it is possible that psychiatry is actually on the leading edge, not lagging behind. they are actually dealing with the kinds of difficulties that have been much more complicated and will have to take into account many more things besides molecular activity inside the body like what goes on in society and how income is distributed and how people experience their lives. >> so one of their strategies than has been to say that what we used to use, roman numerals, now we're switching to eric, and this is so that we can be more like technology and have -- they have been saying that this is a living document. what does this mean? what does it mean for the credibility? >> nobody knows. i wish i could answer that question. lasted many times to many people and i don't know. i mean, the idea is they will beta tested. with the problem with beta testing, anyone who has ever bought a brand new computer program, it is messy and unpredictable and actually turns the consumers, in this case people with mental disorders and to basically guinea pigs which has a whole different resonance

we have other members of ours in psychiatry at sf general, one has work witched the jail psych unit, he practices in the community, he say that is many of his patients receive their meds through healthy sf, if we cut healthy sf, we're going to be throwing a lot more people off of their psych medications and this results in yet another psych cut to a city that has been cutting care to psych for at least the past decade. >> thank you. 30 seconds, my apologies, it's been a long day. >> it's okay, supervisor. the last part of that is the bigger question is why health care costs so much. why should san franciscans and local businesses be set up against each other when huge health care monopolies need a hospital corporations, like kaiser claim non-profit status, do not pay taxes and drive up the cost of care while local government then makes cuts because of the reduced budgets. thank you. >> thank you, sir, next speaker. >> (speaking spanish). >> good afternoon, supervisors, my name is maria, i'm a member of young workers united, we represent resident workers in san francisco, for the majo

we know that this year it did not make it into the diagnosis of dsm-iii as a real psychiatry issue.he big issue is, is it a real addiction or is it a hypersexuallity. too much libido. that's what the debate is. when you talk about addiction, you're talking about real biologic changes in the brain. something happens when somebody has an alcoholic or gambling problem. this to me sounds more like obsessive-compulsive behavior with concentration on sex. somebody that has a real problem cannot get away with it. just like the obsessive person keeps going at it. these are people that may spend a lot of money. they know they have a problem. what's interesting? sometimes when they get caught, they're almost happy that they're through their misery. it's a very deep psychiatric issue. but i'm not sure if it's a real addiction. >> for people who know someone who have it themselves, what is the treatment, dr. siegel? >> i want to add to it something david is saying. a doctor out of ucla who's been the lead researcher here says that basically what she's looking at is the kind of addiction you mig

i don't have a lot of faith in psychiatry as a science.of the drugs you're pushing are interesting... and i'm all for messing around with brain chemistry. i mean, that's how i got through high school. but in my experience, popping pills doesn't relieve social anxiety quite as well as, say, bourbon and marvin gaye. now i get it. you're desperate and i'm full of hooey. so in the words of marvin gaye... "what's goin' on?" everything i say is confidential, right? whatever you say, stays in this room. kind of like vegas. well, except there's no way you're leaving here with more money than when you came in. yeah, like vegas. anyway... last night i'm out with my stupid, lame-ass brother... sounds like you've got some anger towards him.

gary bond, professor of psychiatry, dartmouth psychiatric research center, lebanon, new hampshire; peggy burns, eap counselor, employee assistance program, university of maryland medical system, baltimore city, maryland; neli vasquez-rowland, president, a safe haven, chicago, illinois. of those individuals that are unemployed, there was about a 15.7 percent rate of drug dependency among them. of the ones that are employed with a drug dependency, there were 23.3 million people overall, and about 49.8 percent of them were employed. and from the mental health community, there were 6 million people who were served by mental health authorities across the nation, and roughly 21 percent, or about, of the 6 million, were employed. what does that tell us? what types of challenges, david, do these individuals present as they approach the employment marketplace? well, that's telling me that, actually, most people that are, that are served by my agency, which provides welfare or tanf services or homeless services, do not have mental health or substance abuse problems. there- but the percentage is a

