Kenya hospital imprisons new mothers with no money


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


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


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


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


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


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


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


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


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


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


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


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


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


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


___


Associated Press reporter Tom Odula contributed to this report.


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Senate leaders aim to craft fiscal bill by Sunday


WASHINGTON (Reuters) - U.S. Senate leaders are working to craft legislation by Sunday that averts the year-end "fiscal cliff" of tax hikes and spending cuts, but many details needed to be worked out after a crucial meeting with President Barack Obama on Friday.


U.S. Senate Democratic leader Harry Reid and his Republican counterpart Mitch McConnell, termed the meeting "constructive" and "positive" and said they would keep working on trying to find a solution over the weekend.


After adjourning on Friday, Reid he would probably not call the Senate back into session until about 1 p.m. EST/ 1800 GMT on Sunday to give leaders time to hash out a deal.


"We are engaged in discussions, the majority leader and myself and the White House, in the hopes that we can come forward as early as Sunday and have a recommendation that I can make to my conference and the majority leader can make to his conference," McConnell said on the Senate floor.


"So we'll be working hard to try to see if we can get there in the next 24 hours. So I'm hopeful and optimistic," he added.


An aide to House of Representatives Speaker John Boehner said it was agreed at the White House meeting that the Senate should act first.


"The speaker told the president that if the Senate amends the House-passed legislation and sends back a plan, the House will consider it - either by accepting or amending," the aide said.


However, Reid said it would be difficult to craft a solution that can win passage in both the House and Senate, adding that it involves "big numbers."


"Whatever we come up with is going to be imperfect," Reid said. "Some people aren't going to like it. Some people will like it less. But that's where we are and I feel confident that we have an obligation to do the best we can."


(Reporting By David Lawder, Rachelle Younglai; editing by Christopher Wilson)



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China tightening controls on Internet


BEIJING (AP) — China's new communist leaders are increasing already tight controls on Internet use and electronic publishing following a spate of embarrassing online reports about official abuses.


The measures suggest China's new leader, Xi Jinping, and others who took power in November share their predecessors' anxiety about the Internet's potential to spread opposition to one-party rule and their insistence on controlling information despite promises of more economic reforms.


"They are still very paranoid about the potentially destabilizing effect of the Internet," said Willy Lam, a politics specialist at the Chinese University of Hong Kong. "They are on the point of losing a monopoly on information, but they still are very eager to control the dissemination of views."


This week, China's legislature took up a measure to require Internet users to register their real names, a move that would curtail the Web's status as a freewheeling forum to complain, often anonymously, about corruption and official abuses. The legislature scheduled a news conference Friday to discuss the measure, suggesting it was expected to be approved.


That comes amid reports Beijing might be disrupting use of software that allows Web surfers to see sites abroad that are blocked by its extensive Internet filters. At the same time, regulators have proposed rules that would bar foreign companies from distributing books, news, music and other material online in China.


Beijing promotes Internet use for business and education but bans material deemed subversive or obscene and blocks access to foreign websites run by human rights and Tibet activists and some news outlets. Controls were tightened after social media played a role in protests that brought down governments in Egypt and Tunisia.


In a reminder of the Web's role as a political forum, a group of 70 prominent Chinese scholars and lawyers circulated an online petition this week appealing for free speech, independent courts and for the ruling party to encourage private enterprise.


Xi and others on the party's ruling seven-member Standing Committee have tried to promote an image of themselves as men of the people who care about China's poor majority. They have promised to press ahead with market-oriented reforms and to support entrepreneurs but have given no sign of support for political reform.


Communist leaders who see the Internet as a source of economic growth and better-paid jobs were slow to enforce the same level of control they impose on movies, books and other media, apparently for fear of hurting fledgling entertainment, shopping and other online businesses.


Until recently, Web surfers could post comments online or on microblog services without leaving their names.


That gave ordinary Chinese a unique opportunity to express themselves to a public audience in a society where newspapers, television and other media are state-controlled. The most popular microblog services say they have more than 300 million users and some users have millions of followers reading their comments.


The Internet also has given the public an unusual opportunity to publicize accusations of official misconduct.


A local party official in China's southwest was fired in November after scenes from a videotape of him having sex with a young woman spread quickly on the Internet. Screenshots were uploaded by a former journalist in Beijing, Zhu Ruifeng, to his Hong Kong website, an online clearing house for corruption allegations.


