Kenya hospital imprisons new mothers with no money

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NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.


Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.


Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.


"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."


"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."


The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.


Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.


"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.


She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.


A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.


"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.


Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.


One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.


Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.


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Associated Press reporter Tom Odula contributed to this report.


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Obama invites congressional leaders to 11th-hour ‘cliff’ talks

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President Barack Obama waves to reporters as he steps off the Marine One helicopter and walks on the South Lawn …President Barack Obama will meet Friday at the White House with Republican House Speaker John Boehner and other congressional leaders in what could be a last-ditch effort to avoid the “fiscal cliff” that will see Americans' take-home pay plummet come Jan. 1.


The meeting, confirmed by the White House in a statement late Thursday, will also include Democratic Senate Majority Leader Harry Reid, Republican Senate Minority Leader Mitch McConnell and Democratic House Minority Leader Nancy Pelosi. Vice President Joe Biden was also to attend.


The announcement came after a day in which the leaders traded public barbs, each side insisting the other must act first to spare Americans across-the-board income-tax hikes and deep government spending cuts that, together, could plunge the economy into a new recession. No compromise was evident, though Boehner called the House back to work on Sunday.



“Sen. McConnell has been invited to the White House tomorrow to further discuss the president’s proposals on the fiscal cliff. He is eager to hear from the president,” the Kentucky Republican lawmaker’s office said in a statement.


"Tomorrow, Speaker Boehner will attend a meeting with congressional leaders at the White House, where he will continue to stress that the House has already passed legislation to avert the entire fiscal cliff and now the Senate must act," Boehner spokesman Brendan Buck told reporters by email.


Obama stayed silent. He arrived at the White House on Thursday after leaving his family in Hawaii on their Christmas vacation to return to Washington, departing the island paradise after speaking by telephone individually with the leaders he was to host on Friday.



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Nowhere to use Japan's growing plutonium stockpile

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ROKKASHO, Japan (AP) — How is an atomic-powered island nation riddled with fault lines supposed to handle its nuclear waste? Part of the answer was supposed to come from this windswept village along Japan's northern coast.


By hosting a high-tech facility that would convert spent fuel into a plutonium-uranium mix designed for the next generation of reactors, Rokkasho was supposed to provide fuel while minimizing nuclear waste storage problems. Those ambitions are falling apart because years of attempts to build a "fast breeder" reactor, which would use the reprocessed fuel, appear to be ending in failure.


But Japan still intends to reprocess spent fuel at Rokkasho. It sees few other options, even though it will mean extracting plutonium that could be used to make nuclear weapons.


If the country were to close the reprocessing plant, some 3,000 tons of spent waste piling up here would have to go back to the nuclear plants that made it, and those already are running low on storage space. There is scant prospect for building a long-term nuclear waste disposal site in Japan.


So work continues at Rokkasho, where the reprocessing unit remains in testing despite being more than 30 years in the making, and the plant that would produce plutonium-uranium fuel remains under construction. The Associated Press was recently granted a rare and exclusive tour of the plant, where spent fuel rods lie submerged in water in a gigantic, dimly lit pool.


The effort continues on the assumption that the plutonium Japan has produced — 45 tons so far — will be used in reactors, even though that is not close to happening to a significant degree.


In nearby Oma, construction is set to resume on an advanced reactor that is not a fast-breeder but can use more plutonium than conventional reactors. Its construction, begun in 2008 for planned operation in 2014, has been suspended since the March 2011 Fukushima nuclear meltdowns, and could face further delays as Japan's new nuclear watchdog prepares new safety guidelines.


If Japan decided that it cannot use the plutonium, it would be breaking international pledges aimed at preventing the spread of weapons-grade nuclear material. It already has enough plutonium to make hundreds of nuclear bombs — 10 tons of it at home and the rest in Britain and France, where Japan's spent fuel was previously processed.


Countries such as the U.S. and Britain have similar problems with nuclear waste storage, but Japan's population density and seismic activity, combined with the 2011 Fukushima Dai-ichi nuclear disaster, make its situation more untenable in the eyes of the nation's nuclear-energy opponents. Some compare it to building an apartment without a toilet.


