ECT effect same as Traumatic Brain Injury

5 Things Every TBI Survivor Wants You to Understand

1. Our brains no longer work the same. 
We have cognitive deficiencies that don’t make sense, even to us. Some of us struggle to find the right word, while others can’t remember what they ate for breakfast. People who don’t understand, including some close to us, get annoyed with us and think we’re being “flaky” or not paying attention. Which couldn’t be further from the truth, we have to try even harder to pay attention to things because we know we have deficiencies.

Martha Gibbs from Richmond, VA, suffered a TBI in May of 2013 after the car she was a passenger in hit a tree at 50 mph. She sums up her “new brain” with these words:

Almost 2 years post-accident, I still suffer short-term memory loss and language/speech problems. I have learned to write everything down immediately or else it is more than likely that information is gone and cannot be retrieved. My brain sometimes does not allow my mouth to speak the words that I am trying to get out.

2. We suffer a great deal of fatigue.
We may seem “lazy” to those who don’t understand, but the reality is that our brains need a LOT more sleep than normal, healthy brains. We also have crazy sleep patterns, sometimes sleeping only three hours each night (those hours between 1 and 5 a.m. are very lonely when you’re wide awake) and at other times sleeping up to 14 hours each night (these nights are usually after exerting a lot of physical or mental energy).

Every single thing we do, whether physical or mental, takes a toll on our brain. The more we use it, the more it needs to rest. If we go out to a crowded restaurant with a lot of noise and stimulation, we may simply get overloaded and need to go home and rest. Even reading or watching tv causes our brains to fatigue.

Toni P from Alexandria, VA, has sustained multiple TBI’s from three auto accidents, her most recent one being in 2014. She sums up fatigue perfectly:

I love doing things others do, however my body does not appreciate the strain and causes me to ‘pay the price,’ which is something that others don’t see.  I like to describe that my cognitive/physical energy is like a change jar. Everything I do costs a little something out of the jar.  If I keep taking money out of the jar, without depositing anything back into the jar, eventually I run out of energy. I just don’t know when this will happen.  Sometimes it’s from an activity that seemed very simple, but was more work then I intended. For me, like others with TBIs, I’m not always aware of it until after I’ve done too much.

3. We live with fear and anxiety. 
Many of us live in a constant state of fear of hurting ourselves again. For myself personally, I have a fear of falling on the ice, and of hitting my head in general. I know I suffered a really hard blow to my head, and I am not sure exactly how much it can endure if I were to injure it again. I am deeply afraid that if it were to take another blow, I may not recover (ie, death) or I may find myself completely disabled. I am fortunate to have a great understanding of the Law of Attraction and am trying my hardest to change my fears into postive thoughts with the help of a therapist.

Others have a daily struggle of even trying to get out of bed in the morning. They are terrified of what might happen next to them. These are legitimate fears that many TBI survivors live with. For many, it manifests into anxiety. Some have such profound anxiety that they can hardly leave their home.

Jason Donarski-Wichlacz from Duluth, MN, received a TBI in December of 2014 after being kicked in the head by a patient in a behavioral health facility. He speaks of his struggles with anxiety:

I never had anxiety before, but now I have panic attacks everyday. Sometimes about my future and will I get better, will my wife leave me, am I still a good father. Other times it is because matching socks is overwhelming or someone ate the last peanut butter cup.

I startle and jump at almost everything. I can send my wife a text when she is in the room. I just sent the text, I know her phone is going to chime… Still I jump every time it chimes.

Grocery stores are terrifying. All the colors, the stimulation, and words everywhere. I get overwhelmed and can’t remember where anything is or what I came for.

4. We deal with chronic pain.
Many of us sustained multiple injuries in our accidents. Once the broken bones are healed, and the bruises and scars have faded, we still deal with a lot of chronic pain. For myself, I suffered a considerable amount of neck and chest damage. This pain is sometimes so bad that I am not able to get comfortable in bed to fall asleep. Others have constant migraines from hitting their head. For most of us, a change in weather wreaks all sort of havoc on our bodies.

Lynnika Butler, of Eureka, CA, fell on to concrete while having a seizure in 2011, fracturing her skull and resulting in a TBI. She speaks about her chronic migraine headaches (which are all too common for TBI survivors)

I never had migraines until I sustained a head injury. Now I have one, or sometimes a cluster of two or three, every few weeks. They also crop up when I am stressed or sleep deprived. Sometimes medication works like magic, but other times I have to wait out the pain. When the migraine is over, I am usually exhausted and spacey for a day or two.

5. We often feel isolated and alone.
Because of all the issues I stated above, we sometimes have a hard time leaving the house. Recently I attended a get together of friends at a restaurant. There were TVs all over the room, all on different channels. The lights were dim and there was a lot of buzz from all of the talking. I had a very hard time concentrating on what anyone at our table was saying, and the constantly changing lights on the TVs were just too much for me to bear. It was sensory stimulation overload. I lasted about two hours before I had to go home and collapse into bed. My friends don’t see that part. They don’t understand what it’s like. This is what causes many of us to feel so isolated and alone. The “invisible” aspect of what we deal with on a daily basis is a lonely struggle.

