Alec Baldwin, wife expecting a baby this summer

NEW YORK (AP) — Alec Baldwin and his wife are expecting their first child together.

Publicist Matthew Hiltzik confirmed Tuesday that Hilaria Baldwin is due late this summer.

Alec Baldwin already is the father of a 17-year-old daughter, Ireland, from his previous marriage to actress Kim Basinger (BAY'-sing-ur). Hilaria Baldwin is a special correspondent for the TV show "Extra." The couple wed last June after a three-month engagement.

Alec Baldwin recently won a SAG Award for best actor in a TV series for the NBC comedy "30 Rock," which concluded its seven-year run two weeks ago.

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Prostate Cancer Study Suggests Shorter Treatments

Men with high-risk prostate cancer treated with only 18 months of hormone therapy live just as long as those treated for a more standard 36 months, a new study has found.

If the study results are applied in practice, it could mean much shorter treatment, sparing men months of unpleasant side effects, researchers said Tuesday.

“This may well change the standard of care,” said Dr. Bruce J. Roth, a prostate cancer specialist at Washington University in St. Louis. “Three years of hormonal therapy was almost picked randomly, and there’s nothing magical about that duration.”

Dr. Roth was not involved in the study, but he moderated a news conference for the Genitourinary Cancers Symposium, which will take place starting Thursday in Orlando, Fla., and is where the results will be presented.

Hormone therapy is essentially chemical castration, in which drugs are used to block the body’s production of testosterone, which fuels prostate tumor growth.

The side effects, including hot flashes, loss of sexual desire, fatigue and the weakening of bones and muscles, make life “quite miserable,” said Dr. Abdenour Nabid of Sherbrooke University Hospital Center in Sherbrooke, Quebec, who was the lead investigator.

The study involved 630 patients with localized but high-risk prostate cancer who were treated with radiation therapy and hormone therapy. While that description fits only a small portion of the 240,000 new cases of prostate cancer diagnosed each year in the United States, the results would still apply to thousands of men, researchers said.

After a median follow-up of about six and a half years, 77.1 percent of the men who received 36 months of therapy were still alive, as were 76.2 percent of the men treated for 18 months.

While slightly more men receiving the longer treatment were alive at five years, the difference was not statistically significant, and for the patients already followed for 10 years, the survival rates were similar. The death rate specifically from prostate cancer was also the same after 10 years.

There were also no statistically significant differences in the rate of biochemical failure — when the P.S.A. marker rises — or in the spread of cancer to the bone, Dr. Nabid said. The difference between the two therapy durations on the quality of the patients’ lives is still being studied.

Dr. David I. Quinn, medical director of the University of Southern California Norris Cancer Hospital, said the results “will change the approach for men who’ve got the worst localized prostate cancer that we see.” He said the results went against some previous studies that suggested that “more is better.”

But Dr. Michael J. Morris, associate professor at the Memorial Sloan-Kettering Cancer Center, said that 630 patients might be too few to draw “a relatively sweeping conclusion.” A study meant to prove that two treatments are equivalent may need to be much larger, he said.

Dr. Matthew R. Smith, professor of medicine at Massachusetts General Hospital, said it might be “overreaching” to make a conclusion yet because not many trial patients had died. “I think we need longer follow-up,” he said.

Dr. Nabid, the principal investigator, said that patients would be followed for two or three more years but that he was confident the results would hold up.

The trial enrolled patients at 10 hospitals in Quebec from October 2000 to January 2008. The drugs used were bicalutamide and goserelin, sold by AstraZeneca as Casodex and Zoladex, respectively, but now subject to generic competition. AstraZeneca paid for the study.

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Carnival cruise ship being towed to U.S. after engine fire

A cruise ship that lost power because of an engine fire is being towed from the Gulf of Mexico, with many passengers sleeping on the deck to stay cool and standing in lines to get hot meals and use toilets.

The Carnival Triumph, carrying more than 3,000 passengers and more than 1,000 crew members, could reach Mobile, Ala., by Wednesday or Thursday, depending on sea conditions, according to the U.S. Coast Guard.

It is the latest cruise mishap for an industry that was hoping to rebound from last year's disastrous wreck of the Costa Concordia off the Italian coast. Miami-based Carnival Corp. owns the parent company that operated the Concordia as well as Carnival Cruise Lines, which owns the Triumph.

"These incidents are really, really rare, but when they happen they make big news," said Jay Herring, who worked on the Triumph for two years as a senior information system manager and wrote a book about the industry, "The Truth About Cruise Ships."

Carnival has already announced that it will issue full refunds to the passengers, plus travel expenses and credit toward a future cruise vacation.

