Category Archives: Features

Gov. Edwards Joined Pres. Trump and Other Governors to Discuss Criminal Justice Reform

On August 9, Gov. Edwards joined President Trump, other state governors, and White House cabinet members in a roundtable discussion about the positive impact that criminal justice reform is having across the nation.

Gov. Edwards explained to the President that the package of bipartisan criminal justice reform legislation that Edwards signed into law in 2017 was working.

“In Louisiana, we’re proud of the work we’ve done,” said the Governor. “It’s been sentencing reform, prison reform, and a real focus on reentry and for the first time in 20 years, I can tell you Louisiana does not have the highest incarceration rate in the nation today.”

“We are reinvesting the savings into our reentry program and also into the victim services. And so we are excited about what we’re doing and looking forward to sharing that with you,” according to the press release.

A report in the Advocate by Elizabeth Crips noted that Trump and others at the meeting spoke about the need to enhance job and skills training programs in prisons, and to focus on how to prepare people to be productive citizens when they get out. “Our first duty is to our citizens, including those who have taken the wrong path but are seeking redemption and a new beginning,” Trump said. “That’s people that have been in prison, and they come out and they’re having a hard time.”

According to Gov. Edwards’ press release, he was the only democratic governor attending. Also attending were Gov. Matt Bevin (R-Kentucky), Gov. Phil Bryant (R-Mississippi), Gov. Nathan Deal (R-Georgia), Gov. Doug Burgum (R-N. Dakota), Atty. General Ken Paxton (R-Texas), Atty. General Pam Bondi (R-Florida), Labor Secretary Alexander Acosta, Energy Secretary Rick Perry, Jared Kushner and other White House staffers.

Gov. Matt Bevin of Kentucky, commented, “The most powerful thing about this… I look at guys like John Bel Edwards in Louisiana, represents a different party than I do in Kentucky in terms of our political affiliation. This is something that we are very much of like-mind on. I think this transcends anything political.”

Energy Sec. Rick Perry said, “I want to share with these governors around here; every one of them is courageous…”

Just after the meeting, Gov. Edwards gave President Trump a letter detailing Louisiana’s efforts, said the release.

The Governor wrote, “For nearly twenty years, Louisiana was known as the nation’s incarceration capital. Our imprisonment rate was nearly double the national average. We were spending roughly $700 million annually on corrections, more than any other line item except education and healthcare, but our communities were not safer for it….”

And, “With the technical support from The Pew Charitable Trusts, we convened a bipartisan task force and spent a year scrutinizing our correctional policies and practices. In June of 2017, I signed into law the most expansive criminal justice reform package in Louisiana’s history…Republicans, Democrats and Independents, as well as the business and religious community, came together to pass these historic reforms.”

The Governor invited the President to tour the State Penitentiary at Angola and see efforts to reform the state’s criminal justice system.

“I believe you will gain a great deal of insight by visiting Louisiana State Penitentiary and I look forward to welcoming you to Louisiana on behalf of the people I serve,” Edwards wrote in the letter given to Trump. “The reentry programming services at LSP (Louisiana State Penitentiary) are key examples of how we plan to utilize the savings from our reforms to better prepare those being released from our prison system. In fact, the first year savings is dedicated specifically to the five parishes that generate nearly 50% of Louisiana’s prison admissions…

Also according to the report by Crisp, Governor Edwards joined other Democratic governors in Colorado recently and discussed divisive politics and ways to unite people. “Folks are just anxious,” the Aspen Daily News quoted Edwards as saying Friday at the Aspen Institute event. “We ought not to vilify anyone. I don’t talk about Trump backers as crazy or racist.”

The justice reform efforts have not been without controversy. Critics point to the two individuals who are now accused of murder and others who have been rearrested. District attorneys are some of the most vocal skeptics, according to various sources.

Some estimate that as many as 22 percent are now back in the justice system, according to the Advocate. The Department of Corrections disputes that figure as inflated. “I’m not sure where the DAs are getting their information from,” said the head of Corrections, James LeBlanc. “Our numbers are not anywhere close to what they are saying.”

Dr. Susan Tucker, clinical psychologist and the Assistant Warden at the Bossier Parish Medium Security Facility, has explained the significance of comprehensive psychological programs in the corrections and justice system.

Tucker developed the Steve Hoyle Intensive Substance Abuse Program which has earned national recognition for excellence. In 2016 the Louisiana Legislature commended Tucker and her team in a House Concurrent Resolution pointing to multi-million dollar cost savings to the state because of shorter incarceration times of those offenders who participated in the psychological programs designed by Tucker.

Dr. Raman Singh, previous Medical Director at Corrections, pointed out the reasons for over-incarceration in Louisiana. Based on a 2016 Louisiana Legislative Auditor’s review Singh said the top reasons were mandatory sentences and habitual offender laws, high rates of local incarceration without treatment programs, and “not addressing issues driving criminal behavior such as substance and mental illness.”

Jails and prisons have a disproportionately high number of persons with mental health issues and people with a serious mental illness. He noted that of the mentally ill in society, greater than 40 percent have been arrested and the majority of these are brought in for minor offenses. Those with mental illness spend two to five times longer in jail.

There is a complex interplay of multiple societal factors stemming from problems in education, stressed family structures, socio-economic challenges and lack of job opportunities. The unemployment rate in the mentally ill adults in Louisiana is 88.3 percent.

And while 16 percent of the DOC prison population has been diagnosed with a serious mental illness, 82 percent are diagnosed with a substance use disorder.

Stabilized funding for higher education. State Budget Finally Stable Says Governor Edwards

This week Gov. Edwards authored a guest column in The Advocate detailing the progress Louisiana has made since overcoming the state’s fiscal challenges.

“… Louisiana is projected to have a $300 million surplus for the fiscal year 2018,” the Governor said. “This surplus is available to us because Louisiana businesses are doing
better, more Louisianans are finding work, and the improving economy has allowed corporate tax receipts to outpace expectations. Since I’ve been governor, the unemployment rate has fallen from a high of 6.2 percent to its current rate of 5 percent. But our good news doesn’t stop there.”

Gov. Edwards said that Louisiana now has long-term budget stability.

“For the first time in years, we have a stable budget structure that does not rely on one-time money or gimmicks, and we have put an end to the annual cuts to higher education that have threatened our children’s future. Republicans, Democrats, and Independents did all of that, and we still reduced the tax burden on the people of Louisiana by nearly $600 million.”

“Within weeks the national credit rating agencies removed Louisiana from the negative watch list. Our universities began the fall semester with nearly every campus’ enrollment at record levels because for the second year in a row, we stabilized funding for higher education and fully funded TOPS and Go Grants.”

“Bipartisanship has served our state well in other areas as well. Louisiana has taken the courageous step of implementing historic bipartisan criminal justice reforms. The reforms have been in place for just over a year, and the early results show that they are working. The state is no longer the incarceration capital of the world, a title we held for decades. In addition, the reforms have saved Louisiana $12.2 million, money that we are reinvesting into public safety and efforts to reduce recidivism. Our reforms were focused on nonviolent, non-sex offenders and were based off efforts in other Southern, conservative states, and we are proud to continue working with the White House and other states hoping to follow Louisiana’s lead.”

In a September 25 press release, the Governor announced that Louisiana was second in the nation for personal income growth in 2nd Quarter of 2018, behind only Texas, based on Bureau of Economic Analysis. Personal income in Louisiana grew at a rate of 5.9 percent, outpacing the national average of 4.2 percent, said the statement.

“Last week, we announced that the state ended the last fiscal year with a surplus. Today, the Bureau of Economic Analysis confirmed our assumptions – Louisiana’s businesses are doing better and people are bringing home more in their paychecks. This is excellent news, and just another sign that Louisiana is moving in the right direction. Our economy is growing, more people are working, and we have a stable budget structure for the first time in many years. While this is all positive news, we still have more work to do, but there is no denying that the momentum we have in Louisiana is real.”

The good news comes as a feature of the nationally based economic boom but also after painful legislative battles for the Governor.

After a total of seven special sessions since 2016, and three special sessions this year, Governor Edwards and legislators finally wrestled the budget into some type of order this past spring,
by the passage of an extra .45 percent sales tax, in down to the wire negotiations that ended last week. The move sidestepped drastic cuts to public health and higher education and provides several years of stability.

The new sales tax, a partial renewal of an expiring one percent sales tax, gave the lawmakers some respite from the yearly battles with the budget. The .45 brings the state sales tax to 4.45.

In the special sessions lawmakers were attempting to deal with the state’s budget crisis when more than $1 billion in taxes would expire on June 30, 2018. The two earlier special sessions floundered after the House repeatedly rejected increased taxes.

The House passed a budget that made dramatic cuts to TOPs, universities and state agencies. That budget was vetoed by the Governor.

Focus is on Prevention as Suicide Continues to Rise

One of the measures that flew through the House (85 to 0) and then with amendments, through the Senate (32 to 0), in the regular 2018 Legislative session, was Representative Reid Falconer’s “Louisiana Suicide Prevention Act.”

An ambitious plan, Act 450 directs the Office of Behavioral Health to ensure that administrators of all healthcare facilities licensed by state and all licensed healthcare professionals have access to informational resources and technical assistance necessary for implementation of the zero suicide initiative. The initiative carried a price tag of nearly $800,000. Because of the state’s financial picture, an amendment was added requiring that implementation had to be contingent on obtaining grant money.

The authors of Act 450 note that according to the 2016 America’s Health Rankings report, the number of deaths due to suicide per one hundred thousand people in the United States rose steadily from 2012 through 2016, and Louisiana’s rate of deaths from suicide is nearly ten percent higher than the national average.

The Center for Disease Control continues to rank suicide as the 10th leading cause of death in the US. The most recent year of data (2015) placed suicide deaths at 44,193 nationwide, more than the number killed in automobile accidents, which was 37,757, or homicides, 17,793, for that same year.

Representative Falconer wrote “While suicide occurs among persons of all ages, ethnic backgrounds, and income levels, it is an especially troubling problem among youth in Louisiana, with suicide ranking as the second-leading cause of death in this state for persons between the ages of ten and twenty-four in 2014, the most recent year for which complete data are available.”

Suicide is a pronounced public health concern among military veterans nationwide and in Louisiana particularly, as Louisiana’s veteran suicide rate is over ten percent higher than that of the nation and of the southern region, write the authors. And, more than half of the people who died by suicide did not have unknown mental health condition, reports the CDC.

