Coronavirus: temporary changes to the Mental Health Act
19/03/2020
Why is the government making emergency changes to the Mental Health Act?
The Mental Health Act must continue to function effectively throughout the Covid-19 pandemic, in order to ensure the safety, care, and treatment of people severely affected by mental illness. Emergency legislation has been introduced to Parliament which includes temporary measures to change the Mental Health Act. This is because the government is concerned that Covid-19 will reduce the number of mental health professionals available to help people whose mental health places them at risk.
The changes will not apply from the moment the legislation is passed – they may be activated if the crisis worsens.
Are these changes part of the recent review of the Mental Health Act?
No. These are temporary measures and are separate to the ongoing review of the Mental Health Act. These changes will not happen straight away. They will only happen if staff numbers are significantly reduced.
Rethink Mental Illness will be carefully monitoring the rights and conditions of people detained under the Act. And we will continue to press for reform of the Act once the emergency measures are no longer required.
What are the changes being made?
There are number of changes being made. We have put details of these below.
Changes to the number of doctors required to detain you under the Mental Health Act for assessment and treatment
Usually 3 people have to agree that you need to be detained. These are normally an approved mental health professional (AMHP) and 2 doctors. Under the new legislation the number of doctors is reduced to 1.
The AMHP has to record the reason why the decision to detain you was made on the recommendation of only 1 doctor.
And they should only take this decision if they believe that staff shortages caused by coronavirus mean it would take too long for a second doctor to assess you.
Changes to how long you can be remanded to hospital for
If you are accused of a crime, the court may think that your mental health was a factor in your offence. Under Section 35 and 36 of the Act, the court can send you to hospital for your mental health condition to be assessed.
Normally you can be sent to hospital for no more than 28 days. If your doctor thinks you need to be in hospital longer, they can tell the court. And the court can extend the section for further 28-day periods, up to 12 weeks at the most.
Under the emergency measures there would be no 12-week upper limit.
This means that you can be kept in hospital, under a section 36 or 37, for longer than 12 weeks.
Changes to court orders for the detention of accused or convicted persons in hospital
If you are accused or convicted of a crime, the court may feel that you need to be detained in hospital. Normally 2 doctors have to assess you and agree that you are so unwell that you need to be in hospital.
Under changes to court orders Section 36, 37, 38, 45A, and 51 of the new legislation, you can be sent to hospital if 1 doctor says that you are unwell. But the court has to agree that this is necessary because of the circumstances.
Changes to emergency detention of voluntary patients already in hospital
Under the Mental Health Act, in emergencies professionals have the power to detain you if you are a voluntary patient. This is to stop you leaving hospital if a professional thinks that you are a risk to yourself or others.
Under these powers you can only be held for a short time:
• Under section 5 (2) of the Act a doctor can agree to hold you for up to 72 hours, and
• Under section 5 (4) of the Act a nurse can agree to hold you for up to 6 hours.
You can only be held after this time if a full Mental Health Act assessment is done, and professionals agree to further detain you. This will usually be under sections 2 and 3 of the Mental Health Act.
The emergency legislation will extend these powers, so you can be held for an increased time. This is because it might take professionals longer to assess patients who are held on these temporary sections.
The extended timeframes are:
• Under section 5 (2) – you can be held up to 120 hours, and
• Under section 5 (4) – you can be held up to 12 hours.
Changes to the transfer of prisoners to hospital
Under the Mental Health Act if you are a prisoner you can be transferred to hospital. This happens if 2 doctors think this is the best thing for you, because of the nature of your mental disorder. The Secretary of State for Justice must consent to the transfer.
This power is under section 47 of the Mental Health Act.
The emergency legislation says that only 1 doctor needs to recommend the transfer of you from prison to hospital. But the Secretary of State for Justice must still consent to the transfer.
Changes to continuation of treatment
Under some sections of the Act, your doctor can only continue to authorise your treatment without your consent if a SOAD agrees. SOAD means ‘second opinion approved doctor’.
For example, under section 3 of the Act you can be treated against your will for 3 months. After 3 months, your doctor can only authorise treatment for you without your consent if a SOAD agrees.
Under the change, your doctor will no longer need a SOAD to agree before continuing to authorise treatment that you don’t consent to.
Changes to police holding powers
You might be in the community or your own home. Police might be concerned about the safety of you or others and that you have a mental disorder.
They have powers under the Act to hold you in a place of safety. Depending on your circumstances, this could be a hospital, your home, the home of another or a police station.
The police have these powers under sections 135 and 136 of the Mental Health Act.
You can usually be held for an initial period of up to 24 hours. Which can be extended for a maximum of another 12 hours. The patient can only be held after that time if a full Mental Health Act assessment is done. And professionals agree to further detain the patient. This will usually be under sections 2 and 3 of the Mental Health Act.
The change means that you can be held for an initial period of up to 36 hours. This can be extended for a maximum of another 12 hours.
Are there any changes to mental health tribunals?
Mental health tribunals are not covered in this piece of legislation. But there may be some changes to the way mental health tribunals take place. For example:
• Tribunals will still be taking place,
• Your tribunal hearing may be done by telephone conference,
• At present 3 panel members are needed. This may be reduced,
• It may take longer for your tribunal to take place, and
• Your hearing might be done as a ‘paper hearing’. This means that you wont have to attend the tribunal yourself.
