Courage is the key word!!

My father used to always say that my mother was the most courageous person he knew. There are many descriptors used for the mentally ill, but courageous is the one word that is common for all. They know they have an illness that will never go away; that every day they have no choice but to wake up to another regiment of highs, lows, medicine or no medicine and if they are lucky therapy sessions. Psy-wards in and out of hospital stays or out-patient services; going from one doctor to another. Very sad circle of life for some. This article is a story that we need more of. Our loved ones have wonderful stories of courage and resolve and achievement that should be told, in spite of the stigma.

They had every kind of trophy you could imagine at House of Trophies in Boyle Heights. Soccer, basketball, baseball, football, even fishing. They had trophies 6 inches tall and 6 feet tall, plaques and desk ornaments too, for retiring cops and transit workers and for great teachers.

But nothing for musicians.

I told a clerk I needed a trophy with something a little different on it, like maybe a string player.

It was an unusual request, I could tell, but he went to his computer and came back with a printed image of a conductor and a musical symbol.

"We could do something like this," he said.

I decided to put my faith in House of Trophies and began making plans for the awards ceremony. The plan was to honor a friend I'm constantly asked about by readers and also to recognize two of my buddy's pals.

Since I began writing about Nathaniel Anthony Ayers, a street musician I met almost four years ago in downtown Los Angeles, I've been asked to speak at mental health symposiums, skid row fundraisers, universities and high schools and all kinds of award banquets.

I usually walk away with a plaque and a bad case of guilt. All those groups really should be honoring Mr. Ayers, not me. He's the one who's had to muster the courage to face each day. He's the one who has given a face to the anonymous thousands in the same fight. And he's the one whose story, I hope, is helping de-stigmatize mental illness.

I usually pass along the awards I get to Mr. Ayers, but I thought he should have his very own, which is how I ended up at House of Trophies.

Mr. Ayers had been telling me for months that he wanted to celebrate Beethoven's birthday on Dec. 16. I don't know a lot of people who walk around with Beethoven's date of birth in their heads, but nothing about Mr. Ayers is typical.

Ever since he stumbled upon the Beethoven statue in Pershing Square several years ago, he has conducted himself as if Ludwig were god of the universe and everything beyond.

Mr. Ayers had told me he'd like to perform at Beethoven's birthday party with some of his friends from the Los Angeles Philharmonic. But as the date approached, he feared he wouldn't be sharp enough to play with the pros. He said if he really worked at it, he'd be in good shape by Beethoven's birthday next year. But he wondered if we could still have a party.

Among the few dozen guests were violinist Robert Gupta, pianist Joanne Pearce Martin and cellist Ben Hong, all friends of Mr. Ayers and all members of the L.A. Phil.

Also attending was Adam Crane, the former L.A. Phil publicist who made Mr. Ayers welcome at Disney Hall concerts and became one of his closest friends. Mr. Ayers has had a tough adjustment since Crane moved on to the St. Louis Symphony Orchestra, occasionally strolling up to Disney Hall to see if Crane has decided to come back. Crane was coming to town anyway in December and adjusted his schedule to get here in time for Mr. Ayers' Beethoven party.

As the party approached, I began worrying that the man of the hour might not attend. Mr. Ayers has had a painful, chronic stomach problem for which he was refusing treatment, no matter how bad the agony. Doctors and meds, he says, are not for him. Not yet, anyway, because he recalls too vividly the days of restraints, shock therapy and Thorazine. He is still tough to be around at times and a challenge for the staff at Lamp Community, which handles hard-core, chronic cases of mental illness.

A book I wrote about Mr. Ayers came out last year, and I had been nervous about how he would react to it and to a movie based on the book that will be out in April. He once told me he preferred experiencing life to seeing it reflected in a mirror. Developing insight into one's own illness is difficult for many people. After reading the book, though, he thanked me. He said it wasn't easy to read, but he felt that he needed to. As for the movie, he said he had no desire to see it, in part because the very thought of two-dimensional images on a screen is spooky to him.