The rising rates of suicide has been at the front of the news for some psychologists in the field, and motivated the Louisiana Psychological Association to host suicide prevention expert Dr. April Foreman at their recent state convention.

Foreman is a licensed psychologist serving Veterans as Suicide Prevention Coordinator for Southeast Louisiana Veterans Health Care System. She also serves as Suicide Prevention Lead for Veterans Integrated Service Network 16, a region of Veterans Affairs. She is on the Executive Committee for the Board of the American Association of Suicidology.

Dr. Foreman presented “Suicide Risk Assessment,” at the Louisiana Psychological Association Convention recently, providing an overview of basics of suicide risk assessment, risk levels, and acute vs. chronic risk. She covered the use of safety planning as a follow up to risk assessment, current research innovations pertaining assessment of risk and actual prediction of suicide attempts/deaths, and possible ways this may impact clinical work in the upcoming years.

Dr. Foreman has been working toward this goal for some time. In 2014, Foreman supported Senator Ben Nevers’ effort to ensure that mental health professionals were adequately trained, SB 539. While the mandate was removed, the effort drew attention to the problem.

“This is a public health issue that is squarely in psychology’s wheelhouse,” said Foreman in a previous interview. “Only 9 to 10 percent of mental health professionals can pass a competency exam,” in this topic, said Foreman. “This is a big training deficit.”

Dr. William “Bill” Schmitz, Jr., a licensed clinical psychologist in Baton Rouge, working primarily with the nation’s veterans, and who has served as President of the American Association for Suicidology previously explained the importance. “It is the number one emergency in mental health and the most lethal situation a professional will encounter. But, no one is required to have training,” he said.

Schmitz co-authored a white paper, “Preventing Suicide through Improved Training in Suicide Risk Assessment and Care,” a report of the American Association of Suicidology Task Force, which Schmitz chaired. In the report, authors noted that training for suicide prevention is inconsistent at best. The majority of mental health professionals receive very little, if any formal training in suicide prevention. The exceptions are the psychiatrists; 94 percent have received some training. However, even in this group, only about a quarter of these receive skill development training.

“An hour of didactic training may increase knowledge,” Schmitz explained to the Times, “but it doesn’t do anything to actually change competency.”

Dr. Foreman has also looked carefully into the competency problem. “When the state of Georgia was asking these same questions in 2005,” she said, “they assessed a sample of mental health professionals, and the competency rate was 9 percent. A few hours of training raised the rate to 83 percent,” she said. “That’s a huge difference.”

The rising rates of suicide are a concern. “There are several theories regarding this trend, though a specific and definitive explanation has not emerged,” Schmitz noted. “We do know that suicide attempts, across the lifespan, tend to become more lethal,” explaining that the ratio of suicide attempts to death is 100-200 to one for adolescents and young adults, but for those over 65 the ratio is four to one.

“Coupled with this,” Schmitz said, “I would also add that help-seeking and mental health treatment remain very stigmatized among the older adult populations. There is lingering doubt and fears associated with institutionalization, asylums, and being ‘locked up’ if one divulges any thought of suicide,” he explained. “This is very disconcerting given the clear evidence that even people determined to be at high risk for suicide have been shown to respond to intensive outpatient therapy.

In a previous interview with the Times, Dr. Frank Campbell, a clinical social worker and expert from Lacombe, Louisiana, former Executive Director of the Baton Rouge Crisis Intervention Center, and also Past-President of and American Association for Suicidology, said, “It is important to accept that suicide is a very complex and paradoxical cause of death to develop clear
understandings from. It is an N of 1 and by that I mean each suicide is unique.” Dr. Campbell’s work has been featured in a documentary for the Discovery Channel.

“For me the most comprehensive micro or individual answer to any death by suicide,” he said, “is that it happens as a result of a self-defined crisis where the individual’s ability to cope with the precipitating event which brings on the crisis response––decline in coping and possible increase in maladaptive coping––was unable to keep that person safe from suicide,” Dr. Campbell said.

“Data is helpful in awareness but each death impacts the community in ways that are unique and little research has been conducted on the impact suicide has on generating additional causalities both in the short term or long term for a community.”

“The macro response would include considering the impact of social and economic changes in the past 10 years,” Campbell said, “because economic conditions have historically correlated with upward trends in suicide.”

Also, “… a growing number of citizens who are veterans of military service––mostly men––which are estimated to equal one out of each five deaths by suicide,” he said.

Dr. Schmitz pointed out that there is growing evidence supporting various approaches that help those at risk. “There are treatments that work, there are warning signs and basic skills of suicide assessment and management that should be core clinical competencies,” said Schmitz.

“Unfortunately, the majority of mental health professionals do not obtain this training in either their graduate studies or continuing education,” he said.

“Providers that are not engaging their patients in active discussions about means restriction and crisis response planning really terrify me,” he said.

Dr. Campbell said, “Managing transitions in life if not easy and when health and loneliness are isolating factors along breakdown geographically of the family and health care challenges it is a lot to manage. Generational expectations are not always shared or expressed clearly to family who might be wanting to help but just don’t know how.”

“My thought is that if we had the number of folks who die by suicide each year drowning then we would train more lifeguards to stand by those in the water.

“The river of suicide is large in this country and it is up to all of us in our communities to become trained as lifeguards. One such training that is for all care givers is the two-day ASIST (Applied Suicide Intervention Skills Training) that helps anyone help another at risk from the river to safety for now.”

Lt. Governor Nungesser and Dr. Scott O. Lilienfeld Look at Psychology’s Role

Lt. Governor William (Billy) Nungesser and nationally recognized clinical psychologist, Scott O. Lilienfeld, delivered the welcome and keynote to attendees for the 70th Annual Convention of the Louisiana Psychological Association, held last month in Metairie.

Nungesser highlighted the need for those in Louisiana to think “outside the box” when it comes to Louisiana’s critical needs, helping launch the 2018 theme, “Psychology: Essential Partner for Solving Critical Problems.”

In his remarks, the Lt. Governor pointed to the natural beauty and strengths of the state’s diverse population and environment, and his belief that the state’s culture, history and people are the key to making the state great and working out the problems, he said. Nungesser also spoke on how he and others have addressed natural disasters and built resources through the programs in the Department of Culture, Recreation & Tourism.

Lt. Governor Nungesser has been called one of the state’s top CEOs, for his ground-up business development and his can-do approach to crises like Katrina and Deepwater Horizon. He also spoke about his business background and how problem-solving and innovation was essential.

Nungesser closed with the new branding video and slogan, “Feed Your Soul,” unveiled at Mardi Gras 2018. He explained the method for the branding effort was data-driven, pointing to the evidence-based methods and thinking outside-the-box for the outcomes.

Followed with hearty applause by attendees, the video included an appealing, baritone narrator who said, “Louisiana isn’t for spectators. It’s for participants, for those who want to feed their soul, to not only live in the moment, but to become the moment.”

The video can be viewed at https://www.youtube.com/watch?v=EnGRfDaMU4

Nationally recognized speaker and Emory Professor Dr. Scott O. Lilienfeld, continued the theme with “Being the Essential Partner: Understanding and Overcoming Skepticism about Scientific Psychology.”

Dr. Lilienfeld, recipient of the James McKeen Cattell Award for Lifetime Contributions to Applied Psychological Science from the Association for Psychological Science, reviewed the evidence for the public’s skepticism of psychology as a science and why the public has doubts about information from psychological science.

Among his findings he cited that only 30% agree that “psychology attempts to understand the way people behave through scientific research” and 41% see psychological research as less rigorous than medical research. Along with many findings he noted that an APA Presidential Task Force found that, “Despite psychology’s foundation in science and its standing as the science of human behavior, it is not fully accepted as a science by the general public.”

After Dr. Lilienfeld reviewed the common criticisms of psychology’s scientific status he discussed rebuttals of the criticisms, and gave main reasons for negative public views of psychology.

He noted that the public face of psychology is not represented by psychological scientists. “Psychologists are rarely called on by the media to comment on psychological findings; when they are, they are rarely scientific psychologists,” he said.

He pointed to “The Illusion of Understanding––We’re all ‘psychologists’ in everyday life, so psychology seems easy.”

Among the problems he included the “Confusion Between Psychologists and Psychotherapists,” as an important factor.

He also said that that scientific psychology is challenged by the “scientific impotence excuse,” and that “When psychological findings conflict with our deeply held intuitions, we may resolve that cognitive dissonance by dismissing a scientific approach to the questions at hand…”

Among the remedies, Dr. Lilienfeld said that, “Academic and practicing psychologists have not spent enough of their time disseminating science to the public, combating bad science, and correcting misconceptions of the field.”

“We must play a more active role in educating laypersons about psychology’s scientific side and confronting its nonscientific side,” he said.

Lilienfeld’s work has been cited over 21,295 times. He delivered the Award Address, “Psychology’s Public Image Problem: Why Many Laypersons and Politicians Don’t View Our Field as Scientific,” at APS. He is also a researcher and test author in areas of psychopathy, and also presented, “The Multifaceted Nature of Psychopathy.”

Also highlighted this year was neuropsychologist David Schwartz, PhD, from the Concussion Institute in Atlanta; April Foreman, PhD, licensed psychologist and Suicide Prevention Coordinator for Southeast Louisiana Veterans Health Care System; and Canadian psychologist, and expert in nutritional mental health, Bonnie Kaplan, PhD.

Denise Newman, PhD, chaired a panel with Drs. Alvin Burstein, Dana Labat, and Sandra Loucks, on the “Heart of Change in Psychotherapy.”

“Ethical Issues and Health Disparity,” was presented by co-chairs ValaRay Irvin, PhD and Chris Leonhard, PhD, APPB. Alan Coulter, PhD, and Courtland Chaney, PhD, presented a cross specialty presentation on “Opportunities for Organization Development Interventions in Schools: The Interface of Two Specialties.”

Members of the Louisiana State Board of Examiners of Psychologists and staff presented, “Laws, Rules & Ethics Update.”

Tiffany Jennings, PsyD, presented, “Highlights on Rural Health:Utilizing Telehealth to Increase Access to Care, Support, and Peer Consultation.”

Jill Hayes, PhD, lead a round table discussion on “Ethical and Legal Issues for Misdiagnosis,” with Drs. Denise Newman, John Fanning, and Marc Zimmermann.

