Boost to the Private Rented Sector

The housing minister has revealed the person who will lead the government’s review of barriers to investment in rented homes.

Sir Adrian Montague, a former member of the Housing Finance Group, will examine how best to encourage greater investment in rental properties - helping support the rapid growth of the private rented sector by increasing the supply of affordable homes.

Sir Adrian Montague, one of Gordon Brown's City fixers

The government’s housing strategy published last month highlighted the range of steps being taken to increase the supply of new homes.
Mr Shapps said: ‘The sector has seen several years of strong growth and increasing standards, but in some areas rents have begun to rise faster than wages.
‘Over three million households live in privately rented homes, so it’s vital that we take steps to ensure the sector’s continuing growth and affordability.
‘Sir Adrian brings with him a wealth of experience and knowledge of the role of the private sector in boosting infrastructure investment and of housing policy, making him an excellent choice to lead the review.’
Sir Adrian said: ‘The private rental sector has gone through a period of rapid growth, and it’s crucial that the government does all it can to ensure that demand continues to be met. I aim to help remove barriers to investment, contributing to the continuing health of a sector that millions of people rely on.’

The responsibility of the law to look further into the science behind the brain

http://royalsociety.org/policy/projects/brain-waves/responsibility-law/

Neuroscientists seek to determine how brain function affects behaviour, and the law is concerned with regulating behaviour. It is therefore likely that developments in neuroscience will increasingly be brought to bear on the law. This report sets out some of the areas where neuroscience might be of relevance, along with some of the limits to its application. Specific issues discussed include risk assessment in probation and parole decisions; detecting deception; assessing memory; understanding pain; and Non-Accidental Head Injury NAHI).

Key messages

Key messages of the report include:

• There is a big gap between research conducted by neuroscientists and the realities of the day to day work of the justice system. There is currently no forum in the UK for bringing together neuroscientists and legal professionals to explore areas of mutual interest.
• It is important that professionals at all stages of the legal system who might encounter neuroscience understand some of the key principles on which it is based; the limitations to what studies can tell us; and some of the generic challenges of its application. Lawyers and judges in England and Wales often have no training in scientific principles. Undergraduates in neuroscience are not necessarily taught about the societal implications of the discipline.
• Almost all neuroscientific research in the UK is related to health. However, findings from research have wider policy implications. Important insights for the law would be provided by further research into areas including neuropathology studies to characterise Non-Accidental Head Injury (NAHI); and studies into the relative efficacy of different models of risk assessment in the context of probation, and a possible role for neuroscience to be used in combination with existing approaches.

The spurious case against decriminalization

 This article first appeared in the Centre for Policy Studies blog. Alex Stevens response is posted below.

by Kathy Gyngell

Professor Neil McKeganey and Kathy Gyngell
Drugs decriminalisation has become the new orthodoxy. It is an idea that captured the broadsheets and has won support from the ranks of the great and the good. It is the outcome of a considered campaign of libertarians who can now boast an All Party Parliamentary Group in support of the cause. Drug decriminalisation promises a panacea, a solution to the drug problem, an end to the criminalisation of children and an opportunity to realise the libertarian's dream of freedom for all to take drugs openly. Too good to be true? (£) In a word - Yes.

Hype, selective stats and 'the resounding success' (which equals no nightmare scenario has occurred) of Portugal's formal decriminalisation experiment have made for a persuasive case - a case that rests on the claim that decriminalisation will, if not solve the drug problem, make it better than at present. This is critical. For without it the libertarian agenda for its own sake, the application of Mill's principle of radical individualism to drugs policy, is a step too far. For only its most avowed followers can believe that the regular use of, or addiction to, most currently illicit drugs only affects the person who takes them. And even fewer would be persuaded to back decriminalisation on the grounds that drugs are innately a good thing - that they open the door to perception - the philosophy of the founders of the Beckley Foundation, the appointed collaborators of the new Parliamentary Group. But if a case for the common good can be established, of course it is a different matter.

That the common good would be served by decriminalising drugs however is far from proven. Portugal, which started such an experiment in 2001, has become the decriminalisation lobby's proof of concept. The 'proof' being that the policy has decreased rather than increased the harms associated with drug use. As with the climate change lobby much effort has gone into the presentation and the communication of the statistics involved. But, as with climate change debate, the statistics that have been assembled in telling the Portuguese story of the benefits of decriminalisation are far from clear cut.

The danger of both exaggerating and extrapolating from the Portuguese example are evident. Professor Alex Stevens (an addictions expert from the University of Kent) concluded not long ago that the "Portuguese experience cannot provide a definitive guide to the effects of decriminalisation of drugs but only indications of the results of decriminalisation in the specific Portuguese context. It is not possible to tell the extent to which changes were caused by decriminalisation or the wider drug strategy."  

Against his own better judgement he decided to contradict himself arguing that, "the lack of evidence that decriminalisation caused significant increases in drug use and related harms shifts the burden of proof towards those who claim that it is necessary to criminalise young people in order to limit drug harms". Yet does it sound even remotely reasonable that the burden of proof should now switch from those arguing for a policy of drug decriminalisation to those that support the policy, followed in most countries in the world, of drugs remaining illegal on the basis of one single country's disputed experience of decriminalisation success? We hardly think so.

So what can and can't be said? Has the prime Portuguese objective of reducing drug usage and abuse been achieved? The answer, to date, has to be no. Evidence for problem drug use and injecting drug use going down is for the period between 2000 and 2005, most plausibly the result of the major diversion of addicts to treatment at that time. No data is published for the period since then. These are however completely inconsistent with the 2007 National Survey which show that overall drug use has in fact risen very considerably since 2001 when decriminalisation was introduced; that heroin has risen from 0.7% to 1.1%; that cocaine and amphetamine use has doubled. These figures throw serious doubt on on the earlier PDU and IDU claims, especially since national surveys are more likely to under than over report hard drug use. The slight decline noted in children's use is to 2007 (ESPAD) reflecting, but less than, a Europe wide trend.
Drugs death data in Portugal remains a matter of unresolved controversy there. Significant rises in drug deaths are reported by Portugal's Special Registry of the National Institute of Forensic Medicine. These have been disputed as misleading by Professor Alex Stevens. But deaths reported by the IDT, though lower, are consistently up too since 2003. Neither are official until the major discrepancies are resolved. Further it may be the case that the undisputed increase of toxicological autopsies (the consequence of an increase in suspicious deaths) is itself related to the well documented increase in hard drug use that Professor Stevens failed to acknowledge.

None of this is either definitive or necessarily attributable to any one aspect of policy. So far the decriminalising lobby has chosen not to mention that in 2008 Portugal suddenly found itself with the sixth-highest cocaine seizure total in the world, a seven fold increase from 2001, nor that a murder increase of 40% (peculiar to Portugal) reported in the World Drug Report (P168) over this same period of time possibly, the Report speculates, related to increased trafficking activity.

