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Critic from Leading Medical Group","publishDate":1537225863,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>One of the medical world’s most respected expert bodies is in turmoil as its annual meeting gets underway in Edinburgh, Scotland, after its governing board voted to expel a member.[contextly_sidebar id=\"Kn64ul6ElC5kMYHks5hc2dO2RuxcXwvM\"]\u003c/p>\n\u003cp>The Cochrane Collaboration, which reviews the scientific literature in areas of clinical research and produces widely cited analyses that help guide clinical practice, kicked out a member who has been an outspoken critic of certain vaccines and has blasted the profession of psychiatry for pushing unsafe drugs on unsuspecting patients.\u003c/p>\n\u003cp>The expulsion of Peter Gøtzsche sparked accusations that the Collaboration is too friendly toward the drug industry. Four other members of the organization’s governing board resigned in response, citing concerns that the action “goes against Cochrane ethos.”\u003c/p>\n\u003cp class=\"\">The vote appears to have been 6 of 13 in favor of the move, according to statements from the board members who resigned and Gøtzsche — short of a majority but enough to pass because only 11 voted.\u003c/p>\n\u003cp class=\"\">“This unprecedented action taken by a minority of the Governing Board is disproportionate and damaging to Cochrane, as well as to public health interests,” Gøtzsche said in a \u003ca href=\"https://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/moral_crisis_in_cochrane.pdf\" target=\"_blank\" rel=\"noopener\">letter he circulated on Friday\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Collaboration \u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">posted a statement\u003c/a> on its website Saturday, saying, “Cochrane’s Governing Board considered, as planned, the findings of an independent review and additional complaints related to the conduct of a Member.” The complaints were not specified, but the statement said the board’s co-chairs will provide more details “once this process is complete.”[contextly_sidebar id=\"ynjsrFwcYBXkogb3iv2lea34bcxV6tJK\"]\u003c/p>\n\u003cp>In a longer \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">response posted Monday\u003c/a>, Cochrane’s governing board said that it finds itself in “an extraordinary situation” and that the four board members who resigned “actively disseminated an incomplete and misleading account of events.”\u003c/p>\n\u003cp>The decision, the board said, “is not about freedom of speech. It is not about scientific debate. It is not about tolerance of dissent. It is not about someone being unable to criticize a Cochrane Review.”\u003c/p>\n\u003cp>Instead, the board said, “It is about a long-term pattern of behaviour that we say is totally, and utterly, at variance with the principles and governance of the Cochrane Collaboration.” Although the board did not describe the behavior, the pattern, it claimed, dated back to complaints since 2003, and included three new complaints in March of this year. “All our staff, and our members, have the right to do their work without harassment and personal attacks,” the statement said.\u003c/p>\n\u003cp>Gøtzsche, the director of the \u003ca href=\"https://nordic.cochrane.org/\" target=\"_blank\" rel=\"noopener\">Nordic Cochrane Center\u003c/a>, in Copenhagen, Denmark, has cast doubts about the safety of a vaccine against human papillomavirus (HPV), a cause of cervical cancer, and \u003ca href=\"https://www.youtube.com/watch?v=DiJcSoo3C4Q\" target=\"_blank\" rel=\"noopener\">says\u003c/a> psychiatry has “gone astray” by coercing patients into taking medication, such as antidepressants, they don’t want to use and that cause “brain damage” over the long run. “The way these drugs are used today cause[s] more harm than good. So it would be better for us if the drugs didn’t exist.”\u003c/p>\n\u003cp>Gøtzsche, Cochrane member Tom Jefferson, and another colleague ruffled feathers at Cochrane with a \u003ca href=\"https://ebm.bmj.com/content/early/2018/07/27/bmjebm-2018-111012\" target=\"_blank\" rel=\"noopener\">July 2018 article\u003c/a> that criticized a recent paper from the Collaboration on the safety of the HPV vaccine. The paper prompted a \u003ca href=\"https://www.cochrane.org/news/cochranes-editor-chief-responds-bmj-ebm-article-criticizing-hpv-review\" target=\"_blank\" rel=\"noopener\">rebuttal\u003c/a> from Cochrane that dismissed the concerns and stood behind the original findings.\u003c/p>\n\u003cp>Hilda Bastian, a founding member of the Cochrane Collaboration and an influential writer about science, \u003ca href=\"https://hildabastian.net/index.php/67-the-hpv-vaccine\" target=\"_blank\" rel=\"noopener\">called the review\u003c/a> “a manufactured controversy — a hatchet job by people with such strong intellectual and ideological biases, that they didn’t even pick up that some of their most implausible allegations were based on their own analytical and investigative slip-ups.”[contextly_sidebar id=\"lCLNW34bypWghzUhqKu6Xt2EeSW06udI\"]\u003c/p>\n\u003cp>Complaints about the review that Gotzsche co-authored came late in the process, according to the \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">board’s Monday statement\u003c/a>, and were not the initial trigger of the investigation.\u003c/p>\n\u003cp>As of now, the board said, Gotzsche remains a member of the organization. He was given seven days to respond to the board’s vote. He did not immediately respond to a request for comment from STAT and Retraction Watch.\u003c/p>\n\u003cp>Gøtzsche, who was \u003ca href=\"https://nordic.cochrane.org/news/prof-peter-c-g%C3%B8tzsche-becomes-member-cochrane-governing-board\" target=\"_blank\" rel=\"noopener\">elected to the group’s board of governors in 2017\u003c/a>, blamed the vote on his stance on the drug industry. “As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry. Because of this Cochrane has faced pressure, criticism and complaints. My expulsion is one of the results of these campaigns.”\u003c/p>\n\u003cp>Jefferson, speaking from a reception at the Edinburgh meeting, told Retraction Watch and STAT that people he’s spoken to are outraged. “I’ve been in Cochrane 25 years, this is not how we do things,” he said. “Peter Gotzsche was a democratically elected member of the board. It’s really unheard of.”\u003c/p>\n\u003cp>At least one prominent scientist expressed alarm that the move to jettison Gøtzsche was an assault on free speech. \u003ca href=\"https://profiles.stanford.edu/john-ioannidis\" target=\"_blank\" rel=\"noopener\">John Ioannidis\u003c/a>, of Stanford University, said he is “disturbed” by Gøtzsche’s expulsion and stressed the importance of heterodox views in science.\u003c/p>\n\u003cp>“I adore Peter for his courage and I highly value his major contributions to evidence-based medicine … even if I don’t agree with all of Peter’s views and inferences,” Ioannidis wrote Sunday in an email to a group of more than 100 experts in evidence-based medicine. “I think it is important to make sure that people who disagree with us will get the most opportunity to express and support their views with arguments and evidence and, of course, not get expelled.”[contextly_sidebar id=\"odd8SE7t4b9S7rToLgrBZZS25O72EdXO\"]\u003c/p>\n\u003cp>But at least one other expert defended Cochrane. Allen Frances, chair of the Department of Psychiatry at Duke University, in Durham, N.C., dismissed the notion that Gøtzsche was being unfairly muzzled.\u003c/p>\n\u003cp>“This has nothing to do with freedom of speech,” Frances wrote in the thread that included Ioannidis. Rather, he said, Cochrane is justifiably concerned about remaining an “impartial evaluator of evidence” and providing reliable information to doctors and their patients.\u003c/p>\n\u003cp>“At least in psychiatry, Peter is anything but impartial,” Frances wrote. “He consistently expresses the most extreme views in the most dramatic and misleading way. His role at Cochrane lends its legitimacy to opinions that are dangerous to patients with severe mental illness. As an individual, Peter has total freedom to express extreme opinions, but he has no inherent right to cloak them with Cochrane’s hard won mantle of neutrality.”\u003c/p>\n\u003cp>The four board members who resigned in the wake of the vote said in a statement Saturday that “the expulsion of inconvenient members from the Collaboration goes against Cochrane ethos and neither reflects its founding spirit nor promotes the Collaboration’s best interests. We are concerned that these actions might cause great damage to the reputation of the Collaboration.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">In its own statement\u003c/a>, the governing board said that two other members had resigned because the “situation required further changes in the composition of the Board in order to comply with \u003ca href=\"https://www.cochrane.org/sites/default/files/public/uploads/cochrane_-_articles_of_association_-_final_and_approved_-_october_2016.pdf\" target=\"_blank\" rel=\"noopener\">Cochrane’s Articles of Association\u003c/a>.” Neither of the board’s co-chairs immediately responded to requests for comment.\u003c/p>\n\u003cp>“There appears to be no confidence in the management board at this point,” Jefferson said. “I think the only honorable thing for the rest of the board to do is resign.”\u003c/p>\n\u003cp>\u003cem>This story has been updated with a statement from Cochrane’s governing board. The story is a collaboration between STAT and \u003c/em>\u003ca href=\"https://retractionwatch.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Retraction Watch\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/09/16/expulsion-cochrane-peter-gotzsche-medicine/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n","blocks":[],"excerpt":"One of the medical world’s most respected body of experts is in turmoil after its governing board voted to expel an outspoken critic of certain vaccines and the psychiatry profession for pushing unsafe drugs. The move has sparked accusations that the group is too friendly with drugmakers.","status":"publish","parent":0,"modified":1537556487,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":1355},"headData":{"title":"Turmoil Erupts Over Expulsion of Vaccine Critic from Leading Medical Group | KQED","description":"One of the medical world’s most respected body of experts is in turmoil after its governing board voted to expel an outspoken critic of certain vaccines and the psychiatry profession for pushing unsafe drugs. The move has sparked accusations that the group is too friendly with drugmakers.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Turmoil Erupts Over Expulsion of Vaccine Critic from Leading Medical Group","datePublished":"2018-09-17T23:11:03.000Z","dateModified":"2018-09-21T19:01:27.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444488 https://ww2.kqed.org/futureofyou/?p=444488","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/09/17/turmoil-erupts-over-expulsion-of-vaccine-critic-from-leading-medical-group/","disqusTitle":"Turmoil Erupts Over Expulsion of Vaccine Critic from Leading Medical Group","source":"Health","nprByline":"Adam Marcus\u003cbr />Ivan Oransky\u003cbr />STAT","path":"/futureofyou/444488/turmoil-erupts-over-expulsion-of-vaccine-critic-from-leading-medical-group","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>One of the medical world’s most respected expert bodies is in turmoil as its annual meeting gets underway in Edinburgh, Scotland, after its governing board voted to expel a member.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Cochrane Collaboration, which reviews the scientific literature in areas of clinical research and produces widely cited analyses that help guide clinical practice, kicked out a member who has been an outspoken critic of certain vaccines and has blasted the profession of psychiatry for pushing unsafe drugs on unsuspecting patients.\u003c/p>\n\u003cp>The expulsion of Peter Gøtzsche sparked accusations that the Collaboration is too friendly toward the drug industry. Four other members of the organization’s governing board resigned in response, citing concerns that the action “goes against Cochrane ethos.”\u003c/p>\n\u003cp class=\"\">The vote appears to have been 6 of 13 in favor of the move, according to statements from the board members who resigned and Gøtzsche — short of a majority but enough to pass because only 11 voted.