"Every action we are taking is to get our guests home," Gerry Cahill, Carnival Cruise Lines chief executive, said at a news conference Tuesday. "There is no question that conditions on the ship are very challenging."

No one was injured in the engine fire, but it left the ship without propulsion. Two tugboats were dispatched to pull the cruise ship — nearly the size of three football fields — to Mobile. When the ship arrives, investigators from the U.S. Coast Guard and the National Transportation Safety Board will begin an inquiry into the fire.

The ship departed Galveston, Texas, last week on a four-day cruise to Cozumel, an island off Mexico's Yucatan Peninsula.

Messages from passengers on the Triumph, sent to family and friends, say some of the public and cabin toilets are not operating and only limited power is available to run elevators and heat food.

Several of the text messages were printed on Cruisecritic.com, a review site for cruise vacations. The messages said the rooms were so hot without circulating air that some passengers were sleeping in tents on the deck.

The husband of a passenger said he spoke to his wife Sunday by phone. "At the time I spoke to her, there were no toilets. They were using little red bags. And no running water, no lights, except emergency lighting," he said in a message to Cruisecritic.com.

Other family members said passengers were getting cranky and some were hoarding food. Others reported that without enough power, some toilets had begun to overflow.

Greg Magee, commander of the Coast Guard Cutter Vigorous, which was sent to escort the Carnival Triumph to Mobile, said he does not plan to transfer passengers off the cruise ship, which has been listing to one side as waves crash against the hull.

"It's not a very good option. Conducting an at-seas transfer in these conditions carries a lot of risk, and you would probably be delaying their return to home port," he said.

Magee said he was in constant contact with the cruise ship commander, who has been very cooperative. "He has not requested any assistance, so we have not boarded to see conditions inside," he said.

hugo.martin@latimes.com

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Mahony voting for a new pope rankles some Catholics

Nearly two weeks ago, Los Angeles Archbishop Jose Gomez announced he had removed Cardinal Roger Mahony from all public duties amid revelations that he plotted to conceal child molestation by priests from law enforcement.

But Mahony on Monday found himself back at the center of church business, as one of 117 cardinals who will elect a successor to Pope Benedict XVI.

Mahony was quick to weigh in on the papal news — posting a statement on his online blog at 8:38 a.m., two hours before the archdiocese announced that Gomez would issue his own remarks at the midday Mass at the downtown Cathedral of Our Lady of the Angels.

In the posting, Mahony called Benedict an "extraordinary" successor to St. Peter and that he intended to participate in choosing the next pontiff.

"I look forward to traveling to Rome soon to help thank Pope Benedict XVI for his gifted service to the Church, and to participate in the Conclave to elect his successor," Mahony wrote.

Benedict's unexpected decision to step down created a seemingly awkward situation in the Los Angeles Archdiocese, which is reeling over newly released documents showing how church leaders handled the abuse cases. Documents show that Mahony and Bishop Thomas Curry worked to shield abusers from police. Both have since issued detailed apologies.

Gomez wrote in a letter to parishioners last month that the priest files were "brutal and painful reading. The behavior described in these files is terribly sad and evil. There is no excuse, no explaining away what happened to these children."

Gomez wrote that Mahony, his predecessor as leader of the archdiocese, "has expressed his sorrow for his failure to fully protect young people entrusted to his care. Effective immediately, I have informed Cardinal Mahony that he will no longer have any administrative or public duties." A church spokesman later clarified that Mahony remained a priest "in good standing" and that he maintained all his powers as a cardinal.

Mahony is one of 11 U.S. cardinals who will vote for the next pope.

Father Thomas Rausch of Loyola Marymount University said Mahony has no choice in the matter: Church law requires him to vote, along with all cardinals under age 80, he said.

"It is a sacred responsibility of every cardinal of the church who is able to attend the conclave to vote," said Tod Tamberg, archdiocese spokesman.

Still, Mahony's role in selecting a pope drew mixed reactions among Catholics in Southern California.

Manuel Vega, a retired Oxnard police officer who as an altar boy was molested from the age of 12 to 15 by Father Fidencio Silva, said Mahony would bring shame on the Catholic Church by going to Rome to vote.

"Mahony is going without clean hands. His hands are dirty ... from covering up years of sexual abuse. How can he be part of the conclave?" Vega asked.

Other Catholics said they were pleased that Mahony would be voting. They said they hoped that he would bring a more liberal and American point of view to the conclave, which will be dominated by the conservative cardinals whom Popes John Paul II and Benedict XVI have appointed over the last three decades.

Jane Argento, a parishioner at Holy Family Church in South Pasadena, said she was livid at Mahony when she read about his actions after the archdiocese's release of sex abuse documents. But she said the relatively liberal Mahony reflected her own Catholic convictions about larger roles for women in the church, among other issues. Mahony, she said, was the architect of a pastoral associate program in Los Angeles that had trained several women to run parishes, including her own.

