Turn that frown around during the new year

Some say the goal of managing mental illness is to merely find peace. Then there are those who say that settling for peace is to do nothing more than, well, settle.

The goal, some say, should be achieving some level of happiness and prosperity.

As many people are busy and excited about the upcoming holidays, others are facing holiday season depression that could be exacerbated by loneliness and mental illness or physical disabilities.

That's why there's the aptly named Turn-a-Frown-Around Foundation which, since its establishment in 2001, has helped battle the loneliness felt by hundreds of children and adults with mental or physical conditions.

The organization brings friendship to people and the realization that they are important and have the potential to lead full, rewarding lives.

TAFA has approximately 50 volunteers, the majority of whom have mental or physical disabilities. As they visit children and adults, they build a sense of value and purpose for both themselves and the people they visit.

“It’s amazing that after struggling with the symptoms of my mental illness for many years, I have the tremendous opportunity to use my experiences to help others with similar challenges. It fascinates me that after feeling worthless for such a long time, I believe I live a most worthwhile life. It’s my mission to help others feel this way, too,” said Drew Horn, who co-founded TAFA with Dr. Gregory N. Ervin, a psychopharmacologist.

Horn offers a unique form of stand-up comedy when he visits individuals in psychiatric institutions, nursing homes and other facilities.

“TAFA’s audiences and newly found friends often find a sense of hope and purpose, both critical factors for reintegration into the community and progress toward wellness and recovery,” said Debra L. Wentz, chief executive officer of the New Jersey Association of Mental Health Agencies, Inc.

Just feeling loved and not lonely makes all the difference. Unfortunately, however, for something so simple and priceless, "it is complicated and demands a price,” Horn said.

“I am so proud of what my volunteers and I have been able to accomplish and I know we can achieve so much more," Horn said. "If funding weren’t an issue, TAFA would be reaching out to thousands more children and adults throughout the nation.”

TAFA is having an impact in ending social isolation for a small portion of those in need and is poised to do so much more. In addition to having a profound influence on the children and adults they visit and experiencing their own personal growth, TAFA volunteers are battling stigma of mental illness in the community, Dr. Wentz said.

“While TAFA has a growing cadre of volunteers, it lacks the vehicles and other support necessary to enable it to fulfill its potential of making as substantial and widespread an impact as possible,” she said.

For more information about TAFA or to book events, contact TAFA at 973-744-4138 or via e-mail Drew Horn at frown2smile@aol.com. TAFA asks for a modest honorarium when arrangements are made for Horn or other TAFA volunteers to provide entertainment and support.

TAFA is a 501(c)(3) charitable, nonprofit organization and gratefully accepts donations to dedicate to its work.

New Year's Day can bring out a lot of joy, or create a lot of guilt

From RealSimple.com:

Everyone feels guilty from time to time, but being consumed with compunction can suck the joy out of life. Here are simple strategies for relieving the pressure.

What, exactly, is guilt?

Guilt is a feeling of remorse that arises when you have done something wrong or think you have.

As a rule, "people feel guilty when they feel they've failed or transgressed in some way," says June Tangney, a professor of psychology at George Mason University, in Fairfax, Virginia.

Guilt pops up when a spouse says something he realizes is hurtful, when a parent loses her temper with a child, or when a guest breaks the host's heirloom vase. "It typically arises when you cause someone else pain," Tangney says.

That is why guilt is not all bad, says Mark R. Leary, Ph.D., director of social psychology at Duke University, in Durham, North Carolina: "Emotions like guilt are essential to social relationships." They motivate you to take other people's feelings into account. In most cases, you simply register the feeling of guilt and that leads to some sort of attempt to make amends -- to apologize, to behave with more care -- which can help preserve important relationships.

When guilt becomes a problem

There are times when guilt ceases to serve any purpose other than to make you unhappy. Some people even slide into exhausting self-flagellation. When you obsess about something you've done without any purpose or clear goal, "that's when you need a reality check," says Mark R. Leary, Ph.D.

But even a moderate amount of guilt can weigh on women, who tend to feel it more than men. The general view is that women are more focused on the caring role, and caring is the bedrock of guilt. What's more, in a busy world, says professor June Tangney, women often feel that they must choose between shortchanging family and friends (guilt!), cutting corners at work (more guilt!), and ignoring their own needs (yet another type of guilt!).

"For many women, the standards are impossibly high, and the world -- and their inner voices -- are telling them that nothing they do is good enough," Tangney says. It's all too easy to feel as though you're always falling short.

How to handle your guilt

1. Talk it out.

That unfortunate joke you told at the party sounds horrible when you play it over and over in your head. But if you tell a friend, it may not seem so bad. "Secrecy is the intensifier of guilt," says Edward Hallowell, M.D., the author of "Dare to Forgive: The Power of Letting Go & Moving On," because keeping it to yourself doesn't allow for fresh perspective.

"Once you've bared something that you find troubling and discover that your friend isn't nearly as shocked as you thought she would be, the guilt begins to drain away and you feel better." And even if your friend is somewhat shocked, just airing the topic can keep you committed to being more sensitive in the future.

By discussing the issue openly, "you accept the fact that you're not perfect, that you've done things that aren't pretty," says Hallowell. But that doesn't mean you should punish yourself forevermore.

2. Try to make amends.

If you've done something that you truly regret, say you're sorry and try to remedy the situation. Most people appreciate the conciliatory gesture because it's a signal that you care about their feelings and value the relationship.

And you may find that they weren't all that upset. "Very often the things you are feeling guilty about didn't have any impact on the other person," says Hallowell, "and you're suffering for no reason."

3. Try a reality check.

Guilt often arises automatically, based on standards internalized during childhood. So before you reflexively accept guilt, take a minute to stop and ask, "Am I consciously living by my own expectations?" says Mark R. Leary, Ph.D. Perhaps your mother washed and waxed the floor twice a week. But you may not feel that's the best use of your time and energy, so you choose not to. Still, you feel guilty about not waxing. Those are your mother's priorities, not yours. And keep in mind that you may be the only one who is invested in the thing you feel so guilty about.

"Worrying about your failings as a mother because you didn't bake homemade cupcakes when the child doesn't even care is guilt gone wrong," says Margaret Clark, Ph.D., a professor of psychology at Yale University.

4. Give yourself credit.

Remind yourself that what you did imperfectly is just part of being human, says Leary. Tell yourself, Everybody is late from time to time. Or Everybody says something stupid on occasion. That the behavior isn't unique to you doesn't make it OK, but it's reason enough to stop beating yourself up about it.

Try keeping a journal of all the good things that you've done. "Typically, people who are susceptible to guilt have a hard time giving themselves credit for anything," says Hallowell. So whenever you're feeling overwhelmed by guilt, stop and list five things you've done that are praiseworthy, whether they are small or large.

5. Break a sweat.

Instead of sitting around in a funk, go for a run, a bicycle ride, or a swim or play a few sets of tennis. "Working out is like hitting the reset button on your brain," says Hallowell. "It's hard to exercise and feel guilty at the same time."

Granted, this is not a permanent fix for an overwhelming feeling that you aren't pulling your weight at work or you're neglecting a friend, but it's a perfect antidote for smaller, isolated issues that may keep you awake for a night or two.

6. Beware of guilt trips.

Guilt isn't always something that you load on yourself. Some people (whether they intend to or not) induce guilt in others -- often to advance their own agendas.

To avoid falling prey to this, assess whether the other person's point of view is legitimate and if he or she is taking your needs into account. For example, perhaps your elderly mother doesn't get out much and loves your visits. But your daily presence will not literally cure what ails her, as she none-too-subtly suggests. If making the long trip to see her every day means you have to neglect your own family and yourself, this is a setup for more guilt. In this case, your mother's need is legitimate but her representation of it is exaggerated.

Talk to the other person about solutions that work for both of you so no one feels resentment toward the other. And if all else fails, bringing her a batch of cookies (store-bought) always makes things better.

Are you too guilty?

When you torment yourself over every little transgression, guilt can become toxic, even paralyzing. It can also jeopardize your health, contributing to depression, social anxiety, and eating disorders. "There's a difference between a sensitivity to other people's feelings and toxic guilt," says psychiatrist Edward Hallowell.

To help assess how guilt may be affecting you, see how many of the following statements ring true for you.