This blog will be updated as more information becomes available. Last updated 19/03/20 (Check link at beginning of story)
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**Comment**
Once the genie’s out of the bottle, it’s tough to put it back in.
Too much power in the hands of one person is never a good thing.
Many people carefully tend to the skin on their face, regularly exfoliating, cleansing, and moisturizing. But when’s the last time you tended to the skin on the rest of your body?
Your skin is your largest organ, after all, and there is one simple step you can add to your morning routine that can greatly improve its health – dry skin brushing.
I’m not only referring to your skin’s aesthetic appearance, either (although many would agree this is important to). The benefits of dry skin brushing go beyond skin deep, offering whole-body benefits to your health.
Dry Skin Brushing: 7 Key Benefits
Your skin is a complex system made up of nerves, glands, and cell layers that, when healthy, serves as a buffer that helps protect your body from extreme temperatures and chemicals.
It also produces antibacterial substances to protect you from infection and enables your body to produce vitamin D when exposed to the sun. Your skin even contains densely packed nerve cells that act as messengers to your brain, making your skin a crucial part of your interactions with the world around you.
Another crucial role your skin plays is supporting optimal detoxification. But if your skin is overrun with toxins or dead skin cells, it will not be able to eliminate wastes from your body efficiently.
This is where dry skin brushing can be invaluable, not only in brushing off dead skin cells but also in activating waste removal via your lymph nodes. Beyond this, dry skin brushing offers multiple benefits including:
1. Stimulate Your Lymphatic System
In your body, your lymphatic system is the system responsible for eliminating cellular waste products. Hundreds of miles of lymphatic tubules allow waste to be collected from your tissues and transported to your blood for elimination, a process referred to as lymphatic drainage.
When your lymphatic system is not working properly, waste and toxins can build up and make you sick. Lymphatic congestion is a major factor leading to inflammation and disease. By stimulating your lymphatic system and helping it release toxins, dry skin brushing is a powerful detoxification aid.
2. Exfoliation
Dry skin brushing removes dead dry skin, improving appearance, clearing your clogged pores, and allowing your skin to “breathe.”
3. Increase Circulation
When you dry brush your skin, it increases circulation to your skin, which encourages the elimination of metabolic waste.
4. Reduce Cellulite
Dry skin brushing may help to soften hard fat deposits below the skin while distributing fat deposits more evenly. This may help to diminish the appearance of cellulite.
Dry brushing is also said to help reduce cellulite by removing toxins that may break down connective tissue, although some believe the effect is temporary (and mostly a result of skin become more plump and swollen after brushing).1The Huffington Post reported:2
“When we’d heard dry skin brushing was an effective method for reducing cellulite, we knew we had to include it in our anti-cellulite road test. Sure enough, it was indeed one of the more successful ways to smooth away less-than-perfect spots on your legs.”
5. Stress Relief
The act of dry brushing has been described as meditative (especially if you do it in a quiet space) and may reduce muscle tension, calm your mind, and relieve stress. Many compare it to a light whole-body massage.
6. Improve Digestion and Kidney Function
Dry skin brushing may go even deeper, helping to support your digestion and organ function. According to one skin care and spa expert:3
“…many naturopathic doctors use dry brushing to help with bloating because massaging the lymph nodes helps the body shed excess water and toxins. One of the immediate effects of dry brushing is smoother skin, but it can also help improve digestion, kidney function, and more.”
7. It’s Invigorating
Many people become “addicted” to dry skin brushing (in a good way) because it simply feels so good. Along with glowing and tighter skin, regular dry skin brushers report feeling invigorated after a quick session.
Dry Brushing: How to Do It
First you’ll need a high-quality dry brush. Look for one with bristles made from natural materials. They should feel stiff but not overly so. Ideally, choose a brush with a long handle so you can reach your entire back and other hard-to-reach spots.
Dry skin brushing should be done daily for best results, or even twice a day if you like. Try incorporating it into your normal daily routine, such as doing your brushing before your morning shower and then again after work (avoid doing it too close to bedtime, as it may leave you feeling energized).
When brushing, always brush toward your heart, which is best for circulation and your lymphatic system. You can brush your entire body (including the soles of your feet). Start at your feet and work your way up your legs to your arms, chest, back, and stomach. Avoid brushing your face (unless you have a special brush designed for this delicate skin), your genitals, or any areas with irritations or abrasions (including varicose veins).
The pressure you apply while brushing your skin should be firm but not painful (avoid “scrubbing”). Your skin should be pink after a session (not red or irritated) and you can brush for as long (or as little) as you’d like. An average dry brushing session may last between two and 20 minutes.
Try It… You’ll Probably Get Hooked
The investment in dry skin brushing is small – you can find a high-quality brush for under $20 – but the pay-off is large. If you’ve never tried it, you’re likely to be pleasantly surprised. As one new devotee described in the Examiner:4
“I’ve only been at this for about two weeks, but I’ve already experienced many of the benefits listed above. For one thing, dry skin brushing just feels really good. It’s one of those miraculous practices that manages to be both relaxing and energizing all at the same time. For another, it cured my cellulite! …Dry skin brushing also helped heal some ingrown hairs and some innocuous though unsightly bumps on my arms. My skin is softer and no longer dry or flakey. Additionally, though I’m not sure whether or not it’s related to dry skin brushing, I must say that I’ve been sleeping better and experiencing less ‘brain fog’ throughout the day!”