With little substantive evidence from Portugal the case for decriminalisation falls back on Baroness Meacher's repeated and emotive rhetoric (£) about the 'criminalisation' of our young people and criminalisation regimes.

Professor Stevens too casts a similar but more subtle aspersion. His letter to the Times conjures up a curious logic of the law inherently 'necessitating' the 'criminalisation' of young people in order to limit drug harms.

This perception or interpretation is not just a matter of metaphysical debate. It belies the facts. In 2009, of the 162,610 recorded cases of cannabis possession in England and Wales, over half - 86,953 - were dealt with by a procedure known as a cannabis warning. This has no legal status and does not lead to a criminal record. 19,137 were dealt with through cautions and the 11,492 penalty notices for disorder, did not involve a court appearance, a fine or imprisonment. Only 22,748 cannabis cases, roughly one in eight, ended in court. Thousands more had no recorded outcome at all.
Second to Portugal, the UK has the lowest rate of custodial sentencing in the EU for drug possession, some twenty times less than the Netherlands (a fact that may come as a surprise to many and one for them to chew on) whose rate of problem drug use is a third of ours and considerably less than Portugal's.
Had Lady Meacher acknowledged that we have, de facto, already decriminalised drug use she would not have been far wrong. It would have given more logic and coherence to her case. It would not have made victims of young people. It might have led her to see how misplaced her optimism is that decriminalisation, given an unending supply of treatment, is nothing to fear. For our treatment services, despite massive expansion and a current cost to the tax payer of a billion pounds a year, have yet to crack the challenge of getting more than 3% of their clients drug free.
She now says she wishes to pursue the laudable quest of learning from other countries' drug policies. If so she could do worse than turn to Sweden (a country of similar population size to Portugal) where drug use and possession continue to be against the law but where an enlightened process entirely expunges the criminal record of young people who consent to proven drug treatment programmes. Robust intervention and support for a multiplicity of problems, of which drug use may just be an expression, is the order of the day. As a country with one of the lowest levels of illegal drug use anywhere in Europe, it is perhaps more worthy of her attention.

From Prof Alex Stevens in response:
First, if decriminalisation were the orthodoxy, it would be the policy of the coalition government or its opposition. It is not.

Secondly, the case for decriminalisation does not rest on it producing more 'common good' than criminalisation. Given that criminalisation produces well documented harms (such as high costs to the taxpayer, damage to the prospects of young people who come into adversarial contact with the police and/or get a criminal record, and high racial disparities in enforcement), it is only necessary for advocates of decriminalisation that it produces no more drug-related harm than criminalisation. This is why you are wrong to suggest that there is a contradiction between the two quotes of mine that you use. The Portuguese experience cannot prove that decriminalisation produces less harms than criminalisation. But neither does it show that it is more harmful. Given that the argument for criminalisation is exactly that decriminalisation *does* produce more harm, then the Portuguese case makes it harder for people to make this argument (at least, it does if they want to use the evidence thoroughly, rather than just picking the indicators, countries and time periods that fit their views).

Thirdly, your use of the Portuguese data is, again, selective and misleading. You point out that the reduction in 16 year old drug use reflected other countries' figures, but not that the reported increase in cocaine use was also seen in neighbouring Southern European countries. You point to a rise in seizures and murders and suggest that this indicates increased trafficking. You appear not to have considered the possibility that the rise in seizures was related to the police shifting their attention to the higher end of the drug market (as intended by the policy and as indicated by the smaller number of larger seizures), or that the violence may have been linked to this law enforcement disruption of the market (as several studies in other countries have found; see for example http://bit.ly/lIR2Ak).

Fourthly, you have moved since your letter to The Times (which claimed a definitive increase in drug related deaths) to say that this issue is unresolved. But you fail to acknowledge that the indicator which shows a decrease since 2001 is a better indicator than that which you have used to suggest an increase. No indicator of drug related death is perfect, but the measure that relies on physicians' judgements on cause of death is better than one that depends on the numbers of corpses that happen to be tested for the presence of any drug (whether it was fatal or not).

Fourthly, you suggest that it is inappropriate to use the term 'criminalisation' to describe the UK’s current policy. I agree with you that the cannabis warning has created de facto decriminalisation, but only for some drug users. It only applies to cannabis users who are 18 or over. Younger people, users of other drugs and people who arouse the suspicion of the police (who retain the discretion to arrest for cannabis possession) still face arrest. It is not ‘curious logic’ to suggest that the current law necessarily criminalises young people. Young people make up the majority of illicit drug users. Making possession of some drugs a criminal offence makes criminals of these young people.

Fifthly, your claim that the Netherlands is a heavier user of imprisonment for drug possession is bizarre. You give no source for it, but I assume you are using the EMCDDA 2009 report on drug offences (http://bit.ly/nR0Su). This does indeed suggest that the Netherlands imprisons a higher proportion of recorded offenders than the UK. But to interpret that as suggesting that drug possession is less criminalised in the UK you would have to ignore that these proportions relate only to offences that are recorded when the police catch drug users. In the Netherlands, the police ignore offences of possession of under 5 grams of cannabis (i.e. the majority of drug possession offences that occur). In the UK, in contrast, the police have used the cannabis warning to massively increase the numbers of this type of offence that they record. The comparison you make is therefore invalid.

Finally, you apparently accept the point - in the case of Portugal - that drug laws in one country cannot prove the effects of drug laws. But then you go on to use selective evidence from Sweden to try and prove that criminalisation works. You fail to mention that there is no cross-national correlation between drug laws, arrests or imprisonments and indicators of drug harms.

Works for Freedom

Having a job with a regular income can turn an offender's life around, says community liaison prison officer Dave Damerell, who believes employment is the route out of crime. Too often, they are not given the opportunity to prove that they can hold down a job after a long spell in prison.
But that is not the case for inmates at Norwich prison, where Damerell has helped offenders into employment after creating a work experience ­programme with the local shopping centre.
Since it was set up two years ago, 80% of the 89 offenders who have completed the eight-week scheme left prison with a job lined up – more than double the national rate. And of that group, only one has reoffended since being released from prison.
Damerell says: "Prisoners do really want to change their lives, but quite often they aren't given the opportunity to prove themselves. If you can get prisoners on that first step then you can also reduce the reoffending rate, which also benefits victims of crime."
When the scheme was first developed with the Chapelfield shopping centre, just a 20-minute walk from the male prison, ­offenders were involved in reopening its waste recycling plant, collecting and sorting ­rubbish from the centre shops. The experience not only boosted the prisoners' own employment skills and confidence, but helped to reduce the amount of rubbish from the ­complex that was sent to landfill, cutting it from 37 tonnes a month to just three. Today, offenders can be found at Chapelfield working as part of the maintenance and ­cleaning teams, as well as alongside customer service staff at the centre's information desk.
Damerell, 48, who joined the service 20 years ago, says retailers have been keen to get involved with the scheme even when they knew the criminal background of the ­offenders, who are all low-risk prisoners with a varied criminal history, from drug-related offences to burglary.
He says: "There is 100% disclosure – everybody knows the prisoner's offence. I've had no adverse comments from the retailers; all of them are fully on board."
The work experience programme has been so successful that Damerell is recruiting more local employers to the scheme, while other prisons from across the county are hoping to copy the Norwich model.
Damerell has also helped establish a volunteering programme at the 767-inmate prison in partnership with local charities and other community groups. Every month the prison declares a community day where a group of offenders, as part of their rehabilitation, spend time outside the prison doing voluntary work alongside prison officers and other volunteers and charity workers.