1. You can't seem to stop saying that you're sorry.

2. Other people keep telling you that you're too hard on yourself, that you expect too much from yourself.

3. Your mantras have become "I should have," "I wish I had," "I must."

4. You can't remember the last time you did something just for you: a movie, a manicure, a nap.

5. You can't say no, even if meeting someone else's needs means giving up the movie and the manicure.

6. You avoid people or situations because you think you don't belong or you're not good enough.

7. You feel resentful when you do something for someone else.

8. Everything is your fault.

9. Everything is your fault because you're stupid, bad, or unworthy.

10. You can't accept anything short of perfection from yourself.

Results: If more than five of the 10 statements describe how you often feel, it may be time to take steps to get your guilt under control.

"Talk to friends or family about how you feel," says Hallowell, and try the other techniques in this article. If you still can't rein in your guilt, consider talking to a therapist for more help, says Hallowell.

Remember the neediest!

Holiday blues and serious depression: Know the difference

While many people experience holiday blues, more than 19 million Americans of all ages suffer from depression and are likely to have even more severe symptoms during the holidays, compared to other times of the year, health professionals say.

It is essential to recognize the difference between holiday blues and serious depression and to know about support that is available all year long, according to the New Jersey Association of Mental Health Agencies, Inc.

NJAMHA says it's dedicated to helping children and adults recover from depression and other mental illnesses.

“Anyone could experience holiday blues. Perhaps they are not able to be with family members or they experience high levels of stress, which could be related to having unrealistically high expectations for the holidays," said Debra L. Wentz, Ph.D., Chief Executive Officer of NJAMHA.

"These types of issues could be alleviated by making time for ourselves, setting realistic expectations and trying to share special family memories. For thousands of children and adults, however, depression during the holiday season or any other time of the year is much more serious,”

She added: “If anyone shows a lack of interest in usual activities, sleep disturbances, weight changes or physical symptoms for several weeks, they should see a healthcare professional to determine if they have clinical depression. Treatments and other support are available and have been proven effective. However, without treatment, depression can lead to many serious complications, such as physical illness, drug or alcohol addiction or suicidal thoughts.”

Symptoms of holiday blues are similar to signs of depression: sleep disturbances, changes in appetite, agitation, anxiety, feelings of guilt, difficulty concentrating and decreased interest in activities that are usually enjoyable.

However, a prominent distinction between holiday blues and depression is the length of time these symptoms persist. Holiday blues last from a few days to a few weeks prior to or just after the holiday season, when people return to daily routines and no longer experience stress that is common around the holidays.

Holiday depression or stress could contribute to a tendency for increased use of alcohol or drugs, especially for individuals who are in the early stages of recovery from addictions. Drug or alcohol abuse is commonly associated with not only depression, but also suicide, accidents and domestic violence during the holiday season.

“In addition to having strategies for relieving stress, individuals can try to avoid situations that cause stress or alcohol or drug cravings. Having at least one friend or family member to provide support is equally important,” said Dr. Wentz.

The following are additional tips for during the holidays:

▪ Eat well to build energy and reduce cravings. However, to satisfy a strong urge for something that is sweet or contains alcohol, enjoy sweet foods and non-alcoholic drinks in moderation instead.

▪ Avoid or limit attendance at parties where alcohol will be served.

▪ Relieve stress with sleep, exercise, music, scheduled down time and avoidance of arguments.

▪ Have realistic expectations for how much money is spent on gifts and how much time is dedicated to family and social obligations.

▪ Seek professional help when needed to cope with depression or stress not only during the holiday season, but also any time throughout the year.

For those who suffer from postpartum depression: You're almost home

Congress is just about ready to take a giant leap in the world of postpartum depression treatment.

Sen. Robert Menendez and Congressman Bobby L. Rush are finalizing postpartum-depression treatment and education legislation for its anticipated victory in the U.S. Congress.

The new name of the legislation will be "The Melanie Blocker Stokes Mom’s Opportunity to Access Help, Education, Research and Support for Postpartum Depression Act." The lawmakers want to honor the substantial contributions each has made to this issue and continue to remember the woman - Melanie Blocker Stokes - who has become a symbol of the illness.

Blocker-Stokes was a Chicago native and pharmaceutical sales manager who, after the birth of her daughter, developed a psychosis that ultimately caused her to jump from a 12-story window ledge to her death on June 11, 2001.

The bill, if enacted, would require the secretary of Health and Human Services to expand and intensify research activities regarding postpartum depression and psychosis. The bill would also require additional support for basic and clinical research, epidemiological studies, diagnostic techniques and educational programs.

It is expected the bill will pass in early spring or possibly sooner once Congress reconvenes. It appears that Democratic support is substantial, but there are still some Republicans who need some convincing.

"I assured our legislators that we will be ready to do whatever it takes - writing, blogging, calling, adding our voices, spirit and energy to help achieve this historic victory for America's mothers and children," said Susan Dowd Stone, president of Postpartum Support International.

"Julia," by the Beatles
(A song that John Lennon dedicated to his mother)
Half of what I say is meaningless
But I say it just to reach you,
Julia

Julia, Julia, oceanchild, calls me
So I sing a song of love, Julia
Julia, seashell eyes, windy smile, calls me
So I sing a song of love, Julia

Her hair of floating sky is shimmering, glimmering,
In the sun

Julia, Julia, morning moon, touch me
So I sing a song of love, Julia

When I cannot sing my heart
I can only speak my mind, Julia

Julia, sleeping sand, silent cloud, touch me
So I sing a song of love, Julia
Hum hum hum...calls me
So I sing a song of love for Julia, Julia, Julia

Drugs may not be the first choice in mental health care, some say

Not everyone believes that drugs should be the first alternative in managing mental health issues.

The organization "MindFreedom International" has sent out an "alert" to tell people they have six more days to e-mail the National Institute of Mental Health about its "Strategic Plan," which outlines the agency's research goals for the next five years.

The deadline is this Friday, Dec. 21. E-mail to: strategicplanning2@mail.nih.gov

What's needed? "Voices for Choices in Mental Health!" Mind Freedom has declared.

Mind Freedom wants the NIMH to research on more choices in mental health than "drugs, drugs, drugs, drugs, drugs, drugs and more drugs."

According to Mind Freedom:

• 98 - number of times NIMH draft uses any of words "drug, medication, biological, illness, disease, genetics"

• 38 - number of times NIMH draft uses word "brain"

• 16 - number of times NIMH draft uses word "recovery"

• 2 - number of times NIMH draft refers to the "mind"

• 0 [zero] - number of times NIMH draft uses any of the words "counseling, consumers, survivors, peer, mutual support, empowerment,self-determination, rights, employment, jobs, housing, psychosocial, wholistic, holistic, psychotherapy"
  

You may download a PDF (789 kb) draft of the NIMH strategic plan here: http://www.nimh.nih.gov/about/strategic-planning-reports/nimh-draft-
strategic-plan.pdf

A hidden agenda behind a veil of independence

Here's something to keep in mind as the 2008 election nears.

As much as he says he's independent, Bill O'Reilly really isn't. Only this time, he's using a mental health stereotype as a weapon in his manipulation.

From the liberal blog, News Hounds:

Bill O'Reilly Turns "Loony Left" Into Dangerous Killers

As the election grows closer, Bill O'Reilly's attacks grow more ruthless. His "far-left loon" routine has been kicked up a notch and now he claims the left is not only anti-Christian but also out of control,dangerous and sure to hurt or kill someone. [In November] on The Factor, he used three segments to hammer the message home which is exactly what he advised Republicans to do in his weekly column, 9/22, to prevent a Democratic win in 2008.

After Newt Gingrich claimed that there was an 80 percent chance that Democrats would be victorious in '08', O'Reilly sounded the alarm in his weekly column. He offered the following campaign advise to Republicans which he has been using diligently while campaigning on The O'Reilly Factor.

"Also, the far left is totally out of control in this country, and a smart Republican candidate will tie those loons around the necks of Hillary or Barack Obama. Few Americans want to see Rosie O'Donnell and George Soros spending the night in the Lincoln bedroom. "

So "out of control loons" continued to monopolize The Factor and he even managed to bring Rosie O'Donnell back into the spotlight even though she has been keeping a very low profile. The message of a dangerously violent left emerging was played up and O'Donnell was connected to it.

[In a November segment of] Talking Points, he referred to the arrest of Paul Addis, performance artist, who was caught entering a San Francisco Church with fireworks which O'Reilly said were explosives.

He made this extreme prediction about far left protesters.

