Saturday, March 20, 2010

Friday, March 19, 2010

Lawmakers push to curb medicating foster children

FLORIDA LEGISLATURE

Lawmakers push to curb medicating foster children

Mental-health drugs for foster children would be limited under a legislative proposal being considered in Tallahassee.

Herald/Times Tallahassee Bureau

A year after a seven-year-old boy heavily medicated on powerful psychiatric drugs hanged himself in his Margate foster home, lawmakers are pushing to reform state medical requirements for foster children.

The Senate's Children, Families, and Elder Affairs Committee unanimously approved a measure Thursday designed to curb the prescription of mental-health drugs to children in state care.

The proposed law would require the state Department of Children and Families to assign legal guardians to oversee each child's mental-health care. It prohibits prescribing drugs under clinical trial to foster children and raises the age children are allowed to take these drugs from six years old to 11 years old in many cases.

The measure would also give children some say in the drugs they take.

``We are not just going to medicate them until they turn 18 and then dump them into adulthood,'' said sponsor Sen. Ronda Storms, R-Brandon, chair of the Children, Families, and Elder Affairs Committee.

The state's growing use of adult medication on emotionally and mentally troubled children has sparked debate for years.

Multiple state studies show child-welfare doctors and case managers routinely failed to follow legally required treatment plans or properly document when and why drugs were given to foster children, creating a network of youth sedated by ``chemical straight jackets,'' said Storms.

The death of Gabriel Myers in April further revealed the shortcomings of a 2005 legislation that required more information sharing, parental involvement and second-party review of doctors' prescriptions for the youngest children.

Because foster children are often cared for by multiple service contractors, communication lapses and fragmented mental-health care are still rampant problems, a recent state report on Myers' death determined.

``Our response to him was to medicate him, and medicate him, and medicate him,'' Storms said.

Under the bill, proposed medical treatment plans must be explained to a child and the child must consent to the treatment in most cases before they can begin taking the drugs.

``What this means is less medication and more behavior analysis so that they are not just sedated little zombies,'' said Jan Montgomery, president of the Florida Association for Behavior Analysis, which would train legal guardians to observe and treat behavioral problems.

Still, Montgomery said she did not expect a sudden culture shift, given failed past efforts to track foster children's medical records.

``It's going to be a slow slide toward what we are hoping is the right way,'' Montgomery said.

Cristina Silva can be reached at csilva@sptimes.com


Read more: http://www.miamiherald.com/2010/03/19/1536772/lawmakers-push-to-curb-medicating.html#ixzz0icSPWXnt



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Tuesday, March 16, 2010

Information about the Underserved Populations Committee

Some information about the Underserved Populations Response Committee:

We have had a very positive response to our creation of the Underserved Populations Response Committee. We would like to focus on enhancing services to underserved populations experiencing domestic violence, sexual assault, rape, incest, and stalking. We want to identify underserved populations, subject matter experts, services, organizations, websites, and other resources.

We have heard from many people interested in participating, and received many suggestions for populations to be included.

Set forth below is the list of underserved populations we have identified so far:

• Women of color
• Gay men, lesbians, bisexuals, and transgendered individuals
• Persons with disabilities
• Women who are Orthodox Jews
• Other members of the Faith Community
• People with Limited English Proficiency
• Farm workers
• Undocumented aliens
• Battered immigrant women
• Haitians
• Women who are homeless who have experienced domestic violence, sexual assault, rape, and incest.
Indigenous Women


We also want to serve men who are victims of domestic violence, but we want to discuss how best to do that.

I am sure that I have an incomplete list of underserved populations. That is why it is so important to have a collaborative approach here. If you have additional underserved populations you would like to include, please contact Marc Dubin, Esq., Committee Chair, at mdubin@pobox.com or at 305-896-3000 (mobile).

I have thought of some goals for the Committee, set forth below, but I want to hear from others as to the goals you want us to try to accomplish. I know that there are some remarkable organizations and individuals already working to enhance services to underserved populations around the country

The Underserved Population Response Committee has several goals:

• Identify underserved populations;
• Identify resources, including subject matter experts, and individuals and organizations serving these populations, as well as websites and Blogs with information and resources; and
• Enhance collaborations and partnerships to better serve these populations.

Thank you. I look forward to getting to know you, and look forward to a successful Committee.