He says: "The benefit to the prisoners is that they get to mix with ­normal people outside of the prison environment as part of a group all working together." Since Damerell set up the scheme prisoners from Norwich have clocked up 85,848 volunteering hours between them.
Damerell has worked in resettlement for 10 years and has no plans for a career change. "Having a job on release from prison totally changes a prisoner's life and that of their ­family 100%," he says. "For me, the satisfaction comes from helping somebody achieve that, and, at the same time, reduce the ­reoffending rate and protect victims of crime. I really enjoy getting up in the morning and coming to work – I don't think everybody can say that."

Letter to Frank Dobson MP

Dear Frank Dobson MP and Sir Malcolm

I work for Kazuri Properties Ltd, a social enterprise which rehouses vulnerable women, women leaving supported housing and women leaving prison and domestic violence shelters.  It is based in Camden and Kensington I’m writing to ask you to support Chris White MP’s Bill on “Public Services (Social Value)” at the Third Reading on November 25^th.

This Bill could make a real difference to social enterprises like Kazuri Properties , which are competing for public service contracts. Social enterprises reinvest profits back into services and the local community and have a good track record of delivering efficiencies without compromising on quality.  We’ve done it here at Kazuri and with the help of this Bill, social enterprises across the UK could soon find it easier to win the chance to do the same in their own communities.

Requiring all procurement decisions to demonstrate their wider positive social and environmental impact will ensure that the full weight of the public sector’s purchasing power is directed at achieving social and environmental benefits, alongside delivering financial efficiency.

In particular, the Bill could help to:

• Minimise the impact of the spending cuts on civil society organisations

Civil society organisations are really feeling the impact of the public sector cuts. Ensuring that future public spending decisions create additional social value in the community served could help mitigate against the impact of cuts and ensure that the decisions that are made create greater value.

• Support local job creation

In some areas of the UK where the public sector is by far the largest employer, spending cuts are inevitably going to impact on unemployment. Ensuring that all spending decisions require contractors to support local employment opportunities can play a part in reducing the impact of this.

• Widen the market and increase choice

All too often public sector markets are created in such a way that only a small number of large providers are able to compete.  This Bill would allow the added value social enterprises offer to be taken into account, encouraging them to enter the market and increasing choice, innovation and value for money.

Thank you for taking the time to read my  email and I hope I can count on your support for this Bill.

Yours sincerely,

Farah Damji
Kazuri Properties Ltd 

Dear Mrs Home Secretary, please stop telling racist lies.

Conservative catflap: the truth behind Maya and the deportation row

Spat between two Conservative cabinet ministers rests on a judge's light-hearted remark

Theresa May Home Secretary, winging it. bad hair dye day

via @Guardian

An immigration judge's light-hearted remark about a cat no longer having to fear adapting to Bolivian mice lies behind the outlandish Conservative party conference claim by home secretary Theresa May. Her assertion that a Bolivian student was an illegal immigrant who could not be deported because he had a pet cat – called Maya – was one of three examples she cited as justifying her new drive to prevent human rights protection for family life blocking deportations.
The three examples were drawn from a Sunday Telegraph article in June which detailed 102 cases last year in which article 8 of the European convention on human rights – the right to family life – was cited as a reason for stopping the deportation of illegal migrants and foreign criminals. The other two cases involved a violent drug dealer, whose daughter lived in Britain, and a robber who was not deported because he had a British girlfriend. The paper was careful in its report to say the cat was only part of the reason that stopped the Bolivian student's deportation. May's downfall was caused by her failure to make such a qualification; she pinned the whole thing on the cat.
But the judgment delivered by senior immigration judge Gleeson on 10 December 2008 makes clear that while the cat featured in the case, it was actually a dispute about an article 8 rule then in force that said if someone was settled in Britain with an unmarried partner for more than two years without enforcement action, then they had an automatic right to stay.
Ronan Toal, the barrister in the case, told the Guardian that it wasn't even about a deportation but an application to stay in Britain and the cat had only been mentioned in passing as evidence of the long-term relationship.
"It's totally cynical. It's specious to rely on a completely distorted and inaccurate account of one decision of one tribunal. If that's the best they can do, then that just reveals the poverty of their thinking about human rights in general and article 8 in particular,'' he said.
The judgment makes clear that the joint ownership of the cat was not the crucial factor in allowing the appeal.
The original judgment does not name the cat. Indeed, it goes as far as to omit the cat's name, which led the Sun to print a picture of a cat with its eyes blacked out when it reported the story. It appears that Judge Gleeson's throw-away line at the end of his judgment "that the cat need no longer fear having to adapt to Bolivian mice" may have fuelled some of the tabloid myths that have stemmed from the case.
At a later appeal, when the cat was named as Maya, the Home Office argued that too much weight had been given at the earlier hearing on the impact on the student of having to return to Bolivia and leave behind not only his partner but also the jointly owned cat. May was relying on this last night to but even she conceded that the ruling was only "in part" based on the man's ownership of a cat called Maya.
No wonder Ken Clarke was prepared to offer Theresa May good money on Tuesday that nobody's deportation had been refused by the courts solely because they owned a pet cat.

“I’ve got a war correspondent who can’t go to war,” when war hits the womb, a war correspondent's journey to motherhood

My own mother, my sister and nearly all the women in my family had full-time jobs as mothers. They were wonderful at it. They drove their children back and forth to soccer, skating lessons, piano lessons, private schools, but I sensed, even in my own mother, a kind of distant dissatisfaction.

JANINE DI GIOVANNI

Every time I went to the doctor when I was in my twenties, he repeated the same thing to me: don’t wait too long to have children. But since then I had spent nearly two decades as a war correspondent seeing children wrecked and traumatized by war. I saw babies born in the middle of a siege, saw amputated limbs, kids who stepped on landmines, a young swimmer who lost her breast to shrapnel, budding nine-year-old soccer players who lost their hands to American smart bombs, kids who had breakdowns, kids who were blown up by mortars as they were building snowmen.
read more

From Salon.com

Four in five ex-offenders who are homeless are reconvicted within a year, a new study has found.