A Surefire Plan for Flawless Skin
Eating a healthy diet as described in my nutrition plan, which focuses on whole, bioavailable organic foods, is your number one strategy for helping your body detox naturally while supplying the necessary nutrients your skin needs to thrive. Adding dry brushing on top of a healthful diet will only magnify its benefits. That said, certain foods are particularly effective at promoting beautiful, clear, healthy skin, so if you’re not yet eating the following on a regular basis, now is a great time to start:
Vegetables: Ideally fresh, organic, and locally grown. Fresh vegetable juice is also wonderful for your skin, as are carotenoids, which give red, orange, and yellow fruits their color, and also occur in green vegetables. Studies have shown that eating foods with these deeply colored pigments can make your face actually look healthier than being tanned.
Fermented vegetables are even better as they can be made with the same vegetables but are converted by bacteria into superfoods. Fermented vegetables help promote the growth of friendly intestinal bacteria and aid in immune balance and digestion.
Astaxanthin—a potent antioxidant—has been found to offer effective protection against sun damage when taken as a daily supplement. Some sunscreens are also starting to use astaxanthin as an ingredient to protect your skin from damage.
Once you’ve addressed the dietary suggestions above, the following routine can help you to remove excess flakes to reveal the glowing skin underneath:
Use a dry body brush to get rid of flakes, stimulate your lymphatic system, and more as described above (do this for a few minutes on your dry skin, before getting wet)
Avoid using soap or use the least amount possible, especially in winter or in dry climates, as this may promote and aggravate dry skin
Instead, apply a natural body scrub to exfoliate your skin (also apply this to your skin before getting wet, and choose one that also contains oil to moisturize)
After your shower, apply a heavy natural body butter or natural moisturizing oil (not mineral oil or baby oil) to help seal in moisture; coconut oil works well for this purpose
ABOUT THE AUTHOR Dr Mercola is the founder of the #1 Natural Health Site for nearly 20 years: Mercola.com
Copyright 2020 – permission to reprint fully granted, WITH links to original story
WITH ALL THE PILLS, VACCINES, COLLARS, AND TOPICALS SPENT ON TICK PREVENTION METHODS FOR DOGS, WHY DO CASES OF LYME DISEASE AND OTHER TICK-BORNE ILLNESSES IN DOGS CONTINUE TO RISE?
It’s hard to miss all the tick prevention ads for dogs on TV, from pills to collars and everything in between. And if you’re a dog owner, you can’t leave the vets office without tick prevention being part of your dog’s preventative health plan. With the flea and tick product market estimated to hit $1.34 billion by 2025, it’s clear pet owners are taking disease prevention seriously. So why are more dogs getting Lyme disease now than ever before?
“Infection with Borrelia burgdorferi, the causative agent of Lyme disease, is extremely common in dogs in North America, and is, unfortunately, becoming even more common every year,” said Global Lyme Alliance Scientific Advisory Board member Dr. Richard Goldstein, Executive Director and Chief Medical Officer of U.S. Diagnostics, Zoetis.
Why are tick-borne disease cases increasing in dogs despite a plethora of tick preventative measures, including collars, sprays, pills, powders, vaccines? The number of positive cases of canine Lyme disease has climbed by almost 40% in the last four years (from 245,971 in 2015 to 359,461 in 2019), according to the Companion Animal Parasite Council (CAPC), a nonprofit dedicated to increasing awareness of the threat parasites present to pets and family members.
Increases in the numbers of some other tick-borne diseases affecting dogs are even more alarming. These include canine anaplasmosis, which have nearly doubled from 117,203 in 2015 to 221,568 in 2019— and canine ehrlichiosis, up from 107,985 in 2015 to 200,410 in 2019. Keep in mind these numbers likely represent just a fraction of the actual number of cases.
TICKS ARE NOW A YEAR-ROUND THREAT
Dr. Mary Labato, veterinary internist and clinical professor at Cummings School of Veterinary Medicine at Tufts University, believes multiple factors such as climate change, reforestation, and new suburban developments that push into local fields and woods are playing a role in the increase of tick-borne diseases.
For one thing, not all pet-owners realize that black-legged ticks—the primary carrier of the Lyme disease bacterium—have become a year-round threat. Although winter is underway, ticks can still be found in leaf litter, brush and decaying vegetation—all areas where pets are at risk of picking them up and passing them on to you and your family.
Many people think that ticks die in winter and so they do not need to use tick-control medication during traditionally cold months, like January or February. But stopping anti-tick medications during the winter months is risky. Ticks are quite resilient and most manage to get through the winter just fine. All they need is one day with temperatures of 40 degrees or higher to emerge and begin searching for a blood meal. This past January, for example, in New York State alone more than a dozen days were sufficiently warm for ticks.
“In the past we didn’t expect to come across ticks in the dead of winter,” said Dr. Ann Hohenhaus, staff doctor at New York City’s Animal Medical Center. “But the past couple of winters have been mild, which means ticks are active for more months of the year, increasing the risk of Lyme and other tick-borne diseases in pets.”