"Our nuclear policy was a fiction," former National Policy Minister Seiji Maehara told a parliamentary panel in November. "We have been aware of the two crucial problems. One is a fuel cycle: A fast-breeder is not ready. The other is the back-end (waste disposal) issue. They had never been resolved, but we pushed for the nuclear programs anyway."


Nuclear power is likely to be part of Japan for some time to come, even though just two of its 50 functioning reactors are operating and Japan recently pledged to phase out nuclear power by the 2030s. That pledge was made by a government that was trounced in elections Dec. 16, and the now-ruling Liberal Democratic Party was the force that brought atomic power to Japan to begin with.


Liberal Democrats have said they will spend the next 10 years figuring out the best energy mix, effectively freezing a nuclear phase-out. Japan's new prime minister, Shinzo Abe, said he may reconsider the previous government's decision not to build more reactors.


Construction at Rokkasho's reprocessing plant started in 1993 and that unit alone has cost 2.2 trillion yen ($27 billion) so far. Rokkasho's operational cost through 2060 would be a massive 43 trillion yen ($500 billion), according to a recent government estimate.


The reprocessing facility at this extremely high-security plant is designed to extract uranium and plutonium from spent fuel to fabricate MOX — mixed oxide fuel, a mix of the two radioactive elements. The MOX fabrication plant is set to open in 2016.


Conventional light-water reactors use uranium and produce some plutonium during fission. Reprocessing creates an opportunity to reuse the spent fuel rather than storing it as waste, but the stockpiling of plutonium produced in the process raises concerns about nuclear proliferation.


Fast-breeder reactors are supposed to solve part of that problem. They run on both uranium and plutonium, and they can produce more fuel than they consume because they convert uranium isotopes that do not fission readily into plutonium. Several countries have developed or are building them, but none has succeeded in building one for commercial use. The United States, France and Germany have abandoned plans due to cost and safety concerns.


The prototype Monju fast-breeder reactor in western Japan had been in the works for nearly 50 years, but after repeated problems, authorities this summer pulled the plug, deeming the project unworkable and unsafe.


Monju successfully generated power using MOX in 1995, but months later, massive leakage of cooling sodium caused a fire. Monju had another test run in 2010 but stopped again after a fuel exchanger fell into the reactor vessel.


Some experts also suspect that the reactor sits on an active fault line. An independent team commissioned by the Nuclear Regulation Authority is set to inspect faults at Monju in early 2013.


Japan also burned MOX in four conventional reactors beginning in 2009. Conventional reactors can use MOX for up to a third of their fuel, but that makes the fuel riskier because the plutonium is easier to heat up.


Three of the conventional reactors that used MOX were shut down for regular inspections around the time three Fukushima Dai-ichi reactors exploded and melted down following the March 201l earthquake and tsunami. The fourth reactor that used MOX was among the reactors that melted down. Plant and government officials deny that the reactor explosion was related to MOX.


Japan hopes to use MOX fuel in as many as 18 reactors by 2015, according to a Rokkasho brochure produced last month by the operator. But even conventionally powered nuclear reactors are unpopular in Japan, and using MOX would raise even more concerns.


When launched, Rokkasho could reprocess 800 tons of spent fuel per year, producing about 5 tons of plutonium and 130 tons of MOX per year, becoming the world's No. 2 MOX fabrication plant after France's Areva, according to Rokkasho's operator.


The government and the nuclear industry hope to use much of the plutonium at Oma's advanced plant, which could use three times more plutonium than a conventional reactor.


Meanwhile, the plutonium stockpile grows. Including the amount not yet separated from spent fuel, Japan has nearly 160 tons. Few countries have more, though the U.S., Russia and Great Britain have substantially more.


"Our plutonium storage is strictly controlled, and it is extremely important for us to burn it as MOX fuel so we don't possess excess plutonium stockpile," said Kazuo Sakai, senior executive director of Rokkasho's operator, JNFL, a joint venture of nine Japanese nuclear plant owners.


Rokkasho's reprocessing plant extracted about 2 tons of plutonium from 2006 to 2010, but it has been plagued with mechanical problems, and its commercial launch has been delayed for years. The operator most recently delayed the official launch of its plutonium-extracting unit until next year.


The extracted plutonium will sit there for at least three more years until Rokkasho's MOX fabrication starts up.