A Scientific Poster Session was chaired by Drs. Ashley Jefferson and Melissa Dufrene, and the Science Café was chaired by Drs. Scott Smith and Bridget Sonnier-Hillis.

The Convention included an Industrial-Organizational Psychology Mini-Conference, with presentations by Richard Flicker, PhD, Courtland Chaney, PhD, Jim Stodd, MS, Barry Vose, BS, William Costelloe, PhD, Tyree Mitchell, PhD, John-Luke McCord and Brian Doyle, and Jared LeDoux, PhD.

Lt. Governor, Dr. Scott O. Lilienfeld to Speak at 70th La Psych Assn Convention

Lt. Governor William (Billy) Nungesser will deliver the welcome for the 70th Annual Convention of the Louisiana Psychological Association, and highlight Louisiana’s critical needs, launching this year’s theme for “Psychology: Essential Partner for Solving Critical Problems.” Nationally recognized speaker, Emory Professor Dr. Scott O. Lilienfeld, will continue the theme with “Being the Essential Partner: Understanding and Overcoming Skepticism about Scientific Psychology.”

The two-day conference will be held May 18 and 19 at the Sheraton, 4 Galleria Boulevard, in Metairie, and host an array of national and local presenters, scientific poster and laboratory presentations, and experiential groups, building on the theme of psychology’s unique perspectives and contributions.

Lt. Governor Nungesser has been called one of the state’s top CEOs, for his ground-up business development, and his can do approach to crises like Katrina and Deepwater Horizon.

Dr. Lilienfeld is recipient of the James McKeen Cattell Award for Lifetime Contributions to Applied Psychological Science, Association for Psychological Science (APS). His work has been cited over 21,295 times. He delivered the Award Address, “Psychology’s Public Image Problem: Why Many Laypersons and Politicians Don’t View Our Field as Scientific,” at APS.

Lilienfeld is also a researcher and test author in areas of psychopathy, and will also present, “The Multifaceted Nature of Psychopathy,” during the breakout sessions.

Also highlighted this year is neuropsychologist David Schwartz, PhD, from the Concussion Institute in Atlanta, who will present, “Advances in the Assessment and Management of General and Sports–Related Concussion Injuries.” Dr. Schwartz is an engaging speaker who is known for his entertaining delivery and broad information, noted the conference organizers.

Dr. Schwartz will also present the plenary session for Saturday, the cross-cutting topic, “New Technologies for Assessment and Behavior Change.”
April Foreman, PhD, licensed psychologist and Suicide Prevention Coordinator for Southeast Louisiana Veterans Health Care System will present “Suicide Risk Assessment.” Foreman is Suicide Prevention Lead for Veterans Integrated Service Network 16, and on the Executive Committee for the Board of the American Association of Suicidology.
Dr. Foreman is known for her work at the intersection of technology, social media, and mental health.

In a special Zoom presentation, Canadian psychologist, and expert in nutritional mental health, Bonnie Kaplan, PhD, will present “Nutritional Mental Health.”

Kaplan is Professor Emerita in the Cumming School of Medicine at the University of Calgary, in Calgary, Alberta, Canada, and an expert in the field of nutritional mental health, including topics such as inflammation and mental health, the microbiome and mental health, oxidative stress and mental health, mitochondria and mental health and nutrienttreatment research.

Denise Newman, PhD, will chair a panel with Drs. Alvin Burstein, Dana Labat, and Sandra Loucks, on the “Heart of Change in Psychotherapy,” and panelists will address, “Technical and Ethical Aspirations in Psychotherapy within a Developmental Framework: Navigating Challenging Dynamics in the Therapeutic Relationship,” and address both the theoretical aspects and the technical navigation of the therapeutic relationship as the focus of psychotherapeutic treatment. Dr. Newman is chair of the LPA Psychotherapy Interest Area Committee.

“Ethical Issues and Health Disparity,” will be presented by co-chairs ValaRay Irvin, PhD and Chris Leonhard, PhD, APPB. Along with panelists they will address the intersection between social determinants of health research, and access to quality mental healthcare and health disparities. Irvin and Leonhard will frame issues in the context of the role of ethical principles, codes of conduct, and related policies and laws in the amelioration of disparities.

Alan Coulter, PhD, and Courtland Chaney, PhD, will present a cross specialty presentation on “Opportunities for Organization Development
Interventions in Schools: The Interface of Two Specialties.” Presenters will review the Every Student Succeeds Act (ESSA), organizational development theory, and blend into a discussion for intervening at the individual, group and organizational level in school systems.

Members of the Louisiana State Board of Examiners of Psychologists and staff will present an interactive session on “Laws, Rules & Ethics Update.” They will cover demographic characteristics of licensees, where to locate information regarding current laws, rules and opinions pertaining to psychologists, characteristics of the current Rule-making, and common complaints received by the LSBEP and related ethical violations.

Tiffany Jennings, PsyD, will present “Highlights on Rural Health: Utilizing Telehealth to Increase Access to Care, Support, and Peer Consultation.” Dr. Jennings will cover applications for telehealth and also contraindications, how to set up telehealth, forms and codes, ethics and safety measures.
Jill Hayes, PhD, will lead a round table discussion on “Ethical and Legal Issues for Misdiagnosis,” addressing challenges in correct diagnosis in today’s restrictive insurance environment and complex cases.

A Scientific Poster Session will be held on Friday, chaired by Drs. Ashley Jefferson and Melissa Dufrene. Attendees will enjoy breakfast while they review research findings through poster presentations from psychological science across the state, and speak directly with researchers about their theory, methods, and results.

Breakfast is served again on Saturday at the Science Café on Saturday, chaired by Drs. Scott Smith and Bridget Sonnier-Hillis. Attendees can review findings in psychological science from laboratories around the state, and chat with researchers about how science is rapidly changing in key areas.

The Convention includes an IndustrialOrganizational Psychology MiniConference, organized by the LPA I-O and Consulting Psychology Committee. Attendees will hear topics in four modules. Under Ethical Challenges and Citizen Psychology, RichardFlicker, PhD, will present “Ethical Challenges in I-O Psychology: What would you do?” and Courtland Chaney, PhD, will conduct a session on “An I-O Role for a Citizen Psychologist: The Governor’s Task Force on Sexual Harassment and Discrimination Policy.”

Under the I-O Psychology Practitioner segment, Jim Stodd, MS, will present, “Why I-O Psychology is Superb Training for Those Who Shape and Manage Compensation Programs.” Barry Vose and William Costelloe, PhD, will present, “Seven Steps to Developing an I-O Career.”

Lunch & Learn will address Ethical Dilemmas. The Scholarly Pursuits and I-O Psychology in Healthcare section will begin with Tyree Mitchell, PhD, “Too Much of a Good Thing? The Diminishing Returns of Leadership on Leadership Emergence.”

“The Influence of Untraditional Interview Questions on Applicant Affective Reactions and Perceptions of Organizational Personality,” will be presented by John-Luke McCord and Brian Doyle.

Jared LeDoux, PhD, will present “Applying I-O Psychology in a Hospital Setting.”

For the closing activities of main conference, professional issues are addressed in a communitywide, experiential learning event, known as Lunch & Learn. Specialty interest area groups will address the problems in “Current Ethical & Moral Challenges in Professional Psychology” on Friday, and “Current Professional Challenges in Specialty Areas of Psychology Practice” on Saturday. This working lunch allows attendees to join with colleagues to discover and analyze key issues for today’s professional psychologists.

Facilitators blend the information into the Saturday wrap-up session, and engage attendees in institution-level, strategic analysis in “70 Years of Psychology Contributions––Are We There Yet? An experiential, strategic– planning exercise. Julie Nelson, PhD, and William Costelloe, PhD, will co-chair.

Early registration is open until May 14.

For more information go to the LPA website at: louisianapsychologicalassociation.org.
Science

Bill for School Violence Prevention Calls for More Mental Health Evaluations

Representative Tony Bacala, Republican from Prairieville, representing District 59, has submitted a bill, HB511 which seeks to address reporting of threats of violence and mental health issues.

The legislation would address matters relative to the reporting of threats of
violence and terrorism at schools and requires mental health evaluations.

According to the digest of the bill, currently, the law does not require that teachers, principals, or other school employees report threats of violence or terrorism on school campuses to law enforcement. The present law does not require any person who threatens violence or terrorism in a school setting to undergo a mental health evaluation.

HB511 would require any school employee who learns of a threat of violence or terrorism at a school or a school-related function to report the threat to law enforcement.

“Any administrator, teacher, counselor, bus operator, or other school employee, whether full-time or part-time, who learns of a threat of violence or threat of terrorism, whether through verbal communication, written communication, or electronic communication, shall report the threat to local law enforcement.”

The proposed law provides for procedures for law enforcement upon receiving a report of a threat of terrorism or violence on a school campus or school-related function.

The legislation would require mandatory mental health evaluations for individuals who make threats of violence or terrorism at schools or school-related functions. Any individual making a threat of violence or terrorism at a school or school-related function is prohibited from being within 500 feet of the school until undergoing a mental health evaluation and being cleared by a mental health professional to do so.

“If the person who is reported to law enforcement is a minor, then the local law enforcement agency shall contact the local child protection unit of the Department of Children and Family Services. The local child protection unit shall file a motion with the appropriate judicial district court for a medical, psychological, and psychiatric examination as authorized by Children’s Code Article 760.”

Representative Bacala is a retired Deputy of the Ascension Parish Sheriff’s Office, and attended LSU and the FBI National Academy.

Dr. Chaney Serving on Governor Edwards’ Task Force to Prevent Sexual Harassment and Discrimination

Governor Edwards named Industrial-Organizational Psychologist Dr. Courtland Chaney to the Governor’s Task Force on Sexual Harassment and Discrimination Policy.

In a statement on December 15 the Governor’s Office announced the new Task Force and stated that seven members are included who will “review current harassment and discrimination policies within every state agency that falls under the executive branch, as well as research and identify the most effective ways to create work environments that are free from any form of harassment or discrimination.”

Dr. Courtland Chaney is a licensed industrial-organizational (I-O) psychologist in private practice in his company, Human Resource Management Associates, Inc., located in Baton Rouge. Chaney currently serves as a Director on the Executive Council of the Louisiana Psychological Association. He was a faculty member in the Department of Management at Louisiana State University until his retirement in 2010.

“Sexual harassment and discrimination,” said Governor Edwards in the December announcement, “have no place in the workplace and this task force will provide critical feedback on the current policies and procedures in our state agencies that are working and what improvements are needed in order to provide safe work environments for our employees.”