"As "Talking Points" has stated, unless the situation is dealt with by the authorities, people are going to die. In the last couple of weeks, Secretary of State Condoleezza Rice has been assaulted, President Clinton shouted down and the Bill Maher program interrupted. The mainstream media has been largely silent in condemning these actions. And some loons are even encouraging them"

Medea Benjamin appeared to discuss the incident, called an "assault" by O'Reilly, involving a member of Code Pink confronting Condi Rice with a hand full of fake blood. O'Reilly reported that the protester was facing 10 years in prison which Benjamin said was untrue. She insisted that the charges were misdemeanors. It was clear that O'Reilly knew he had been caught exaggerating.

O'REILLY: All right, now she is, this Desiree Fairooz is charged with disorderly conduct, defacing government property, assault on a federal officer. She — these are felonies, I think.

BENJAMIN: No, these are misdemeanors.

O'REILLY: All misdemeanors.

BENJAMIN: Yes.

O'REILLY: If convicted, she could face 10 years in prison. Now.

BENJAMIN: That's not true.

O'REILLY: Well, that's what it says right here on the sheet. Maybe it's not, but the court date for her is December 5th. She could face up to 10 years in prison. That's what it says. Anyway.

BENJAMIN: No, they're misdemeanors.

Misdemeanor or not, O'Reilly got his message through and succeeded in hanging the "loons around the necks" of Democrats once again. Even after a segment about the horriffic right wing Westboro Baptist Church, O'Reilly mentioned the far left right before condemning Westboro. In fact, he claimed that the head of the church is a registered Democrat.

So make no mistake, Independent Bill is using The O'Reilly Factor to campaign for the Republicans.

Beware of parents who manipulate, and then alienate

Ever hear of children who are manipulated by one parent to turn against the other?

Some children figure it out and reconcile and with their "lost" parent. Many, however, don't.

"Parental alienation syndrome occurs when a parent emotionally manipulates a child into turning against his or her other parent, in the absence of abuse or neglect," says Dr. Amy J.L. Baker.

That's why Baker has written "Adult Children of Parental Alienation Syndrome: Breaking the Ties that Bind," because it presents what has become a growing problem not only in families that are suffering from divorce, but also those that manage to stay together.

The book "describes the 11 different catalysts to having the realization that one was a victim of parental alienation, [and] describes the long-term effects of parental alienation syndrome," she said.

The book is based on research interviews with 40 adults who were alienated from a parent as a child, according to Baker's website, http://www.amyjlbaker.com.

Baker is a nationally recognized expert in parent-child relationships - especially children of divorce, parental alienation syndrome, and emotional abuse of children.

The book describes the three different familial contexts where parental alienation can occur, and explores the ways in which parental personality disorders provides the psychic foundation for alienation, Baker said.

It also compares PAS to emotional abuse of children, and compares alienating parents to cult leaders who use the same thought reform and emotional manipulation techniques.

The book is written for both parents and the mental health professionals working with adult children of parental alienation syndrome, as well as currently alienated children, Baker said.

"The book offers insight into this experience from the perspective of the children who lived through it and offers hope to parents worried about losing their children to this tragic and painful experience," Baker said.

"Adult children of parental alienation syndrome: Breaking the ties that bind," was published by W.W. Norton in April 2007 and is available in some bookstores and on Amazon.

A little organization goes a long way

The New Jersey Mental Health Institute, Inc. may seem like it has a limited reach because it's specified as a "New Jersey" group.

But the NJMHI does so much more in so many places that are much farther away.

Just to name a few:

* Delivery of keynote presentations and trainings for a total of more than 50,000 individuals. Three statewide conferences focused on cultural competence to improve treatment quality for diverse populations - not only ethnic groups, but also elderly immigrants and gay and lesbian clients. NJMHI also coordinated training for more than 23,000 mental health providers in New Jersey's Children's System of Care.

* Establishment of the Tsunami Mental Health Relief Project. More than 100 individuals in Sri Lanka were trained to help nearly 20,000 children and adults cope with the devastating effects of the tsunami in December 2004.

* Awarding of scholarships to 20 bilingual, bicultural students pursuing Master's degrees in social work.

* Developing and supporting policies that have increased access to non-emergency mental health services and decreased utilization of emergency and inpatient services among Hispanics in New Jersey. An additional 13,532 Hispanics received outpatient care in 2006, compared to 2000. Furthermore, 33 percent more Hispanics received screening services and 25 percent fewer Hispanics used emergency services between 2005 and 2006.

* Collaboration with other state and national organizations to battle stigma and discrimination; support families whose loved ones have mental illness; and influence the development of policies to support providers in delivering the most effective mental health services.

Chances are you have a friend or family member with mental illness, as it affects one in every five Americans. Imagine if your loved ones could not receive the care they need because of stigma, lack culturally competent providers or lack awareness of available services, the organization says.

Like many children and adults across the country, they would miss the vital opportunity to receive treatment that would change their lives. The New Jersey Mental Health Institute, Inc. (NJMHI) has made great strides toward solving this problem. With your support, NJMHI can have an increasingly significant impact on the lives of thousands of individuals.

Clearly, NJMHI is well poised to achieve so much more, especially with your support. That's why the group is asking for a tax-deductible donations to maintain its success.

The NJMI thanks everybody for their commitment in helping the group improve the lives of adults and children with mental illness.

Six years later, there's still a place to go for those suffering from Sept. 11

Even six years later, there are still places to go if you're a casualty of the Sept. 11, 2001 attacks.

And they're not just places that care for those who suffer physically. There are still thousands of people still suffering from the aftershocks of the event, and deal with lingering depression and fatigue.

There are still people who live alone, and suffer from the effects of losing a loved one. There are some who were there, and suffer from post-traumatic stress.

Anne Marie Baumann is the senior vice president of the FealGood Foundation, and she's been receiving many calls from people who are becoming ill - mentally and physically.

Baumann is still shocked herself by the lack of services provided to survivors of the attacks.

"They are looking for much needed help with not much available," she said. "It really is a shame and a discgrace!!!"

Giver her a call at 631-724-3320.

Finally, there's someone who not only cares about mental health, but how it's portrayed

Filmmakers often consider their craft a personal statement, but rarely is it to personal to the point of being real life.

Sure, “A Beautiful Mind,” was personal. But it was a Ron Howard project, and he grew up in the comforts of Hollywood and an atmosphere that was virtually free of the kind of personal hell that the movie represented so well.

Joseph Greco, however, grew up in Florida with a schizophrenic mother who suffered many of the same issues afflicting Marcia Gay Harden’s character in his movie, “CANVAS.”

Indeed, “CANVAS,” was so personal that Greco often calls it “a labor of love.” He believes others will feel the same way – particularly those who went through the same kind of personal hell.

“We want people to know that this a family like any family,” he told me in a recent interview.

“CANVAS” has been in the movie theaters for more than a month, and it’s received a number of decent reviews from The New York Times, Roger Ebert and others. But many critics were among the first to point out that it’s one of the few movies about mental illness that refrains from over-the-top depictions and stereotypes.

(For an example of an over-the-top depiction, watch “Me, Myself and Irene,” the 2000 movie starring Jim Carrey that mocks schizophrenia.)

That was because Greco, 35, wanted people to know what it was like to deal with someone they love who had wild mood swings. He wanted people to know what it’s like to be connected to somebody who couldn’t keep track of their emotions.

You can laugh, he says, but he wants you to understand, too.

“It was extremely cathartic and therapeutic [the movie] – I had to express something that was very harrowing,” he said. “I would hyperventilate in college whenever I would talk about my mother.”

This is an honest and serious depiction that, at times, charms and even humors people, too. But it can be dark, and even The New York Times noted that it’s ending is a bit too dark, giving the moviegoer a bit of an empty feeling at the end since – unlike “A Beautiful Mind” – there appears to be a lack of resolution.

Greco doesn’t apologize for that – in fact, he tried hard to resist the tendency to “romanticize mental illness and deal with the clichés.” He even had to stop movie producers from insisting that he either kill off or “cure” the Marcia Gay Harden character.

“I wanted to tell it as straight as I possibly could,” he said. It’s not a pretty picture.”

Greco hopes the movie, which also stars Joe Pantoliano of “Sopranos” fame, will take mental health one step closer to respectability and one step farther away from “the easy joke” that schizophrenia, bipolar disorder and other illnesses have become in movies.

“Mental illness affects all of us, and as in the case of ‘Me, Myself and Irene,’ it was always about the easy joke,” he said. “You would never do that about somebody with breast cancer.”