Via Homeless Link

The study from Homeless Link, the umbrella organisation representing the homelessness sector, called on more joined up action from those involved in housing to tackle the lack of accommodation for ex-offenders.

The report also said that there should be more training on housing issues for criminal justice workers. Nearly half of the respondents working in the sector said they would benefit from such training, while more than a third of homelessness providers also wanted training to understand the issue.

The survey of 400 staff and 75 clients also found strong links between homelessness, addiction and prison. Almost two thirds of adults using homelessness or drug services had spent time in prison, child care or other institutions, it found, while 20 per cent of homelessness service clients are in contact with probation.

Alice Evans, head of policy analysis at Homeless Link, said: ‘While our research has uncovered localised pockets of good practice, the majority of experiences show there is a need for agencies to work together more closely to prevent people who have previously offended and are now homeless falling deeper into the cycle of homelessness and reoffending.

‘We are calling for the homeless and criminal justice sectors to provide services that complement each other, both on a national and local level. With greater financial pressures and a shift towards localism, joint approaches will prove crucial in meeting our shared aims of reducing reoffending and homelessness.’

Boris Johnson, diary fixture and Mayor has a good idea.

Government blocks bid to keep drunks out of jail

viaEvening Standard

The Government is blocking a pioneering plan to cut crime by letting violent drunks take breath tests instead of going to prison, the Mayor's policing spokesman said today.

Either you're in front of Boris, or Westminster is behind him.

Boris Johnson wants anyone convicted of alcohol-related violence to stay out of prison as long as they attend a police station twice a day to take a £1 breathalyser test and prove they are sober.
But the plans for mandatory sobriety tests are being blocked by Ministry of Justice officials, City Hall said.
Kit Malthouse, deputy mayor for policing, said the ministry is refusing to back the plan because it is "not very good at coping with new ideas".
It comes days after the new Scotland Yard commissioner, Bernard Hogan-Howe, said constant testing of convicted drunks is needed to cut crime.
The twice-a-day breath tests plan was inspired by a successful programme in America.
Mr Johnson said such a programme needed to be introduced in the wake of the riots as "the horror and expense of the current booze culture" was evident throughout accident and emergency departments throughout London.

 

Mentally ill offenders: Our fear of introducing them back into society

Forensic nursing is one of the most demanding and misunderstood areas of care in the NHS. Nursing manager Theo Bello gives an inside view about the challenge of working with mentally ill offenders and public fear about their release back into society.

Mental health is one of the least popular areas of nursing and you can go one better – by specialising in forensic nursing which looks after offenders whose mental illness precludes them from prison.
At present, there are about 4,000 patients being treated in secure units around the UK for a variety of conditions. Typical crimes include murder, rape and sexual offences influenced by accompanying mental illnesses including bi-polar, schizophrenia and personality disorders.

Everyone coming into a secure unit is assessed before admission and we get our fair share of fakers who pretend to be ill thinking life in a forensic unit is preferable to prison. However, it’s difficult to fake mental illness for any length of time and it is often people’s rationality that trips them. People with full-blown psychosis are genuinely distressed and that can be someone who is climbing the walls or standing stock-still for hours at a time.
I can’t pretend nursing started as a personal choice for a vocation, but it has certainly become one in the 15 years since my initial career in civil engineering hit the rocks after my overseas qualifications weren’t recognised in the UK.
I remember asking a careers advisor at the time what was the most cast-iron job in terms of employment and demand, and he said people were always going to get sick so why not try the NHS?
Nursing can be a tough profession, but also a very rewarding one and you learn a lot about yourself in the process – especially in an environment like forensic services. People do however carry a lot of preconceptions about working on secure wards. I know I did before I joined the service, with the usual concerns about the threat of physical violence and wondering if I could work with people who’d committed some disturbing crimes.
I remember one patient who had murdered his girlfriend’s child while she went out to get a pint of milk. He calmly sat down after leaving the body in the kitchen, lit a cigarette and waited for her to come back as if nothing had happened. This  really shook me up because I had a child of same age at the time and I just kept re-running it through my mind. I was looking at this patient’s actions with my own moral compass and values which is pointless when someone has a serious mental illness.
People do the most shocking and bizarre things but at some level it makes perfect sense to them even if it leaves the rest of us shaking our heads in disbelief.
Our job is to find out why patients behave the way they do, what triggers their behaviour and if their condition can be effectively treated.
I’d say good communication skills, empathy, maturity and respect are key skills in being a good mental health nurse, along with a commitment to build a strong therapeutic relationship with patients and colleagues.
A lot of incidents involving confrontation are down to a perceived lack of respect that staff shows patients. It’s something we work hard to bridge because so much rests on it. Just a fraction of a correction in that social interaction makes a huge difference and everyone gets what they want.
One of the biggest conflicts of interest I have is restraining a patient from hurting themselves or others. I personally struggle with the fact that I am here to build relationships with patients and help treat and support them yet may also be called upon to restrain them if they become violent.
At present, we’re at something of a watershed in forensic services because we need more effective mechanisms for getting patients back into the community which is free from political interference.
There is huge public fear around mental health and that irrationality goes through the roof when a murderer is mentally ill.
The circumstances are tragic but no-one can provide a cast iron guarantee that any offender won’t commit another crime on release and that fear is multiplied when it involves mental illness.
Politics, sensationalist media coverage and widespread public prejudice about mental illness are a potent cocktail that keeps us in stalemate because it’s the safest position to occupy. Ideally, all mental health services will maintain a safe and effective process of treatment and rehabilitation through the stratification of patients according to the risks they present.
I believe specialised community housing, a close-knit support group of mental health workers and close monitoring would all make a move into the community more effective in the long-term.
Re-offending rates are low compared to those leaving the prison system and the chance of an individual being murdered by someone with a psychosis is about one in ten million – the same as being struck by lightening.
A revised approach has to be found and it’s a case of who is going to be brave enough to seek a new way forward free from the blame game when a serious incident does take place.

Theo Bello is a nursing manager with Barnet, Enfield and Haringey Mental Health NHS Trust and oversees the management of several low and medium secure units at Chase Farm Hospital in north London.
This article first appeared in the Independent 

"Jesus Loves Nukes"

 Top Air Force Official Issues Religious Neutrality Policy in Wake of Truthout's "Jesus Loves Nukes" Exposé
  by  Jason Leopold

A top US Air Force official, in an attempt to ensure the Air Force adheres to the Constitution as well as its own regulations and policies, issued guidelines that calls on "leaders at all levels" to take immediate steps to maintain "government neutrality regarding religion."