andirector of psychiatry the law. [applause] >> thank you everyone. this is part of a course we decided to open up, so i will continue to play professor here arei will assume all of you just sitting in. you know law professors call on people, so stay awake. the problem of mental illness mentalme -- excuse me, illness and violence and guns is really part of suicide more than and it's really quite right. i noticed that the suicide is dramatically understudied. jeff is doing some exciting studies in academia on the of gun control and suicide and you had a slide that on that. something maybe later we can ask you to look at that? here's a question. if most violence is not a function of mental illness, if that is not suicide, does a mental health scholarship have anything to say about that? only about 4% of homicides have anything to do with mental illness, is it a scholarship issue? it's true that violence is not causing serious mental illness and now we are thinking things like schizophrenia. jeff did a good job of showing us that there might be a agencie

he is a professor of psychiatry and behavioral science at duke university.althertise is mental services effectiveness research. he has received numerous awards for his outstanding contributions to mental health research and has written numerous papers. 175 comes to mind. perhaps the country's leading authority on the link between mentale and severe illness. [applause] >> i would like to speak with you for a few minutes tonight on the link between violence and severe mental illness, gun violence and mental illness. in the context -- my slides are automatically advancing. in the context of the other causes, the other important causes of violence in our society. and what such an understanding might imply for the product of developing better laws and policies that will be both more effective and fair. in terms of reducing gun violence but also avoiding sexually reinforcing the stigma that goes with the unfortunate understanding our belief in the public mind that all people with mental illness are dangerous. which is the cause of a great deal of stigma and discri

[laughter] the chinese people at that point see psychiatrist, was thatted why of psychiatry new to you? >> right. how can a person be depressed when she doesn't feel depressed? >> a lot of what you talk about are events you wrote about in the book. two-thirds of the book are your life in chicago before you gain all this success, before you moved to california. talking op the phone the other day, you -- you talked about how difficult it was to write this second portion of your memoir, that you embarked on it, when you were a hot commodity, and it didn't work. talk about the difficulties of telling this part of your life story. >> well, after 20 years of making a living as an author, and sitting next to jkrowling, i, as an author, i start to realize the asset of my life. it's how i approach it. by now, i know the right way to write the book. the book ought to be written, but the point is do i have the courage. pickedded daughter says if you leave me anything leave me your stories, but not the sugar coated or air blushed version. that was key. >> i read a lot of imb grant stories, told by

as you said i'm board certified in general psychiatry and child and adolescent psychiatry. i have experience in research and teaching. retired general. medical centers and medical regions. the federal courts and the office of the military commissions have qualified me as a psychiatric and medical expert. i have had multiple interviews with detainees, attorneys and spent nearly three months in guantanamo over the past four and a half years. i currently provide consultation and expert testimony as needed on current oar former detainees. i have reviewed files of nearly 50. the treatment of hunger strikers at guantanamo compromises the core ethical values of our medical profession. the a.m.a. has long endorsed the principle that every competent patient has the right to refuse medical intervention. the world medical association and red cross have determined force feeding through the use of restraints is not only an ethical violation but violates article three of the geneva. it destroys the trust essential for all clinical treatment including medical issues unrelated to force fee

was the idea of psychiatry new to you? >> right. i never heard of. i saw how can a person be depressed when she is not feeling depressed? >> so, i mean a lot of what you're talking about are, are events you write about in this book. two thirds of the book is your life in the chicago before you gained all the success, before you moved to california. talking on the phone the other day you talked about how difficult it was to write this second portion of your memoir. that you embarked right on it after "red a veil -- azalea" you were a hot commodity and it didn't work. talk about the difficulties of telling this part of your life story. >> well, after 20 years of making it, living as a author and being on best selling list and, getting to set right next to j.k. rowling in british book awards, i as a author i think i start to realize the asset of my life, i can make it as a book. just how i approach it. by now i know the right way to write this book. the book ought to be written but the point is do i have the courage? do i, so my daughter said, mom, if y