Kirsten Selberg from San Francisco, CA, fell while ice skating just over a year ago and sustained a TBI. She speaks to the feelings of depression and isolation so perfectly:

Even though my TBI was a ‘mild’ one, I found myself dealing with a depression that was two-fold. I was not only depressed because of my new mental and physical limitations, but also because many of my symptoms forced me to spend long periods of time self-isolating from the things — like social interactions — that would trigger problems for me. With TBI it is very easy to get mentally and emotionally turned inward, which is a very lonely place to be.

State care abuse victims feel fast-track pressure

People who were abused while in state care say they feel under pressure to accept fast-track compensation offers, for fear of receiving nothing.

Photo: 123RF

The Ministry of Social Development is offering historical claimants the option to have their abuse claims settled on face value, and after some fact-checking they will be paid out and offered an apology.

Eighty percent of people offered a fast-track offer so far have accepted it.

One woman, who wanted to be known as Debs, was abused in foster care as a child.

She lodged a compensation claim with the Ministry of Social Development nine years ago and this year was offered $5000 under the fast-track system.

"When the mail came through and I opened it and read it was $5000, I was gutted, and refused to take it. My life is worth more than five grand after what I went through."

Debs said she was low on money so took the offer, but that was partly because she worried that, if she did not, she could end up with nothing.

Her payment was one of the 401 fast-track offers made so far. Of those, there have been 307 payouts totalling nearly $5.8m.

Daryl Brougham said he put in his claim in 2011 for abuse suffered from when he was aged from three months to 18 years old.

He accepted an offer of $70,000 this year - which he said barely covered the medical bills caused by the abuse.

Mr Brougham said when he started talking about his payout, others told him of their much lower fast-track offers.

"Emails of people saying: 'Daryl, I did that too and I was only offered $2000, $5000, $7000'.

"And a lot of them come back to me and say 'Daryl, I took it, because that was the only option I had. I couldn't afford a lawyer and what else am I supposed to do?'"

Minister of Social Development Anne Tolley said it would be "disappointing" if people felt pressured.

Photo: RNZ

The Labour Party's justice spokesperson, Jacinda Ardern, said the fast-track offers she had seen left the impression the claimants could end up with nothing if they did not take it.

"The way in which the offer has been made, certainly as I've heard from claimants themselves, had left them with a feeling that if they did not take this offer they could be waiting a very long time and possibly not settle at all."

The Minister of Social Development, Anne Tolley, defended the process, saying claimants were clearly told they could ignore the offer and opt for the full process.

"It would be disappointing if people felt that they were under pressure.

"From the correspondence I've had, there are a large number of people that are really grateful for the opportunity to have their case recognised, and an apology, and to have the matter settled so that they could move on."

The fast-track offers so far had only been made to people without legal representation and Mrs Tolley said those with lawyers would get offers soon.

But some of those who were abused said the Government was deliberately targeting people who were more likely to accept an offer first, so that it could cross them off the list.

Related

7 Ways Childhood Adversity Changes Your Brain

Source: Darrin Henry/Shutterstock

If you’ve ever wondered why you’ve been struggling a little too hard for a little too long with chronic emotional and physical health conditions that just won’t abate, feeling as if you’ve been swimming against some invisible current that never ceases, a new field of scientific research may offer hope, answers, and healing insights.

In 1995, physicians Vincent Felitti and Robert Anda launched a large-scale epidemiological study that probed the child and adolescent histories of 17,000 subjects, comparing their childhood experiences to their later adult health records. The results were shocking: Nearly two-thirds of individuals had encountered one or more Adverse Childhood Experiences (ACEs)—a term Felitti and Anda coined to encompass the chronic, unpredictable, and stress-inducing events that some children face. These included growing up with a depressed or alcoholic parent; losing a parent to divorce or other causes; or enduring chronic humiliation, emotional neglect, or sexual or physical abuse. These forms of emotional trauma went beyond the typical, everyday challenges of growing up. (For stories of those who faced childhood adversity, see these videos on Laura and John, two patients featured in my newest book, Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal.)

The number of Adverse Childhood Experiences an individual had had predicted the amount of medical care she’d require as an adult with surprising accuracy:

• Individuals who had faced 4 or more categories of ACEs were twice as likely to be diagnosed with cancer as individuals who hadn’t experienced childhood adversity.
• For each ACE Score a woman had, her risk of being hospitalized with an autoimmune disease rose by 20 percent.
• Someone with an ACE Score of 4 was 460 percent more likely to suffer from depression than someone with an ACE Score of 0.
• An ACE Score greater than or equal to 6 shortened an individual’s lifespan by almost 20 years.

The ACE Study tells us that experiencing chronic, unpredictable toxic stress in childhood predisposes us to a constellation of chronic conditions in adulthood. But why? Today, in labs across the country, neuroscientists are peering into the once inscrutable brain-body connection, and breaking down, on a biochemical level, exactly how the stress we face when we’re young catches up with us when we’re adults, altering our bodies, our cells, and even our DNA. What they’ve found may surprise you.

Some of these scientific findings can be a little overwhelming to contemplate. They compel us to take a new look at how emotional and physical pain are intertwined. (For more on why I wrote about how ACEs can change the way we see illness and how we do medicine, see this video.)

[In Part I of this article, we’ll talk about the science of early adversity and how it changes us. In Part II, we’ll talk about all the science-based ways in which we can reverse these changes, and get back to who it is we hope to be, so stay tuned for the good news.]

