From FB–A Revolution in Psychiatry-no more psychotropic drugs! Goodbye to this nonsense, says Norway.

Åsgård psychiatric hospital in Tromsø, Norway is a rather tired-looking facility, its squat buildings mindful of institutional architecture from the Cold War era, and in terms of its geographic location, it could hardly be located further from the centers of western psychiatry. Tromsø lies 215 miles north of the Arctic Circle, with tourists coming during the winter months to catch a glimpse of the Northern Lights. Yet it is in this remote outpost, on a hospital floor that had been closed but was recently refurbished, that one can find a startling sign on the door to the ward: medikamentfritt behandlingstilbud.

The translation to English: medication free treatment. And this is an initiative that the Norwegian Ministry of Health ordered its four regional health authorities to create.

Magnus Hald, at the entry to the medicine-free ward in Tromsø

The title—medication free treatment—does not precisely capture the nature of the care provided here. This is a ward for psychiatric patients who do not want to take psychiatric medications, or who want help tapering from such drugs. The governing principle on this ward, which has six beds, is that patients should have the right to choose their treatment, and that care should be organized around that choice.

“It is a new way of thinking,” said Merete Astrup, director of the medication-free unit. “Before, when people wanted help, it was always on the basis of what the hospitals wanted, and not on what the patients wanted. We were used to saying to patients, ‘this is what is best for you.’ But we are now saying to them, ‘what do you really want?’ And they can say, ‘I am free; I can decide.’”

This ward, while located far from the centers of power in western psychiatry, can be seen as a “beachhead” for dramatic change, said Magnus Hald, chief of psychiatric services at the University Hospital of North Norway. “We have to consider the patient’s perspective as equally valuable as the doctor’s perspective. If patients say this is what they want, that is good enough for me. It’s about helping people move forward in their lives in the best possible way, and we should help people move forward with the use of drugs if that is what they want, and if they want to sing a drug-free song, we should be backing them. We should be making that happen.”

As might be expected, this initiative, which has been long in the making, is roiling Norwegian psychiatry. It is a story of many dimensions: successful political organizing by user groups; pushback from academic psychiatrists; debates about the merits of psychiatric drugs; and an effort—most notably in Tromsø, but in other regions of the country too—to rethink psychiatric care.

“The debate is a lot like what you see when there is a paradigm shift threatening to happen,” Hald said.

The User Voice Is Heard

The Ministry of Health’s mandate for medicine-free treatment resulted from years of lobbying by five user organizations, which came together in 2011 to form Fellesaksjonen for Medisinfrie Behandlingsforlop (Joint Action for Drug-Free Treatment in psychiatry). What is particularly remarkable about this mandate is that it required the health ministry to override the objections of a medical profession and listen instead to a group of people that usually have little political standing in society.

When I asked the leaders of the user groups about this, they spoke—with some pride—of a political culture in Norway that strives to be inclusive of all groups. This practice has been evolving for decades, and several referred to a change in abortion law as a bellwether moment in this transformation of their society.

Prior to 1978, a woman seeking an abortion had to apply to a commission of two physicians for permission to end her pregnancy, with the application made by her physician. If married, the woman’s husband had to consent. However, with a strong feminist movement pushing for change, that year Norway passed an Abortion on Demand law, which gave the woman the right to make this choice.

That same year, Norway passed a Gender Equality Act, which stated that women and men should be given equal opportunities in education, employment, and cultural and professional advancement. Today, gender equality laws require that each gender represent at least 40% of the members of official committees, the boards of public companies, and local governmental bodies. In a similar vein, labor unions remained strong in Norway, and today businesses are expected to hold yearly meetings with their employees to discuss their operations and how they might be improved.

All of this tells of a country that was intent on creating a society where the voices of all its citizens could be heard, and this ethic spilled over into health care. It became customary for hospitals and other health care providers to set up “user councils,” with the understanding that “users should have a voice and should be listened to,” said Håkon Rian Ueland, leader of We Shall Overcome, a psychiatric survivor group. “And this isn’t only in psychiatric care. Users and the relatives of users in all areas of medicine should be listened to.”

While this provided fertile soil for the rise of user groups in psychiatry that would have access to politicians and the health ministry, their potential political power was mitigated by the fact that the various groups had different philosophies about psychiatry and the merits of its treatments. On the one hand, there was We Shall Overcome. Founded in 1968, it is best described as a psychiatric survivor group, intent on fighting—as its name indicates—for the civil rights of “ex-patients.” On the other hand, there are more moderate groups like Mental Helse, which, with its 7,500 members, is the largest mental health organization in Norway. For the longest time, these differences made it difficult for the user groups to successfully lobby the government for change.

“We don’t agree on anything,” said Anne Grethe Terjesen, leader of LPP, a national association for families and “carers” in mental health. “So the government says, ‘you want this, but there are others that want that.’ This allowed them to ignore us.”

However, during the past 15 years, all of the user groups watched with dismay as one particular aspect of modern psychiatry—an increase in forced treatment—took hold in Norway. At least one study found that Norway has the highest rate of forced treatment of any country in Europe, and such compulsory orders regularly follow discharged patients into the community, which user groups see as both shameful and horribly oppressive. Today, outpatient teams come to a person’s home to ensure compliance with an order to take medication, which can be for “life,” the leaders of the user groups said.

“That’s the problem,” Terjesen said. “Once they have documented that you have to use the medication, it is very, very difficult to come off that order. If you say you don’t want it, you can complain to a commission, but most lose there.”

Added Per Overrein, a leader with a user group called Aurora: “I have never heard of a patient winning” at a hearing.

In 2009, Grete Johnsen, a long-time mental health activist, joined with other activists to write a manifesto for change titled Cooperation for Freedom, Safety and Hope. “We wanted to create an alternative to psychiatry,” she said. “We wanted to create something of our own. Our goal was to create a place, or a center, with freedom and without forced treatment, and without medication being the center of care.”

In fairly short order, five diverse organizations joined together to lobby for such change. Much like Mental Helse, LPP is a more moderate organization. Aurora, We Shall Overcome, and White Eagle all come more from the psychiatric-survivor end of the spectrum.

“The groups are very different, and so it took quite a bit of discussion about how to say things, and how to come across to different levels of government, and how to pick the best person to come across with a united, unified message,” Ueland said.

Although the groups were focused on ending forced drug treatment, they didn’t think that they could achieve that goal, and so they focused on getting the government to support “medication free” treatment for those who didn’t want to take the drugs. This was not such a radical request, as it fit with the principle that hospitals and other health care providers should listen to “user” groups and develop care responsive to their wishes. Starting in 2011, the health minister began publishing a “letter” each year telling the country’s four regional health authorities to set up at least a few beds that could provide such care. Yet, year after year, the minister’s letters were regularly ignored by the four authorities, Terjesen said.

“They wouldn’t listen. The hospitals weren’t doing anything. Nothing happened. We were very frustrated. No one in Norway cared.”

And then, she said, “something happened.”

The “something” was a cascade of negative news about the state of psychiatry in Norway. There were stories about “illegal things happening in psychiatric wards,” and how “belts were being used so much more often,” Ueland said. A study reported that forced treatment was 20 times more common in Norway than in Germany. And outcomes for psychiatric patients weren’t particularly good, either.

The leaders of the Fellesaksjonen for Medisinfrie Behandlingsforlop

“We were lucky,” Terjesen said. “Treatment was not good. If treatment had been very good, it would have been more difficult. But everything coming from the government now was that we do not have good results, people are dying early, we are using much money, the users are not satisfied, the whole package is not good. The minister says we cannot have this.”

On November 25, 2015, the Norwegian Health Minister, Bent Høie, issued a directive, which effectively transformed the “recommendation” contained in previous letters into an “order.” The country’s four regional health authorities, in “dialogue with user organizations,” needed to create a plan for “treatment measures without drugs.”

“Many patients in mental health care do not want treatment with medications,” he wrote. “We must listen to them and take this seriously. No one will be forced to take medication as long as there are other ways to provide the necessary care and treatment. I think the creation of drug-free treatment is too slow, and have therefore asked all the regional health authorities to have established this offer (of drug-free treatment) by 1 June 2016.” In addition, he said, the authorities should offer “a planned reduction of drug therapy for those patients who want it.”

The health ministry had put its stake in the ground. This initiative fit in with a larger goal that Høie had set in one of his earlier letters. “We will design a health care system that puts the patient at the center . . . it involves giving them rights . . . Patients’ rights are to be strengthened.”

The Resistance from Psychiatry

The leaders of Fellesaksjonen speak today about how this was a “brave” thing for Høie to do, and how it showed that he was “a listening person.” But they also knew that this mandate, which raised questions about the merits of antipsychotics and other classes of psychiatric drugs, would stir opposition from many corners of psychiatry, which proved to be the case. No regional authority met the June 1, 2016 deadline, and in many corners of Norwegian psychiatry, psychiatrists spoke out in fierce opposition to it. Tor Larsen, a professor of psychiatry at Stavanger University, publicly derided it as a “giant mistake.”

“Drug free treatment is not only a bad idea, but simply may end up being an introduction of systematic malpractice in Norwegian psychiatry. At worse, lives lost,” he wrote. “The most seriously ill often lack understanding of their disease . . . (they) do not see themselves as sick.

Comment:  if the patient does not see themselves as “sick”, and they like themselves the way they are, isn’t this a human and civil right?  If the patient has been on the drugs and finds they don’t like the way they are on the drugs, isn’t it the patient’s right to be the way that works best for them, as long as they are not a harm to others, and they aren’t harming themselves physically?