\u003c/p>\n\u003cp class=\"\">“This unprecedented action taken by a minority of the Governing Board is disproportionate and damaging to Cochrane, as well as to public health interests,” Gøtzsche said in a \u003ca href=\"https://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/moral_crisis_in_cochrane.pdf\" target=\"_blank\" rel=\"noopener\">letter he circulated on Friday\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Collaboration \u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">posted a statement\u003c/a> on its website Saturday, saying, “Cochrane’s Governing Board considered, as planned, the findings of an independent review and additional complaints related to the conduct of a Member.” The complaints were not specified, but the statement said the board’s co-chairs will provide more details “once this process is complete.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In a longer \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">response posted Monday\u003c/a>, Cochrane’s governing board said that it finds itself in “an extraordinary situation” and that the four board members who resigned “actively disseminated an incomplete and misleading account of events.”\u003c/p>\n\u003cp>The decision, the board said, “is not about freedom of speech. It is not about scientific debate. It is not about tolerance of dissent. It is not about someone being unable to criticize a Cochrane Review.”\u003c/p>\n\u003cp>Instead, the board said, “It is about a long-term pattern of behaviour that we say is totally, and utterly, at variance with the principles and governance of the Cochrane Collaboration.” Although the board did not describe the behavior, the pattern, it claimed, dated back to complaints since 2003, and included three new complaints in March of this year. “All our staff, and our members, have the right to do their work without harassment and personal attacks,” the statement said.\u003c/p>\n\u003cp>Gøtzsche, the director of the \u003ca href=\"https://nordic.cochrane.org/\" target=\"_blank\" rel=\"noopener\">Nordic Cochrane Center\u003c/a>, in Copenhagen, Denmark, has cast doubts about the safety of a vaccine against human papillomavirus (HPV), a cause of cervical cancer, and \u003ca href=\"https://www.youtube.com/watch?v=DiJcSoo3C4Q\" target=\"_blank\" rel=\"noopener\">says\u003c/a> psychiatry has “gone astray” by coercing patients into taking medication, such as antidepressants, they don’t want to use and that cause “brain damage” over the long run. “The way these drugs are used today cause[s] more harm than good. So it would be better for us if the drugs didn’t exist.”\u003c/p>\n\u003cp>Gøtzsche, Cochrane member Tom Jefferson, and another colleague ruffled feathers at Cochrane with a \u003ca href=\"https://ebm.bmj.com/content/early/2018/07/27/bmjebm-2018-111012\" target=\"_blank\" rel=\"noopener\">July 2018 article\u003c/a> that criticized a recent paper from the Collaboration on the safety of the HPV vaccine. The paper prompted a \u003ca href=\"https://www.cochrane.org/news/cochranes-editor-chief-responds-bmj-ebm-article-criticizing-hpv-review\" target=\"_blank\" rel=\"noopener\">rebuttal\u003c/a> from Cochrane that dismissed the concerns and stood behind the original findings.\u003c/p>\n\u003cp>Hilda Bastian, a founding member of the Cochrane Collaboration and an influential writer about science, \u003ca href=\"https://hildabastian.net/index.php/67-the-hpv-vaccine\" target=\"_blank\" rel=\"noopener\">called the review\u003c/a> “a manufactured controversy — a hatchet job by people with such strong intellectual and ideological biases, that they didn’t even pick up that some of their most implausible allegations were based on their own analytical and investigative slip-ups.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Complaints about the review that Gotzsche co-authored came late in the process, according to the \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">board’s Monday statement\u003c/a>, and were not the initial trigger of the investigation.\u003c/p>\n\u003cp>As of now, the board said, Gotzsche remains a member of the organization. He was given seven days to respond to the board’s vote. He did not immediately respond to a request for comment from STAT and Retraction Watch.\u003c/p>\n\u003cp>Gøtzsche, who was \u003ca href=\"https://nordic.cochrane.org/news/prof-peter-c-g%C3%B8tzsche-becomes-member-cochrane-governing-board\" target=\"_blank\" rel=\"noopener\">elected to the group’s board of governors in 2017\u003c/a>, blamed the vote on his stance on the drug industry. “As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry. Because of this Cochrane has faced pressure, criticism and complaints. My expulsion is one of the results of these campaigns.”\u003c/p>\n\u003cp>Jefferson, speaking from a reception at the Edinburgh meeting, told Retraction Watch and STAT that people he’s spoken to are outraged. “I’ve been in Cochrane 25 years, this is not how we do things,” he said. “Peter Gotzsche was a democratically elected member of the board. It’s really unheard of.”\u003c/p>\n\u003cp>At least one prominent scientist expressed alarm that the move to jettison Gøtzsche was an assault on free speech. \u003ca href=\"https://profiles.stanford.edu/john-ioannidis\" target=\"_blank\" rel=\"noopener\">John Ioannidis\u003c/a>, of Stanford University, said he is “disturbed” by Gøtzsche’s expulsion and stressed the importance of heterodox views in science.\u003c/p>\n\u003cp>“I adore Peter for his courage and I highly value his major contributions to evidence-based medicine … even if I don’t agree with all of Peter’s views and inferences,” Ioannidis wrote Sunday in an email to a group of more than 100 experts in evidence-based medicine. “I think it is important to make sure that people who disagree with us will get the most opportunity to express and support their views with arguments and evidence and, of course, not get expelled.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But at least one other expert defended Cochrane. Allen Frances, chair of the Department of Psychiatry at Duke University, in Durham, N.C., dismissed the notion that Gøtzsche was being unfairly muzzled.\u003c/p>\n\u003cp>“This has nothing to do with freedom of speech,” Frances wrote in the thread that included Ioannidis. Rather, he said, Cochrane is justifiably concerned about remaining an “impartial evaluator of evidence” and providing reliable information to doctors and their patients.\u003c/p>\n\u003cp>“At least in psychiatry, Peter is anything but impartial,” Frances wrote. “He consistently expresses the most extreme views in the most dramatic and misleading way. His role at Cochrane lends its legitimacy to opinions that are dangerous to patients with severe mental illness. As an individual, Peter has total freedom to express extreme opinions, but he has no inherent right to cloak them with Cochrane’s hard won mantle of neutrality.”\u003c/p>\n\u003cp>The four board members who resigned in the wake of the vote said in a statement Saturday that “the expulsion of inconvenient members from the Collaboration goes against Cochrane ethos and neither reflects its founding spirit nor promotes the Collaboration’s best interests. We are concerned that these actions might cause great damage to the reputation of the Collaboration.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">In its own statement\u003c/a>, the governing board said that two other members had resigned because the “situation required further changes in the composition of the Board in order to comply with \u003ca href=\"https://www.cochrane.org/sites/default/files/public/uploads/cochrane_-_articles_of_association_-_final_and_approved_-_october_2016.pdf\" target=\"_blank\" rel=\"noopener\">Cochrane’s Articles of Association\u003c/a>.” Neither of the board’s co-chairs immediately responded to requests for comment.\u003c/p>\n\u003cp>“There appears to be no confidence in the management board at this point,” Jefferson said. “I think the only honorable thing for the rest of the board to do is resign.”\u003c/p>\n\u003cp>\u003cem>This story has been updated with a statement from Cochrane’s governing board. The story is a collaboration between STAT and \u003c/em>\u003ca href=\"https://retractionwatch.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Retraction Watch\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/09/16/expulsion-cochrane-peter-gotzsche-medicine/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444488/turmoil-erupts-over-expulsion-of-vaccine-critic-from-leading-medical-group","authors":["byline_futureofyou_444488"],"categories":["futureofyou_1062"],"tags":["futureofyou_61","futureofyou_1597","futureofyou_1430","futureofyou_1527"],"collections":["futureofyou_1097"],"featImg":"futureofyou_444491","label":"source_futureofyou_444488"},"futureofyou_441292":{"type":"posts","id":"futureofyou_441292","meta":{"index":"posts_1591205157","site":"futureofyou","id":"441292","score":null,"sort":[1525478437000]},"guestAuthors":[],"slug":"big-jump-in-number-of-inmates-prescribed-psychiatric-drugs-in-california","title":"Big Jump In Number Of California Inmates Prescribed Psychiatric Drugs","publishDate":1525478437,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>When 47-year-old Edward Vega arrived in jail, he couldn't quiet the voices in his head. He felt paranoid, as though he was losing control. \"I knew if I didn't get my medication, I was going to hurt someone,\" says Vega.[contextly_sidebar id=\"YDcmJjX7F7HH44z0nu01J3iPX3pogbrO\"]\u003c/p>\n\u003cp>He was right. A week after being arrested for alleged drug possession, Vega says, he assaulted a fellow inmate and ended up in isolation, which only made him feel worse.\u003c/p>\n\u003cp>Finally, a doctor prescribed drugs that Vega says helped. He had been taking them on the outside until he ran out — just before he was arrested.\u003c/p>\n\u003cp>\"The medication hasn't totally taken away the voices, but I am able to differentiate reality from fiction,\" says Vega, who was released three months ago.\u003c/p>\n\u003cp>The number of inmates in California who've been prescribed psychiatric drugs has jumped about 25 percent in five years, according to a recent \u003ca href=\"http://calhps.com/reports/PolicyBrief_PsychotropicMedications_CalHPS.pdf\">analysis\u003c/a> of state data. These inmates now account for about a fifth of the county jail population across the state.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The increase might be a reflection of the growing number of inmates with mental illness, though it also might stem from better identification of people in need of treatment, say researchers from \u003ca href=\"http://calhps.com/reports/PolicyBrief_PsychotropicMedications_CalHPS.pdf\">California Health Policy Strategies\u003c/a>, a Sacramento-based consulting firm.\u003c/p>\n\u003cp>Amid a \u003ca href=\"https://www.pbs.org/newshour/nation/amid-shortage-psychiatric-beds-mentally-ill-face-long-waits-treatment\">severe shortage of psychiatric beds\u003c/a> and community-based treatment throughout the state and nation, jails have become repositories for people in the throes of acute mental health crises.[contextly_sidebar id=\"D5Bt82ZgsZndCE9fShaMqKXcPTJBdRrC\"]\u003c/p>\n\u003cp>The number of people with mental illness in jails and prisons in the U.S. is \"astronomical,\" says \u003ca href=\"https://law.stanford.edu/directory/michael-romano/\">Michael Romano\u003c/a>, director of Three Strikes & Justice Advocacy Project at Stanford Law School, who was not involved in the research. \"In many ways, the whole justice system is overwhelmed with mental illness.\"\u003c/p>\n\u003cp>Contributing to the problem in California is a 2011 federal court order, and a state decision a few years later, that had unintended consequences.\u003c/p>\n\u003cp>In 2011, the U.S. Supreme Court ordered California to \u003ca href=\"https://www.npr.org/2011/05/23/136579580/california-is-ordered-to-cut-its-prison-population\">reduce\u003c/a> the prison population because of overcrowding that the judges said constituted cruel and unusual punishment. Three years later, \u003ca href=\"https://www.cdcr.ca.gov/News/prop47.html\">a state proposition\u003c/a> reclassified some felony crimes as misdemeanors. Taken together, that led to a huge influx of offenders going to county jails instead of state prisons.\u003c/p>\n\u003cp>The CHPS analysis, based on survey data from 45 of California's 58 counties, opens a window into how the largest state is coping with the influx.