1. Epigenetic Shifts

When we’re thrust over and over again into stress-inducing situations during childhood or adolescence, our physiological stress response shifts into overdrive, and we lose the ability to respond appropriately and effectively to future stressors—10, 20, even 30 years later. This happens due to a process known as gene methylation, in which small chemical markers, or methyl groups, adhere to the genes involved in regulating the stress response, and prevent these genes from doing their jobs. As the function of these genes is altered, the stress response becomes re-set on “high” for life, promoting inflammation and disease.

This can make us more likely to over-react to the everyday stressors we meet in our adult life—an unexpected bill, a disagreement with a spouse, or a car that swerves in front of us on the highway, creating more inflammation. This, in turn, predisposes us to a host of chronic conditions, including autoimmune disease, heart disease, cancer, and depression.

Indeed, Yale researchers recently found that children who’d faced chronic, toxic stress showed changes “across the entire genome,” in genes that not only oversee the stress response, but also in genes implicated in a wide array of adult diseases. This new research on early emotional trauma, epigenetic changes, and adult physical disease breaks down longstanding delineations between what the medical community has long seen as “physical” disease versus what is “mental” or “emotional.”

2. Size and Shape of the Brain

Scientists have found that when the developing brain is chronically stressed, it releases a hormone that actually shrinks the size of the hippocampus, an area of the brain responsible of processing emotion and memory and managing stress. Recent magnetic resonance imaging (MRI) studies suggest that the higher an individual’s ACE Score, the less gray matter he or she has in other key areas of the brain, including the prefrontal cortex, an area related to decision-making and self-regulatory skills, and the amygdala, or fear-processing center. Kids whose brains have been changed by their Adverse Childhood Experiences are more likely to become adults who find themselves over-reacting to even minor stressors.

3. Neural Pruning

Children have an overabundance of neurons and synaptic connections; their brains are hard at work, trying to make sense of the world around them. Until recently, scientists believed that the pruning of excess neurons and connections was achieved solely in a “use-it-or-lose-it” manner, but a surprising new player in brain development has appeared on the scene: non-neuronal brain cells—known as microglia, which make up one-tenth of all the cells in the brain, and are actually part of the immune system—participate in the pruning process. These cells prune synapses like a gardener prunes a hedge. They also engulf and digest entire cells and cellular debris, thereby playing an essential housekeeping role.

But when a child faces unpredictable, chronic stress of Adverse Childhood Experiences, microglial cells “can get really worked up and crank out neurochemicals that lead to neuroinflammation,” says Margaret McCarthy, PhD, whose research team at the University of Maryland Medical Center studies the developing brain. “This below-the-radar state of chronic neuroinflammation can lead to changes that reset the tone of the brain for life.”

That means that kids who come into adolescence with a history of adversity and lack the presence of a consistent, loving adult to help them through it may become more likely to develop mood disorders or have poor executive functioning and decision-making skills.

4. Telomeres

Early trauma can make children seem “older,” emotionally speaking, than their peers. Now, scientists at Duke University; the University of California, San Francisco; and Brown University have discovered that Adverse Childhood Experiences may prematurely age children on a cellular level as well. Adults who’d faced early trauma show greater erosion in what are known as telomeres—the protective caps that sit on the ends of DNA strands, like the caps on shoelaces, to keep the genome healthy and intact. As our telomeres erode, we’re more likely to develop disease, and our cells age faster.

5. Default Mode Network

Inside each of our brains, a network of neurocircuitry, known as the “default mode network,” quietly hums along, like a car idling in a driveway. It unites areas of the brain associated with memory and thought integration, and it’s always on stand-by, ready to help us to figure out what we need to do next. “The dense connectivity in these areas of the brain help us to determine what’s relevant or not relevant, so that we can be ready for whatever our environment is going to ask of us,” explains Ruth Lanius, neuroscientist, professor of psychiatry, and director of the Post-Traumatic Stress Disorder (PTSD) Research Unit at the University of Ontario.

But when children face early adversity and are routinely thrust into a state of fight-or-flight, the default mode network starts to go offline; it’s no longer helping them to figure out what’s relevant, or what they need to do next. According to Lanius, kids who’ve faced early trauma have less connectivity in the default mode network—even decades after the trauma occurred. Their brains don’t seem to enter that healthy idling position—and so they may have trouble reacting appropriately to the world around them.

6. Brain-Body Pathway

Until recently, it’s been scientifically accepted that the brain is “immune-privileged,” or cut off from the body’s immune system. But that turns out not to be the case, according to a groundbreaking study conducted by researchers at the University of Virginia School of Medicine. Researchers found that an elusive pathway travels between the brain and the immune system via lymphatic vessels. The lymphatic system, which is part of the circulatory system, carries lymph—a liquid that helps to eliminate toxins, and moves immune cells from one part of the body to another. Now we know that the immune system pathway includes the brain.

The results of this study have profound implications for ACE research. For a child who’s experienced adversity, the relationship between mental and physical suffering is strong: the inflammatory chemicals that flood a child’s body when she’s chronically stressed aren’t confined to the body alone; they’re shuttled from head to toe.

7. Brain Connectivity

Ryan Herringa, neuropsychiatrist and assistant professor of child and adolescent psychiatry at the University of Wisconsin, found that children and teens who’d experienced chronic childhood adversity showed weaker neural connections between the prefrontal cortex and the hippocampus. Girls also displayed weaker connections between the prefrontal cortex and the amygdala. The prefrontal-cortex-amygdala relationship plays an essential role in determining how emotionally reactive we’re likely to be to the things that happen to us in our day-to-day life, and how likely we are to perceive these events as stressful or dangerous.