How to cover mental health - and abide by the moral imperative

To paraphrase Bob Woodward, journalists – and their readers – should seek the truth or, more realistically, the “most obtainable version” of it.

But in its coverage of crime that involves people with mental illness, the media has consistently produced information that is incomplete, inconsistent and, as a result, untruthful to the point of outrageousness.

In such matters, the media needs to grasp the complexity of mental illness – which would include developing an understanding of the background, symptoms and effects of schizophrenia, bipolar disorder and other illnesses – before going to print or doing a broadcast.

But the media has too often chosen the low-road and typically gone for the fear-mongering, consumer-driven components of a story rather than promoting a profound understanding that – if they tried – could attract the same amount of readers they normally get, as well as perform a public service.

The media also have failed to provide a consistent balance in the form of an alternative viewpoint that could help explain – and lend clarity to – such issues. Providing balance in crime news could help shape a new understanding of mental illness and, perhaps, help people better understand why certain crimes are committed.

Perhaps the biggest culprit is the tabloid media, which has developed its own vocabulary of terms to paint people with mental illness as less than desirable. These news outlets routinely dehumanize people by labeling them with derogatory terms such as “wacko” or “loon” – even if the story has a remote connection, or even lacks any association, with mental illness.

Language is, perhaps, the media’s sharpest weapon, and it’s allowed The New York Post, The New York Daily News and many papers like it to be seduced by the need to condense, shock, outrage and, ultimately, demean those with mental illness. A search of newspaper headlines through the Lexis-Nexis online research site, for example, revealed that, since March 1995, the word “wacko” has appeared in articles published by The Daily News and The Post more than 500 times (The same term was used in The New York Times, which has shown more sensitivity toward mental health issues, 238 times, but not one appeared in a headline). The term was sometimes used to describe some cases where mental illness was not necessarily an issue – but, because of the headline, it’s either unfairly implied or alleged that mental illness was connected to crime, or it was even the direct cause of it.

One such Daily News headline on April 20, 2004 read thusly: WEB HATE SITES LURING SICKOS, WACKOS, WEIRDOS. Toward that end, Michael Jackson is always an easy target, such as this example from the Daily News on April 1, 2004: JACKO GOES MUM BUT STAYS WACKO. On March 14, 2004, this headline appeared in The New York Post: STANDOFF; WACKO HOLDS GRANNY HOSTAGE.

None of these stories, however, produced any evidence that the people described as “wacko” were ever diagnosed with a mental illness. Has Michael Jackson ever even visited a psychiatrist?

Sometimes, these editorial headline decisions are made BEFORE the facts of a particular case come to light. The Feb. 7, 2007 issue of Columbia Journalism Review, for instance, cited the reporting of the bizarre adventures of Lisa Nowak as an example, noting the former astronaut “soared” across newspaper front pages earlier this year not for her recent shuttle mission to the international space station, but for the details surrounding her arrest and subsequent charges for attempted murder and kidnapping.

As CJR noted, Nowak had recently separated from her husband of 19 years, with whom she had three children. She graduated from the U.S. Naval Academy and worked at NASA for more than 20 years. Many news reports, however, focused not on her accomplished background or her recent marital troubles, but on the sensationalistic case evidence produced by police: Nowak allegedly wore adult diapers so she wouldn’t have to stop during her 900-mile road trip to confront Air Force Capt. Colleen Shipman, whom Nowak allegedly considered a rival for the affections of another astronaut, William A. Oefelein, according to CJR.

Twenty-four hours after the story broke, it was still unclear whether Nowak suffered from any illnesses related to mental health. Still, the news media jumped on this story and immediately applied derogatory mental health terms to describe the disgraced astronaut and her adventures – none more so than The New York Daily News, which displayed a front page, bold-type, black-and-white headline that said: “Dark Side of the Loon.” To this day, it’s still unclear whether Nowak suffers from any type of mental illness, but it didn’t matter: The Daily News had effectively dehumanized her before she even had a diagnosis from a psychiatrist.

In some ways, television news – particularly Fox News – has adopted the same kind of shock-and-awe philosophy as The Post and The Daily News. The 24-hour news outlets have helped promote that approach by employing commentators who offer strongly worded diatribes that strike a nerve with a public that’s weary of random, unexplained kidnappings and killings in today’s society.

Bill O’Reilly, host of “The O’Reilly Factor,” has, perhaps, taken this approach a step further than most commentators, making it his regular practice to use the word “loon” to describe anyone who is undesirable or, more accurately, anyone who disagrees with him. In the process, he’s reinforced his obvious bias against people with mental illness more often than he promotes his line of clothing. Just three months ago, a quick search of "Bill O'Reilly" and "loon" on You Tube yielded no more than 10 video-clip entries. Now the list is endless - page after page shows O'Reilly equating "loons" with pedophiles and people who exhibit other forms of inappropriate behavior – as well as the “far left” peace advocates who protest against the Iraq war. Other talk-show hosts who imitate him have caught on, too, and they've made continuous references to "left-wing loons" and other groups.

Here is an example of one such O’Reilly diatribe, taken from his nationally syndicated newspaper column published on Nov. 12, 2007 and entitled “Never mind the far-left loons, the war on terrorism is real.” Notice how “lunacy,” in O’Reilly’s mind, essentially boils down to stupidity:

“So now the far-left loons in the media are saying there really isn’t an organized terror threat in the world and this whole war on terror deal is a hype job,” he wrote. “That must come as great comfort to the thousands of families who lost loved ones on 9/11. They must really appreciate the St. Louis Post-Dispatch editorializing: ‘After nearly six years of hearing the Bush administration make assertions about the war on terrorism that turn out – to put it kindly – overblown.’ I’m just wondering how ‘overblown’ the terror war is for the five thousand individuals injured when al-Qaida blew up two U.S. embassies in Africa, not to mention the 257 human beings who were murdered in that attack. But it might be hard to comprehend ‘overblown’ when you’re dead.

“The nutty professor Paul Krugman, who teaches at Princeton and writes op-ed lunacy for The New York Times, is also on the diminish-terror bandwagon. This is from his desk: ‘There isn’t any such thing as Islamofascism – it’s not an ideology; it’s a figment of the neocon imagination.’ That’s like saying there is no such thing as stupidity, right, professor?”



The gotcha headlines, some media have argued, attract people who otherwise wouldn’t give a damn about what’s going on in the world around them. In a Dec. 20, 2001 article published by the Asia News Network, Fox News chairman Roger Ailes defended his network’s overall approach to news and how it deals with crime and terrorism stories by saying: “Look, we understand the enemy... They want to murder us. We don't sit around and get all gooey and wonder if these people have been misunderstood in their childhood. If they're going to try to kill us, that's bad.”

But all that is beside the point. To quote Albert Brooks in the movie “Broadcast News,” they’re burying the lead, and not reporting on the root cause of the murder or what can be done to prevent such horrific acts from happening again.

In a June 16, 1995 New York Times article, reporter Lisa Foderaro noted: “Language is such a sensitive area in the mental health field because it can reflect an individual's very notion of what mental illness is – whether a serious disease or merely a psychiatric label put on an emotional crisis or an altered state of consciousness – and because it can be belittling or empowering.” She then quoted Nora Weinerth of the National Stigma Clearinghouse in New York, who said: “When language is used to devalue, it shapes attitudes that, in turn, become public policy.”

Having balanced coverage would perhaps counteract against the stereotypes. In criminal matters, reporters could give mental illness awareness efforts the same kind of respect they give to police departments who want to inform a public about a suspect who’s on the loose. If a reporter discovers that a suspect is schizophrenic, or obsessive compulsive, or bipolar, maybe he or she should call up psychiatrists or the National Alliance on Mentally Illness to learn more about the illness, and then report on it. Psychiatrists, psychologists or advocates could be on the same “call list” – right alongside the police – when a murder takes place and the evidence is clear that the suspect has a mentally illness.

The New York Times is, perhaps, one of the few who “get it” and explore what happens in criminal cases involving people with mental illness as well as revealing the so-called “dark side” of the suspect. It was, in fact, one of the first publications to explore what happened to Andrew Goldstein before he pushed Kendra Webdale to her death on a subway track in New York City. The man was diagnosed with schizophrenia, and he had failed numerous times to get treatment before he killed the 32-year-old woman eight years ago.