\u003c/p>\n\u003cp>\"We think this is the first part of a more systematic discussion about what is going on in the jails and in the broader community with respect to mental health,\" says \u003ca href=\"http://calhps.com/team_member/david-panush/\">David Panush\u003c/a>, a co-author of the report, which was funded in part by the California Health Care Foundation.\u003c/p>\n\u003cp>Far more people with mental illness are housed in jails and prisons than in psychiatric hospitals. Insufficient staff training and poor patient treatment have contributed to inmate suicides, self-mutilation, violence and other problems, say advocates for the mentally ill.[contextly_sidebar id=\"pepgQkVipmt7yN3DpLndFi1ek2hPWxA5\"]\u003c/p>\n\u003cp>One oft-cited complaint is that inmates have poor access to psychiatric prescriptions to treat such conditions as schizophrenia, major depression and bipolar disorder.\u003c/p>\n\u003cp>Jail officials in California say they are trying to better identify incarcerated people who could benefit from such drugs. The numbers suggest the strategy may be working. According to the CHPS report, an average of 13,776 inmates in the 45 California counties were on psychotropic medications in 2016-2017, up from 10,999 five years ago.\u003c/p>\n\u003cp>But the portion of inmates taking psychotropic medicine varies widely by county — from 8 percent in Glenn County to 32 percent in Sonoma and Napa, according to the analysis. The report is based on data from the \u003ca href=\"http://www.bscc.ca.gov/m_bsccboard.php\">Board of State and Community Corrections\u003c/a>, an independent state agency.\u003c/p>\n\u003cp>In Los Angeles County, whose jails have been described as the largest mental institution in the country, about 30 percent of the roughly 18,000 inmates are mentally ill and most of those diagnosed are on medication, says Dr. Joseph Ortego, chief psychiatrist for correctional health services in L.A. County.\u003c/p>\n\u003cp>Although some still are missed in the screening process, he says, the county jails have improved identification and treatment of inmates and expanded staffing as part of the department's 2015 settlement with the U.S. Department of Justice. The department had alleged inadequate mental health care and suicide prevention in the jails.\u003c/p>\n\u003cp>Overall, medications are likely under-prescribed in jails, psychiatrists say.\u003c/p>\n\u003cp>\"You need enough mental health professionals to treat the very large numbers of mentally ill people in jails,\" says \u003ca href=\"https://www.researchgate.net/profile/Harry_Lamb\">Dr. H. Richard Lamb\u003c/a>, professor emeritus of psychiatry at the University of Southern California School of Medicine. \"There probably aren't enough.\"\u003c/p>\n\u003cp>And the medications these doctors prescribe are a crucial aspect of treatment, Lamb says.\u003c/p>\n\u003cp>Some advocates for the mentally ill worry that the drugs are at times prescribed inappropriately. \u003ca href=\"http://www.mhac.org/about-us/staff/\">Zima Creason\u003c/a>, president and chief executive officer of Mental Health America of California, says psychoactive medicines, though sometimes necessary, are no substitute for comprehensive care for jail inmates.\u003c/p>\n\u003cp>\"Sadly, they just throw a bunch of pills at them because there is nothing else,\" she says, adding that jails should also be providing individual and group therapy, more time outside of cells and sufficient recreation time.[contextly_sidebar id=\"wc4q4QN6RflEHjnrUL9pMkzABwKTOUXL\"]\u003c/p>\n\u003cp>\"Jail is not conducive for real recovery,\" Creason says. \"We are never going to put a dent in the numbers unless we provide a therapeutic environment.\"\u003c/p>\n\u003cp>Like people who live outside the correction facilities, inmates can be subject to involuntary drug treatment, officials say, but only if a court deems that step appropriate.\u003c/p>\n\u003cp>County jail officials, including Dr. Alfred Joshua, chief medical officer for the Sheriff's Department in San Diego County, say the influx of mentally ill inmates and the rising need for psychotropic drugs stems from a lack of resources for patients in the community.\u003c/p>\n\u003cp>\"When they have [an] exacerbation of mental illness, they do many times come into contact with law enforcement,\" Joshua says.\u003c/p>\n\u003cp>Some of the most common charges that bring people with mental illness to jail are drug offenses and parole violations. Those who are homeless frequently get charged with panhandling, public urination and related crimes.\u003c/p>\n\u003cp>In addition to trying to improve treatment inside the jails, Los Angeles and San Diego county officials say they are working more closely with community organizations to ensure inmates with mental illness get the services they need after their release.\u003c/p>\n\u003cp>Vega says a local community group, the \u003ca href=\"http://www.neighborhoodhouse.org/#sthash.nTPgadqU.dpbs\">Neighborhood House Association\u003c/a>, was able to help in his case, ensuring he got his meds and other treatment.\u003c/p>\n\u003cp>\"Without the medication,\" Vega says, \"I would probably be right back in jail.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>\u003cem> is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente. You can follow Anna Gorman on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/annagorman\">@annagorman\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Big+Jump+In+Number+Of+Inmates+Prescribed+Psychiatric+Drugs+In+California&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Amid a severe shortage of psychiatric beds and community-based treatment throughout the state and nation, county jails have become repositories for people in the throes of acute mental health crises.","status":"publish","parent":0,"modified":1525460659,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":34,"wordCount":1162},"headData":{"title":"Big Jump In Number Of California Inmates Prescribed Psychiatric Drugs | KQED","description":"Amid a severe shortage of psychiatric beds and community-based treatment throughout the state and nation, county jails have become repositories for people in the throes of acute mental health crises.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Big Jump In Number Of California Inmates Prescribed Psychiatric Drugs","datePublished":"2018-05-05T00:00:37.000Z","dateModified":"2018-05-04T19:04:19.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441292 https://ww2.kqed.org/futureofyou/?p=441292","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/04/big-jump-in-number-of-inmates-prescribed-psychiatric-drugs-in-california/","disqusTitle":"Big Jump In Number Of California Inmates Prescribed Psychiatric Drugs","source":"Health","nprImageCredit":"erwin rachbauer","nprByline":"Anna Gorman, NPR","nprImageAgency":"imageBROKER RM/Getty Images","nprStoryId":"608271211","nprApiLink":"http://api.npr.org/query?id=608271211&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/05/04/608271211/big-jump-in-number-of-inmates-prescribed-psychiatric-drugs-in-california?ft=nprml&f=608271211","nprRetrievedStory":"1","nprPubDate":"Fri, 04 May 2018 14:43:00 -0400","nprStoryDate":"Fri, 04 May 2018 05:00:24 -0400","nprLastModifiedDate":"Fri, 04 May 2018 14:43:49 -0400","path":"/futureofyou/441292/big-jump-in-number-of-inmates-prescribed-psychiatric-drugs-in-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When 47-year-old Edward Vega arrived in jail, he couldn't quiet the voices in his head. He felt paranoid, as though he was losing control. \"I knew if I didn't get my medication, I was going to hurt someone,\" says Vega.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He was right. A week after being arrested for alleged drug possession, Vega says, he assaulted a fellow inmate and ended up in isolation, which only made him feel worse.\u003c/p>\n\u003cp>Finally, a doctor prescribed drugs that Vega says helped. He had been taking them on the outside until he ran out — just before he was arrested.\u003c/p>\n\u003cp>\"The medication hasn't totally taken away the voices, but I am able to differentiate reality from fiction,\" says Vega, who was released three months ago.\u003c/p>\n\u003cp>The number of inmates in California who've been prescribed psychiatric drugs has jumped about 25 percent in five years, according to a recent \u003ca href=\"http://calhps.com/reports/PolicyBrief_PsychotropicMedications_CalHPS.pdf\">analysis\u003c/a> of state data. These inmates now account for about a fifth of the county jail population across the state.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The increase might be a reflection of the growing number of inmates with mental illness, though it also might stem from better identification of people in need of treatment, say researchers from \u003ca href=\"http://calhps.com/reports/PolicyBrief_PsychotropicMedications_CalHPS.pdf\">California Health Policy Strategies\u003c/a>, a Sacramento-based consulting firm.\u003c/p>\n\u003cp>Amid a \u003ca href=\"https://www.pbs.org/newshour/nation/amid-shortage-psychiatric-beds-mentally-ill-face-long-waits-treatment\">severe shortage of psychiatric beds\u003c/a> and community-based treatment throughout the state and nation, jails have become repositories for people in the throes of acute mental health crises.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The number of people with mental illness in jails and prisons in the U.S. is \"astronomical,\" says \u003ca href=\"https://law.stanford.edu/directory/michael-romano/\">Michael Romano\u003c/a>, director of Three Strikes & Justice Advocacy Project at Stanford Law School, who was not involved in the research. \"In many ways, the whole justice system is overwhelmed with mental illness.\"\u003c/p>\n\u003cp>Contributing to the problem in California is a 2011 federal court order, and a state decision a few years later, that had unintended consequences.\u003c/p>\n\u003cp>In 2011, the U.S. Supreme Court ordered California to \u003ca href=\"https://www.npr.org/2011/05/23/136579580/california-is-ordered-to-cut-its-prison-population\">reduce\u003c/a> the prison population because of overcrowding that the judges said constituted cruel and unusual punishment. Three years later, \u003ca href=\"https://www.cdcr.ca.gov/News/prop47.html\">a state proposition\u003c/a> reclassified some felony crimes as misdemeanors. Taken together, that led to a huge influx of offenders going to county jails instead of state prisons.\u003c/p>\n\u003cp>The CHPS analysis, based on survey data from 45 of California's 58 counties, opens a window into how the largest state is coping with the influx.\u003c/p>\n\u003cp>\"We think this is the first part of a more systematic discussion about what is going on in the jails and in the broader community with respect to mental health,\" says \u003ca href=\"http://calhps.com/team_member/david-panush/\">David Panush\u003c/a>, a co-author of the report, which was funded in part by the California Health Care Foundation.\u003c/p>\n\u003cp>Far more people with mental illness are housed in jails and prisons than in psychiatric hospitals. Insufficient staff training and poor patient treatment have contributed to inmate suicides, self-mutilation, violence and other problems, say advocates for the mentally ill.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>One oft-cited complaint is that inmates have poor access to psychiatric prescriptions to treat such conditions as schizophrenia, major depression and bipolar disorder.\u003c/p>\n\u003cp>Jail officials in California say they are trying to better identify incarcerated people who could benefit from such drugs. The numbers suggest the strategy may be working. According to the CHPS report, an average of 13,776 inmates in the 45 California counties were on psychotropic medications in 2016-2017, up from 10,999 five years ago.\u003c/p>\n\u003cp>But the portion of inmates taking psychotropic medicine varies widely by county — from 8 percent in Glenn County to 32 percent in Sonoma and Napa, according to the analysis. The report is based on data from the \u003ca href=\"http://www.bscc.ca.gov/m_bsccboard.php\">Board of State and Community Corrections\u003c/a>, an independent state agency.\u003c/p>\n\u003cp>In Los Angeles County, whose jails have been described as the largest mental institution in the country, about 30 percent of the roughly 18,000 inmates are mentally ill and most of those diagnosed are on medication, says Dr. Joseph Ortego, chief psychiatrist for correctional health services in L.A. County.\u003c/p>\n\u003cp>Although some still are missed in the screening process, he says, the county jails have improved identification and treatment of inmates and expanded staffing as part of the department's 2015 settlement with the U.S. Department of Justice. The department had alleged inadequate mental health care and suicide prevention in the jails.