Some industry analysts suggest allowing Web surfers in a controlled setting to vent helps communist leaders stay abreast of public sentiment in their fast-changing society. Still, microblog services and online bulletin boards are required to employ censors to enforce content restrictions. Researchers say they delete millions of postings a day.


The government says the latest Internet regulation before the National People's Congress is aimed at protecting Web surfers' personal information and cracking down on abuses such as junk e-mail. It would require users to report their real names to Internet service and telecom providers.


The main ruling party newspaper, People's Daily, has called in recent weeks for tighter Internet controls, saying rumors spread online have harmed the public. In one case, it said stories about a chemical plant explosion resulted in the deaths of four people in a car accident as they fled the area.


Proposed rules released this month by the General Administration of Press and Publications would bar Chinese-foreign joint ventures from publishing books, music, movies and other material online in China. Publishers would be required to locate their servers in China and have a Chinese citizen as their local legal representative.


That is in line with rules that already bar most foreign access to China's media market, but the decision to group the restrictions together and publicize them might indicate official attitudes are hardening.


That comes after the party was rattled by foreign news reports about official wealth and misconduct.


In June, Bloomberg News reported that Xi's extended family has amassed assets totaling $376 million, though it said none was traced to Xi. The government has blocked access to Bloomberg's website since then.


In October, The New York Times reported that Premier Wen Jiabao's relatives had amassed $2.7 billion since he rose to national office in 2002. Access to the Times' Chinese-language site has been blocked since then.


Previous efforts to tighten controls have struggled with technical challenges in a country with more than 500 million Internet users.


Microblog operators such as Sina Corp. and Tencent Ltd. were ordered in late 2011 to confirm users' names but have yet to finish the daunting task.


Web surfers can circumvent government filters by using virtual private networks — software that encrypts Web traffic and is used by companies to transfer financial data and other sensitive information. But VPN users say disruptions that began in 2011 are increasing, suggesting Chinese regulators are trying to block encrypted traffic.


Curbs on access to foreign sites have prompted complaints by companies and Chinese scientists and other researchers.


In July, the American Chamber of Commerce in China said 74 percent of companies that responded to a survey said unstable Internet access "impedes their ability to do business."


Chinese leaders "realize there are detrimental impacts on business, especially foreign business, but they have counted the cost and think it is still worthwhile," said Lam. "There is no compromise about the political imperative of controlling the Internet."


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It's husband No. 3 for actress Kate Winslet


NEW YORK (AP) — Kate Winslet has tied the knot again.


The Oscar-winning actress wed Ned Rocknroll in New York earlier this month. The private ceremony was attended by Winslet's two children as well as a few friends and family members, her representative said Thursday.


It is the third marriage for the 37-year-old Winslet. She was previously married to film directors Jim Threapleton and Sam Mendes.


The 34-year-old Rocknroll, who was born Abel Smith, is a nephew of billionaire Virgin Group founder Richard Branson.


The couple had been engaged since last summer.


Winslet won a Best Actress Oscar for her performance in the 2008 film "The Reader."


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Kenya hospital imprisons new mothers with no money


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


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


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


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


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


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


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


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


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


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


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


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


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


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


___


Associated Press reporter Tom Odula contributed to this report.


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House back Sunday night, will have 29.5 hours to strike deal on fiscal cliff


President Barack Obama salutes as he returns via Marine One from a Christmas visit with his family in Hawaii, to …Will parachutes be provided? Republican House leaders informed their rank-and-file on a conference call Thursday that they have to be back at work at 6:30 p.m. Sunday – giving them, oh, 29.5 hours to forestall the “fiscal cliff.”


Absent a last-minute compromise, Americans will see across-the-board income-tax hikes and painful federal spending cuts come into force January 1. Some economists fear that, taken together, the measures could plunge the economy into a new recession.


Technically, however, the Congress could vote the cliff into oblivion at any time – either before OR after the income-tax increases and spending cuts are slated to take effect. Republican House Majority Leader Eric Cantor noted on Twitter that lawmakers “may be in session through Wednesday, January 2.”


House Speaker John Boehner told his troops on the conference call that the Senate would have to act first, either by passing, or by amending, legislation the House has already passed to avert the cliff.