In a May 23, 1999 New York Times Magazine article, the newspaper explained how there were numerous attempts to get Goldstein help before he committed murder. But the system failed him like it failed many others. According to the Times: “They knew he was dangerous. In the two years before Kendra Webdale was instantly killed on the tracks, Andrew Goldstein attacked at least 13 other people. The hospital staff members who kept treating and discharging Goldstein knew that he repeatedly attacked strangers in public places. They knew because he had attacked them -- two psychiatrists, a nurse, a social worker and a therapy aide in two years' time. Over and over, his hospital charts carried warnings.”

The Times continued: “They knew. Long before this subway push … the state of the nation's shattered mental-health system all but assured such calamities. Yet for each hospitalization – there were 13 in 1997 and 1998 alone – Goldstein was given medication, then discharged, often after just a few days, to live on his own in a basement apartment. And now the consequences were front-page news: ‘Horror on the Tracks,’ read the tabloid headlines, ‘The Face of a Madman.’ ”

Editor's note: This blog entry was originally submitted as an assignment for Richard Wald's Critical Issues class at Columbia University.

Badlands
By Bruce Springsteen

Lights out tonight
trouble in the heartland
Got a head-on collision
smashin' in my guts, man
I'm caught in a cross fire
that I don't understand
But there's one thing I know for sure girl
I don't give a damn
For the same old played out scenes
I don't give a damn
For just the in betweens
Honey, I want the heart, I want the soul
I want control right now
talk about a dream
Try to make it real
you wake up in the night
With a fear so real
Spend your life waiting
for a moment that just don't come
Well, don't waste your time waiting

CHORUS
Badlands, you gotta live it everyday
Let the broken hearts stand
As the price you've gotta pay
We'll keep pushin' till it's understood
and these badlands start treating us good

Workin' in the fields
till you get your back burned
Workin' 'neath the wheel
till you get your facts learned
Baby I got my facts
learned real good right now
You better get it straight darling
Poor man wanna be rich,
rich man wanna be king
And a king ain't satisfied
till he rules everything
I wanna go out tonight,
I wanna find out what I got
Well I believe in the love that you gave me

I believe in the love that you gave me
I believe in the faith that could save me
I believe in the hope
and I pray that some day
It may raise me above these

CHORUS

mmmmmmmm, mmmmm, mmmmmm

For the ones who had a notion,
a notion deep inside
That it ain't no sin
to be glad you're alive
I wanna find one face
that ain't looking through me
I wanna find one place,
I wanna spit in the face of these badlands

CHORUS

From WSJ: In case of a psychiatric emergency, read this:

Before there were living wills, people were just left to die.

And if they had a mental illness, they were left to suffer.

Now - as noted in this entry from the Wall Street Journal's Health Blog - there is a movement to prevent either situation from reaching a crisis point.

And, as the blog noted, it was the Terri Schiavo case that highlighted the importance of giving family directives on what to do when patients are unable to communicate their wishes.

The piece, entitled, "In Case of Psychiatric Crisis, Read This," talks about Psychiatric Advance Directives, or PADs.

It notes: "PADs are legal documents that patients can prepare to state in advance of an acute psychiatric crisis what medications, hospitals and other treatments they would prefer or like to avoid.

Twenty-five states have laws allowing PADs. In North Carolina, a sample form includes such items as preferences about electroconvulsive therapy, or ECT, and tips for medical personnel on how to minimize the use of restraints or seclusion. A model form in Texas lays out details on a patient’s consent, or lack of it, for specific medications. A Michigan form guides a patient in legally designating a personal advocate in case of crisis.

But how are PADs actually used? And what happens if, in the breach, a doctor’s judgment clashes with the stated wishes of the patient? The Health Blog asked medical sociologist Jeff Swanson from Duke University, who’s been active in research on mental health policy and treatment options for people with serious mental illness.

First, Swanson laid out a key difference between the advance directives for psychiatry and those typical for medical care. A living will focuses primarily on “forgoing unwanted treatment,” Swanson said. “The goal of the psychiatric advanced directive is to [help you] recover. You’re trying, in a way, to protect yourself from decisions you might make when you’re ill.”

Swanson explained that an advance directive helps people to maintain some autonomy when they otherwise lose their ability to decide. But there can be legitimate questions about whether patients are thinking clearly when they create PADs, or what to do if they say later that they don’t want to follow their PADs, he said.

Though PADs are legal documents, most state laws on the subject contain override clauses, Swanson said. In a crisis, a doctor can invoke his or her clinical judgment to act in the best interest of the patient, essentially ignoring the PAD. Empirical data are hard to come by. But “clinical experience and anecdotal reports suggest that overrides occur with some frequency,” according to a commentary Swanson published last year in the Journal of the American Academy of Psychiatry and Law.

Are PADs worth the trouble then? Some psychiatrists have wondered if it would make more sense to draw up a crisis plan, rather than a legal document, to guide treatment.

Swanson, who has conducted quantitative and qualitative research on the topic, said that some patients say that even if their directives aren’t followed, they still feel the documents give them respect within the mental health system. “Just the fact that someone needs a legal document for respect is telling,” Swanson said."

PTSD is not just a "war thing."

Post-traumatic stress has a long reach.

But one of its most misunderstood qualities is that it only applies to soldiers who have served in the battlefield.

In fact, it can affect people of any age and stripe - including teenagers and young adults who live in the peaceful fields of suburbia.

And anyone can encounter the kind of heartache and mental anguish that many soldiers feel when they struggle in their return to civilian life.

This is the story of Jill Manges, as reported by insidehighered.com:

Jill Manges guesses that if she’d suffered an epileptic seizure that day in class, she’d still be enrolled at Eastern Illinois University. But Manges, who has post-traumatic stress disorder, instead suffered a flashback during French history that led her to shout and sob uncontrollably.

“I can’t deny the fact that what happened was disruptive,” says Manges, who was sentenced to a year-long suspension by the university judicial board last month for violating two sections of the student conduct code barring the disruption of university functions and the academic environment in particular (see standards Id. and IVa. of this document).

“But I wonder if they would do this to someone who had an epileptic seizure in class or had a hangover in class or had an asthma attack, because that’s disruptive too.”

In a letter to Manges dated September 17, Eastern Illinois’ assistant director of judicial affairs writes that given Manges’ admission that she violated the two code of conduct standards prohibiting disruptive behavior during the September 5 “incident” (in other words, the in-class flashback), and “the seriousness with which the board viewed this incident, it is their recommendation that you be suspended from the university, effective immediately, for a minimum of an academic year through the Spring Semester, 2008, during which you would be prohibited from being on the campus without prior permission of the vice president for student affairs or his designee.”

“This was a very difficult decision for the board because they recognize that you have made progress in dealing with the situation but the board is concerned about your well-being as well as the well-being of the greater EIU community. Therefore, the board encourages you to seek a medical withdrawal from the university,” the letter continues, indicating that should that be Manges’ choice, the board would not submit its suspension recommendation to campus leadership.

“In consequence, as a condition of your readmission to the university,” the letter says, “you will need to provide documentation as evidence of your continued improvement and ability to keep your condition under control....”

Eastern Illinois officials won’t comment on the specifics of Manges’ case. But speaking more broadly about how they handle mental health issues on campus, they stress that they always have students’ best interests at heart.

“Since we’re in such a rural area and some of our services are limited, we realize this may not be the best environment to really serve all students and we also recognize that sometimes a student may not be good in this environment for other students,” says Heather Webb, director of judicial affairs at the university.

“Everything is done on a case-by-case basis,” says Sandra Cox, the director of the counseling center. “Usually when information goes out there, [people] only have a very small portion of the truth, they have a very small portion of the behaviors that are brought up. They have a very small portion of the whole picture.”

A Flashback and its Fall-Out

While enrolled at Eastern Illinois, Manges says she saw a private counselor off campus to deal with her diagnosis of PTSD — a result of the sexual abuse she experienced from 1999 through 2000, when someone she knew not only abused her but also collected money from other men who did the same.

She was sitting in French history class September 5 when she could feel a flashback coming. Trying to leave but unable to exit the room in time, she collapsed before reaching the hallway.

“I don’t remember what happened because I was disassociating, but what witnesses said, what my professor said, is that I started sobbing uncontrollably, shouting, screaming. I was unresponsive; I was just lying on the floor,” Manges says.

For the 10 to 15 minutes the episode lasted (of the 50-minute Wednesday afternoon class), the other 15 students “responded by sitting quietly and letting those of us who needed to act do so,” says David Smith, the professor teaching the course. “I was extremely proud of how the students responded.”