Also appointed to the task force were Terrence Ginn, deputy commissioner for finance & administration at the Louisiana Board of Regents; Sandra Schober, deputy director of administrative services for the Louisiana Attorney General’s Office; Makayla Weber-Harris, staffing assistant division administrator of the Louisiana State Civil Service.

Also appointed were Janice Lansing, chief financial officer of the Coastal Protection and Restoration Authority; Tina Vanichchagorn, deputy executive counsel, Office of the Governor; Suzette Meiske, human resources director for the Louisiana Community Technical College System.

“Every member of this task force brings a wealth of experience and knowledge to the table, and I have confidence in their ability to meet the goals and objectives set before them,” said Gov. Edwards.

In an Executive Order he outlined the duties of the group:

• Review the sexual harassment and discrimination policies of each state agency within the executive branch.

• Research and identify the most effective mode of training to prevent workplace sexual harassment and discrimination and evaluate the effectiveness of the existing video state employees are required to view each year.

• Develop a protocol for sexual harassment and discrimination policy orientation for new employees, those participating in any state sponsored training academy and employees promoted to supervisory positions.

• Research and identify the specific conduct that should be prohibited by sexual harassment and discrimination policies.

• Research and identify a clear reporting process when an allegation is made as well as the most appropriate action that should be taken once an investigation is completed.

The Task Force was created after Governor Edward’s deputy chief of staff, Johnny Anderson, voluntarily resigned amid an investigation of a harassment claim against him. Anderson says he is innocent of any wrongdoing. Some critics noted that Anderson should not have been hired because he had a similar problem while at Southern University, according to reports in the TimesPicayune.

Dr. Chaney commonly provides anti-harassment training for businesses that he assists and believes all decision-makers should ask themselves certain questions, involving, “Am I acting in an ethical manner? Am I treating people fairly, the way I would want to be treated, the way I would want my loved ones to be treated?” And, “Am I in compliance with all federal, state and local laws?”

He often engages his attendees to talk as a group and or individually, to dig into these types of questions even more thoroughly where needed.

“In my judgment, most antiharassment training––including sexual harassment––focuses on following the EEOC guidelines …” he said.

But after that analysis, which can be comprehensive, Dr. Chaney believes that the issues can extend to the organizational culture.

“I believe our next effort should be focused on describing the type of organizational culture we aspire to have and articulating the behaviors we expect of organizational members,” he explained. “The expected behaviors should then be reinforced through human resource management practices, including performance management, feedback, and progressive discipline.”

Dr. Gormanous Sole Candidate for LSBEP

The Louisiana State Board of Examiners of Psychologists (LSBEP) opened self-nominations at their Long Range Planning Meeting held in Baton Rouge on November 17 and found that
Dr. Greg Gormanous was the only qualified candidate for the upcoming election.

Dr. Gormanous is the retired Chair of the Psychology Department at Louisiana State University at Alexandria, and served briefly in June to September 2015 as the LSBEP’s Executive Director.

Gormanous has also previously served on the board twice, the first time in 1981 to 1984 and then from 1986 to 1989

In a message to licensed psychologists the board’s Executive Director Jaime Monic wrote, “ LSBEP’s policy on elections states that the Board will proceed with the election process if at
least one (1) nomination has been submitted. One nomination was received, therefore the Board is proceeding with the election accordingly.”

Licensed psychologists may vote until the election closes on December 22.

Following that the results will be transmitted to the Louisiana Psychological Association who will submit a list to the Governor.

Dr. Gormanous noted several goals of his service on his self-nomination form. “My view for regulating psychology in LA is helping the board become more effective and efficient in protecting consumers of psychological services,” he wrote, “while simultaneously ensuring due process, irrespective of particular staff, board members, issues and personalities.

He noted that his purpose and goals are: “To proactively enhance effectiveness, collegiality
and transparency with administrative, legislative, media, professional, psychological & public stakeholders in order for the LSBEP to ensure statutorily that consumers have access to qualified providers of psychological services and to ensure enforcement of ethical standards of practice to which providers are required to adhere, with appropriate over sight of the Board’s function by the state of Louisiana.

“In both Louisiana and North America, there have been cataclysmic shifts in regulatory  psychology in the last three years. And rapid transformational regulatory changes are on the immediate horizon. Thus, LSBEP is facing & will face additional significant challenges in the next five years.

“1. Revising the “complaint” rules, procedures and practices by focusing on two equally  important objectives: protecting consumers of psychological services AND ensuring due process for all.

“2. Achieving more effective outcomes for the expenditure of legal fees – presumably underway now.

“3. Staying a pace with changes in education and training. For example, other jurisdictions will be moving toward eligibility for candidates to sit for the EPPP 1 after doctoral course work is
completed.

“4. Adjusting to implementation of the competency model (EPPP 1 Knowledge and EPPP 2 Skills) by other jurisdictions and considering what is best for consumers in LA.

“5. Revisiting Generic versus Specialty Credentialing. Does the board stay with its “opportunity for registering…within a limited list of recognized specialties…” or does it implement the health service psychologist (HSP) & general applied psychologist (GAP) categories recognized by APA and ASPPB?

“6. Exploring any ramifications of implementation of the ASPPB’s PEP for LA.”

He also wrote: “A common view in the regulatory community – be it pharmacy, psychology, social work, veterinary medicine, or whatever-is that it takes a year or two for a new board member to figure out her/his role. Past & current experiences as an active member of ASPPB
and FARB & short term services as ED of LSBEP have prepared me to serve.”

Dr. Gormanous is Professor Emeritus of Psychology, LSU Alexandria, and earned his PhD from the University of Southern Mississippi in General Psychology in 1976. He member of
Association of State & Provincial Psychology Boards (ASPPB), the Federation of Associations
of Regulatory Boards, the American Psychological Association, the Society for
Industrial & Organizational Psychology (APA Div. 14), the Society of Consulting Psychology
(APA Div. 13), and the Association for Psychological Science.

Psychology Laboratory Directors Discuss Research at “Science Café”

Psychological scientists from laboratories around the state shared their work at the first “Science Café,” hosted by the Louisiana Psychological Association this week in New
Orleans. Researchers from the University of New Orleans, Pennington Biomedical and the
University of Louisiana Lafayette discussed current advancements with psychologists
attending the association’s Fall Workshop.

Dr. Elliot Beaton, Assistant Professor in the Department of Psychology at the University
of New Orleans and the director of the Stress, Cognition, and Affective Neuroscience Laboratory, discussed how stress affects brain development and function in children and adolescents at ultra-high risk for later development of serious mental illness.

The goal of Dr. Beaton’s work is to help explain diagnosis, prevention, and mitigation by
understanding early prodromal indicators. He uses functional and structural magnetic
resonance imaging with network connectivity analyses. Dr. Beaton combines this with
behavioral, psychophysiological, hormonal, and immunological stress measures. He was joined by researchers Ashley Sanders, MS, and David Stephenson, MS.

Dr. Christopher Harshaw, Assistant Professor, directs the Mechanisms Underlying Sociality Laboratory at U. of New Orleans. His focus is on understanding the role played by somatic factors in cognition and behavior. Autism Spectrum Disorders frequently exist with a
variety of somatic complaints and issues, including gastrointestinal problems, allergic and immune disorders, as well as thermoregulatory and/or metabolic dysfunction. Dr. Harshaw discussed whether and to what extent such somatic correlates are simply “noise” versus causally related to clinically important facets of dysfunction.

Dr. Robert Newton, Jr., is Associate Professor and director of the Physical Activity & Ethnic Minority Health Lab at Pennington Biomedical. Dr. Newton discussed the effect of
physical activity on African American’s health through the Aerobic Plus Resistance
Training to Increase Insulin Sensitivity in African American Men study. One major goal of
the study is to determine the physiological effects of exercise training in this hard-to-reach
population. African-Americans suffer disproportionately from various health conditions, and
decreased physical activity and increased inactivity levels have been shown to be independent
risk factors for the development of chronic diseases including cardiovascular disease,
diabetes, and obesity. AfricanAmericans spend less time in activity and more time in inactivity than is recommended.

Dr. Valanne MacGyvers is Assistant Professor at the University of Louisiana at Lafayette, where she has taught for 23 years. In her lab Dr. MacGyvers focuses on issues of mindset in achieving excellence, examining the role of mindset in the prediction of academic excellence and in the understanding of psychological problems in adolescents, including depression, anxiety and eating disorders. She discussed current research which examines academic achievement in college and graduate school, measurement development, the role of music in preparing impoverished preschoolers for Kindergarten, understanding the development of empathy, and people’s attitudes about breast feeding in public.

Dr. T. Scott Smith is Assistant  Professor and director of the Louisiana Applied and Developmental Psychological Sciences Laboratory, a laboratory primarily focused on applied
research, or how information may be used to understand the world better or even make adjustments towards our overall  understanding of cognition. One major area of focus is cell phone distraction and how cell phone distraction affects the learning process, not only in the
classroom, but also how applicable distractions may affect driving behaviors and eyewitness
memory.

Dr. Smith also discussed his work on the effects of video game play on aggressive behaviors for children, adolescents, and adults, and how young children process information, specifically reconstruction memory, and how these processes affect their ability to be (in)effective witnesses.

Dr. Charles Taylor, Assistant Professor of mechanical engineering, is founder of the Cajun Artificial Heart Laboratory, a biomedical research lab with high-end computing and
visualization systems as well as a mock circulatory loop for the purpose of testing artificial heart valves. Dr. Taylor is a bioengineering professor and his lab delivers research capabilities
to the artificial internal organ community in the form of robust in vitro systems, with accompanying computational tools, to accelerate medical device development. Dr. Taylor
discussed the theories and principles of artificial organ creation and his on-going projects.

Dr. Taylor and Dr. Scott Smith, from the U. of Louisiana Lafayette Psychology Department, are
collaborating to develop the SMART test or Sensory Motor and Reaction Time Test for persons with blindness and visual impairment.

More Mental Health, Less Incarceration – Prison Reforms Launched

In an announcement this week, Gov. Edwards said that key parts of the “Justice Reinvestment Initiative,” a package of reform measures passed by the 2017 Legislature, will begin to be implemented. Certain inmates in Louisiana who are currently serving a sentence for non-violent, non-sex offenses, as defined by Louisiana law, will be released an average 60-90 days early. This is an effort to reduce the state’s incarceration rate, the highest in the nation, a pledge the Governor made in taking office.