So I was shocked when, at the last minute, he decided to see a screening for cast and crew. Many of his friends at Lamp play themselves in the movie because director Joe Wright insisted on not using actors. They were excited about seeing themselves on the screen, and Nathaniel wanted to be with them, rather than miss what in effect was his own party.

We sat together at the Arclight. I'd seen the movie, but still I was anxious, and so was Mr. Ayers. He kept his eyes closed through the entire film, but he experienced it -- felt it, really -- in his own way. He loved the music, grumbled at certain depictions, laughed at funny lines and joined in the shout-outs when his friends saw themselves up on the screen.

I was humbled by him, proud of him, worried for him. What he's got doesn't go away. Every day's a challenge.

The first award at the Beethoven party was presented in absentia to Peter Snyder, an L.A. Phil cellist who retired last week after nearly 40 years with the orchestra.

Snyder has already moved up to the Central Coast and couldn't make the party. He was the musician who volunteered to give lessons to Mr. Ayers in a vacant skid row apartment three years ago, hoping it would make Mr. Ayers comfortable enough to move in off the streets of skid row.

Those lessons were the key, I think, even though Mr. Ayers resisted moving indoors, saying that he couldn't leave Beethoven alone on the streets of downtown L.A. Crane got him past that by going to the Disney Hall gift shop and getting a bust of Beethoven to place in the apartment. Mr. Ayers has lived in that apartment ever since.

At the Beethoven party, held in a basement music room at the L.A. Times, Crane's plaque was inscribed "Mensch of the Century."

Mr. Ayers was not just the man of the hour but the life of the party. He warmed nicely to the crowd, had a smile on his face most of the evening and was in his glory when Gupta and Martin offered a rousing rendition of the Mendelssohn Violin Concerto.

He also did pretty well in his own performance despite the lack of any rehearsal, playing cello to Martin's piano on the Bloch Prayer and a bit of the Schubert Arpeggione Sonata.

Standing tall on the piano throughout the performance was Mr. Ayers' new trophy, a gaudy 2-foot-tall beauty with metallic red and the best fake gold available. It was inscribed:

"Disciples of Beethoven Award

"For a half century of devotion to music. For a talent that knows no bounds. And for a story of courage and perseverance that speaks to thousands."

No Mental Illness

No mental illness here, Just old fashioned greed and a warped sense of the "Pretty boy" syndrome in my opinion.

Unless politics is a mental illness Blagojevich is sane!

By Usha Nellore
Examiner Columnist 12/19/08

It is now official. Illinois Governor and Democrat Rod Blagojevich was caught with his hands in the cookie jar and was arrested for his latest egregious run against federal law. For three years the feds scrutinized his wheelings and dealings, but not until now was he nailed with what seems like irrefutable evidence on tape, trying to sell Barack Obama's Senate seat to the highest bidder. As governor of Illinois he had the power to appoint the next senator to the vacated seat -- and did not take this task lightly.

He saw in it the perfect opportunity to angle for a Cabinet post in the Obama administration or perhaps an ambassadorial appointment. From Jesse Jackson Jr. to Valerie Jarrett, the latter being Barack Obama's confidante and adviser, he was certain all were for sale in exchange for the appointment. At one point in time he confessed on tape that he wanted to bag himself a position in a nonprofit organization affiliated with labor unions. This, he believed, could be achieved by appointing someone to the seat favorable to the Obama camp. The unions, pleased, would grant him his Christmas wish and pull him into a $250,000 per annum job for his benevolence.

Now the pundits shake their heads and exclaim these machinations are the worst ever in the annals of political corruption and can only be explained by Blagojevich having taken leave of his senses. In an article by Susan Saulny of the New York Times, Mike Jacobs, Illinois state senator, said Blagojevich may have lost his grip on reality. He said of his friend, "I am not sure he is playing with a full deck of cards." Cindy Canary of Illinois Campaign for Political Reform is quoted in the same article as saying she is trying to figure out the pathology to explain Blagojevich's actions. James Carville, Democrat and political commentator, laughs self-consciously and tells Wolf Blitzer of CNN Blagojevich's sins do not reflect our political system. In other words, Blagojevich is a rare political mutation wrought by delusions of grandeur and ambition run amok.

