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Transcripts

November 19, 2003

Host: Michael Grant
Topics:
· Special legislative session on CPS and state prisons;
· The effects of stress on mental and physical health.

In-Studio Guests:
· Howie Fischer, Capital Media;
· Michael Meyer, President and Chairperson for the Institute for Mental Health Research.

>> Michael Grant: Tonight on "Horizon," lawmakers trying to make progress in the special legislative session. We will update you on CPS, state prison bills, other news from the capital. Plus, a look at the role of stress on our bodies and minds. Mental health is the topic of the symposium aimed at lawmakers and opinion leaders.

>> Michael Grant: Good evening, I'm Michael Grant. Our state lawmakers making headway in the Colonel special legislative session. Some critics at the capital not happy with the lack of progress on bills dealing with bed shortages for Arizona prisons and the child protective service agency. Meantime, plan to boost early childhood education was unveiled yesterday. That plan devised by the 38-member Arizona school readiness board is recommending that the state fund several programs for children of needy families. Here to fill us in on those stories and probably more, even if we don't ask him, is Howie Fischer, chief correspondent with capital media.

>> Howard Fischer: I think I have been insulted.

>> Michael Grant: You don't need that after a long day, watching nothing get done at the state capitol. Is anything getting done?

>> Howard Fischer: You're right. Virtually nothing. The plan was to have the Senate today debate the prisons bill and they got to the floor and looked at all the proposals and amendments and said, we ought to sit down behind closed doors and see if we can work something out and as we speak at 2 minutes after 7:00 they're behind closed doors.

>> Michael Grant: Interesting development because the house, of course, fairly handily passed the plan on, I think it was late Monday night if I recall correctly, and the Senate had a virtually identical bill sitting in the Senate and it was thought generally, 24 hours or so ago, that those things were going to emerge and they were going to go up to the ninth floor, it was going to be vetoed and nobody was sure what would happen then.

>> Howard Fischer: You have two factors at work. A lot of the Republicans who supported this in the house knew this wasn't going to be the final plan, so they could be good loyal Republicans and vote for the bill and keep Eddie Farnsworth, the majority leader, happy. The senators have some other ideas they would like to consider. For example, mark Anderson, who is a Republican of Mesa says, look, if we're going to raise $40 million by a thousand-dollar hike in drunk driving fines we ought to take some of that money and do drug treatment behind bars. His belief is we can run a pilot program and find out if people who are made of clean are drugs have a low recidivism rate. You have other folks saying why are we dealing with permanent prisons now? Why don't we just deal with temporary beds? We are 4,000 inmates over capacity. There are many out of state companies that have temporary beds. There are other folks who are also saying, let's expand the bidding to have not only private companies bidding on it but also perhaps states. There are other states that have prisons.

>> Michael Grant: Let me cycle back to that point because it does seem to me, given the fact this is a special session, although it's approaching the length of a regular session, why not just keel deal with the -- deal with the temporary situation, allocate enough money for 3,000 or so beds, and take up larger issues in the regular session?

>> Howard Fischer: Well, two people, Russell Pearce and Bob Burns, who respectively head the House and Senate appropriations committee, they are convinced that private prisons are the way to go, that they are cheaper, that they're more reliable, that you don't have the same -- some of the same issues to deal with as far as having more state employees. They're convinced the only way they're going to convince the director of the department of corrections and the governor into long term contracts for private prison is to do it now as part of the deal for more temporary beds and their deal says you will put 1600 inmates in private prisons in Arizona. That means building private prisons, and the companies obviously aren't going to do that without long-term contracts. Five, ten, 15 years.

>> Michael Grant: Let me go to Child Protective Services. As I understand it, Senate president Ken Bennett has a plan now that would go both to substantive CPS reforms as well as a little money for some additional CPS workers?

>> Howard Fischer: A little money, and that's the operative word in this fight. As you know, the governor said, "I need $35.5 million. I need 27 million just for supplemental just to keep CPS operating at its current levels and I need another 8.5 million to hire more caseworkers and increase the pay because the turnover there is phenomenal." The senator put in a bill -- actually has a blank where the money is, and he says, "somewhere between 4 and $8 million and we'll deal with the is supplemental down the road." That causes real heartburn among Democrats. I don't think they want a kiss and a promise that, don't worry we'll take care of it. Of course, the Senate president says, wait a second are it's only November, the fiscal year runs through June 30th, how can we tell now that we need $27 million more in an agency that has perhaps $250 million budget?

