TORONTO – an antipsychotic drug used as a therapy for schizophrenia appears to have an unusual property — it can neutralize some cancer stem cells that allow tumours to come back after treatment.

In lab experiments, Canadian researchers found that thioridazine can alter cancer stem cells that give rise to a type of leukemia, as well as those that generate certain breast cancer cells, without harming normal stem cells.

The discovery, reported Thursday in the journal Cell, came after researchers screened about 3,000 compounds in search of those that would selectively inhibit human cancer stem cells.

Thioridazine is one of about 20 agents winnowed down through high-tech drug screening that appear to work against cancer stem cells, said principal investigator Mick Bhatia, scientific director of the Stem Cell and Cancer Research Institute at McMaster University.

“Cancer stem cells, what they do is they keep proliferating,” Bhatia said from Hamilton. “But they don’t do what normal stem cells do, which is make other cell types. and then those cells perform their function and then die. That’s the normal life cycle.

“Cancer stem cells refuse to go through that life cycle because they never differentiate. they just keep making copies of themselves.”

That’s why, even if a patient’s malignancy appears to have been eradicated with chemotherapy and radiation, the cancer can come back, Bhatia said.

“And the feeling there is that the drugs we’re using aren’t targeting the cancer stem cells, so you’re not getting to the root. You’re just picking the dandelion off the top.

“And it looks good for a while, the lawn looks fine, but if you don’t dig at it and get the root, it just comes back.”

Bhatia admits that thioridazine’s apparent power over cancer stem cells came as a bit of a surprise.

The drug works against schizophrenia, for example, by targeting dopamine receptors in the brain. Dopamine is a chemical messenger that plays a variety of roles in the brain, including helping to regulate attention, cognition and movement.

The drug is also used to treat the symptoms of Parkinson’s disease, which develop in response to declining dopamine levels caused by the death of brain cells that make the neurotransmitter.

Thioridazine doesn’t appear to kill cancer stem cells, but rather encourages them to differentiate, thus exhausting the pool of self-renewing cells.

The researchers showed that the drug affects leukemia stem cells without harming normal blood stem cells. It turns out that unlike normal blood stems cells, leukemia cells have a dopamine receptor on their surfaces — making them vulnerable to the drug.

Dopamine receptors also appear on some breast cancer stem cells, the researchers found.

“This gives us some explanation,” Bhatia said. It also suggests that dopamine receptors might serve as a biomarker for early detection of rare, tumour-initiating cells in patients.

Michael Rudnicki, CEO and scientific director of the Stem Cell Network of Canada, described the paper as a “beautiful study, a very nice piece of work.”

“I think this paper really exemplifies the Canadian leadership in cancer stem cell research,” Rudnicki said Thursday from Ottawa. “Cancer stem cells were really discovered here in Canada, and this work takes it to a new level.”

He said the researchers’ findings strongly support the notion that already-approved, “human-ready” drugs exist in the global pharmaceutical armamentarium that could bolster doctors’ ability to defeat some cancers.

“Everything that we can do to build up the toolbox for the clinicians treating cancer will help this,” said Rudnicki, who was not involved in the study.

The McMaster-led team, which includes physicians, is planning to test thioridazine in combination with standard anti-cancer drugs in a small group of adults with acute myeloid leukemia who have not responded to chemotherapy alone.

The researchers’ next step is to investigate the effectiveness of thioridazine in other types of cancer, as well as exploring the potential of the other compounds identified so far, Bhatia said.

“We really want these drugs to be something that we can target at a clinical level.”

In the future, thousands of other compounds will be analyzed with McMaster’s robotic stem cell screening system in collaboration with other academic groups and the pharmaceutical industry.

“The goal for all of the partners,” said Bhatia, “is the same — to find unique drugs to change the way we tackle and treat cancer.”

help by family is emerging as among effective methods for treating mental conditions. PHOTO: FILE

KARACHI: 

For the world outside, people diagnosed with psychiatric challenges are ostracized. But in the safety of the Recovery House in Gizri, they receive the support of their family and are treated with the dignity they deserve.

The rehabilitation centre disseminates awareness and education for treatment of their clients, who are otherwise stigmatized as ‘mental patients’.

The Recovery House, which is a project of the Caravan of Life Pakistan Trust, organised a seminar at the Beach Luxury hotel on Sunday.

Dr Tabassum Alvi, an assistant professor at the Jinnah Medical and Dental College, pointed out that rehabilitation is not a ‘cure’ but can end the symptoms, relapses and other problems that clients face.

Dr Alvi said that there are six evidence-based practices to improve mental health services in supporting the recovery process. they are medication management, assertive community treatment, integrated dual disorders treatment, illness management and recovery, family psycho education and supported employment.

Of these, she said, the help by family and assertive community treatment are emerging as among the most effective methods. she shared the example of one of her very first patients, a 34-year-old man with a 13-year history of schizophrenia. his symptoms comprised suspiciousness, sexual impulsivities and social dysfunction. “He was treated with medicines but it was only after incorporating rehabilitation that he learnt about his condition and its management.” Today, he is helping others in their path to recovery.

