It sounded too good to be true and unfortunately it was.  Three research studies out Thursday severely diminish the hope that a cancer drug already on the market could be an Alzheimer’s treatment.

In February 2012 scientists at Case Western University Medical Center reported that a drug approved to treat skin cancer cured a mouse of a form of Alzheimer’s.  They reported the drug eliminated the plaque that is the hallmark of Alzheimer’s from the brains of the mice and that the mice seemed to recover from their memory and other cognitive problems.

The study, published in the journal Science, got doctors and patients alike excited.

If this were true it would have been a gigantic step.  Since the drug, Targretin, was already approved as a cancer treatment, doctors knew its safety profile and were free to prescribe it “off label” to treat any condition, including Alzheimer’s. 

Researchers quickly set up trials of the drug in people with Alzheimer’s. But some patients’ families did not want to wait for the human experiments.  They asked their doctors for prescriptions and in many cases, according to anecdotal reports, they got them.

But in this week’s edition of Science, three other teams of highly respected Alzheimer’s experts report they could not repeat the mouse results.

"It was hot stuff. It was the new miracle drug for Alzheimer's,’ said Sangram Sisodia, a professor of neuroscience at the University of Chicago.

Sisodia said he and fellow Alzheimer's colleagues, who included Dr. Rudolph Tanzi of Massachusetts General Hospital in Boston and Dr. David Holtzman of Washington University School of Medicine, wanted to see if they could replicate the stunning results in their own labs. Scientists don’t usually accept results as valid until they’ve been repeated several times.

It’s one of the main reasons researchers publish their findings – so that others can try them out and validate them.

The three labs failed to see any effects on Alzheimer's plaques in three strains of mice that were treated with Targretin.

"There is absolutely no reduction in amyloid levels in the brains of mice treated with this compound," Sisodia wrote in a technical comment in the journal Science. Teams at the University of Florida and researchers at the University of Leuven in Belgium published similar findings in the same journal.

"I was a fan of the original study," said Dr. Samuel Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center in New York, who was not involved in any of the studies.

"It was very dramatic. It cut plaque loads by three-quarters over less than a week. No one had ever seen anything like it before."

Gandy has had several patients asking for the treatment, but he said the drug can damage the liver and requires very careful monitoring.

"I have universally declined and advised others to decline,” he told Reuters.

(Reuters contributed to this story)

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• Alzheimer's numbers to triple by 2050

The Oklahoman via AP

Children wait for their parents to arrive at Briarwood Elementary school after a tornado destroyed the school in south Oklahoma City, Okla., on Monday. One student there died.

Parents across the country took a collective deep breath on Tuesday as they prepared their children for school. It's been a traumatic year -- the shootings in Newtown, Conn., the Boston marathon bombings, and now a devastating tornado in Oklahoma that has killed 24 people and buried a school full of cowering youngsters, killing seven. 

It’s understandable that children and parents are affected by these events, even those living far away, psychologists say.

“It’s that fear of the unknown – the ‘my God, that could happen to me’,” says Katey Smith , who heads the trauma response team at The Center of Hope, a nonprofit family support center in Greenwich, Conn. “This time, it was an act of God or a natural disaster, which can be just as scary if not scarier, because there is nothing you can do to stop it. You can’t stop a tornado. People are feeling powerless."

Worse, the children were killed and injured in schools, places where they are supposed to be protected and safe. Parents drop their children off in the morning believing they'll be well taken care of until they pick them up - not that they'll be waiting in the rubble of the parking lot to find out if their child is alive or dead, as parents of children at Plaza Towers Elementary School in Moore, Okla., did on Monday. Nearby Briarwood Elementary was also destroyed and one child was killed there. 

But there are ways to cope and they often involve facing the facts; limiting exposure to endless media reports about the disasters; and giving people something to do.

Looking at the real facts about a disaster can be reassuring, says Steve Brock, director of the school psychology graduate training program at California State University, Sacramento.

“Be honest and factual with your children,” Brock said in a telephone interview. “The truth is that what happened in Moore, Okla., and especially what happened at Sandy Hook elementary school are extraordinarily rare events.”

“Statistically, these situations are so incredibly rare,” agrees Eric Rossen, director of professional development and standards for the National Association of School Psychologists. He headed a team looking for information on school killings after the Newtown shootings, in which 20 first-graders were killed. “We were able to find statistics that showed there would be one homicide in each (U.S.) school every 5,000 years,” Rossen said.