\u003c/p>\n\u003cp>Overall, medications are likely under-prescribed in jails, psychiatrists say.\u003c/p>\n\u003cp>\"You need enough mental health professionals to treat the very large numbers of mentally ill people in jails,\" says \u003ca href=\"https://www.researchgate.net/profile/Harry_Lamb\">Dr. H. Richard Lamb\u003c/a>, professor emeritus of psychiatry at the University of Southern California School of Medicine. \"There probably aren't enough.\"\u003c/p>\n\u003cp>And the medications these doctors prescribe are a crucial aspect of treatment, Lamb says.\u003c/p>\n\u003cp>Some advocates for the mentally ill worry that the drugs are at times prescribed inappropriately. \u003ca href=\"http://www.mhac.org/about-us/staff/\">Zima Creason\u003c/a>, president and chief executive officer of Mental Health America of California, says psychoactive medicines, though sometimes necessary, are no substitute for comprehensive care for jail inmates.\u003c/p>\n\u003cp>\"Sadly, they just throw a bunch of pills at them because there is nothing else,\" she says, adding that jails should also be providing individual and group therapy, more time outside of cells and sufficient recreation time.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Jail is not conducive for real recovery,\" Creason says. \"We are never going to put a dent in the numbers unless we provide a therapeutic environment.\"\u003c/p>\n\u003cp>Like people who live outside the correction facilities, inmates can be subject to involuntary drug treatment, officials say, but only if a court deems that step appropriate.\u003c/p>\n\u003cp>County jail officials, including Dr. Alfred Joshua, chief medical officer for the Sheriff's Department in San Diego County, say the influx of mentally ill inmates and the rising need for psychotropic drugs stems from a lack of resources for patients in the community.\u003c/p>\n\u003cp>\"When they have [an] exacerbation of mental illness, they do many times come into contact with law enforcement,\" Joshua says.\u003c/p>\n\u003cp>Some of the most common charges that bring people with mental illness to jail are drug offenses and parole violations. Those who are homeless frequently get charged with panhandling, public urination and related crimes.\u003c/p>\n\u003cp>In addition to trying to improve treatment inside the jails, Los Angeles and San Diego county officials say they are working more closely with community organizations to ensure inmates with mental illness get the services they need after their release.\u003c/p>\n\u003cp>Vega says a local community group, the \u003ca href=\"http://www.neighborhoodhouse.org/#sthash.nTPgadqU.dpbs\">Neighborhood House Association\u003c/a>, was able to help in his case, ensuring he got his meds and other treatment.\u003c/p>\n\u003cp>\"Without the medication,\" Vega says, \"I would probably be right back in jail.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>\u003cem> is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente. You can follow Anna Gorman on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/annagorman\">@annagorman\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Big+Jump+In+Number+Of+Inmates+Prescribed+Psychiatric+Drugs+In+California&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441292/big-jump-in-number-of-inmates-prescribed-psychiatric-drugs-in-california","authors":["byline_futureofyou_441292"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_952","futureofyou_61","futureofyou_177","futureofyou_204","futureofyou_1430"],"featImg":"futureofyou_441293","label":"source_futureofyou_441292"},"futureofyou_441130":{"type":"posts","id":"futureofyou_441130","meta":{"index":"posts_1591205157","site":"futureofyou","id":"441130","score":null,"sort":[1525122037000]},"guestAuthors":[],"slug":"baltimore-video-highlights-americas-emergency-psychiatric-crisis","title":"Viral Video Highlights America's Emergency Psychiatric Crisis","publishDate":1525122037,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>A viral video from Baltimore is drawing attention to a crisis that's unfolding in emergency rooms across the country: Surging numbers of patients with psychiatric conditions aren't receiving the care they need.\u003c/p>\n\u003cp>On a cold night in January, a man walking by a downtown Baltimore hospital saw something that shocked him. He started recording the incident on his phone.[contextly_sidebar id=\"szGKbRaruZx5ZzbLuwCWnThGfKj4M6NW\"]\u003c/p>\n\u003cp>Imamu Baraka's video, which has been viewed more than 3 million times, shows security guards walking away from a bus stop next to the emergency room of University of Maryland Medical Center Midtown Campus.\u003c/p>\n\u003cp>One is pushing an empty wheelchair. The woman they left there is wearing a thin yellow hospital gown and socks.\u003c/p>\n\u003cp>\"Wait, so you're just going to leave this lady out here with no clothes on?\" Baraka asks the guards. They continue walking away.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The woman, later identified as a 22-year-old named Rebecca, staggers near the bus stop. She appears distressed and confused. She moans and shouts.\u003c/p>\n\u003cp>\"Are you OK, ma'am? Do you need me to call the police?\" Baraka asks.\u003c/p>\n\u003cp>Nationwide, hospitals are struggling to provide services to people with psychiatric emergencies. Between 2006 and 2013, ER visits increased by more than 50 percent for psychoses and bipolar disorders and depression, anxiety and stress reactions \u003ca href=\"https://www.hcup-us.ahrq.gov/reports/statbriefs/sb216-Mental-Substance-Use-Disorder-ED-Visit-Trends.pdf\" target=\"_blank\" rel=\"noopener\">according to the Healthcare Cost and Utilization Project\u003c/a>, which compiles health care data. Between those years the number of visits climbed from 3,448 visits to 5,330 per 100,000 U.S. patients ages 15 and older.[contextly_sidebar id=\"OwR2yLry7rt36cQxbBEeKvzvQmLWRIHK\"]\u003c/p>\n\u003cp>\"We're just failing patients with mental illness and it's just getting worse as time goes on,\" says \u003ca href=\"https://www.acep.org/Membership/Leadership/John-J--Rogers,-MD,-CPE,-FACEP,-President-Elect/#sm.00001sg4kgdr2xd0gwjdhu1dohu7f\" target=\"_blank\" rel=\"noopener\">Dr. John Rogers\u003c/a>, president-elect of the American College of Emergency Physicians.\u003c/p>\n\u003cp>In the viral video, Rebecca has a visible wound on her forehead, and her breath forms white clouds in the cold. Baraka calls for an ambulance, which brings her back to the hospital that just discharged her.\u003c/p>\n\u003cp>Rebecca's mother, Cheryl Chandler, says she happened to click on the video, not knowing it showed her daughter. \"Once he focused on her face I realized it was her. And I think I went into shock initially,\" Chandler says.\u003c/p>\n\u003cp>That realization set off a desperate search. The hospital wouldn't tell her where she was. Chandler called the police. They found out that the hospital didn't readmit Rebecca, even though according to \u003ca href=\"https://www.documentcloud.org/documents/4417187-UMMC-Investigation-2.html\" target=\"_blank\" rel=\"noopener\">a federal regulator's report\u003c/a>, Rebecca told workers in the ambulance, \"I do not feel normal, and do not know what normal is.\"\u003c/p>\n\u003cp>Hospital staff put her into a cab that took her to a nearby homeless shelter, where family members found her the next day. She's been hospitalized on and off since the incident.\u003c/p>\n\u003cp>\"She could have got hypothermia. She could have died. She could have been raped, she could have been killed,\" Chandler says. \"All she wanted was treatment and they had two opportunities to do it and denied it both times.\"[contextly_sidebar id=\"qVILeFSoPW1ICG0oW2MIVApcccHW7EoZ\"]\u003c/p>\n\u003cp>Rebecca was clearly asking for medical care, her mother says, which ERs are legally required to provide.\u003c/p>\n\u003cp>\"That, what I saw in the video, was my worst nightmare for Rebecca,\" Chandler says. Several years ago, Rebecca was diagnosed with bipolar and schizoaffective disorders. Her mom adds that she's a shy and lovable introvert who loves animals and making art.\u003c/p>\n\u003cp>Rebecca has insurance and had been in a residential home when she went missing, Chandler says.\u003c/p>\n\u003cp>The hospital has apologized and says it has already put in place measures to correct the issues.\u003c/p>\n\u003cp>Chandler says she hopes that means it won't happen to other patients. But she adds that Rebecca will continue to suffer from the hospital's decisions: \"No part of Rebecca, because of this, is going to heal. No part. We can't make the scars go away.\"\u003c/p>\n\u003cp>James E. Farmer, a lawyer for Rebecca's family, says they're investigating now and considering filing lawsuits. \"It's going to be difficult to determine the exact extent of harm to Rebecca,\" he says. \"I could not imagine the psychological damage and harm that was done as a result of this.\"\u003c/p>\n\u003cp>The Centers for Medicare & Medicaid Services says the hospital failed to discharge the patient safely, among other breaches.\u003c/p>\n\u003cp>According to the federal regulator's report, Rebecca was \"resistant to discharge and refused to get dressed into street clothes when requested by nursing.\" The hospital stated there was a \"communication failure\" which led to her discharge into the cold weather, though the report says it is not clear whether nursing or security staff made that decision.\u003c/p>\n\u003cp>Chandler says she's heard from other families with similar stories: \"The only difference is it wasn't caught on video.\u003cem>\"\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>\"They told me to leave\"\u003c/strong>\u003c/p>\n\u003cp>Here's another story from Baltimore, about Laura Pogliano and her son Zaccaria. Zac, who had schizophrenia, died in 2015 of heart failure when he was 23.\u003c/p>\n\u003cp>Zac was sensitive and empathetic, and loved playing the piano, his mother says. He started to show symptoms of the disease when he was 16. He became paranoid, and started doing things like hiding kitchen implements out of fear that someone was trying to kill his family.\u003c/p>\n\u003cp>\"His personality just drastically changed,\" Pogliano says. \"He had a thousand rituals around things so that he wasn't harmed.\"\u003c/p>\n\u003cp>Then, as part of his illness, Zac started to think that he actually did have dramatic injuries. Like a gunshot wound or a pulverized ankle. He'd call 911.\u003c/p>\n\u003cp>\"He got to the point where he would pick up the phone at the drop of a hat and say, can someone come and help me, I'm having a heart attack,\" Pogliano says.\u003c/p>\n\u003cp>This happened about 20 times in the two years before his death, she says. Often, ambulances took Zac to Good Samaritan Hospital, where Pogliano says the doctors would typically call her to let her know he arrived and would provide appropriate care for him. Later, hospital staff would call her to pick him up.\u003c/p>\n\u003cp>But one night after Zac went to the ER, Pogliano woke up hours later and got worried that she hadn't received a call.\u003c/p>\n\u003cp>\"I just got in the car and drove over there, and he was sitting outside. It was early spring but it was still wintery, probably 40 degrees out, 45 degrees out,\" she says.[contextly_sidebar id=\"rDd0VJsZFkI99YckcnBP9H20wW3og3pM\"]\u003c/p>\n\u003cp>\"All he had on was what he wore to the hospital, which was a pair of white linen shorts. I know he didn't have shoes on. ... And a hospital gown and no shirt. I said to him, 'Oh my gosh, what are you doing here?' He said, 'They told me to leave.' \"\u003c/p>\n\u003cp>A hospital spokeswoman acknowledged that Pogliano was a patient there but says she found no indication that he was ever inappropriately evaluated or mistreated. She says she couldn't comment further because of federal privacy laws.\u003c/p>\n\u003cp>Emergency room doctors are frustrated at the growing gap in care for patients with psychiatric disabilities.\u003c/p>\n\u003cp>\"We're kind of tired of waiting for legislators and regulators to act and to meet their responsibility to these patients in the form of providing funding for resources,\" says Rogers, the president-elect of the American College of Emergency Physicians.