What nonsense! Blagojevich did not arrive at this behavior without previous experiences in the bazaar of politics. He was a state legislator in Illinois, a prosecutor and a member of the U.S. House of Representatives. He bought and sold a lot of favors. Businesses fed his campaign coffers in exchange for state contracts. Antoin Rezko, now in prison for fraud and bribery, collected campaign money for Blagojevich as he did for President-elect Obama.Obama endorsed Blagojevich in 2002 and again in 2006. Blagojevich endorsed Obama in 2004 after he won the Democratic nomination.

It seems someone from the Obama camp did speak to Blagojevich about this Senate appointment because the governor was apoplectic on tape that the Obama camp was unwilling to offer him anything more than gratitude for giving them the appointee they wanted. Did this contact from camp Obama bother to tell the feds that Blagojevich had an auction scheme to put Sotheby's to shame?

Suppose the feds and the Chicago Tribune editors had not been after Blagojevich for the past few years and suppose the governor had not been caught with his pants down by hard-nosed Patrick Fitzgerald, U.S. attorney for Chicago. Then what would have happened? That is the right way to ponder this melodrama. Union bosses, would they have given the governor what he wanted for a Senate appointment that suited their fancy? Obama and camp, would they, in exchange for the governor's favor, have given him a position, perhaps as ambassador to Serbia, striking two fruits with one stone, appointing a man of Serbian origin to the post and banishing him to Belgrade?

If the answer to these questions is a resounding "No!" then Blagojevich is a lone lunatic in the jungle of politics tormented by a disorder robbing him of his mind. If the answer to these questions is a "maybe," then Blagojevich's only affliction is a case of one rascal nosing out all the other possible rascals in his neighborhood! Let us not insult those who struggle courageously with mental illness everyday by lumping them with Blagojevich.

Interesting history, but don't want to re-visit

Mentally ill inmates: Modern-day Bedlam

by Bob Joondeph, Guest opinion

Wednesday December 17, 2008, 1:14 PM

When Captain Craig Ward, who manages the Union County Jail, referred to the behavior of an inmate with mental illness as "bedlam," he was spot on. (The Oregonian, Mentally Ill Inmates Strain Rural Jails, Dec. 14.)

The word "bedlam" is defined as: "a place, scene, or state of uproar and confusion." It originated as the popular name for first insane asylum in London: The Hospital of St. Mary of Bethlehem. Bedlam Hospital started taking people with mental illness in 1357. Conditions were awful. According to a visitor, the noise was "so hideous, so great; that they are more able to drive a man that hath his wits rather out of them." Violent or dangerous patients were manacled and chained to floors or walls. Londoners could visit Bedlam and pay a penny to stare at the inmates. According to The Catholic Encyclopedia:"one could peer into their cells and laugh at their antics or violent fights. Visitors were permitted to bring long sticks with which to poke and enrage the inmates."

Fortunately, we have made great progress in our understanding of mental illness since the heyday of Bedlam. Through early identification, the devastating effects of major mental illness may be avoided. Through counseling, medications, social supports and individualized therapies, those who experience major mental illness can and do recover and return to productive membership in society.

But left unidentified and untreated, these disorders may prevent a person from working and undermine family and social supports. While mental illness does not itself render a person more dangerous than others, poverty, isolation and substance abuse may lead to criminal behavior and time in jail or prison. Everyone (the person, the victim, their families, the jail, the community) would be better off if that person had received assistance early on. Yet, for decades, we have severely underfunded mental health and chemical dependency services.