Giving up on using plutonium for power would cause Japan to break its international pledge not to possess excess plutonium not designated for power generation. That's why Japan's nuclear phase-out plan drew concern from Washington; the country would end up with tons of plutonium left over. To reassure Japan's allies, government officials said the plan was only a goal, not a commitment.


Japan is the only nation without nuclear weapons that is allowed under international law to enrich uranium and extract plutonium without much scrutiny. Government officials say they should keep the privilege. They also want to hold on to nuclear power and reprocessing technology so they can export that expertise to emerging economies.


Many officials also want to keep Rokkasho going, especially those in its prefecture (state) of Aomori. Residents don't want to lose funding and jobs, though they fear their home state may become a waste dump.


Rokkasho Mayor Kenji Furukawa said the plant, its affiliates and related businesses provide most of the jobs in his village of 11,000.


"Without the plant, this is going to be a marginal place," he said.


But Rokkasho farmer Keiko Kikukawa says her neighbors should stop relying on nuclear money.


"It's so unfair that Rokkasho is stuck with the nuclear garbage from all over Japan," she said, walking through a field where she had harvested organic rhubarb. "... We're dumping it all onto our offspring to take care of."


Nearly 17,000 tons of spent fuel are stored at power plants nationwide, almost entirely in spent fuel pools. Their storage space is 70 percent filled on average. Most pools would max out within several years if Rokkasho were to close down, forcing spent fuel to be returned, according to estimates by a government fuel-cycle panel.


Rokkasho alone won't be able to handle all the spent fuel coming out once approved reactors go back online, and the clock is ticking for operators to take steps to create extra space for spent fuel at each plant, Nuclear Regulation Authority Chairman Shunichi Tanaka said.


"Even if we operate Rokkasho, there is more spent fuel coming out than it can process. It's just out of balance," he told the AP.


A more permanent solution — an underground repository that could keep nuclear waste safe for tens of thousands of years — seems unlikely, if not impossible.


The government has been drilling a test hole since 2000 in central Japan to monitor impact from underground water and conduct other studies needed to develop a potential disposal facility. But no municipality in Japan has been willing to accept a long-term disposal site.


"There is too much risk to keep highly radioactive waste 300 meters (1,000 feet) underground anywhere in Japan for thousands or tens of thousands of years," said Takatoshi Imada, a professor at Tokyo Technical University's Decision Science and Technology department.


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Katie Holmes' Broadway play 'Dead Accounts' closes

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NEW YORK (AP) — Katie Holmes' return to Broadway will be much shorter than she would have liked.


The former Mrs. Cruise's play "Dead Accounts" will close within a week of the new year. Producers said Thursday that Theresa Rebeck's drama will close on Jan. 6 after 27 previews and 44 performances.


The show, which opened to poor reviews on Nov. 29, stars Norbert Leo Butz as Holmes' onstage brother who returns to his Midwest home with a secret. Rebeck created the first season of NBC's "Smash" and several well-received plays including "Seminar" and "Mauritius."


Holmes, who became a star in the teen soap opera "Dawson's Creek," made her Broadway debut in the 2008 production of "All My Sons." She was married to Tom Cruise from 2006 until this year.


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Online: http://www.deadaccountsonbroadway.com


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Kenya hospital imprisons new mothers with no money

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NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.


Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.


Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.


"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."


"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."


The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.


Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.


"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.


She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.


A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.


"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.


Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.


One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.


Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.


___


Associated Press reporter Tom Odula contributed to this report.


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Winter storm whips into Northeast

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CONCORD, N.H. (AP) — The death toll from a powerful winter storm that pushed through the nation's midsection into the Northeast has risen to 7.


Officials in Ohio are blaming the bad weather for a crash that killed an 18-year-old girl, who lost control of her car Wednesday afternoon and smashed into an oncoming snow plow on a highway northeast of Cincinnati.


The storm is expected to drop one to two feet of snow on parts of the Northeast just a day after it swept through the nation's middle, dumping a record snowfall in Arkansas and ruining holiday travel plans.


The National Weather Service says the Northeast's heaviest accumulations will be in northern Pennsylvania, upstate New York and inland sections of several New England states before the storm heads to Canada on Friday.


Despite the wet weather, no flights are delayed Thursday morning cities like New York, Philadelphia and Boston.