“If the Senate will not approve these bills and send them to the president to be signed into law in their current form, they must be amended and returned to the House,” he said, according to a source on the call.

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Afghan bomber attacks near major US base


KABUL, Afghanistan (AP) — A vehicle driven by a suicide bomber exploded at the gate of a major U.S. military base in eastern Afghanistan on Wednesday, killing the attacker and three Afghans, Afghan police said. The Taliban claimed responsibility for the attack.


Police Gen. Abdul Qayum Baqizai said a local guard who questioned the vehicle driver at the gate of Camp Chapman was killed along with two civilians and the assailant. The camp is located adjacent to the airport of the capital of Khost province, which borders Pakistan. Chapman and nearby Camp Salerno had been frequently targeted by militants in the past, but violent incidents have decreased considerably in recent months.


Taliban spokesman Zabihullah Mujahid said in an email that the bomber targeted Afghan police manning the gate and Afghans working for the Americans entering the base. He claimed high casualties were inflicted.


NATO operates with more than 100,000 troops in the country, including some 66,000 American forces. It is handing most combat operations over to the Afghans in preparation for a pullout from Afghanistan in 2014. Militant groups, including the Taliban, rarely face NATO troops head-on and rely mainly on roadside bombs and suicide attacks.


NATO forces and foreign civilians have also been increasingly attacked by rogue Afghan military and police, eroding trust between the allies.


On Tuesday, the Interior Ministry said a policewoman who killed an American contractor in Kabul a day earlier was a native Iranian who came to Afghanistan and displayed "unstable behavior" but had no known links to militants.


The policewoman, identified as Sgt. Nargas, shot 49-year-old Joseph Griffin, of Mansfield, Georgia, on Monday, in the first such shooting by a woman in the spate of insider attacks. Nargas walked into a heavily-guarded compound in the heart of Kabul, confronted Griffin and shot him once with her pistol.


The U.S-based security firm DynCorp International said on its website that Griffin was a U.S. military veteran who earlier worked with law enforcement agencies in the United States. In Kabul, he was under contract to the NATO military command to advise the Afghan police force.


The ministry spokesman, Sediq Sediqi, told a news conference that Nargas, who uses one name like many in the country, was born in Tehran, where she married an Afghan. She moved to the country 10 years ago, after her husband obtained fake documents enabling her to live and work there.


A mother of four in her early 30s, she joined the police five years ago, held various positions and had a clean record, he said. Sediqi produced an Iranian passport that he said was found at her home.


No militant group has claimed responsibility for the killing.


The chief investigator of the case, Police Gen. Mohammad Zahir, said that during interrogation, the policewoman said she had plans to kill either the Kabul governor, city police chief or Zahir himself, but when she realized that penetrating the last security cordons to reach them would be too difficult, she saw "a foreigner" and turned her weapon on him.


There have been 60 insider attacks this year against foreign military and civilian personnel, compared to 21 in 2011. This surge presents another looming security issue as NATO prepares to pull out almost all of its forces by 2014, putting the war against the Taliban and other militant groups largely in the hands of the Afghans.


More than 50 Afghan members of the government's security forces also have died this year in attacks by their own colleagues. The Taliban claims such incidents reflect a growing popular opposition to the foreign military presence and the Kabul government.


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Mint, otro Linux para quienes quieren explorar el mundo fuera de Windows






Una de las grandes virtudes de Linux (un sistema operativo libre para PC y otros dispositivos) es la cantidad innumerable de versiones disponibles. Estas distribuciones, además, son en su enorme mayoría de uso gratis, y representan una buena alternativa para los que no desean invertir en una licencia de Windows o quieren explorar -sin gastar- alternativas para la computadora hogareña.


Hemos recomendado en varias ocasiones opciones sencillas de usar e instalar que tienen herramientas iguales o muy similares a las que pueden encontrarse en Windows, destacando la ductilidad de las distribuciones disponibles y cómo hacer para probarlas sin complicarse demasiado , usando un CD regrabable o un pendrive, para no afectar el Windows instalado en la computadora.






En los últimos años fue Ubuntu el que más hizo para facilitarle el trabajo a los neófitos que venían de Windows, automatizando y simplificando procesos de instalación, creando un sitio amigable, sumando instrucciones de instalación y uso en lenguaje no técnico e incluso haciendo acuerdo para preinstalarlo en equipos de marca , pero la elección de la interfaz de usuario Unity (algo rígida) le hizo perder adeptos.


