Daughter’s suicide sparks advocacy role — (Pacifica Tribune)

Pacifica Tribune

By Chris Hunter

Jim Torlakson uses art to make a statement

When a parent outlives a child, we all can sympathize with the grief that remains.

Sometimes, the specific tragedy can inspire a kind of rebirth through advocacy. In national news, Bay Area resident Cindy Sheehan has been inspired by the death of her son in Iraq to challenge President Bush on the war. John Walsh turned the disappearance and murder of his son Adam into a life’s work to prevent, or at least catch, criminals.

Locally, James Torlakson has found that his artistic background is helping him become an advocate for a growing battle against drug companies and their pharmaceutical therapies for depression.

On March 15, 2004, his daughter Elizabeth, just 21 years of age, entered a closed BART tunnel in San Francisco and threw herself in front of a train. She had been under the care of a doctor who had prescribed the drug Celexa to treat her depression.

A debate on the effectiveness of mood-altering drugs is growing in intensity, with more and more people recognizing the possible connection between drugs meant to heal and the sometimes-negative effect they can produce. In fact, it’s becoming something widely recognized as an important, public topic. Most objective websites, even those produced by the drug companies themselves, indicate that “suicide” is a potential side effect of taking the drug Celexa, for example. But they also point to the countless patients who are helped by the drug.

Torlakson’s brother, Tom Torlakson, is a California State Senator (D-Anitoch) who has initiated legislation that would simply require doctors to have a brief training session about the controversy before prescribing drugs to depressed young people. Senate Bill 524 is not yet law, and has been struggling against drug company lobbying. Ironically, when Elizabeth Torlakson died, the San Francisco Chronicle wrote about her as the niece of State Senator Tom Torlakson, leaving her father out of the news story completely. Lately, Jim Torlakson says his politician brother is doing all he can to help.

The FDA earlier this year ruled that drug companies must place a “Black Box” warning on some drugs indicating that they could possibly induce suicidal behavior in some cases, particularly in children and adolescents. In last weekend’s The Boondocks, a nationally syndicated Sunday newspaper comic strip by Aaron McGruder, a cartoon character promoting “Truth” asks an adult in one panel “Did you know that Prozac can lead to suicide?”

The growing awareness of the problem has given Pacifican James Torlakson a little bit of comfort, but nothing will ever take away the pain of having lost his daughter. So, he has embarked on a journey to help other families realize they are not alone with similar grim situations.

Torlakson, who teaches art at City College of San Francisco, has been relentless in his exploration of his daughter’s death. He acquired eerie BART photos showing her last few moments alive. He analyzed every detail of the police reports, the autopsy and every other official bit of paperwork he could get his hands on. His most prized possession is the toxicology report that links the drug his daughter was taking to her death.

“I’ve had a lot of things of a real spiritual nature happen,” says Torlakson. “I asked God what to do next. The answer was just instant; a complete package.”

The revelation for Torlakson was to use his artistic talents to speak for himself and the other families across the nation who have similar stories. His website, already established as a showcase for his art, became a virtual gathering place for like minds. His ultimate goal is to establish the “Elizabeth Torlakson Foundation” as an entity that can have an impact on the issue. A small artistic shrine in his workshop, devoted to Elizabeth, is an example of how Torlakson tries to keep the memory of his daughter alive. He gives a lot of credit to his wife, Stephanie, for her unconditional support of his current activities.

He created a poster that shows a handgun next to a bottle of pills. Another poster shows a graphic image of exactly what happened to his daughter when the BART train hit her. Alongside the image is a series of statements and indictments of drug companies, doctors and others Torlakson blames.

“It’s just at the beginning,” he says of his web and poster efforts. “The very core issue is to save lives by getting people aware of the problem.”

As if to prove that he is really not alone, Torlakson has been receiving email from people who stumble across his website and the story of Elizabeth.

“I’m the mother of five children,” writes one woman, going on to tell of her 15-year-old son who committed suicide while taking the drug Celexa. “I found the website about Elizabeth Torlakson and just felt the need to make contact. Thank you for sharing your story through pictures.”