According to Herringa:

“If you are a girl who has had Adverse Childhood Experiences and these brain connections are weaker, you might expect that in just about any stressful situation you encounter as life goes on, you may experience a greater level of fear and anxiety.”

Girls with these weakened neural connections, Herringa found, stood at a higher risk for developing anxiety and depression by the time they reached late adolescence. This may, in part, explain why females are nearly twice as likely as males to suffer from later mood disorders.

This science can be overwhelming, especially to those of us who are parents. So, what can you do if you or a child you love has been affected by early adversity? The good news is that, just as our scientific understanding of how adversity affects the developing brain is growing, so is our scientific insight into how we can offer the children we love resilient parenting, and how we can all take small steps to heal body and brain. Just as physical wounds and bruises heal, just as we can regain our muscle tone, we can recover function in under-connected areas of the brain. The brain and body are never static; they are always in the process of becoming and changing.

Stay tuned for Part II: Recovering from Post Childhood Adversity Syndrome—How Do We Come Back to Who We Really Are? where we’ll talk about what we can do, and the powerful science of how to heal.

Follow Donna Jackson Nakazawa on Facebook and Twitter, or subscribe to her blog at DonnaJacksonNakazawa.com.

Lake Alice claimants angry at long delays

The Government has spent almost $500,000 in its battle with about 100 former Lake Alice child patients who say they were abused and tortured at the mental institution in the 1970s.

In response to a request under the Official Information Act, the Deputy Director-General of Health, Debbie Chin, said $483,570 had been spent dealing with the claimants from 1997 until last month.

But the former patients remain bitter at the length of time the settlement has taken.

Ms Chin said $399,464 had been spent on proceedings taken by Christchurch lawyer Grant Cameron, who represents most of the claimants, and $84,106 on other claimants.

Most of the cost ($387,814) for all claims had gone to the Crown Law Office, which had been handling the claim for the Ministry of Health, as well as $39,934 in fees for medical experts and $55,820 in investigation expenses.

Ms Chin declined to say how much settling the claims would cost the Government or even to provide an estimate.

In July the Government offered the 95 claimants represented by Mr Cameron up to $6.5 million to settle their case, lodged in the High Court in April 1999.

Those papers alleged former patients were tortured and abused at the hospital, near Marton, between January 1972 and December 1977 while in the child and adolescent unit.

They claim they were given the drug paraldehyde and electric shock treatment as forms of punishment.

Since the offer was made, retired High Court judge Sir Rodney Gallen has met about half of the claimants to hear their stories. Sir Rodney has the task, under the settlement, of determining whether the compensation should be equally divided.

But one former patient, who has not been named, remained bitter at the length of time taken to settle the dispute and excessive crown costs.

Former National Health Minister Bill English expressed horror in 1997 at the claims and said it had to be cleared up quickly, but four years later the matter was only about to be settled, he said.

"The money does not go half the way to healing the violence that occurred. They could have come with an apology," Mr English said.

A spokeswoman for Mr Cameron said it was hoped Sir Rodney's report would be finished in two or three weeks.

Auckland lawyer Phillipa Cunningham, who is representing two claimants who are not part of the settlement process, said their case had been set down for trial in April next year.

Dr Selwyn Leeks, the psychiatrist at the child and adolescent unit during the 1970s, lives in Melbourne and could not be contacted for comment.

Though Dr Leeks is no longer registered in New Zealand, a Medical Council spokeswoman said the council had considered one complaint against him last year but decided not to take any further action.

She declined to comment on whether there were other complaints against Dr Leeks.

- NZPA

'Dump and run' culture at CYF

117 children were abused last year while in CYF care. Photo / iStock

A damning report on Child, Youth and Family says children in state care are being moved up to 60 times between multiple foster carers because the agency is not giving enough attention to their long-term care.

The report by Children's Commissioner Dr Russell Wills, the first of what he plans as annual reports on Child, Youth and Family, also reveals that 117 children were abused last year while in CYF care.

It says the agency is focused on "front-end" investigations as it struggles with 150,000 notifications of possible child abuse or neglect each year, but does not provide enough ongoing supervision and support to foster carers and staff looking after 5133 children in state care.

"While the quality of front-end social work practice we observed was generally high, this was not the case for 'back-end' practices, ie, the services that CYF provides to children following initial assessments and investigations," the report says.

"Ineffective case management can lead to care placements breaking down and children having to move ... we heard of children who had had upwards of 20, 40 and in one case over 60 care placements in their short lives. This is not acceptable."

The report says there were 88 cases of substantiated abuse of children by CYF caregivers in 2013-14, plus 25 of children abused while with their parents but still formally in state care, and five abused in unapproved placements.

These figures are much higher than the 23 to 39 children a year abused by caregivers reported by the agency itself in the past four years.

Dr Wills' report says CYF has difficulty recruiting and retaining staff, employs many casual workers in its residences, and staff are "insufficiently trained and supported". "Inconsistent management of young people results in young people acting out, sometimes aggressively," it says.

Two-thirds of the children told Dr Wills' team they were happy with how much contact they had with their families. But a third were unhappy. "I'm one of four but I've never met my siblings. We were separated at birth. They won't introduce you," one young person said.