“Louisiana’s label as having the highest incarceration rate in the nation may be part of our past, but it will not be a part of our future,” said Gov. Edwards.

The package of 10 pieces of legislation is designed to steer less serious offenders away from prison, strengthen alternatives to imprisonment, reduce prison terms for those who can be safely supervised in the community, and remove barriers to successful reentry.

“For more than a year, stakeholders from every walk of life in Louisiana publicly met to
thoroughly review our criminal justice system. Following a model set forth by other Southern,
conservative states, their goal was to make Louisiana a safer place for our children while
being smarter on crime than we have been in the past…” he said.

“Along the way, we will, undoubtedly, find areas where we can improve these changes,” the
Governor said, including “alternatives to incarceration.”

The effort is estimated to save approximately $262 million, with more than $180 million of
those savings being reinvested in programs that reduce the recidivism rate and empower offenders to leave a life of crime.

Louisiana is the latest state to enact such reforms; many others have experienced simultaneous drops in their crime and imprisonment rates. For example, the Texas incarceration rate is down 16% and crime down 30%. In North Caroline incarceration is down 16% and crime down 16%.

The House and Senate votes for S.B. 139 (the bill that includes changes to parole and good time) passed by 26- 11 in the Senate, 75-30 in the House, and then 20-13 in the Senate
concurrence.

This past June, Dr. Raman Singh, Director, Medical and Behavioral Health, Louisiana Department of Public Safety & Corrections, told psychologists at the Louisiana Psychological Association, that the leverage for dramatic changes in the state’s incarceration rate was to institute behavioral health reforms in the Louisiana criminal justice system.

Singh, a medical doctor and cardiologist by training, said, “Louisiana’s incarceration rate
contributes to over-representation of the mentally ill in the criminal justice system.”

Dr. Susan Tucker, clinical psychologist and the Assistant Warden at the Bossier Parish
Medium Security Facility, and President-Elect of LPA, introduced Dr. Singh and explained the
significance of comprehensive psychological programs in the corrections and justice system.
Tucker developed the Steve Hoyle Intensive Substance Abuse Program nationally recognized for excellence.

In 2016 the Louisiana Legislature commended Tucker and her team in a House Concurrent Resolution pointing to multi-million dollar cost savings to the state because of shorter incarceration times of those offenders who participated in the psychological programs designed by Tucker.

Singh explained to the audience of psychologists and professors that the reasons for over-incarceration in Louisiana are well-established. Based on a 2016 Louisiana Legislative Auditor’s review Singh said the top reasons were mandatory sentences and habitual offender laws, high rates of local incarceration without treatment programs, and “not addressing issues driving criminal behavior such as substance and mental illness.”

“Incarceration of mentally ill exacerbates symptoms of mental illness. Rarely does incarceration of the mentally ill lead to an improvement in their mental status,” said Singh.

In a related story, in October Attorney General Jeff Landry wrote that taxpayers should be concerned about this “dangerous legislation.” He said that some of those released will
qualify for welfare and that the savings, targeted toward programs to help prisoners with addiction, mental health, and job skills, “…has apparently now morphed…” into more grants rather than taxpayer savings.

Governor Edwards replied that Landry should “Learn the Facts, Stop the Fear Mongering,” in a press release this week.

 

Inside the Opioid Crisis

by J. Nelson

In an example of flawed decisions in the medical/pharma industrial complex, over-prescribing has catapulted overdose deaths to the top, compared to peak years for auto fatalities, HIV or gun deaths.

“We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths,” writes the Center for Disease Control (CDC).

The National Institute on Drug Abuse says opioid overdoses account for 60% of those deaths.
Researchers from the University of Virginia say these statistics are underreported by 24% for opioids and 22% for heroin overdose deaths, and with particularly large errors in certain states, one being Louisiana.

Overdoses are trending up, not down, by almost 20% for last year. STAT News predicts that
opioids could kill nearly 500,000 people in the next decade.

At the peak of the prescribing frenzy, 2013, doctors wrote nearly 250,000,000  opioid prescriptions––enough for every adult in the United States of have his or her own bottle of pills, reports the CDC.

Despite the flood of legal opioids into the society, the CDC reported no change in pain that would meaningfully drive the prescribing: “…there had not been an overall change in the amount of pain that Americans reported.”

Last year, 20 years after the opioid marketing blitz and prescribing ramp-up began, the
CDC found that there was no long-term benefit for opioids compared to no opiods. However, they did find ample evidence for harm, a fact that the FDA had failed to discover when they approved drugs like OxyContin in the 90s.

Not surprisingly, at least for psychologists, the CDC did find that psychological and physical treatments for pain were beneficial (“CDC Guideline for Prescribing Opioids for Chronic Pain – United States, 2016,”). This despite the fact that these non-medical approaches are rarely integrated into treatment programs.

Echoing the overprescribing of antidepressants, citizens hoping for genuine healthcare appear to have once again become the unwitting lab rats of a commercial, profit–driven industry, where they and many providers are lulled into quick fixes that ignore long-term consequences and the psychology of the whole person.

Depth of the Problem

Opioids are derived from the same type of compound as heroin, and morphine-like effects for pain relief. The effects also include feelings of relaxation and euphoria. One recreational user described it as “Bliss.” Another as, “Physical––warmth, relaxation. Mental––Joy, boost in self-confidence, loss of anxiety…”.

Schedule I and II drugs have been determined to have a high risk for physical and psychological addiction. Schedule I are illegal and Schedule II are considered to have medical value and so legal by prescription. Heroin is a Schedule I opioid. Drugs like oxycodone, hydrocodone, and methadone are Schedule II opioids.

With continued use, tolerance and dependence result. Increased dosages are needed for the same results. Researchers say that dependency can occur after as few as seven days. Overdose risks go up.

In the 1990s drug manufacturers launched new opioid formulations, assumed to be safe. They expanded markets to non-cancer pain and moderate or temporary pain. Building on a new theme that all pain should be eliminated the opioid market quadrupled from 1999 to 2010, according to the General Accounting Office (GAO).

Physicians for Responsible Opioid Prescribing (PROP) found that the supposed safety of the new formulations in the 1990s was based, not on research, but primarily on a letter to the editor in a medical journal. The sound-bite idea began to circulate in the medical communities and was uncritically accepted as fact, notes PROP researchers.

The risk of addiction is serious. Among new heroin users, approximately 75% report having abused prescription opioids before turning to heroin, notes the CDC. The National Institute on Drug Abuse places the figure at 80%. PROP researchers reported that people get hooked by a prescription and then turn to street heroin.

Heroin use has been increasing among men and women, in all income levels. Those historically low in rates of heroin use––women, the privately insured, and those with higher incomes are seeing the greatest increases, says CDC. While addictions were up overall, those mainly affected were whites, especially those with less education.

In 2015 two Princeton researchers, Anne Case and Angus Deaton, presented findings to the  National Academy of Sciences that drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis, had increased so dramatically that all-cause mortality was up for US
middle-class whites, while declining for Blacks, Hispanics and for those in other countries.

“Over the 15-year period, midlife all-cause mortality fell by more than 200 per 100,000 for black non-Hispanics, and by more than 60 per 100,000 for Hispanics. By contrast, white non-Hispanic mortality rose by 34 per 100,000.”

“This is a disturbing trend,” said Dr. William Schmitz, Jr., Past-President of the American
Suicidology Association The addiction chips away at the person’s hope and adds to the
burdensomeness they experience,” he said. “There is overlap between the accidental overdose and the intentional. The person may think, ‘I’m taking this and if I die, I die and if not, I’ll be here tomorrow.’ What this really speaks to is the increasing need for collaboration in mental and physical health,” he said.

The Problem in Louisiana

Louisiana is in the middle of the crisis, with some of the highest opioid prescribing rates and an escalating death rate from overdose.

In a Louisiana House Health and Welfare Committee hearing this past April, Representative  Helena Moreno told members that there are “… more opioids prescribed in Louisiana than are people in this state.”

In 2007, Louisiana prescribers gave out 110.1 opioid prescriptions per 100 persons, based on numbers from the CDC. Only five others were higher: West Virginia (135.1), Kentucky (130.8), Tennessee (128.8), Alabama (120.3), and Oklahoma at (114.4).

Little change has occurred in recent years. In 2012 the map of southern rural states was the
same, with Louisiana a 112.4 rate, with a slight drop to 108.9 in 2015. The rate again dropped
slightly last year, down to 100.4.

The Louisiana Commission on Preventing Opioid Abuse, looking at internal figures from the state’s Prescription Monitoring Program (PMP), says that the number is even higher. “Over the last six years, since the PMP began monitoring narcotic prescribing behavior, Louisiana has
averaged 122 prescriptions per 100 persons. This rate is 39% percent higher than the national
average (87.44).”

Addictions have rocketed up along with prescriptions. Ed Carlson, CEO Odyssey House
Louisiana, testified at a Senate hearing that, “All of the drug and alcohol treatment programs
throughout the state were overwhelmed with the amount of the people who were seeking
and needing treatment. We currently have waiting lists for all of our programs,” he said.

Louisiana has also experienced a significant increase in overdose deaths, with a 12.4%
increase for 2014 to 2015, according to the CDC.

Another characteristic of the opioid crisis is the inconsistency in prescribers, not accounted
for by the illness level of those being treated.

Prescribing varies widely across the nation from county to county. In 2015, six times more
opioids per resident were dispensed in the highestprescribing counties than in the
lowest-prescribing counties, notes the CDC. Characteristics such as rural versus urban,
income level, and other demographics, explain only about a third of the differences
found in prescribing rates across the country.

In Louisiana, highest parishes include Evangeline (192.1), St. Landry (145.5) Rapides (144),
Richland (139.3), Washington (136), and Tangipahoa (129.5).

Examples from ProPublica, using Medicare Part D information, shows that Hydrocodone Acetaminophen was the first ranked drug prescribed in Louisiana with 812,468 claims.

Highest prescribers were physicians in Pain Medicine and Physical Rehabilitation. The top
prescriber wrote 14,223 prescriptions for opioids. Of his 866 patients, 91% filled at least
one prescription for an opioid. The review by ProPublica rated his patients as less sick than
average.

Another prescriber in Alexandria reported 1,333 patients receiving prescriptions from Medicare Part D and 98% of these filled at least one prescription for an opioid.

