Harold Sackeim reverses position in upcoming study « ect.org

Harold Sackeim reverses position in upcoming study « ect.org

Harold Sackeim reverses position in upcoming study

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by Linda Andre Director, CTIP

The Cognitive Effects of Electroconvulsive Therapy in Community Settings

NIMH-funded research study published in the January 2007 issue of Neuropsychopharmacology
Author and primary investigator: Harold Sackeim

Funding: NIMH grants

#35636, Affective and Cognitive Consequences of ECT, funded since 1981 for a total of approximately ten million dollars so far (grant has been renewed through 2009)

#59069, ECT Practices in Community Settings—Evaluating Outcomes, funded since 1999 for a total of approximately 3.5 million dollars so far

Summary: After 25 years and millions of dollars of federal funding to research the adverse cognitive effects of ECT—25 years in which not one single longterm followup study was ever published—self-proclaimed “world expert” on ECT Harold Sackeim has now reversed his position, admitting that ECT routinely causes permanent memory loss and deficits in cognitive abilities. His new study—the first to be published in which he followed patients as long as six months, and one of his only studies to use controls—validates a generation of patient reports of permanent iatrogenic disability, and disproves Sackeim’s previously published claims that these reports were simply symptoms of mental illness. Other findings: there is no evidence that ECT increases intelligence, as Sackeim has previously claimed; and women are much more likely than men to experience severe permanent amnesia.

Significance: Harold Sackeim has been called the Pope of ECT, and for good reason. He’s published more on ECT than anyone in the world, has received more money to research it than anyone in the world, and is the author of the American Psychiatric Association’s patient information statement and consent forms, which are used by most hospitals in America. Through his writing, teaching, testimony—and positions on peer review, editorial, and funding boards, including NIMH grant review panels—he has more influence on what the profession and the public believe about ECT than anyone in the world. What Harold says goes.

Conclusion: This study could have been done at any point in the past 25 years. If it had, a generation of patients could have been warned of the likelihood of permanent significant memory and cognitive deficits before, instead of finding out after, ECT. In fact, there is evidence—from Harold’s own statements—that over the years he has in fact conducted studies following up ECT patients for a long as five years…but never published the results. Why not? Why did it take 25 years and over ten million dollars to validate what patients have been saying all along? In other words: What did Harold know, when did he know it, and why wasn’t it revealed?

Quotable quote from the study: This study provides the first evidence in a large, prospective sample that the adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings.

For a detailed critique, see below. 

For the past 25 years, patients who received electroconvulsive therapy (ECT) have been told by the nation’s top ECT doctor that the controversial treatment doesn’t cause permanent amnesia or cognitive deficits and, in fact, improves memory and increases intelligence. Psychologist Harold Sackeim of Columbia University also taught a generation of ECT practitioners around the world that permanent amnesia is so rare it could never be studied. Sackeim was the popularizer if not originator of the position that former patients who said the treatment erased memory were simply mentally ill and thus not credible.

His newest and perhaps last ECT research study disproves his tenaciously held claims about the treatment’s harmlessness. It is, in effect a stunning self-repudiation of a 25-year research career…one in which he accepted federal research money with one hand and consulting fees from shock machine companies with the other.

See, for instance, the key finding:

This study provides the first evidence in a large, prospective sample that the adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings.

Similarly, from the abstract:

Despite ongoing controversy, there has never been a large scale, prospective study of the cognitive effects of electroconvulsive therapy

Sounds like the research team is congratulating itself for being “the first,” as if they’d made a discovery before anyone else, doesn’t it? You might think that…if you didn’t know that Sackeim has held the only available NIMH research grant to study ECT’s adverse effects, titled “Affective and Cognitive Consequences of ECT,” continuously since 1981…and if you didn’t know what Sackeim promised the federal government in his original application for grant funding:

“The major objective of the proposed research is to examine the effects of bilateral and right unilateral electroconvulsive therapy on affective and cognitive functioning. The consequences of the two treatment modes will be studied in regard to neuropsychological functions that have previously not been studied…Drug-free inpatients presenting major unipolar depressive disorder will be tested before, during and after treatment and a matched normal control group will be tested at comparably spaced times.”

Instead of doing this, however, he used his grant money largely to compare different types of ECT to each other, not to examine the effects of ECT; and only less than a handful of his 200+ published studies used normal controls, an absolute necessity to isolate the effects of ECT.

Why did it take 25 years to conduct one large, long-term controlled follow-up study? And in the absence on this research, why did Harold so confidently assure professionals, patients, legislators, and the public that ECT was safe?

A closer look at the study shows us that, in fact, Harold and his team are still not being honest with us, still not revealing all they know. They tried their damnedest not to find out what ECT really does…but failed. Here they reveal only the minimum information they had to concede after using every trick in the book to bias their research in favor of not finding negative effects of ECT.