Una de las alternativas que venía creciendo en popularidad era Linux Mint (gratis), y los últimos números de DistroWatch , un sitio que lista las diferentes distribuciones y su popularidad, lo dan como el rey de 2012. Mint usa a Ubuntu como base, por lo que aprovecha algunas de sus herramientas (como la que permite instalarlo dentro de Windows para poder usarlo sin afectar la instalación original) y viene con una gran cantidad de componentes multimedia preinstalados, para facilitar la reproducción de audio y video, entre otras cosas (las distribuciones más “puras” suelen evitar esto para promover el uso de estándares libres de audio y video).


Hace poco más de un mes Linux Mint liberó su versión más reciente, Nadia 14, que incluye dos entornos de escritorio que resultarán muy agradables para quienes no se sienten cómodos con Unity, porque mantienen el esquema tradicional de Windows y Gnome 2.x: una barra de herramientas en la parte inferior de la pantalla, ventanas con los botones de control a la derecha, etcétera.


Linux Mint 14 tiene dos versiones: MATE (basado en Gnome 2.x, y cuyo nombre está inspirado en la yerba mate) y Cinnamon (canela, en inglés) de aspecto similar pero con algunos detalles visuales más atractivos: menús de notificaciones más sofisticados, escritorios virtuales persistentes, miniaturas en el administrador de ventanas y más.


cómo instalarlo


Cualquiera de ellas se puede meter en un pendrive o disco externo y correr desde allí o, si se quiere, instalarlas en la PC, junto con Windows (es compatible con Windows 8) o en una partición nueva. Alcanza con descargar el archivo ISO de instalación (hay uno para MATE y otro para Cinnamon). Ese archivo (900 MB, aproximadamente) se puede grabar en un DVD con una aplicación para quemar imágenes de disco: en Windows está el freeware CDBurnerXP , por ejemplo. Con el disco en la lectora, al encender al PC debería cargar primero Mint antes que Windows (si no, habrá que cambiar una configuración en el BIOS). Podremos usarlo como si estuviera instalado en la PC y luego, si queremos, instalarlo en el disco rígido de nuestra computadora, cuidando de hacerlo en una partición vacía o dentro de Windows.


Otra opción es instalarlo en una memoria USB (de 2 GB o más de capacidad). Para eso hay que usar la aplicación Image Writer (gratis, hay que cliquear donde dice win32diskimager-binary.zip para descargar el archivo). Luego habrá que cambiar la extensión del archivo de .ISO a .IMG para que Image Writer reconozca el archivo y pueda copiarlo en el pendrive (atención que borrará todo lo que está allí).


Si al prender la PC con el pendrive conectado no lo reconoce, habrá que cambiar el orden de carga de sistemas operativos, una opción que suele aparecer apenas se prende la PC (y que no estará disponible si la computadora es muy vieja) para ordenarle que cargue primero el contenido de la memoria USB.


Para quienes estén pensando en probar una distribución de Linux y buscan reducir el “choque cultural” con una interfaz de usuario que sea parecida -pero no idéntica- a la del Windows tradicional, y que además sea sencillo de usar, tienen en Linux Mint 14 Nadia una opción muy atractiva.


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Patrick Dempsey brews up coffee shop purchase


LOS ANGELES (AP) — Patrick Dempsey says he wants to rescue a coffee house chain and more than 500 jobs.


The "Grey's Anatomy" star said Wednesday he's leading a group attempting to buy Tully's Coffee. The Seattle-based company filed for Chapter 11 bankruptcy protection in October.


Dempsey said he's excited about the chance to help hundreds of workers and give back to Seattle.


The actor has a strong TV tie to the city: He plays Dr. Derek Shepherd on "Grey's Anatomy," the ABC drama set at fictional Seattle Grace Hospital.


Tully's has 47 company-run stores in Washington and California, as well as five franchised stores and 58 licensed locations in the U.S.


Any sale would have to be approved by a judge. A bankruptcy court hearing is set for Jan. 11 in Seattle.


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


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


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


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


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


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


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


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


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


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


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


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


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


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


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


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


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


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


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


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


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


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


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


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


___


Online:


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


___


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


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