Even when parents may be feeling worried themselves, they need to help their children feel safe, experts say.

 “I think it’s our job as adults to put it in the proper perspective,” Rossen added. “We want to give them the objective facts that help them understand the threat.” Older children and teenagers benefit from hearing the statistics. While two terrible events have affected schools in a single year, Rossen points out there are thousands of schools and tens of millions of schoolchildren.

“Try not to sidestep this. You don’t want to lie,” says Rossen. “You want to say there was a tornado and people were hurt by it.” But then it’s time to reassure children they are safe, now.

Parents should focus on being calm, because kids pick up on emotional responses.

“One thing I would tell the parents – their reactions are powerful,” Rossen said. “You see this all the time in younger children – something or frightening happens and they immediately refer back to Mom and Dad. Be careful about how you act and how you respond in front of the children.”

Another rule: Watch what the kids are watching. “You want to limit their exposure to the coverage of the event,” says Rossen. “As a caring adult, be present if they are watching it.”

Smaller children probably should not watch or hear such news at all -- they cannot process it, the experts agreed. But even older children need help managing the overload. "In today’s society you can be viewing this stuff literally 24/7," Brock said.

And there's no reason to bring it up if a child seems unaware or uninterested. "I am not saying we put our kids on an island and pretend these bad things don’t happen. They do," Brock added.

People were traumatized by the media images of the 1995 bombing of a federal building in Oklahoma City, Brock says. “After the Oklahoma City bombing, kids who watched more television were more anxious and more stressed than kids who watched less television. Monitor their viewing and in some cases, perhaps, restrict it,” he advised.

“Too much media exposure of this kind can really heighten their anxiety,” agreed Cindy Dickinson, crisis intervention manager for the Fairfax County, Va., public schools and a head of the National Association for School Psychologists.

Even in adults, watching the images over and over can provoke anxiety and what’s known as vicarious trauma. “It’s something in my living room. I can go turn on my TV now and see that tornado,” Brock said said. “Imagine what it is doing to young, impressionable kids who don’t have world experience -- they haven’t flown across the country a couple of times and don’t realize how far away these events may be.”

All the experts agreed that it’s best to direct kids and children alike to the positive things that are happening – police, firefighters and neighbors rushing to help the victims and one another. "Remind them who the helpers are in the school community," says Dickinson. Like the teacher in Moore, who draped herself over six children to protect them.

Rule number three – give people something to do.

“One of the messages that is very empowering is knowing how to reach those you care about in an emergency,” Dickinson said. A disaster like this one offers an opportunity to rehearse emergency preparations. “Kids need to know who to call if you can’t reach your parents so you can say you are OK,” she said.

If done at a calm time, such rehearsals don’t worry children but give them a sense of control, Dickinson says. “That is why we have fire drills and so forth in schools,” she said. “When the real thing comes, they save lives. That’s the message.” Memorizing cellphone numbers is a helpful exercise and can pay off in times of confusion.

Older children and teenagers benefit from even more. “Tell them, ‘let’s talk about some ways we can help each other if there’s an emergency, how we can alert people and help them stay safe’,” Dickinson says.

“Eleven to 12-year-olds really have a sense of moral responsibility and of  trying to help others. They really take things on like this.”

And helping the victims can help everyone cope, Dickinson says. “We want to remind them the nation cares,” she said.

“Like with Newtown, so many people just want to help,” Smith agreed. “That’s a great way to feel you are doing something.” It’s important to work through organizations – Newtown officials had to deal with piles of stuffed animals that ended up being more of a problem than a help.

Memorials can also help – religious ceremonies, candle-lighting events, moments of silence.  Acts of public ritual are also helpful because they allow action to be taken, they require organization and they reaffirm community structure,” Smith said.

Related:

• Tornado sounded like a train coming
• Children among the victims
• How to help: Red Cross, food banks
• What you can do to help after the tornado

A typical boy with ADHD can appear to be in perpetual motion, but that activity doesn’t guarantee a healthy weight when he grows up. A long-term study released Monday finds that men diagnosed with attention deficit hyperactivity disorder as children are twice as likely to be overweight or obese in adulthood as those who never had the disorder.

These findings, published in Pediatrics, may be surprising to parents because drugs such as Ritalin or Adderall used to treat ADHD can suppress appetite, said Dr. F. Xavier Castellanos, the study co-author and a professor of child and adolescent psychiatry at New York University.

Robert Bukaty / AP

Ritalin can suppress the appetite in children who take it for ADHD.