What tricks did they use here?

1) The assumption that ECT does not cause permanent amnesia and cognitive deficits was built into the design of the study. How so? The study allowed subjects who’d had ECT before, as recently as two months prior, to be counted as the “before ECT” patients–meaning before this course of ECT. It assumed that any effects of ECT resolve within two months. 43% of the subjects had had prior ECT, so that at least half of the data involved comparing the effects of ECT to the effects of more ECT–not isolating the effects of ECT.

2) The outcome measures used to measure amnesia and cognitive function are irrelevant and inadequate to measure the known effects of ECT. Yet even deliberately using measures that would result in underestimating deficits, these deficits were still found to be profound and persistent!

For a critique of the tests used by Sackeim, see Robertson and Pryor’s article, Memory and cognitive effects of ECT: informing and assessing patients, in Advances in Psychiatric Treatment (2006), vol. 12, p. 228-238. For example, the Mini Mental Status exam used by Sackeim is a test that screens for dementia, the grossest and most glaring form of cognitive disability, and is useless for detecting the kinds of deficits caused by ECT.

Sackeim uses a memory test he invented himself, the Autobiographical Memory Inventory. This test is unpublished, not publicly available, not validated, and is not used except by ECT advocates. Robertson and Pryor note that the majority of questions are not relevant to the types of information forgotten by ECT survivors, nor can the test detect amnesia beyond a one-year period. A string of references in Sackeim’s new article attempt to provide support for the claim that the AMI “has shown strong reliability and validity as a measure of retrograde amnesia.” Not only do they not show this, but all the referenced articles were written by Sackeim himself!

3) Patient IQs were estimated pre-ECT using a method that underestimates intellectual ability especially with much higher than average IQs; no attempt was made to ascertain actual IQ. No one looked at these patients’ IQs post-shock to see what happened to them; why not?

Sackeim et al. conclude, based on inaccurate assumptions and no data from these or any other patients, that “Individuals with greater premorbid abilities can better compensate for the impact of ECT on cognitive functions” (references claiming to support this point have nothing to do with ECT but are articles about an unproven theory of “cognitive reserve”).

Even if the researchers didn’t choose to seek out survivors of ECT who once had very high IQs, or to respond to the many survivors of formerly superior IQs who have contacted them, there is a substantial record of accounts by persons who had extremely high or genius IQs who have spoken and written publicly of the devastating effects of having those IQs lowered by ECT (Jonathan Cott, Linda Andre, Anne Donahue, and Marilyn Rice are four such individuals.) None of these accounts suggests that people with “greater premorbid abilities” have an easier time after ECT; in fact, they strongly suggest the opposite.

In addition to these tricks, the researchers used one of the most reliable methods of biasing results: concealing data.

1) “A substantial number of secondary cognitive measures” are said to have been administered along with the named tests, yet the researchers nowhere reveal what they were and what the results were.

2) The names of the seven facilities in the New York City metropolitan area are not revealed. While this isn’t necessary for evaluating the results of the study, it means the facilities with the worst outcomes can’t be held publicly accountable, nor can the millions of city residents protect themselves from the worst offenders.

3) The results of the cognitive tests on the 24 control subjects are not revealed, nor is how they compared to the people who had ECT.

It’s a very big deal for the Sackeim team to use matched normal controls; in 25 years and hundreds of studies they have not done so. Normal controls are essential to ethical and valid research. This article states that “The comparison sample completed the same neuropsychological battery at time points corresponding to the assessment period in patients.” But you search in vain to find out how the controls did on the five named tests of memory and cognitive functioning and the unnamed “secondary measures”, and how they compared to the ECT patients immediately and six months after ECT. It’s not in the text, and it’s not in the tables. So why have the controls take the tests at all, if you’re not going to reveal the results?

Only one thing is revealed: The normal controls did much better than the bilateral ECT patients on the (flawed) measure of amnesia:

“The average decrement in AMI-SF scores in patients treated exclusively with BL ECT was 3.4 and 2.8 times the amount of forgetting seen in the healthy comparison groups at the post-ECT and 6-month time periods, respectively, suggesting that the deficits were substantial.”

4) Sackeim does not reveal—has never revealed in hundreds of published articles—his financial ties to the shock machine companies Mecta and Somatics. Yet in sworn testimony, Sackeim admits he has worked for Mecta for at least twenty years. He designs their shock machines for them. Not only is disclosure required by journals such as Neuropsychopharmacology (ironically, the subject of a recent scandal in which authors and even the journal’s editor did not reveal their ties to another company which has hired Sackeim, Cyberonics), it is also required by state law (because Sackeim is an employee of New York State) and federal law (because Sackeim accepts NIMH money). Sackeim flaunts these laws by not disclosing the money he makes from the shock machine manufacturers.