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Thai 'Yellow Shirt' leaders charged for 2008 rally

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BANGKOK (AP) — Protest leaders in Thailand were indicted Thursday for storming the prime minister's office compound and sealing off Parliament during massive anti-government rallies in 2008 at the height of political turmoil, which left the country deeply divided to this day.


Prosecutors filed charges against Sondhi Limthongkul, Chamlong Srimuang and other leaders of the People's Alliance for Democracy, also known as the Yellow Shirts.


They face up to five years in prison for trespassing at Government House during an August 2008 rally, in which protesters stormed the compound and thousands occupied the grounds for weeks. They face an additional seven years in prison for blockading the Parliament in an October 2008 rally that left hundreds injured.


They also led a two-week seizure of Bangkok airports but have not yet been charged for that.


Mostly hailing from the urban elite, the Yellow Shirts' protests grew from their visceral hatred for former Prime Minister Thaksin Shinawatra, a telecommunications tycoon, whose democratically elected government was in power from 2001 until it was overthrown in a 2006 military coup. The Yellow Shirts claimed he was corrupt and that his proxies were running the country after he went into exile following the coup.


His sister, Yingluck, is now premier, which critics say has helped accelerate long-stalled legal cases against opponents of Thaksin, who says the corruption charges that he says are trumped up.


After a year of martial law following the 2006 coup, fresh elections were held that were again won by Thaksin's allies, triggering the Yellow Shirt protests, which took a heavy toll on the economy and tourism. The political turmoil continued for months until the pro-Yellow Shirt Democrat Party formed a government in December 2008 without an election. That brought to the streets tens of thousands of Thaksin supporters, mostly rural folk, who called themselves the Red Shirts.


They were evicted from central Bangkok in a military operation in April 2010 that left dozens of people dead.


The deadlock was finally broken when the Democrat Party stepped aside and called elections in July 2011 that Yingluck's party won. Thaksin remains in exile.


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Apple still can’t build enough iPad minis

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A common issue often presents itself when Apple (AAPL) launches new products: it can’t build them fast enough. We’ve seen it time and time again, most recently when Apple launched the iPhone 5 and 150,000 dedicated factory workers still couldn’t keep up with demand. Now, a report has surfaced claiming that Apple’s manufacturing partners in the Far East can’t build units fast enough to keep pace with Apple’s iPad mini orders.


[More from BGR: Microsoft Surface trampled at the bottom of the tablet pile this Christmas]






According to Digitimes’ supply chain sources, Apple’s parts suppliers have prepared enough components to build between 10 million and 12 million iPad mini tablets in the fourth quarter to accomodate heavy demand. Apple’s manufacturing partners are only expected to ship 8 million assembled units, however.


[More from BGR: Mark Cuban: Nokia Lumia 920 ‘crushes’ the iPhone 5]


The report states that yield rates are improving though, and Apple is expected to ship 13 million iPad mini tablets in the first quarter of 2013.


This article was originally published by BGR


Gadgets News Headlines – Yahoo! News





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DC police investigating 'Meet the Press' incident

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WASHINGTON (AP) — District of Columbia police say they are investigating an incident in which NBC News reporter David Gregory displayed what he described as a high-capacity ammunition magazine on "Meet the Press."


Police spokesman Tisha Gant said Wednesday the department is investigating whether Gregory may have violated D.C. firearms laws that ban the possession of high-capacity magazines. She declined to comment further.


While interviewing National Rifle Association CEO Wayne LaPierre on Sunday's program, Gregory held an object, apparently as a prop to make a point, and said it was a magazine that could hold 30 rounds.


High-capacity ammunition magazines are banned in the District of Columbia, regardless of whether they're attached to a firearm. "Meet the Press" is generally taped in Washington.


An email seeking comment from NBC was not immediately returned.


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Predicting who's at risk for violence isn't easy

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CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.


Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.


But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.


"They're yellow flags. They only become red flags once the blood is spilled," he said.


Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.


Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)


Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.


Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.


"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."


The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."


In a guidelines for families, the academy lists several risk factors for violence, including:


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.


Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.


Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.


According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.


Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.


Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.


And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.


All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.


Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.


Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.


Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.


___


Online:


American Academy of Child & Adolescent Psychiatry: http://www.aacap.org


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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