Now, as The Oregonian pointed out, the Governor's Recommended Budget continues this tradition by calling for a 90% cut in non-Medicaid adult community mental health funding.
Under pressure from the federal government, Oregon is taking steps to correct the deplorable conditions at Oregon State Hospital. And yet we continue to look the other way while our jails are asked to carry on the tradition of Bedlam Hospital. Mental health treatment can and should be provided to inmates. Community mental health services need to provide more screening, treatment, housing and supports. Cutting these services will not only contribute to more human suffering and homelessness but will also generate higher back-end costs to taxpayers due to avoidable prison, jail and hospital days.

What can we realistically do? For starters, we should seek efficiencies by regionalizing community mental health services, including housing and acute care. We should continue to integrate the delivery of mental health services with physical health. We should demand greater accountability for the use of public resources through reporting of clear, measurable outcomes. We should assure that all Oregon inmates are properly screened for mental illness and have access to adequate treatment. And we should provide the funds to get this done.

To do less is to direct Captain Ward and his colleagues throughout Oregon to operate modern-day Bedlams.

Inmates

In my opinion, some inmates could be viable members of society. A lot of our mentally ill persons are incarcerated. This is due largely to the fact that they are not taking the correct medically prescribed drugs. I had a meeting with parents about a child in the fourth grade that I knew to be diagnosed as bi-polar. At this meeting the dad finally admitted that his father was bi-polar, he was bi-polar and he was very sad to hear that his child was following in the footsteps of the two generations before him. This dad said that his whole life in school, he could not stay focused and he was placed in the corner of the room, alone. He would refuse to work and was mostly in a depressed frame of mine through his elementary school experience. He said his dad takes a huge amount of medicine daily to maintain his mental illness. This dad said that he dropped out of school and now works a minimum wage job with no hope for anything better the rest of his life. Thankfully, he also stated that he did not want this for his child and that he would actively seek the proper medical care for his fourth grade child. I am amazed at the parents who are not brave enough to admit to teachers that they have mental illness in their families and would choose to not help their poor children who are innocent victims of the repeat behaviors of their parents. This is our children and the future of America and they deserve the best chance for success they can get. Parents of mentally ill children need to also get past the "stigma" of mental illness and do their job, get their children to licensed medical professionals for the proper help with their illness. Ignoring the problem is not a solution. Keepthedialogueup!!!

In N.H., more women inmates

Study cites lack of alternatives

CONCORD, N.H. - Women are being incarcerated in New Hampshire at a faster pace than men due largely to crimes involving drugs and alcohol and because of a lack of rehabilitative and treatment options, according to a study by The New Hampshire Women's Policy Institute.

Poverty, mental illness, unemployment, and domestic violence are underlying factors, the study found.

"Women's role as primary caregivers for children complicates both their incarceration as well as their path to rehabilitation," the study's authors wrote.

The study said the upward incarceration trend will have future costs on taxpayers and their children.

"While New Hampshire's current correctional model is effective in protecting public safety during an offender's incarceration, it is costly and ineffective in terms of long-term successful rehabilitation. New Hampshire would do well to experiment with another model, and the female offender population, being less violent and more directly involved in the care of children, would be a good place to start," the authors recommend.

The study estimates that on any given day about 430 women are behind bars in the state's prison for women and in county jails. Another 1,450 were supervised in their communities last year, and about 960 were released from jail - for a total of 2,850 involved with the system at some point.

Female admissions to county jails increased by 24 percent between 2003 and 2007 compared with a 14 percent increase during the period for men, the study said. Female admissions to state prison increased 64 percent during the period.

Additionally, in six of New Hampshire's largest communities, arrests of women increased 25 percent between 2002 and 2006 compared with 9 percent for men. Alcohol offenses among young women were one of the fastest-growing categories. The communities studied are Concord, Manchester, Keene, Laconia, Plymouth, and Portsmouth.

The study estimates that two-thirds of the female inmates have children and nearly half are single mothers who must turn to relatives or the state foster care system to care for their children during their incarceration. The authors estimated that 1,300 children are affected annually.