This article is a damning critique of work done over 25 years (and at the expense of millions of taxpayer dollars) by this very team of researchers.

If you know that Sackeim’s been funded for decades to do this research and chose not to do it, the following statements read very differently than the researchers intended. Instead of self-congratulation, they read as condemnation.

“Empirical information about ECT’s long-term effects derives mainly from small sample studies conducted in research settings, with follow-up intervals limited to two months or less…These studies could not adequately assess the severity and persistence of long-term deficits.”

The use of small samples and short-term follow-up characterizes all of Sackeim’s work until now, and was their choice, deliberately made so as not to know (officially) about “the severity and persistence of long-term deficits.” These researchers single-handedly had the wherewithal to address these belatedly-acknowledged flaws in their own research at any time since 1981.

“We conducted the first large-scale, prospective study of cognitive outcomes following ECT.”

Why the first study only after 25 years? What of the generation of patients—two and a half million people according to their own estimate—who have received shock in those years without knowing the long-term consequences?

“Severity of depressive symptoms showed little relationship with the cognitive measures. At the post-ECT time point, none of the 11 measures were related to concurrent HRSD scores. Findings were also negative for 8 of the 11 measures at the six-month follow-up.”

Translation: patients aren’t just imagining or lying about their cognitive and memory deficits because they’re crazy. Yet in many published articles written on the NIMH dime, and over and over in public testimony and in court, that is exactly what Sackeim and Prudic have claimed. And they have influenced countless others to believe it.

DAMNING FINDING #1: amnesia is substantial and permanent

“The average decrement in AMI-SF scores in patients treated exclusively with BL ECT was 3.4 and 2.8 times the amount of forgetting seen in the healthy comparison groups at the post-ECT and 6-month time periods, respectively, suggesting that the deficits were substantial.”

“At the six-month time point, there continued to be a significant relationship between the number of BL ECT treatments and the extent of retrograde amnesia.”

“Greater amnesia for autobiographical events was significantly correlated with the number of ECT treatments received 6 months earlier.” 

DAMNING FINDING #2: cognitive deficits are substantial and permanent

“Compared to baseline performance, at the postECT time point the total patient sample showed deficits in the mMMS, sensitivity of the CPT, delayed recall of the BSRT, delayed reproduction on the CFT…” (All are measures of memory and cognitive ability).

“This study provides the first evidence in a large, prospective sample that the adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings.”

DAMNING FINDING #3: ECT permanently affects reaction time

“Although psychomotor function is of practical importance with respect to driving and other motor activities, the impact of ECT on this domain has rarely been examined…”

(Once again: Whose fault is that?)

“The fact that relative reaction time deficits were observed at the 6-month follow-up indicates a persistent change in the speed of information processing, motor initiation, or response levels…The findings here raise the concern that this form of stimulation has deleterious long-term effects of elemental aspects of motor performance or information processing.”

DAMNING FINDING #4: Bilateral ECT is no good

“For decades, BL ECT represented the gold standard with respect to ECT efficacy…A majority (of US ECT practitioners) administer mainly or exclusively BL ECT…
There appears to be little justification for the continued first-line use of BL ECT in the treatment of major depression.”

(More than 90% of the ECT given in the U.S., and at least as high a proportion in other countries, is bilateral.)

DAMNING FINDING #5 They lied when they wrote in the APA consent form that ECT improves your memory

What this team has said in numerous published articles—and what Sackeim wrote into the American Psychiatric Association guidelines on ECT, the “bible” used by all rank and file shock doctors—that ECT improves memory and intelligence, is not true.

“It is noteworthy that most cognitive parameters were substantially improved at 6-month follow-up relative to pre-ECT baseline, presumably because of the negative impact of the depressed state on baseline performance…It cannot be concluded, however, that the extent of improvement in any group returned to premorbid levels.”

DAMNING FINDING #6: A much greater percentage of women than men are damaged by ECT than men: 81% vs. 18%.

“There was a gender difference, with a greater preponderance of women (81.6%) compared to men (18.4%) in the persistent deficit group.” 

No doubt Sackeim and his handlers will try to “spin” this study as a scientific breakthrough, and hold him up as a reformer and patient advocate. Nothing could be farther from the truth.

Where is the apology to the generation of people who were lied to, who will never regain their memories and their cognitive abilities?

Full study

Children in state care are being abused and CYF is failing them - report | Stuff.co.nz

Children in state care are being abused and CYF is failing them - report | Stuff.co.nz

Children in state care are being abused and CYF is failing them - report

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Stuff.co.nz

Children's Commissioner Russell Wills talks about the State of Care report released by his office.

Children removed from their family home are being sexually and physically abused in foster homes - and the Social Development Minister says there's no evidence they're any better off in state care.

Children's Commissioner Russell Wills has released his first annual report in to how well Child Youth and Family (CYF) are looking after children in state care. His findings reveal the Government department is failing thousands of children.