The freedom of choice the health minister now wants to impose will thus lead to a lot of very seriously ill people being deprived of the right to the best possible treatment.”

This was the core argument repeatedly made by psychiatrists against the initiative: the drugs were effective; there were no non-drug treatments that had been shown to be effective for psychosis; and patients who didn’t want the medications didn’t understand that they were ill and needed the medications.

This initiative will “create an attitude that largely supports a pronounced skepticism about drug therapy,” wrote Jan Ivar Røssberg, a professor of psychiatry at Oslo University, in Aftenposten, Norway’s largest newspaper. “My fear is that the measure will mean that people with psychotic disorders come later to optimal treatment that you know works . . . I cannot be responsible for the teaching of psychiatry at the University of Oslo that would support this development” of medication-free treatment.

The debate has continued since then, and even after Tromsø opened its medication-free ward in early January, there remained considerable question of whether other regional authorities would comply with the spirit of the health ministry’s directive. The Norwegian Psychiatric Association, for its part, officially decided to “keep an open mind,” and address the topic at its annual meeting. “Do antipsychotics work?” wrote Anne Kristine Bergem, president of the association. “Or do they not have the effect we have been led to believe?”

The Donald Trump of Antipsychiatry

The association had identified the scientific question at the heart of this initiative. Forced treatment meant forced use of antipsychotics, and with the controversy ongoing, a non-profit organization, Stiftelsen Humania, joined with Fellesaksjonen to organize a public debate on this initiative, which was held on February 8 in Oslo. They titled it: “What is the knowledge base for treatment with or without the use of psychotropic drugs?”

“I would like to see this argued,” Ueland said, in the afternoon before the debate. “They say they want proof that alternatives work. I say, ‘why don’t you provide proof that your treatment works? I have read a lot of articles and a lot of books, and I still have not seen proof that your drugs work. I have seen proof that they make people feel ill, that they take away their emotions, that they treat symptoms, but give me proof that they work on psychosis, that they work on what they call schizophrenia.’ I want to see that before they sit there and tell us that we can’t have drug-free treatment.”

Comment: This is very true.  No one has ever truly been cured from psychiatric illnesses by the use of opiods or other prescription drugs. They are not cures. They are masks, which work primarily by making the patient sleep most of the time.

Einar Plyhn

The leader of Stiftelsen Humania is Einar Plyhn, a businessman whose company, Abstrakt Forlag, publishes academic texts. He came to this battle after suffering the loss of both his wife and son to suicide, neither of whom had found relief from psychiatry. “My experiences as bereaved by suicide two times brought me into a psychiatric ward myself, where the only treatment I got was medication and ECT,” he said. “After finally getting off all the meds, I started to publish books critical of psychiatry, and arranging conferences.”

One of the books he published was a Norwegian translation of Anatomy of an Epidemic. In that book, I had written about the long-term effects of antipsychotics (concluding that the research showed that, on the whole, they worsen long-term outcomes), and so Plyhn had asked that I speak at this debate. The other speakers were Ueland, Røssberg, and Jaakko Seikkula, who presented on Open Dialogue Therapy in northern Finland (where psychotic patients are not regularly placed on antipsychotics). Magnus Hald was part of the panel.

The debate took place at the Litteraturhuset in Oslo, and a half hour before the auditorium doors opened, there was a large crowd of people waiting to get in, evidence of how the medication-free initiative had stirred up considerable public interest. The auditorium quickly filled, with the overflow crowded into an adjacent room, where they could watch the debate on video, which was being streamed on the Internet. The audience included mental health professionals, members of user organizations, and one or more representatives from the pharmaceutical industry.

Ueland spoke first, reading a powerful blog from a 25-year-old woman in a locked ward who described the trauma of being forcefully treated. Then it was Røssberg’s turn, and, it’s fair to say, he came ready to do battle.

Jan Ivar Røssberg

Røssberg said that three of the user groups were “antipsychiatry” organizations; argued that there were no non-drug therapies that had been proven to be effective as short-term treatments for psychosis; and criticized Seikkula’s published articles on Open Dialogue as scientifically worthless. He described me as the “Donald Trump of Antipsychiatry,” and while I wasn’t quite sure of the analogy being made, everyone understood it wasn’t a compliment. He then pointed to Norway’s TIPS study as proof that antipsychotics provided a long-term benefit.

This study was designed to test the benefit of early detection of a “first-episode of nonaffective psychosis.” One cohort had a “duration of untreated psychosis” of 5 weeks before entering treatment, versus 16 weeks for the comparison group. Both cohorts were treated conventionally with antipsychotics, and then followed for 10 years. At the end of that time, among the patients who were still alive and in the study, 31% in the early-treatment group were in recovery, versus 15% in the 16-week cohort. If antipsychotics worsened long-term outcomes, Røssberg argued, then the early treatment group—because they had 11 weeks of additional exposure to antipsychotics—should have fared worse.

“If you take a pill that shows you get a poor prognosis, then if you have an earlier start with a pill, you should have a worse outcome. Is that clear?” he said.

I presented next, recounting the history of science I had published in Anatomy of an Epidemic(and since updated), and then Seikkula reviewed the Open Dialogue program, with its good long-term outcomes. The panel debate was mostly more of the same, with Hald adding his thoughts to the mix. He raised a question that would seemingly resound with every psychiatrist.

“There are many patients that psychiatry doesn’t think need the medications,” he said. “But we don’t know who they are. And since we don’t know who they are, we could choose not to give anyone medication, or we could choose to give everyone medication. Psychiatry chooses to give everyone medication. We give neuroleptics to people that we see do not get better with their psychotic symptoms. But they still keep getting neuroleptics. So how come they keep getting neuroleptics if they don’t get better?”

Afterwards, I asked Plyhn his thoughts about the debate. I was a little dispirited, in large part because I thought it had shown once again how difficult it is to have a public discussion about the merits of psychiatric drugs, but Plyhn took a longer view. Shifts in societal thinking—which is necessary for this medication-free initiative to gain public support—come slowly.

“My impression is that there is a growing concern among some psychiatrists, psychologists and nurses regarding how evidence-based the expanding use of psychotropic drugs actually is,” he said. “The conferences we have had will hopefully contribute to some rethinking” of their use.

The TIPS Study in Review

After the debate, I did regret that I hadn’t found the time to discuss the TIPS study in detail, given that Røssberg had presented it as evidence of the long-term effectiveness of antipsychotics. The study had been designed to assess the effectiveness of early treatment, rather than the long-term effects of such drugs, and although there were patients in both cohorts who stopped taking antipsychotics, there had been no reporting of 10-year outcomes grouped by medication use. There also was reason to question whether the early-treatment group had better outcomes. The comparative group was older and more severely ill at baseline, yet their symptomatology was similar to the early-treatment group at 10 years and a higher percentage in this group were “living  independently” at the end of the study. But more to the point, the outcomes in the early-treatment group, which emphasized immediate and long-term use of antipsychotics, didn’t tell of an effective form of care.

This was a study of younger patients experiencing a first episode of psychosis, and often such episodes may clear up on their own with time. There were 141 patients in the early-treatment group, and at the end of 10 years, here were their collective outcomes:

  • 12 had died (9%)
  • 28 had dropped out and were lost to treatment (20%)
  • 70 were still in the study and had not recovered (50%)
  • 31 were still in the study and had recovered (22%)

In other words, once the outcomes for the patients who died or were lost to treatment were added to the findings, nearly 80% hadn’t fared well (if being lost to treatment is seen as a poor outcome.) This outcome stands in sharp contrast to longer-term outcomes with Open Dialogue therapy in northern Finland, where at the end of five years 80% are working or back in school, asymptomatic, and off antipsychotics. I wished that I had prepared a slide comparing the two, and asked the Norwegian audience which of the two programs they preferred to embrace.

That data alone would have made for a more interesting public discussion, but then, a few weeks later, a study was published that added new information about the TIPS study. In order to gain insight into the recovery process, TIPS researchers—a team that included Tor Larsen from Stavanger University—interviewed a sample of 20 “fully recovered” patients from their program. While many of the 20 said they thought antipsychotics were helpful during the acute phase of treatment, long-term use was “considered to compromise the contribution of individual effort in recovery,” and was “perceived to reduce likelihood of functional recovery,” the researchers reported.

Seven of the 20 fully recovered patients had refused to take antipsychotics from the beginning, and thus had “never used” the drugs. Another seven had stopped taking them, meaning that 14 of the 20 fully recovered patients interviewed for the study were off antipsychotics. Røssberg had cited the TIPS study as evidence that argued against the medicine-free initiative, but this outcome data told of “full recovery” in patients treated initially without antipsychotics and in patients who tapered from the medications, the twin forms of care that the initiative is meant to provide.

Rethinking Psychiatric Drugs

As the debate revealed, the implementation of the Health Ministry’s medication-free directive is in flux. In Tromsø, where Magnus Hald is the director of psychiatric services, the regional health authority has opened a ward dedicated to such care. In the rest of the country, the regional health authorities are setting aside individual beds for medicine-free care, and mostly reserving the six beds for non-psychotic patients, which means that the initiative isn’t serving as an alternative to forced treatment with antipsychotics.

