A Longitudinal Study of Violent Behavior in a Psychosis-Risk Cohort. Brucato G1, Appelbaum PS1, Lieberman JA1, Wall MM1, Feng T1, Masucci MD1, Altschuler R1, Girgis RR1.

Neuropsychopharmacology. 2018 Jan;43(2):264-271. doi: 10.1038/npp.2017.151. Epub 2017 Jul 26.
A Longitudinal Study of Violent Behavior in a Psychosis-Risk Cohort.
Brucato G1, Appelbaum PS1, Lieberman JA1, Wall MM1, Feng T1, Masucci MD1, Altschuler R1, Girgis RR1.
Author information

There is a lack of insight into the relationships between violent ideation, violent behavior, and early, particularly attenuated, psychosis. Our aims were to examine the relationships between baseline violent behavior and violent ideation and outcome violent behavior and conversion to psychosis in at-risk individuals. We longitudinally assessed 200 individuals at clinical high risk for psychosis for violent ideation and violent behavior using the Structured Interview for Psychosis-Risk Syndromes (SIPS), and rated these according to MacArthur Community Violence categories. Fifty-six individuals (28%) reported violent ideation at baseline, 12 (6%) reported violent behavior within 6 months pre-baseline, and 8 (4%) committed acts of violence during the follow-up time period. Information about violent ideation was obtained only by indirect, but not direct, inquiry about violent ideation. Both violent ideation and violent behavior at baseline significantly predicted violent behavior (RR=13.9, p=0.001; RR=8.3, p=0.003, respectively) during follow-up, as well as a diagnosis of psychosis (RR=2.3 and 2.4, respectively; both p<0.001), independent of more than 40 clinical and demographic variables. The targets of the subjects’ violent ideation at baseline were completely different than their subsequent targets of violent behavior. Violent behavior occurred within 7 days (SD 35 days) of a diagnosis of syndromal psychosis. These data suggest that checking carefully for violent ideation and behavior in clinical high-risk patients is essential, as these have predictive value for conversion to psychosis and likelihood of violence in the future.
PMID: 28745307 DOI: 10.1038/npp.2017.151


UPDATE – Autopsy Report Released; Cause and Manner of Death Determined

Fairfax County Police Department News

On Tuesday, April 28, Cold Case detectives with the Major Crimes Division obtained Natasha McKenna’s completed autopsy report from the Department of Health, Office of the Chief Medical Examiner.

As quoted from the Report of Autopsy regarding Natasha McKenna,

“Cause of Death: Excited delirium associated with physical restraint including use of conductive energy device, contributing: Schizophrenia and Bi-Polar Disorder”

“Manner of Death: Accident”

Detectives are still awaiting examination reports for the medical equipment that was utilized to monitor McKenna’s vital signs prior to paramedics responding to the Adult Detention Center.

As is customary in all complex criminal investigations, forensic analysis of all potential evidence, though time intensive, is standard to ensuring all proper and fair conclusions are reached based on accurate and detailed facts. This detailed and thorough investigation, once complete, including all evidence collected, including the recently received medical examiner’s report, any audio or video recordings, witness statements, and…

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Mentally Ill Woman, Natasha McKenna Is Tased To Death By Deputies On



Graphic Video Shows Natasha McKenna, Mentally Ill WomanVideo Mentally Ill Woman, Tased in Jail Before Her Death
curi56September 18, 2015UncategorizedEdit from my blog

“Graphic Video Shows Natasha McKenna, Mentally Ill WomanVideo Mentally Ill Woman, Tased in Jail Before Her Death”





Mentally Ill Woman, Natasha McKenna Is Tased To Death By Deputies On



Officer Involved
Graphic Video Shows Natasha McKenna Tased in Jail Before Her Death

A Virginia sheriff’s department released a video today showing the in-custody events leading up to the death of mentally-ill inmate Natasha McKenna after she was shot with a Taser multiple times by authorities. The video’s release comes just days after a Fairfax County official decided not to seek criminal charges in connection with the deadly incident.
The 48-minute long video posted on YouTube starts with a filmed statement from Fairfax County Sheriff Stacey Kincaid discussing this week’s announcement that criminal charges would not be brought, and explaining that various media reports about what happened compelled her to release the Video.