Maori make up a growing share of all children in care, up from 52 per cent in 2010 to 58 per cent, including 68 per cent of young people in the nine CYF residences, compared with 24 per cent of all children under 15. But only 23 to 24 per cent of CYF staff since 2006 self-identified as Maori. The report adds only 20 per cent of young people in state care, and just 15 per cent of Maori in care, left school with at least NCEA level 2 in 2012. The national average is 75 per cent.

It says 30 per cent of the children in care aged 14 to 16 were charged with offences last year, compared with 1 per cent of that age nationally.

"It is not uncommon for a young person leaving care to quickly end up homeless, jobless and lacking support from a caring adult," it says. "Many will become parents themselves very young. Others end up in prison."

Dr Wills recommends setting targets for NCEA pass rates and other long-term outcomes, putting more resources into ongoing care, boosting staff training, setting up an independent advocacy service for children in care, prioritising Maori cultural capability and iwi links, and raising the care-leaving age from 17 to 18.

Key report findings:

• It is not uncommon for a young person leaving CYF care to quickly end up homeless, jobless, and lacking support from a caring adult.

• Many will become parents themselves very young. Others end up in prison.

• About 30 per cent of children in care between the ages of 14 and 16 are being charged with offences, compared to about 1 per cent of children this age cohort in the general population.

• Of the 1743 children who left CYF custody in 2014, 284 "aged out" of the care system when they turned 17. Of that figure, CYF could not did not know why 1042 had left care.

• In 2013-14, there were findings of substantiated abuse relating to 117 children in the custody of CYF.

• Some CYF residences needed to be upgraded, the report found. "In one residence, a number of young people complained that sleeping in close proximity to their in-room toilet was unpleasant."

• CYF has difficulty recruiting and retaining staff, and capability issues mean some staff do not have the skills and capability necessary to do their job well.

• Many CYF sites have unfilled vacancies. It is challenging for sites and residences to recruit Maori staff.

• Being chronically short-staffed puts additional pressure on existing staff and affects morale.

• Issues with retention of staff were due to people moving into different jobs within the sector or experiencing burnout.

• Some Youth Specialty Service carers characterised CYF's attitude to placement of children as "dump and run."

'This is a challenge for the whole of society'

Social Development Minister Anne Tolley said she was "fine with all his recommendations". She will take a paper to Cabinet next month with a business case developed by a panel led by economist Paula Rebstock to transform CYF from being focused on "transactions" such as investigations to being a "child-centred" agency.

"I'm expecting that the new system will require extra resources in there. We certainly have to lift the capability of our care placements and really get better support," Ms Tolley said.

She said CYF had care agreements with five iwi, was about to start a six-month trial with Tainui, and was seeking deals with all other iwi.

Mrs Tolley told Radio New Zealand she thought the report was pretty grim, but it was nothing new.

"The majority of people in the prison system had been in the care of CYF," she said.

But attempts to improve the system in the past had been nothing more than "quick fixes" and a complete system overhaul was required.

"I'm absolutely determined that we will get a system that does put children at the heart of everything that they do."

She agreed with RNZ's Guyon Espiner when he suggested she'd had seven years in power, yet the situation was getting worse.

"That's why I'm leading a major overhaul."

But Mrs Tolley said she did not want to fall into the trap of throwing more money at CYF and hoping its problems would go away.

Public Health Association chief executive Warren Lindberg welcomed the report, but said the focus should also be on the social issues that underlie why children are taken into care in the first place.

He said the biggest challenge was for society to tackle those issues.

"We're talking issues such as intergenerational violence, inadequate housing, financial hardship, addiction, poor mental health and a lack of extended family/whanau support," he said.

"We need to better understand the reasons why so many kids are unsafe and be much more willing to address the difficult issues that put families under strain and lead to children suffering.

"This is a challenge for the whole of society and not something that should be left to CYF alone."

Mr Lindberg said he understood the importance of getting children in urgent need of protection into safety.

"However, we are troubled at what seems to be lack of planning for good outcomes for children in care and that our systems are not focused on ensuring children are better off as a result of state intervention.

"What is particularly concerning is the larger proportion of Maori children in state care and the lack of cultural capability to adequately ensure good outcomes and meet children's cultural needs."

Opposition calls for action

Labour's Jacinda Ardern also welcomed the recommendations and said Labour had introduced a bill to raise the leaving age to 18 in 2008, but this was dropped by National later that year.

Ms Ardern said the report painted a "terrible picture" of children in care, and fixing CYF should be a top priority for the Government.

"The minister was right to call for a review of CYFs through the expert advisory panel but she is wrong to imply that resources aren't part of the issue.

"This is a department that is doing its best. It is focused on the front end - getting kids out of immediate danger - but what happens to them next is dire. It has been described as 'dump and run'."

Ms Ardern pointed to the report's findings of limited resources and high caseloads, and said the expert advisory panel could not fix everything.

"This is undeniably a department that needs more than advice and recommendations, it needs cross government support. And so do the 5000 children they are caring for right now."

'If CYF was a family, it would have had state intervention by now'

Conservative lobby group Family First responded to the report with a renewed call for an independent watchdog to monitor the policies, procedures and the resourcing of CYF.

"If CYF was a family, it would have had state intervention by now," Family First national director Bob McCoskrie said.

"Despite the important work it does and some excellent social workers, there is increasing evidence of massive systemic failure in the organisation as a whole."