\u003c/p>\n\u003cp>Even as there is increasing demand, there are fewer resources to care for psychiatric patients. It can be difficult for doctors to find an inpatient bed — the numbers are have decreased dramatically over the decades. Rogers says there have been significant cuts to community and outpatient resources — so the emergency department is often the only place for psychiatric patients to go.\u003c/p>\n\u003cp>\"Every emergency physician in the country knows this problem well and wants to do something about it,\" Rogers says.\u003c/p>\n\u003cp>Often the ER is not properly equipped with staff that can offer treatment to psychiatric patients. The emergency room's mission is to assess and stabilize, but the actual care they can provide psychiatric patients is fairly limited. \u003ca href=\"https://www.acep.org/uploadedFiles/ACEP/newsroom/NewsMediaResources/StatisticsData/Psychiatric%20Boarding%20Summary.pdf\">A 2008 survey of ER doctors\u003c/a> found that 62 percent of them said there were no psychiatric services provided while the patients were in the ER.[contextly_sidebar id=\"lGkbbkYcbyqeAi9PmdSR23pZZwe16xA2\"]\u003c/p>\n\u003cp>\"And the disparity between our ability to care for a patient with a medical problem and a patient with a psychiatric problem is growing, that gap is increasing,\" Rogers says.\u003c/p>\n\u003cp>He says Rebecca's case is an outlier. More common, he says, is that ERs will hold patients for too long before they can transfer them somewhere that can treat them. In \u003ca href=\"http://newsroom.acep.org/2015-02-24-psychiatric-emergencies\" target=\"_blank\" rel=\"noopener\">a recent poll of emergency physicians\u003c/a>, 84 percent said that psychiatric patients are \"boarded\" in their departments for hours or days. Rogers says he's heard of patients being held for weeks.\u003c/p>\n\u003cp>And the options for where to transfer them are often limited. \"And that's where it starts breaking down,\" he says. \"The time that it takes to get someone transferred for something like that is just unacceptable....They wait, and wait, and wait.\"\u003c/p>\n\u003cp>It's a bad situation for everyone – for patients with psychiatric disabilities, and for other patients who have lengthy wait times because ERs are overwhelmed.\u003c/p>\n\u003cp>\"They're being asked to do way too much with way too few resources,\" says Susan Stefan, a lawyer focusing on rights of people with psychiatric disabilities. ERs \"have a specific mission, which is to provide emergency medical care, and they're being turned into essentially 24-7 social service agencies.\"[contextly_sidebar id=\"Ei91X4TinBmgcEKaNWK697YV179b4rWn\"]\u003c/p>\n\u003cp>Stefan, who wrote a \u003ca href=\"https://www.amazon.com/Emergency-Department-Treatment-Psychiatric-Patient/dp/0195189299\" target=\"_blank\" rel=\"noopener\">book about treating psychiatric patients in ERs\u003c/a>, says it's common for them to transfer people to homeless shelters because they are not equipped to find people stable housing.\u003c/p>\n\u003cp>And there's another crucial point here: The ER is simply a bad place to treat severe mental illness, even as it is becoming increasingly central for those patients.\u003c/p>\n\u003cp>\"The emergency department is probably the worst place for somebody in psychiatric crisis,\" Stefan says. \"It's loud, it's chaotic and people don't take a lot of time because they don't have a lot of time.\"\u003c/p>\n\u003cp>And it's not straightforward to transform an ER into a place that \u003cem>is\u003c/em> appropriate to provide treatment to people who are in the middle of psychiatric crises — although there are hospitals that are experimenting with new models to better serve these patients.\u003c/p>\n\u003cp>The Alameda Health System in Alameda County, Calif., is a model that both Stefan and Rogers point to. There, a doctor named Scott Zeller has set up a dedicated psychiatric emergency service — a department separate from the standard emergency room that can provide specialized evaluation and treatment for these patients.\u003c/p>\n\u003cp>The Alameda model reduced boarding times by 80 percent, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935777/\" target=\"_blank\" rel=\"noopener\">study published \u003c/a>in the \u003cem>Western Journal of Emergency Medicine\u003c/em>, and the fast, stabilizing treatment made it far less likely that the patient would need to be transferred to an inpatient bed.\u003c/p>\n\u003cp>If there were adequate services in place, most of the people coming to ERs for psychiatric crises wouldn't need to come there at all, says Jennifer Mathis, the director of policy and legal advocacy at the Bazelon Center for Mental Health Law.\u003c/p>\n\u003cp>\"And much as everybody loves to talk about the need for mental health services, that doesn't translate into state policy and funding for community mental health services,\" she says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The problem here, Mathis says, is political will. There's a big gap between politicians talking about mental health and actually making sure people are getting the services they need.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Failing+Patients%27%3A+Baltimore+Video+Highlights+Crisis+Of+Emergency+Psychiatric+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"A viral video is drawing attention to a problem in hospital emergency rooms across the country. More and more patients with urgent psychiatric conditions aren't receiving the care they need.","status":"publish","parent":0,"modified":1525460489,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":55,"wordCount":1934},"headData":{"title":"Viral Video Highlights America's Emergency Psychiatric Crisis | KQED","description":"A viral video is drawing attention to a problem in hospital emergency rooms across the country. More and more patients with urgent psychiatric conditions aren't receiving the care they need.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Viral Video Highlights America's Emergency Psychiatric Crisis","datePublished":"2018-04-30T21:00:37.000Z","dateModified":"2018-05-04T19:01:29.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441130 https://ww2.kqed.org/futureofyou/?p=441130","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/30/baltimore-video-highlights-americas-emergency-psychiatric-crisis/","disqusTitle":"Viral Video Highlights America's Emergency Psychiatric Crisis","source":"Health","nprByline":"Merrit Kennedy, NPR","nprImageAgency":"Jared Soares for NPR","nprStoryId":"599892160","nprApiLink":"http://api.npr.org/query?id=599892160&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/04/29/599892160/failing-patients-baltimore-video-highlights-crisis-of-emergency-psychiatric-care?ft=nprml&f=599892160","nprRetrievedStory":"1","nprPubDate":"Sun, 29 Apr 2018 10:46:00 -0400","nprStoryDate":"Sun, 29 Apr 2018 08:10:51 -0400","nprLastModifiedDate":"Sun, 29 Apr 2018 10:46:17 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/wesun/2018/04/20180429_wesun_failing_patients_baltimore_video_highlights_crisis_of_emergency_psychiatric_care.mp3?orgId=1&topicId=1128&d=484&p=10&story=599892160&ft=nprml&f=599892160","nprAudioM3u":"http://api.npr.org/m3u/1606859358-3e7f6f.m3u?orgId=1&topicId=1128&d=484&p=10&story=599892160&ft=nprml&f=599892160","path":"/futureofyou/441130/baltimore-video-highlights-americas-emergency-psychiatric-crisis","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/wesun/2018/04/20180429_wesun_failing_patients_baltimore_video_highlights_crisis_of_emergency_psychiatric_care.mp3?orgId=1&topicId=1128&d=484&p=10&story=599892160&ft=nprml&f=599892160","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A viral video from Baltimore is drawing attention to a crisis that's unfolding in emergency rooms across the country: Surging numbers of patients with psychiatric conditions aren't receiving the care they need.\u003c/p>\n\u003cp>On a cold night in January, a man walking by a downtown Baltimore hospital saw something that shocked him. He started recording the incident on his phone.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Imamu Baraka's video, which has been viewed more than 3 million times, shows security guards walking away from a bus stop next to the emergency room of University of Maryland Medical Center Midtown Campus.\u003c/p>\n\u003cp>One is pushing an empty wheelchair. The woman they left there is wearing a thin yellow hospital gown and socks.\u003c/p>\n\u003cp>\"Wait, so you're just going to leave this lady out here with no clothes on?\" Baraka asks the guards. They continue walking away.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The woman, later identified as a 22-year-old named Rebecca, staggers near the bus stop. She appears distressed and confused. She moans and shouts.\u003c/p>\n\u003cp>\"Are you OK, ma'am? Do you need me to call the police?\" Baraka asks.\u003c/p>\n\u003cp>Nationwide, hospitals are struggling to provide services to people with psychiatric emergencies. Between 2006 and 2013, ER visits increased by more than 50 percent for psychoses and bipolar disorders and depression, anxiety and stress reactions \u003ca href=\"https://www.hcup-us.ahrq.gov/reports/statbriefs/sb216-Mental-Substance-Use-Disorder-ED-Visit-Trends.pdf\" target=\"_blank\" rel=\"noopener\">according to the Healthcare Cost and Utilization Project\u003c/a>, which compiles health care data. Between those years the number of visits climbed from 3,448 visits to 5,330 per 100,000 U.S. patients ages 15 and older.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"We're just failing patients with mental illness and it's just getting worse as time goes on,\" says \u003ca href=\"https://www.acep.org/Membership/Leadership/John-J--Rogers,-MD,-CPE,-FACEP,-President-Elect/#sm.00001sg4kgdr2xd0gwjdhu1dohu7f\" target=\"_blank\" rel=\"noopener\">Dr. John Rogers\u003c/a>, president-elect of the American College of Emergency Physicians.\u003c/p>\n\u003cp>In the viral video, Rebecca has a visible wound on her forehead, and her breath forms white clouds in the cold. Baraka calls for an ambulance, which brings her back to the hospital that just discharged her.\u003c/p>\n\u003cp>Rebecca's mother, Cheryl Chandler, says she happened to click on the video, not knowing it showed her daughter. \"Once he focused on her face I realized it was her. And I think I went into shock initially,\" Chandler says.\u003c/p>\n\u003cp>That realization set off a desperate search. The hospital wouldn't tell her where she was. Chandler called the police. They found out that the hospital didn't readmit Rebecca, even though according to \u003ca href=\"https://www.documentcloud.org/documents/4417187-UMMC-Investigation-2.html\" target=\"_blank\" rel=\"noopener\">a federal regulator's report\u003c/a>, Rebecca told workers in the ambulance, \"I do not feel normal, and do not know what normal is.\"\u003c/p>\n\u003cp>Hospital staff put her into a cab that took her to a nearby homeless shelter, where family members found her the next day. She's been hospitalized on and off since the incident.\u003c/p>\n\u003cp>\"She could have got hypothermia. She could have died. She could have been raped, she could have been killed,\" Chandler says. \"All she wanted was treatment and they had two opportunities to do it and denied it both times.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Rebecca was clearly asking for medical care, her mother says, which ERs are legally required to provide.\u003c/p>\n\u003cp>\"That, what I saw in the video, was my worst nightmare for Rebecca,\" Chandler says. Several years ago, Rebecca was diagnosed with bipolar and schizoaffective disorders. Her mom adds that she's a shy and lovable introvert who loves animals and making art.\u003c/p>\n\u003cp>Rebecca has insurance and had been in a residential home when she went missing, Chandler says.\u003c/p>\n\u003cp>The hospital has apologized and says it has already put in place measures to correct the issues.\u003c/p>\n\u003cp>Chandler says she hopes that means it won't happen to other patients. But she adds that Rebecca will continue to suffer from the hospital's decisions: \"No part of Rebecca, because of this, is going to heal. No part. We can't make the scars go away.\"\u003c/p>\n\u003cp>James E. Farmer, a lawyer for Rebecca's family, says they're investigating now and considering filing lawsuits. \"It's going to be difficult to determine the exact extent of harm to Rebecca,\" he says. \"I could not imagine the psychological damage and harm that was done as a result of this.\"\u003c/p>\n\u003cp>The Centers for Medicare & Medicaid Services says the hospital failed to discharge the patient safely, among other breaches.