“There is no better way to share what actually occurred than to make this video availability for the community to view in its entirety,” Kincaid said. …
and explaining that various media reports about what happened compelled her to release the Video.,

The 48-minute long video posted on YouTube starts with a filmed statement from Fairfax County Sheriff Stacey Kincaid discussing this week’s announcement that criminal charges would not be brought

“Graphic Video Shows Natasha McKenna, Mentally Ill WomanVideo Mentally Ill Woman, Tased in Jail Before Her Death”

Mentally-Ill Female Inmates Housed in Male Facility: Report

Mentally-ill female inmates housed in male facility: report


Ombudsmna says Canada’s federal prisons, “serve no underlying correctional or rehabilitative purpose.”

Laura Stone

10 hours ago
October 31, 2017
Some female inmates with serious mental-health conditions are being sent to a men’s facility for treatment, a practice the federal prison ombudsman calls “completely unacceptable” in a new report.
Canada’s correctional investigator, Ivan Zinger, also said that while the use of solitary confinement has decreased significantly in the past few years, conditions “continue to be problematic” and Indigenous inmates are still overrepresented.
In his first report since being appointed to the job in January, Mr. Zinger focused on the conditions of confinement in Canada’s federal prisons, which “serve no underlying correctional or rehabilitative purpose.”

The wide-ranging report touched on everything from poor food quality, unsatisfactory work opportunities and unsafe transport vehicles, making 17 recommendations to the Correctional Service of Canada (CSC). It also calls for terminally ill inmates to be able to access medical assistance in dying, as well as a safe tattooing program in federal prisons….THE GLOBE AND MAIL

How brain scans can tackle the stigma behind mental illness

How brain scans can tackle the stigma behind mental illness

New techniques may soon be able to identify children at increased genetic risk for psychiatric illnesses.
This article is published in collaboration with
The Conversation
25 Oct 2017
David Rosenberg
Professor, Psychiatry and Neuroscience, Wayne State University

As a psychiatrist, I find that one of the hardest parts of my job is telling

Parents and their children that they are not to blame for their illness.
Children with emotional and behavioral problems continue to

                                        suffer considerable stigma.

Many in the medical community refer to them as “diagnostic and  therapeutic orphans.”

Unfortunately, for many, access to high-quality mental health care remains elusive.

An accurate diagnosis is the best way to tell whether or not someone will respond well to treatment, though that can be far more complicated than it sounds.

I have written three textbooks about using medication in children and adolescents with emotional and behavioral problems. I know that this is never a decision to take lightly.

But there’s reason for hope. While not medically able to diagnose any psychiatric condition, dramatic advances in brain imaging, genetics and other technologies are helping us objectively identify mental illness.

Knowing the signs of sadness
All of us experience occasional sadness and anxiety, but persistent problems may be a sign of a deeper issue. Ongoing issues with sleeping, eating, weight, school and pathologic self-doubt may be signs of depression, anxiety or obsessive-compulsive disorder.

Separating out normal behavior from problematic behavior can be challenging. Emotional and behavior problems can also vary with age. For example, depression in pre-adolescent children occurs equally in boys and girls. During adolescence, however, depression rates increase much more dramatically in girls than in boys.

It can be very hard for people to accept that they – or their family member – are not to blame for their mental illness. That’s partly because there are no current objective markers of psychiatric illness, making it difficult to pin down. Imagine diagnosing and treating cancer based on history alone. Inconceivable! But that is exactly what mental health professionals do every day. This can make it harder for parents and their children to accept that they don’t have control over the situation.
Fortunately, there are now excellent online tools that can help parents and their children screen for common mental health issues such as depression, anxiety, panic disorder and more.
Most important of all is making sure your child is assessed by a licensed mental health professional experienced in diagnosing and treating children. This is particularly important when medications that affect the child’s brain are being considered.
Seeing the problem
Thanks to recent developments in genetics, neuroimaging and the science of mental health, it’s becoming easier to characterize patients. New technologies may also make it easier to predict who is more likely to respond to a particular treatment or experience side effects from medication.

Our laboratory has used brain MRI studies to help unlock the underlying anatomy, chemistry and physiology underlying OCD. This repetitive, ritualistic illness – while sometimes used among laypeople to describe someone who is uptight – is actually a serious and often devastating behavioral illness that can paralyze children and their families.

Image: The Conversation
Through sophisticated, high-field brain imaging techniques – such as fMRI and magnetic resonance spectroscopy – that have become available recently,

we can actually measure the child brain to see malfunctioning areas.