Children interviewed for the report spoke of sexual, physical and verbal abuse in foster homes; of being moved around constantly; separated from siblings; depression, drugs and alcohol.

Social Development Minister Anne Tolley said none of the findings in Wills' report were a surprise.

"If the state takes them into their care then they have the responsibility to make sure those kids live better lives and I don't see the evidence and the Children's Commissioner report doesn't see the evidence that this is happening," Tolley said.

Wills said CYF was failing to put children at the centre of what they do.

"When children are in care, Child Youth and Family is effectively their parent. That is a significant responsibility," he said.

"These children should come out of the system in a better place and with the prospect of better future lives. Unfortunately we can't say they are."

In 2013-14 there were 117 children in the custody of CYF reported to be abused; 88 were in the care of a CYF caregiver, 25 were formally placed with their parents but still officially in CYF custody, and five were abused while living with an unapproved caregiver or in an unapproved placement.

Children interviewed for the report said despite abuse being quite common, very few cases were officially recorded.

Tolley said when abuse was uncovered it was acted on but the report had shown there was "no sort of outside body that looks at CYF independently other than [the Children's Commissioner]".

An expert panel already set up to overhaul CYF would address this, she said.

The report also details how 1000 of the 1700 children who leave care each year are unaccounted for.

Only 20 per cent of children in state care achieve NCEA level 2 compared to a national average of 70 per cent.

Nearly a third of 14 to 16-year-olds in state care were charged with a criminal offence.

Eva Bradley Photography

Children's Commissioner Russell Wills says children in state care should come out better off but they're not.

While CYF was good at intervening and assessing high-risk kids - they hadn't managed to work out how to provide good long term care, Wills said.

Labour's children spokeswoman Jacinda Ardern said the buck stopped with CYF and they were responsible for the outcomes of children in their care.

"We've got to start acknowledging that the kids we are seeing in this system now are the kids we see in prison 10 years down the track - that is not anecdotal, that is fact."

 - Stuff

Teacher offered student sexual rewards in exchange for school work - National - NZ Herald News

Teacher offered student sexual rewards in exchange for school work

The teacher has since been censured and her registration has been cancelled following the affair, which took place last year. Photo / Thinkstock

A teacher who had sex with a student on a number of occasions, and later offered him sexual rewards in exchange for completing his school work, has admitted her actions were "totally unprofessional".

The teacher has since been censured and her registration has been cancelled following the affair, which took place last year.

In its written decision, the Teachers' Disciplinary Tribunal said the female teacher was found to have behaved in a unprofessional manner amounting to serious misconduct, after entering into an inappropriate relationship with the Year 13 student.

However, she was granted name suppression in the interest of protecting the student, and her young children.

The tribunal said the teacher had sex with the student, who was not named, on a number of occasions, at his house, during school hours and on school grounds.

She was also found to have exchanged inappropriate Facebook messages with the student in which she would offer sexual rewards to motivate him to do his school work.

The message said: "do a bit of learning of the techniques other than simile then do it with no notes... if you do you can have a special request tomorrow... haha pretty much do anything you want any way but you can have that as your motivation if it'll help."

The affair was revealed following an investigation by the secondary school, after the student's parents laid a complaint.

The teacher admitted to the tribunal that she had behaved "totally unprofessionally".

"However what I did was totally out of character compared to my 20 years previously."

The teacher said she was suffering health issues at the time of the affair, was having problems with work, her own family, and was coping with the loss of her father who had recently passed away.

She told the tribunal the affair began when the student kissed her, and "made me feel like I was really special to him".

"... It stunned me and I was flattered and responded unprofessionally.

"He made me feel like I mattered and I was someone who he counted on to be in his life not as his teacher, but as a person."

The student said he wanted to lose his virginity to someone he "trusted" and who was "special", the teacher told the tribunal.

She went on to say she would "absolutely" go back and change things if she could.

Tribunal chairman Kenneth Johnston said the teacher was motivated by her own needs, and had very little "genuine regard" for the student.

"The inappropriate relationship was not a "one-off". It was sustained for a considerable period of time. It involved a number of sexual encounters.

"There is no evidence which satisfies the tribunal that the respondent even now recognises the seriousness of her misconduct."

The teacher was censured, and had her registration cancelled.

- NZME.

Level of child abuse 'horrifying' | Otago Daily Times Online News : Otago, South Island, New Zealand & International News

Level of child abuse 'horrifying'

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A panel tasked with examining historical abuse in New Zealand's state institutions has heard a litany of physical, emotional and sexual abuse, describing it as "horrifying" and "deeply shocking".

However, the Confidential Listening and Assistance Service said the "most shocking thing was that much of this was preventable".

"If people had been doing their jobs properly and if proper systems had been in place, much of this abuse could have been avoided with better oversight," the panel said.