In his policy memorandum dated September 1, but sent Tuesday to all major commands, Air Force Chief of Staff Gen. Norton A. Schwartz said, "Leaders ... must balance Constitutional protections for an individual's free exercise of religion or other personal beliefs and its prohibition against governmental establishment of religion."

Air Force Joint Chief Gen. Norton A. Schwartz addresses National Guard delegates during the National Guard Association of the United States conference in Nashville, Tennessee, September 12.

The First Amendment establishes a wall of separation between church and state and Clause 3, Article 6 of the Constitution specifically prohibits a "religious test."

The Air Force immediately suspended the mandatory Nuclear Ethics and Nuclear Warfare training immediately following the publication of Truthout's report. David Smith, a spokesman for the Air Education and Training Command told Truthout last month the ethics training "has been taken out of the curriculum and is being reviewed."

"The commander reviewed it and decided we needed to have a good hard look at it and make sure it reflected views of modern society," Smith said.

The decision angered Sen. John Cornyn (R-Texas) who fired off an angry letter to Secretary of the Air Force Michael B. Donley criticizing the move and demanding Donley provide him with a report detailing "actions taken" by the Air Force that led to the suspension of the ethics training.

But the Air Force went further, pulling all of its training materials "that address morals, ethics, core values and related character development issues" pending a "comprehensive review," Smith told the Air Force Times.

That decision was made after a Reserve Officers Training Corps (ROTC) instructor, who read Truthout's report, sent the Military Religious Freedom Foundation (MRFF), a civil rights organization, copies of ROTC leadership training materials, which also contained Christian-themed citations from the Bible. The PowerPoint slides in that presentation the unnamed instructor sent MRFF are used in all colleges and universities that have an ROTC program.

Schwartz said commanders and supervisors, "must avoid the actual or apparent use of their position to promote their personal religious beliefs to their subordinates or to extend preferential treatment for any religion."

"Commanders or supervisors who engage in such behavior may cause members to doubt their impartiality and objectify," Schwartz added. "The potential result is a degradation of the unit's morale, good order and discipline."

Furthermore, he advised Air Force leadership who may have concerns "involving the preservation of government neutrality regarding religious beliefs" to speak with a chaplain and staff judge advocate "before you act."

 

Systemic Issues

That Schwartz, a member of the Joint Chiefs of Staff, was forced to issue such an edict underscores how widespread the problems have been within the Air Force related to commanders endorsing religion, particularly fundamentalist Christianity.

Indeed, some examples over the past few years include an email circulated in 2009 by military command and staff officers to all personnel stationed at Creech Air Force Base in Nevada inviting them to attend a Bible study class in which the topic of discussion referred to Jews as "whiners."

  

Restorative Justice, a deconstructionalist approach to pure justice.

13 September 2011

More offenders will face the consequences of their actions with the launch of the first-ever register of restorative justice practitioners.

Funded by the Ministry of Justice and implemented by the Restorative Justice Council (RJC), the register lists all qualified practitioners of restorative justice - a process where offenders meet their victims and hear about the pain they have caused.

Justice Minister Crispin Blunt said: 'Restorative Justice demands criminals take an active role in acknowledging the harm they have caused, as well as making amends.

'The register we are launching today will encourage the increased use of restorative justice by making it quicker and easier to find a local practitioner, as well as acting as the first-ever benchmark of quality and professionalism that ensures victims are safeguarded.'

Restorative justice, already used in England and Wales, empowers victims and communities to overcome the negative impact of crime - with 85 per cent of victims who have taken part reporting a positive experience.

Reformed offender Scott said: 'When I heard about the pain I caused I couldn’t understand why I did it and I felt sick hearing that.'

'I can’t do burglaries now, because I keep hearing Michelle’s words in my head and it stops me doing it.'

For more information on RJ

http://www.restorativejustice.org/

MoD admits risk of "combat stress" in British troops.

 via Iraq Solidarity
 
According to the Telegraph, estimates based on official Ministry of Defence figures show, that 191,690 British soldiers have been deployed in both Iraq and Afghanistan since 2001, with some 50,000 of these soldiers having seen action in both conflicts.

Experts have warned that a tidal wave of trauma is going to hit the United Kingdom, as a direct consequence of service inside of Iraq and Afghanistan, with research showing that an estimated 27 per cent of veterans, being likely to develop mental health problems from their time on the front line.

Of these, around 5 per cent are likely to suffer from the more serious Post Traumatic Stress Disorder (PTSD), which can lead to alcoholism, depression, domestic violence and a wide range of other devastating problems. Combat Stress, the veterans’ mental health charity, have predicted, that based on MoD figures, around 51,000 British veterans are likely to develop psychological issues.

The charity have also stated, that around 9,200 veterans were potentially going to display symptoms of PTSD – which is twice the amount of Combat Stress’s current case load, while Andrew Cameron, Combat Stress’s chief executive, has warned, that the number of veterans contacting the charity is steadily increasing, infact, up 10 per cent each year!

Meanwhile, according to a new survey, half of Britain’s doctors are unaware of official guidelines on how to diagnose the scars left from the front line, leading many to fear that thousands of veterans are not being diagnosed early enough, to prevent the onset of post-traumatic stress disorder (PTSD).

The survey, which was carried out by ComRes, found that just 42 per cent of GPs are familiar with the guidelines on PTSD, while forty-nine per cent said they were not familiar with them at all. ComRes, was commissioned by Combat Stress, who surveyed around 1,006 GPs across the UK in July 2011.

Combat Stress, the veterans’ mental health charity, said these figures showed that too few doctors were diagnosing PTSD among veterans, with just 5 per cent of the veterans the charity was helping, being referred to it by a General Practitioner.

Walter Busuttil, director of Combat Stress's medical services has said: “Our clinical audits tell us that 80 per cent of veterans who come to us for clinical treatment, have first tried to get help from either their GP or other specialist services, but have not received the support and treatment that they needed. “This has led to around half the veterans who come to Combat Stress each year essentially self-referring.”

Dr Clare Gerada, chairman of the Royal College of General Practitioners, admitted that “inequalities persist surrounding the care of military personnel when they return to the UK”, adding that the college has produced guidance “to help GPs better understand veterans’ particular needs”.

Already across the United Kingdom, up to a third of all homeless people are former soldiers, sailors and airmen, with as many as 8,000 veterans currently serving time in jail, which is nearly 10 per cent of the British prison population but the shocking fact remains, is that it can still take approximately fourteen years after leaving the services, for a veteran to make contact with Combat Stress.

The charity has produced an online leaflet titled Meeting the Healthcare Needs of Veterans, which is available for downloading but also check out the Royal British Legion for more information on other practical welfare services, that are equally available to both Veteran’s and their dependents.