Moreover, Lyme disease is spreading to areas once not considered to be at high risk for tick-borne disease. Historically, ticks were mostly found in the Northeast and Upper Midwest. But starting in the second half of the 20th century, developers increasingly pushed into forested areas to build housing. Therefore, more homes and businesses now exist in previously forested areas, which are home to animals such as white-footed mice, deer, and chipmunks which host ticks. “Suburbia has now moved into fields and woods taking away wildlife-exclusive areas,” said Dr. Labato. “So people and dogs are spending more time together in areas where they come in contact with ticks both from the foliage and the wildlife.”
According to a new study from CAPC, Lyme disease prevalence has also been spreading in states not traditionally considered to be at high risk for the illness. These include regions in Illinois, Iowa, North Dakota, Ohio, Michigan and Tennessee. Two decades ago, you would never have seen ticks, for instance, in Northern Minnesota, and now you do.
TICK PREVENTION ONLY WORKS IF USED CONSISTENTLY
Dr. Goldstein emphasizes that in Lyme-endemic areas, every dog should be protected by their owner by “administering high-quality tick products and taking them [their pet] to their veterinarian to receive an annual Lyme vaccine.” However the use of the vaccines for dogs has been widely debated so talk to your vet about what’s best for your pet.
Yet despite the many anti-tick products on the market, some pet-owners are reluctant to use those that contain pesticides. Instead they may opt for a natural remedy, such as a product with essential oils, whose efficacy is unproven. There is no proof, for example, that apple cider vinegar, which is recommended by a number of websites as a tick preventative, works at all.
For that matter, not even highly effective brand name products will stop or kill 100 percent of the ticks your pets encounter. A 2017 Centers for Disease Control and Prevention initiative surveyed 2,727 households in three states where Lyme disease is endemic—Connecticut, Maryland and New York. More than half had a dog, cat or both in the residence and about 88% of those households reported using some form of tick control. Despite this about 20% of households with pets still found ticks on their animals.
Veterinarians are quick to point out, however, that preventatives only work if they are conscientiously used. “Market research indicates that pet owners are not 100% compliant,” said Dr. Hohenhaus. “Just because pet owners have the medication doesn’t mean they apply it on the schedule prescribed by their veterinarian.”
CHECK FOR TICKS DAILY
Moreover, Dr. Labato says: “With more options for prevention, we become complacent and rely on the sole activity of the tick preventative. But you still need to check each day for the presence of ticks on dogs, cats, and people.”
If a tick bites your dog, it can transmit Lyme bacteria, but only if it stays attached for more than 24 hours. That’s why Dr. Goldstein also stresses the importance of checking for ticks and removing them every day. “Go through your pet hair by hair,” he said. “Look at the paws. Look at the ears. Look around the muzzle, the face.”
Dr. Goldstein also suggests setting up perimeter boundaries in yards. “If you’re up against woods in your yard,” he explains, “a barrier of wood chips or pebbles will prevent ticks from going across your property. They can be carried across it by an animal, of course, but at least they won’t cross such a barrier like that without assistance.”
“The most important thing to stress is prevention.”
Revealed: Basic Math Error Likely Cause Of Global Coronavirus Panic!
Published on
Written by Jim Holt
Before the US economy disintegrates into nothingness — Will any so-called expert out there also notice that the WHO Director caused a global coronavirus panic over a basic math error?
The controversial Ethiopian politician and Director General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, claimed in a press conference in early March that the fatality rate for the coronavirus was many multiples that of the fatality rate of the common flu.
While many people globally have built up immunity to seasonal flu strains, COVID-19 is a new virus to which no one has immunity. That means more people are susceptible to infection, and some will suffer severe disease.
Globally, about 3.4% of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1% of those infected.
This statement led to the greatest panic in world history as the global elite media shared and repeated that the coronavirus was many, many times more deadly than the common flu.
The Problem Is His Statement Is False.
It Was Not Accurate!
As The Gateway Pundit reported Monday, the coronavirus mortality rate reported by the media as stated by Dr. Ghebreyesus is completely inaccurate.
Here’s a summary of the analysis updated with today’s latest numbers proving the Director General’s statement was very misleading and materially false:
N/A – not available
A look at the numbers:
** Tedros Adhanom Ghebreyesus used the actual number of deaths due to coronavirus divided by confirmed cases to get his 3.4% mortality rate number (from last week -since that time the mortality rate based on current reported numbers is near 4%)
** Tedros Adhanom Ghebreyesus then compared the actual coronavirus mortality rate to an estimated flu mortality rate of 0.1% — The US flu mortality rate is based on an estimated 22,000 deaths divided by an estimated 36 million flu cases giving a 0.1% mortality rate.
** Tedros Adhanom Ghebreyesus compared known numbers for coronavirus (3.4 percent mortality rate) but did not include the estimated number of those infected who are asymtomatic. This number is likely in the tens of thousands and could be in the millions! There is no way of knowing right now. One study released this week revealed that 6 of 7 people infected by coronavirus are asymptomatic! They do not know they are infected!
** Tedros Adhanom Ghebreyesus then compared the known numbers of 206,845 cases of coronavirus to the millions of estimated annual cases of flu cases. Again he does not include the asymtomatic cases, the 6 of 7 people infected who do not suffer severe symptoms.
** If asymtomatic cases are included in Ghebreyesus’s calculation the actual mortality rate of the coronavirus is somewhere between 0.2% to 0.8% or lower.