. >> professional richard bonnie is an expert in law in psychiatry.is considered a definitive textbook on the hinckley trial. >> as far as the prosecution was concerned that the dominant diagnosis was that this was a person with a narcissistic personality disorder that was infatuated with jodie foster, and what he really wanted was to be famous. but he was in touch with reality. as far as the defense was concerned, that he basically had a form of schizophrenia, that he was out of touch with reality, was descending into psychosis, that he was delusional. >> my interpretation of insanity goes back to the old mcnaughton rule. it's very simply, can the individual differentiate right from wrong? and clearly during my interview with john hinckley, he clearly understood the difference between right and wrong. >> the prosecution argued that hinckley had carefully planned the attack. >> the fact that he was able to travel, the fact that he did look at the schedule, put that type of effort into planning this type of event, that's premeditated activity. >> the d

national advisory council on drug abuse and he is also an associate professor of psychology and psychiatry at columbia university. he is a board member of the college on problems of drug dependency and has conducted 22 years of research and psychopharmacology and the science of drug addiction. dr. hart welcome to "after words." >> guest: thanks for having me. >> host: this is a fascinating book and let me say up front it's your personal story as well as the work or the results of your work in science. but the heart and soul of that i would say and if i'm wrong i hope you will tell me i'm wrong is that you are saying you know what, i think there are 20 plus million americans who do illegal drugs. >> guest: the national government conducts a survey every year and this has been known for some time. there are 20 plus million americans who use drugs on them regular basis. >> host: then you also say that over the generations over time people have always use drugs. >> guest: people have always use drugs and people will always use drugs. that's a fact. i will have to use that one. i didn't know th

psychiatry, thanks for coming all the way to the wild west to see us all. we appreciate it.that you have seen about one third of the country's history to it so i would like to know -- >> i have lived it. i have seen it all. >> that's right. so, the question is can we turn it around? because right now seeing one thing after another after another coming out of this government, and you think that's going to do it to it that's going to turn the american public around. they will start paying attention. what can we do to turn it around? [applause] >> i think the first thing we have to do is recognize the idea that any one citizen can't do much is simply not true. our system is rooted in the reality that for it to work, each of us has to participate helping to guide and direct the course of this country. some people say maybe i won't vote. there are so many in the neighborhood that vote the other way. why bother? it doesn't make any difference if you write a letter to the editor or stand up and you have some mayors and state or local officials. if people are picking on them on a fa

, for example towards those with mental illness there's a study done in the american journal of psychiatry done on that, but also stigma for those who might seek treatment and how policies and even this discussion how that might affect those folks. >> well, i could commencht on that briefly from the point of view of the research literature. and there is some -- there's literature on public opinion about people with mental illness. and you -- a couple things there. one is that about, you know, 60% of adults in this country believe that people with schizophrenia are likely to be dangerous, which is a huge exaggeration of the actual evidence for it. it's a little bit lower, about 40 if you think about anybody with mental illness. that's what people believe. second thing is that that attitude is actually tied to desire for social distance from people with mental illness and tied for coercion for social policies and there's a nexus of attitudes that are related to stigma, and those are damaging to people with mental illness and they actually have an affect that is just, you know, the opposite o

the national advisory council on drug abuse and is also an associate professor of psychology and psychiatry at columbia university. he is a board member of the college on problems of drug dependency and has conducted 22 years of research in the pharmacology and the drug addiction. dr. hart, welcome to "after words." >> guest: thanks for having me. >> host: this is a fascinating book. let me say up front it is a fascinating story as well as the work or the result of your work in science. but the heart and soul i would say coming and i hope if i'm wrong you will tell me, but you are saying you estimate there are 20 plus million americans who do illegal drugs. >> guest: the national government conduct a survey every year and this has been known for some time there is 20 plus million americans who use drugs on a regular basis. >> host: then you also say that over the generations of retired people always used drugs >> guest: that is a fact. >> host: so birds fly and men get high. >> guest: i didn't know that one. [laughter] >> host: okay but you're point in writing this book is a scientist that