In its final report, released to Fairfax under the Official Information Act, chairwoman Judge Carolyn Henwood said the panel members were "profoundly affected" by what they heard.

• Read the report here

"As the numbers grew and more voices were heard, a picture was painted for us of a careless, neglectful system which allowed cruelty, sexual abuse, bullying and violence to start and continue.

"Through their words and tears, we could see the invisible welts and bruises, as well as the deeper hurt and emotional damage."

More than 1100 people came forward to speak to the panel between 2008 and June this year, covering child welfare care, psychiatric care and health camps, and residential education.

"Our panel meetings revealed an alarming amount of abuse and neglect, with extreme levels of violence," Judge Henwood said.

"I was deeply shocked by their stories and by the overall level of violence and abuse that New Zealanders were willing to inflict on children.

"Serious physical and sexual abuse came from a wide range of people and from both genders. Foster caregivers and extended families, social workers and staff, teachers, the clergy, cooks, gardeners, night watchmen; even other children and patients all took part in abuse.

"We heard of people using their fists and their feet, as well as weapons and other implements on occasion, to attack children. Many very severe beatings for no apparent reason were reported to us."

Lack of affection 'almost standard'

As many boys as girls were sexually abused - about 57% of both genders, the report said.

The panel heard from children "who went to their beds in fear each night".

"There was often violence by the foster parents, beatings and housework and kitchen tasks, and verbal abuse. Lack of affection was almost standard.

"We heard from people who had been always hungry. We heard of children made to sleep in a shed. We heard many accounts of foster fathers who came into the child's bedroom at night to abuse that child, even when the bedroom was shared by other children."

Older girls "often had to live with regular sexual intercourse with their foster father".

Speaking up about the abuse often led to punishment and blame being placed on the child, the report said.

In boys' and girls' homes a "system of institutionalised bullying" appeared to be in place. Staff who were not violent or abusive turned a blind eye to what went on.

Boys' homes "allowed violence to be institutionalised", while girls' homes "made assumptions of promiscuity".

Both types of care homes would lock children up in isolation units for long periods of time, the report said.

"These children experienced a general absence of love, human warmth, encouragement, training and modelling in fundamental human behaviour."

Children told parents dead 

Judge Henwood reported the panel being left "dumbfounded at the reasoning of the system" which moved children into state care.

It appeared to be "relatively easy" to make children state wards in the past, the report said, with some being taken away from their parents on "flimsy reasoning", or on request of a step-parent who did not want the child.

In some cases children were taken from family and falsely told their parents were dead. Some children were moved into homes with an environment the same, or much worse, than those they were removed from.

"Some of these foster families were, on the face of it, of high standing in the community, but behind closed doors there was neglect and cruelty."

Most people who spoke to the panel did not know the name of their social worker. Many rarely saw their social worker, and if they did it was in the presence of their foster carer. The few children who did report abuse were often ignored or told it was their own fault, the report said.

"The lack of effective oversight was the biggest failure of the state.

"The gap between policy and practice has to be confronted," the report said, adding that while policies against locking children up were in place, "the practice continued unabated".

There were race aspects to the problem as well, the panel found, with an over-representation of Maori in state care. Maori boys were "likely to be treated more harshly and put into care, especially institutions, more readily, and for more trivial reasons such as truancy", the report noted.

It was in such institutions that many Maori boys joined gangs to find "a sense of family".

"We were told that many gangs actually began in state institutions."

Darkl legacy 

The report concluded: "It has become clear to us that the neglect and abuse of children and the previously frequent practice of locking children up in institutions has contributed to a dark legacy of suffering and crime in this country."

Boys' homes "set up young people to align with a gang", the report said, which would lead to life-long allegiance, and "kept the individual in a criminal lifestyle".

"It was often reported to us by prisoners that they saw crime as retaliation for the way they had been treated in care."

While the recommendations section of the report was redacted, the panel urged a "whole of Government response" to deal with the legacy of abuse.

It called for more direct support and social investment, saying that helping families to stay together "could save many significant costs later". Foster families also needed better support.

An agreed strategy was needed to ensure the cultural needs of Maori children were met while they were in care, it said.

It was "crucial" the voices of children in care were listened to, the panel said.

An attitude of respect for children and their rights "needs to be fostered by Government through policy and public campaigns".

"Even now, New Zealand has no official 'duty of care' towards children written into its law."

The report also called for the settlement of historic claims "to occur as soon as possible".

- By Patrice Dougan of NZME News Service

Generation of children brutalised in state care won't get public apology | Stuff.co.nz

Generation of children brutalised in state care won't get public apology

FAIRFAX 

State care-givers used fists, feet, and weapons to attack children in a period between the early 1940s and 1990s, says the final report of the Confidential Listening and Assistance Service. 