An ambulance came, and Manges declined to go to the hospital. She says it’s her understanding that at least two classes, including her French history class, were canceled, and one other was moved. There were six or seven classrooms on the hall, Smith says, and other professors came into the hallway to see what was going on.

Manges experiences such severe flashbacks – which she describes as akin to reliving a traumatizing event – once every two weeks or so. This was the first time one happened in a public academic setting at Eastern Illinois, she says, although she had a similar experience in a classroom at a community college that she previously attended (she transferred to Eastern Illinois in January of this year).

Upon returning to her room on September 5, Manges says she had two voice-mail messages waiting: one from judicial affairs, asking her to see a campus counselor, and one from the counseling center. Wanting to comply, she called the judicial affairs official, who met Manges to walk her over to the counseling center. The next day, Manges met with judicial affairs for a meeting, and her parents came to the university for a second meeting the day after. “Pretty much the gist of it was she told me how much of a disruption I had caused,” Manges says.

Smith, who says that he was interviewed by several college officials about the incident, adds that in his conversations, judicial affairs staff focused on the flashback and the disruption of classes.

After a hearing September 13, Manges says she learned of the year-long suspension and her option to accept a medical withdrawal. She chose the latter so her family could get her tuition money back. Because of that, she says she can’t appeal the judicial board’s decision. She’s living in her off-campus apartment, with plans to get a job, move to Boston in January and apply to finish college there. She was a junior history major and writing minor at Eastern Illinois. She has no plans to sue, saying she has neither the money nor the time.

Manges says she had come up on judicial affairs’ radar screen once previously, back in the spring when she spoke with a professor about experiencing suicidal thoughts. Manges says she was asked by college officials at that time to sign a behavioral contract agreeing to continue psychological treatment and keep up her academic coursework. Manges, who says she is not suicidal now, signed the contract.

She says that she upheld it and that the contract — and the suicidal ideation she experienced in the spring — did not come up during her judicial board hearing, which focused on the PTSD. She says that a letter from her therapist certifies that she is not a threat to herself or others.

And as Gary Pavela, author of Questions and Answers on College Student Suicide: A Law and Policy Perspective (2006: College Administration Publications), points out, “Research indicates that the odds that a student with suicidal ideation will actually commit suicide are 1,000 to one.” Several national reports following the 1999 Columbine High School shooting show that “it is inadvisable to create the impression that there is some kind of automatic, hair-trigger response to behavior that is viewed as disruptive or that falls outside of the area of disruptive into suicidal ideation,” Pavela says, as the perception of harsh penalties can prevent students from seeking help.

“I don’t know what we can do except to make students aware that this is happening at the campus,” says Manges, who describes a general lack of awareness of mental health issues. “Honestly, because there’s not a lot of knowledge about mental illness, mental illness still has a huge stigma. People don’t understand it; people are scared of it because they don’t understand it.”

“I was certainly disappointed at the outcome,” says Smith, the professor of the French history course. He testified on Manges’ behalf at the judicial board hearing.

“I certainly hoped that the student would be returning to the class, wanted her to come back” — as, he says, did the other students in the course.

“I would hope that in the wake of terrible tragedies like at Virginia Tech that universities don’t close themselves off as places where students can deal with difficult issues.”

Psychology and Behavior

Eastern Illinois administrators say they make a concerted effort to help students deal with their problems while staying on campus. “Whenever possible, we try to work with the student to help them through their mental illness,” says Webb, the judicial affairs director. She mentions the behavioral contracts cited by Manges as one example. A number of situations, including excessive alcohol consumption and suicidal ideation, could result in students being asked to sign a contract, which outline a set of expectations.

“It doesn’t say we expect you not to experience mental health issues. We expect that,” Cox of the counseling center says. “What we look for are changes in behavior.”

Webb says that, whenever it’s appropriate, she contacts the counseling center to see if a voluntary withdrawal might be an option for a student facing charges in the judicial system. In fact, when asked whether there were any inaccuracies in a student newspaper story outlining Manges’ take on what happened, officials clarified a policy stipulating that when mental illness is impacting student behavior, the possibility of a voluntary medical withdrawal is always discussed prior to judicial proceedings.

“[What’s been] put out there is that Eastern has suspended students based on mental health reasons. And that is incorrect,” says Cox. But, she adds, “if there are long-term or consistent behaviors that are in violation of the student conduct code…then we have to look to see, do we have the services for someone who is struggling to a significant extent?”

While Cox says she processes a handful of voluntary withdrawals per week at the university of about 12,000 students, not once in her 11 years at Eastern Illinois has the university had to complete its mandatory withdrawal process for psychological reasons, reserved for the most extreme cases involving threats to the self or others and an inability to take care of oneself.

Yet, while Manges technically signed a voluntary withdrawal form, to her it might as well have been mandatory. “I was between a rock and a hard place. I chose a hard place,” she says. “I’ve always been under the impression that people who take a medical withdrawal do it for themselves. For me, it was something that I was pretty much forced into doing.”

The Bigger Picture

While what Manges says happened at Eastern Illinois may not be common, nor are such experiences uncommon, says Karen Bower, a senior staff attorney at the Judge David L. Bazelon Center for Mental Health Law. Bower says she routinely (more than once a month) gets calls from students who are forced to leave college for mental health reasons.

“They all feel very betrayed by the school and say that being out of school isn’t going to help them,” says Bower, who was involved with recent lawsuits on similar issues against George Washington University and Hunter College of the City University of New York that both ended in settlements.

“We have urged that schools not use disciplinary action for behavior that’s a result of mental illness,” Bower says — echoing Professor Smith’s sentiment that a judicial board hearing didn’t seem like an appropriate venue for addressing his student’s situation.

“I am concerned that judicial affairs as a body is designed to handle certain kinds of cases that this kind of event — when someone is not operating in a voluntary manner — they’re not well-equipped to deal with,” says Smith.

In its model policy, the Bazelon Center recommends that involuntary leave only be used in a situation where an individualized assessment determines that a student is a direct threat to the self or others. Under the Americans with Disabilities Act, Bower adds, colleges are required to provide reasonable accommodations for students. That could mean, in this case, she says, waiving the rule about class disruptions for Manges, or mitigating any sentence.

“I think they think it’s objective, but discrimination based on conduct that’s the result of disability is the same as discrimination based on disability,” Bower says. “The use of the disciplinary system as a whole is really a way of removing students from an environment instead of finding out what kinds of supports and services they need to stay in school and be successful.”

Although college leaders say they have the students’ interests at heart — in addition to the interests of other students — when advocating medical withdrawals, Manges says in her case, at least, the time off won’t be helpful.

“Being in school is extremely important to me and it is part of the healing process. It is my way of reclaiming my life; it is my way of getting back what was stolen from me when I was younger,” says Manges.

“I can’t do anything right now. I can work, I can go to therapy, but I was going to therapy while I was in school.”

Who's "crazy," and is that such a bad thing?

It would be cliche' to say that, to bloggers, Bill O'Reilly is the gift that keeps giving. It would also be inaccurate.

He's more like the cold that won't go away, the rash that won't stop itching or the headache that can't be cured by a double dose of extra-strength Tylenol.

Once again, our favorite target recently used mental health stereotypes to attack people on a personal level. But, as this Miami Herald columnist writes, it's not necessarily a bad thing.

Sometimes, it helps the cause when the repeat offenders continue to perpetuate stereotypes and promote hysteria. It allows people like myself, and Andres Oppenheimer, to expose their ignorance.

Who’s crazy, me or Bill O’Reilly?
By Andres Oppenheimer

On Nov. 8, I had the distinction of being called “a crazy columnist” and a “nut” on prime-time television by conservative Fox News anchorman Bill O’Reilly for a column I had written about the urgent need for a comprehensive solution to America’s immigration crisis.

I’m not going to disqualify O’Reilly — or the CNN anti-immigration crusader Lou Dobbs — as a Hispanic-phobic hate monger. Rather than trying to smear him, as O’Reilly did to me, I will focus on how deceiving his arguments are. You judge.

First, the facts. In my Nov. 4 column, “Angry migrant underclass might erupt in U.S.,” I argued that the rapid escalation of the U.S. anti-immigration hysteria is a dangerous trend. It will create an underclass of nearly 13 million people who won’t leave this country, who can’t realistically be deported and who — if deprived of a path to earned legalization — will become increasingly frustrated and angry, I said.

