they become distrustful, questioning genuineness and sincerity in the system, and still on a quest for something more. The defiant interactions of these children are only fueled more by these problems inherent in current psychiatric practice. When persons feel they are unheard and become desparate, they often adopt a defiant stance. If we sought to create places of sanctuary, places of understanding, places where experience is heard, we may be on a better track to meeting the needs of troubled teens. I have been confused many times how that drug addicted teens are weaned off of street drugs only to be psychiatrically hospitalized and given prescribed drugs. I wonder what message we are sending.

-Dan L. Edmunds, Ed.D.
www.humanepsychiatry.info

TIMELINE

Dr.D.L.Edmunds is the leader of the worldwide movement for a more humane mental health system. An existential therapist working mainly with children and teens, he has developed approaches focused on restoring relationships, developing meaning, and resolving conflicts. His focus has also been in regards to consciousness, extreme states of mind, developmental differences, and exploring the human condition. He has been a strong advocate for social justice issues.
1991- Edmunds serves as a legislative aide to State Senator Robert W. Schaffer. He later serves as the youngest registered professional lobbyist and involves himself in various political campaigns. He becomes a member of Students for Peace and Justice.He serves as a volunteer for the Larimer County Veterans Affairs Office.
1992- gains approval for the creation of a Youth Commission in Ormond Beach,FL. He serves as a campaign coordinator for a congressional campaign. Meets Martin Luther King III.
1993- volunteers with Peninsula Medical Center and as part of the REACH program for developmentally challenged children at St.Brenden's Catholic Church in Ormond Beach.
1994- organizes a student ministry at the University of Florida.
1995- completes coursework in Chinese Buddhism with Dr. Chih wa Chan as well as Comparative Religion and Christian Mysticism with Drs. Dennis Owen and Gene Thursby.
1996- is ordained as a deacon in the Eastern Orthodox Church.
1997- earns a BA in Comparative Religion, minor in Socilogy from the University of Florida. Receives ordination to the priesthood in Greek Old Calendar Orthodox Church.
1998- publishes journal article on the State of the Soul After Death in University of Scranton's Journal for Eastern Christian Studies.
1999- receives MA in Theology from the University of Scranton. Received into National Honor Society for Theological Studies.Begins doctoral program in Community Counseling at University of Sarasota.
2000- completes doctoral level coursework in Dispute Resolution via Nova Southeastern University. Spends a period attached to an Eastern Orthodox monastery.Begins practice as a therapist with a private agency.
2001- hosts local radio program addressing family issues and needs of children.
2002- begins autism support group and publishes articles on relational approaches.
2003- begins delivering lectures on autism and developmental differences as well as drug free relational approaches to ADHD.
2005- presents at ICSPP conference.serves as clinical coordinator for therapeutic equestrian program. Begins work as a psychological evaluator.
2006- delivers a number of speeches and presentations on human rights in the mental health system. Receives Doctorate of Education in Community Counseling from University of Sarasota. Publishes text- Children Our Treasure.
2007- appointed Dean of Faculty and Professor of Religion and Human Services for St. James Theological Seminary. Receives honorary Doctorate of Education.
2008- appointed as faculty and member of Advisory Board for European American University. Received as a clergyman in the Liberal Catholic Apostolic Church. Performs ordination to minor orders of a person with Down's Syndrome. Begins work on development of Lazarus House project.

www.humanepsychiatry.info

The Forces That Drive Us Mad and Being Human Again

There are powerful social forces which are heeped upon us. We cannot escape them. Children are told to behave 'appropriately'. Yet, what is appropriate? What does this mean? It is a social construct, and the most powerful of these social forces is the family. From the earliest point, a child is taught what are the 'appropriate' responses- when and what to laugh at, when to cry and when not to, and often how to feel.The family defines what is 'appropriate' but is it? One family may condone violence, another abhor it. The dynamics of the family shape us for life. What has been the experience of the parents may be forced upon the child to be their experience. Hence why adolescence is often a turbulent time as the teen seeks to become autonomous and create an experience apart from their parents experience or what they have been told to experience. But what of those who are stifled to the point where they can experience nothing but what the other has told them to experience? Here lies some of the root of what we may term 'insanity'. Being that each seeks a level of autonomy, each seeks to have their own experience, when this does not arise, then the person must cast off the shackles of these familial and social forces, often to the extreme of departing from all accepted notions of reality or what is termed by the mainstream as 'acceptable'. Once again, what is 'acceptable'? The message can be contradictory. We may be taught through our familial faith to not harm another, yet we are exposed to the forces of violent society, the prevalent self centeredness and greed, and we may then ask, what is 'acceptable'? Is the 'acceptable' necessarily what we have been taught? Is it necessaerily what we have learned? What is it that we have learned? Is it possible that we may have to unlearn? Behavior results from our experience. If a behavior is deemed by some as maladaptive, it can only be seen in light of experience. But can we really know the experience of another? Will we only choose to judge the experience of another by our own experience? Will we invalidate the other because they do not share our perception of experience? Will we force them to have 'our experience' and thus behave as we do? Are we right? Are we wrong? Who is to say? Could there be commonality in our experiences that we can recognize? Can we journey with each other? To find what is 'acceptable' is to find our humanity, to find our inner being, to find those links of experience which remain in spite of the social forces that cause us to sway this way and that, and for some tear at their core being and identity. When we are free, we can experience the other, when we are free, we can be ourselves. If we are free, we can reshape these social forces, and they will not be storms, but unifying forces helping us to recapture our sense of what it means to be human and to truly love again. How do we be free? Must be become 'mad' to be free? But are the 'mad' really free or have they been driven to this barren place? We can only be free once we have come to a state of unlearning, of unknowing, a rebirth where we are not bound by blame and shame and the darkness of past traumas or of ideas we have learned and carried forward because it is all we knew.