"I'm relieved that Mahony is going," Argento said. "Frankly, it's one more vote for a more progressive church."

Larry Loughlin, 77, a parishioner and social worker, said it was reasonable that Mahony vote, given church rules, and that he was not the only cardinal accused of failing to remove predatory priests from churches and schools. Others include Cardinal Justin Regali, who was accused of ignoring evidence of sex abuse, including rape, in the Philadelphia archdiocese before retiring in 2011.

"Mahony is not the only cardinal to be accused of protecting priests, it is a worldwide crisis," Loughlin said.

Parishioners who attended Monday's midday Mass at the downtown cathedral said they were saddened by news of Benedict's resignation but hailed it as a chance to renew a church still suffering from the repercussions of the abuse scandals. The scandals also appeared to be on the mind of Gomez, who celebrated the Mass and called for prayer "for anyone who has been hurt by a member of the church" and for "the healing for wounds and restoration of trust."

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'Identity Thief' grabs $34.6M to debut at No. 1

LOS ANGELES (AP) — Jason Bateman and Melissa McCarthy's "Identity Thief" has made off with the weekend box-office title with a $34.6 million debut.

The top 20 movies at U.S. and Canadian theaters Friday through Sunday, followed by distribution studio, gross, number of theater locations, average receipts per location, total gross and number of weeks in release, as compiled Monday by Hollywood.com are:

1. "Identity Thief," Universal, $34,551,025, 3,141 locations, $11,000 average, $34,551,025, one week.

2. "Warm Bodies," Lionsgate, $11,356,090, 3,009 locations, $3,774 average, $36,481,172, two weeks.

3. "Side Effects," Open Road Films, $9,303,145, 2,605 locations, $3,571 average, $9,303,145, one week.

4. "Silver Linings Playbook," Weinstein Co., $6,425,271, 2,809 locations, $2,287 average, $89,519,510, 13 weeks.

5. "Hansel and Gretel: Witch Hunters," Paramount, $5,753,165, 3,285 locations, $1,751 average, $43,836,018, three weeks.

6. "Mama," Universal, $4,229,665, 2,677 locations, $1,580 average, $63,951,810, four weeks.

7. "Zero Dark Thirty," Sony, $4,006,860, 2,562 locations, $1,564 average, $83,567,450, eight weeks.

8. "Argo," Warner Bros., $2,375,344, 1,405 locations, $1,691 average, $123,608,957, 18 weeks.

9. "Django Unchained," Weinstein Co., $2,303,495, 1,502 locations, $1,534 average, $154,516,627, seven weeks.

10. "Bullet to the Head," Warner Bros., $2,078,192, 2,404 locations, $864 average, $8,269,214, two weeks.

11. "Top Gun" in 3-D, Paramount, $1,965,737, 300 locations, $6,552 average, $1,965,737, one week.

12. "Lincoln," Disney, $1,873,537, 1,517 locations, $1,235 average, $173,621,006, 14 weeks.

13. "Parker," FilmDistrict, $1,867,411, 2,004 locations, $932 average, $15,848,064, three weeks.

14. "Life of Pi," Fox, $1,745,744, 924 locations, $1,889 average, $108,530,249, 12 weeks.

15. "Les Miserables," Universal, $1,555,550, 1,447 locations, $1,075 average, $143,983,705, seven weeks.

16. "The Hobbit: An Unexpected Journey," Warner Bros., $1,468,374, 1,001 locations, $1,467 average, $298,333,426, nine weeks.

17. "Parental Guidance," Fox, $1,071,766, 1,219 locations, $879 average, $74,344,256, seven weeks.

18. "Wreck-It Ralph," Disney, $1,065,817, 757 locations, $1,408 average, $184,414,532, 15 weeks.

19. "The Impossible," Summit, $957,594, 739 locations, $1,296 average, $16,668,338, eight weeks.

20. "Quartet," Weinstein Co., $940,930, 244 locations, $3,856 average, $5,000,417, five weeks.

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Online:

http://www.hollywood.com

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Universal and Focus are owned by NBC Universal, a unit of Comcast Corp.; Sony, Columbia, Sony Screen Gems and Sony Pictures Classics are units of Sony Corp.; Paramount is owned by Viacom Inc.; Disney, Pixar and Marvel are owned by The Walt Disney Co.; Miramax is owned by Filmyard Holdings LLC; 20th Century Fox and Fox Searchlight are owned by News Corp.; Warner Bros. and New Line are units of Time Warner Inc.; MGM is owned by a group of former creditors including Highland Capital, Anchorage Advisors and Carl Icahn; Lionsgate is owned by Lions Gate Entertainment Corp.; IFC is owned by AMC Networks Inc.; Rogue is owned by Relativity Media LLC.