**Tedros Adhanom Ghebreyesus’s calculations of a 3.4% mortality rate is off by nearly 3.0%!
Ghebreyesus compared apples to oranges and his numbers were completely inaccurate!
* * * * * * * * * * *
As of Wednesday morning.
There were 7,301 confirmed cases in the US.
There were 116 confirmed deaths associated with the coronavirus in the US.
The mortality rate for those two sets of numbers is 1.6%.
We also know that according to a new study by the journal Science — 6 of 7 coronavirus victims, or 86% of infections, were undocumented.
If latest study published in the Science journal is correct then the coronavirus scare will be the greatest hoax in world history causing trillions and trillions of dollars in economic damage.
The WHO and Tedros Adhanom Ghebreyesus need to be held responsible!
PRINCIPIA SCIENTIFIC INTERNATIONAL, legally registered in the UK as a company
incorporated for charitable purposes. Head Office: 27 Old Gloucester Street, London WC1N 3AX.
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**Comment**
No one is denying there are serious, even fatal cases of viral illnesses (some are of the Corona type). There always have been and there always will be. No one is diminishing the need for everywhere to take care of themselves (something we should already be doing) and avoid people when sick. What is going on right now; however, is beyond sanity and needs to be checked and reigned in.
I’m far more worried about the actions of panic-driven people than I am of a virus.
And then there’s this interesting 2015 article: https://www.nature.com/news/engineered-bat-virus-stirs-debate-over-risky-research- that has a recently added disclaimer that their story is being unwittingly used for unverified theories that this virus was engineered. Two of the authors work at the Key Laboratory of Special Pathogens & Biosafety, Institute of Virology, in Wuhan, China
Key take-aways from the article (you be the judge about engineered viruses):
Scientists investigated a virus found in horseshoe bats in China and then created a chimeric virus which included part of the bat virus and part SARS virus. They found this newly created virus infects human airway cells.
Virologist Simon Wain-Hobson points out that this novel virus grows “remarkably well” in human cells, and “If the virus escaped, nobody could predict the trajectory.”
The study began before a US moratoriumon federal funding for this type of SARS, influenza, and MERS research that increases virulence (gain of function). The NIH allowed it to proceed and concluded the work was not so risky as to fall under the moratorium.
Per usual, there’s people who stand to gain a lot from a panic. I wish I could say scientists are immune from this, but more and more science is being hijacked by unethical people who care more about obtaining grants than they do about the truth. We see this in Lyme/MSIDS research, vaccine research, and in many other areas. Also, authorities are covering up details about the origin of this virus and the role they played in its potential spread.
The truly frightening aspect, besides the diminishing individual freedoms and negative impact on the economy, is the forthcoming vaccine which has been fast-tracked and bypasses important animal testing phase:
Brenna and Joel Siebold are seen with their son, Leo, 2, at their home in Mount Horeb, Wis., on Feb. 14, 2020. Leo has heterotaxy syndrome, a condition in which his internal organs are abnormally arranged, causing frequent hospital visits for the family. On Sept. 5, 2018, Leo was taken to the American Family Children’s Hospital in Madison, Wis., with a fever. Medical personnel reported them for possibly abusing the then 9-month-old, citing tiny bruises on his body. Although they were cleared of the allegations, the Siebolds say the episode left them with lingering trauma.
Brenna Siebold had just returned home from teaching third grade at Mount Horeb Intermediate Center. Her 9-month-old son, home with his sitter, was acting sluggish. She took Leo’s temperature: 103 degrees.The fever was only the latest health scare in Leo’s short life. He was born with heterotaxy syndrome, in which the internal organs are abnormally arranged. He had already endured two surgeries, and doctors instructed the Siebolds, of Mount Horeb, to bring him to the emergency room any time he ran a fever above 100.4 degrees.
That day, Sept. 5, 2018, Brenna dropped off her older children, Jocelyn and Jonah, at her parents’ house. Her husband, Joel, was at work as a custodian at Glacier Creek Middle School in Cross Plains. Then she drove Leo to a familiar destination: American Family Children’s Hospital in Madison.
Coburn Dukehart / Wisconsin Watch
Leo Siebold, 2, is seen with his brother Jonah, 5, at their home in Mount Horeb, Wis., on Feb. 14. Medical personnel at American Family Children’s Hospital in Madison, Wis., reported their parents, Brenna and Joel Siebold, of possible abuse to Leo when he was 9 months old. Police and child welfare officials ruled the allegations unfounded, but Brenna Siebold says she is now “petrified” to take any of their five children to the hospital.
The visit was traumatic. Leo thrashed and screamed while ER staff and Siebold struggled to hold him down to insert a needle into his veins and poke a catheter into his groin. “There was blood all over the table,” Siebold recalled.
The following day, staff confronted the Siebolds about bruises found on Leo — bruises that Dr. Barbara Knox, head of the hospital’s Child Protection Program, flagged as possible signs of abuse.
The encounter sparked an investigation that threatened to rip apart the Siebold family and ruin their careers. Surgical scars on Leo were listed as bruises. Demonstrably false information was inserted into his medical record. And Knox allegedly misrepresented herself as a specialist in an attempt to convince the family to approve additional medical testing.
Police instantly dismissed the abuse allegation. Child welfare officials would clear the couple after two months. But the episode left Brenna Siebold “petrified” of seeking emergency medical care for their children, including twins, Hazelle and Hank, born in December.