True Believers: A Bad Idea Gains Momentum

According to a 2003 report by the GAO, several national pain organizations issued new
guidelines in the mid-1990s, based on their belief that pain was undertreated in non-cancer
pain patients.

In 1995, the American Pain Society, led by Dr. Russell Portenoy, a New York pain doctor, recommended that pain should be treated in a special category. In an investigative
report by the Wall Street Journal (“A Pain-Drug Champion Has Second Thoughts”), said
Portenoy urged the tracking of pain as a “Fifth Vital Sign.”

The idea of a 5th vital sign was adopted by the Joint Commission on Accreditation of Healthcare Organizations, the Veterans Administration, and the Federation of State Medical Boards who provided reassurance to doctors who wanted to more freely prescribe opioids. The Federation drew up recommendations with the help of individuals linked to drug manufacturers, including Purdue Pharma (OxyContin), according to WSJ. The federation received nearly $2 million from opioid makers.

Around the same time, OxyContin was approved by the FDA, but lists no research on the drug.

An explanation by the FDA states: “At the time of approval, FDA believed the controlled-release formulation of OxyContin would result in less abuse potential, since the drug would be absorbed slowly and there would not be an immediate “rush” or high that would promote abuse. In part, FDA based its judgment on the prior marketing history of a similar product, MS
Contin, a controlled-release formulation of morphine approved by FDA and used in the medical community since 1987 without significant reports of abuse and misuse.”

In a Los Angeles Times investigation, based on sealed court documents, the physician who led the agency’s review of the drug, declined to speak with the press. The Times noted that shortly after OxyContin’s approval, the physician left the FDA and in two years was working for Purdue Pharma.

As enthusiasm grew the then Agency for Health Care Policy and Research, part of the national Department of Health, offered reassurance to prescribers about their “exaggerated concerns.”

The GAO noted that providers and hospitals were further required to ensure that patients received pain treatment. The Joint Commission implemented its pain standards for hospital
accreditation in 2001, a guide sponsored by Purdue Pharma.

Reassurances of safety appeared to be based on limited scientific research, a letter to the editor to JAMA, according to PROP and others, and perhaps a small study of 38 individuals.

How could such a gap in scientific decisions occur?

“Most doctors and virtually all patients are unschooled in how meaningfully to compare the
risks of foregoing versus undergoing treatment, and the patient’s frantic desire to ‘do
something now’ often trumps the doctor’s ancient commitment to ‘first, do no harm,’” wrote law professor John Monahan in a special report on statistical illiteracy in medicine, published by the Association for Psychological Science.

Dr. Jason Harman, a decision science expert at LSU, notes, “Doctors have very complex jobs. I know from some of my work on learning in complex systems that accurate and timely feedback is essential for optimal performance in a complex task.”

Some outcomes however have delayed or obscured feedback. In terms of opioids, the
immediate feedback a doctor receives is generally positive––pain is reduced––while
feedback about negative consequences is delayed if it is received at all. This basic
structure of feedback in the environment makes it very understandable to me how
doctors, who have the best intentions, could fall into such an ultimately harmful practice
…”

Marketing Blitz on Doctors’ Psyches

In 1997 Purdue Pharma created a marketing effort that overshadowed anything previously and catapulted sales of OxyContin.

“Purdue directed its sales representatives to focus on the physicians in their sales territories who were high opioid prescribers,” said the GAO. “This group included cancer and pain specialists, primary care physicians, and physicians who were high prescribers of Purdue’s older product, MS Contin. One of Purdue’s goals was to identify primary care physicians who would expand the company’s OxyContin prescribing base. Sales representatives were also directed to call on oncology nurses, consultant pharmacists, hospices, hospitals, and nursing homes.”

By 2003 primary care physicians had grown to constitute nearly half of all OxyContin prescribers, based on data from IMS Health, an information service providing pharmaceutical market research. The GAO report stated that the DEA expressed concern that this resulted in OxyContin’s being promoted to physicians who were not adequately trained in pain
management.

Purdue doubled the total OxyContin sales force by 2000 to nearly 700 and reached up to
94,000 physicians. Bonuses topped at $240,000, on a salary of $55,000.

Purdue expanded its physician speaker bureau, conducted speaker-training conferences,
sponsored pain-related educational programs, and issued OxyContin starter coupons for
patients’ initial prescriptions.

They also sponsored pain-related Web sites, advertising OxyContin in medical journals, and
distributed OxyContin marketing items to health care professionals–fishing hats, stuffed plush toys, coffee mugs with heat-activated messages, music compact discs, luggage tags, and pens containing a pullout conversion chart.

Purdue conducted over 40 national pain management and speaker training conferences,
usually in resort locations, to recruit and train health care practitioners for its national speaker bureau. Over five years, more than 5,000 physicians, pharmacists, and nurses, whose travel, lodging, and meal costs were paid by the company, were engaged. By 2002, Purdue’s speaker bureau list included nearly 2,500 physicians and over 20,000 pain-related educational programs.

“For the first time in marketing any of its products, Purdue used a patient starter coupon program for OxyContin to provide patients with a free limited-time prescription,” and by 2001 34,000 coupons had been redeemed nationally.

Purdue’s market share increased fourfold for cancer pain and tenfold for non-cancer pain by 2002.

Outdated Medical Model of Pain

“It is now widely accepted that pain is a biopsychosocial phenomenon,” clinical health
psychologist and Past-President of the Southern Pain society, Dr. Geralyn Datz, told the Times.

“For many years the biomedical model of treatment has prevailed as a way to treat pain patients,” Datz said. “This model is based on some very early research about acute pain and basically states that there is a one-to-one correspondence between the extent of injury and the amount of pain experienced. Therefore, large injuries lead to large pains and small injuries lead to small pains,” she said.

Datz explained that this model also assumes that surgery and medications can fix pain. “While
this is sometimes true, this model fails to appreciate what we now know about the central nervous system,” she said.

“We know that chronic pain is a complex and dynamic process, and it involves a person’s
thoughts, beliefs, experiences and these all can influence pain for better or worse. In addition, conditions such as depression and anxiety can arise from the presence of pain, and these also can worsen pain through interactions of the brain with the body.”

“In order to really address chronic pain, we must address the persons reactions to it and teach ways to overcome it, including retraining the brain away from the unpleasant pain signals. This is a psychological process involving education and training and coaching,” Datz said.

“We know that cognitive behavioral treatments create quantifiable changes in the brain, and
that these are distinct to this type of treatment. So these effects are lasting and result in long
term success.”

Dr. Datz says that the “best results are achieved through collaborative care,” but too often, insurance companies make it difficult for patients to have this type of help.

Treating with inappropriate drug therapy, is costly,” said Dr. John Caccavale, author of Medical Psychology Practice and Policy Perspectives. The cost for adverse drug reactions in 2001 was $72 billion to $172 billion while the cost for the drugs was $132 billion. “Actually, it’s now worse,” Caccavale said. “The incidence of hospitalizations from adverse events has risen substantially because of the growing use of medications in all categories.”

Failed Health System

The opioid crisis suggests one more area of poor outcomes for the U.S. healthcare system.
Bloomberg has reported that of 55 countries in a measure of life expectancy and high medical
care spending, the U.S. ranks 50th, dubbing the U.S. the “least-efficient” health- care system in the world. In a comparison of age–adjusted deaths from all causes, the World Health Organization ranks the United States last in similar countries.

Medical care is the largest industry in the U.S., accounting for almost $3 trillion in sales in 2015, according to the National Health Expenditure Data from CMS. At the same time, life expectancy in the U.S. is only 78.9 years, falling behind all other nations except for those such as Jordan, Colombia, and Russia, said Bloomberg.

Likewise, Louisiana ranks 50th of all the states, according to the Louisiana Department of Health and the 2015 Report from America’s Health Rankings.

“Health is a misnomer, because most activity involves illness,” say authors of “The Anatomy of Health Care in the United States” in a 2013, JAMA article. “Prevention requires tools that are often unfamiliar because educational, behavioral, and social interventions, not usually considered to be part of medicine, may be most effective for many diseases,” the authors write.

The system is politically closed to innovation. Three hundred “Advisors and Experts,” primarily from the American Medical Association’s House of Delegates, representing 109 medical specialties, lobby an “Editorial Panel,” composed of representatives from medical societies,
insurance companies and the government, decide on what is paid for, by way of codes.

The “Current Procedural Terminology” or CPT codes, and how much is paid for each service, is decided behind closed doors of the Relative Value Scale Update Committee,” or “RUC,” by those who stand to profit the most.

The system includes the FDA. Dr. Irving Kirsch, Associate Director of the Program for Placebo Studies at Harvard Medical School, has laid out the damning evidence that drug companies and the FDA skew research to approve drugs that have little actual value. The FDA receives 40 percent of its funding from the pharmaceutical companies, Kirsch said.

Add to this the political force of the top spenders for lobbying in Washington: Blue Cross/Blue Shield (3rd), American Hospital Association (4th) the American Medical Association (5th), and the Pharmaceutical Industry (6th).

This closed system is not surprising. In 2002 the 10 drug companies in the Fortune 500 made $35.9 billion in profits, more than all the other 490 companies profits combined.

Legislators in Louisiana are trying. In 2017 there were numerous bills and resolutions put forth to stem the tide of prescribing.

Senators Mizell and White asked for medical societies and hospitals to eliminate pain as the 5th vital sign, in Resolution 21. House Bill 192 led by Representative Moreno and 43 others, put some restrictions on prescribing opioids, became law as Act 82.

Act 88 by Representive Leger and others established the Drug Policy Board’s Advisory Council on Heroin and Opioid Prevention and Education, and Act 76 led by Senator Mills encourages prescribers to use the Prescripton Monitoring Program, where currently only about one third use the system.

The enforcement of these measures will depend on the professional boards. The Department of Health has filed a suit against drug companies.

It will be seen if this can help in the opioid prescribing crisis or the “underlying epidemic” suggested by Case and Deaton that may have contributed what author Christopher Caldwell calls, “American Carnage.”

Dr. Chafetz Invited Speaker at Swedish Neuropsychological Society in Stockholm, Sweden

Dr. Michael Chafetz, invited speaker for the Swedish Neuropsychlogical Society in Stockholm,
August 22, presented his research and other scientific advancements in the area of disability
assessment and malingering.

He also presented his work at the Karolinsk Institute, Danderyg Hospital, and Rehabilitation
Clinic in Stockholm on August 23.