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Monday, March 15, 2010

DOJ: Victims with Disabilities

Victims with Disabilities

The Bureau of Justice Statistics (BJS), in response to the mandates of Public Law 105-301, the Crime Victims with Disabilities Awareness Act (CVDAA), is working to develop the capability to measure crimes against people with disabilities. The Act requires the enhancement of the National Crime Victimization Survey (NCVS) to collect these data.

Since 2000, BJS has initiated several activities to lay the foundation for developing such estimates. Consistent with the experience of other Federal agencies, there are a number of issues that must be addressed in order to design methodologies to meet the mandates of the legislation, including developing a reliable set of questions to identify people with developmental and other disabilities, and developing procedures to accommodate, as necessary, interviews with such people. BJS and the Census Bureau, which conducts NCVS interviewing, consulted and worked with staff from a number of Federal agencies to develop survey questions to identify people with disabilities.

In July 2000, BJS added to the NCVS Crime Incident Report a test of supplemental items designed to obtain information from victims of crime on any health conditions, impairments or disabilities affecting their everyday life. In fall 2001, BJS, together with the Census Bureau, fielded a test among known persons with development disabilities in California to further test questions related to disability and to determine what types of interview techniques work best with different types of populations with disabilities.

Based on the results of the tests, BJS and the Census Bureau developed a revised set of questions to address problems that were identified. The revised questions were implemented into the NCVS in January 2004, and will be evaluated to determine whether they obtain reliable information. Once finalized, the questions will produce estimates of the faction of victims who have disabilities. The survey will rely on population estimates from other sources to enable the production of victimization rates for people with disabilities.

People with developmental disabilities are four to 10 times more likely to be victims of crime than other people are. (Sobsey, D., Wells, D., Lucardie,R., and Mansell, S. 1995. Violence and Disability: An Annotated Bibliography. Baltimore, MD. Brookes Publishing.)

In response to a recent survey of women with physical disabilities, 56 percent reported abuse, a number consistent with other studies of this nature. Of this group, 87 percent reported physical abuse; 66 percent reported sexual abuse; 35 percent were refused help with a physical need; and 19 percent were prevented from using an assistive device. (Wayne State University. 2004. Michigan Study on Women with Physical Disabilities. Washington, D.C.: National Institute of Justice, U.S. Department of Justice.)

In this same survey, 74 percent of the women reported abuse that was chronic in nature and 55 percent reported multiple abuse situations in their adult lives. The abuser was their male partner 80 percent of the time. (Ibid.)

Of the women with physical disabilities reporting abuse, their abusers were using drugs and/or alcohol 53 percent of the time. (Ibid.)

Only 33 percent of the abused women with physical disabilities who were surveyed sought assistance to address the abuse, and from this group, there were “mixed reactions” as to whether the assistance had been a positive experience. (Ibid.)

In a five-year retrospective study of 4,340 child patients with disabilities in a pediatric hospital, 68 percent were found to be victims of sexual abuse and 32 percent were victims of physical abuse. (Willging, J.P., Bower, C.M., and Cotton, R.T. 1992. “Physical Abuse of Children: A Retrospective Review and an Otolaryngology Perspective.” Archives of Otolaryngology and Head and Neck Surgery 118(6):584-590.)

The National Rehabilitation Information Center estimates that as many as 50 percent of patients who are long-term residents of hospitals and specialized rehabilitation centers are there due to crime-related injuries. In addition, it is estimated that at least six million serious injuries occur each year due to crime, resulting in either temporary or permanent disability. (Office for Victims of Crime Bulletin. 1998. Working with Victims of Crime with Disabilities. Washington, D.C: U.S. Department of Justice.)

In a study of 946 women, 62 percent of women with and without disabilities reported that they had experienced emotional, physical, or sexual abuse. However, women with disabilities reported experiencing their abuse for longer periods of time (3.9 vs. 2.5 years respectively). In addition to the types of abuse experienced by the entire group, women with disabilities specifically reported that their perpetrators sometimes withheld needed orthotic equipment (e.g., wheelchairs, braces), medications, transportation, or essential assistance with personal tasks such as dressing or getting out of bed. (Young, M.E., et al. 1997. “Prevalence of Abuse of Women with Physical Disabilities.” Archives of Physical Medicine and Rehabilitation Special Issue. 78 (12, Suppl. 5) S34-S38.) For more information visit, www.bcm.tmc.edu/crowd/national_study/national_study.html.