\u003c/p>\n\u003cp>According to the federal regulator's report, Rebecca was \"resistant to discharge and refused to get dressed into street clothes when requested by nursing.\" The hospital stated there was a \"communication failure\" which led to her discharge into the cold weather, though the report says it is not clear whether nursing or security staff made that decision.\u003c/p>\n\u003cp>Chandler says she's heard from other families with similar stories: \"The only difference is it wasn't caught on video.\u003cem>\"\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>\"They told me to leave\"\u003c/strong>\u003c/p>\n\u003cp>Here's another story from Baltimore, about Laura Pogliano and her son Zaccaria. Zac, who had schizophrenia, died in 2015 of heart failure when he was 23.\u003c/p>\n\u003cp>Zac was sensitive and empathetic, and loved playing the piano, his mother says. He started to show symptoms of the disease when he was 16. He became paranoid, and started doing things like hiding kitchen implements out of fear that someone was trying to kill his family.\u003c/p>\n\u003cp>\"His personality just drastically changed,\" Pogliano says. \"He had a thousand rituals around things so that he wasn't harmed.\"\u003c/p>\n\u003cp>Then, as part of his illness, Zac started to think that he actually did have dramatic injuries. Like a gunshot wound or a pulverized ankle. He'd call 911.\u003c/p>\n\u003cp>\"He got to the point where he would pick up the phone at the drop of a hat and say, can someone come and help me, I'm having a heart attack,\" Pogliano says.\u003c/p>\n\u003cp>This happened about 20 times in the two years before his death, she says. Often, ambulances took Zac to Good Samaritan Hospital, where Pogliano says the doctors would typically call her to let her know he arrived and would provide appropriate care for him. Later, hospital staff would call her to pick him up.\u003c/p>\n\u003cp>But one night after Zac went to the ER, Pogliano woke up hours later and got worried that she hadn't received a call.\u003c/p>\n\u003cp>\"I just got in the car and drove over there, and he was sitting outside. It was early spring but it was still wintery, probably 40 degrees out, 45 degrees out,\" she says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"All he had on was what he wore to the hospital, which was a pair of white linen shorts. I know he didn't have shoes on. ... And a hospital gown and no shirt. I said to him, 'Oh my gosh, what are you doing here?' He said, 'They told me to leave.' \"\u003c/p>\n\u003cp>A hospital spokeswoman acknowledged that Pogliano was a patient there but says she found no indication that he was ever inappropriately evaluated or mistreated. She says she couldn't comment further because of federal privacy laws.\u003c/p>\n\u003cp>Emergency room doctors are frustrated at the growing gap in care for patients with psychiatric disabilities.\u003c/p>\n\u003cp>\"We're kind of tired of waiting for legislators and regulators to act and to meet their responsibility to these patients in the form of providing funding for resources,\" says Rogers, the president-elect of the American College of Emergency Physicians.\u003c/p>\n\u003cp>Even as there is increasing demand, there are fewer resources to care for psychiatric patients. It can be difficult for doctors to find an inpatient bed — the numbers are have decreased dramatically over the decades. Rogers says there have been significant cuts to community and outpatient resources — so the emergency department is often the only place for psychiatric patients to go.\u003c/p>\n\u003cp>\"Every emergency physician in the country knows this problem well and wants to do something about it,\" Rogers says.\u003c/p>\n\u003cp>Often the ER is not properly equipped with staff that can offer treatment to psychiatric patients. The emergency room's mission is to assess and stabilize, but the actual care they can provide psychiatric patients is fairly limited. \u003ca href=\"https://www.acep.org/uploadedFiles/ACEP/newsroom/NewsMediaResources/StatisticsData/Psychiatric%20Boarding%20Summary.pdf\">A 2008 survey of ER doctors\u003c/a> found that 62 percent of them said there were no psychiatric services provided while the patients were in the ER.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"And the disparity between our ability to care for a patient with a medical problem and a patient with a psychiatric problem is growing, that gap is increasing,\" Rogers says.\u003c/p>\n\u003cp>He says Rebecca's case is an outlier. More common, he says, is that ERs will hold patients for too long before they can transfer them somewhere that can treat them. In \u003ca href=\"http://newsroom.acep.org/2015-02-24-psychiatric-emergencies\" target=\"_blank\" rel=\"noopener\">a recent poll of emergency physicians\u003c/a>, 84 percent said that psychiatric patients are \"boarded\" in their departments for hours or days. Rogers says he's heard of patients being held for weeks.\u003c/p>\n\u003cp>And the options for where to transfer them are often limited. \"And that's where it starts breaking down,\" he says. \"The time that it takes to get someone transferred for something like that is just unacceptable....They wait, and wait, and wait.\"\u003c/p>\n\u003cp>It's a bad situation for everyone – for patients with psychiatric disabilities, and for other patients who have lengthy wait times because ERs are overwhelmed.\u003c/p>\n\u003cp>\"They're being asked to do way too much with way too few resources,\" says Susan Stefan, a lawyer focusing on rights of people with psychiatric disabilities. ERs \"have a specific mission, which is to provide emergency medical care, and they're being turned into essentially 24-7 social service agencies.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Stefan, who wrote a \u003ca href=\"https://www.amazon.com/Emergency-Department-Treatment-Psychiatric-Patient/dp/0195189299\" target=\"_blank\" rel=\"noopener\">book about treating psychiatric patients in ERs\u003c/a>, says it's common for them to transfer people to homeless shelters because they are not equipped to find people stable housing.\u003c/p>\n\u003cp>And there's another crucial point here: The ER is simply a bad place to treat severe mental illness, even as it is becoming increasingly central for those patients.\u003c/p>\n\u003cp>\"The emergency department is probably the worst place for somebody in psychiatric crisis,\" Stefan says. \"It's loud, it's chaotic and people don't take a lot of time because they don't have a lot of time.\"\u003c/p>\n\u003cp>And it's not straightforward to transform an ER into a place that \u003cem>is\u003c/em> appropriate to provide treatment to people who are in the middle of psychiatric crises — although there are hospitals that are experimenting with new models to better serve these patients.\u003c/p>\n\u003cp>The Alameda Health System in Alameda County, Calif., is a model that both Stefan and Rogers point to. There, a doctor named Scott Zeller has set up a dedicated psychiatric emergency service — a department separate from the standard emergency room that can provide specialized evaluation and treatment for these patients.\u003c/p>\n\u003cp>The Alameda model reduced boarding times by 80 percent, according to a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935777/\" target=\"_blank\" rel=\"noopener\">study published \u003c/a>in the \u003cem>Western Journal of Emergency Medicine\u003c/em>, and the fast, stabilizing treatment made it far less likely that the patient would need to be transferred to an inpatient bed.\u003c/p>\n\u003cp>If there were adequate services in place, most of the people coming to ERs for psychiatric crises wouldn't need to come there at all, says Jennifer Mathis, the director of policy and legal advocacy at the Bazelon Center for Mental Health Law.\u003c/p>\n\u003cp>\"And much as everybody loves to talk about the need for mental health services, that doesn't translate into state policy and funding for community mental health services,\" she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The problem here, Mathis says, is political will. There's a big gap between politicians talking about mental health and actually making sure people are getting the services they need.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Failing+Patients%27%3A+Baltimore+Video+Highlights+Crisis+Of+Emergency+Psychiatric+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441130/baltimore-video-highlights-americas-emergency-psychiatric-crisis","authors":["byline_futureofyou_441130"],"programs":["futureofyou_54"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_61","futureofyou_177","futureofyou_204","futureofyou_1430"],"featImg":"futureofyou_441153","label":"source_futureofyou_441130"},"futureofyou_437973":{"type":"posts","id":"futureofyou_437973","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437973","score":null,"sort":[1514275314000]},"guestAuthors":[],"slug":"video-for-lsd-what-a-long-strange-trip-its-been","title":"VIDEO: For LSD, What A Long Strange Trip It's Been","publishDate":1514275314,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Psychedelic drugs are getting a makeover, with scientists exploring their potential in treating debilitating conditions like cluster headaches, addiction or anxiety, with promising results.\u003c/p>\n\u003cp>That's despite the fact that very few researchers are legally allowed to study psychedelics, largely because of LSD's decades-old reputation as a counterculture drug that sparked bad trips.\u003c/p>\n\u003cp>Back in the 1960s, LSD was touted as a tool to shed social conventions and fast-forward to enlightenment – or as LSD advocate Timothy Leary memorably said, \"Turn on, tune in, drop out.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"Y62bP7N4rAZf0wVWIiXnJDweibkHKwpr\"]He was hardly the first to feel the chemical's allure. Back in the 1930s, Swiss chemist Albert Hofmann had shelved LSD after first testing it as a treatment for heart disease. But he couldn't shake the feeling that there was something more to it. After accidentally ingesting a bit and having a mild psychedelic experience, Hofmann decided to go further.\u003c/p>\n\u003cp>He eats 250 micrograms of LSD and, scientist that he is, starts\u003ca href=\"https://www.maps.org/images/pdf/books/lsdmyproblemchild.pdf\"> journaling his experience\u003c/a>. He only gets one entry down before he starts having really intense hallucinations. As he bikes home, he feels like time and space are standing still and objects around him are warping and wavering in weird shapes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The next day, he writes, \"A sensation of well-being and renewed life flowed through me... everything glistened and sparkled in a fresh light.\"\u003c/p>\n\u003cp>LSD seems to shut off certain controls in the brain, allowing signals from one part of the brain to flow unchecked to other regions – particularly the regions that process sensory inputs from the outside world and the regions that define our sense of self. This might explain \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">why LSD can cause hallucinations\u003c/a>. It's also why it could plausibly be beneficial to treat depression or anxiety, allowing signals in the brain to bypass pathways that aren't working so well.\u003c/p>\n\u003cp>Years of experimentation with LSD both in the laboratory and as a recreational drug suggest that it is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/\">physically and mentally safe\u003c/a> for healthy individuals. But it can also bring on terrifying hallucinations and sensations, including anxiety and paranoia, especially if people aren't prepared for the experience.\u003c/p>\n\u003cp>In the 1950s, the \u003ca href=\"https://www.npr.org/sections/pictureshow/2010/12/01/131724898/lsd-testing\">U.S. Army\u003c/a> tested LSD's potential to incapacitate enemy soldiers, but it turned out to be too expensive and difficult to deliver by aerosol. The CIA also tested it as tool for mind control by administering it to people, sometimes illegally and without their knowledge or consent, in the notorious \u003ca href=\"https://www.npr.org/2017/03/28/521779864/inside-darpa-the-pentagon-agency-whose-technology-has-changed-the-world\">Project MKUltra\u003c/a>.\u003c/p>\n\u003cp>In the early 1960s, it was embraced by a growing counterculture movement searching for mind-altering experiences through art and music from groups like Jefferson Airplane and the Grateful Dead. LSD became simultaneously the most studied psychoactive drug in history and a leading cause for young people ending up in the emergency room. When the federal government \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">banned LSD\u003c/a> as a dangerous drug in 1971, it also restricted any further research on the drug and other known psychedelics.