Chafetz is a board certified clinical neuropsychologist working in independent practice
in New Orleans. His research program has involved validity assessment in low functioning
children and adults being assessed for Social Security Disability, state rehabilitation, and child
protection. He has authored numerous peer-reviewed articles on these topics, challenging
assumptions concerning individuals with intellectual disability.

At the Neuropsychological Society Chafetz’s presentation was titled, “The Long and Short of Malingering in Neuropsychological Assessment: Ethical, Scientific, and Practical Concerns.”

He also presented “Validity Assessment in Public Disability Claims,” at the Karolinsk Institute,
Danderyg Hospital on August 23. Dr. Chafetz covered many ethical and scientific issues for the
Swedish neuropsychologists, including understanding the definitions and background
regarding malingering, biological bases, adaptation and behavioral biology, and the rigorous
development of the field. He also reviewed validity and base rates and important metrics for the neuropsychologists in evidence-based methods.

Dr. Chafetz also covered ethics and boundaries regarding the validity examination in disability and numerous case examples, along with the special case of low IQ, malingered pain-related disability, costs of malingering, andmalingering in children.

Also presenting at the conferences were Muriel Lezak, whose book on Neuropsychological Assessment is required reading in the field, and Grant Iverson, who is a leading researcher on validity and on traumatic brain injury.

The conference was organized by Dr. Christian Oldenburg, President of the Eastern Region of the society. Dr. Oldenburg is a neuropsychologist who, along with his colleagues is working to assist the Swedish disability system.

Dr. Chafetz has consulted for a United States Senator on Social Security policy concerning validity assessment, testified at hearings at the Institute of Medicine, and consulted for the Office of the Inspector General on these issues.

He has presented invited addresses at the American Psychological Association, National
Academy of Neuropsychology, American Academy of Clinical Psychology, several state
psychological associations, the Association of Administrative Law Judges, the Federal Administrative Law Judge Conference, and various bar associations.

In 2015, his book on Intellectual Disability in the forensic arena was published by Oxford University Press.

Louisiana Dodges Most of Harvey Hurricanes

On August 28, the President approved Gov. Edwards’ Federal Emergency Declaration request
for Beauregard, Calcasieu, Cameron, Jefferson Davis, and Vermillion Parishes and ordered Federal assistance to supplement state, tribal and local response efforts due to the emergency conditions resulting from Tropical Storm Harvey.

But Louisiana appears to have been mostly spared, even though rain gauges showed up to 22 inches in some areas. There was some major flooding in the southwest area, but then mostly moderate flooding or minor elsewhere.

In Texas the rainfall topped records with over four feet of rain being reported and deaths have edged up over 60. Estimated loss in property damage continues to climb and USA Today reporting that the $190 billion loss would make it the most costly natural disaster in modern history.

The property loss, along with the psychological impacts, will be the most significant for many. The average person in the US does not have $500 in savings, and when the flood victims say they’ve “lost everything,” they mean it just that way.

Many from Louisiana rushed to help in Texas, with donations, services, cash and setting up shelters.

Dr. Mark Crosby, who led in recovery for the Watson, Louisiana community, ground zero for the Flood of 2016, told the Times, “We’re sending supplies.”

Crosby said, “The first thing people want is to know someone cares,” he said. “Teams, crews, family and friends coming in to help is important. Next, financial assistance, gift cards, cash. No clothes. No clichés. Someone to listen.”

Houston’s woes follow on the heels of what some in the Baton Rouge area are still attempting to recover from, the Flood of 2016. Like in Harvey, the August ‘16 flood was bizarre rainfall event that was, “…unlike anything we have ever seen before,” Crosby said last year. “The Flood of 2016 will go down in the history books as one of the worse natural disasters in our community, Crosby said. Harvey, however, has rewritten the history books with over 50 inches
of total rainfall being reported.

However, over the last generation, Katrina remains the most expensive and fatal of all the storms. Using data from the National Oceanic and Atmospheric Administration, Moody’s analytics, and New York Times, the website fivethirtyeight.com lists the top five storms:

1. Hurricane Katrina, Aug. 25, 2005. Damages were $160.0 billion and deaths at 1,833. 2. Hurricane Sandy, Oct. 30, 2012. Damages were $70.2 billion and deaths at 159. 3. Hurricane Rita, September 20, 2005. Damages were $23.7 billion and deaths at 119. 4.Hurricane Ike, September 12, 2008. Damages were $34.8 billion and deaths at 112. 5. Hurricane Hugo, September 21, 1989. Damages were $34.8 billion and deaths at 112.

Harvey stands to top Katrina in property damage, but many predict that Houston will recover, driven by its economic stability and business culture. But twelve years later, New Orleans is still not fully recovered. Today, the city is only 80 percent of the population prior to Katrina.

A US attorney for the Eastern District said that many companies left after Katrina and did not return because of the state’s acceptance of corruption. Former Representative Billy Tauzin characterized the state: “Half of Louisiana is under water and the other half is under
indictment.” Following Katrina a Senate seat flipped to Republican and so did the governor’s office. The New Orleans Mayor was sent to jail for bribery charges and the Democratic congressman was also convicted.

Rebuilding, even for Houston will take time. “The problem for so many is rebuilding,” said Crosby, “relocating and restarting their lives as schools try to reopen, as businesses try to salvage their operations and as neighborhoods …” he said. And just as the clean-up starts in Texas and Louisiana, here comes Irma and Jose.

Dr. Constance Patterson Beloved Leader in Psych Community Dies July 8

 

Constance Kindrick Patterson passed away on July 8 after a battle with renal cancer. She was a leader in the psychology community who touched many lives as colleague, supervisor, mentor and friend. She embraced her community and the people in it with integrity, wisdom and a genuine caring for others and dedication to excellence in the profession.

She served as President of the Louisiana School Psychological Association, as Coordinator of the School Psychology Program and Professor of Practice in the Psychology Department of Tulane University, and as Director in the Executive Council for the Louisiana Psychological Association. She conducted a private practice, supervised interns, and served as an investigator for the state psychology board, as well as many other community roles.

A private tribute and ceremony was held on July 23 in Slidell where family and friends shared stories about Dr. Patterson, “Conni,” and afterward spread her ashes in Moonraker Lake.

Later that day a public gathering was held at one of Conni’s favorite places in Algiers, her adopted community and neighborhood. Friends honored her at The Old Point Bar, located at 545 Patterson Street, Algiers Point, at the curve of the Mississippi River.

Constance Kindrick Patterson, PhD, born in 1952, had a full professional life–she branched out into the social fabric of school psychology and was embraced for her character, values and dedication to excellence.

Tulane colleague Dr. Bonnie Nastasi said, “School psychology in the U.S. is a complex network, with changing relationships and crossed paths. Conni’s presence in my professional life is a great illustration of this. I initially met Conni when she was a doctoral student at Illinois State University and I was a faculty member. I moved on from there, Conni completed her program, and later joined LAS*PIC (located in New Orleans, my hometown) as director of internship program in school psychology and remained in that position until Katrina,” Natasi said. “For several years, she and I were faculty members in the school psychology program at Walden University where she directed field placements. Eventually we both returned to New Orleans and assumed faculty positions in the School Psychology Program at Tulane…”

“Over the years,” Nastasi said, “Conni has been a dear colleague and friend. I have had the utmost respect for her wisdom, professional knowledge and expertise, integrity, and caring spirit.”

Mark Swerdlik, PhD, CoCoordinator, Graduate Programs in School Psychology and Professor of Psychology at Illinois State University, also
knew Conni in many roles. “My relationship with Conni spanned over three decades,” said Dr. Swerdlik, who was her colleague in clinical practice, then her program advisor, internship supervisor and dissertation co-chair when she was a doctoral student at Illinois State University. “…and since 2012 we were university educator colleagues,” he said. “Conni was a wonderful colleague always willing to offer case consultation.”

“I remember being very impressed with her clinical insights,” he said. “Over the years she was coordinator, I recall being impressed with how seamlessly she seemed to be able to mentor interns and then transition to that of colleagues and so many former interns became her close friends.”

Dr. Alan Coulter, Senior Manager at the Human Development Center LSU Health Sciences Center (LSUHSC) also knew Conni as both intern and colleague. “I knew Conni from 1994 until the day she died,” Dr. Coulter said. “I have known her as intern, school psychologist, coordinator of LAS*PIC, graduate educator, independent practitioner, and friend. Conni Patterson was a stalwart professional who embodied the highest ideals of our profession. She was a deeply caring individual who solemnly upheld her commitments especially in the guidance of interns as they expand their knowledge and skills.”

Dr. Constance K. Patterson earned her doctorate in 1999 from the APA Accredited school psychology program at Illinois State University, where she also received her masters and undergraduate. She had earlier begun her career in clinical and worked with children and families.

She completed her School Psychology Internship in 1995 from the Human Development Center, the then LSU Medical Center, and worked as a Certified School Psychologist in Harvey, Louisiana, for the Jefferson Parish Public School System.

Her dissertation was, “Student, Teacher and School Setting Factors Affecting Classification of Students with Emotional/ Behavioral Disorders: A Study of One School System in Louisiana.”

Between 1997 and 2006, she served as Assistant Professor in the Department of Interdisciplinary Human Studies, School of Allied Health Professions LSUHSC and was the CoDirector for the Internship Consortium, then moved to the Quality Assurance Coordinator, for the National Center for Special Education Accountability Monitoring, at the Human Development Center, LSUHSC. By 2004 she had received her license from the state psychology board in School Psychology.

“I seem to also recall,” said Dr. Swerdlik, “that when Conni was searching for a school psychology internship among several sites she was considering the Louisiana School Psychology Internship Consortium,” he said. “She wasn’t sure about this internship as she had not previously lived in New Orleans. As we all know Conni fell in the love with the city and it’s people and they with her and as they say the rest is history.”

In 2006 Conni worked at Unified School District in Tucson, Arizona and also took a position as Assistant Professor in the School of Psychology for Walden University.

By 2011 she turned all of her attention to Louisiana, working for Plaquemines Parish School, and taking a position with Tulane, where she served as Professor of Practice in the Department of Psychology, advancing to Coordinator of the Tulane School Psychology Program.

Conni was an active community member and held a variety of leadership roles. She served as President for the Louisiana School Psychological Association and also as President– Elect, Futures Committee Chair, Membership Chair, Presenter Coordinator, and as Associate Editor and later as Coordinating Editor of the Louisiana School Psychologist.