Sobsey and Doe estimate that more than half of abuse of people with disabilities is generally perpetrated by family members and peers with disabilities and that disability professionals (i.e., paid or unpaid caregivers, doctors, nurses) are generally believed responsible for the other half. It is estimated that approximately 67 percent of perpetrators who abused individuals with severe cognitive disabilities accessed them through their work in disability services. (Sobsey, D., & Doe, T. 1991. “Patterns of sexual abuse and assault.” Journal of Sexuality and Disability, 9(3): 243-259.)

Sixty-one percent of sexual assault survivors with disabilities who received counseling services at SafePlace in Austin, Texas, between 1996-2002, reported multiple perpetrators of violence. Approximately 90 percent of the sexual violence perpetrators were not strangers to their victims. (SafePlace. 2003. Stop the Violence, Break the Silence. Austin, TX.)

In a national survey of domestic violence and rape-crisis agencies, 67 percent of the survey participants reported that their center had served people with mental illness labels over the past year. Despite the high incidence of violence against people with disabilities, few participants reported that their center served people with cognitive disabilities (seven percent), physical disabilities (six percent), or who are blind, deaf or have hearing loss (one percent). (Schwartz, M., Abramson, W., & Kamper, H. 2004. “A National Survey on the Accessibility of Domestic Violence and Sexual Assault Services to Women with Disabilities.” Unpublished raw data. Austin, TX. SafePlace.)

Note: Given the small size/scope of some of these studies, results cannot be extrapolated to the nation as a whole.

With funding from the Department of Justice (Office for Victims of Crime), SafePlace's Disability Services ASAP (A Safety Awareness Program), in Austin, Texas, is working with 10 victim assistance organizations from across the country to enhance and expand services for crime victims who have disabilities. The organizations include: The Southern Arizona Center Against Sexual Assault, Tucson, AZ; The Chadwick Center for Children & Families at Children's Hospital and Health Center, San Diego, CA; Ability 1st, Tallahassee, FL; Partnership Against Domestic Violence, Atlanta, GA; Carbondale Illinois Police Department, Carbondale, IL; The Lafourche Parish Sheriff's Office, Thidodaux, LA; Safe Passage, Northhampton, MA; Rape Crisis Center of Central Massachusetts, Worcester, MA; Ulster County Crime Victims Assistance Program, Kingston, NY; and the Network of Victim Assistance, Doylestown, PA. SafePlace is administering grant funding and providing expert training and technical assistance to the 10 organizations to foster innovative practices, principles and community partnerships for delivering accessible services to crime victims with a wide range of disabilities. Each of the 10 victim assistance organizations has conducted a community needs assessment and developed a strategic plan to determine the best way to address the identified gaps and barriers to victim services for people with disabilities. Additionally, each organization has developed a programmatic evaluation plan to identify performance measures for determining progress and success and a sustainability plan to ensure that activities continue beyond the grant period. The organizations will continue to implement their strategic plan during the second and third years of the project. This venture takes the lessons and achievements of SafePlace's model Disability Services program (begun in 1996) to communities across the country. For more information about the Disability Services ASAP project, visit www.austin-safeplace.org.

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DOJ; Stalking

Stalking

According to findings from the National Violence Against Women Survey, eight percent of women and two percent of men in the United States have been stalked in their lifetime. (National Institute of Justice. 1998. Stalking in America: Findings from the National Violence Against Women Survey. Washington, D.C.: U.S. Department of Justice.)

Based on an analysis of 103 studies of stalking-related phenomena representing 70,000 participants, the prevalence across studies for women who have been stalked was 23.5 percent and for men was 10.5 percent. The stalking averaged a duration of nearly two years. (Spitzberg, B. 2002. “The Tactical Topography of Stalking Victimization and Management.” Trauma, Violence & Abuse, 3(4).)

The average physical violence incidence rate in the above-mentioned study was 33 percent and the incidence of sexual violence was over 10 percent. (Ibid.)

According to the above-mentioned analysis, restraining orders against stalkers were violated an average of 40 percent of the time. In almost 21 percent of the time, the victim perceived that the behavior following the implementation of the order worsened. (Ibid.)

A recent analysis of 13 published studies of 1,155 stalking cases found that the average overall rate of violence experienced by the victims was 38.7 percent. (Rosenfeld, B. 2004. “Violence Risk Factors in Stalking and Obsessional Harassment.” Criminal Justice and Behavior, 31(1).)