and that's going to help solve one of the great dilemmas in all of psychiatry. what are the biological sub strays of these major psychiatric disorders. at the moments we know very little about them. ten years from now we will know substantially more. >> we'll only that if we have the right tools. the problem for us now is we're still, we're looking inside the black box. we're better than we were five years ago, much, much better but we've got to get better yet to be able to understand what is the precise circuitry difference between someone with depression, someone without. what is in autism that leads to the behaviors that we're seeing that are so obvious but when you look at the gross brain it's not there at all. >> i'm a little more optimistic than some of the other at the table. i think there are likely to be early wins for neurological disorders. and i can give you a couple of examples. right now for patients who have parkinson's disease as the disease progresses, they become less and less able to move, to speak. and one of the treatments that's used now is

interesting because like now a lot of times when people call medical clinics or if they call the psychiatries clinic i used to work at in michigan, they'll talk to somebody about research before they even see a doctor or something like that. the relationship between especially medical academic centers and research right now is very close. almost -- i mean, some people are seeing researchers and, you know, while they're in a time of crisis before they're even getting treatment and stuff. so i think these issues are going to be increasingly important as we move forward because it's how a lot of academic centers are getting funding now, different kinds of research. >> one of the things i've learned over the years is try to avoid drugs as much as you can. [laughter] try every other method that you can think of -- diet, whatever. [laughter] [applause] you know, there are times when you can't avoid it, you know? antibiotics. and if you can't avoid it, you can also ask questions like the questions harriet's -- first of all, you can ask how long has this drug been on the market, because if it just ca

of the national advisory council on drug abuse and also an assistant professor of psychology and psychiatry at columbia university. he is a board member of the college on problems of drug dependency and has conducted 22 years of research in narrow psychopharmacology and the science of drug addiction. welcome. >> sent you for having me. >> this is a fascinating book. it is your personal story as well as the result of your work in science. but the heart and soul of it i would say and i hope from wrong of tell me tell you are saying, you know what god 20 plus million americans who do illegal drugs. >> the national government conducts the survey every year. this has been known for some time. twenty plus million americans to use drugs and regular basis. >> and you also say over the generations people have always used drugs. >> people of always use drugs and people will always use drugs. that's a fact. birds fly, men get high. >> all have to use that one. i did know that one. >> but your point in writing this book as a scientist is that given these realities the impact that tracks have on social

i want to remind you he is not only in author 46 he's an associate professor in psychology and psychiatry at columbia university and a member of the national advisory council on drug abuse and a board member of the college on the problems of drug dependency and has done 22 years of research and d nero psycho pharmacology. carl hart come it has been a pleasure to learn about you. this is a biography as well as a book about drugs, society and race. congratulations on your book. >> that was "after words," book tv signature program and which authors of the latest nonfiction books are interviewed by journalists, public policy makers, legislators and others familiar with their material. "after words" airs every weekend on book tv at 10 p.m. on saturday, 12 p.m. and 9 p.m. on sunday at 12 a.m. on monday. you can also watch "after words" on line. go to booktv.org and click on "after words" in the book tv series and topics list on the upper right side of the page. >> now on book tv, richard beaman examines the landscape of the united states between the meeting of the continental congress on septem

as you said i'm board certified in general psychiatry and child let adolescent psychiatry and have extensivetired at the rank of brigadier general medical centers and medical regions. the federal courts and the office of the military commissions have qualified me as a psychiatric and medical expert i have had multiple interviews, multiple interviews with detainees, advised attorneys and spend cumulatively three months at guantÁnamo over the past four and a half years. i am currently providing consultation and expert testimony is needed on seven current or former detainees. i've reviewed medical intelligence and military files of nearly 50. the treatment of hunger strikers at guantÁnamo compromises the core ethical values of our medical profession. the ama has long endorsed the principle that every competent patient has the right to refuse medical intervention. the world medical association and the international red cross have determined that forced feeding through the use of restraints is not only an ethical violation but contravenes common article iii of the treaty conventions. for spinning