Some of her other many roles included serving on the Oversight Committee and then on the Advisory Board for the Louisiana Health and Disability Project, on the Advisory Board for the Louisiana Center for Excellence in Autism, and as a School Psychology Focus Group member for the State Department of Education. She served on the Dean’s Committee on Multicultural Issues at LSUHSC and on the Multicultural Training Advisory Committee at the LSU Human Development Center. She was Chair of the Supervision Interest Group for the National Association of School Psychologists.

Conni was a regular speaker and lecturer and spoke on a variety of topics. Her presentations at the National Association of School Psychologists included: “Meeting the challenges of providing internship supervision,” with colleague Dr. George Hebert; “Distance education and field experience;” “Practical strategies for supervision of school psychologists;” and “Generational diversity: Implications for consultation and teamwork,” and she presented research with Drs. Alan Coulter, George Hebert and others, on “Fantasies vs. Job Realities: How interns spend their time.”

Dr. George Hebert, friend and colleague, related that he and Conni were the first psychologists to re-enter the New Orleans Public Schools after Katrina. “… History shall record that she was first,” he said, “because as a Southern gentleman, I held the door open for her.”

Conni also presented at the American Psychological Association including: Has school psychology lost its way? New rules for accountability, a symposium with colleague Dr. Coulter; and Creative training partnerships: Designing internship consortia to support preferred practices, a symposium.

She presented at the annual meeting of the Council of Directors of School Psychology Programs, Traditionalists, Boomers, Xers, and Millenials: School psychological practice across generations and implications for training;” at the American Society of Ophthalmic Nurses, “Meeting the challenge of working across cultures;” and at the Council of Directors of School Psychology Programs.”

She published “Collaborative supervision of internship experiences,” in the Handbook of education, training, and supervision of school psychologists in school and community, with colleague Dr. George Hebert; “Impact of generational diversity in the workplace,” in The Diversity Factor; “School Psychologists as Leaders in a time of change,” in Louisiana School Psychologist; “ Generational diversity: Implications for consultation and teamwork, in Louisiana School Psychologist; and “Working with Gay, Lesbian, Bisexual and Questioning youth: A new training curriculum for school psychologists,” in NASP Communique.

Dr. Carmen Broussard, Professor in Psychology at Nicholls, said, “Conni was available. She was usually in attendance at the state and local level in a number of Dr. Constance Patterson, Beloved Leader continued university and organization events. Her varied experiences in and out of Louisiana led to her thoughtful insight about any matter being discussed,” she said.

“Conni was a friend. She remembered people and she remembered things about them, in a way that made you feel so comfortable. I tried to never miss an opportunity to stop and talk awhile when we crossed paths,” she said. “Conni was a fierce supporter of our profession. She was willing to speak up when needed. She was willing to do some of the work. We owe her many thanks for her service to our organizations and to the many students that she has groomed to carry on.”

Following the announcement of her death, the Louisiana Psychological Association passed a Resolution in her honor, writing: “… Dr. Patterson’s distinguished life includes multiple areas of service and contribution, exhibiting in all she did her dedication to excellence, scholarship, mentoring of others, and the protection and support of the dignity of all people, in all walks of life; …”

One of her interns, Levi Zitting, said, “Her breadth of influence and commitment to quality work in the field was awe inspiring. I hope she can rest in her well deserved peace and that her friends can find comfort.”

Another of her interns, Ms. Connie Morris, said, “She had a way of leading me to answers that helped me develop confidence in my own professional judgment. Even more fortunate for me was the friendship that we shared over the past 20 years,” she said. And, “…we also had several wonderful conversations about life in the abstract and what is truly important in life. During one such conversation, Conni spoke of how meaningful it was to have an impact on the professional development of those who become your peers. For her, it was both an awesome responsibility and a privilege…Truly,” she said, “the privilege was ours.”

“I will miss her terribly,” said Bonnie Nastasi, “but will always cherish the moments of
professional commiseration and casual laughter and companionship. I will miss the opportunity to walk down the hall and visit with her on campus or relax over a glass of wine. Conni’s contributions to the profession will be long remembered and I expect many others will miss her spirit as I will.”

“Everyone that knew her was impressed with her strong character and firm self-control,” said Alan Coulter. “Conni modeled for others that a professional embodies high standards, deep humility, and a good sense of humor…” “Her passion for life and for teaching others was strong and she fought her disease until the last day,” Coulter said. “For Conni, she was intent on being in charge of her own life to the end. There is no way to adequately describe the magnitude of our loss.”

Family and friends composed an obituary including these excerpts:

“Dr. Patterson had a distinguished career during which she mentored more than a hundred professionals and influenced countless others.

“…she carefully shaped training to model effective and ethical practices of interns. Those interns now practice as school psychologists throughout the U.S.

“Dr. Patterson mentored countless school psychologists, teachers, school administrators, and families experiencing challenges. At her passing, many people reached out with stories of how Conni served as an inspirational role model of ethical and family-focused practice. She was an active member of the Algiers Point community in New Orleans supporting the arts, music, and people in need. No one can adequately capture or describe the breadth of her reach and influence on the practice of school psychology and her spirit of reaching out to others.

“During her illness, Conni was supported by her school psychology family and close friends who maintained communication with Conni’s many friends, colleagues, and her family in Virginia. All involved are grateful for mutual support and for Conni’s relief from suffering.

“Conni is survived by her mother, Lorena McCann, her daughter Melanie Hoerner (husband Jerry), her 3 grandchildren, Jared, Caleb and Marley, her sisters, Jean Kindrick, Becky Gibson, Trish Lutz, and Stacey Moffet, and numerous nieces and nephews.

“A memorial school psychology internship fund has been established in her name with the LSU Health Foundation. Donations should be addressed to the Dr. Conni Patterson Scholarship Fund, c/o www.lspaonline.org.”

 

Behavioral Health Key to Louisiana’s Problems in Corrections says Director

Dr. Raman Singh, Director, Medical and Behavioral Health, Louisiana Department of Public Safety & Corrections, told psychologists last month that the leverage for dramatic changes in the state’s incarceration rate was to institute behavioral health reforms in the Louisiana criminal justice system. The legislature passed laws in its 2017 session to begin the reforms that Governor Edwards said was a top priority, and some of the key changes Singh explained were needed to overhaul the problems Louisiana has in its corrections and justice system.

Singh, a medical doctor and cardiologist by training, spoke to a packed session at the Convention of the Louisiana Psychological Association (LPA) held June 2 and 3 in New Orleans.

“Louisiana’s incarceration rate contributes to over-representation of the mentally ill in the criminal justice system,” Singh told the audience, noting that the United States has the highest per capita incarceration rate in the world and that Louisiana has the highest per capita incarceration rate in the US. Dr. Susan Tucker, clinical psychologist and the Assistant Warden at the Bossier Parish Medium Security Facility, and in-coming President-Elect of LPA, introduced Dr. Singh and explained the significance of comprehensive psychological programs in the corrections and justice system. Tucker developed the Steve Hoyle Intensive Substance Abuse Program which has earned national recognition for excellence. In 2016 the Louisiana Legislature commended Tucker and her team in a House Concurrent Resolution pointing to multi-million dollar cost savings to the state because of shorter incarceration times of those offenders who participated in the psychological programs designed by Tucker. Dr. Singh is responsible for the functional supervision of medical and behavioral health staffs who coordinate on-site care for 19,000 offenders assigned to state prisons, for all off-site health care needs for 38,000 DOC offenders and 16,000 local offenders housed in all state prisons and 104 local jails or detention centers. Singh explained to the audience of psychologists and professors that the reasons for over-incarceration in Louisiana is well-established. Based on a 2016 Louisiana Legislative Auditor’s review Singh said the top reasons were mandatory sentences and habitual offender laws, high rates of local incarceration without treatment programs, and “not addressing issues driving criminal behavior such as substance and mental illness.” Singh said that the 599 criminal statute and 164 mandatory minimum sentences contribute to over-incarceration in Louisiana, which are sentences without benefit of probation, parole or suspension. He said that 55 percent of mandatory minimum sentences are for non-violent crimes and that these minimums “shift sentencing discretion from judges to prosecutors.” Another serious factor is the high rates of local incarceration in Louisiana where there is no treatment. Jails and prisons have a disproportionately high number of persons with mental health issues and people with a serious mental illness (SMI), Dr. Singh explained. He noted that of the mentally ill in society, greater than 40 percent have been arrested and the majority of these are brought in for minor offenses. Those with mental illness spend two to five times longer in jail. Singh told the attendees that there was a complex interplay of multiple societal factors stemming from problems in education, stressed family structures, socio-economic challenges and lack of job opportunities. He pointed out that the unemployment rate in the mentally ill adults in Louisiana is 88.3 percent.

And while 16 percent of the DOC prison population has been diagnosed with a SMI, 82 percent are diagnosed with a substance use disorder. “Incarceration of mentally ill exacerbates symptoms of mental illness. Rarely does incarceration of the mentally ill lead to an improvement in their mental status,” said Singh. His vision is to reduce the criminalization of those with mental illness and to resolve the crisis with a comprehensive solutions that provide treatment to those who need it. He promotes the Medicaid expansion and mental health parity. He said that 43 percent of the entire eligible Medicaid Expansion population in Louisiana has a mental health condition, and that offenders with mental illness or substance use disorder can be treated effectively. He wants more outpatient mental health care, more Rapid Stabilization Centers, and emerging models that prevent arrest and incarceration of adults with mental illness, called the Forensic Assertive Community Treatment Programs. To help create alternatives to incarcerating those with mental illness, Dr. Singh said that Forensic Diversion Facilities are needed to help alternative sentencing for offenders with mental health issues and who have committed a minor crime. Expansion of the Mental Health Courts are essential, especially because a majority of offenders are incarcerated for “crimes of survival” such as theft of food or breaking in to find a place to sleep. He wants to strengthen family and communities and help judges divert nonviolent offenders away from jails with better mental health legislation. Dr. Singh serves on the Louisiana Governor’s Drug Policy Board, Louisiana Task Force on Telehealth Access, Louisiana Re Entry Council, Louisiana Medicaid Quality Committee, Louisiana Commission on Preventing Opioid Abuse as well as chairs the Louisiana Commission on HIV/AIDS and Hepatitis C. He has also been appointed by Governor Edwards to be his liaison to the White House Data Driven Justice Initiative project.