Even so, the directive is a mandate for change, and the day after the debate, I drove with Einar Plyhn and Inge Brorson, one of the board members of Humania Stiftelsen, to Lier Hospital, 25 miles southwest of Oslo, to meet with the group at Vestre Viken Trust developing medicine-free treatment for the Southern and Eastern Regional Health Authority. Brorson used to work at the trust, which operates several psychiatric hospitals and provides services to a region with about 500,000 residents (about 1/10th of the Norwegian population), and he had helped stir up interest in the initiative by encouraging the psychiatrists and clinical staff there to investigate the medical literature regarding the long-term effects of psychiatric drugs.

Psychologist Geir Nyvoll, who led the meeting, began by referring to this body of scientific research. He had taken a four-month leave from work to closely study the research literature for neuroleptics, and then he and psychiatrist Odd Skinnemoen had presented their findings to the clinic. “Knowledge and awareness is the foundation of change,” he said. “This is where we are.”

As a first step toward creating such change, the trust is developing a “continual improvement program,” which it has titled “Right and Reduced Use of Medications.” Under the program, staff will prescribe psychiatric drugs in lower doses; carefully monitor drug side effects; avoid the use of medication when “treating normal problems in life, such as for negative life events;” and discontinue medications when they aren’t producing a good effect.

In response to the health minister’s directive, the trust has set up one medication-free bed at Lier Hospital for psychotic patients, and five such beds at two other hospitals for patients with less severe disorders. The trust is embracing the principle that “patients should have the right to choose treatment without medication,” said psychiatrist Torgeir Vethe.

“Every patient should have that possibility. And if a patient does not want to use medication, we should give the best help we can, even though we as professionals might say the best treatment is if you use medication.”

With these two “parallel” efforts now underway, the trust is organizing a research program to assess their effectiveness. The hope is that this will provide a better “evidence base” for the medicine-free initiative, and for “shared decision-making” with patients. “So we are wondering, are we on the threshold of something new?” asked psychologist Bror Just Andersen.

The trust has already developed a research record for what it calls basal exposure therapy, which it introduced in 2007 with the goal of reducing polypharmacy in “treatment resistant” patients. The belief behind this therapy is that hospitals “over-regulate” psychiatric patients, which means that staff are constantly controlling their behavior and helping them to avoid situations that provoke an “existential catastrophic anxiety,” said psychologist Didrik Heggdal. With basal exposure therapy, the goal is the opposite. They “under-regulate” the patients, forcing them to seek out staff when they want help and encouraging them to confront their existential anxiety.

“We give the patient freedom,” Heggdal said. “The level of control is extremely low at the ward. We treat the patient as an adult, as an equal and with the respect for a person who is there to work with himself or herself. We are there to assist them in this work with themselves. And when we do this, they mobilize their resources. We shouldn’t be surprised.”

In a study of 38 patients treated with basal exposure therapy (14 of whom had a schizophrenia spectrum diagnosis), their use of antipsychotics and other psychiatric drugs notably declined over the course of 13 months. Nine of the 26 who came into the study on antipsychotics were off such drugs by the end; 7 of 10 on mood stabilizers (antiepileptics) successfully discontinued those medications.

Vethe, Andersen, Heggdal and others spoke of how they thought they were entering a new era of care, which presented both opportunities and challenges. The challenges were familiar ones: colleagues who were skeptical of what they were doing; societal expectations that they use antipsychotics to handle “violent” patients; and worries that if they didn’t follow accepted standards of care and something went wrong, they could end up in trouble with regulators. Their concerns were many, but the bottom line, several said, was that they felt they were approaching “new and better times.”

“I have been in this business for 35 years as a clinical psychiatrist and director, and I am very grateful that I can take part in the change that is slowly coming to psychiatry now, because it was really, really needed,” said psychiatrist Carsten Bjerke, chief medical officer of Blakstad Psychiatric Hospital.

A Paradigm Shift in Full Swing

During the last few years, the Open Dialogue program in Tornio, Finland has come to be seen in the U.S. and other countries as a therapy that offers the promise of treating psychotic patients in a new way, which can lead to much improved long-term outcomes and involves prescribing antipsychotics in a cautious, selective manner. Perhaps not surprisingly, Magnus Hald’s thinking and beliefs—and thus the ideology present on the Tromsø ward for medication-free treatment—are closely aligned with the Open Dialogue approach.

Magnus Hald

Hald was close friends with Tom Andersen, a professor of social psychiatry at the University of Tromsø who is often remembered today as a founder of “dialogical” and “reflective” processes. They began working together in the late 1970s, and as they developed “reflective teams,” they incorporated the Milan approach to family therapy—which involved “systemic thinking and practices”—into their work. A key principle of this approach, Hald has written, is that “people change according to circumstances around them, and important parts of these circumstances consist of their family life in the local community.” The two traveled widely, teaching their new ways, and during the 1980s, they developed a relationship with Jaakko Seikkula and the Open Dialogue team in Tornio, Finland.

In subsequent years, the Finnish group was better able to document their outcomes with dialogical practices because they believed in psychiatric diagnosis, or at least believed in the use of DSM III diagnoses for reporting outcomes, whereas the Tromsø group did not, Hald said. In Tromsø, they also didn’t focus as much on limiting the use of antipsychotics, even though Andersen became “more and more opposed” to their use. “In terms of not using drugs, it was difficult to practice, and we didn’t have a real commitment to that part,” he said.

Even so, Hald had seen people with different types of psychiatric symptoms do well without drugs, and it was this past philosophy and experience that made him eager to embrace the health minister’s directive. “For me, it’s a possibility to organize something that is very clear cut. We should give people the possibility to choose not to be treated with neuroleptics when they are experiencing a serious mental problem. I always thought this was a good idea.”

With Hald enthusiastic about the mandate, the Northern Regional Health Authority has given the University Hospital of North Norway an annual budget of 20 million Norwegian kroner ($2.4 million U.S.) to run the six-bed, medicine-free ward at its Åsgård facility. This support allowed Hald and his hospital to start from scratch in hiring staff, with Merete Astrup, a psychiatric nurse, starting work as director of the ward last August. She had always wanted to work in a setting that provided patients with the right to “choose” whether they wanted to take medications, and that attitude is now present with all of the staff, which will number 21 when hiring is complete.

“I am so happy to be here, and know I am working the way my heart wants to work,” said art therapist and nurse Eivor Meisler. “I have been dreaming about working without medications.”

Tore Ødegård

Tore Ødegård, a psychiatric nurse, said that he had grown resistant to working on wards where people were regularly coerced, which is why he jumped at the chance to work here. “I would argue with people to get them to take their drugs. I was a part of that system, and now I am part of a system that does not have as its main purpose to give drugs, but to help people cope with problems, and do so without medication. I find that very fascinating, and it is a privilege to be part of this.”

And then Ødegård shrugged his shoulders: “But we really don’t know how to do this yet. People want to come here to get off drugs, and that can be a struggle, with different problems. The psychiatrist will say, ‘We have not been educated to get people off drugs, just to add drugs.’ We have to experience this, and learn how to get people off drugs.”

One of the staff who has such experience is Stian Omar Kistrand. He struggled with drug addiction from 2001 to 2002, which turned into bouts of mania, depression, suicidal thoughts, and hearing voices. His own path to recovery, he said, came “from searching into my history. I realize that I have to accept everything, and then I wake up one morning, and the world is totally different. I have seen the light about having to accept everything in my past and my life.”

Stian Omar Kistrand

He sees the people coming to this ward through that perspective. “The people who come here don’t want medication. This is their deepest wish. We say, ‘you can come to us, we want you as you are, come to us with your delusions, your illness, your thoughts and feelings and history—everything is good.’ We can meet them as they are. When people experience that, something essential happens. It takes away the mistrust and the fear, and says to the person, this is okay. And then the person can start growing. That is the most important thing.”

The ward is not yet serving as an alternative to forced drug treatment. The patients come here as referrals from other hospitals and psychiatric settings, and they can get transferred here only if they ask for this care and their supervising psychiatrist agrees to it. But once they are here, they are now in a patient-centered environment, which provides them with autonomy. There are no closed doors, and they are free to check themselves out and go home, if that is what they want. And while they are staying here, they can organize their time as they wish. One of the days I was there, the patients took off midday to go shopping in town.

The rooms on the six-bed ward are fairly spartan, each with a single bed and a writing desk, mindful of a dorm room at college. Meals are prepared in a kitchen on the ward and served in a large common room, where people often pass the time talking, the windows framing a soothing landscape of sea and snow-capped mountains to the west. The sun had made its first winter appearance only a week or so before I arrived, and yet the afternoon light now lingered for hours, bathing the mountains in a soft pink glow.

The therapeutic programs make for a day that unfolds in a fairly lazy, gentle way. Reflective therapy sessions, daily walks in the chilled air, and exercise in a gymnasium downstairs are all part of a weekly schedule. As this “therapy” occurs, the patients write up their own accounts of how it has gone, which become part of their health records.

“This gives us much better insight into the perspective of the patient,” said Dora Schmidt Stendal, a psychiatrist nurse and art therapist. “Normally (in past settings), I would write a report of a conversation, and I had thought that I was carrying the voice of my patients, but the voice of patients on their own terms is so different. We have to pay respect to their world when they get a chance to express themselves freely. This documentation makes us more aware of their perspectives.”

The patients also get to see what the therapists write. “You have to think very carefully about what you write,” Stendal said. “Patients may not agree, and then you can have a conversation about it. Their opinion matters. They are being taken seriously.”