“It’s not uncommon for kids treated with ADHD medications to be fairly thin,” Castellanos said. Because parents often worry that thinner boys won't grow as tall, “sometimes [they] will encourage their boys to eat more.”

Instead, to help avert weight problems down the road, parents should be alert to poor eating habits. “If anything, you have to pay attention to how many times they’re having fast food, how many times they’re having fried food, whether they’re getting meals supersized," Castellanos said.

The study comes at a time when ADHD rates are rising. A new report from the Centers for Disease Control and Prevention found that ADHD is the most common mental health issue in children ages 3-17, with nearly 7 percent of kids receiving a diagnosis.

The NYU researchers followed 222 boys -- 111 with ADHD and 111 without, for an average of 33 years -- hoping to better understand the disorder's effects on the brain. The boys with ADHD, all from middle-class, white families, were diagnosed between the ages of 6 and 12.

Decades later, when some of the men returned for brain scans, many of the now 40-something adults who had ADHD as children had gained so much weight they barely fit into the fMRI machine, Castellanos said.

The researchers then asked about the body-mass index of all 222 participants, discovering that men diagnosed with ADHD as children were significantly heavier than those without the disorder. The average BMI for the ADHD participants was 30.1, compared to 27.6 among those who never had the disorder. The obesity rate among the men who’d had an ADHD diagnosis was 41.4 percent, compared to 21.6 percent among those who never had the disorder.

An adult with a BMI of 25 or higher is considered overweight, according to the Centers for Disease Control and Prevention. 

Castellanos suggested the connection between obesity and an ADHD diagnosis may be explained by some of the disorder's common symptoms: lack of impulse control; difficulty paying attention to details; and poor planning skills. These symptoms could lead to problems such as unhealthy food choices and an irregular eating patterns that continue into adulthood, he said.

While the study was only of men, Castellanos suspects that the results would hold true for women as well. 

The new study “shows exactly what I would have expected,” said child psychiatrist Dr. James McGough, director of the UCLA ADHD clinic. “People with ADHD have a terrible time delaying gratification. They’re very impulsive and they don’t think about consequences. Their problems with organization may make it more difficult to stay on a regular eating schedule which leaves them more likely to binge eat.”

Obesity expert Dana Rofey says “sneak eating and aberrant eating patterns” are common among many of her young, male patients with the disorder.

“Once they start eating, they don’t stop,” said Rofey, an assistant professor of pediatric psychiatry and psychology at the University of Pittsburgh Medical Center and weight management director at the Children’s Hospital of Pittsburgh.

Rofey hopes the study will prompt parents to help their sons develop healthful eating habits -- before they become a problem.

“That may mean tracking food intake or using a pedometer to keep track of activity, she said. “You want to encourage your child to do more outside with their friends, instead of spending hours texting or looking up their friends on Facebook.”

Related:

• New psychiatric manual stirs criticism

The fifth edition of the American Psychiatric Association's manual of mental disorders is finally out, offering the latest revision in nearly 20 years of the diagnostic bible used by individuals and agencies, insurers, schools and government bodies to navigate the mental health landscape.

But just as it’s birthed, the new Diagnostic and Statistical Manual of Mental Health Disorders -- widely known as the DSM-5 -- is under attack by prominent critics, including the chairman of the task force that created the last version.

Dr. Allen Frances, who led efforts on the DSM-4, minces no words in describing the new 1,000-page tome that’s part guide, part dictionary for theorists and practitioners alike.

“My advice for people is not to buy the DSM-5, not to use it, not to teach it,” Frances told NBC News. “I do not think it will be useful for those endeavors.”

He suggests that doctors and everyone else use the International Classification of Diseases instead.

The psychiatric society is releasing the manual early Friday in advance of a meeting in San Francisco. Its backers say it offers better organization and more precise diagnoses than its predecessors.

“The changes to the manual will help clinicians more precisely identify mental disorders and improve diagnosis while maintaining the continuity of care,” said Dr. David J. Kupfer, chair of the DSM-5 task force, in a statement. "We expect these changes to help clinicians better serve patients and to deepen our understanding of these disorders based on new research."

But Frances and other critics say the new manual too often turns normal reactions to life events into diagnosable mental conditions.

Earlier this week, Dr. Thomas Insel, director of the National Institute for Mental Health, declared that the DSM-5 lacked “validity” because its diagnoses lack objective standards and measures.