The Government will not offer a formal public apology to all children who were in state care during a 50 year period of brutal abuse.

The final report of the Confidential Listening and Assistance Service has detailed the harrowing experiences of children at the hands of people who were meant to keep them safe.

The report, which heard evidence from more than 1100 people, is still under consideration by the Government.

The abuse detailed in the report covers foster homes, institutions, asylums, health camps and borstals from the early 1940s up to 1992. 

BEN CURRAN/ FAIRFAX NZ

Social Development Minister Anne Tolley is awaiting advice on the recommendations of the report, but says the Government will not be making a public apology. 

Social Development Minister Anne Tolley said it would inform a separate panel overseeing the overhaul of Child, Youth and Family. But asked if the Government would apologise to the children of these institutions, she said: "No".

"But I do acknowledge that some people in the care of government institutions were failed and let down badly, and that they still suffer the trauma from that experience.

"That is why we now have two processes in place to offer an apology and a financial settlement to claimants."

Judge Carolyn Henwood, who headed the panel that has been hearing grievances since 2008, said:  "Foster caregivers and extended families, social workers and staff, teachers, the clergy, cooks, gardeners, night watchmen,  even other children and patients, all took part in abuse.

"We heard of people using their fists and their feet, as well as weapons and other instruments on occasion, to attack children," she says in the report.

"When we asked people why they had come, they said they wanted to be heard, they wanted an apology and accountability, and they wanted to improve state care for children, for the next generation."

Even now, New Zealand had no official "duty of care" towards children written into its law, Henwood said.

READ MORE: 
* Payout for abuse victims 'deeply flawed'* MSD 'answerable to no one' in payout process, says lawyer

The report finds as many boys as girls suffered sexual abuse. In boys' homes, cell-like units were often used for prolonged isolation, while in girls' homes, "assumptions were made of promiscuity".

In foster care situations, the panel describes stories of mothers who were "street angels, house devils".

"There was often violence by the foster parents, beatings and housework and kitchen tasks, and verbal abuse. Lack of affection was almost standard," the report says.

"We heard many accounts of foster fathers who came in the child's bedroom at night to abuse that child, even when the bedroom was shared by other children."

Cabinet documents obtained show a backlog of 921 historic claims has built up. The Government is aiming to settle them by 2020.

To date, 307 payments have been made, totalling $5.78 million. It's understood that payouts vary between $6000 and $60,000.

Wellington lawyer Sonja Cooper,  who is acting for about 500 claimants, has renewed calls for a public inquiry into the abuse.

"We still have a number of ongoing concerns for children still in care – our youngest clients are teenagers still."

She said the panel had delivered on its terms "admirably".

"But we certainly have ongoing and grave concerns about MSD's commitment, and the Government's commitment to an ongoing and meaningful process of resolution. It needs to go outside of MSD."

The recommendations of the panel have been withheld, but it is understood the report recommends the Government appoint someone to be responsible, on behalf of the state, for the monitoring of children in care.

The Office of the Children's Commissioner is already mandated to monitor CYF, and will also be extending its monitoring to include non-government residential care services and foster care services.

PANEL MAKES 89 REFERRALS TO POLICE

Through the work of the panel, police have been able to connect alleged offenders to several victims and some prosecutions have followed, the report says.

A police spokesperson said the majority of referrals were for requests for information only.

"Often records could not be located or had been destroyed due to filing practices that existed at the time of investigation."

If victims wished to make a complaint, that was dealt with at a district level.

"It would be difficult to say how many of these complaints resulted in convictions as each complaint was sent to the appropriate district [where the victim was based] for further investigation.

"Police have been limited by old recording, filing and investigation techniques that are not the practice of today."

 - Stuff

Victim forced into electric shock ‘therapy’ after reporting sex assault in state care | Australia news | The Guardian

Victim forced into electric shock ‘therapy’ after reporting sex assault in state care

When a child sexual abuse victim reported to staff at the state-run home in charge of his care that he was being assaulted by another boy, he was forced to undergo electric shock “therapy” so severe that it burned his skin, a royal commission heard on Tuesday.

The psychologist who administered the treatment also gave evidence on Tuesday, telling the royal commission into institutional responses to child sexual abuse that the shocks felt no stronger than flicking an elastic band against a wrist, and was only given to adults. But later the psychologist described the treatment as “quite severe”, and apologised.

Robert Cummings told the royal commission on Tuesday that he first entered state care at age 15 after being repeatedly beaten by his father and stepmother, and running away from home. 

He was moved through different state-care facilities, but was first abused and raped at Harrison House, a Methodist institution in Hawthorn, Victoria, the commission heard.

Over about seven weeks, the house manager, identified only as BGV, forced Cummings to dress up in women’s clothing before raping him, which was an almost daily occurrence, the commission heard. Cummings said there were no adults, apart from BGV’s wife, to report the abuse to.