Although the staff don’t use DSM diagnoses to describe their patients, the patients do arrive on the ward with such categorizations, and the four that were here when I visited could be described—in DSM terms—of struggling with depression, mania, and bipolar disorder, with one or two having “psychotic” symptoms. One spoke of being a lightning rod for evil in the world, while another told of terrors that come visiting in the night. Three of the four were willing to sit with me and tell their stories.


Merete Hammari Haddad, who is part Sami (the indigenous people of northern Norway), has lived with a diagnosis of “bipolar” for nearly a decade.

For the first part of her adult life, all had gone fairly well. She worked as a teacher and for a time as a school principal, and had earned a master’s degree, her research focusing on how people achieved their highest potential. She got involved in coaching others, residing for a time in Dublin and then Oslo. “I was succeeding,” she said.

Merete Hammari Haddad

Her husband is also part Sami, and some time ago, they moved back to Alta, a Sami community on Norway’s northern coast. Like many indigenous people, the Sami community has struggled to maintain its culture and self-governance, and when Merete moved back to Alta, she was intent on helping the community become more optimistic and happy. “I came in so cheerful, and I wanted to bring that to my community. But I was naïve. People didn’t want that, and I got attacked. I was so stupid. I turned negative about myself. My husband saw changes in me, only he doesn’t like to talk. I felt alone.”

Eventually, her husband had her hospitalized. She was told she was bipolar and that she would have to take lithium for the rest of her life. “I felt terrible on the drug,” she said. “I had no feelings. It was just like not living.”

Two years ago, she decided that she couldn’t go on like this anymore. “I needed to feel happy again. I wanted to feel glad again. And I accepted my feelings. I knew my sorrows, my fears. When I stopped, I could feel. I could let my tears flow, and I could fill the room with my sorrows. But nobody accepted it. Not my family, not my husband. I just had to trust in myself.”

The time that followed continued to be tumultuous. Her familial relationships, and her relationship to her community, remained strained. Even so, she continued thinking about how she could help “people realize their human potential,” and this past December, she started a company to pursue that end, obtaining a government grant of 100,000 kroner to do research on the topic. But as she pursued this business, her isolation from her husband grew. In late January, her husband concluded that she “was too enthusiastic,” and had her hospitalized.

“I was taken away with force in handcuffs,” she said. “And all I got was medicine, medicine, and they forced me.”

However, after a little more than a week in that first hospital, she successfully lobbied to be transferred to the medicine-free ward in Tromsø. After five days here, during which time she and her husband had confronted their problems, she was going home.

“My husband and I are so aware now of what was wrong. We found a new direction together. We were here to have a new dialogue, and now we have a new direction on how we want to be in the future.”

In dialogical terms, her distress had been caused by the “spaces in-between” her and her husband, and thus relief from that stress required mending that space, as opposed to fixing her brain chemistry. “I just needed a bed, food, and care,” she said. “Here I’ve been seen, I’ve been heard, and I can talk about everything. They never said I was sick. Now I don’t feel like there is something wrong about being human.”


When I was first introduced to Mette Hansen, during a group discussion in the common room, she had, with an impish grin, asked me a question that has stayed with me ever since. “When you look into the mirror,” she said, “what do you see?”

That’s a fascinating question for anyone to ask, and I thought it told of a sense of freedom that she had found from being on the ward. She could speak her mind here.

Mette Hansen

She had been first diagnosed with bipolar in 2005, when she was 40 years old and overwhelmed with work and—as a mother of three—family obligations. “I had no time for myself,” she explained. “I couldn’t do what people wanted me to do.”

She found lithium helpful, as it calmed her down. After a time on sick leave, she went back to work in a grocery store, and her life remained fairly stable for years. But then, in 2015, she was diagnosed with breast cancer, and after she had surgery, she spent several months struggling to sleep. In December of that year, she “got crazy again,” which led to another stint in a hospital. Then last September, with the side effects from the lithium piling up—weight gain, swollen hands, shaking, and thyroid problems—she decided she would like to taper off the medication.

This was a dramatic step for her to take. Her husband and her family didn’t want her to attempt this, because the drug was “working,” but she needed to take control of her life. “I said, after 12 years on lithium, I have to try this. I am my own boss, and if my husband can’t accept this, it’s his problem.”

The ward, she said, was giving her “quiet” and helping her stay safe as she tapered from the lithium. “I don’t have to care about my neighbors or my family back home. I can talk about different things, the illness and how to behave. Merete (Astrup) is the first who met me with politeness. It’s something different, and that is really nice. I love it here.”

Now that she was down to ¼ the dose of lithium that she had been on in September, she was also beginning to question whether such a powerful drug had been so necessary. “I am a little bit higher. I call it magic. Lithium is like wearing a life jacket when you are on a mountain trip and you are not going fishing. Why should you have a life jacket? Maybe you need a sleeping bag, or some wood.”

As she looks to the future, she now sees this ward as a refuge, one that she could return to if, after going back home, she struggled again. “It’s important knowing that I could come back here and decide for myself what to do,” she said.


Much of my time with Hanna Steinsholm was spent discussing her love for music, and our shared memory of reading Jack Kerouac’s On the Road, and thoughts about Sal Paradise and his manic friend, Dean Moriarty. “I love the illustration of mania,” she said at one point. “There is a lot of pain and tears to go for what you aim for. There is always dark in the light.”

Her entry into the psychiatric system had come as a child, when she was diagnosed with ADHD, and also had conflicts with other youth in her small town. “I was made fun of when I was a kid. I felt something was lacking in me when I was a teenager.” She subsequently was given other diagnoses, and she struggled in multiple ways: self-harming, fighting with thoughts of evil and with feelings of anxiety about making it in the world as a folk singer. “I always thought people expected me to write a song that would blow them away.”

Hanna Steinsholm

She felt it was important that she could be here without having to take Abilify, the antipsychotic drug she had been on. She needed some structure, and help with her self-injurious behaviors.

“Being on Abilify was boring and gave me a feeling of hopelessness, and I didn’t want to do that. I couldn’t think on the drug. And if I am going to be in the world, I have to be smart and be a version of me that people like. People know that I am sick. I have to prove that I can make something out of the destruction, and make something big out of it.”

She had been on the medicine-free ward for several weeks, and there was no real timetable for her to leave. “I have found it better than I thought I would. It is easy to go with the flow, and not have them question you all the time, like they do in other hospitals, and with their suspicions of you, thinking you will become a killer. This is taking some time to accept, that I won’t be questioned all the time.”

And then we returned to speaking about the escapades of Sal Paradise and Dean Moriarty, characters in a novel published 60 years ago and yet one that somehow remained so vivid in both of our memories.

The Challenges to Come

Such are accounts from the first few patients to be treated on this “medication-free” ward. But if this effort in Tromsø is going to have an impact in the larger world of psychiatry, their patient outcomes will need to be tracked and reported on in medical journals. A plan for doing such research is still being drawn up.

It won’t be possible to do a randomized trial, noted psychologist Elisabeth Klaebo Reitan. As such, they will mostly need to rely on periodic interviews, which “describe who are the people who are getting treatment” and provide follow-up snapshots of “symptoms, functioning, and social activity, and other recovery measures” over periods of five and ten years. In a sense, the bottom-line outcome will be whether they can “make changes” in their lives, she said.

Skeptics of Norway’s medicine-free initiative are already raising questions about the types of patients who will be treated in the Tromsø ward (and in the other medicine-free beds being set up in the country). The thought is that they will be patients who are “less ill” and without the behavioral problems—violent behaviors, and so forth—that “require” the use of antipsychotics. A medication-free ward can’t present itself as a true alternative to forced treatment unless it can take on more difficult patients too.

Merete Astrup

“That will be a challenge we would like to try to understand,” Astrup said.

The expectation is that they will work with agitated patients in the same manner that they work with all patients, engaging in a respectful dialogue with them, and that the ward atmosphere will provide its own calming effects. If a patient becomes agitated, they will want to know: “Why are you so agitated? Have we done anything toward you that would make you so agitated? What can we do to make it better for you?”

It will be important, she added, that “we not make rules that say, ‘you should not break a glass.’ We need to create an atmosphere where this is a place where such things don’t happen. And if someone did throw a glass, we will look at it as the community that broke down. We didn’t want (the person) to have to throw a glass to get our attention.”

Again and again, Astrup and her staff spoke about how all this is so new, and how they have so much to learn. At the same time, they spoke with confidence of being able to respond well to the challenges that will come, and with confidence too that their ward, since it was established in response to a directive from the Health Ministry, will be given a real chance to succeed.

Hald, for his part, sees this ward as a step toward wholesale change in Norwegian psychiatry. “Is this going to work? I think so, but I am not sure how we will do it. It is going to be a challenge. But if this works well, the whole mental health system has to change. This would transform the system.”

“Professional” guardian Mary Rowan kidnaps again, places disabled man in uninspected “group home” and he dies in fire 2 days later.

You would think that they took out April Parks 3 weeks ago for having hundreds of wards she kidnapped, forced them into dangerous group homes and nursing homes against their will, drained estates by churning bills and strife in families, Mary Rowan would be next.

Think again.  She’s still hot on the trail of being an infamous serial murderer of the disabled and elderly victims she guardianizes and then drains estates and kills them off.


Video above: Mary Rowan ward Raymond Davis among five men dead in fire in uninspected group home; husband John Cavataio featured in footage

Probate Court judge ordered Davis seized from his own apartment by Rowan and Detroit police March 7, 2017; two days later he died in fire

Well-known country music star Sharmian Lynette Worley’s mother Wanda Worley also a Mary Rowan kidnap victim, song below is for her mom

Are wealthy elite running homes for victims of probate kidnappings?