“Psychiatric rehabilitation is about recovery, quality of life and community integration,” she said. It requires a patient’s self-determination, optimism on the doctors’ part and care that the dignity and worth of the individual is not undermined. for the method of rehabilitation, it is most important to select the goal that is chosen by the consumer, not by the practitioner or the consumer’s family.

M* said she was able to work with her brother, who has schizophrenia, once she learnt how to change her own behaviour when he suffers an attack or a relapse. M’s brother used to be a banker and developed the condition due to stress. After their parents’ death M was alone in dealing with the situation. “However it improved when I learnt how to deal with it and in only a year he developed a sense of humour,” she said.

Dr Alvi said that assertive community services are an emerging method which has great potential for treatment of the mentally ill. It is a multidisciplinary approach in which a team comprising people in the surroundings of the patient share round-the-clock responsibilities of care.

The Recovery House’s director Saira Ali said that it is a private non-profit care centre that aims to provide a secure environment for the consumers. they learn to live with and manage their condition as independently as possible, to work productively, to help others and maintain those accomplishments throughout their lives.

The Recovery House runs two programmes: the Day Treatment programme which features lessons three days a week and the Residential Treatment with sessions and lesions six days a week. there are currently 14 people in rehabilitation, while the centre has a capacity of 25.

*Names have not been disclosed to protect the privacy of individuals

Published in the Express Tribune, May 22nd, 2012.

A Must Read for all your cashiers!

First, it is an established fact that getting ahead in the convenience store industry is much, much easier than in most any other industry. While we absolutely believe in the value of a good education–indeed many company’s help fund continuing education for their employees, our industry does not require a college degree.

Many managers and general managers worked their way up the ladder without a high school diploma, and most go back and get a GED & more.

I’ve been thinking of this subject matter for more than a year now, but it took a quote from William Feather, to get me started: “Success seems to be largely a matter of hanging on after others have let go!” While I have never said it nearly that well, I’ve been preaching the premise for years. Now, let’s get into the “secrets of getting ahead.” they are so overwhelmingly simple that you might have trouble believing them, but, let me ask, “what have you got to lose by keeping an open mind?”

You will absolutely stand out from the crowd if you merely:

* Resist the urge to call in sick. this is a biggie and will immediately separate you from 75% of your co-workers. Yeah, I know you genuinely don’t feel well some days and, tell the truth, a couple of hours later, most times at least, you are feeling just fine. I personally don’t want to take time off when I’m sick. Why? when busy I tend to forget how bad I might feel. you know I’m right. Discipline allows you to shine!

* Show up when you’re scheduled. and not one or 30 minutes later. Admit it, you know it bugs the heck out of you when your shift replacement delays your carefully made plans.

* Show up with a good attitude and ready to work. Customers make choices every day about where they will stop to buy gas, beer and cigarettes. they make these decisions as much on the basis of the person behind the counter as they do on price!

* look and act the part. How really difficult is it to be bright, clean and looking sharp? when I say “act,”that’s what I mean. The store and front counter is your stage. The customers are your audience and their smiles and compliments are your applause! you have an awesome opportunity to affect the way hundreds of people feel about the start or finish of their day every day!

* do your share and a little bit more – every day!

* Understand that one “Aw, heck” from your Boss, wipes out the last few “Attaboys.” this understanding is critical to your growth. Most of us tend to maximize the “attaboys” and minimize the “Aw Heck’s.” That’s reverse thinking.

* Team players develop into team leaders. Simply put, be loyal to your paycheck, go the extra mile by doing things like volunteering to do the tough jobs. It makes the day go faster and you’ll like yourself better. be a positive force and help lead others along the right path. Don’t turn a blind eye on a dishonest vendor or a cheating co-worker. keep your integrity and honesty intact!

* Fight the urge to “walk” when things are not going well. The c-store annals are full of stories of individuals who “stuck it out” through tough times and ended up in top management or even as owners of the business. Understand that your fellow workers feel the same as you. every time one of them gives into discouragement and leaves, you automatically rise in managements eyes. Read that again and burn it into your mind, there is no Utopia. Stay the course. You’ll be glad you did!

* For goodness sakes give a notice if you find a better position. Giving a notice makes great sense for you. Giving notice once again separates you from the masses and, more importantly, in most cases it allows you to be rehired should another opportunity at the company arises. Having plans to return always keep your options open!

While I’ve said quite a bit, I have not said anything that resembles “difficult.” We all have to work somewhere and convenience stores present an ever increasing and constantly improving opportunity for meaningful employment and advancement. in a difficult world, indeed, convenience stores are a veritable emergency room for workers and travelers!

Jim Callahan, PartnerConvenience Store Solutions1 Quail run DriveNewnan, Ga. 30265

Posted on Friday, Mar. 7, 2008 — 8:55 AM

When your mother told you to eat your vegetables it appears that maternal wisdom had a scientific basis. Researchers with Vanderbilt-Ingram Cancer Center and the Shanghai Cancer Institute in China have discovered a possible link between a diet rich in certain vegetables and a decreased risk for breast cancer. The study appears in the March issue of the American Journal of Clinical Nutrition.