>> Michael Grant: I was going to say something of a point, isn't it, only four months into the fiscal year, and they're already saying, well, gee, we're roughly 10% short.

>> Howard Fischer: But one of the problems becomes, if you know you're running 10% short, you can do one of two things. You can keep spending at current levels and hope and pray the legislature will come up with the money. Legally that's probably unconstitutional because you are saying, well we're going to run out and create a crisis, overspend our budget. The other alternative is you create waiting lists for things like subsidized child care which means certain people aren't going to get their services and that's why the government wants the supplemental money now.

>> Michael Grant: Lets me go back to the substantive side of CPS reform. The Senate president trying to meld certain portions of the governor's bill with a Romley bill and move along those lines?

>> Howard Fischer: Very clearly I think there's a consensus that you need to change and refocus CPS. There was a belief that the old law said your main function is kind of keeping families together and keeping kids safe, too. Both what Rick Romley wanted to do and what the governor wanted to do is say, this is your prime directive, you shall take care of kids, this is what you're supposed to be doing if they're in danger, take them out. To that they added some provisions of what Rick Romley wanted. He wants more openness, more transparency to the system, in other words, open court hearings. Now, there are some protections in there that theoretically would preclude certain names from being published but his belief is as long as the entire system of when a child becomes dependent, when a child is taken away from the parent is hidden from the public and is hidden from the legislature, nobody really knows if they're doing a good job. So that gets added to that. There's some redefinitions of what constitutes child abuse in there, that you've got situations in a case where perhaps a mother tests positive for drugs, they're still negotiating pieces of that. I don't think they're going to deal with it the way Rick Romley wanted. He wanted the situation if the CPS comes in the home and the drugs are sitting out and available to the child, well, therefore, that's abuse and you can take the child. I think that's a little too onerous for folks.

>> Michael Grant: What the school readiness board?

>> Howard Fischer: Well, we had all sort of forgotten about this. This goes back to Jane Hull. She appointed 38 folks headed by Nadine Basha to take a look at the whole question of are children ready for school? There's a belief that kids are showing up in first grade not only that they can't read, and maybe that's expected, but they don't each have the most basic skills in terms of recognizing letters, in terms of social skills. Even in terms of the health preparation, there are kids who haven't gone through the well baby clinics. There are kid who haven't had their shots. And the idea was to take a look and say, chow we make kids ready for school?

>> Michael Grant: And the main suggestion they have come up with is certainly not a new suggestion. That's full-day kindergarten.

>> Howard Fischer: And a very expensive suggestion. You could talk over $100 million a year to do that. I think the recognition is maybe we'll phase it in in areas where there are a lot of needy kids but they're also looking at child care operations. They recognized most mothers in the state have to work. So you can tell if a state -- if a day-care center is passed its fire exams and everything else but you can't tell the quality of the programs. Do kids learn? Do they understand their colors there? Are they progressing? More than just, sit clean and is it safe?

>> Michael Grant: And this kind of a system would be administered by whom or did they get down to that level of detail?

>> Howard Fischer: I think the belief is it would be done probably by the Department of Health Services but, again, the -- this need to be worked out. Because, again, you need money here. You can't just say we want a grading system without determining, A., what are the scales you're going to use and B. who is going to do it and with what money.

>> Michael Grant: A week today is the week before Thanksgiving. Legislature going to shut down by that time or not?

>> Howard Fischer: Well, the good news is they're going to shut down. The bad news is I don't know whether we'll be done yet. You have a lot of lawmakers leaving town next week. Some of the bills they were counting on dealing with tomorrow and Friday are going much slower than possible, either they're going to put something simple out and throw up their hands and adjourn sine die or decide they don't have enough lawmakers next week and shut it down and come back.

>> Michael Grant: Howie Fischer, thanks for the info.

>> Michael Grant: For many of us, stress has become a major factor in our lives and almost constant companion at work and at home but what exactly is stress and how does it affect our bodies? One ASU researcher is focussed on the causes and the effects of stress.