Torlakson says he is in touch with other people who have lost children and is hoping to provide graphic images and posters to link the grieving community. Some advocates have asked Torlakson for images. He has also designed and had made a lapel pin promoting the political advocacy action.

“I’m helping with the grieving process,” says Torlakson. “That’s what we do. It will help pull people together. This is more important than anything I’ve ever created. The work is painful, but I have not been this inspired since I began my career. This is what I’m supposed to be doing and I’ve just put my heart in it.”

For details about what James Torlakson is doing, visit his website at www.jamestorlakson.com. He is exhibiting some artwork, unrelated to this project, at the US Bank office in Eureka Square. He also would like to hear from anyone interested in participating in his work or helping to fund his efforts at promoting public awareness.

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Depression CME Mandate Defeated in California — (Psychiatric News)

Legislation to require the more than 30,000 primary care physicians in California to qualify to treat depression was defeated shortly before the state legislature adjourned in August.

The California State Assembly rejected by a wide margin a bill (SB 524) that would have created a mandatory continuing medical education (CME) requirement for all family physicians who treat depression. The Assembly rejection followed the California Senate’s approval of the measure on May 23.

The bill stated that “all primary care physicians who treat patients for depression and other related ailments, specifically through the prescribing of [selective serotonin] reuptake inhibitors (SSRIs) and other newer antidepressants, shall complete four units of mandatory continuing education on that subject every four years.”

The California Psychiatric Association (CPA) joined other physician groups to oppose the bill on the basis that it would discourage family physicians from treating depression because of the burden of additional mandated CME. That would result in reduced health care access for Californians with depression.

“Consultation and collaboration between psychiatrists and family physicians is the most important thing to get the highest quality of care, and this bill just wouldn’t have achieved this goal,” said Randall Hagar, the CPA’s director of government affairs.

The bill was sponsored by Sen. Tom Torlakson (D), whose interest in the issue developed after the suicide of his 21-year-old niece in March 2004. At the time she was taking Celexa prescribed by a general practitioner for depression.

Torlakson said in testimony that the use of antidepressant medications, specifically SSRIs, has increased significantly in recent years. Concern also has grown, he said, that in some cases the drugs may increase suicidal tendencies in those with depression, especially for adolescents and young adults.

The legislation, Torlakson said, arose from concerns that physicians are either unaware of the risks or are inadequately monitoring the danger such medications can pose to youths.

The legislation followed the Food and Drug Administration’s October 2004 order that drug companies label all antidepressant medications distributed in the United States with strongly worded warnings regarding “clinical worsening, suicidality, or unusual changes in behavior” associated with initiation of antidepressant therapy.

The California legislation was supported by the California Psychological Association due to what it describes as a lack of standardized treatment protocols for physicians prescribing SSRIs—protocols that recommend the frequency of office visits when prescription medications are started, dosage is changed, or medication ended.

Opponents of the measure countered that the link between suicide and SSRIs remains unsettled and argued that uncertainty should not be enshrined in law until more is known. Untreated depression, Hagar said, is a much larger and more serious societal issue and entails many serious consequences, of which suicide is one.

“Legislative micromanagement of continuing education requirements can never be an effective substitute for medical judgment,” Hagar said.

California physicians are required to complete 100 hours of CME every four years. The only other specifically required CME courses are one-time courses covering pain management and treatment of the terminally ill. Physicians are exempt from those CME requirements if they do not directly care or provide consultations for patients in those categories, said state officials.

Opponents of the bill said the legislation would have created the first disease-specific education requirement for California physicians, which could open the door to requiring CME for many other high-profile conditions.

In addition to the CPA and CMA, the legislation was opposed by the American College of Obstetricians and Gynecologists, California Academy of Family Physicians, California Association of Physician Groups, California Society of Industrial Medicine and Surgery, California Society of Physical Medicine and Rehabilitation, Medical Board of California, and Osteopathic Physicians and Surgeons.

This was the first year the bill was considered by the legislature, and because the state Senate approved it, opponents said they may need to fight it again in the next legislative session.