Corresponding author Jay Fowke, Ph.D., assistant professor of Medicine at Vanderbilt-Ingram, said 3,035 women diagnosed with breast cancer were identified through the Shanghai Cancer Registry. they were closely matched with 3,037 women randomly chosen from the general population there. The women filled out questionnaires about their diet, including consumption of cruciferous vegetables like Chinese cabbage, bok choi and turnips. Americans typically eat more broccoli, kale and cauliflower in the cruciferous vegetable family.

“Cruciferous vegetables contain some compounds that may have a cancer-inhibitory effect,” explained Fowke. “here we were able to identify a group of women who seem to particularly benefit from a high intake of these vegetables.”

While there was only a small positive relationship between a diet high in these vegetables and a reduction in breast cancer risk for the overall study population, there was a striking risk reduction – 50 percent – among women with a certain genetic profile. Researchers identified three forms of the GSTP1 genotype among the cancer patients: Ille/Ile, Ile/Val and Val/Val.

“Women who consumed more of these cruciferous vegetables and who also had the Val/Val genetic polymorphism had a lower breast cancer risk. So we cautiously interpreted this as diet being a factor that may reduce the impact of genetic susceptibility in overall breast cancer risk,” said Fowke.

The Vanderbilt-Ingram researchers focused on cruciferous vegetables because they contain two chemicals called isothiocyanates and indole-3-carbinol which may affect carcinogenesis by triggering cell death or by shifting estrogen metabolism. Studies by other researchers have suggested cruciferous vegetables may reduce the risk of lung, stomach, colorectal and bladder cancers.

“we have known for some time that certain foods, like soy foods, appear to interfere with the development of breast cancer because they contain plant estrogens,” said Fowke. “The protective effect from cruciferous vegetables in this study was certainly suggestive of a risk reduction, but researchers need to replicate this finding in other studies.”

Scientists were able to isolate the specific genetic profile linked with a positive dietary impact because the women in the study submitted DNA through blood and cheek cell samples. Wei Zheng, M.D., Ph.D., professor of Medicine at Vanderbilt-Ingram is the principal investigator for the Shanghai Breast Cancer study.

“The Shanghai Breast Cancer Study is one of the largest and most comprehensive epidemiological studies conducted to date for this common cancer,” according to Zheng. “we have published over 100 research papers in this study addressing a large range of significant issues related to the etiology and survival of breast cancer. The results reported by Dr. Fowke may have significant implications in breast cancer prevention.”

While women in this study answered questionnaires about their diets, researchers want to measure more precisely the intake of cruciferous vegetables. To aid in future studies they are collecting urine samples which contain biomarkers for the beneficial chemicals.

Authors for this paper include: Sang-Ah Lee, Wei Lu, Chuangzhong Ye, Ying Zheng, Qiuyin Cai, Kai Gu, Yu-Tang Gao, Xiao-ou Shu and Wei Zheng.

SAN DIEGO — the director of a wildly popular video about brutal African warlord Joseph Kony has been diagnosed with brief psychosis and is expected to stay in the hospital for weeks, his wife said Wednesday.

Jason Russell, 33, was hospitalized last week in San Diego after witnesses saw him pacing naked on a sidewalk, screaming incoherently and banging his fists on the pavement. he was in his underwear when police arrived.

His outburst came after the video’s sudden success on the Internet brought heightened scrutiny to Invisible Children, the group he co-founded in 2005 to fight African war atrocities.

Russell’s family said that the filmmaker’s behavior was not due to drugs or alcohol. he was given a preliminary diagnosis of brief reactive psychosis, in which a person displays sudden psychotic behavior.

“Doctors say this is a common experience given the great mental, emotional and physical shock his body has gone through in these last two weeks,” Danica Russell said in a statement.

Researchers say those with personality disorders are at greater risk for having an episode. Brief reactive psychosis is triggered by trauma or major stress such as an accident or death of a loved one. other stressors can include sleep deprivation or dehydration.

Symptoms include hallucinations, delusions and strange speech and behavior. People typically recover within a few weeks without medication. others have to take antipsychotic drugs to alleviate symptoms or undergo talk therapy to cope.

The condition causes “temporary debilitation, but in general people have good recoveries,” said Dr. Stephen Marder, professor of psychiatry at UCLA.

In some cases, doctors say brief reactive psychosis can signal the beginning of a more serious mental illness such as schizophrenia.

Danica Russell said it may be months before her husband returns to San Diego-based Invisible Children.

“Jason will get better. he has a long way to go, but we are confident that he will make a full recovery,” she said.

Russell narrates the 30-minute video “Kony 2012,” which has been viewed more than 84 million times on YouTube since it was released this month. in the video, Russell talks to his young son, Gavin, about Kony and the Lord’s Resistance Army.

The Invisible Children group has been criticized for not spending enough directly on the people it intends to help and for oversimplifying the 26-year-old conflict.

Invisible Children has acknowledged the video overlooked many nuances but said it was a “first entry point” that puts the conflict “in an easily understandable format.” It said money that directly benefits the cause accounted for more than 80 percent of its spending from 2007 to 2011.

—

Does every crime warrant the death penalty? if so, you have no problem with the way inmates are treated in Arizona’s prisons.