there is little integration of primary care and psychiatry which beginning to change. an important federal study known for the comparison of psychotropic medications, the caton study, also found that a small minority of individuals were receiving care who had high cholesterol or high blood pressure and somewhere around 1/3 who had diabetes that were receiving the treatment. this is a death sentence. that's certainly goes a long way to explain some of those outcomes we have been seeing in terms of the mortality and morbidity of people with serious mental illness physical health care is a core service and behavioral health care systems have a basic responsibility to provide access to health care both for disease management but also for wellness aec you cannot lose that was recovery focus. management and integration of medical care for people with serious bill must should be part of our basic missions. showed you a slide earlier that helped us persuade our state in missouri why we should be the first out of the block. we were able to achieve the status under the affordabl

co-director of psychiatry and the law. [applause] >> thank you everyone.e decided to open up, so i will continue to play professor here and i will assume all of you are just sitting in. you know law professors call on people, so stay awake. the problem of mental illness and crime -- excuse me, mental illness and violence and guns is really part of suicide more than homicide and it's really quite right. i noticed that the suicide is dramatically understudied. jeff is doing some exciting studies in academia on the effect of gun control and suicide and you had a slide that mentioned something on that. maybe later we can ask you to look at that? here's a question. if most violence is not a function of mental illness, if that is not suicide, does a mental health scholarship have anything to say about that? only about 4% of homicides have anything to do with mental illness, is it a scholarship issue? it's true that violence is not causing serious mental illness and now we are thinking things like schizophrenia. jeff did a good job of showing us that there might

. >> i want you to stay with us and bring in gail, associate professor of psychiatry at new york presbyterian> pleasure. >> dana called anthony weiner stubborn. other people may say he's delusional. this wasn't having an affair -- extramarital affair. this, to me, is -- stranger because he's sexting pictures of his private parts to young women and he kept doing it. even after he resigned from congress. as dana says, but -- he will stay in the race and stick it out. what drives him? >> i would be embarrassed. >> you know, i -- i think the question really is going to come down to, you know, did he have treatment basically after all of this? because -- this reflects basically very purim pulse control. right? if you are caught and you are -- you have a career demise and you still feel compelled to do something, then your ability to control your impulses, you know, is very questionable. i think that -- voters do have a right to be concerned about that. about -- you know, are they going to elect someone who has really purim pulse control and urges that they cannot contain. however, people can chang

as you said i'm board certified in general psychiatry and child and addless nt psychiatry.e experience in research and teesming. retired general. medical centers and medical regions. the federal courts and the office of the military commissions have qualified me as a psychiatric and medical expert. i have had multiple interviews with detainees, attorneys and spent nearly three months in guantanamo over the past four and a half years. i currently provide consultation and expert testimony as needed on current oar former detainees. i have reviewed files of nearly 50. the treatment of hunger strikers at guantanamo compromises the core ethical values of our medical profession. the a.m.a. has long endorsed the principle that every competent patient has the right to refuse medical intervention. the world medical association and red cross have determined force feeding through the use of restraints is not only an ethical violation but violates .rticle three of the geneva it destroys the trust essential for all crin cal treatment including medical issues unrelated to force feeding. i

and little integration of primary care in psychiatry, which is beginning to change.ut one very important federal study that is largely known for the comparison of psychotropic medications, the study with adults who were challenge with schizophrenia, also found that a small minority of individuals were receiving care to have high cholesterol or high blood sugar, blood pressure. and somewhere around the third who have diabetes were receiving no treatment at all. this is a death sentence, which sorely goes along way to explain some of those outcomes that we've been seeing in terms of the mortality, morbidity of people with serious medicos to some basic principles its fiscal health care is a core service for people with a series meant it does. and behavior health care systems have a basic responsibility to provide access to health care. both for disease management but also for wellness and recovery. you can't lose that wellness and recovery focus. and at the management and integration medical care for people with serious mental illness should be part of our basic mission