Mr McCoskrie said CYF performed a necessary function but the lack of accountability to its process and procedures, and its overwhelming workload, should concern all families.

"There is no external and independent accountability. We need CYF to get it right, and we need to know that they're getting it right. That evidence is not there."

Unicef NZ national advocacy manager Deborah Morris-Travers welcomed the report and said it pointed to a range of systemic issues.

"It goes without saying that a child taken into state care should never be worse off as a result of that care.

But ensuring the long-term wellbeing of children who may have been traumatised by abuse and neglect, or who have committed an offence, requires skilled, coordinated input by social workers, teachers, health professionals and others.

"The State of Care report suggests the state, as a 'corporate parent', is currently failing to provide this."

Ms Morris-Travers said it was positive to see that CYF had strong intake and initial assessment processes designed to keep children safe.

"This is important, but good practice cannot stop at the front end of the system. Running through this report is a sense that the system, and some of the staff working within it, are not child-centred."

Ms Morris-Travers said that, in addition to the report's 53 recommendations, the Government needed to invest more in the Children's Commissioner to strengthen its monitoring of CYF.

"These issues are too important to be left to chance."

See more: occ.org.nz

Treated like 'dogs' under state's care

Tupua Urlich and Carmel West welcome the commissioner's proposals. Photo / Jason Oxenham

A teen brought up in the care of the New Zealand Government says he was treated "like a dog".

"The caregivers had their own part of the house, so you felt quite cut off and disconnected from the people," said Tupua Urlich, now 19, who was in state care from age 5 to 16.

"They treated you like a dog, I suppose. You're fed, you're given things to keep safe and clean, and that's about it, that's about all they'll give you."

Mr Urlich was taken from his mother because of drug and alcohol issues. His father, who came from a Mongrel Mob family, was killed shortly afterwards.

Mr Urlich was placed with an uncle, but when the uncle moved to Australia, he was placed in a succession of CYF homes, some housing many young people.

"There were bars on the windows, alarms on the bedroom doors," he said. He was moved many times, attending multiple schools in Hawkes Bay, the Waikato and Auckland.

"It's horrible on your mental health," he said.

Carmel West, now 21, was in state care for her first 18 years and didn't meet her mother until she was 16. She and her brother were placed together for the first six years but then lost touch until Ms West was 14. She was moved several times before getting a stable placement at Dingwall Trust in Papatoetoe when she was 9.

She said she understood why she was put into care, but felt CYF should have kept her in touch with her family. The two young people welcomed the proposals for an advocacy service and for raising the age of leaving care to 18. "The age [currently 17] is stupid," Ms West said. "You can't sign a tenancy agreement, you can't sign a power bill, because you have to be 18 to do that."

- NZ Herald

Holding girl in police cell for days

Holding girl in police cell for days unacceptable - Labour

Photo / Getty Images

Bad weather was part of an "exceptional combination of circumstances" that led to a teenager being held in police cells for four days because Child, Youth and Family could not find a bed for her, Social Development Minister Anne Tolley says.

Labour has said what happened to the West Auckland teenaged girl was extraordinary and unacceptable.

The teenager was "terrified" listening to other prisoners scream through the night, and tried not to eat or drink so she did not have to use the toilet in front of anyone.

Know of similar cases? Email here.

A bed was eventually found for her in a youth justice facility - in Palmerston North.

Ms Tolley said today that there was "an exceptional combination of circumstances" in the case, including "the nature and record of offending, availability of beds and the weather".

"I'm advised there was a significant risk to the safety of CYF staff in this case, and I would expect the agency to take any necessary precautions to ensure the safety and security of staff and young people," Ms Tolley said in a statement.

Youth justice residences are being investigated by an independent panel which is advising Ms Tolley about an upcoming overhaul of CYF.

"The panel will provide advice on whether there are more effective options , perhaps in a community setting, for some of the young people held in these residences," Ms Tolley said.

"In its interim report the panel makes it clear there is an over-use of custodial remand - it forms 73 per cent of total admissions to youth justice residences, but 75 per cent of the young people remanded go on to receive a non-custodial sentence at Youth Court."

Jacinda Ardern, Labour's spokeswoman for children, said the problem of capacity at residences was not new, and it what had happened to the young woman was unacceptable.

"To have a young person kept in that situation for four days is unacceptable, and just should not have happened in the first place. Police cells are not designed to hold adults for long periods of time, let alone children.

"To learn that they don't have available beds for young women, it seems extraordinary, given it is well known in the sector that there is a growing number of girls falling into the category of needing to come into care and protection because of criminal behavior."

A judge has blasted CYF for taking so long to find the girl a bed and questioned whether the agency was meeting its legal obligations for young people.

Judge Lisa Tremewan said the situation "frankly needs to stop".

Under the law, youths can be held in police custody only if the court is satisfied they are likely to abscond or be violent or if CYF does not have suitable facilities to detain them. CYF must try to find a bed for them at a youth facility.

The 16-year-old girl, who cannot be named for legal reasons, was arrested for the first time in May and charged with common assault, resisting arrest, possession of utensils for cannabis and disorderly behaviour. On September 10, she was arrested for breaching bail.

Her lawyer, Jenny Verry, said she had been recently diagnosed with attention deficit hyperactivity disorder (ADHD) and that was behind much of her alleged offending.

After the teenager's arrest, she was taken to the Henderson police station. CYF was notified, but as there was no bed available in the Auckland youth justice facility, she had to stay put.