We have found, for example, that children 8 to 19 years old with OCD never get the “all clear signal” from a part of the brain called the anterior cingulate cortex. This signal is essential to feeling safe and secure. That’s why, for example, people with OCD may continue checking that the door is locked or repeatedly wash their hands. They have striking brain abnormalities that appear to normalize with effective treatment.
We have also begun a pilot study with a pair of identical twins. One has OCD and the other does not. We found brain abnormalities in the affected twin, but not in the unaffected twin. Further study is clearly warranted, but the results fit the pattern we have found in larger studies of children with OCD before and after treatment as compared to children without OCD.
Exciting brain MRI and genetic findings are also being reported in childhood depression, non-OCD anxiety, bipolar disorder, ADHD and schizophrenia, among others.

Meanwhile, the field of psychiatry continues to grow. For example, new techniques may soon be able to identify children at increased genetic risk for psychiatric illnesses such as bipolar disorder and schizophrenia.

New, more sophisticated brain imaging and genetics technology actually allows doctors and scientists to see what is going on in a child’s brain and genes. For example, by using MRI, our laboratory discovered that the brain chemical glutamate, which serves as the brain’s “light switch,” plays a critical role in childhood OCD.
What a scan means
When I show families their child’s MRI brain scans, they often tell me they are relieved and reassured to “be able to see it.”

Children with mental illness continue to face enormous stigma. Often when they are hospitalized, families are frightened that others may find out. They may hesitate to let schools, employers or coaches know about a child’s mental illness. They often fear that other parents will not want to let their children spend too much time with a child who has been labeled mentally ill. Terms like “psycho” or “going mental” remain part of our everyday language.
The example I like to give is epilepsy. Epilepsy once had all the stigma that mental illness today has. In the Middle Ages, one was considered to be possessed by the devil. Then, more advanced thinking said that people with epilepsy were crazy. Who else would shake all over their body or urinate and defecate on themselves but a crazy person? Many patients with epilepsy were locked in lunatic asylums.

Then in 1924, psychiatrist Hans Berger discovered something called the electroencephalogram (EEG). This showed that epilepsy was caused by electrical abnormalities in the brain. The specific location of these abnormalities dictated not only the diagnosis but the appropriate treatment.

That is the goal of modern biological psychiatry: to unlock the mysteries of the brain’s chemistry, physiology and structure. This can help better diagnose and precisely treat childhood onset mental illness. Knowledge heals, informs and defeats ignorance and stigma every time.


Please rescpect them in their own dramatic life!

Attorneys representing some 12,000 mentally ill inmates filed a motion Tuesday asking a federal judge to require Illinois Department of Corrections enforce a 2015 settlement agreement reached in the case of Rasho v. Baldwin. 


what-life-is-like-in-a-prison-camp-in-the-dnr-body-Image ©

Thousands of Illinois inmates are asking a federal judge to take action and help resolve a “human rights disaster” they say is taking place inside state prisons.
Attorneys representing some 12,000 mentally ill inmates filed a motion Tuesday asking a federal judge to require Illinois Department of Corrections enforce a 2015 settlement agreement reached in the case of Rasho v. Baldwin.
In their motion, attorneys from three legal organizations – Equip for Equality, Uptown People’s Law Center and Dentons – claim IDOC hasn’t held up its end of that agreement, which required it to establish “a mental health system to facilitate timely, consistent, and individualized treatment.”
The class-action suit began in 2007 after attorneys claimed treatment of mentally ill patients within Illinois’ correctional facilities had devolved to the level of “cruel and unusual punishment.” They say Ashoor Rasho, whose name appears on the lawsuit as its lead plaintiff, had been isolated and restrained inside the Pontiac Correctional Center instead of receiving the necessary treatment for his depression and auditory hallucinations.
“If we stopped right now then the case would have been 10 years of work down the drain, because we still don’t have a functional and meaningful mental health treatment system,” Equip for Equality attorney Andrea Antholt said. “These are human beings, these are fathers and brothers and mothers and sisters and they need help.
“We have people being physically injured, emotionally injured – real life harm to real life people – and that shouldn’t be acceptable to anyone.”