He ran away and lived on the streets for two months, the commission heard, before being picked up by police and taken to Turana Youth training centre in Victoria, a home for children and juvenile offenders who had been made wards of the state. There, he was frequently punched and beaten by staff and other boys, he said.

“I was placed in a cell with an older boy, whose name I don’t recall,” Cummings said. 

“Within the first week, he sexually abused me while we were locked in the cell at night. I refused to perform oral sex on the boy, so he punched me until I agreed to do it.”

Cummings said that when he reported the incident to a senior officer at the home, the officer told him that the sexual abuse was “only happening because of your homosexuality”. 

Despite denying he was a homosexual and insisting that he had been sexually abused in his cell, and previously raped while at Harrison House, the officer told Cummings: “This is your fault, you need to be cured,” the commission heard.

Shortly after reporting the abuse, Cummings said two staff members “frogmarched me to Royal Park hospital”. 

“I was scared and didn’t know what was happening,” Cummings, now 60, told the commission. 

“When I arrived at the hospital, I recall the doctor saying words to me to the effect of ‘You’re here because you’re homosexual and we’re going to cure that with electric shock treatment’.” Cummings was 16 years old at the time, the commission heard.

Despite at no stage consenting to the treatment, Cummings said a letter obtained from the hospital written by Dr Douglas Hibbs to Dr Graham Mellsop stated that Cummings had requested the treatment because he did not want to stay a homosexual. 

Cummings said documents that he consented to the treatment, and that he was a homosexual, were false.

The treatment involved strapping electrodes to his ankles and showing him images of half-naked women and fully naked men, the commission heard. Cummings said every time a naked man was shown to him, he would also be given an electric shock.

“At times, I wasn’t ready for the electric shock, so when a picture of a naked man appeared and I wasn’t prepared, I was thrown off the chair,” Cummings said. 

“This session lasted about half an hour to 45 minutes and I remember being terrified and in pain the whole time. During the next two sessions, I spoke to the doctor because I was scared and didn’t want to receive the electric shocks anymore.

“I recall that I met with Hibbs again, where I told him that I didn’t want to receive electric shocks because I was scared and because I felt I was being punished.”

Instead, the strength of the shocks was increased, Cummings said, leaving his skin burned. 

“There were times when the burn marks on my ankles were weeping,” he said.

“Therefore, they had to use the other ankle.”

Cummings said word got back to other boys at Turana that he was being treated for homosexuality, prompting them to call him names and to gang-rape him. He attempted suicide in Turana twice, the commission heard.

The royal commission is investigating three Victorian state-run youth centres in its latest hearings.

Counsel assisting the commission, Penny Dwyer, said “significant efforts” had been made to contact Mellsop and Hibbs and to obtain their answers to questions from the commission. Both now reside in New Zealand, she said.

“It appears then that they have not made themeslves amenable to this jurisdiction,” Dwyer said. 

Thomas Verberne, the psychologist who administered the treatment to Cummings, appeared before the commission on Tuesday afternoon. Verberne said the treatment was known as aversion therapy, and that he had been the first to introduce it to Victoria after reading about its use in the US in a medical journal. 

He predominantly administered it to homosexuals who had been referred to him or who came to him of their own free will, Verberne told the commission, because at the time, homosexuality was still perceived by the medical profession as a disorder.

But it was only given to adults, Verberne said, adding that if anyone protested to the therapy he would have stopped it immediately. He did not recall treating Cummings, though he acknowledged documents presented to him by the commission which stated Cummings was referred to him.

One of the hospital documents presented to the commission by Dwyer wrongly referred to Cummings as being 18 years old at the time of treatment.

Verberne described this error as a “slip of the pen” by the referring doctor. He said he would have remembered if any patient was a child, or if they had been shocked so severely that they had fallen out of their chair or been burned, and that it was not possible to increase the strength of the shocks, which came from a battery.

“Look, may I explain the discomfort or pain ... the shock was quite comparable [to] if you have a rubber band around your wrist and you flick it,” he said.

“If anybody had of said, ‘Oh no, I can’t stand it,’ that would be the end of the session and the end of the treatment.”

But later in the cross-examination, Verberne described the treatment as “quite severe”.

No other staff were present in the room while he administered the electric shocks, Verberne said. He said he could not recall exactly why he discontinued the therapy as a form of treatment. 

“I can’t remember any discomfort or misgivings with the treatment, but after a relatively short time I gave it up,” Verberne said. “Why? That’s a question I have for myself but presumably it has something to do with not being very comfortable about it after all.”

It may have also have been stopped because the “trickle” of patients referred for the therapy dried up, he said.

Though he could not recall treating Cummings, Verbone apologised to him at the end of his cross-examination. 