Plastic soldiers plastic wars

The hell of war comes home. In July 2009 Colorado Springs Gazettea published a two-part series entitled “Casualties of War”. The articles focused on a single battalion based at Fort Carson in Colorado Springs, who since returning from duty in Iraq had been involved in brawls, beatings, rapes, drunk driving, drug deals, domestic violence, shootings, stabbings, kidnapping and suicides. Returning soldiers were committing murder at a rate 20 times greater than other young American males. A separate investigation into the high suicide rate among veterans published in the New York Times in October 2010 revealed that three times as many California veterans and active service members were dying soon after returning home than those being killed in Iraq and Afghanistan combined.

We hear little about the personal hell soldiers live through after returning home.

  via Dorothy

Why is Mental Health illness on the Rise? by Omar Shahid

This piece was first published in the Huffington Post

New findings from the European College of Psychopharmacology reports that 164.8 million Europeans - 38.2% of the population - suffers from a mental disorder.

However the recognition and medicalization of mental illnesses is now more prevalent then ever; doctors are accused of too hastily classifying 'abnormal behaviour' as a mental ailment. This is cited as one of the reasons for the 'increase' in mental health.

Furthermore, the stigma attached to mental disorders is nowhere near as heinous compared to previous decades. Only 50 odd years ago, those who struggled with mental disorders were locked up in a clandestine environments, today, thankfully, we're much more willing to admit that we have a problem and receive a diagnosis.

The findings also tell us that women suffer disproportionately more from mental disorders than men do. Hans-Ulrich Wittchen, one of the report's authors, says the reason why women suffer twice as much depression and anxiety disorders is because of their inability to successfully balance work with their family life.
While some misogynists or religious zealots may claim that women were not somehow 'designed' to simultaneously balance work and family life, an alternative explanation - and one supported by evidence - is that women go to see the doctors more often than men do.

There are a couple of factors relating to mental health that time and time again seem to evade public attention.
The first is the increase in prescription of antipsychotic drugs. In 2008, antipsychotics became the best-selling therapeutic prescription drugs in the United States - exceeding drugs to treat high cholesterol and acid reflux. Investigative journalist James Ridegeway said in a piece he wrote for Al Jazeera recently that drug companies now encourage the prescription of atypical antipsychotics to patients for off-label use. This should concern us. For what other reason would drug companies be doing this other than to boost their profits? And will British drug companies soon copy their American counterparts?

The second thing that is seldom discussed is the ubiquitous refrain propounded by some anti-consumerists: 'depression arises when we can't satisfy our insatiable wants'. While it is true that we live in a profoundly consumerist society (I don't think anybody denies this), whether consumerism leads to depression or other mental illnesses seems like a proliferative jump. The relationship between consumerism and mental illness isn't generally taken seriously, but why isn't it?

It is not unusual to hear that mental illness is on the rise, but we rarely hear what is being done to prevent the issue. If we concede that it is not that mental health is increasing, it is that we are able to diagnose it better, that still doesn't solve the problem. The World Health Organisation has said by 2020, depression is expected be second most burdensome disease worldwide; shaving the life expectancy of countless people.
When we do decide to confront the issue, antipsychotic drugs and consumerism should both be discussion points.

Amendment proposed for he Armed Forces Bill, diversion and assessment

Amendment 24

Moved by Baroness Finlay of Llandaff

24: After Clause 11, insert the following new Clause-

"Procedure on arrest for substance abuse, violence against the person or damage to property

After section 74 of AFA 2006 insert-

"Procedure on arrest for substance abuse, violence against the person or damage to property

(1) If a person subject to service law-

(a) has been arrested on suspicion of committing an offence,

(b) would be the person's first offence, and

(c) the offence is related to substance abuse, violence against a person or damage to property,

prior to any decision as to charge, the prosecuting authority shall consider diverting the person for specialist services to assist with substance abuse and mental health treatment either in the community or through existing services in Her Majesty's armed forces.

(2) The prosecuting authority shall also commission and obtain a psychiatric assessment of the arrested person in order to assess that person's needs and manage that person safely.

(3) No decision to charge the arrested person shall be made at the time of arrest and such a decision shall take place only when the prosecuting authority has consulted the specialist services involved and reviewed the psychiatric assessment.

(4) The above conditions do not apply unless, at the time of arrest, the arrested person was serving in Her Majesty's armed forces.""

Baroness Finlay of Llandaff: My Lords, I know that the hour is late and I am grateful to the Committee for allowing me to move this amendment at this time. The basis of the amendment is to identify people serving in the Armed Forces who commit offences while fuelled by drugs or alcohol, and who therefore have related underlying mental health problems. There is a duty of care on the Ministry of Defence to afford special consideration to those people whose alcohol abuse or drug treatment has come as a result of their experience and to put them into appropriate programmes as soon as possible, preferably before any charging decision is made.
In civilian life, at the discretion of the police or the Crown Prosecution Service, there is the opportunity to permit a defendant to go into a treatment programme in the community rather than go before the magistrate and get a criminal record. The idea behind this amendment is that the Armed Forces covenant, which is the basis behind much of what we have been addressing today and is so important, in no way could inadvertently disadvantage someone in the forces.
The way in which military court services operate means that in-depth access to the defendant's circumstances sometimes may not come to light. Therefore, mental health and substance misuse issues can be missed and could even be exacerbated with disastrous consequences in the long term. Sadly, there are stories of really frenzied attacks and incidents that have been fuelled particularly by alcohol. An SAS veteran, Chris Ryan, pointed out that it is often 10 or 15 years after people have left the Armed Forces that they reach their lowest point.
The underlying premise of the amendment is that if you can pick people up early and treat the root cause when they are exhibiting the early symptoms of drug and alcohol misuse, you would prevent a long-term problem later. The Armed Forces operate a parallel structure of community mental health teams, so the infrastructure is in place. In his report of 2010, Fighting Fit, Dr Andrew Murrison MP noted that the linked issue of alcohol abuse is significantly associated with service in the Armed Forces and there is evidence that it is more common among combat veterans. This is not a small problem-it is one that needs to be addressed. It has been estimated that up to four out of five cases where military personnel have been involved with criminal activity may be fuelled by alcohol and drugs, and that they would not have committed the offences if it had not been for the excessive use of these substances.
There is an emerging problem in Afghanistan where heroin misuse is becoming particularly linked to criminal activity among serving personnel. There are community psychiatric nurses and consultant psychiatrists on hand in Afghanistan to deal with this, and there are very good outcomes when they deal with the problems immediately, in contrast to them becoming chronic problems. The US has learned lessons from its experience in Vietnam with drug abuse in particular and has realised that punishment does not actually work because you put these people into civilian life, but that early intervention is particularly helpful. One of the problems is that if people are discharged out into civilian life and do not have the infrastructure support they need, the outbursts and consequent violence often associated with them can injure and traumatise or even possibly kill people who are closest to the person themselves.
It has also been estimated that 25 per cent of all home repossessions are from people with a service background, and there is a suggestion that that may be linked to higher alcohol consumption and spending a lot of money on alcohol, because alcohol consumption is extremely expensive.
The idea behind this amendment is to reflect the reality that we are asking a lot from our troops-we are asking them to risk life and limb-and that some of them will find that the way they cope with the trauma they have experienced is to try to numb themselves using drugs or alcohol, and that when they are really fuelled up like that they then go and commit offences. Unless we intervene rapidly and pick them up we may be creating a lifetime of dependency and problems rather than intervening early. I beg to move.