\u003c/p>\n\u003cp>But scientists hadn't forgotten its early promise.\u003c/p>\n\u003cp>Researchers have successfully fought for approval to study LSD, as well as other psychedelics such as psilocybin (the active compound in magic mushrooms) and MDMA, also known as the club drug ecstasy.\u003c/p>\n\u003cp>Carefully controlled studies have shown that LSD helps relieve debilitating cluster headaches, that \u003ca href=\"https://www.npr.org/sections/health-shots/2016/12/03/504136736/how-a-psychedelic-drug-helps-cancer-patients-overcome-anxiety\">psilocybin alleviates depression\u003c/a> in terminal cancer patients, and that \u003ca href=\"https://www.npr.org/2015/09/13/439963019/researchers-turn-to-popular-club-drug-to-treat-ptsd\">MDMA can help relieve the trauma of PTSD\u003c/a>. Earlier this year, the FDA gave MDMA a \"\u003ca href=\"https://www.maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials\">breakthrough therapy\u003c/a>\" designation, fast-tracking its path to Phase 3 clinical trials and and if all goes well, approval as a legal treatment.\u003c/p>\n\u003cp>\u003cem>Angus Chen is a journalist in New York. He's on Twitter @angrchen.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Freddy Arenas is an \u003ca href=\"http://www.freddyarenas.com/\">independent director\u003c/a> who has created animations for \u003c/em>The New York Times, California Sunday Magazine\u003cem>,\u003c/em> Google\u003cem> and \u003c/em>HBO Documentaries\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem> Meredith Rizzo produced this animation for NPR.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=VIDEO%3A+For+LSD%2C+What+A+Long+Strange+Trip+It%27s+Been&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"It's been reviled and revered, criminalized and exploited by the CIA. And now and other psychedelic drugs are being tested as legitimate medical treatments. NPR's original animation tells the tale.","status":"publish","parent":0,"modified":1514396393,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":650},"headData":{"title":"VIDEO: For LSD, What A Long Strange Trip It's Been | KQED","description":"It's been reviled and revered, criminalized and exploited by the CIA. And now and other psychedelic drugs are being tested as legitimate medical treatments. NPR's original animation tells the tale.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"VIDEO: For LSD, What A Long Strange Trip It's Been","datePublished":"2017-12-26T08:01:54.000Z","dateModified":"2017-12-27T17:39:53.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"437973 https://ww2.kqed.org/futureofyou/?p=437973","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/26/video-for-lsd-what-a-long-strange-trip-its-been/","disqusTitle":"VIDEO: For LSD, What A Long Strange Trip It's Been","nprByline":"Angus Chen\u003cbr />NPR Shots","nprImageAgency":"Freddy Arenas for NPR","nprStoryId":"571123483","nprApiLink":"http://api.npr.org/query?id=571123483&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2017/12/16/571123483/video-for-lsd-what-a-long-strange-trip-its-been?ft=nprml&f=571123483","nprRetrievedStory":"1","nprPubDate":"Tue, 19 Dec 2017 11:41:00 -0500","nprStoryDate":"Sat, 16 Dec 2017 07:00:00 -0500","nprLastModifiedDate":"Tue, 19 Dec 2017 11:41:24 -0500","path":"/futureofyou/437973/video-for-lsd-what-a-long-strange-trip-its-been","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Psychedelic drugs are getting a makeover, with scientists exploring their potential in treating debilitating conditions like cluster headaches, addiction or anxiety, with promising results.\u003c/p>\n\u003cp>That's despite the fact that very few researchers are legally allowed to study psychedelics, largely because of LSD's decades-old reputation as a counterculture drug that sparked bad trips.\u003c/p>\n\u003cp>Back in the 1960s, LSD was touted as a tool to shed social conventions and fast-forward to enlightenment – or as LSD advocate Timothy Leary memorably said, \"Turn on, tune in, drop out.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>He was hardly the first to feel the chemical's allure. Back in the 1930s, Swiss chemist Albert Hofmann had shelved LSD after first testing it as a treatment for heart disease. But he couldn't shake the feeling that there was something more to it. After accidentally ingesting a bit and having a mild psychedelic experience, Hofmann decided to go further.\u003c/p>\n\u003cp>He eats 250 micrograms of LSD and, scientist that he is, starts\u003ca href=\"https://www.maps.org/images/pdf/books/lsdmyproblemchild.pdf\"> journaling his experience\u003c/a>. He only gets one entry down before he starts having really intense hallucinations. As he bikes home, he feels like time and space are standing still and objects around him are warping and wavering in weird shapes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The next day, he writes, \"A sensation of well-being and renewed life flowed through me... everything glistened and sparkled in a fresh light.\"\u003c/p>\n\u003cp>LSD seems to shut off certain controls in the brain, allowing signals from one part of the brain to flow unchecked to other regions – particularly the regions that process sensory inputs from the outside world and the regions that define our sense of self. This might explain \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">why LSD can cause hallucinations\u003c/a>. It's also why it could plausibly be beneficial to treat depression or anxiety, allowing signals in the brain to bypass pathways that aren't working so well.\u003c/p>\n\u003cp>Years of experimentation with LSD both in the laboratory and as a recreational drug suggest that it is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/\">physically and mentally safe\u003c/a> for healthy individuals. But it can also bring on terrifying hallucinations and sensations, including anxiety and paranoia, especially if people aren't prepared for the experience.\u003c/p>\n\u003cp>In the 1950s, the \u003ca href=\"https://www.npr.org/sections/pictureshow/2010/12/01/131724898/lsd-testing\">U.S. Army\u003c/a> tested LSD's potential to incapacitate enemy soldiers, but it turned out to be too expensive and difficult to deliver by aerosol. The CIA also tested it as tool for mind control by administering it to people, sometimes illegally and without their knowledge or consent, in the notorious \u003ca href=\"https://www.npr.org/2017/03/28/521779864/inside-darpa-the-pentagon-agency-whose-technology-has-changed-the-world\">Project MKUltra\u003c/a>.\u003c/p>\n\u003cp>In the early 1960s, it was embraced by a growing counterculture movement searching for mind-altering experiences through art and music from groups like Jefferson Airplane and the Grateful Dead. LSD became simultaneously the most studied psychoactive drug in history and a leading cause for young people ending up in the emergency room. When the federal government \u003ca href=\"https://www.npr.org/sections/health-shots/2016/04/13/474071268/how-lsd-makes-your-brain-one-with-the-universe\">banned LSD\u003c/a> as a dangerous drug in 1971, it also restricted any further research on the drug and other known psychedelics.\u003c/p>\n\u003cp>But scientists hadn't forgotten its early promise.\u003c/p>\n\u003cp>Researchers have successfully fought for approval to study LSD, as well as other psychedelics such as psilocybin (the active compound in magic mushrooms) and MDMA, also known as the club drug ecstasy.\u003c/p>\n\u003cp>Carefully controlled studies have shown that LSD helps relieve debilitating cluster headaches, that \u003ca href=\"https://www.npr.org/sections/health-shots/2016/12/03/504136736/how-a-psychedelic-drug-helps-cancer-patients-overcome-anxiety\">psilocybin alleviates depression\u003c/a> in terminal cancer patients, and that \u003ca href=\"https://www.npr.org/2015/09/13/439963019/researchers-turn-to-popular-club-drug-to-treat-ptsd\">MDMA can help relieve the trauma of PTSD\u003c/a>. Earlier this year, the FDA gave MDMA a \"\u003ca href=\"https://www.maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials\">breakthrough therapy\u003c/a>\" designation, fast-tracking its path to Phase 3 clinical trials and and if all goes well, approval as a legal treatment.\u003c/p>\n\u003cp>\u003cem>Angus Chen is a journalist in New York. He's on Twitter @angrchen.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Freddy Arenas is an \u003ca href=\"http://www.freddyarenas.com/\">independent director\u003c/a> who has created animations for \u003c/em>The New York Times, California Sunday Magazine\u003cem>,\u003c/em> Google\u003cem> and \u003c/em>HBO Documentaries\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem> Meredith Rizzo produced this animation for NPR.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=VIDEO%3A+For+LSD%2C+What+A+Long+Strange+Trip+It%27s+Been&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437973/video-for-lsd-what-a-long-strange-trip-its-been","authors":["byline_futureofyou_437973"],"categories":["futureofyou_1"],"tags":["futureofyou_1431","futureofyou_1432","futureofyou_1430"],"featImg":"futureofyou_437974","label":"futureofyou"},"futureofyou_437901":{"type":"posts","id":"futureofyou_437901","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437901","score":null,"sort":[1513875809000]},"guestAuthors":[],"slug":"metoo-doctor-who-treats-victims-of-sexual-abuse-struggles-to-absorb-patients-pain","title":"#MeToo: Doctor Who Treats Victims of Sexual Abuse Struggles to Absorb Patients' Pain","publishDate":1513875809,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>On a recent shift in in the emergency department, I evaluated a young woman who had been raped a few summers ago. The shift before that, I’d met with a teenager who had been sexually abused by her father. And just before meeting her I had tended to a middle-schooler who had been sexually assaulted at school.\u003c/p>\n\u003cp>These three women came to the hospital for variety of reasons — they struggled with issues ranging from truancy to substance abuse to thoughts of suicide. Part of my job as a psychiatry resident is to explore the stressors that influence suffering. More often than not, I find those stressors stem from sexual violence.\u003c/p>\n\u003cp>I’m learning that for my patients, sexual violence is an abnormal commonality: It happens to almost everyone, even though it should happen to no one.\u003c/p>\n\u003caside class=\"pullquote alignright\">The task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/aside>\n\u003cp>The #MeToo movement has been a powerful reckoning of the damage of unwanted sexual behavior. It’s given a voice to an incredible amount of pain, and freed some women of the burdens they have borne for years. With the Time Person of the Year Award going to the Silence Breakers, the movement seems to have hit a peak of cultural awareness.\u003c/p>\n\u003cp>But in the halls of my hospital, and in my day-to-day work as a second-year resident, the task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am angry on behalf of the women in my care. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As patients relay the details of these violent encounters, it’s hard not to internalize their horror stories. I feel impotent in my ability to make the world a less hostile place to live, and on some days I just feel incompetent because it’s so hard to keep absorbing these stories.\u003c/p>\n\u003cp>The intersection of the rise of #MeToo and my growing responsibilities in medicine are forcing me to confront the lingering pain of my own experiences. I also recognize that I may be experiencing secondary trauma, and that it might impact the care I give my patients.\u003c/p>\n\u003cp>While I was treating the young woman who had been assaulted by her father, I gave her room to share her story. She didn’t reveal much. I was secretly relieved.\u003c/p>\n\u003caside class=\"pullquote alignright\">Is it better to be sensitive or better to be detached?\u003c/aside>\n\u003cp>Later, while presenting information about this patient to my attending, I couldn’t answer some of her questions about my patient’s abuse. I had convinced myself I was being compassionate by not forcing the patient to relive her trauma, but really, I was hiding behind her silence to not have to absorb another harrowing story.