If not, then there is terrible, unacceptable truth to the lawsuit filed earlier this week by the American Civil Liberties Union claiming that Arizona’s prisons systematically violate inmates’ protection from “cruel and unusual” punishment under the eight Amendment.

The day the lawsuit was filed I wrote about it for azcentral.com.  I didn’t expect public reaction to be all that positive. it wasn’t. Not based on some of the responses I received from readers.

Daniel Pochoda, legal director of the ACLU of Arizona told me, “if someone in prison loses a leg because of symptoms that were ignored, as has happened, or someone goes blind, or other things that leave them incapacitated, for the most part these individuals will get out of prison. And because of their inability to work they will wind up on the public dole and we will pay for them in the long term. but that isn’t the most important part. The most important part is doing what is right. Allowing people to die so horribly, that can’t be OK."

Or can it?

Here are a few examples cited in the lawsuit, followed by examples of responses I received from readers.

LAWSUIT: “For two years, mr. (Ferdinand) Dix … exhibited many symptoms consistent with lung cancer, including a chronic cough and persistent shortness of breath, and he tested positive for tuberculosis. Due to the metastasized cancer, mr. Dix’s liver was infested with tumors and grossly enlarged to four times normal size, pressing on other internal organs and impeding his ability to eat, but no medical staff even performed a simple palpation of his abdomen. Instead, medical staff told him to drink energy shakes. When mr. Dix was finally taken to an outside hospital in a non-responsive state in February 2011, his abdomen was distended to the size of that of a full-term pregnant woman … mr. Dix died from the untreated cancer a few days after ADC finally sent him to the hospital.”

READER: “I didn’t realize prison was supposed to be a five star resort.”

LAWSUIT: “in July 2010 … Tony Lester (an inmate) who had paranoid schizophrenia, multiple personality disorder, and auditory hallucinations, had been taken off suicide watch, taken off his medications, and housed in the general population, where he was given a hygiene kit that included a razor. He used the razor blade to slit his throat, groin, and wrists, and he wrote the word “VOICES” in his blood on an envelope. An ADC internal investigation found that the four responding officers stood by and did not administer any basic first aid.”

READER: “I’m sorry, take care of our VETERANS first, criminals are just that, criminals.”

LASWUIT: “in another example, in May 2011, a prisoner who was four months pregnant began experiencing painful contractions and spotting blood, and went to Perryville’s medical unit. The staff person on duty told her it was nothing serious, that her problems were “all in your head” … She was sent back to her living unit, and she continued to experience great pain and cramping for an hour and a half, until she miscarried.”

READER: “if I got cancer right now I would die too, as I have no way to pay for any treatment. is that fair? I work every single day, pay my bills … but because we have to spend millions on (inappropriate term) and prisoners’ care there is nothing left for anyone else.”

The sister of Ferdinand Dix told me that her brother, who died from untreated cancer, had been sentenced to five or six years in prison for drug related offenses.

“Yes, my brother battled with addiction and was incarcerated for it,” she said. “but he was also my mother’s son, my brother and a friend when you needed one.  above all else, however, he was a human being who did not deserve to suffer as he had been suffering while an inmate…”

Unless every crime warrants a death sentence.

(Column for Mar. 8, 2012 Arizona Republic)

He knows it’s all in his head.

Everyday is a battle with paranoid schizophrenia. things are going well for Sebring now. For three years, he has held down a full time job and paid for his own apartment. It took him more than 30 years struggling with drug abuse and homelessness, though, to get the upper hand on his mental illness.

Mental illness ranks third after substance abuse and lack of affordable housing on the list of the most commonly cited causes of homelessness. between 20 and 25 percent of the homeless population in the United States suffer from some form of severe mental illness, according to the Substance Abuse and Mental Health Services Administration. The percentage nearly doubles if lesser illnesses like clinical depression and anxiety disorders are taken into account.

When it comes to beating homelessness, it’s these people who often struggle most, said Neil Donovan, executive director of the National Coalition for the Homeless. many turn to illegal drugs as a means to self medicate.

“Pulling out of homelessness is hard,” Donovan said. “Mental illness makes it exponentially harder.”

But there is hope. Sebring is proof of that.

Sebring, a short, stout man who keeps his cinnamon-colored facial hair trimmed in a neat goatee, smoked his first marijuana joint in the fourth grade.

His grandmother, who raised him, was a chain smoker. one summer evening, he snuck a cigarette from her stash and took it behind the chicken coop. he lit. he inhaled. And he gagged. The smoke burned his lungs. It tasted terrible. That might have been the end of it, but, just then, his uncle came lumbering through the bushes. Watching Sebring hacking and hacking, the uncle shook his head.

“Don’t smoke cigarettes,” he said. “I’ve got something better.”

The following decades were a drug-induced blur. Sebring became a drug dealer. he got kicked out of one school and failed most of his classes in the next. he isn’t sure when he started experiencing symptoms of schizophrenia. It was hard to tell the drug hallucinations from the schizophrenic ones. he couldn’t sleep because the voices in his head were too loud. he self medicated by doing more drugs.

“The voices were relentless,” he said.

“Leave the state,” the voices told him. “You’re an alien.” “The FBI is tracking you.”