Corrections officials told the institute the growing number of pregnant inmates is straining the system. One jail superintendent said he contacted the state to arrange care for an unborn child but was told the state could not intervene because the child was not yet abandoned or neglected. Estimated costs of a pregnant inmate are $20,000 for medical care and transportation.

The study also said the system is taxed by inmates' mental health issues. Two-thirds of the women said they had a previous diagnosis of mental illness.

"The jails are functioning as an integral part of the state's mental health system without sufficient resources to identify and treat mental health problems," the study concluded.

Another Promising Bit of Research

Bipolar Disorder Genes, Pathways Identified By Indiana University Neuroscientists

Main Category: Bipolar
Also Included In: Neurology / Neuroscience; Psychology / Psychiatry
Article Date: 24 Nov 2008 - 1:00 PST

Neuroscientists at the Indiana University School of Medicine have created the first comprehensive map of genes likely to be involved in bipolar disorder, according to research published online Nov. 21 in the American Journal of Medical Genetics.

The researchers combined data from the latest large-scale international gene hunting studies for bipolar disorder with information from their own studies and have identified the best candidate genes for the illness.

The methodology developed at the IU Institute of Psychiatric Research enabled Alexander B. Niculescu III, M.D., Ph.D., and his team to mine the data from the genome-wide association studies and other study results on the levels of gene activity in human blood samples and in animal models. Genes with the highest levels of prominence were determined to be the most active in contributing to the disorder.

The researchers also were able to analyze how these genes work together and created a comprehensive biological model of bipolar disorder.

"Based on our work, we now project that there will be hundreds of genes - possibly as much as 10 percent of the human genome - involved in this illness," said Dr. Niculescu, who is an assistant professor of psychiatry and director of the laboratory of neurophenomics at the IU School of Medicine. "Not all genetic mutations will occur in every individual with bipolar disorder. Different individuals will have different combinations of genetic mutations. This genetic complexity is most likely what made past attempts to identify genes for the disorder through genetic-only studies so difficult and inconsistent."

Dr. Niculescu compared the process to a Web search. "The process was similar to a Google approach, the more links there are to a page on the Internet, the more likely it is to come up at the top of your search list. The more experimental lines of evidence for a gene, the higher it comes up on your priority list of genes involved in the disorder."

Until now there have been few statistically significant findings in searches of the human genome as it applies to bipolar disorder, he said.

"By integrating the findings of multiple studies, we were able to sort through, identify genes that were most likely to be involved in bipolar disorder, and achieve this major breakthrough in our understanding of the illness," Dr. Niculescu said.

Bipolar disorder, sometimes called manic depression, affects nearly 2.3 million Americans. A serious illness, people who suffer from it can experience mild or dramatic mood swings, shifts in energy and a diminished capacity to function.

Dr. Niculescu, a practicing psychiatrist and a molecular geneticist, said this work opens exciting avenues for psychiatric researchers and clinicians, as well as for patients and their families. "First and foremost, these studies will lead to a better understanding of bipolar and related disorders," he explained. "Second, the researchers now plan to study individuals to see which combination of genes is present in individuals to come up with a genetic risk score."

The goal, he said, is to be able to apply the risk score to test individuals even before the illness manifests itself for preventive measures - lifestyle changes, counseling, low-dose medications - or to delay or stop the illness from developing.

"Third, in individuals who already have the illness, genetic testing in combination with blood biomarkers for the disease, could help determine which treatments works best so personalized treatments could be developed," Dr. Niculescu said.

The research was done in collaboration with colleagues at the Scripps Research Institute, the University of California- San Diego, SUNY Upstate medical University and the National Institute of Mental Health. IU researchers involved were Helen Le-Niculescu, Ph.D., John I. Nurnberger, M.D., Ph.D., Meghana Bhat, M.D., and Sagar Patel.

Grant funding for the research was provided by National Institute of Mental Health.

Indiana University School of Medicine