Grief is one of several examples, said Frances, who has written a book about his objections called “Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life.”  

“It staggers the imagination!” he said. “In two weeks after the loss of a person you love, if you are still feeling these symptoms: loss of interest, reduced appetite, trouble sleeping, less energy, it qualifies as major depressive disorder. Now it becomes a target of a drug company.”

Thanks to DSM-5, Frances said, a drug company representative could go to primary care doctors – who do the majority of psychotropic drug prescribing in the United States -- and market an anti-depressant based on this new DSM criteria and not be illegally marketing the drug off-label.

“This is the legalized conversion of a sacred ritual and an inherent part of being a mammal – mourning -- and turning it into a mental disorder,” he said. 

Others have criticized the new guide for turning extreme childhood temper tantrums into a diagnosable condition -- “disruptive mood dysregulation disorder” -- while removing Asperger’s disorder as a separate diagnosis, folding it into the overall “autism spectrum disorder.”

The APA strongly disagrees with Frances' criticisms. Dr. Jeffrey Lieberman, APA’s president-elect and the chair of the department of psychiatry at Columbia University, said personal slights and self-interest are part of the motivation behind Frances’ position.

Leaders of DSM-5 “treated him disrespectfully” Lieberman said, “and it provoked him.”

Attacking DSM-5 gives Frances a “new platform to become the savior of normal – that’s his book -- saving society from those irresponsible psychiatrists and the DSM,” he added.

Medical diagnoses of all kinds have expanded over the last 100 years as science gained new knowledge, Lieberman argued, pointing out that in the 1800s, there were only two mental health diagnoses: idiocy and insanity. The new volume recognizes those advances.

Arthur Caplan, the director of medical ethics at New York University’s Langone Medical Center, and a frequent contributor to NBC News, believes the controversy over new DSM criteria is misplaced.

Just because something is common, or natural, like acne and tooth decay, doesn’t mean it shouldn’t be named as a condition. While Caplan agreed that there are abuses of diagnosis, medications and treatments, it’s not necessarily DSM’s fault. Even if something is diagnosable, he said, both doctors and patients are often too tempted to treat when doing nothing might be best.

The problem isn’t with the new manual, but with a culture that demands a quick fix, making it easy for general practitioners, who may not see the same patient week after week, to accede, said Gail Saltz, a psychiatrist, psychotherapist and TODAY Show contributor. That can lead to over-diagnosis and, worse, overtreatment.

What matters isn’t necessarily what the DSM says, but “are your symptoms impairing your functioning?” she explained.

“If ‘Internet Addiction’ is in the DSM matters less than if you are sitting in front of a computer eight hours every day, because then you’re not functioning.”

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young Ph.D., of "The Chemistry Between Us: Love, Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com), now on sale.

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Getty Images via CDC

CDC's most comprehensive look yet at mental health shows ADHD affects close to 7 percent of US kids.

The most comprehensive report on specific mental disorders in children shows attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed problem in kids aged 3-17, with close to 7 percent of kids having a diagnosis.

Another 3.5 percent have behavioral problems, 3 percent have anxiety and 1.1 percent have autism. For teenagers, addiction to drugs, alcohol and tobacco are the most common issues, the Centers for Disease Control and Prevention reported on Thursday.

These percentages translate into millions of children, said CDC’s Ruth Perou, who put the study together. She found that 6.8 percent of U.S. children have ADHD. “That’s about 4.18 million children,” Perou told NBC News.

“This first report of its kind documents that millions of children are living with depression, substance use disorders, ADHD and other mental health conditions,” CDC director Dr. Tom Frieden said in a statement.

“No parent, grandparent, teacher or friend wants to see a child struggle with these issues. It concerns us all. We are working to both increase our understanding of these disorders and help scale up programs and strategies to prevent mental illness so that our children grow to lead productive, healthy lives.”

It adds up to a lot of kids. “It is estimated that 13 –20 percent of children living in the United States (up to 1 out of 5 children) experience a mental disorder in a given year and an estimated $247 billion is spent each year on childhood mental disorders,” the report reads.

The report takes data from many other surveys. The estimates on autism spectrum disorder might not be quite up to date. In March, CDC published a survey showing 2 percent of U.S. schoolkids – or about a million children – have been diagnosed with some sort of autism.

Thursday’s report was finished before that latest data came out, Perou said.

Behavioral disorders affect 2.1 million children, Perou says. “We are not looking at whether kids misbehave or are having a bad day,” she said. “What we are talking about is a child incapable of behaving well or playing well with others.”