University of Wisconsin-Madison
Dr. Barbara Knox was placed on paid leave in mid-2019 while University of Wisconsin officials investigated “unprofessional acts that may constitute retaliation against and/or intimidation of internal and external colleagues.” Knox voluntarily left her position at the medical school and the American Family Children’s Hospital in October. She now works for Alaska CARES, a child abuse response and evaluation program in Anchorage.
Now Knox — considered a national expert on child abuse who testifies as an expert for prosecutors around the country — is under the microscope.
The University of Wisconsin placed her on paid leave in mid-2019 after colleagues inside and outside of the hospital accused her of intimidation or retaliation, an internal letter shows.
Dr. Ellen Wald, chairwoman of the Department of Pediatrics at the UW School of Medicine and Public Health, wrote to Knox on July 5, saying the administrative leave involved concerns about “your workplace behavior, including unprofessional acts that may constitute retaliation against and/or intimidation of internal and external colleagues.”
The university took three months to produce that two-page letter after Wisconsin Watch filed a November public records request for complaints against Knox in her personnel file.
After the letter was released, a UW-Madison spokeswoman confirmed that Knox voluntarily left her $204,000-a-year position as an instructor and physician at the UW-affiliated children’s hospital in October.
UW Health spokesman Tom Russell said the hospital took “appropriate action” after investigating the allegations against Knox but declined to specify what that was.
Russell also said UW Health hired a consultant in September to evaluate the Child Protection Program — and implemented recommendations for improvement. Among them: a monthly multi-disciplinary conference to review cases.
Knox now works as the medical director of Alaska CARES, a child abuse response and evaluation program based at the Children’s Hospital at Providence in Anchorage. President of the nonprofit Academy on Violence and Abuse, Knox also has worked with the FBI.
Courtesy of the Siebold family
Leo Siebold’s arm is seen on Sept. 8, 2018, one day after he was released from American Family Children’s Hospital. The hospital reported Brenna and Joel Siebold to police and child welfare officials after medical personnel found tiny bruises on Leo, then 9 months old, that they labeled as possible signs of abuse. The Siebolds say this bruise likely was sustained during a traumatic trip to the emergency room three days earlier as ER staff and Brenna Siebold struggled to hold Leo down to insert a needle and catheter.
Two email messages with questions about her leave and about the Siebold case were not returned. A voicemail asking Knox to respond to the questions also was not returned.
Knox is a prominent member of the growing field of child abuse pediatrics. Board certification for child abuse pediatrics began in 2009. As of 2018, there were 346 such physicians in the United States, including five in Wisconsin.
As the specialty has grown, so has outside scrutiny of its work. News investigationsand advocacy groups are increasingly questioning some of these doctors’ qualifications to separate the hundreds of thousands of legitimate cases of child abuse from accidents or underlying medical conditions.
In addition to the Siebolds, Wisconsin Watch has heard from two other Madison-area parents who report being cleared of child abuse allegations after American Family Children’s Hospital reported them to authorities.
Russell defended the work of the Child Protection Program. Abuse is a leading cause of death and disability in children, and program staff are dealing with “some of the toughest issues imaginable,” he said. The program’s staff and physicians “are committed to approaching each patient and family with empathy, compassion and support during intensely stressful times,” Russell added.
Knox ‘pressured’ colleague to find abuse
Soon after arriving at the children’s hospital in 2006, Knox drove the prosecution of Jennifer Hancock, a Verona day care provider who was convicted of killing an infant in her care. Hancock, now serving a 13-year prison term, is appealing the conviction in Dane County Circuit Court.
Hancock’s attorneys, led by the UW Law School-based Wisconsin Innocence Project, presented three medical experts during testimony in late 2019 and early 2020 who say pre-existing medical problems could have contributed to the 2007 death of the 4-month-old. Among the experts: the UW Hospital forensic pathologist who conducted the baby’s autopsy.
Coburn Dukehart / Wisconsin Watch
Jennifer Hancock glances back at her family in Dane County Circuit Court in Madison, Wis., on Dec. 19, 2019. Hancock, 49, is seeking a new trial after being convicted for the death of a 4-month-old child in her care. The forensic pathologist who testified at trial has since changed his view of the cause of death from abuse to “undetermined.” Hancock is serving a 13-year prison sentence for first-degree reckless homicide for the baby’s 2007 death.
Dr. Michael Stier testified that Knox and others at that hospital pressured him to conclude that the child was abused, possibly coloring his testimony at the 2009 trial.
During a post-conviction motion hearing in November, Stier said he felt “peer pressure” to conclude that the baby suffered a skull fracture and that it was caused by abuse. Anyone who voiced an objection, he testified, “probably would’ve been laughed out of the room and told to go back to medical school.”
“It’s possible, either consciously or subconsciously, the narrative that I provided under oath … is partly based on that,” Stier testified.
Stier said he has witnessed brain bleeding similar to that child in other people who died from natural causes, accidents or drug overdoses. The baby also had a heart virus that may have contributed, Stier said.
He is sure the infant had no skull fracture.
Coburn Dukehart / Wisconsin Watch
Dr. Michael Stier, forensic pathologist at the University of Wisconsin Hospital, testifies in Dane County Circuit Court in Madison, Wis., on Nov. 21, 2019. Stier’s testimony helped to convict Jennifer Hancock, a Verona day care provider, in the 2007 death of a 4-month-old baby in her care. Stier has since changed the interpretation of his findings, identifying several possible causes of the baby’s death besides abuse.