Lord De Mauley: My Lords, Amendment 24, moved by the noble Baroness, Lady Finlay, would apply whenever a member of the Armed Forces was arrested for a first offence related to alcohol or unlawful drugs, violence or damage to property. Before it could charge the accused, the service prosecuting authority would have to consult specialist substance abuse and mental health services, and to obtain and take into account a psychiatric report on the accused. The importance of the psychological state of an offender and the appropriateness in some cases of a specialist social or mental health approach instead of prosecution is well understood in both the civilian and service justice systems.
When a case is serious enough to go to the service prosecuting authority, it must consider the evidence available as to whether the suspect had the necessary intent to commit the offence under consideration. It must also consider whether the public and service interests-the interests of justice-make a prosecution appropriate. It is also the responsibility of the service prosecuting authority to keep these issues under review the accused's state of mind and whether continued proceedings are appropriate. The service prosecuting authority is therefore able to review in context its assessment of what the interests of justice require.
It is also the service prosecuting authority's duty to disclose to the defence any facts it becomes aware of which go to mitigate the seriousness of the alleged offence. Where it seems to the service prosecuting authority that the interests of justice are not best served by prosecution, it can, and often does, go back to the chain of command to discuss how the chain of command can help to bring the suspect into contact with specialist services. This often forms part of a discussion on whether administrative action might be more appropriate than prosecution.
In court, in an extreme case, the defence may seek a decision that the accused is unfit to plead. There are special statutory provisions under which the judge advocate will consider and decide such applications. Where an accused is convicted, there are statutory provisions under the Criminal Justice Act 2003 for medical reports and pre-sentence reports. The court must generally obtain and consider a medical report before passing a custodial sentence where the offender appears to be mentally disordered. This is a report on the offender's mental condition made by a specialist medical practitioner. A pre-sentence report must generally be obtained by a court whenever it is considering a custodial sentence for an offender. The aim of such reports is to assist the court in deciding the most suitable method of dealing with the offender. It is made by the probation service and must, of course, be disclosed to the offender. The same requirements apply in both the service and civilian justice systems.
I believe that the current role of the service prosecuting authority in deciding whether to charge is the right one. It should, and does, consider what the interests of justice require, and in particular whether prosecution is appropriate. It does so by taking into account the evidence before it. However, I hope the noble Baroness will accept that it would be going too far to require the service prosecution authority to consult specialist services and obtain a psychiatric report in every case covered by the amendment. To do so would confuse the role of prosecutor and the court. It is right for the prosecutor to have some discretion in whether to prosecute and to respond to what the interests of justice plainly require. However, there is an important boundary to be maintained between that role and the proposed role requiring the prosecution to obtain and weigh expert evidence in every case before it can bring a charge.
Furthermore, the requirement for a psychiatric assessment in all the cases covered by the amendment would be excessive, and even unfair to the suspect. It would involve a delay before a decision was made on bringing a charge even in the simplest case. It would appear to expect, or perhaps require, the suspect to submit to psychiatric assessment even where he or she was not raising any psychological issue and there was no reason to suppose that there was such an issue. In some cases it would be impossible to complete this process within the very tight statutory limits that apply in the service and civilian justice systems to keeping a person in custody before charge. In other words, it would go well beyond what the needs of a fair and efficient system of justice require.
Lastly, it would mean that the procedures before charge, and the role of the service prosecuting authority, were very substantially different from those in the civilian system. We recognise the importance of the psychological and social background of an offender, but I do not consider that there are grounds for such different approaches between the service and civilian justice systems. Therefore, I ask the noble Baroness to withdraw the amendment.
Baroness Finlay of Llandaff: I am most grateful to the Minister for his detailed response to my amendment. I had hoped that the words "shall consider" in the first part of the amendment did not create an obligation.

However, in the light of what he has said, I can see that I do not have the right wording. I wish to read what he has said, possibly discuss the matter with him outside the Committee and then consider what to do. In the mean time, I beg leave to withdraw the amendment.

Amendment 24 withdrawn.

Rioters, ordinary criminals not special cases

by Robert Winnett, Mary Riddell and Christopher Hope

In an interview with The Daily Telegraph, Keir Starmer says those convicted of involvement in the riots should not be seen as a “separate category”, as some judges have argued.

Instead, he says, the Crown Prosecution Service and other legal authorities “need to keep our feet on the ground” and “remind ourselves that we are dealing with ordinary criminal cases”.

Surveys have suggested that courts have handed down sentences to those involved in the riots that are about a quarter longer than normal. Some people have been incarcerated for months for stealing low-value items.

Mr Starmer makes clear that he is not commenting on individual sentencing. However, his warning that disorder cases should be treated like all others will be taken as a signal that he opposes the tough line taken by many, the Prime Minister included.

His remarks raise the prospect that many of the sentences will be reduced by the appeal courts. “We should not treat these cases as a separate category,” he says. “We should treat them as we do any other case.”

Why the Failure of the Rehabilitation Revolution Fails us All, from Inside Time

 By A psychology Assistant at a Southern prison, from insidetime issue September 2011

A prison psychology assistant wonders why all the government’s good ideas about rehabilitation have been shelved

A strain of vindictive stupidity stalks the land. At a time when our public services are being restructured, reduced or cut completely we have been offered a way to make savings that would have had a positive impact on one of the most difficult areas of public policy and possibly even changed the country’s approach to penal justice.

A recent U-turn on sentencing policy is a huge upset to the justice minister Ken Clarke, who had planned to end the rise in prison numbers and begin a “rehabilitation revolution” to reduce this country’s re-offending rate. It seemed like an idea whose time had come, with drastic changes needed to save money and a Tory party in power who wished to disavow their “nasty party” image. Clarke’s proposals were distinctly un-Tory, but they were also clearly welcomed by the party leadership, who would have known exactly what they were getting when they appointed him.

That the Coalition was forced to change its mind on the policy at a time when the argument for economic austerity had been all but won is a sign that public anger towards offenders is the only force sufficiently dangerous to change the mind of a government hell bent on its drive to reduce the size of the state.
Pictures of “Baby P” galvanised the nation’s conscience three years ago and forced the Labour government to address the chronic under-support of child protection services. Since then, this campaign has been more or less forgotten as social services are forced to make job cuts in the wake of massive budget cuts to local government.