The girl said: "It was shit. I felt like I was going to die. I was cooped up for four nights."

When the girl appeared in the Waitakere District Court on September 14, Judge Tremewan was disturbed to hear she was still in police custody.

"In my view this is unacceptable," she said. "I am very concerned that you have been at the police station since last Thursday night. That is not a suitable arrangement for you. I would have thought that something suitable would have been arranged by now."

The judge ordered CYF to find the girl a bed "immediately".

"In my view, the department needs to meet its statutory obligations to ensure that appropriate arrangements are made for female youth as well as male youth, particularly given this is the biggest city in the country. I am aware that it has been an issue in some other cases."

Those cases include at least four other teenage girls held in cells due to a lack of youth justice beds; one of them was pregnant.

" ... it frankly needs to stop," Judge Tremewan said.

Mrs Verry said sending girls out of Auckland was "a huge problem" and a rise in female offending was partly to blame. "There's not enough beds committed for them. It's really unfair."

CYF residential and high needs services general manager Nova Salomen said there was "flexibility around gender allocation of beds when the need arises".

"We monitor the gender allocation over time and modify it according to demand and trends," she said.

"Both male and female young people have to move due to operational requirements.

"If we have to move them away from their community it is for the shortest possible time ... This is the reality of operating a national service in a small country. However, we have the young person's interests front and centre."

Ms Salomen said it was "unfortunate" the 16-year-old had had to be held in the cells.

"That would not have been our choice. However, she was visited daily by a social worker and her wellbeing assessed. We are focused on the safety and wellbeing of all young people at our residences as well as our staff. "

She said the girl would have been transferred to Palmerston North sooner, but fog delayed her flight.

"And due to her refusal to travel, road options were not safe for staff."

Waitakere police inspector Rod Fraser said every effort was made to ensure youths who had to be held in cells were "as comfortable as possible and that they have a placement with CYF as soon as practicable".

"This is never an ideal situation for police as the police cells are designed for short-term adult accommodation with limited catering, showering and supplied bedding."

- NZ Herald

ECT Effects Brain Functions and Cognition,

ECT Effects Brain Functions and Cognition, so says Dr. Max Fink

As I mentioned in my previous blog post, Dr. Edward Shorter was kind enough to supply me with a paper by Dr. Max Fink, The Seizure, Not Electricity, Is Essential in Convulsive Therapy: The Flurothyl Experience, to demonstrate that the amount of electricity used in electroconvulsive therapy (ECT) is “irrelevant” because it is only the seizure induced by ECT that is of any relevance. I hope I made it quite clear from the perspective of scientific studies concerning the damaging effects of electricity that the amount of electricity is far from irrelevant. However, I’m sure Dr. Shorter was referring to the “therapeutic” effects of ECT, which is attributed to the grand mal seizure.

Every physician and scientist involved with a branch of medicine that deals with seizures knows that seizures cause neurological damage. This, in fact, was the reason psychiatrists conceived of the idea of inducing epileptic like seizures in their patients. Psychiatrists observed that with the damage of successive epileptic seizures, the problems that disturbed their patients became less and less of a problem. Thus, if the same neurological damage could be induced in a patient who didn’t have epilepsy, the problems this patient has should also disturb him or her, or at least others, less and less. 

Causing neurological damage was also the goal of the drugs developed for psychiatric use, to which Dr. Shorter and the coauthor of the book Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness, Dr. David Healy, are bringing public attention. This is why “antipsychotic” drugs were first called neuroleptics. Although neuroleptics do not cause neurological damage through the same means as ECT, that is, through a grand mal seizure, the goal of both antipsychotic drugs and ECT is to cause enough neurological damage so that the problems the patient has are no longer a problem, particularly for those who have to deal with the patient.

The first neuroleptic drug, chlorpromazine, was regarded as a non-permanent "pharmacological lobotomy," just as ECT is often referred to as an "electrical lobotomy."

It seems that Drs. Shorter and Healy like to suggest that the grand mal seizure induced by ECT is somehow different, and therefore not damaging, than seizures induced by epilepsy, diabetic hypoglycemia, traumatic brain injury, and other medical conditions. Such a suggestion could only be due to criminal deception or ignorance of scientific knowledge concerning seizures. Since I wouldn’t want to imply Drs. Shorter and Healy are involved in anything criminal, I will only assume that they are idiots when it comes to medicine concerned with seizures. As a professional train in dealing with electricity, I have already demonstrated in my last blog post that they are idiots when it comes to electricity, so it seems safe to assume that they are also idiots concerning other aspects of ECT. 

Dr. Shorter’s idiocy is clearly demonstrated with the paper he supplied me with by Dr. Max Fink. The reason he sent this paper to me was to show that it is the seizure and not the electricity that produced the “therapeutic” effects of ECT. This paper does in fact do this. However, the object of the paper is to convince psychiatrists to induce “therapeutic” seizures by some means other than electric shock to avoid the damage caused by electricity. (e.g. “[T]he electricity path did directly affect brain functions,” i.e. “the impact of electricity on the brain’s memory and speech centers.”) Since the main point was to suggest that the electricity does not cause any damage, only an idiot would provide a paper that demonstrates the very opposite. 