Wed. March 29, 2017,  11 a.m., 33rd District Court

19000 Van Horn at Allen Rd; Woodhaven; Judge Jennifer Coleman Hesson

By Diane Bukowski

March 27, 2017

DETROIT, MI —  Serial kidnapper-guardian Mary Rowan continues to strike. Now she may also be an accessory to murder. But Wayne Co. Prosecutor Kym Worthy is ignoring her and has charged one of the allegedly mentally ill residents of a home at Whittier near Beaconsfield for a fire fanned by gusting winds that killed five men March 9.

The men were Raymond Davis, James Johnson, Leo Dear, William Ballard, and Norman Connors according to Channel Four.

On March 7, Rowan and Detroit police seized Raymond Davis, who is blind, from his own apartment, according to probate court records. Two days later  he was dead in a fire in the Whittier Ave. apartment building where Rowan placed him. See

Although Channel Four reported Rowan had just obtained custody of Davis, her name first appears in his records Jan. 19, 2017. Channel Four interviewed John Cavataio, who admitted his wife was Davis’ guardian. VOD established in its earlier stories on Rowan that she is married to John Cavataio and lives in Grosse Pointe Park.

Six months ago, Rowan seized Wanda Lynette Worley, mother of well-known Nashville-based country music star Sharmian (pronounced Char-min) from the home she shared with her daughter in Brownstown Twp. Sharmian told VOD it was not Rowan’s first attempt. See

“First, Mary Rowan come banging on my mobile home, screaming as loud as she could, ‘Where is Wanda Worley, I’m the guardian.’” Sharmian told VOD. “I told her get off my property now and she left. A week or two later, I was in my front yard, weatherizing  the house and cleaning it a with hose. She pulled up again. I still didn’t know who the woman was. I continued washing my house. I told her again do not come on my property. She looked like the Wicked Witch of the West, very scary and intimidating, and I was not giving my mother to her. So I squirted her with  the hose and got her wet.”

Both Sharmian and Rowan called the police, who took her mother after assuring Sharmian she would be OK and would be back in a couple of days.

But Wanda Worley has not come back home for good since. Meanwhile, Sharmian faces misdemeanor charges of “resisting, hindering and obstructing a police officer/public official.”

A trial on the charges will take place in 33rd District Court Wed. March 29 at 11 a.m, in front of Judge Jennifer Coleman Hesson. In 2012, however, the Michigan Supreme Court ruled in People vs. Moreno that resistance to illegal police conduct is justified. See link to story below.

Additionally, during testimony in 2012 in the well-known case of Marianne Godboldo, Detroit police officers testified that it is not their job to seize individuals subject to probate court orders, but the job of the Wayne County Sheriff’s department.

Two judges in Detroit dismissed all criminal charges against Godboldo twice, saying the order produced by CPS worker Mia Wenk to take her 13-year-old daughter was invalid. When a third trial was scheduled, Godboldo tragically succumbed to a brain aneurysm from the pressure and has been in a coma since.

Sharmian said, “I never saw a court order to take my mom, and if there is one, I believe it is fake. I want to get her [Rowan] for lying to the police, kidnapping and filing fake documents. I don’t believe the judge’s signature appointing Mary Rowan as my mom’s guardian is his. The records say she was appointed Sept. 21, 2016, but my mom was in the hospital then.”

Wayne County Probate Court Judge David Braxton is handling Wanda Worley’s case. Sharmian told VOD that she has been working to get her mother off the highly addictive prescription drug Lyrica. She said she believes that various doctors and hospitals have prescribed drugs for her that make her unable to function properly.

She said she voluntarily admitted her mother to a psychiatric hospital in Wyandotte last fall, showing documents from Probate Court that indicated SHE was her mother’s guardian. But when she came to take her home, the hospital called police on her, and she was forced to contact a legal services attorney to get her mother released back home.

Worley told VOD during a brief visit with her daughter last week that she has been shunted from one Detroit home to another, allegedly adult foster care homes. She is currently at 12317 Monica. It is questionable whether any of the homes are licensed as such.

Sharmian said her mother had been at the Monica address for five months, with eight other men and women. Her mother told her a woman named Wendy runs it.

“Every one of them is a ward of Mary Rowan,” Sharmian said her mother told her. “None of them know what she looks like. They all hate her. One 83-year-old woman says Mary Rowan cleaned out her bank accounts and took her house. My mom got bedbugs while she was there. They finally brought in an exterminator and threw all the beds out. Then, when those 60 mph winds happened, the home lost electricity for 3 days and no one saved the people for three days—they were freezing. Then they put mom and eight others in another home  on Lindsay St. There are more homes, all of them about 15 minutes away from the Monica address, and the people believe Wendy owns all of them.”

However, Wayne County records list the taxpayer at the Monica address as Capital Clearance Group, Ltd. It is four years delinquent on property taxes there, like the house on Whittier that burned.  According to Register of Deeds records, the group also owns 31 other properties in Detroit. The company is not registered with the State of Michigan. Various sites claim it is based in Wyoming and has offices all over the world. See

“Three investment experts and banking elites came together in 2007 and amidst the Sub-Prime debt crisis of 2008 and burst of the property bubble, managed to collectively conduct a wholesale acquisition of land and properties across various states at a low borrowing cost and purchase price,”  says one site. “In a short span of just one year, the founders of Capital Clearance Group managed to grow it to tens of millions of dollars in total Assets Under Management based on its current market value.” See

Are rich folks running what are essentially prisons for those illegally kidnapped through the probate courts? Sharmian said she is now working with groups throughout the country against such abuse. She has a Facebook page at She and her mother were recently interviewed on The Oakley Radio blogspot at

From–Health Care Fraud blog by US DOJ–many, many indictments! Over $130 million in fraud alone in Mar. 2017

From Ken  Ditkowsky;
 Law enforcement is working!     The Philip Esformes indictment in Florida and Seth Gillman plea of guilty in Illinois are the lodestar cases of Health care fraud as they lead directly to one of the most lucrative and prolific criminal enterprises in the United States.    Here in Chicago our local miscreants are so strong that the CALL for an HONEST INVESTIGATION are fighting words.   Any attorney who uses these words as is applied to judicial corruption or the massive Medicare frauds or the Elder Cleansing scandal will find himself/herself in the ‘sights’ of the Illinois Attorney Registration and Disciplinary Commission.    If not intimidated the lawyer will find himself/herself with a suspended law license.   God Help the lawyer with a skin color that is dark.  (Lanre Amu got an interim and 3 year suspension of his law license because he was caught practicing law while ‘black!’   Jim Crow is alive and kicking at the ARDC).
Jerome Larkin, the administrator of the IARDC was so convincing to his kangaroo panels that even though the judge in question never denied the charges and a respected business magazine echoed the very same charges that Amu made, Amu’s panels found by clear and convincing evidence that Amu’s charges were improper and he wrongfully accused judges of corruption.    Indeed, when Lawyer JoAnne Denison echoed charges of judicial corruption and disseminated them in her blog  MaryGSykes she was subjected to the very same fate!
Fake news is child’s play here in Illinois.    The Constitution of the State of Illinois is a technicality to be ignored by our public officials and the Constitution of the United States is a rumor invented by Donald Trump!   Indeed, whatever Jerome Larkin, the Political elite and the judicial elite says is the LAW OF THE LAND in Illinois and the fact that his utterances have no basis in reality is irrelevant.    We are engaged in a great civil war against the elderly and as far as Illinois is concerned the elderly are just another commodity to be exploited!
Fortunately the United States of America is still the home of the brave and land of the free.   The Justice Department’s list of indictments in health care fraud is growing.     Soon, we hope they will turn their attention to some of the larger miscreants and their protectors.   For instance, Philip Esformes is not unknown in Chicago and it is rumored that he and his father (and a bunch of associates) have quite a elder cleansing operation going right here in Chicago and that it is well protected by the political and judicial elite. Dr. Incompetent charging a finite number of patients for examinations that he never made is small potatoes.    On a single elderly person (commodity) over a million dollars of savings and other assets can be stolen.   In the Mary Sykes case 3 million dollars was allegedly stolen.   In Alice Gore 1.5 million disappeared along with the gold from Alice’s teeth.   *******