>> Kathleen Matt: Virtually anything in our environment, anything our lives can be considered a stressor. If, in fact, it evokes a response in us where we are not able to adapt to it.

>> Reporter: While most people seek to avoid stress, Kathleen Matt chooses to surround herself with it and its by products in her lab at ASU's sport research institute. A professor of neuroendocrinology, she and her students are studying the body's response to stress and how that translates into the development of disease.

>>Kathleen Matt: What we look at is not only trying to understand the basic and physiological and underlying neuroendocrine mechanisms of stress but how those are altered by exercise, by fitness status, by nutrition level, by socioeconomic status, by a variety of things with -- in the environment.

>> Reporter: Stress is an unavoidable and often unpredictable part of daily life but the body's reaction consists of a very predictable two stage response. The first stage begins when adrenalin and noradrenalin are released into the bloodstream.

>>Kathleen Matt: I typically use the example of a student or anyone sort of put in a position where everybody is everybody is watching you when you have to give a talk and as you move to the front of the room you can feel your heart start to race and you can also hear your breathing increase a little bit, you feel like you can't catch your breath and you may even have your mouth go dry. That is all a result of the sympathetic nervous system which is the first arm of the stress response.

>> Reporter: The second arm of the response involves increased production of another stress hormone called cortisol.

>>Kathleen Matt: Cortisol actually regulates glucose. It's basically anticipating that you will need more glucose mobilization in order to fuel you through this challenge. So typically if we look evolution airy, our challenges had been physical challenges, a lion coming, and so the increases in adrenalin and noradrenalin increased cardiovascular capacity, aerobic capacity, increased mobilization of 52 so that you can run away from the lion. So that's typically what our stress response is. We also get that same response, as I pointed out, when somebody might ask you to come up and give a talk.

>> Reporter: The fear of public speaking falls into the category of psychological stress, and Matt and her students have found a unique way to measure its effects on the body.

>>Woman: I'll put you through a series of simple tests.

>>Kathleen Matt: We developed something which my students have called the Matt stress reactivity protocol, and what it is is it's a series of stressors. It's all presented to the participants in a computer, and we measure their stress responses throughout this time period.

>>Patient: Blue.

>>Woman: That's it.

>>Patient: Green.

>> Reporter: As the study participants work their way through increasingly stressful challenges, changes in heart rate are monitored.

>>Woman: I will have you chew on one.

>>Reporter: Hormonal changes which can be detected in saliva samples are also determined. Matt has tested over 250 individuals, many of whom were part of a continuing study on the effect of stress on the autoimmune disease rheumatoid arthritis. The researchers now have expanded their investigation to include a number of other factors, including gender.

>>Kathleen Matt: Looking at gender differences, everyone showed a response to stress, but the responses of cortisol in blood pressure were much greater in males than their matched feel male colleagues. So we think that being able to look at stress responses might be able to give us some clues that would link us to disease prevalence and disease risk.

>> Reporter: One risk factor for diseases such as diabetes and a high percentage of body fat, and the current data indicates that elevated levels of cortisol are associated with high body fat percentages.

>>Kathleen Matt: We are also looking at changes in bone mineral density, and the development of osteoporosis. Cortisol is very negative on bone density, and so this, in fact, may be one of the reasons why individuals with depression, who have elevated cortisols have also been shown to have an increased risk for osteoporosis.

>> Reporter: Because fitness levels can affect the stress response, the researchers are trying to learn more about the benefits of exercise. As part of a physical challenge, study participants are put on a treadmill. The speed and grade of the trade mill are increased.

>>Woman: We're going to have you step to the side and take a blood draw immediately.

>> Reporter: Blood is drawn at intervals from a cannula inserted in the arm so hormonal changes can be measured.

>>Kathleen Matt: We also have been hooked up so that we can capture the gases that escape and we can look at oxygen consumption and CO2 production, which are the products that come from metabolism, and so this allows you to know what kinds of substraits, whether you're burning fats, whether you're burning carbohydrates. We also at the same time have an EKG running so that we can look at changes in the heart rate and cardiovascular capacity as this is occurring.

>> Reporter: Matt hopes these efforts willfully more explain why exercise conditioning builds resilience to physical stress and if that same conditioning will build up a resistance to -- which is an ideal research subject because of its sensitivity to environmental changes.