As with research into diffuse electrical injury (DEI), research into ECT, such as that done by Dr. Max Fink, acknowledges that the electricity used in ECT does cause damage. The very research that is the basis of the book written by Drs. Edward Shorter and David Healy fully acknowledges this. The question is: why do Drs. Shorter and Healy say ECT does not cause damage? As stated above, the only logical conclusion I can come to is that they are either criminals or idiots. Since it would be unjust to ignorantly attribute evil intent, I will only conclude that Dr. Edward Shorter and Dr. David Healy are idiots unless it can be proven that they are criminals.

Nancy Rubenstein on the May 16, 2015 International Protest of Electroshock

The Heresy of Materialistic Psychiatry: To Consider Before Getting Electroconvulsive Thera...

The Heresy of Materialistic Psychiatry: To Consider Before Getting Electroconvulsive Thera...: The following article was written by Steven Strnad . It is posted here with his consent, for which we are grateful. This essay is compos...

A JOKE or is it

Defence Attorney: Did you have ECT?

Plaintiff: Yes.

Defence Attorney: How do you know you had ECT?

Plaintiff: This “Statement of Benefits Paid” shows a psychiatrist and an anesthesiologist billed the health care system for such a procedure every Monday, Wednesday, and Friday for these five consecutive weeks.

Defence Attorney: Do you have any other evidence than just this piece of paper?

Plaintiff: No.

Defence Attorney: Do you actually remember having ECT?

Plaintiff: No.

Defence Attorney: Do you have any recollection whatsoever of having ECT?

Plaintiff: No.

Defence Attorney: So how can you claim something happened when you have no memory whatsoever of it happening?

Plaintiff: The ECT erased my memory.

Defence Attorney: Your Honour, we have already heard expert testimony that ECT causes no memory loss. Furthermore, the psychiatric diagnosis of the plaintiff demonstrates that he is delusional, which proves the claim that he had ECT is just a delusion. My clients simply accidentally filled in the wrong numbers when filling out their time sheets. They have already submitted corrections and have returned the additional funds they received due to their error, which they regret deeply.

Judge: This is pretty clear. I can’t let this case continue. Case dismissed… However, I am concerned about the health of the plaintiff and his delusions. What will happen to him?

Defence Attorney: My clients are also concerned about him and have offered to treat him pro bono.

Judge: This is very commendable. You doctors are a credit to your profession. Do you think you can really help him?

A Defendant: Yes, Your Honour. We plan to give him ECT until he’s not a problem whatsoever

VICTIM OF PSYCHIATRIST’S TESTICLE-ZAP THERAPY SAYS PAIN EXCRUCIATING

Lake Alice Mental Health Hospital

www.nzherald.co.nz
By Martin Johnston
May 24, 2012

Zapping a teenage boy on the testicles with an electric shock machine because he was considered naughty was an act far outside normal practice, a medical academic told police.

“In summary, Dr [Selwyn] Leeks’ treatments appeared to depart significantly from the standards of the day,” wrote Dr Garry Walter, professor of child and adolescent psychiatry at the University of Sydney.

“This was in the areas of his direct clinical care – including his method of use of electrical treatments, and his dubious reasons for some of those treatments – his level of supervision of staff … and his documentation … .”

Aucklander Paul Zentveld, aged 51, who was admitted to the now-closed Lake Alice Hospital near Wanganui five times as a teenager, said yesterday that he was one of several males at the child and adolescent unit who were punished by being given electro-convulsive “therapy” on their genitals.

Dr Leeks, who subsequently shifted to Melbourne, was in charge of the unit, which operated from 1972 to 1977.

Mr Zentveld said he was given ECT as punishment for bed-wetting, which was later attributed by a urologist to a medical condition.

Mr Zentveld said he was mistreated this way in eight sessions, each involving three separate shocks. It was done without anaesthetic.

“The pain was just excruciating.”

He was speaking after the Herald revealed yesterday that the United Nations committee against torture asked the Government on May 7 to explain its response to complaints from former child and adolescent patients of Lake Alice.

It wants to know if there will be an independent assessment of the police investigation of complaints of child torture, which ended in 2009 without any prosecutions of former Lake Alice staff and without some of the complainants being interviewed by police.

Dr Leeks, who is in his early 80s, could not be reached for comment. He has previously denied wrongdoing at Lake Alice.

The police asked Professor Walter to comment on alleged mistreatment at Lake Alice.

His report was obtained under the Official Information Act by the Citizens Commission on Human Rights, which sent a copy to the UN committee.

Commenting on practices from the 1970s, Professor Walter said it was appropriate to treat children with ECT – after first administering anaesthetic and muscle relaxant medications and with the electrodes applied only to the head – for conditions including major depression.

Low-level electrical current had been used in “aversion therapy”, to treat behaviour disorders, but ECT had never been medically approved for this purpose.

ECT via the genitals or knees would not produce a convulsion, the desired effect; might harm the affected part of the body; and might cause long-term psychological problems.

“Patients would regard this as a procedure whose primary purpose was to punish, rather than to treat.”

The commission has called for the Government to reopen the police investigation.

Police have previously said there was no evidence of criminal offending.

The Justice Ministry has said the Government will respond to the committee.

Please take a minute to save some people and sign our Petition · BAN THE USE OF ECT IN NZ · https://www.change.org/p/new-zealand-government-ban-the-use-of-ect-in-new-zealand?recruiter=108623255&utm_campaign=twitter_link_action_box&utm_medium=twitter&utm_source=share_petition …