“If I were to testify at trial today, I would not testify that (the baby’s) death was caused by non-accidental inflicted injury,” Stier wrote in a sworn affidavit. “Instead, I would testify that there is no definitive cause of death. In other words, the cause of death is undetermined.”
In August, Dane County Deputy District Attorney Matthew Moeser sent a letter informing a defense attorney in another case that the UW had placed Knox on administrative leave while it investigated complaints about her behavior.
The move came as Knox was working with Moeser, the prosecutor in the Hancock case, and on two FBI cases, according to the UW.
In response to emailed questions, Dane County District Attorney Ismael Ozanne did not address the UW’s decision to place Knox on leave. In his 10 years as district attorney, Ozanne wrote that he has never had a reason to doubt the diagnoses of the Child Protection Program. He said the program, where “necessary or appropriate,” consults other specialists at the hospital in reaching its diagnoses.
Coburn Dukehart / Wisconsin Watch
Dane County District Attorney Ismael Ozanne is seen in Dane County Circuit Court in Madison, Wis., on Dec 19, 2019, prior to the start of Jennifer Hancock’s hearing. Ozanne wrote in an email that he has never had a reason to doubt the diagnoses of the Child Protection Program.
“I have faith that the members of that program have made assessments and offered opinions based on sound medical science,” he wrote. “The UW Child Protection Program relies upon research that is widely accepted by many entities such as the American Academy of Pediatrics and the Society for Pediatric Radiology.
“My office’s goal in any prosecution is to seek the truth and to pursue justice. The UW Child Protection Program has been and remains an invaluable partner in this work.”
Parents accused of abuse
On Leo Siebold’s second day in American Family Children’s Hospital, three women approached the Siebolds and two of their children, Leo and Jonah, along with Brenna’s parents, in a playroom. One was Knox, who identified herself as a “blood specialist,” according to the Siebolds and Brenna’s parents, Randy and Nancy Gerke.
Brenna Siebold was instantly suspicious. She had talked to Leo’s hematologist at the hospital earlier that day, and that doctor had not mentioned any problems. UW Health declined to address the allegation that Knox had misrepresented herself, and Knox did not respond to emailed questions about the incident.
Coburn Dukehart / Wisconsin Watch
Brenna Siebold is seen with her son Leo, 2, and daughter Hazelle, 2 months, at their home in Mount Horeb, Wis., on Feb. 14. Siebold is speaking out about the unfounded allegations of possible child abuse leveled against them by Dr. Barbara Knox and members of the Child Protection Program at American Family Children’s Hospital in Madison, Wis. Knox has since voluntarily left the hospital after being investigated for unprofessional acts toward colleagues.
Siebold said Knox eventually admitted she was there on behalf of the Child Protection Program. She mentioned the bruises on Leo’s arms, legs and torso. She wanted the Siebolds to consent to a full body X-ray and additional blood tests. Her suspicion: possible abuse.
The hospital’s guidance advised doctors to notify the Child Protection Program of even small bruises found on infants who are not yet “cruising,” or pulling themselves up on furniture. Such bruises, the guidance warned, are “sentinel” injuries that can signal possible child abuse. Knox helped to write the policy, basing it on “national guidelines and practice,” Russell said.
The Siebolds offered several innocent explanations for Leo’s bruises. Perhaps they came from Leo’s “Army crawling” over toys on the wooden floor of the family home — or from Leo’s struggle with Brenna Siebold and ER staff during the examination a day earlier. Knox and physician assistant Amanda Palm rejected those theories. The hospital reported the bruises to authorities as “unexplained.”
In this family video clip, Leo Siebold is seen crawling on the floor of his Mount Horeb, Wis., home on Sept. 1, 2018. On Sept. 7, 2018, American Family Children’s Hospital officials reported Joel and Brenna Siebold to authorities for possible abuse, citing small bruises on Leo, then 9 months old. The Siebolds say they told Dr. Barbara Knox and physician assistant Amanda Palm that Leo was “Army crawling,” which could explain the bruises. The hospital reported the bruises as “unexplained.”
Video courtesy of the Siebold family.
(Go to link for video)
Mount Horeb Police officers Susan Zander and Jenn Schaaf interviewed the Siebolds at the hospital; one officer knew Brenna Siebold personally. They quickly discounted the allegations, writing in a one-paragraph police report that the bruises were “caused by medical staff.”
After a two-month investigation, the Dane County Department of Human Services also concluded there was no evidence of abuse.
Minor bruises could spark even more investigations under a bill introduced in 2019 by U.S. Sen. Tammy Baldwin, D-Wisconsin. It would create a $10 million demonstration program on how to use “sentinel injuries” in children 7 months and younger, including minor bruises, to detect — and prevent — child abuse and fatalities.
Doctor charged with abuse — experts disagree
Recently, a Milwaukee hospital’s handling of child abuse allegations has attracted national attention. Officials at Children’s Wisconsin hospital say they are investigating their approach to identifying child abuse after NBC News reported on a disputed case involving one of the hospital’s own doctors. In late January, Dr. John Cox was criminally charged with abusing a 1-month-old infant whom he and his wife, fellow Children’s Wisconsin physician Dr. Sadie Dobrozsi, were adopting.