psychiatry, thanks for coming all the way to the wild west to see us all. we appreciate it.t you have seen about one third of the country's history to it so i would like to know -- >> i have lived it. i have seen it all. >> that's right. so, the question is can we turn it around? because right now seeing one thing after another after another coming out of this government, and you think that's going to do it to it that's going to turn the american public around. they will start paying attention. what can we do to turn it around? [applause] >> i think the first thing we have to do is recognize the idea that any one citizen can't do much is simply not true. our system is rooted in the reality that for it to work, each of us has to participate helping to guide and direct the course of this country. some people say maybe i won't vote. there are so many in the neighborhood that vote the other way. why bother? it doesn't make any difference if you write a letter to the editor or stand up and you have some mayors and state or local officials. if people are picking on them on a fairl

a boardid i'm certified in psychiatry.n treatment, research teaching, retiredration, commo in medical centers and medical regions. the federal courts in the office of the military commissions have qualified me as a psychiatric and medical expert. i have had multiple interviews with detainees, advised attorneys and spent cumulative three months in guantanamo ba or the past four and a half years. i provide consultation and expert testimony if needed on seven former detainees. i have reviewed medical intelligence and military files of 50. the treatment of hunger strikers compromises the core ethical values of our medical profession. ama has long endorsed the principle that every competent patient has the right to refuse medical intervention. medical association and the international red cross have determined that for speeding through the use of restraints does not -- is not violation butl contravenes article three of the geneva convention. force-feeding undermines the position-patient relationship by destroying the trust that

as you said i'm board certified in general psychiatry and child adolescent psychiatry in and of extensive brigadier general commanding medical centers and magical -- medical reasons. the federal court in office of commissions have called bite me as a psychiatric and medical expert. i've had multiple interviews, multiple interviews with detainees advised attorneys and spent cumulatively three months at guantÁnamo over at guantanamo over the past four and a half years. i currently provide consultation and expert testimony is needed on seven and current and former detainees. i have reviewed medical intelligence and military files of nearly 50. the treatment of hunger strikers at guantÁnamo compromises the core ethical values of our medical profession. the ama has long endorsed the principle that every competent patient has the right to refuse medical intervention. the world medical association and the international red cross are determined that for speeding through the use of restraints is not only unethical violation but contravenes common article iii of the geneva convention. force-feeding

you're going to stay after school at my psychiatry school. >> steve: unfortunately because this happened a little scared. we've got an e-mail from terrified producer number one who says, this incident with brian has me shaken. i no longer feel safe going to work without a helmet. [ laughter ] i stay close to walls and peek around corners looking out for brian. just praying he won't be there with a basketball! am i normal or am i nuts? >> all right. let's get serious for a second. they're nuts! why? because i watched the video and i see brian suddenly springing into action, like a healer, comforting this child, showing empathy, showing how badly he feels for what was clearly an accidents. >> brian: clearly an accident. you saw his dad grab him quickly and also there is something else to reveal. titus is a full contact kid. he had a cut on the bask his head. he had fallen prior to his appearance. >> gretchen: watch out. don't admit that. you'll be accused of doing that. >> i know. here is the best part. i watched this with my wife and she said, is that his father? when she saw you comforti

he is a professor of psychiatry and behavioral science at duke university.is expertise is mental health services effectiveness research. he has received numerous awards for his outstanding contributions to mental health research and has written numerous papers. 175 comes to mind. perhaps the country's leading authority on the link between violence and severe mental illness. [applause] >> thank you and good evening, everyone. it's an honor and privilege to be part of this important conversation at stamford. i would like to thank you all for coming. youuld like to speak with for a few minutes tonight on the link between violence and severe mental illness, gun violence and mental illness. my slides are automatically advancing. sorry about that. in the context of the other causes of violence in our society, with such an understanding and what it might imply for it to be both more effect than fair in terms of reducing gun violence but also avoiding and reinforcing the stigma that goes with the unfortunate understanding or belief in the public mind that all people