In a sunlit garden in Dorset, a middle-aged man is looking at photographs of his life. He pauses on a family group beside a caravan, a faded black-and-white snap stained with streaks of tea, and gently touches his forefinger to the face of a woman, pretty but careworn. She is in her 30s, with her arms around two boys. He says, “Mummy.”

He moves his finger to the man in the group, a stiff-backed, hawk-nosed figure in a suit and Homburg hat: “Grandad!” He flips to the next photo and grins broadly: “Daddy Edge!” the man in the picture, seated on a sea wall, is grinning, too — their faces look almost identical.

The man turns to the next picture and taps it with his forefinger, twice, as though he has remembered someone who, long ago, had been very important to him. it is a school portrait of a boy in a blue pullover, his freckled face a mask of fright and bewilderment. the man says ruminatively, “Michael Edge.”

Michael is a remarkable man. half a century ago, when he was four years old, he was one of the first British children to be recognised as autistic. in the US, the word autism had been coined two decades earlier, to describe a tiny group of adolescents – fewer than a dozen in the first study. the children exhibited bizarre and often deeply troubled behaviour, in a pattern so clear-cut it might have been designed from a template. But in Britain, until 1961, almost all doctors regarded these symptoms as part of some general “childhood psychosis” or junior version of schizophrenia.

“Child psychotics” were generally placed in institutions before their sixth birthdays. they were seen as unmanageable and untreatable. But Michael was different. his parents, an ordinary working-class couple from Essex, vowed that their son would stay with them and be brought up as one of the family. Fifty years on, he lives as independently as possible under the eye of carers he regards as close friends, in a secluded village cul-de-sac on the south coast. Michael cannot know it but his life, and his mother’s indefatigable love for him, have been a pioneering model for any family with an autistic child, including my own.

When other children were starting nursery school, Michael Edge, aged four, was taken by his parents to a psychiatrist. He had been an easy baby, a good sleeper who seemed to develop well, but from the age of about two and a half he began to regress. his vocabulary dwindled until soon he could not speak, only scream. “His grandfather kept insisting there was nothing wrong with him,” says his mother, Joan, “but Michael was fascinated by lightbulbs – if there was a light on he’d go round and round it, as if he was hypnotised.”

He ceased to respond to Joan’s voice, ignoring her even when she called his name, though he responded to stray noises – neighbours’ children, a dog’s bark – with paroxysms of terror. the family GP couldn’t explain it and sent them to University College Hospital (UCH), near Regent’s Park in London.

The hospital’s consultant child psychiatrist was Kenneth Soddy, an expert with 30 years’ experience. “He told us Michael was autistic,” Joan says. “And he advised us to send our child away and forget him, because he wouldn’t ever improve. ‘Do it for your own sakes,’ he said. we went into the park and I cried my eyes out.”

Joan is 81 now, and Michael is 53. She and her husband, Cliff, a railway worker, fought to find the best school and the best treatment for their son, not once but again and again. Their family suffered appalling stresses, and Joan’s health was almost destroyed. Even today, Joan faces daily worries about his future. “No one can tell me if he’ll have a normal life span,” she says. not even Michael’s most experienced care workers can offer a clue.

The Edge family are well named: throughout Michael’s life, they have been pushing at boundaries.

In the Dorset garden Michael stands up from the photo album and covers his ears with his hands. There are too many people he doesn’t recognise here today, and they are talking too much. He calls out, “Dee-Dee”, and stamps along the patio, moving with exaggerated determination. “Dee-Dee!”

A woman appears and he studies her face intently for a moment. Then, with a relaxed swagger, he returns to his house, goes through the French windows into his sitting room and disappears. “He takes his cues from me,” says Deanna Zebedee, one of Michael’s favourite carers. “If he’s stressed, he looks at me and sees I’m calm and he’s fine again.”

Deanna started working for the Wessex Autistic Society last July and, although she had not cared for adults with learning disabilities before, she and Michael hit it off instantly. It’s a misconception that people with autism are indifferent to the personalities of others, and doubly wrong to assume that someone who can barely talk cannot have a sense of humour. Michael and Deanna laugh at the same things and share jokes. “The other day in a café,” Deanna says, “he sat me down at one table and then took his plate to the other end of the room, so that the only way I could see him was to lean round a corner. And the whole time I was peeping at him, he was looking back, laughing at me!”

A fish supper in a café is one of Michael’s pleasures. his order never changes: cod with a slice of lemon, chips and beans, two sachets of ketchup, an orange juice with two straws and sticky toffee pudding with ice cream to follow. Deanna knows better than to try to change that pattern: if he was ever served with pizza, for instance, or sausage and mash, Michael might become afraid that he couldn’t have fish again, and refuse to go back. Instead, she is encouraging him to eat outside during the summer, under a café umbrella, or in the park, or (her most recent success) on a picnic bench overlooking the sea. “We get on really well,” she says. “I give him time to think things over, time to process what’s happening.”