>>Kathleen Matt: One of the things that we see in the lab that we also saw in the field is that both males and females are involved in taking care of young and that they form pair bonds. When you break these breeding pairs apart, what you see, physiologically, are large increases in cortisol.

>> Reporter: Increased levels of cortisol have been found to produce pronounced changes in hamster behavior. When stressed they eat more and their body fat increases. They also are much less likely to defend their territories.

>>Kathleen Matt: What they look like in essence is they look like individuals who are depressed. We've looked at neurotransmiters in the brain. We've seen decreases in norepinephrine and dopamine which are the same kind of neurotransmiters we see in humans when they are depress the. So this has become a very useful model for us to begin to look at the mechanisms of how chronic stress can actually alter things in the brain but then result in these downstream effects.

>> Reporter: Matt continues to explore the many implications of the stress response and while too much stress is unhealthful for hamsters or humans, some stress can be a good thing.

>>Kathleen Matt: There are enormous benefits to stress. Stress is what enables athletes to accomplish much more than they may have ever dreamed possible and allows us to accomplish things and do feats we hadn't imagined because we are mobilizing and energizing all of these resources. When it moves into the realm of having negative consequences is when it's duration is -- its duration is prolonged.

>> Reporter: Not surprisingly, Matt recommends exercise for one of the best methods for coping with stress, along with getting adequate rest. She also emphasizes the importance of eating a healthful diet.

>>Kathleen Matt: Then I think the other thing is being able to look at your stressors and look at them in a very proactive way. So dividing them into the things that you can change and change them, and the ones that you can't change, you're going to have to accept. And you'll reduce the possibility that you're going to have these chronic effects.

>> Michael Grant: Stress certainly is one aspect of mental health. It is factored into studies going on to understand, identify, treat and prevent mental illness. The institute for mental health research is presenting a symposium on mental health. The program is titled "Beautiful Minds and Creative People: Erasing the Stigma of Mental Iillness." Target audience for the conference, policymakers, business leaders and media. Here to talk more about the symposium is Michael Meyer. He is the president and chairperson for the institute for mental health research. Mike, glad you could join us. Just got off a plane from New York.

>>Mike Meyer: Yes, I did. Nice to be here. Talk about stress.

>> Michael Grant: Was appear stressful drive from Sky Harbor?

>>Mike Meyer: It was a little bit of a stressful drive from Sky Harbor but I'm home and it's nice to be here and my 3-year-old is happy I'm home, too.

>> Michael Grant: I bet. You're going to open up the symposium with introductory remarks labeled, why care about mental health? And that's a logical place to start. Why care about mental health?

>>Mike Meyer: Well, I think, you know, there's been a lot talked about about mental health in the last week or two on your network and other networks, but first of all, it's the basic numbers. I mean, if you believe most of the surgeon general's report, the most recent surgeon general's report, 20% of Americans in any given year are dealing with a mental illness. Now, if you took and that just talked about our state, that would imply that about a million people in this state, if those numbers are roughly accurate, are dealing with some sort of a mental illness in their family. Now, there's obviously severity issues. If you look at the State of Arizona, the State of Arizona alone funds treatment for about 100,000 children and kids. That's just what the State of Arizona is doing, not what private sector is doing, et cetera, or what you're doing if you have resources. So I think that, first of all, the issues are the numbers are tremendous. Second, these are illnesses that are very difficult. I describe them often as nuclear bombs going off inside families. I mean, when you're dealing with depression, when you're dealing with autism, dealing with Alzheimer's, dealing with schizophrenia, these are chronic conditions. There are treatments. There are ways to help, but these are very difficult things for people and for families. And they lead to all sorts of other things, addictive disorders, divorce, absenteeism at work, job loss. There are a lot of reasons why we should be paying attention to this area and why we need to put more money into research and more money into education which is part of what we are trying to do on Friday.

>> Michael Grant: Has the stigma lessened maybe over the past 10 years or so?