“Robert, I’m very sorry about all the consequences of having been involved in the therapy that I gave you,” Verberne said to Cummings.

“Having heard Robert’s testimony, I feel very sorry he had reactions to it later on in life.” 

Had he foreseen these affects, Verberne said he would have never administered the treatment.

The treatment had severely affected Cummings’ interpersonal relationships, the commission heard.

“I found that in my early 20s, I was an angry and violent young man,” Cummings told the commission. 

“I developed a hatred for homosexuals and was picked up by police for assault and battery a few times, however, I was never charged. I deeply regret acting out at that time. I felt that the hatred I developed for homosexuals at the time was caused by the electro-shock sessions and the abuse I had suffered up to that point in my life.

“I am currently married, but I have poor intimacy abilities.

“Most times, I don’t enjoy having sex.”

Cummings said when he requested copies of his ward files from the Department of Human Services under the Freedom of Information Act, the documents had a lot of blanked-out information.

“I was told that this was to protect the identity of others,” Cummings said. “There was no further explanation provided.”

Cummings, who dedicated his life to social work following his abuse, called for better reporting mechanisms for children in care to ensure they felt protected and safe when reporting abuse, and said penalties should be increased for perpetrators. 

The statute of limitations on victims should also be removed, he said.

The hearings continue.

Twisted Sister - We're not gonna take it (With Lyrics)

Fake Hutt doctor Linda Astor releases murderous patient

Fake Hutt doctor Linda Astor releases murderous patient - 150 years of news | Stuff.co.nz

Fake Hutt doctor Linda Astor releases murderous patient - 150 years of news

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Linda Astor after and before her sex change. The Polish-born fraudster was working as a psychiatrist at Hutt Hospital, probably under false credentials, when she freed a violent and suicidal patient who later killed his girlfriend.

A bogus doctor at Hutt Hospital released an insane and violent patient in 1996 who went on to commit a brutal killing.

In the months after Leslie Parr's killing of his girlfriend in Naenae, Lower Hutt, it emerged that the psychiatrist who signed him out was a Polish transsexual fraudster who had fled the country. Linda Astor did not even meet Parr at Hutt Hospital in April 1996 before removing a six-month compulsory treatment order, issued just nine days earlier by a court that decided he was too mentally disturbed to face an assault charge.

A year later, his girlfriend was horrifically slaughtered. "When Fiona Maulolo's two daughters approached their mother's Hutt Valley house on April 18, 1997, they would never have suspected what they would find," The Dominion reported.

A police photograph of Linda Astor at the time of her arrest on shoplifting charges in the United States in October 2001.

"The youngest of the two girls, then 10, entered the Wilkie Cres, Naenae, house to a nightmare – her mother's bloodstained, headless body in the bath. Her head, found by police later that day, was wrapped in a plastic bag in the clothes dryer.

"Maulolo died at the hands of schizophrenic boyfriend Leslie Raymond Parr, who had been released from compulsory psychiatric treatment a year earlier. Six days before the discovery of her body, Parr had repeatedly hammered a chisel into her heart, then severed her head with an axe."

In late 1996, Astor transferred to Nelson-Marlborough Health Services, but never returned from a conference in Paris the following June. The health service fired her as its clinical director of mental health and laid a complaint with police, who found drugs and sex hormones at her home.

Complaints began emerging about Astor's use of shock treatment and drugs at Hutt Hospital. The Medical Council insisted Polish authorities had confirmed her degree, but her work history increasingly appeared to have been fabricated.

"If there is no proof that she qualified as a psychiatrist, then every mental health patient in this country assigned to her care has been damaged," Alliance party leader Jim Anderton told The Evening Post.

Hutt Hospital never would have accepted murderer Parr if it had known his violent and suicidal history:  doctors believed he was subject to a more minor Mental Health Act order, a spokeswoman told the Post.

Staff also blamed an untrained Maori liaison officer for failing to pass on a plea for help from Parr's GP following his release. The liaison officer said the hospital paid him $8000 hush money after the tragedy.

A coroner's report published in 2002 damned the hospital, saying Parr was "radically rediagnosed" there.

The same year, Astor was deported from the United States after being caught shoplifting and having her criminal past discovered. She had been working at a substance abuse hospital and an adolescent welfare agency in New Hampshire and Vermont.

In 2004, a New Zealand television news crew tracked Astor down to a Polish hospital for the mentally insane where she was employed as a senior psychiatrist, after again falsifying her employment history.

"Bogus psychiatrist Linda Astor, whose incompetence led to a brutal psychotic killing, is once again fooling authorities and looking after the mentally ill," The Dominion Post said.

"She resigned the next day and has since disappeared."

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The Dominion Post – 150 Years of News is available via dompost.co.nz or 0800 50 50 90. Priced at $34.95 + $3 postage and handling or $29.95 + $3 p&h for subscribers.

 - Stuff

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