Children with a diagnosed behavioral disorder, such as oppositional defiance disorder, have constant conflicts with authority that affect their ability to attend school. “They are having such challenges in how they are dealing with emotions or behavior that it impairs their ability to lead their day-to-day lives,” Perou said.

The survey confirms a lot of what experts already knew: autism, conduct disorders and ADHD are more common among boys; depression is more common among girls. More children were diagnosed as they got older.

The data on adolescents aged 12 to 17 show a million teenagers are drug or alcohol abusers, and more than 695,000 are addicted to tobacco. This doesn’t mean casual use or experimentation, but serious addiction, Perou said. “You are looking at something that is debilitating and really impairs their ability to function day to day,” she said.

The good news is that there are treatments for all the disorders, Perou said, and CDC is working to help come up with more approaches that work. “We can make a difference in their lives,” she said.

CDC has information for teachers and parents on spotting mental illness in kids.

The definitions for all the disorders come from the DSM-IV, the guide used by mental health professionals to diagnose and classify disease. A new version, the DSM-V, comes out Friday, and many of the changes have been widely leaked.

Thursday’s report will set a baseline, so that changes in classifying mental health issues that come from changes in the DSM-V can be tracked, Perou said.

Related:

• Psychiatrists face off over new DSM
• No more crazy cat ladies?
• Kids at risk of suicide can get guns
• Depressed kids earn less money later

Could little Johnny, that kid who always seems to be in trouble for hurting other children, be a psychopath in the making? Or is he just rambunctious? And if he’s at risk of becoming a future psychopath, could science catch it early, and head off a life of trouble?

A new study from British researchers suggests this may one day be possible. 

Adult psychopaths are known to be unable to place themselves in the position of those they hurt. They have little or no empathy. They can’t “feel your pain."

But “there is a lot of variability among children with conduct problems,” one of the researchers, Essi Viding, professor of psychology at University College London’s Institute of Cognitive Neuroscience, told NBCNews.com. 

The study, published Thursday in the journal Current Biology, gathered a sample of 37 boys verified by surveys completed by teachers and parents to have serious conduct problems such as causing harm to others and uncaring attitudes toward others, and a control group of 18 boys who did not. The boys were aged 10 to 16.

The boys were placed in a functional magnetic resonance imaging (fMRI) machine that depicts which areas of the brain are active in response to a stimulus. The boys were shown a series of 192 photos of hands and feet in pain, or no pain, situations. For example, an image might show a hand resting on a table top with a knife laying beside it, or the same hand on the table with the point of the knife blade about to pierce it.

As a group, the boys with serious conduct problems tended to show decreased activation in areas of the brain -- especially the anterior cingulate cortex, and the insula -- that are critical for empathy for pain, in comparison to the control group of boys.

With lower empathy, they were less reactive to others’ pain. This could be the root of what the researchers call “callous traits.”

Reduced response to pain of other people, the researchers wrote, “could reflect an early neurobiological marker indexing risk for empathic deficits seen in adult psychopathy.”

If that sounds a little scary, like the Philip K. Dick novel “Minority Report” (made into a movie by Steven Spielberg in 2002), in which crime is predicted and future wrongdoers labeled and arrested before they offend, Viding and others in the field stress two points: any such future is a long way off, and that’s not the goal of the research.

For one thing, fMRI studies of psychopathy have yielded a variety of results, sometimes conflicting ones. Last month, for example, a study published in the journal JAMA Psychiatry by Jean Decety of the University of Chicago, a leading expert in the field of social neuroscience, found that incarcerated men with psychopathic traits had greater activation of the insula region in response to images of pain – the opposite of what Viding’s group found.

There could be a number of reasons for conflicting results, suggested Abigail Marsh, a Georgetown University professor of psychology. A recent Marsh study published in the Journal of Child Psychology and Psychiatry tracked with the Viding team’s results – reduced response from brain regions key to empathy. But, she said, “we found a very small change in instructions” – to imagine the person in a picture is one’s self versus another person – “made a very big difference in the patterns of brain activity we observed.”

Plus there are obvious age, developmental and life experience differences between an adult incarcerated population and children.

In order to clear the fog, Decey said, “we really need many more studies of this kind.”   

Meanwhile, whatever the fine details, it is clear that the brains of psychopaths work differently than those of non-psychopaths. Psychopaths, for example, often show dysfunction in the amygdala, where fear is processed. As a result, psychopaths are bad at recognizing fear in others.