>>Mike Meyer: I think it has. You and I talked a little about that, but I think it is nowhere near the lessening that you see -- I mean, 50 years ago if you took cancer, for example, 50 years you a field goal you go back and look at some of the writings, people thought you could catch cancer, it was contagious, there was a stigma to people that had cancer. I think the stigma still exists for a lot of people that are dealing with a mental illness and their families. There's stigma in the workplace. There's stigma in that people often don't want to go to a mental health clinic or they don't want to tell somebody that they -- that they went to see a psychiatrist. So I think that the stigma is still there, and part of what we're trying to do is create more of an awareness among policy people to try to erase that and destigmatize because mental illness is an illness like any other illness.

>> Michael Grant: Certainly people still react adversely to that kind of news, particularly where it is a service provider involved. You don't want to hear that your airline pilot, for example, is seriously depressed. Maybe your doctor or your surgeon, those kinds of things. Whereas if you heard that the same person was suffering from a physical ailment, wouldn't necessarily the same reaction.

>>Mike Meyer: It's kind of interesting, if my airline pilot is being treated appropriately and is on the right treatment protocols and his illness is stable, or her illness, I wouldn't have any problem with flying with that person. So I think again it's all the way you look at it. It's kind of ironic that when you take the stigma of mental illness, for example and you talk about insurance, we don't have insurance parity, for example, right now. I thought it was kind of ironic, as you know, Mike, I've worked in healthcare my entire life, I have always kind of thought it was ironic that the two worst areas of reimbursement for insurance in this country is pediatrics and mental illness or mental health. We cover worst or kids and our brains and something needs to change there, too.

>> Michael Grant: The target audience for the symposium, lawmakers, opinion leaders, government officials. Why is that the target audience?

>>Mike Meyer: I think with a we're trying to do with the symposium, when the institute was created in 2002, its focus was research and it's still heavily research focused, but we also made a commitment that education was going to be the second pillar in terms of focus, and what we want to tried to do with this symposium in conjunction with our partners, the mental health association of Arizona and ASU and the U of A, is we want to raise the level of awareness of policymakers in all areas, whether it's business person who is running a major corporation, whether it's a legislator, whether it's the news media, to what they can do to impact positively people that have these types of illnesses and erase the stigma that is connected with them.

>> Michael Grant: DHS director Kathy Eden is going to be talking about the breakdown of Arizona's mental health system. Give us a quick preview on that.

>>Mike Meyer: I think she's going to talk about the breakdown and to some extent the rebuilding. When I moved here almost 20 years ago, I think Arizona was ranked 51st in the country in terms of services to people with mental illness, and we're doing a lot better now. I mean, we have a long ways to go but I think there's been a lot more dollars put into the system. There are a lot more bright people that have come in. One of the thing that we're proud of is that the research institute recruited, along with the U of A, the first scientists we brought into the state about three, four months ago. She is -- we recruited her from Johns Hopkins and she is the first academically based child psychiatrist here in the state. So I think that the state has come a long way since 10, 15 years ago.

>> Michael Grant: All right. Mike Meyer, thanks for being here. The symposium is –

>>Mike Meyer: Friday.

>> Michael Grant: And the location?

>>Mike Meyer: It's at the La Posada resort, it's by invitation only, but I've been out of town, I'm not sure, there may still be some possibility to attend. You could call our offices, can I give the number out?

>> Michael: Absolutely.

>>Mike Meyer: The institute's office number is 406 -- excuse me, 406-4360. Sorry. Lapse of memory there. Also we will very shortly have a website which people can also go on, which is imhr.org.

>> Michael Grant: Try it one more time.

>>Mike Meyer: imhr.org is the website.

>> Michael Grant: Mike Meyer, thank you for joining us. For transcripts of this program and related links, you can go to our website. That address is www.kaet.asu.edu. Click on "Horizon" and follow the links. You can also see what's on upcoming "Horizon" programs. Speaking of which, here is a look at what is coming up tomorrow on "Horizon."

>>Reporter: They would like to get married but right now they cann't because it's against the law in Arizona. However, they are continuing their court battle against that law and hope appear recent ruling in Massachusetts allowing same-sex marriage will help their cause. Learn more about that Thursday on "Horizon."

>> Michael Grant: And, of course, on Friday please join us for more on the special session, other news of the week on the Journalists Roundtable thing. Thank you very much for being here on a Wednesday evening. I'm Michael Grant. Have a great one! Good night.

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