Read the full motion here.
Attorneys mention the case of one inmate, referred to only using the pseudonym “Henry,” who began suffering from depression and hearing voices while in isolation at another Illinois prison. Following a failed suicide attempt in June, Henry spent the next three months placed on “crisis watch” inside a stripped-down cell without his “clothes or property.”
“During that three-month crisis placement, his treatment plan was never updated,” attorneys in the motion state. “Other than seeing the psychiatrist once, Henry received no mental health treatment while on crisis watches. The only interaction he had was a daily check-in by a mental health professional for a few minutes at his cell door.”
The initial suit dragged on for nearly a decade before the sides reached an agreement in December 2015. While IDOC has since made some changes – such as expanding staff training and constructing new mental health facilities – this week’s motion claims the department hasn’t implemented several of the required remedies.
A federal-appointed compliance monitor wrote in a May 2017 report that IDOC had “considerably improved” the quality of its mental health services. But he also noted “tremendous problems” persisting within prison psychiatric services, and found the department was noncompliant in several areas, including treatment planning and suicide prevention.
In a follow-up memo published last week, the same monitor referenced IDOC’s “continuing emergency” caused by a lack of psychiatric services for mentally ill inmates.
“I must reiterate that IDOC is in a state of emergency regarding its provisions of psychiatric care,” the monitor wrote.
Antholt said some of the noncompliance issues are rooted in staff vacancy issues. The settlement itself didn’t require IDOC to budget out new positions, rather it asks the department to fill existing spots that have gone unfilled.
Alan Mills, executive director of the Uptown People’s Law Center, said the department has also fallen behind on basic medication management and has a standing backlog of more than 2,000 psychiatric appointments.
“This is not sort of a theoretical, constitutional thing that they ought to be doing,” he said. “People are desperately suffering in there … We have a human rights disaster inside of our prisons right now.”
IDOC has already outlined its plan to cut that backlog down significantly by the end of the year. It has also expanded the time available to hold psychiatric appointments, authorizing employee overtime and additional clinics to be run during second shifts and weekends……



“The agency,” she said, “stands by its record.”
Follow Matt Masterson on Twitter: @ByMattMasterson

Andrew Rawlins: Prison mental health care criticised after inmate suicide

what-life-is-like-in-a-prison-camp-in-the-dnr-body-image-1437397705-size_1000.jpg ©

Andrew Rawlins had struggled with mental health problems from an early age, his family said
The sister of a prison inmate who took his own life just 48 hours after being remanded in HMP Bristol says she “has no faith in the system”.
Andrew Rawlins, a father-of-one from Clevedon, had struggled with mental health problems from an early age.
His sister Katrina said he should have been cared for in a mental health unit rather than remanded in custody.
Avon and Wiltshire Mental Health Partnership NHS Trust said it was to review the way inmates are monitored.
Mr Rawlins was on bail over an alleged assault when he was arrested for walking naked to a supermarket and sent to prison.
His sister had tried and failed to have him sectioned, and said of the prison service: “They don’t help people who are ill really.”
Anxiety and distress
The 26-year-old was one of five prison inmates who killed themselves at HMP Bristol last year – the second highest number of any prison in England and Wales.
A record number of inmates took their own lives in prisons in England and Wales in 2016, the Ministry of Justice recorded.
It said there were 119 self-inflicted deaths – 29 more than the previous year and the highest number since records began in 1978.
The Howard League for Penal Reform said prison suicides had reached “epidemic proportions”.
Mr Rawlins was living with his sister and her partner Tom Turner in May last year when the couple became alarmed at his behaviour.
Ms Rawlins told BBC Inside Out West: “He started sending threatening messages to me, Tom and a few other family members. Just sort of lashing out at us all the time really.”
She was also concerned because he was using cannabis and had threatened to kill himself several times.
The couple called a mental health helpline and were told the quickest way to get him sectioned was to call the police.
“Nothing whatsoever was being done for him,” said Mr Turner.

Image caption
Katrina Rawlins said people who are mentally ill should be in hospital, not prison
“We were being passed backwards and forwards from the police and the mental health service saying ‘well if he’s using cannabis we’re not going to go near him’.”
Then one morning in July, the couple said he smoked “a large amount” of the drug before undressing and walking naked to a local supermarket.
After failing to obtain any help from mental health services, the couple called the police and he was arrested.
Mr Turner said: “We didn’t want him arrested but we had to get something done and that was our only option.
“They say to trust the system, but I’m sorry to say after all this I have zero respect for the way things are working with the mental health side of things.”
The arrest put Mr Rawlins in breach of bail conditions and he was remanded in custody at HMP Bristol.
Within 48 hours he had hanged himself. The inquest into his death found he had taken his own life whilst suffering extreme anxiety and distress.
Ms Rawlins said: “I have no faith in the system. People who are mentally ill shouldn’t be in prison, they should be in hospital.”
In another high-profile case, Callum Smith, 27, from Cheltenham was found hanged in his cell at HMP Bristol in March 2016.

Image copyright
Cullum Smith Family
Image caption
Callum Smith, 27, from Cheltenham was found hanged in his cell at HMP Bristol last year
He had a history of mental illness and was “paranoid and delusional” when he was remanded after threatening to burn down his mother’s house.
An inquest found his suicide was contributed to by a number of inadequacies and failings by the prison service while he was in custody…..