Viding agreed that “we are a very long way from reliably predicting future psychopathy by testing children. In fact, I am very skeptical about us ever being able to do so.”

But that’s not necessary to help children because the real goal is treatment, not pinpointing a future serial killer. “We are hoping that, as has been the case for autism, we are able to develop earlier identifiers that will allow us to begin treatment when children are young,” Marsh said.

Research shows that if such children can be identified, behavioral therapy, such as rewarding empathetic behavior toward others, and training parents in adopting a warmer parenting style, can work, though it’s still early and, Viding said, it may always be difficult to parent such children.

No child should ever be labeled a psychopath, Viding said, because their brains and life experiences are still  developing and, especially if given intervention, they may never wind up psychopathic, but callous traits are a real problem.

“Research clearly shows that not all children with conduct problems are alike. It may sound more politically correct not to acknowledge that, but ultimately that stance is not going to be helpful for the children and their families. In my own experience, parents of children with conduct problems and callous traits are often desperate for help.” 

Related links: 

Speech patterns may give psychopaths away

Facebook profile may expose mental illness

U.S. mental health experts urge focus on early treatment

TODAY

Liza Long, who penned an essay pouring out her anguish over her son's mental illness after Adam Lanza shot and killed 26 people in Newtown Conn., including 20 young children.

Liza Long’s son first went into the juvenile justice system at 11. He’s mentally ill, but the woman who wrote the viral Internet essay “I am Adam Lanza’s mother” told Congress the police are often the only authorities who can help deal with violent, mentally ill children.

Pat Milam repeatedly begged doctors in New Orleans to keep his psychotic and suicidal son hospitalized. Soon after they refused and released him in 2011, the young man killed himself while trying to set off a giant propane bomb in his bedroom, he told a Congressional hearing on mental health care held after the shootings of 20 young children and six adults last December in Newtown, Conn.

“We tell our daughters and our sons, ‘Oh, you are sick but we are not going to help you until you become dangerous.' Then when they become dangerous we blame and punish them,” Fairfax, Va. writer Pete Earley told the hearing on mental illness. “In that scenario, tell me who is crazy.”

Tuesday’s hearing of the House Energy and Commerce oversight subcommittee was carefully staged to show the anguish felt by parents of mentally ill children and young adults who struggle with police and health care providers to get treatment.

All three parents complained that doctors’ interpretations of  HIPAA -- the Health Insurance Portability and Accountability Act -- prevented them from helping their children. Doctors, they said, feared sharing vital information for fear of violating privacy rules. And, they complained, too often they had no one to call but police when their children became violent.

“Parents like me are struggling physically, emotionally, and financially,” Long, a Boise, Idaho, mother of four told the hearing via video link. “The stigma for parents and children is real. The magnitude of this problem will only be recognized after tragedies like Newtown.”

She said her son “Michael” -- she uses a pseudonym to protect him -- has never been properly diagnosed with any one illness. When she told him she was testifying, he told her, "Tell them I’m not a bad kid. Tell them I want to be well,’” she said.

“Parents like me are living in fear. Will my child be bullied? Will my child be the bully? Will I be blamed for my child’s explosive behavior?” Long said. Schools need more money to pay for counselors and behavioral interventionists, Long said.

Dr. E. Fuller Torrey, a psychiatrist who founded the Treatment Advocacy Center, says mentally ill patients are far less likely to become violent if they get treated.

The approach is called assisted outpatient treatment, and he says he used it successfully while working in a psychiatric hospital in Washington, D.C.

“I would go to the court and say, ‘Your Honor, this individual has been to the hospital 19 times. He has no awareness of his illness,’” Torrey testified.

The law allowed Torrey to order such a patient to receive a once-monthly injection of medication to help him stay well -- something that is key with some mental illnesses that cause patients to fear medication, mistrust doctors and to be unable to understand that they are ill. Studies have shown this type of forced treatment can decrease homelessness, arrests and can help prevent the patients from becoming victims of crimes.

Torrey says 44 states have assisted outpatient treatment laws, which allow for forced treatment under certain circumstances, but they are not used consistently.

“The crisis we find ourselves in is not just a question of funding. Rather the current situation demands more intelligent targeting of available funds towards the most promising treatments,” subcommittee chairman Tim Murphy, a Pennsylvania Republican, told the hearing.