I even used the word “intifada” — granted, I wanted to grab your attention — to describe the worst-case scenario of what could happen if undocumented immigrants are given absolutely no legal path to earned upward mobility. In that context, I cited the examples of the Palestinian youths’ riots in Israel in the 1990s and the 2005 riots by Muslim youths in the suburbs of Paris.

My main point was that the estimated 1.8 million U.S.-raised undocumented youths — who were brought to this country as toddlers, often speak no other language than English and don’t even remember their countries of origin — will soon be thrown into the U.S. labor market with zero chances of getting a legal job.

What is going to happen with these youths? Most are barred from applying for in-state college tuition and will grow up on the streets. Many of them will join the gangs that are already terrorizing many U.S. cities. Undocumented kids, especially the brightest ones, need to be given an opportunity to gain U.S. citizenship, as was contemplated in the Dream Act that was recently defeated in the U.S. Senate.

As soon as my column was published, I was flooded with e-mails from all over the country. By Wednesday, MiamiHerald.com Web site had a whopping 93 pages of comments on the column. Many of them were openly hostile against Hispanic immigrants and claimed — wrongly — that my column was inciting violence.

On Nov. 8, O’Reilly said in an on-air conversation with Fox News analyst Laura Ingraham that “there is a crazy columnist in Miami, Miami Herald, who says that the Hispanics are going to rise up.”

Ingraham said I was “intimating something akin, Bill, to a race war. ... It’s insane.” He responded, “He’s a nut. He’s a nut, this guy.” She added that I am part of “a crazy far-left anarchist wing” of the immigration debate.

My opinion: For the record, I never called for violence, nor would I. Suggesting that I was endorsing violence, as was done in the O’Reilly show, is irresponsible journalism.

But even more irresponsible is what O’Reilly and other cable television anti-immigration crusaders are doing every day: inciting Americans to rebel against “illegal immigrants” — most of whom are Hispanic — without offering any realistic solutions to America’s immigration problem.

As long as the income gap between the United States and Latin America continues to be as wide as it is, as long as U.S. employers keep welcoming undocumented immigrants to do low-paid work and as long as U.S. consumers continue to prefer paying less for services performed by undocumented workers, the immigration flow will continue, no matter how many stretches of fence we place along the 2,000-mile border.

If we want to reduce illegal immigration, we will have to allow greater legal immigration and at the same time increase economic ties with Latin America to help our neighbors grow and reduce their people’s pressures to emigrate.

Above all, we need to give the 1.8 million U.S.-raised undocumented children an earned path to legalization. Otherwise, we will be creating an underclass of social pariahs, many of whom will end up joining street gangs.

Are these fears crazy? Am I nuts? You decide.

Andres Oppenheimer is a Latin America correspondent for the Miami Herald. E-mail: aoppenheimer@miamiherald.com.

From Marlboro man to PTSD

From the San Francisco Chronicle:

The photo of the "Marlboro Man" in Fallujah became a symbol of the Iraq conflict when it ran in newspapers across America in 2004. Now the soldier has returned home to Kentucky, where he battles the demons of post-traumatic stress.

The photograph hit the world on Nov. 10, 2004: a close-cropped shot of a U.S. Marine in Iraq, his face smeared with blood and dirt, a cigarette dangling from his lips, smoke curling across weary eyes.

It was an instant icon, with Dan Rather calling it "the best war photograph in recent years." About 100 newspapers ran the photo, dubbing the anonymous warrior the "Marlboro Man."

The man in the photograph is James Blake Miller, now 21, and he is an icon, although in ways Rather probably never imagined.

He's quieter now -- easier to anger. He turns to fight at the sound of a backfire, can't look at fireworks without thinking of fire raining down on a city. He has trouble sleeping, and when he does, his fingers twitch on invisible triggers.

The diagnosis: post-traumatic stress disorder.

His life in Kentucky, before and after the clicking shutter, says as much about hundreds of thousands of new American war veterans as his famous photograph said about that one bad day in Fallujah -- a photo Miller cannot see as an icon.

"I don't see a whole lot," he said. "I see a day I won't care to remember, but that I'll never forget."

Miller was assigned to the 1st Battalion, 8th Marine Regiment of the 2nd Marine Division, based in Camp Lejeune, N.C.

"Right before we got ready to leave for Iraq, I guess I was a little nervous. I started smoking more -- I went from about a pack-and-a-half a day to 2 1/2 packs a day," he said. "When we got to Iraq ... I was smoking 5 1/2 packs."

For a while, Iraq didn't seem all that bad. Miller and his fellow Marines settled into a routine in Anbar province in western Iraq, setting up hiding places among the palms and sand, and watching for the white pickups that insurgents would use to plant bombs and fire mortars.

There also was time for candy and laughter with the Iraqi children who came running to see the American troops. Miller felt like he was helping.

Then, on Nov. 5, 2004, in the middle of a sandstorm, the Marines got the word that they might be heading for an assault on Fallujah -- at the time, the capital of the Iraqi insurgency.

No American forces had gone inside the city in months. And now Miller would be among the first. He had been a Marine for less than two years.

"It puts butterflies in my stomach right now," he said. "I don't know if you can describe it. I don't think words can."

The night before U.S. forces went into the city, Miller gathered with his fellow Marines and led them by memory through a passage from the Bible, John 14:2-3.

"In my Father's house, there are many mansions: if it were not so, I would have told you. I leave this place and go there to prepare a place for you, so that where I may be, you may be also."

The assault on Fallujah began Nov. 8, 2004, when U.S. planes, using a combination of high explosives and burning white phosphorus, hammered the city in advance of the artillery push. Miller was under fire from the moment he stepped out of the personnel carrier.

It lasted into Nov. 9 -- the day that, for a while, would make Miller's face the most famous in Iraq.

As Miller remembers that day, he was on a rooftop taking fire and calling for support on his radio - a 20-pound piece of equipment that he had to lug around along with nine extra batteries, hundreds of extra rounds of ammunition, and a couple of cartons of cigarettes.

As insurgent bullets from a nearby building pinged off the roof, a horrified Miller heard footsteps coming up the stairs behind him. He raised his rifle -- and barely had time to halt when he saw it was embedded Los Angeles Times photographer Luis Sinco.

Miller returned to his radio, guiding two tanks to his position. When they opened fire, he said, the thunder left his body numb -- but the building housing the attackers had collapsed. Later, he said, they would find about 40 bodies in the rubble.

"I was never so happy in all my life to take that handset away from my head," Miller said. "I lit up a f -- cigarette."

His ear was bleeding from the sound of the tank firing -- Miller still can't hear out of his right ear. His nose bled from a nick he took when his rifle scope and radio got tangled up midfire. He looked at the sunrise and wondered how many more of those he would see.

He was vaguely aware that elsewhere on the rooftop, Sinco was taking pictures.

At a briefing the next day, Miller's gunnery sergeant walked up to him, grinning, and said: "Would you believe you're the most famous f -- Marine in the Marine Corps right now? Believe it or not, your ugly mug just went all over the U.S."

The Marines wanted to pull him out of Fallujah at that point, Miller said, not wanting the very public poster boy to die in combat. But he stayed.

He won't talk about the weeks that followed. He only mentions moments, like still frames from a film. The day his column barely survived an ambush, escaping through a broken door as bullets struck near their feet. The morning he woke up to discover that a cat had taken up residence in the open chest cavity of an Iraqi body nearby, consuming it from within.

The day he discovered that Demarkus Brown had been killed.

"When we found out, I told a couple of my buddies who were close to him, too. We just sat around, and we didn't say much at all," Miller said. "You didn't have the heart to cry."

But it wasn't those terrible benchmarks that affected him the most, Miller said. It was the daily chore of war: the times he had to raise his rifle, peer through the scope and squeeze the trigger to launch a bullet, not at a target, not at a distant white truck, but at another human being.

"It's one thing to be shot at, and you shoot a couple rounds back, just trying to suppress somebody else," Miller said. "It's another thing when you see a human being shooting a round at you, knowing that you're shooting back with the intent to kill them. You're looking through a scope at somebody. It's totally different. You can make out a guy's eyes."

When Miller returned to America, he brought back a big duffel bag packed with numerous letters and gifts from those who had seen his photo. It was only later that he discovered he'd brought home some of the war, too.

None of the Marines talked much about the strain that war puts on one's emotions, Miller said.

The "wizards" -- military psychologists -- gave the returning troops a briefing on the subject, but nobody paid much attention. Even guys who were taking antidepressants to help them sleep didn't think much about the long-term consequences.