Criminal and Civil Enforcement

March 2017

March 24, 2017; U.S. Attorney; Northern District of Texas
Federal Jury Convicts Doctor of $40 Million Medicare Fraud
DALLAS – Following a five-day trial before U.S. District Judge Jane Boyle, a federal jury has convicted Noble U. Ezukanma, 57, of Fort Worth, Texas, of seven counts of health care fraud offenses, announced U.S. Attorney John Parker of the Northern District of Texas.
March 23, 2017; U.S. Department of Justice
Miami-Based Physician Charged for Role in Pain Pill Diversion and Medicare Fraud Scheme
A physician licensed in Puerto Rico, who was practicing medicine in Miami, was charged in a 16-count indictment unsealed today for his alleged participation in a multi-faceted $20 million health care fraud scheme involving the submission of false and fraudulent claims to Medicare and Medicaid and the illegal distribution of oxycodone and other controlled substances.
March 23, 2017; U.S. Attorney; Northern District of Alabama
NW Alabama Pharmacies Owner Sentenced to Six Month’s Home Confinement for Obstructing Medicare Audit; Ordered to Pay $2.5 million Fine
BIRMINGHAM – A federal judge today sentenced the owner of two northwest Alabama pharmacies to six month’s home confinement for obstructing a Medicare audit, ordered him to pay a $2.5 million fine and prohibited him from working in a pharmacy during his year on probation.
March 23, 2017; U.S. Attorney; Western District of Wisconsin
Osceola Nutritional Supplement Provider & CEO Sentenced
Madison, Wis. – Jeffrey M. Anderson, Acting United States Attorney for the Western District of Wisconsin, announced that Gottfried Kellermann, 76, Osceola, Wis., was sentenced today by U.S. District Judge James D. Peterson to a six-month period of home confinement, a $50,000 fine, and five years of probation, for intentionally violating Clinical Laboratory Improvement Amendments regulations. Kellerman’s co-defendant, NeuroScience, Inc., was sentenced to a five-year period of probation and a $140,000 fine for conspiring to defraud the United States. The defendants pleaded guilty to these charges on October 14, 2016.
March 22, 2017; U.S. Attorney; Northern District of Illinois
Chicago Chiropractor Indicted for Allegedly Billing $10 Million to Medicare and Private Insurers for Nonexistent Treatment
CHICAGO – A Chicago chiropractor with a clinic in the West Lawn neighborhood has been indicted on federal fraud charges for allegedly submitting at least $10 million in bogus claims to Medicare and private insurers.
March 22, 2017; U.S. Attorney; Eastern District of Michigan
Two Physicians Found Guilty For Distributing Oxycodone
Dr. Anthony Conrardy, age 61, and Dr. William McCutchen, III, age 46, were found guilty yesterday of unlawfully distributing Schedule II narcotics by a federal jury in Detroit, MI, acting United States Attorney Daniel L. Lemisch announced today. Dr. Anthony Conrardy was convicted of five counts of unlawfully distributing Oxycodone and Dilaudid, and Dr. William McCutchen, III was convicted of four counts of unlawfully distributing Oxycodone.
March 17, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Houston-Area Registered Nurse Pleads Guilty to Conspiring to Defraud Medicare of More than $5 Million
A Houston-Area registered nurse pleaded guilty today for his role in a Medicare fraud scheme that resulted in losses to Medicare of more than $5 million.
March 17, 2017; U.S. Attorney; District of Puerto Rico
Doctor Sentenced To Seven Years In Prison For Health Care Fraud
SAN JUAN, P.R. – Doctor Juan José Tull-Abreu was sentenced to serve 63 months of imprisonment for health care fraud, and a consecutive term of 24 months for aggravated identity theft, for a total term of imprisonment of 87 months, announced United States Attorney for the District of Puerto Rico, Rosa Emilia Rodríguez-Vélez.
March 16, 2017; U.S. Attorney; Eastern District of Washington
Spokane Area Cardiologist, Dr. Romeo Pavlic, to Pay $300,000 Resolving Alleged False Health Care Claims
Spokane, WA – Today, the United States Attorney’s Office (USAO) for the Eastern District of Washington announced a settlement agreement with Dr. Romeo Pavlic and various companies he owns. The settlement resolves allegations that for years Dr. Pavlic, a Spokane-area cardiologist, falsely billed Medicare and Medicaid by repeatedly and falsely claiming to have provided services and tests to vulnerable patients when in fact he had not.
March 14, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
South Florida Home Health Owner Charged for Role in $15 Million Medicare Fraud Scheme
A South Florida home health care owner was charged in an indictment unsealed today for his alleged participation in a $15 million health care fraud scheme involving fraudulent claims for home health services.
March 14, 2017; U.S. Attorney; District of Connecticut
Stamford Dental Office Manager Pleads Guilty to Defrauding Insurance Companies
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that ELENA ILIZAROV, 44, of Stamford, waived her right to be indicted and pleaded guilty yesterday before U.S. District Judge Victor A. Bolden in Bridgeport to one count of wire fraud stemming from her use of an identity theft victim’s personal identifying information to submit fraudulent bills to private insurance companies offering dental insurance.
March 13, 2017; U.S. Department of Justice
Charles River Laboratories International Inc. Agrees to Pay United States $1.8 Million to Settle False Claims Act Allegations
Charles River Laboratories International Inc. has agreed to pay the U.S. government $1.8 million to settle claims that it violated the False Claims Act by improperly charging for labor and other associated costs that were not actually provided on certain National Institutes of Health contracts, the Justice Department announced today. Charles River is a for-profit corporation headquartered in Wilmington, Massachusetts.
March 10, 2017; U.S. Attorney; Middle District of Pennsylvania
Lancaster County Woman Guilty Of Healthcare Fraud
HARRISBURG- The United States Attorney’s Office for the Middle District of Pennsylvania announced that Tammie Sensenig, age 45, of Lancaster, Pennsylvania, pleaded guilty March 8, 2017, before United States Magistrate Judge Martin C. Carlson to a criminal information charging her with healthcare fraud.
March 7, 2017; U.S. Attorney; Middle District of Florida
Tampa Man Pleads Guilty To Paying Health Care Kickbacks
Tampa, FL – United States Attorney A. Lee Bentley, III announces that Anthonio Miller (26, Tampa) today pleaded guilty to conspiracy to pay kickbacks in connection with a federal health care benefit program. He faces a maximum penalty of five years in federal prison.
March 6, 2017; U.S. Department of Justice
California Clinic Owner Sentenced to 63 Months in Prison for Role in Occupational Therapy Fraud Scheme
A rehabilitation clinic operator in Los Angeles County was sentenced to 63 months in prison today for his role in a $3.4 million Medicare fraud scheme that involved billing for occupational therapy services that were not medically necessary and not provided.
March 6, 2017; U.S. Attorney; Southern District of Texas
Clinic Manager Heads to Prison for Health Care Fraud
HOUSTON – The 47-year-old owner and operator of Elite P. Care Medical Services has been sentenced for her role in a health care fraud conspiracy that billed Medicare and Medicaid for more than $1 million in fraudulent health care claims, announced U.S. Attorney Kenneth Magidson.
March 6, 2017; U.S. Attorney; District of New Jersey
Bergen County Doctor Convicted Of Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. – A family doctor practicing in Bergen County, New Jersey, was convicted today of all 10 counts of an indictment charging him with accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
March 6, 2017; U.S. Attorney; District of Vermont
Brandon Woman Sentenced for Medicaid Fraud
The Office of the United States Attorney for the District of Vermont announced that Misti Baker, 36, of West Rutland, Vermont, was sentenced on Friday by United States District Court Judge Geoffrey W. Crawford for healthcare fraud. Judge Crawford sentenced Baker to time served plus two years of supervised release and ordered her to pay $77,306.57 in restitution.
March 3, 2017; U.S. Department of Justice
Unlicensed Medical Professional Convicted for Role in $1.3 Million Medicare Fraud Scheme
A federal jury in Houston convicted an unlicensed medical professional who was posing as a physician yesterday for his participation in a $1.3 million Medicare fraud scheme.
March 3, 2017; U.S. Attorney; Southern District of Florida
Two Women Plead Guilty to Orchestrating $20 Million Medicare Fraud Scheme at Seven Miami Area Home Health Agencies
Two Miami residents pleaded guilty today to fraud charges stemming from their roles in a $20 million home health care fraud scheme.
March 3, 2017; U.S. Attorney; District of Maryland
Biller for Medical Equipment Provider Sentenced to Four Years in Federal Prison for Health Care Fraud, Aggravated Identity Theft and Defrauding the IRS by Failing to File Tax Returns
Baltimore, Maryland – U.S. District Judge Marvin J. Garbis sentenced Elma Myles, age 52, on March 2, 2017, to four years in prison, in connection with her role in a health care fraud scheme, aggravated identity theft, and conspiracy to defraud the United States for failing to file income tax returns. Judge Garbis also ordered Myles to pay restitution of $1,207,585.38 to Medicaid.
March 3, 2017; U.S. Attorney; Western District of Virginia
Personal Care Attendant Pleads Guilty to Making a False Statement as it Relates to a Health Care Benefit
Charlottesville, VIRGINIA – A personal care attendant, who for four years lied about the amount of hours she worked for a homebound retiree, pled guilty yesterday in the United States District Court for the Western District of Virginia in Charlottesville to federal false statement charges, Acting United States Attorney Rick A. Mountcastle and Virginia Attorney General Mark R. Herring announced.
March 2, 2017; U.S. Department of Justice
Third Detroit-Area Physician Pleads Guilty in $5.4 Million Dollar Health Care Fraud Scheme
A Detroit-area physician pleaded guilty today for his role in a $5.4 million Medicare fraud scheme involving phony physician visits and drug prescriptions.
March 2, 2017; U.S. Attorney; Southern District of Texas
All 12 Convicted in Health Care Fraud Conspiracy Involving Area Mental Health Centers
HOUSTON – A federal jury has convicted the final defendant of 12 involved in a conspiracy to pay and receive kickbacks relating to the Medicare program, announced U.S. Attorney Kenneth Magidson. The jury deliberated for four hours following a three-day trial before convicting Cheryl Waller, 70, of Houston, of one count of conspiracy to pay and receive kickbacks and one count of receiving kickbacks.
March 1, 2017; U.S. Attorney; Southern District of New York
Cardiologist, Neurologist, And Others Charged In $50 Million Health Care Fraud Scheme, And Civil Suit Filed Against Clinic And Participants In The Fraud
Preet Bharara, the United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation (“FBI”), Scott J. Lampert, Special Agent-in-Charge of the New York Regional Office of the United States Department of Health and Human Services Office of the Inspector General (“HHS-OIG”), and James P. O’Neill, the Commissioner of the New York City Police Department (“NYPD”), announced today criminal and civil actions relating to a 12-year scheme to defraud Medicaid, Medicare, and other private health insurance companies out of more than $50 million. Today’s actions include the unsealing of an Indictment charging ASIM HAMEEDI, FAWAD HAMEEDI, MICHELLE LANDOY, DESIREE SCOTT, EMAD SOLIMAN, and ARIF HAMEEDI with, among other things, health care fraud, identity theft, and making false statements, and the filing of a civil fraud lawsuit against CITY MEDICAL ASSOCIATES, P.C., and ASIM HAMEEDI, among others, seeking treble damages and civil penalties under the False Claims Act for the fraudulent claims for reimbursement submitted by CITY MEDICAL ASSOCIATES to Medicare and Medicaid between 2003 and November 2015.