Earley says his son, who was 22 when he became ill, finally got treatment. He praised Virginia for tackling mental health after a mentally ill Virginia Tech student killed 32 people and wounded 17 in 2007. But he found it difficult. "Parents can’t do anything because of civil rights laws," he said.

“There was a time when I wished my son had not been born,” Earley, who wrote the book “Crazy”, told the hearing. “But today my son is doing great. He has a job, lives on his own, pays taxes. If he was sitting here today before you today you would not know that he has a mental illness,” Earley added.

“This is not a problem of us not knowing what to do. This is a problem of us not doing it. No father should ever be told, ‘Bring your son back after he tries to kill someone or tries to kill you.’"

Milam said he tried hard to get his son Matthew treated in a New Orleans hospital after he filled his bedroom with bomb-making materials, but his doctors and health insurance company insisted he was well enough to go home. Matthew had repeatedly threatened suicide and had tried at least twice, drinking bleach and slashing his own throat with a knife.

“I can’t tell you the words I used,” Milam said. “I was enraged they would let him out.” Matthew died at the age of 24,  trying to set off the bomb in his bedroom, and investigators later said they found enough explosives in there to have leveled the house.

“We have 15 million children and teenagers who have a psychiatric disease or serious learning disorder in the U.S. today. Less than half get any help,” Torrey said.

Dr. Thomas Insel, director of the National Institute of Mental Health, said there’s no coherent U.S. system for managing mental health needs. “We are often forced to respond in an acute way to what is a chronic problem,” he said.

People with diabetes get medications, medical care and counseling to help keep themselves well. Mental health patients need the same consistent approach, he said.

Related links:

• Mom's blog on mental illness goes viral
• Mental illnesses share common DNA roots
• Glitch in medical code threatens mental health care
• After shootings, states rethink mental health cuts

Your spouse is despondent, says life isn’t worth living – and has a gun. What do you do?

It’s a common scenario – suicide rates among young adults increased more than 200 percent over the past 50 years and suicide is the 10^th leading cause of death in the United States, according to federal statistics.

This weekend’s apparent suicide of singer Mindy McCready highlights one other statistic about suicide – people who use guns are far more likely to actually kill themselves than people who attempt suicide using pills, car exhaust or some other method.

“More than 50 percent of suicides in this country are committed using firearms,” says Dr. Liza Gold, a professor of psychiatry at Georgetown University Medical Center. “If you limit the means, you can save people’s lives.”

But getting a gun away from anyone can be difficult, as the recent debate over changes to gun laws can demonstrate. Gold and her colleague Dr. Alan Newman have some pointers for friends, relatives and caregivers of people who might be at risk of suicide and who have access to guns.

“If you have a family member with chronic mental illness, guns should not be accessible to that person,” Gold said in a telephone interview. “People are often ambivalent about committing suicide. They go back and forth, and they are scared, especially if it’s in a moment of crisis. If you can get them through that crisis period, often they can get better.”

With a gun, "there is no second chance," says Gold.

Rule number one – don’t fight over the gun. “Never try to disarm anyone,” she says. “You definitely don’t want to get into a shoving match over a weapon with someone who in distress…and potentially might not be thinking clearly or rationally,” she added.

“If you know the person has access to a weapon, is suicidal, and is not willing to give up the weapon or becomes agitated if you ask for it, back off and call the police immediately. The people most likely to be shot and killed by family members -- with or without mental illness -- are other family members.”

It’s also important not to make the person defensive. Gold recommends using “I” language. “You say, ‘Look, I am worried about you. I love you and I am concerned,’” Gold advises. “You say, ’I would feel better if you would let me take the gun out of the house. I would feel better, would it be okay if I made the gun safe?’”

It is much less threatening, Gold says, than accusations. “If you say, ‘You’re crazy -- give me that gun right now’, people don’t respond well to that kind of approach. Let them know you are worried. Let them know it’s temporary and you are not taking it away from them forever.”

It’s also all right and downright desirable to contact a loved one’s doctor, says Newman. It’s not a violation of doctor-patient confidentiality if the doctor doesn’t reveal anything about the patient.

“A lot of clinicians make a mistake – they have somebody they are giving psychotherapy to or giving medications to and the relationship is all doctor-patient. They don’t communicate with the family,” Newman says.

“In that case, the doctor is pretty much limited to what the patient tells them.” A psychiatrist needs to know if someone who is depressed and potentially suicidal has a way to get hold of a gun.

“If the family wants to give you information, in that case you are not violating confidentiality. You are listening,” Newman says.