"What the hell are those people going to do once they get out? They ride it out until they get an honorable discharge, and then they're never diagnosed with anything," Miller said. "How the hell are you going to do anything for them after that? And that's how so many of these guys are ending up on the damn streets."

Miller dismissed the early signs, too. When he and his buddies reacted to a truck backfire by dropping into a combat stance and raising imaginary rifles, well, that was to be expected. And when his wife, Jessica -- the childhood sweetheart whom Miller had married in June -- told him he was tightening his arm around her neck in the night, that was strange, but he figured it would pass. So would the nightmares he began to have about Iraq, things that had happened, things that hadn't.

Then one day, while visiting his wife at her college dorm in Pikeville, Miller looked out the window and clearly saw the body of an Iraqi sprawled out on the sidewalk. He turned away.

"I said, 'Look, honey, I just got to get out of here.' I couldn't even tell her at the time what had happened," he said. "(I thought), 'Well, that's it. That's my little spaz I'm supposed to have that the psychiatrists were talking about ... I'm glad I got it out of the way."

But he hadn't. Jessica, a psychology student, tried to help with a visualization technique. But when he looked inside himself, Miller found a kind of demonic door guarded by a twisted figure in a black cloak. Under the cloak's hood, he spotted the snarling face of the teufelhund, a Marine Corps icon -- the devil dog.

"So I come out again, without closing the door," he said. "After all this happened, my nightmares started getting a lot f -- ing worse."

Finally, Miller went to a military psychiatrist, who diagnosed him with signs of post-traumatic stress disorder. Miller thought that meant he could not be deployed. But in early September, he joined a group of Marines headed to police New Orleans in the wake of Hurricane Katrina.

"I really didn't want to go. ... There was a possibility we would be shooting people," he said. "We could be going into another (urban warfare) environment just like Iraq, except this would actually be U.S. citizens.

"Here we go, Fallujah 2, right here in the states."

Not long after they arrived, as Hurricane Rita bore down on them, the Marines were packed into the amphibious assault ship Iwo Jima to wait out the storm offshore. And one day, as Miller headed for the smoke deck with a Marlboro, a passing sailor made a whistling sound just like a rocket-propelled grenade.

"I don't remember grabbing him. I don't remember putting him against the bulkhead. I don't remember getting him down on the floor. I don't remember getting on top of him. I don't remember doing any of that s -- ," Miller said. "That was like the last straw."

On Nov. 10, 2005 -- the Marine Corps' 230th birthday and one year to the day after the Marlboro Man picture appeared in the Los Angeles Times, Miller was honorably discharged after a medical review. His military career was over.
Miller returned to eastern Kentucky, the place he had spent years trying to escape. He wanted the familiarity and safety of the people and land he'd known since birth.

"Maybe it made me think twice about what I had lost," he said. "What I was really missing."

In a way, though, his family is still missing Blake Miller -- the Miller who left Kentucky for Iraq a couple of years ago.

The man who left was easygoing, quick to laugh, happy to sit in a relative's house and eat and smoke and talk. The man who came back is quick to anger, they say, and is quiet. He still smiles often but does not easily laugh.

And when he takes a seat in his adoptive grandmother's home, amid her collection of ceramic Christ figurines, it is in a chair that faces the door.

Mildred Childers, who owns those figurines, sees Miller's difficulties as a crisis of faith. She still remembers Miller's call just before the assault on Fallujah, and his terrible question: "How can people go to church and be a Christian and kill people in Iraq?"

"He was raised where that's one of the Ten Commandments, do not kill," she said. "I think it's hard for a soldier to go to war and have that embedded in them from small children up, and you go over there and you've got to do it to stay alive."

Recently, some of his Marine buddies have been calling Miller up, crying drunk, and remembering their war experiences. Just like Papaw Joe Lee used to do when Miller was a boy.

"There's a lot of Vietnam vets ... they don't heal until 30, 40 years down the road," Miller said. "People bottle it up, become angry, easily temperamental, and hell, before you know it, these are the people who are snapping on you."

Jessica interrupted. "You're already like that," she said.

She recalled her own first glimpse of the Marlboro Man -- an image seen through tears of relief that he was alive, and misery at how worn he looked.

"Some people thought it was sexy, and we thought, 'Oh, my God, he's in the middle of a war, close to death.' We just couldn't understand how some people could look at it like that," she said. "But I guess for some people it was glory, like patriotism."

She looked at her quiet husband through the smoke drifting from his right hand.

"But when it comes out and there's actually a personality behind that picture, and that personality, he has to deal with all the war, and all he's done, people don't want to know how hard it actually is," she said.

"This is the dark side of the reality of war. ... People don't want to know the Marlboro Man has PTSD."

Miller stood outside his father's home in Jonancy, looking over the beaten mobile homes, the rows of corn, potatoes and cabbage. For a change, he wasn't smoking - he's down to a pack-and-a-half a day.

"There ain't a goddamn thing around here," he said. "My whole life, all I did was watch my old man bust his ass."

It was why he joined the Marines -- why part of him wishes he could go back.

"My whole life, all I've ever known is working on cars, doing body work, cutting grass, manual labor, you know? It was something different," he said. "You always hear those commercials -- it's not just a job, it's an adventure. It was, you know?"

On the other hand, Miller isn't sure he'd want to go back to combat -- nor sure he'd ever let any kid of his enlist. He has mixed feelings about the oversize copy of the Marlboro Man picture proudly displayed in the lobby of the Marine recruiting station in Pikeville.

Some of his relatives and friends are against the war; others see it as a fight against terrorism.

Miller himself seems torn -- proud of the troops fighting for freedom, but wondering whether there was a peaceful way, to find terrorists in Iraq without invading.

There was no time for such questions in Fallujah. But now, at night, when he can't sleep, Miller thinks of the men he saw through his rifle scope, and wonders: Were they terrorists fighting against America? Or men fighting to protect their homes?

"I mean, how would we feel if they came over and started something here?" he asked. "I'm glad that I fought for my country. But looking back on it, I wouldn't do it all over again."

It helps, sometimes, to talk about it -- last week, Miller did what he hopes other veterans do: He had his first visit with a Veterans Administration counselor.

"I've got my whole life ahead of me," he said. "I'm too young to lay down and quit; too young to let anything beat me."

Down the road, Miller hopes to start a business. For now, he is waiting for his disability benefits to kick in. Maybe then, he and Jessica can afford the big wedding they had always wanted. She already has her white wedding dress. He still intends to wear his Marine Corps blues.
Veterans and stress

Post-traumatic stress disorder is an ailment resulting from exposure to an experience involving direct or indirect threat of serious injury or death. Symptoms include recurrent thoughts of a traumatic event, reduced involvement in work or outside interests, hyper alertness, anxiety and irritability.

About 317,000 veterans diagnosed with the disorder were treated at Department of Veterans Affairs medical centers and clinics in fiscal year 2005. Nearly 19,000 veterans of the wars in Iraq and Afghanistan were seen for the disorder in veterans' medical centers and Vet Centers from fiscal year 2002 to 2005.

A recent study of soldiers and Marines who had served in Iraq and Afghanistan found that about 17 percent met criteria for post-traumatic stress disorder, depression, or generalized anxiety disorder. Of those whose responses were positive for a mental disorder, 40 percent or fewer actually received help while on active duty.

For more information, contact your local veterans facility, call (877) 222-VETS or visit one of the following Web sites:

U.S. Department of Veterans Affairs National Center for Post-Traumatic Stress Disorder: www.ncptsd.va.gov/

San Francisco Chronicle Guide for Returning Veterans: http://www.sfgate.com/returningvets/

Wake Me Up When September Ends/Green Day

Summer has come and passed
The innocent can never last
Wake me up when September ends

Like my fathers come to pass
Seven years has gone so fast
Wake me up when September ends

Here comes the rain again
Falling from the stars
Drenched in my pain again
Becoming who we are

As my memory rests
But never forgets what I lost
Wake me up when September ends

Summer has come and passed
The innocent can never last
Wake me up when September ends

Ring out the bells again
Like we did when Spring began
Wake me up when September ends

Here comes the rain again
Falling from the stars
Drenched in my pain again
Becoming who we are

As my memory rests
But never forgets what I lost
Wake me up when September ends

Summer has come and passed
The innocent can never last
Wake me up when September ends

Like my fathers come to pass
Twenty years has gone so fast
Wake me up when September ends
Wake me up when September ends
Wake me up when September ends