The National Autistic Society (NAS) believes that around one in 100 people have autism in Britain today, a total of more than half a million. in America, the prevalence is similar, reckoned at one in 110. But in the early 1960s it was almost nonexistent: by February 1964 the newly formed Society for Autistic Children, precursor to the NAS, reported in the Guardian that it knew of just 2,000 cases. this was partly because British psychiatrists had been reluctant to apply a diagnostic term that imputed blame to the parents: “autism” was a word coined by American medics who theorised that loveless families and “refrigerator mothers” could induce total withdrawal in children. its most vocal advocate was Bruno Bettelheim, a survivor of Dachau, who claimed that rigid, emotionless parents were the equal of concentration-camp guards.

In Britain, paediatricians used blanket diagnoses that covered behavioural problems and learning difficulties. But, however it was described, cases on the “broad autistic spectrum” (as it is termed today) were becoming far more visible in Britain after the war. one leading psychiatrist, Gerald O’Gorman, told the Royal Society of Medicine in 1952: “The greatly increased attention which has been paid recently to the subject of childhood psychosis has prompted some pertinent questions: ‘What happened to all these children in the past?’ and ‘Why haven’t we seen them?’”

Autism in Britain was invisible 100 years ago. There are two well-known accounts of children in 19th century France who certainly appear autistic, and a superb description by Mark Twain of a blind youth on a US train who could not talk but who rocked wildly in his seat, imitating the noises of the express: “Clattering, hissing, whistling, blowing off gauge-cocks, ringing his bell, thundering over bridges with a row and a racket like everything going to pieces, whooping through tunnels, running over cows… for three dreadful hours he kept it up.” his report sounds very much like autism – but in the whole of British Victorian literature there is nothing to match it.

The full name of the first British child to be documented with autistic behaviour is not known; we have only his initials, from his case study. “JS” was born on 13 October 1933 and taken at nine years old to Great Ormond Street Hospital, where he was seen as an outpatient. He had been a normal baby, but after his third birthday began to lose interest in his parents, his toys and his surroundings, and became withdrawn. He stopped speaking. Fits of rage and terror became frequent. After he was woken by a firework he became afraid of going to sleep, and he could not go to school because he clung constantly to his mother. She was devoted to him, but the constant attention and probing from the specialists upset JS so badly that he became unmanageable. He was placed in a mental hospital, where he would leap across a room to avoid human contact, and where his only noises were echolalia – imitating the sounds he heard around him, like Mark Twain’s railway companion.

JS had one very ordinary trait – a sweet tooth. He could hear a mint wrapper rustling in the next room. He liked to suck his food and swallow it without chewing. one day, aged 28, he choked to death.

That case study was presented in the British Journal of Psychiatry in 1963 by Dr Mildred Creak, one of the pioneers of autism research in Britain. She began working at Great Ormond Street in 1942, the year JS was first seen there. But her fascination with psychiatry went back 20 years, to a Quaker hospital in York called the Retreat. a Rockefeller Scholarship in the early 30s took her to America, where she worked with the first doctors to specialise in childhood mental disorders. Foremost among them was Leo Kanner, who published the first formal description of autism in 1943 after studying 11 American children, all born around the same time as Britain’s JS.

Creak, who was both a Quaker and a former wartime major in the Royal Army Medical Corps in India, knew of Kanner’s work and didn’t like it. She admired his “excellent clinical description” but she felt it focused on a narrow range of disorders without defining them, and at the expense of more nebulous mental problems. By 1956, though, she was prepared to identify autism where she saw undeniable instances of “Kanner’s Syndrome”. She began working with Gerald O’Gorman to pin down what was, and was not, autism. they compiled a nine-point checklist including: “sustained impairment of interpersonal relationships”; “unawareness of personal identity”; “preoccupation with particular objects” and “striving to maintain sameness”. Abnormal sensitivity to sound and “islets of skills or knowledge” were other factors. the list was published in 1961 and without it Michael Edge would probably not have had his diagnosis.

“I was determined not to give in,” Joan says. “I don’t know how our marriage survived, but it did. My husband wasn’t a particularly tolerant man, but he was wonderful with Michael. And my dad, he was marvellous – he used to spoil him and bring sweets every Sunday and play Michael’s LPs for him. Michael used to love the groups. He couldn’t speak, not to answer a question or tell you something, but he could read all the names of the bands on the album covers… the Beatles, the Stones. He absolutely loved music and so did I, so we were always singing and dancing in our house.”

A family friend ran a nursery school near their home in Essex but, though he attended only in the mornings, the staff could not cope with Michael. Intelligent and alert, he was desperately frustrated that he could not express his emotions or communicate even his most basic needs. Many people made the assumption that, because he could not talk or use sign language, he was scarcely sentient. But if a complex jigsaw was put in front of him he could do it without looking at the picture on the box-top; he could even do it with the pieces face down. “He made it look easy,” Joan said. “But woe betide us if there was a piece missing. We’d all be on our hands and knees, frantically looking for it, and he’d be very distressed if we couldn’t find it.”