February 2017

February 28, 2017; U.S. Attorney; Northern District of Texas
Sixteen Individuals Charged in $60 Million Medicare Fraud Scheme
DALLAS – An indictment returned by a federal grand jury in Dallas last week, and unsealed today, charges 16 individuals with offenses related to their participation in a health care fraud scheme, announced John Parker, U.S. Attorney for the Northern District of Texas.
February 24, 2017; U.S. Department of Justice
Administrator of Miami-Area Home Health Agency Sentenced to 126 Months in Prison for Involvement in $2.5 Million Medicare Fraud Scheme
Today, the administrator of a Miami-area home health agency was sentenced to a 126 month prison term for his role in a $2.5 million Medicare fraud scheme.
February 24, 2017; U.S. Attorney; Southern District of Texas
Jury Convicts Rio Grande Valley Area Durable Medical Equipment Company Owner of Health Care Fraud
McALLEN, Texas – A McAllen federal jury has convicted the owner of an area durable medical equipment (DME) company owner on all counts for her scheme to defraud Texas Medicaid through fraudulent billings, announced U.S. Attorney Kenneth Magidson. The jury deliberated for six hours following a seven-day trial before convicting Maria Garza, 41, of McAllen, on all 18 counts as charged.
February 22, 2017; U.S. Attorney; District of Puerto Rico
Owner Of Durable Medical Equipment Company And Three Physicians Charged With Health Care Fraud And Aggravated Identity Theft
SAN JUAN, P.R. – On February 13, 2017, a Federal Grand Jury in the District of Puerto Rico returned a superseding indictment charging Dr. Dante A. Rodríguez-Rivera, Javier Efraín Siverio-Echevarría, Dr. George D. Alcántara-Cardi, Dr. Martha Nieves, Javier Antonio Aguirre- Estrada, and Carlos Maldonado-López with multiple counts of conspiracy to commit health care fraud, health care fraud and aggravated identity theft. The defendants were arrested today, announced Rosa Emilia Rodríguez Vélez, United States Attorney for the District of Puerto Rico, Scott Lampert, the Special Agent in Charge of the Office of the Inspector General for the U.S. Department of Health and Human Services (“HHS-OIG”), and Douglas A. Leff, Special Agent in Charge of the Federal Bureau of Investigation’s Puerto Rico Field Office (“FBI”).

From PA–One Sex Abuse Victim tells his story – the Hurting.

This is from a psychologist who is helping him who wrote this for publication on my blog:

Exposing America’s Most Damaging Secret
 On Friday, May 27th, ABC featured a startling program about Bill Cosby that exposed his long history of drugging and raping dozens of young women. Earlier this Spring, Brock Turner a student at Stanford University in Palo Alto California, raped a nearly unconscious woman. He was sentenced to a slap on the wrist by a judge who apparently did not want to harm his athletic career. Brock’s father stated that the minor sentence was too much “just for getting 20 minutes of action”.
 What do these sexual abuse incidents tell us? Plenty. In nearly 50 years of full time practice as a clinical psychologist, I have witnessed many damaged and destroyed, suicidal women and several equally damaged men who were unable to get relief from their anger, self loathing and self destructive behaviors that resulted from “ keeping the secret”. All perpetrators know that rape is a felony and punishable by imprisonment. To protect themselves from incarceration, they threaten their victim with horrendous consequences if they tell anyone.
 Nearly all abuse victims suffer immensely from being raped and would be better off if they could confide in someone. Seldom, however, are victims able to think about their horror, or talk about it. It is common to internalize the anger, hate, shame and place the blame on themselves. Their body become a sealed container for their suffering. We now know this process as PSTD  (Post Traumatic Stress Disorder). Shockingly, our college campuses appear to becoming similar to war zones for co – eds. There have been reports indicating that 40 percent of the women at Stanford University experienced rape. And, this is occurring at a University where the students are among the brightest and most talented in our country. Nearly half the women graduate with horrors rather than honors. The Brock Turner rape “sentencing” revealed serious flaws and biases in our judicial system. Namely, that affluence can and does, influence the outcome of heinous sexual crimes.
 Universities are not the only institutions where such atrocities occur, some treatment hospitals, established specifically to help the challenged and traumatized have been investigated for patient abuse.
 Approximately 45 years ago, I held three administrative positions in an adolescent treatment hospital in Faribault Minnesota. The Founder and Chief Psychiatrist asked me to work with Paul, a recently admitted 14 year old. It was easy to see that he was different from the other patients because he was stable, sensitive, super bright, alert, and studious. Most importantly, he was the only patient in the entire hospital who did not need medications. This caught my attention because all of the other patients were diagnosed with adolescent psychosis and required medication!
 Nearly 40 years later I learned that Paul’s affluent parents started placing him in residential hospitals at the age of five years old. Apparently, they were not interested in being parents to their only son and did not seem to care he was being mercilessly abused (physical and sexual). In the 1960’s and 1970’s, it was socially acceptable for wealthy parents to rid themselves of unwanted children by placing them in such hospitals. Paul was placed at the adolescent hospital in Minnesota when he was 14. The abuse and corruption that later occurred at this Psychiatric hospital went as far as “renting” adolescent boys and girls to men in the community for sexual purposes.
 In the late 1980’s the psychiatric hospital was closed by the state. The founding Psychiatrist lost his medical license, and is now deceased. One “positive” result of this horrendous story is that Paul is currently finishing an informative and somewhat unbelievable screenplay called “The Hurting”. The screenplay is an expose about what happened to him, and likely continues to occur in some hospitals and treatment facilities.
 I am encouraged that the General Public is becoming interested in the realities of sexual trauma that is a devastating epidemic. It does far more damage to the victims than ever imagined. The Academy Award winning movie “Spotlight” is a film that exposed the sexual abuse of alter boys in the Catholic Church. “The Hurting” may open the door to what occurs in some fully accredited and licensed facilities whose medically defined purpose is to help patients heal and adjust more favorably to life. Here is a demo trailer of “The Hurting”.
Dr. David Klimek, PHD, P.C. and associates
Licensed Consulting Psychologists
200 Fuller CT, Suite 11018
Ann Arbor Michigan 48125
And I would like to thank PA and Dr. Klimek for writing this to share what happens when children are brutalized by rape.  It is a horrendous crime that scars the victim for life, each and every day.
As a lawyer suspended for writing on this blog about these crimes and others, I want my victims to know I have not gone away, and even if the ARDC ignores brutality by lawyers, there are still honest, ethical professionals out there fighting for civil rights, human rights and other rights.
Victims of courtroom and other crimes are in my prayers always.
They need and demand justice, even if the ARDC and the court system ignores their pleas.

Looking for free or cheap office space to help clients blog about corruption and report to authorities

Lost my lease and now I have to move.  I need a kind, caring and understanding landlord that wants to clean up the court system.  NW side of Chicago w/parking for clients needed.  $800 per month or less.  Need one office and access to conference room space. I also write books about corruption in the courts.

I am a not for profit so I can rent from other not for profits such as churches, synagogues, etc.

Call me if you know of  anything or have anything.  773-255-7608.