Stalkers with a prior intimate relationship are more likely to verbally intimidate and physically harm their victims than stranger stalkers. Among six different studies, risk factors for violence ranged from 45 percent to as high as 89 percent among stalkers with prior intimate relations with victims compared to risk factors for stalkers who targeted strangers or acquaintances, which ranged from five percent to 14 percent. (Ibid.)

History of substance abuse proves to be one of the strongest predictors of increased rates of violence in stalking crimes. In combination, the strongest risk markers for assessing the likelihood of stalking violence are: 1) threats and intimidation; 2) the existence of prior intimate relationships; and 3) substance abuse. (Ibid.)

Stalking in the context of intimate partner violence often goes unreported as a crime. In an analysis of 1,731 domestic violence police reports, 16.5 percent included a narrative description of stalking behavior, yet the victim used the term “stalking” in only 2.9 percent of the cases and the officer used the term “stalking” in only 7.4 percent of the cases. (Tjaden, P. and Thoennes, N. 2001. Stalking: Its Role In Serious Domestic Violence Cases. Washington, D.C.: U.S. Department of Justice.)

Stalking allegations are more prevalent in reports involving domestic violence victims and suspects when they are former rather than current intimates. Of domestic violence reports involving formerly dating couples and co-habitants, stalking was involved in 47.4 percent of the reported cases. Of reports involving separated or divorced couples, stalking occurred in 32.7 percent of the cases. When stalking was reported in domestic violence cases involving married couples the rate dropped to 9.6 percent; for co-habiting couples, it dropped to 6.7 percent; and for dating couples, it dropped to 19.7 percent. (Ibid.)

The prevalence of anxiety, insomnia, social dysfunction, and severe depression is much higher among stalking victims than the general population, especially if the stalking involves being followed or having one's property destroyed. (Blaauw, E., et al. 2002. “The Toll of Stalking.” Journal of Interpersonal Violence, 17(1).)


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Friday, March 12, 2010

Underserved Populations - Latina Women

Article

When Susan Reyna learned in May that she had a won a grant to help fund her work with victims of domestic violence in a community of mostly migrant Latina women, all she could think of was how far she and others had come.

"I thought of the abuse I watched my mom go through; what I survived," said Reyna, a third-generation migrant worker who witnessed domestic violence and experienced sexual abuse as a child. "We've come so far since those first days; we have brought domestic violence as a health issue to a national level!"

Reyna was awarded $120,000 by the Boston-based Robert Wood Johnson Community Health Leadership Program award, to enhance MUJER, Inc. (The program's name in Spanish means "woman.") MUJER, in Homestead, Fla., is now addressing what has been considered the greatest obstacle that Latina women face when trying to escape domestic violence: fragmentation of services.

MUJER offers comprehensive care to victims by partnering with a network of over 15 other community agencies that provide serves ranging from legal aid to healthcare.
(Continued)


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Underserved Populations - Indigenous Women

Report on Listserv on Indigenous Women

"In both United States and Canadian mainstream news, the disproportionate rate of sexual violence against Native/American Indian, Alaska Native, and First Nations women is consistently underreported. Indeed, as Amnesty International concluded in April 2007, despite centuries of brutalisation of Indigenous women, and even with the recent addition of its own one-hundred-thirteen pages of documentation of “many incidents of sexual violence against American Indian and Alaska native women[,]…the great majority of stories remain[s] untold.” At the same time, Indigenous women have been asserting their own stories around the trauma of violence in ways that work toward making whole what colonialism attempts to systematically dismember. One particularly powerful venue of re-membering the piecemeal and partial representations of violence against Native women in mainstream U.S. news is the U.S.-based internet community CAVNET_IW (Communities Against Violence Network - Indigenous Women), whose formation, intentions, and practices serve as a potent counter-narrative to the mainstream news media's consistent efforts to render Native women's stories invisible and insignificant. As a site that not only disseminates news about violence against Indigenous women but creates a forum for women to tell their own stories, CAVNET_IW has fashioned a potential safe space through which immediate and historical trauma affecting Native women paves pathways to personal healing and political change. At the same time, CAVNET_IW, a carefully monitored discussion space requiring member sign-up and message screening before posting, paradoxically works to end violence and heal trauma by necessarily circulating life stories that keep episodes of traumatic violence constantly present in the consciousness of CAVNET_IW members."

To apply for membership in CAVNET_IW, write to sarahdeer@yahoo.com.
To apply for membership in CAVNET, visit www.cavnet.org and apply online.


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