\u003c/p>\n\u003cp>I reported what I could to the Department of Children and Families, while telling myself that the next time, I would do better. But, the whole experience was disheartening because I didn’t know if I could actually be better about managing my emotions.\u003c/p>\n\u003cp>I’ve been trying for a long time.\u003c/p>\n\u003cp>I remember standing over an incubator in the neonatal intensive care unit, afraid to examine the tiny baby girl inside. Born out of incest and rape, she barely weighed 4 pounds. I was a medical student, tending to the outcome of the physical impact of sexual violence, but I didn’t know what to do with all the pain this little baby embodied.\u003c/p>\n\u003cp>I couldn’t bring myself to touch her. She wasn’t crying, and I used that as an excuse to distance myself from her story of sexual violence. I didn’t know how to help her. I decided in that moment that it would be better if neither of us started crying.\u003c/p>\n\u003cp>But, is it better to be sensitive or better to be detached? I’ve \u003ca href=\"https://www.statnews.com/2017/10/19/kidney-stone-medicine/\">written before\u003c/a> about the numbing effect of medical training. We learn to distance ourselves from our patients’ pain and practice detached concern so that we can do our jobs and focus on the problems at hand without freaking out. As physicians, we must work to hold onto our empathy — the capacity to put ourselves in our patient’s shoes and share in their experiences.\u003c/p>\n\u003cp>Yet, I doubt I will ever be able to hear a patient’s story of sexual violence and not be angered, not be revolted. Too many of us are intimately familiar with this misogynistic and metastatic cruelty, and I’d never considered what it would be like when we actually do share in those experiences.\u003c/p>\n\u003cp>When I was a little girl, I took tennis lessons. One summer, before fifth grade, when I was 9, the instructor said sexually explicit things to me. At the time, I didn’t understand why he said these things to me. Yet I knew enough to be ashamed, to feel compromised. I never reported him. I quit tennis instead.\u003c/p>\n\u003cp>This wasn’t the first — or the last — experience I remember when I think about #MeToo. But it’s the only one I feel safe enough to write about.\u003c/p>\n\u003cp>[contextly_sidebar id=\"JLHugSZUKIVVE8gXX4IbdyVIlukTf9dL\"]To be a woman in this world is to be vulnerable. I know my patients’ struggles, even when I don’t know the damning details. But, if I want to treat them well, as a female physician, subject to the very same societal forces, I need to figure out how to manage those details, and their impact on my well-being. Otherwise, self-preservation will not allow me to serve my patients in the way they deserve.\u003c/p>\n\u003cp>A recent \u003ca href=\"http://abcnews.go.com/Politics/unwanted-sexual-advances-hollywood-weinstein-story-poll/story?id=50521721\" target=\"_blank\" rel=\"noopener\">news poll\u003c/a> found that 1 in 2 women surveyed said they had been sexually harassed. The Centers for Disease Control and Prevention says that 1 in 5 women have been \u003ca href=\"https://www.cdc.gov/ViolencePrevention/pdf/SV-DataSheet-a.pdf\" target=\"_blank\" rel=\"noopener\">raped\u003c/a> in their lifetimes.\u003c/p>\n\u003cp>I need to find, for myself and my patients, that way to bolster strength in lifetimes of vulnerability and that way to find dignity in oceans of shame. Then, I need to help them believe, as I work on this with myself, in their value as women —that they have a right to be heard and a right to be understood, and a right to heal, if that is possible.\u003c/p>\n\u003cp>But first, I have to deal with my grief that sexual trauma ever happens to us, at all.\u003c/p>\n\u003cp>\u003cem>This story has been changed to reflect that the statistic from the Centers for Disease Control and Prevention indicates past experience.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/12/18/metoo-patients-trauma/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The intersection of the rise of #MeToo and my growing responsibilities in medicine are forcing me to confront the lingering pain of my own experiences.","status":"publish","parent":0,"modified":1513882343,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1178},"headData":{"title":"#MeToo: Doctor Who Treats Victims of Sexual Abuse Struggles to Absorb Patients' Pain | KQED","description":"The intersection of the rise of #MeToo and my growing responsibilities in medicine are forcing me to confront the lingering pain of my own experiences.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"#MeToo: Doctor Who Treats Victims of Sexual Abuse Struggles to Absorb Patients' Pain","datePublished":"2017-12-21T17:03:29.000Z","dateModified":"2017-12-21T18:52:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"437901 https://ww2.kqed.org/futureofyou/?p=437901","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/21/metoo-doctor-who-treats-victims-of-sexual-abuse-struggles-to-absorb-patients-pain/","disqusTitle":"#MeToo: Doctor Who Treats Victims of Sexual Abuse Struggles to Absorb Patients' Pain","nprByline":"Jennifer Adaeze Okwerekwu\u003c/br>STAT News","path":"/futureofyou/437901/metoo-doctor-who-treats-victims-of-sexual-abuse-struggles-to-absorb-patients-pain","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>On a recent shift in in the emergency department, I evaluated a young woman who had been raped a few summers ago. The shift before that, I’d met with a teenager who had been sexually abused by her father. And just before meeting her I had tended to a middle-schooler who had been sexually assaulted at school.\u003c/p>\n\u003cp>These three women came to the hospital for variety of reasons — they struggled with issues ranging from truancy to substance abuse to thoughts of suicide. Part of my job as a psychiatry resident is to explore the stressors that influence suffering. More often than not, I find those stressors stem from sexual violence.\u003c/p>\n\u003cp>I’m learning that for my patients, sexual violence is an abnormal commonality: It happens to almost everyone, even though it should happen to no one.\u003c/p>\n\u003caside class=\"pullquote alignright\">The task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/aside>\n\u003cp>The #MeToo movement has been a powerful reckoning of the damage of unwanted sexual behavior. It’s given a voice to an incredible amount of pain, and freed some women of the burdens they have borne for years. With the Time Person of the Year Award going to the Silence Breakers, the movement seems to have hit a peak of cultural awareness.\u003c/p>\n\u003cp>But in the halls of my hospital, and in my day-to-day work as a second-year resident, the task of tending to sexual trauma is ever-present, and sometimes feels suffocating. I am angry on behalf of the women in my care. I am reminded of my own experiences, and I recognize with each shift how pervasive — and persistent — this type of predatory behavior is.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As patients relay the details of these violent encounters, it’s hard not to internalize their horror stories. I feel impotent in my ability to make the world a less hostile place to live, and on some days I just feel incompetent because it’s so hard to keep absorbing these stories.\u003c/p>\n\u003cp>The intersection of the rise of #MeToo and my growing responsibilities in medicine are forcing me to confront the lingering pain of my own experiences. I also recognize that I may be experiencing secondary trauma, and that it might impact the care I give my patients.\u003c/p>\n\u003cp>While I was treating the young woman who had been assaulted by her father, I gave her room to share her story. She didn’t reveal much. I was secretly relieved.\u003c/p>\n\u003caside class=\"pullquote alignright\">Is it better to be sensitive or better to be detached?\u003c/aside>\n\u003cp>Later, while presenting information about this patient to my attending, I couldn’t answer some of her questions about my patient’s abuse. I had convinced myself I was being compassionate by not forcing the patient to relive her trauma, but really, I was hiding behind her silence to not have to absorb another harrowing story.\u003c/p>\n\u003cp>I reported what I could to the Department of Children and Families, while telling myself that the next time, I would do better. But, the whole experience was disheartening because I didn’t know if I could actually be better about managing my emotions.\u003c/p>\n\u003cp>I’ve been trying for a long time.\u003c/p>\n\u003cp>I remember standing over an incubator in the neonatal intensive care unit, afraid to examine the tiny baby girl inside. Born out of incest and rape, she barely weighed 4 pounds. I was a medical student, tending to the outcome of the physical impact of sexual violence, but I didn’t know what to do with all the pain this little baby embodied.\u003c/p>\n\u003cp>I couldn’t bring myself to touch her. She wasn’t crying, and I used that as an excuse to distance myself from her story of sexual violence. I didn’t know how to help her. I decided in that moment that it would be better if neither of us started crying.\u003c/p>\n\u003cp>But, is it better to be sensitive or better to be detached? I’ve \u003ca href=\"https://www.statnews.com/2017/10/19/kidney-stone-medicine/\">written before\u003c/a> about the numbing effect of medical training. We learn to distance ourselves from our patients’ pain and practice detached concern so that we can do our jobs and focus on the problems at hand without freaking out. As physicians, we must work to hold onto our empathy — the capacity to put ourselves in our patient’s shoes and share in their experiences.\u003c/p>\n\u003cp>Yet, I doubt I will ever be able to hear a patient’s story of sexual violence and not be angered, not be revolted. Too many of us are intimately familiar with this misogynistic and metastatic cruelty, and I’d never considered what it would be like when we actually do share in those experiences.\u003c/p>\n\u003cp>When I was a little girl, I took tennis lessons. One summer, before fifth grade, when I was 9, the instructor said sexually explicit things to me. At the time, I didn’t understand why he said these things to me. Yet I knew enough to be ashamed, to feel compromised. I never reported him. I quit tennis instead.\u003c/p>\n\u003cp>This wasn’t the first — or the last — experience I remember when I think about #MeToo. But it’s the only one I feel safe enough to write about.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>To be a woman in this world is to be vulnerable. I know my patients’ struggles, even when I don’t know the damning details. But, if I want to treat them well, as a female physician, subject to the very same societal forces, I need to figure out how to manage those details, and their impact on my well-being. Otherwise, self-preservation will not allow me to serve my patients in the way they deserve.\u003c/p>\n\u003cp>A recent \u003ca href=\"http://abcnews.go.com/Politics/unwanted-sexual-advances-hollywood-weinstein-story-poll/story?id=50521721\" target=\"_blank\" rel=\"noopener\">news poll\u003c/a> found that 1 in 2 women surveyed said they had been sexually harassed. The Centers for Disease Control and Prevention says that 1 in 5 women have been \u003ca href=\"https://www.cdc.gov/ViolencePrevention/pdf/SV-DataSheet-a.pdf\" target=\"_blank\" rel=\"noopener\">raped\u003c/a> in their lifetimes.\u003c/p>\n\u003cp>I need to find, for myself and my patients, that way to bolster strength in lifetimes of vulnerability and that way to find dignity in oceans of shame. Then, I need to help them believe, as I work on this with myself, in their value as women —that they have a right to be heard and a right to be understood, and a right to heal, if that is possible.\u003c/p>\n\u003cp>But first, I have to deal with my grief that sexual trauma ever happens to us, at all.\u003c/p>\n\u003cp>\u003cem>This story has been changed to reflect that the statistic from the Centers for Disease Control and Prevention indicates past experience.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/12/18/metoo-patients-trauma/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437901/metoo-doctor-who-treats-victims-of-sexual-abuse-struggles-to-absorb-patients-pain","authors":["byline_futureofyou_437901"],"categories":["futureofyou_1"],"tags":["futureofyou_1275","futureofyou_1421","futureofyou_1430","futureofyou_1429","futureofyou_1312","futureofyou_1420"],"featImg":"futureofyou_437906","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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