At the urging of a social worker from UCH, Cliff and Joan sent their son to a school for the deaf at Belmont Hospital in Surrey, hoping he would benefit from speech therapy. He boarded there and the couple visited at weekends: “It was very hard: he was only six, and it was so difficult to leave him.” Michael learned to speak a few words, but his teacher saw how bitterly he missed his home and petitioned Essex’s local authorities to set up a school for autistic children. they did: a unit for four pupils opened in Romford in 1964. But if it was difficult to find psychiatrists who understood autism, it was almost impossible to find teaching staff. “One woman there bullied Michael dreadfully,” says Joan. “She was pulling his hair whenever he screamed. He was so unhappy and when he was nine I practically had a breakdown, just from the way he used to yell when he came home.”

This was the pattern that JS and his family had followed: a mother at her wits’ end asks for professional help and the intervention makes the child worse – so distraught that he has to be placed in an institution. But Joan was desperate not to give in: “I’d never forgive myself if Michael had gone into a hospital then. I know what would have happened – he’d have been drugged up to the eyeballs.”

Her older son, Terry, who was 14, gave quiet support and refused to complain. “It was difficult for Terry because we could never go out like a normal family,” Joan says. her father, Ernie, came over to look after his grandson for a couple of hours every week, so Cliff and Joan could go for a walk and a drink together. And Cliff himself was often at home during the day because he worked shifts with a railway maintenance team that repaired tracks by night.

“His employers never helped – they didn’t do that in the 60s,” Joan says. “It was an utter nightmare. the people next door had a dog that barked all the time and it used to set Michael screaming and screaming. These neighbours were church-going people, but they were horrible about it. they just said Michael ought to get used to the noise.”

At her lowest point, Joan blamed herself. though there was no evidence that autism was hereditary and no other sign of it in her family, she felt certain she was somehow responsible for her son’s condition. “The doctor told me not to be silly, it could have happened to anyone. But I thought it was my fault.” a local authority psychiatrist, Dr Vincenzi, who argued passionately that children who were parted from their parents would never overcome behavioural problems, managed to place Michael at an ESN (educationally sub-normal) day school. Even this was only half a solution; the school had no provision for autism.

Joan’s lifeline came, not from the authorities, but from a friend, Hilda – ”a placid sort of person, very patient”. Michael responded to her calm, quiet voice and Hilda offered to sit with him for a day each week, so that Joan could find work as an agency temp. “I used to operate a calculating machine and I got odd days’ work. I might feel like death warmed up going in there, but by the time I came home I felt wonderful, because I’d got away from the house. And I gradually got better.”

In 1968 a school opened in Gravesend, Kent, specifically for autistic children. Michael became a weekly boarder, coming home for weekends and holidays, and stayed until he was 20. the family started to take breaks together, staying in a chalet in Norfolk. “Cliff was so good with him, taking him to the pub for an orange juice and some crisps – the pub had a jukebox and Michael loved that. But wherever we went, we were ruled by his routines. He had to do the same thing every time. If he wanted to turn left, we could never turn right.”

With Michael at school during the week, Joan and Cliff began raising funds for autism charities. Their first venture was a beetle drive – the 70s version of a Trivial Pursuit party. After that came the dances, with the amateur band from the Ford plant at Dagenham, and then the quizzes. they could raise several hundred pounds in an evening, and over the years Cliff and Joan collected more than £10,000 for charity.

A home for adults with learning difficulties in Colchester looked a hopeful placement for Michael when he left school. But he was miserable there and he settled only when an NAS centre in Wessex offered him a home. at first he was unwilling to leave his room; gradually, his carers encouraged him to eat with others, then to leave the house, on expeditions to the park or the shops. “When he first came here, he found it very difficult to understand where he was, what he could expect of us,” says Mandy Gibson, who has worked with Michael for more than 20 years. “So he wouldn’t interact with anybody. And it was our aim to help him get out into the community, to go shopping, to go swimming, to take part in different activities. It’s been a long, slow process, but he’s got there. He’s changed so much – if he’s got a problem, he can find the words to tell us. He copes with so much that, years ago, he couldn’t have managed at all: going to Tesco, visiting local attractions, taking a drive round the countryside with staff. He’s doing exceptionally well.”

Michael also returns to Essex for regular visits: “We kept all his old LPs and his gramophone, though it’s broken now,” Joan says. “He used to play them when he came home, but only two records each day. that was his self-imposed routine… except at Christmas. On Christmas Day he could play them as many times as he liked!”

Michael Edge’s life is like the prototype for my son’s. like Joan and Cliff, my wife and I have two sons. our younger boy, David, is 15, and profoundly autistic. He likes videos instead of vinyl, but the attraction is the same: records and movies never change, by a single note or a frame. they are dependable, unlike the real world. certain noises are unbearable: not dogs, but ambulance sirens. like Michael, my son can be calmed by a drive in the car, or driven to head-banging frustration if he is misunderstood.

When David was being assessed, aged two-and-a-half, a consultant in his 60s came and stood next to me as I watched my son through a two-way mirror. I asked him if he’d always specialised in autism. “Not really,” he said. “You hardly used to see it, years ago. If you did, the child would go into an institution by the age of five, and nature would take its course. I sometimes think that’s still the kindest option, for the family as well as the child.”

“When you say nature would take its course…”

“Well, there was a lot more TB around in those days,” he said.

When David is Michael’s age, I shall be 86. the fear of what will happen to him, and who will care for him, is constant. to watch Michael with his mother in his village garden brought a rush of reassurance, a sense that someone has already made a path for us to follow.