University of Wisconsin-Madison
Dr. Barbara Knox and physician assistant Amanda Palm are seen on the cover of the Spring 2018 Physician Assistant Spotlight newsletter. The article features the Child Protection Program at the American Family Children’s Hospital. Palm is quoted as saying, “Knowing that you’re helping is really powerful.”
The story cited 15 experts, including physicians from Children’s Wisconsin, who identified a series of medical mistakes and misstatements that cast doubt on whether the baby showed signs of abuse. Authorities removed the infant from the couple’s home last May.
Cox had taken the baby to the hospital after he fell asleep with her in bed and feared he may have rolled onto her. The child later was found to have a broken collarbone.
Unnamed emergency room doctors quoted in the NBC News story described an “out of control” child abuse team at Children’s Wisconsin that routinely reported minor injuries to authorities. In addition, three doctors at the hospital told NBC News that the child abuse team instructed them to alter medical records — labeling children as possible abuse victims even when the doctors did not suspect it.
The story quoted experts who found the baby’s birthmarks were mistaken for bruises and that a crucial blood test to determine whether the infant had a bleeding disorder that could have caused bruising was misinterpreted.
Kate Judson, executive director of the nonprofit Center for Integrity in Forensic Sciences in Madison, told Wisconsin Watch that a finding of child abuse requires ruling out other causes by taking a thorough history, diagnostic testing and consultations with experts such as hematologists, endocrinologists, neurologists and dermatologists.
But she has seen child abuse pediatricians ignore these “important steps,” claiming they themselves have the expertise to make these determinations — even ignoring contradictory expert opinions and laboratory testing, which she called “disconcerting.”
Coburn Dukehart / Wisconsin Watch
Jennifer Hancock, 49, is seeking a new trial after being convicted of homicide in 2009 for the death of a 4-month-old boy who was in her care. A medical expert who testified in the first trial has since changed the interpretation of his findings. Hancock is currently serving a 13-year prison sentence for first-degree reckless homicide for the 2007 death of the infant. Hancock is seen in Dane County Circuit Court in Madison, Wis., on Dec. 19, 2019.
Judson said these doctors can wield significant power within a hospital and “physicians can run into problems when they get sideways with child abuse pediatricians.” She cited cases of doctors who faced discipline or criminal prosecutionfor contradicting the findings of child abuse pediatricians.
Madison attorney Notesong Thompson, a former member of the Wisconsin Child Abuse and Neglect Prevention Board, believes child advocacy teams at hospitals have “way too much power” and are “running amok.”
“Child advocacy is the reason I went to law school,” she said. “It sickens me how it’s become so twisted.”
Thompson was an emergency room nurse for 17 years at Children’s Wisconsin where she worked with Cox. Thompson told Wisconsin Watch she is certain her former colleague is innocent.
“If you think about the nicest person in the world being accused of child abuse — that’s John,” she said.
Surgical scars marked as bruises
Courtesy of the Siebold family
Leo Siebold is seen on Sept. 8, 2018, one day after he was released from American Family Children’s Hospital. The hospital reported Brenna and Joel Siebold to police and child welfare officials after medical personnel found tiny bruises on Leo, then 9 months old, that they labeled as possible signs of abuse. The Siebolds were cleared of the allegations.
During a lengthy interview at the dining room table of their home in Mount Horeb — a village known for its large carved wooden trolls dotting Main Street — the Siebolds documented issues similar to those raised in the Cox case.
The couple showed photos taken of Leo shortly before and after his hospitalization. The bruises on his arms, leg and abdomen were tiny — barely visible. Joel Siebold says Leo did have a few bruises that “obviously came from being held in the ER.” But Amanda Palm reported many more.
“She found bruises everywhere — things that weren’t even there,” he recalled. “His surgical scars — he has two scars on each side of his abdomen. She charted those.”
Brenna Siebold jumped in. “She was charting diaper rash — like the tabs from the diaper. You get a little red — she was charting those.”
UW Health declined to discuss the situation, citing patient confidentiality.
The Siebolds found false information in Leo’s medical records, including an incorrect reference to the family being covered by BadgerCare, the state’s health insurance program for low-income residents. “That whole entire thing was just made up,” Joel Siebold said. “Nothing in that is true — at all.”
Coburn Dukehart / Wisconsin Watch
The Siebolds are seen at their home in Mount Horeb, Wis., on Feb. 14. From left are: Joel; Jocelyn, 9; Hazelle, 2 months; Hank, 2 months; Jonah, 5; Brenna and Leo, 2. Brenna Siebold is a teacher and her husband Joel works as a school custodian. The allegations of possible child abuse that officials at a Madison, Wis., hospital made against them — later declared unfounded — threatened to ruin their careers and split up their family, they say.
Brenna Siebold remains haunted by her family’s run-in with Knox’s team at American Family Children’s Hospital. She wonders how less-educated parents — or ones without such strong community ties and family support — could weather such accusations.
That is why she is speaking out.
“I knew there were other people out there like us — and who we will never know because of (health care) confidentiality,” Siebold said.
“I worried about a single mother. I worried about a mother of color. I worried about a family that doesn’t speak English. … And that’s the teacher in me. I was like, ‘If this happens, I want to prevent (it.)’ ”