schools maybe there is a consumer market for this and i think there would be much more rational -- >> psychiatryiculties have been a dysfunctional marketplace was the we had every state with different standards. so it's hard for anyone to take to scale what is working. now on a voluntary basis a huge amount of the state level, 46 states in b.c. praised standards so having a high bar for everyone and having a common hi are creates a level playing field folks can compete and folks can get out there and let the best ideas rise to the top so it is a huge opportunity going forward that literally has never existed in the history of education. >> our children are going to use the technology that's their. why not be more productive and me get educational. i very what i do each year based on the needs of the students come up the standards are still there and we are getting successful what we are doing. >> can you talk about the evidence that this is actually working in the classroom? it all sounds fabulous kids using their smart phones to learn to read how we know that it's working? >> we need to continu

a couple weeks ago we admitted a female veteran directly to our program from the inpatient psychiatry units with absolutely no weight. of -- absolutely no wait. >> we have not heard from you mcgough. do you want to add to that? >> enqueue, mr. chairman. we had to estimate the capacity of some of the programs that are women only and some that are asked gender. for the purpose of our review, we only looked at those .vailable for women we did obtain data on our site visits and we also looked at data that had to do with capacity. we were told when we were on site that these rogue rims were somewhat underutilized. -- that these programs were somewhat underutilized. timeframe,, the data provided by the aj -- ring this time frame, the data provided by vha reflected an occupancy rate 51%.ng from 42% through the programs that had a higher occupancy rate included bay pines, new jersey, and sheridan, wyoming. as far as your question about how long it takes to access the programs, we can get you that information. we reviewed 166 medical records as part of our review. in a report we do have the da

but a couple of weeks ago we admitted a female veteran directly to our program from the inpatient psychiatry unit with absolutely no wait. >> we haven't heard from you, miss -- do you have anything you want toed a to that? >> thank you, mr. chairman. as far as with our review we looked at 14 different programs, va facility programs. and we had to estimate the capacity because some of the programs are womens on and some are mixed gender. for purposes of our review we only lookedded a beds available for women with mst. our estimated capacity was approximately 600. we did obtain data, both while we were on our site visits and looking at va self-reported data that had to do with capacity, and we were consistently told the programs were underutilized. the time period was the first two quarts of fiscal year 12, and during that time frame, the data provided by va to northeast program evaluation center for these particular programs reflected an occupancy rate ranging from 42% through 81%. the programs that had a higher occupancy rate included bay pines, lionses, new jersey, and sheridan, wyoming. as

couple of weeks ago we had admitted a female veteran directly to our program from the inpatient psychiatryunit with absolutely no weight whatsoever. >> we have not heard from you. did you have anything you wanted to add a maximum thank you, mr. chairman. as far as our review, we looked at 14 different programs and we had to estimate the capacity because some of the programs are women's only and others are mixed gender. it was approximately 600. we did obtain data and we will get the data. we were told that they were sometimes underutilized. october 21, 2011 through march 31, 2012. there are particular ranges up to 81% in the programs had a higher occupancy rate, including bay pines and new jersey and wyoming. as far as questions about how long it takes to access the programs, we can get you that information. >> within our report we do have the data certified by facilities and how long it took from the time that the patient was referred to the program. to the so the patient entered one of the residential programs. >> we are respecting how the va is doing things. it is a dramatic testimony a

and so the third myth is really how we deal with race-based misdiagnosis in psychiatry or mental health. our approach is to make the clinician more sensitive to racial or ethnic issues. but i show in any work that racist assumptions are imbedded in the structure of healthcare systems and i argue we need to teach the medical system to be what i call structurally competent rather than teaching individual doctors to be culturally competent or culturally sensitive. >> thank you. harriet, i just wanted to say a word before you get your chance. and that is, in our constitution, the one right that is listed in it, not the bill of rights but in the constitution, is the right to take out a patent. amazingly enough, that was built in by thomas jefferson. and your book, "deadly monopoly" questions some of that patenting, so tell us what you found. >> hello, harlem. very happy to be here. and excellent question. i would don't point out that thomas jefferson was not actually a fan of patents he didn't like them very minute. he didn't really want patents to be issued. he bowed to pressure but james m