“I think he’s happy these days,” says Joan. “He’s much more relaxed, because he can do everything in a set order. when he visits me at home, he has to go round each room, touching the doors so many times, and then he feels safe. And every Thursday evening we talk on the phone – not a proper conversation, but he can say lots of words now. the staff at Wessex Autistic Society have helped him along more than I could have believed possible. And at the end of every call, he’s got this routine we have to follow before he can put the phone down: he says, ‘See you,’ and I have to say, ‘See you,’ and we repeat it eight times.

“He lives in the past, always talking and thinking about things long ago. those things can’t change, you see. when my husband died, Michael couldn’t understand at first, but he does talk about Daddy Edge now. Autistic children are quite childlike, but they’re lovely. Michael could be a lot worse. a lot of good things have happened, too. I wouldn’t have missed it for anything, really.”

Advocates for forced psychiatric treatment are using the death of Kelly Thomas, a homeless man with schizophrenia, as a rationale for Orange County to implement Laura’s Law.

This law is a controversial, costly measure that has not proven effective and would undermine the human rights of those labeled mentally ill. Mr. Thomas’ death following a beating by Fullerton police is heartbreaking, but Laura’s Law would not have prevented it.

Laura’s Law expands forced treatment by allowing people with a history of hospitalization or suicide attempts to be placed under court-ordered treatment, even though they are not presently a danger to themselves or others. those who fail to comply can be detained by police and hospitalized against their will, thereby increasing the possibility of more tragic incidents.

At the same time, Laura’s Law does nothing to stem violence against those with psychiatric disabilities or the homeless nor does it provide police training in crisis intervention that might have saved Thomas’s life. it also fails to address a root cause of homelessness – lack of affordable housing for those who must meet all their living expenses on $830 in monthly disability benefits.

Forced psychiatric treatment – including the use of forced medication, is often counterproductive: renewing trauma and steering people away from the mental health system altogether.

Moreover, many psychiatric medications have a long list of toxic, even life-threatening side effects. Research indicates that although medications may reduce symptoms in the short-term, long-term recovery rates from serious psychiatric disability are higher for un-medicated patients than for those maintained on psychiatric medications.

Thus, many people have rational reasons for deciding against using or staying on these medications.

One of the authors of this piece, who has 16 years of experience as a person diagnosed with severe mental illness, ended up in the emergency room twice because of debilitating side effects from psychiatric medications. she found medication ineffective; however, the individual psychotherapy she receives is alleviating her symptoms and helping her recover.

Currently, the law allows people who are a danger to themselves or others or gravely disabled to be involuntarily treated. Laura’s Law potentially subjects any person with a significant mental health history to involuntary treatment, greatly expanding the number of people deprived of their rights without any clear gain to them or society.

Fortunately, there is no need for such extreme measures. Evidence shows that the expansion of voluntary mental health treatment builds trust and is the most effective approach to recovery from mental illness.

Orange County already offers full service partnerships (FSPs), a highly successful approach to voluntary mental health treatment that includes community based recovery services, housing, 24-7 emergency response, and family and peer support. FSPs have reduced hospitalization rates by 50 percent, incarceration rates by 88 percent and homelessness by 70 percent. however, fewer than 600 people are currently served by FSPs in the county, while the number of people who would take advantage of these services if available is likely to be many times that number.

The FSPs are effective because they address critical needs of people with serious psychiatric disabilities who become homeless. We believe expansion of these programs in Orange County, combined with improved training for law enforcement staff in responding to people in crisis would be a successful twin-track approach.

Laura’s Law is costly to implement, burdens our courts, and is unlikely to make a positive difference in anyone’s life. in California’s economic climate, scarce public dollars are far better spent expanding proven voluntary programs and crisis intervention training. Ann Menasche is a staff attorney in the San Diego Office of Disability Rights California, which is currently investigating the death of Kelly Thomas. Charmaine Mahealani Asher is a member of the California Network of Mental Health Clients.

FORT BRAGG, Calif., Sept. 18 (UPI) — County supervisors in Northern California are considering changes in rules for mental-health diversion programs as they hunt for an elusive accused killer.

Aaron Bassler has been holed up in the deep woods of Mendocino County for four months after allegedly shooting two forestry workers — one of them a Fort Bragg city councilman — to death after he had been diagnosed with schizophrenia-like symptoms.

Now county supervisors are using the manhunt around Fort Bragg to take another look at the rules regarding court-ordered psychiatric evaluations and pretrial diversion programs.

The Los Angeles Times said Sunday that Bassler’s father, Jim, has urged changes that would force mentally ill defendants in the criminal justice system to undergo treatment beyond the initial examination, or at least inform family members of a potentially dangerous diagnosis.

“I am hoping there’s some kind of change made,” said Bassler. “He really wanted to hide his delusions from people. But being around him, it was a constant thing.”

Some mental health professionals urged caution, saying there has been no proven link between the killings and Bassler’s mental-health status.

A major question has been the small crop of opium poppies Bassler was allegedly tending in the area where the slayings occurred; however, officials note there were no significant clandestine marijuana patches in the area.