Doctors need to be careful in reaching out to family members. “I have seen everything you can imagine, from family members who don’t want the person to get better to family members who are afraid that if they tell you about firearms, the gun may be confiscated,” Newman says.

He advises giving patient and family members alike a plan for keeping the patient safe. “The worst thing is to say to the family right before they leave is to make sure you get rid of the guns. It shouldn’t be an offhand comment,” he said.

And then a doctor needs to check back and make sure the gun has been removed or locked up.

In the worst case, the police are trained to deal with people who are armed and possibly suicidal, and it may be necessary to call them, Newman and Gold both said. “At the end of the process, if you really feel like someone is imminently dangerous – that is the criteria for involuntary detainment in pretty much every state,” Gold says.

“Certainly they will at the very least send a mental health crisis team or a police officer to see what is going on.”

Newman recommends the American Association of Suicidology’s website for more advice. 

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Shelley Metcalf

Carlo Joyce, right, and Thomas Joyce share a moment on their wedding day on July 10, 2010.

As a teenager, Carlo Joyce’s relationship with his parents was strained. He’s gay, but hid that fact from family and most of his friends. So he usually found himself lying when his folks asked where he was going and with whom.

“After I came out at 19, things got better with my family,” he recalled. But then he joined the Marines and had to hide his sexuality all over again.

He had to go to strip bars to fit in, and when the other guys talked about sex, or dating, he had to be sure he changed the gender in his stories. “It was very stressful to live that double life,” he explained. “I always had to watch what I said.”

Now, in a study released today in the journal Psychosomatic Medicine, a team of psychologists and neurologists from McGill University and the University of Montreal has found that leading that double life affects physical and mental health. Gays, bisexuals and lesbians who disclosed their sexuality to family, friends and co-workers were psychologically healthier and had lower levels of a key stress-related hormone than those who were still “in the closet.”

That finding could help explain a remarkable study published last year by a group of researchers from Columbia University in the American Journal of Public Health. They found that after Massachusetts enacted its same-sex marriage law in 2003, there was a significant drop in medical and mental health care visits -- and therefore costs – incurred by gay men.

Lead author of the Montreal study, Robert-Paul Juster, a PhD student at the Centre for Studies on Human Stress at the University of Montreal, said “it seems to be that if you’re using more avoidance coping, and wishful thinking, then you get poorer health. If you aren’t dealing with the problem, it affects health in a negative way.”

On the other hand, dealing with the problem by transitioning from “in” to “out” can instill a great sense of accomplishment. “A rebirth happens that makes them feel much more empowered and conscientious” for having taken what many see as a risky action. That sense of empowerment can have ripple effects benefitting overall health and well-being.

Juster’s study was complex. It included 87 people with a mean age of about 25, 46 of whom were lesbian, gay, or bisexual, and 41 of whom were heterosexual. There were slightly more men than women.

All the participants completed a battery of psychological testing to gauge traits like depressive symptoms, chronic stress, burnout, anxiety and conscientiousness. Blood samples were taken by the researchers, and the participants collected their own urine and saliva at five time points each day for two consecutive days. These were tested for a series of 21 biomarkers related to immune function, metabolism, inflammation, the cardiovascular system, and the endocrine system.

When all the numbers were sifted, and differences like social and economic status were controlled for, it turned out that disclosed sexual minorities had fewer symptoms of depression.

They also had lower cortisol levels 30 minutes after waking. That’s important because cortisol, a key stress hormone, spikes about half an hour after we wake up, like an ignition spark getting us ready to face the day. But you don’t want too much or too little. Disclosed gay men and lesbians were just right. In fact, dislcosed gay men also had lower cortsone levels than straight men.     

Juster isn’t sure why, exactly. It could be because the gay men were in better physical shape. It could also be that because heterosexual men have never had to go through the stress of living life undercover, they’re less practiced at coping and so less resilient to life’s stress.

Joyce, now 33, and living in San Diego, has had a lot of practice. He’s an engineer at a large corporation. When he first started that job, he again hid his sexual orientation, from co-workers and bosses.

“It was like I was back in the closet,” he said. The hiding was self-imposed, but stressful all the same. “Once I did come out, it was much less stressful and I found great acceptance and support.” When he married his partner, many of his co-workers attended. (To clarify, the July 10, 2010, wedding was not a legal marriage as recognized by the state.)  “Life’s much easier,” he said.

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young Ph.D., of "The Chemistry Between Us: Love, Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com), now on sale.

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