From Ken Ditkowsky–Ferreting out corruption in the courts

Subject: Re: [JudicialMisconduct] Fwd: Petition to Reinstate Law License and Notice of Claim for Damages against IARDC – Corrected Version
Date: Mar 24, 2017 1:48 PM
Ferreting out corrupt judges is NOT a task for the faint hearted.
With title records now on-line in many jurisdictions it is now relatively easy from the computer literate to find out where a particular judge resides, see how the title to his/her home is listed, and review the various transactions that have been placed of record.    Indeed, it is not that difficult to even ascertain the moderately hidden transactions in the spouse’s or children’s names. However, the task becomes a little more sophisticated when devices such as Land trusts and corporations are used as conduits for extra – circular remunerations.
In the blogs Probate Sharks, MaryGSykes and a bunch of others Janet Phelan’s investigations are chronicled as she unmasked a number of jurists.   Others also have done fantastic work in exposing the criminals in black robes; however,  no device designed by the criminals is exclusive or not available for usage.   In fact that only way to ascertain if the judge hearing your case is ‘wired’ or ‘fixed’ is to observe the Court record, his/her rulings and the final result.    Even then, a really clever jurists can avoid detection.
My baptism came in the Mary Sykes 09 P 4585.    Yes, in my five decades in the practice of law and thousands of files I was well aware of some shady and illegal practices by certain judges that forfeited rights of my clients.   In most of these cases I had to grin and bear it, but in Sykes the attorney for the guardian and the two guardian ad litem tried to intimidate me and stop me for representing my clients.   My wife was shocked by the content of the telephone calls I received from one of the guardian ad litem and the attorney for the guardian.   I laughed the calls off, and made a telephone call for a friend who was a former Federal Special agent.
What I did not realize at the time was the cancer that had become metastatic.   As you are aware the intimidation failed and no one has shut me up as of yet.   What has not happened however is that I have not been successful in 1) obtaining an acceptable result for my clients and other persons similarly situated, and 2) the miscreants who systematically dehumanized Mary Sykes and redistributed her 3 million dollars in life savings to their own accounts have not been forced to return the booty!   In fact these miscreants continue in their dehumanization and redistribution activities almost without interruption. 
It is a given that not one of the miscreants is committing his portion of the 18 USCA 371 conspiracy innocently or as a charity.   From my vantage point even though the State of Illinois is on the verge of Bankruptcy the Illinois Department of Revenue has little, if any, interest in collecting the taxes, interest or penalties that need to be assessed.   The mere call for an HONEST INVESTIGATION however causes the public funds to be drawn upon without limitation so that the miscreants (Political and Judicial elite) are fully protected.
It is given that public figures such as Jerome Larkin, the administrator of the Illinois Attorney Registration and Disciplinary Commission did not file patently false disciplinary pleadings because he really believes that exposing judicial corruption is akin to “yelling fire in a crowded theater!”    No one believes that Judge Connors ignored the mandatory judicial duties required by 755 ILCS 5/11a – 10 because she never read the statute which she administered for 12 years!   (On page 91 of her evidence deposition she admitted that her decisions were pre-determined i.e. wired – so it was no surprise to obtain a letter from the Sheriff of Cook County that disclosed that no summons was ever served by his office on Mary Sykes).
As we all get old and every individual reading this e-mail could be subjected to the very same elder cleansing as Mary Sykes, Alice Gore, Carolyn Wyman ******  how do we or our loved one know what is in fact happening.    How do we convince Law Enforcement to protect us from the cancer of elder cleansing and the WAR AGAINST THE ELDERLY AND THE DISABLED that Larkin and his co-conspirators are successfully waging?
In this battle each of us may be called on the fight, the honest political class also has a stake.   The President of the United States – if he desires to actually provide health care to America – must address this cancer.    The theft committed by the Warriors who are promulgating this War against us (the elderly, the potential elderly and the disabled) are well funded and in the case of Philip Esformes stole a billion dollars from the Medicare Program.   In the many other Philip Esformes like case hundreds of billions of dollars have been stolen from the USA.     Private savings of people such as Mary Sykes have also been stolen and not recovered.   Hell – even the gold in your teeth is not safe.
The criminals that we are all fighting are not dumb bunnies too stupid to get out of the rain – they occupy positions of trust and confidence that we pay huge sums in taxes and other remunerations to protect us.    The IARDC which Larkin administers obtains millions of dollars to protect the public from corrupt lawyers; however, when Seth Gillman stole millions of dollars from Hospice care patents (and the government) the IARDC was totally disinterested.   In fact it did not become interested until the ‘word on the street’ revealed that Gillman was co-operating with the United States of America.   Immediately the IARDC under Larkin’s administration sought and obtained from the Illinois Supreme Court an interim suspension of Gillamn’s law license.    
JoAnn Denison exposed corruption in her blog MARYGSYKES and not only did Larkin overtly violate Illinois Law (by hiring a vulnerable and unlicensed court reporter) but he has yet to “fess up” to his action, but has continued in attempting to silence Attorney Denison.
All who fight corruption in the courts had better not be of faint-heart!   Many in the health care industry and in government agencies have vested interests that you are fighting.  They cannot afford honest Courts!   An honest judge would have dismissed the Petition for a Guardianship of Mary Sykes in August 2009 when the petitioner could not obtain a physician to testify that Mary Sykes was incompetent.   As Mary had not been properly served with summons dismissal for want of prosecution would have been appropriate.   But Judge Connors was in the pocket! (see page 91 of her evidence deposition!).    Two guardian ad litem were in the ‘pocket!’   exactly why there had to be two guardian ad litem for an elderly woman who was obvious competent is still a mystery – except that the attorney for the petitioner seeking to be guardian appears to have a bit of clout!.    
JoAnne Denison and I both protested – the protest was not met with favor – the idea of an HONEST INVESTIGATION was so outrageous that hundreds of thousands of dollars of STate of Illinois money was spent to attempt to silence both of us and all those citizens who feel aggreived.
The admission of Justice Maureen Connors is unusual.   Most judges (corrupt and not corrupt) know that the first obligation of a judge is determine if jurisdiction is had.   Connors was aware that she had no jurisdiction – she did not care as she knew she was covered.
It is exactly Connor’s knowledge that her pernicious breach of trust is totally protected that make any real inquiry into just how the remunerations are received by the miscreants at best guesswork or at worse not for public knowledge except by procrustean efforts – some of which might be hazardous.   For this reason we desperately need President Trump to take a lead and direct the Attorney General of the United States to do an HONEST and comprehensive investigation of the elder cleansing that is the ISIS terrorism associated with the WAR ON THE ELDERLY AND THE DISABLED.

From: kenneth ditkowsky <>

Sent: Tuesday, March 21, 2017 5:58 PM
Subject: Re: [JudicialMisconduct] Fwd: Petition to Reinstate Law License and Notice of Claim for Damages against IARDC – Corrected Version

If anyone needs to be reminded that Jim Crow is alive and well in Illinois, the Lanre Amu case is a clear case.    The record in the Amu case suggests that Amu’s crime was having a dark skin.   This conclusion is bolstered by the outrageous treatment of Diane Nash by the Larkin IARDC conspiracy.    Ms. Nash was barred from a hearing room in which a kangaroo hearing as to JoAnne Denison was being heard.   Ms. Nash (a civil rights icon) was the only person who was not admitted. There was a empty seat right next to me (I was observing and seated right next to Attorney Amu).    I known there was no mistake to the denial of allowing Ms. Nash to attend as I personally wrote the IARDC administrator (by e-mail) and requested an apology to Ms. Nash.   To date not even the usual insincere apology has no been forthcoming.
Mr. Amu’s petition is attached along with the article from Crain’s Chicago Business.    
The maltreatment of Mr. Amu was clearly gross violation of the decency expected by Americans from their government.  Exactly how the United States of America and the State of Illinois can tolerate the outrage that Jerome Larkin and the Illinois judicial system have done to Mr. Amu is a mystery.   How such conduct on the part of public officials can be condoned is also a mystery.
I join with Mr. Amu in demanding an HONEST INVESTIGATION and I go one step further – I demand that if an HONEST INVESTIGATION finds that the allegations of Mr. Amu are accurate that a grand jury be impaneled and that every attorney associated with the prosecution against Mr. Amu who did not speak up against the civil rights violations perpetrated against Mr. Amu be subject to severe professional disciple. There is no place in the Courts of Illinois for racism!    Mr. Larkin in allegedly perpetuating it and JIM CROW has breached his public trust.    (As has every attorney involved in the Amu case!) 

From: ”Lanre O. Amu’ via JudicialMisconduct <>

Sent: Tuesday, March 21, 2017 5:25 PM
Subject: [JudicialMisconduct] Fwd: Petition to Reinstate Law License and Notice of Claim for Damages against IARDC – Corrected Version

‘Lanre O. Amu, P.E. (Illinois ’89), B.C.E. (U of MN, ’84), M.S.C.E. ( U of MN, ’86 ), M.B.A. (UIC, ’89), J.D. (1995)
0909 301 3007   0815 781 6971
—–Original Message—–
From: ‘Lanre O. Amu <>
To: kgjablonski <>; jjgrogan <>
Sent: Tue, Mar 21, 2017 11:24 pm
Subject: Petition to Reinstate Law License and Notice of Claim for Damages against IARDC – Corrected Version

Attention: IARDC  (Corrected for Typographical errors)


‘Lanre O. Amu, P.E. (Illinois ’89), B.C.E. (U of MN, ’84), M.S.C.E. ( U of MN, ’86 ), M.B.A. (UIC, ’89), J.D. (1995)
0909 301 3007   0815 781 6971

Tonight–Live on Cooper’s Corner Cable TV show–discussions on 4 Horror Story in the Court Books–Carmen Tozzo, Carol Wyman, Mike Larsen’s Book and American Nightmare



Here is the link to the show:

And we are still looking for 3 little girls (now in their teens) who were human trafficked and raped by a Monster as young as age two.  Their names are Layla, Emily and Annie Thomas. Two are twins. They are reported to be in Texas but could be anywhere.  If you know of where they are, please contact me immediately. There is a grandma looking for them, the biological mother has taken drugs and let the girls be sold to men for sex. The grand mother wants the girls back, safe and sound.

The books:

Each of these books was discussed on the show and how a corrupt court system allowed extremely vulnerable citizens–three young girls and two elderly women, so suffer through horrors propagated by the US court system.

We will be doing a follow up show next week and hope to have some of the authors on the show.

These are important topics today that can affect everyone in the US–allowing children to be raped in Kankakee and the police and court are in on it (the girls see police officer cars in front of their home when men come to have sex with them for cash), and guardianship court where seniors are forced into locked down nursing homes where they are abused and their estates drained.