In the current climate when the government remains immune to the lobbying of disability rights groups, healthcare professionals and public sector unions, there is much to learn about our priorities. We live in a country where to be “too lenient” is a political problem but to be negligent of the needs of the extremely vulnerable is not. News of cuts to disability benefit, to mental health and social services have created nothing like the furore raised to the suggestion that we reduce the amount of time offenders spend in prison from two thirds of their sentence to a half.

This change would have saved the Ministry of Justice £130m, but now that saving will have to come from other aspects of its work. One of the prime candidates is the probation service, which monitors the behaviour of offenders upon release. It will be a supreme irony that the same vituperative public who demanded a reversal of sentencing policy in the name of their safety will very likely be out at further risk by the u-turn.

A psychology Assistant at a Southern prison

Short term meditation induces changes in the brain

Short-term meditation induces white matter changes in the anterior cingulate

The anterior cingulate cortex (ACC) is part of a network implicated in the development of self-regulation and whose connectivity changes dramatically in development. In previous studies we showed that 3 h of mental training, based on traditional Chinese medicine (integrative body–mind training, IBMT), increases ACC activity and improves self-regulation. However, it is not known whether changes in white matter connectivity can result from small amounts of mental training. We here report that 11 h of IBMT increases fractional anisotropy (FA), an index indicating the integrity and efficiency of white matter in the corona radiata, an important white-matter tract connecting the ACC to other structures. Thus IBMT could provide a means for improving self-regulation and perhaps reducing or preventing various mental disorders.

Read more

From PNAS

Combatting stress through biofeedback and lemons

Measure your stress and relaxation responses.Bio feedback is a tool to monitor physiological symptoms and to project physical reactions, being used more and more in the US military to "de-stress" veterans.

Colin Moses and Kazuri

BUILDING ON SUCCESS - Colin Moses in interview from OFF_PRESS on Vimeo.

Making ex-offenders pay, ex-offenders pay back society through conservation work

Offenders supervised by Northumbria Probation Trust took on vital conservation work in a national park.

The 12 offenders worked for a week at Snowdonia doing construction work with the National Trust and Charity Mobex North East. They also built dams to help re-establish the wetland, improve vegetation for wildlife and stop erosion.

During the week the offenders improved their communication skills, increased their self esteem while also paying something back to society by helping with this important conservation work.

Nick Hall, acting chief executive for Northumbria Probation Trust said: 'I am very impressed with the work the offenders completed and the impact this has had on them.

'I had met some of the group on a previous occasion and was amazed at the transformation in them. The conservation work has helped them to believe in themselves and realise that they can achieve other things in life without offending.'

The offenders who took part in the conservation work were subject to licence supervision on release from prison and living in Approved Premises in Northumbria.


First published on  http://justice.gov.uk/

 

Israeli researchers seek to develop 'morning-after-pill' for post-traumatic stress disorder

Treatment intended to prevent psychiatric episodes, similar to the treatments administered today after a stroke to prevent further complications, or after an event that could lead to post-traumatic stress disorder.

By Dan EvenTags: Israel health

An initial clinical trial conducted on 24 people involved in traffic accidents seems to corroborate earlier animal experiments indicating that it may be possible to develop a "morning-after pill" to prevent the development of post-traumatic stress disorder. The Israeli researchers who conducted the trial determined that the administration of a hormone reduces the risk of developing PTSD by 80 percent.

The project, led by Prof. Joseph Zohar, head of the psychiatry department at Sheba Medical Center, Tel Hashomer, and chairman of the Israeli Consortium on PTSD, is designed to develop a treatment to prevent psychiatric episodes, similar to the treatments administered today after a stroke to prevent further complications, or after an event that could lead to post-traumatic stress disorder.

	Photo by: AP

"Most psychiatric conditions, such as depression or even schizophrenia, develop gradually and not at a specific point in time, but PTSD appears in response to a specific traumatic event," explains Zohar.

"The treatment of post-trauma in the past several years is rich in myth and thin on facts, especially when it comes to first-aid after exposure to trauma," he adds.

Until recently, it was common practice to treat individuals exposed to traumatic events with tranquilizers from the Benzodiazepine family, such as Valium. But apart from their relaxing effect, these drugs delay the release of cortisol in the body. Animal experiments suggest that this "neutralization" of the hormone reduces the body's ability to defend itself against PTSD. American medical organizations began advising against Benzodiazepine treatment directly after stress exposure, and researchers began looking for better pharmaceutical alternatives.

Prof. Hagit Cohen, head of the anxiety and stress research unit of Be'er Sheva's Ben-Gurion University of the Negev, carried out an animal trial in which mice were exposed to a stress stimulus - in this case, litter soaked in cat urine. Some of the mice developed extreme stress symptoms, which were reduced when they were injected with cortisol shortly after developing the symptoms. The results of the study were published in the Biological Psychiatry journal in 2008, and gave rise to the human trial.

The pilot involved 24 survivors of traffic accidents who showed symptoms of stress after being admitted for treatment at the Sheba emergency room. Of the 12 subjects who were treated with the one-time injection of cortisol, only one was diagnosed with PTSD a month after the exposure to stress; at the end of a three-month period in which their conditions were monitored, none showed signs of PTSD. Of the 12 who received a placebo injection only, three developed PTSD.

The accepted medical definition of PTSD is the presence of an acute stress reaction to exposure to a traumatic event for at least a month after the event itself. Between 10-15 out of every 100 individuals are likely to develop PTSD after exposure to traumatic events; among people considered at high risk, who present with stress symptoms shortly after the exposure, as in the case of the Sheba trial subjects, the risk of PTSD climbs beyond 50 percent.

In the trial, 100 milligrams of cortisol were administered by injection, but Zohar noted that the use of cortisol in pill form will also be examined. Cortisol has a number of medical uses, and in the case of allergic and asthmatic attacks, it is administered in larger doses than the ones used in the clinical trial.

The protocol for the trial called for administering the cortisol within six hours after the exposure to the traumatic event - in this case, a traffic accident.

"In medicine, we call this period 'the golden hour' - in this case, the period during which the traumatic memory is fixed. If the emotional memory is not fixed in place, PTSD does not develop later on," Zohar said.

The results of the trial will be published in the December issue of the European Neuropsychopharmacology journal. The researchers recently received approval in principle for a research grant from the U.S. National Institute of Mental Health.

The results of the clinical trial could pave the way for the development of preventive treatments in psychiatry, similar to the administration of tetanus vaccine after exposure to toxins.

"The work raises the possibility in the future of developing a rapid treatment that could be given to people, such as combat soldiers, who have been exposed to traumatic events. There is a need for an agent that could be administered in the field and that does not impair motor responses or performance and that does not have a soporific effect - and cortisone meets these requirements," Zohar said.