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Bloomberg Lauds Companies for Cutting Salt Content

Mayor Michael R. Bloomberg, in the midst of a long-running campaign to change the eating habits of New Yorkers and consumers across the country, declared a victory against salt on Monday, as 21 companies, from Kraft and Goya to FreshDirect, said they had met the first stage in reductions in salt content in foods.

After focusing on reducing trans fats and smoking, Mr. Bloomberg turned his attention to salt in 2010, announcing that about 30 companies had signed up to reduce salt in foods by 25 percent within five years, as a way of lowering consumers’ blood pressure and saving lives lost to heart attack and stroke.

“These companies have a huge presence on our shelves and in our diets,” Mr. Bloomberg said at a news conference at City Hall as he announced the results, surrounded by a half-dozen executives of food companies.

The first stage focused on the low-hanging fruit — salsa, dips, bacon, ketchup, barbecue sauce, cold cuts, processed cheese, salad dressing, canned beans and pizza — foods whose salt content is so high that reducing it up to a point probably would not be noticed by many consumers.

Mr. Bloomberg called them “some of America’s most beloved and iconic foods,” suggesting that the cuts might have a disproportionately salutary effect. But Dr. Thomas A. Farley, the city’s health commissioner, said he did not know how much salt the results so far had removed from the average person’s diet.

One side effect of the salt reduction drive is that food companies are looking for salt substitutes to make food taste better.

The main way to do that is to add potassium chloride instead of sodium chloride, said Russ Moroz, vice president for research at Kraft Foods. But because potassium tends to have a bitter, mineral taste, other ingredients have to be added. He said these were proprietary secrets, and he declined to name them.

Potassium is good, Dr. Farley said, because it lowers blood pressure and most people do not get enough of it. It is removed from fruits and vegetable during processing, he said. Mr. Bloomberg said he thought fears of additives were overdone.

But a salt industry scientist said Monday that too much potassium could be bad for the kidneys, and that the “cocktail of chemical constituents” added to balance the bitterness and enhance the salty taste could present unknown risks, as those ingredients were undisclosed.

“They do it with one eye on the lab and the other eye on the label,” said Morton Satin, vice president for science and research at the Salt Institute, a trade association. “They make sure it’s below the level that the F.D.A. requires for it to be on the label.”

Mr. Satin said that the link between high blood pressure and salt was just “a theory,” and that reducing salt too much could have harmful effects, like iodine deficiency in children, a cause of mental retardation, and diabetes.

Some companies said reducing salt proved to be a popular marketing tool. Goya reported that it had reduced salt in its regular canned beans by 5 or 6 percent, without any drop in sales. “We tasted them, and you really wouldn’t notice the difference,” Joseph Perez, senior vice president of Goya Foods, said Monday.

Mr. Bloomberg said it might surprise many people to know that bread and rolls were the “biggest contributor” to salt in the diet. Eating a muffin, he said, could be worse than eating a small bag of Lays potato chips.

Bread makers are hard to spot on the list of companies that have pledged to reduce salt, perhaps, Mr. Satin said, because it is more difficult to make bread without salt. However, some companies, like Au Bon Pain, have reduced salt in some baked goods.

On an irreverent note, Mr. Bloomberg said that he loved Subway sandwiches and would eat his favorite, the Italian B.M.T. — it includes salami, pepperoni and ham — regardless of the salt content, but that he was glad that it now contained 27 percent less.

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Toy makers play up classics and creativity

NEW YORK — A digital Barbie vanity mirror that allows makeup experimentation without the mess. Customizable figurines mounted on spinning tops that battle in a portable arena. New Play Doh Plus that's fluffier and more malleable.

The hippest new toys showcased at the American International Toy Fair this week are interactive, adaptable and, often, more than a bit familiar.

"We're reinventing older brands so that kids can rediscover them as if they were new," said John Frascotti, chief marketing officer for Hasbro Inc., at the show in New York City. "A 5-year-old doesn't know or care that a toy has actually been around for decades."

More than 31,000 attendees — including 1,000 exhibitors — are congregating at the annual event, which is considered to be the start of a yearlong scramble to identify, market and occasionally copy the products expected to dominate the Christmas shopping season.

This year the hunt feels even more urgent. The U.S. toy industry had a lackluster 2012, with revenue falling slightly from the year before to $16.5 billion. Sales dropped even further compared with 2008, when they totaled $21.6 billion, according to research firm NPD Group.

Manufacturers, distributors, importers and buyers crowd the 366,000 square feet of space in the Jacob K. Javits Convention Center to display more than 150,000 products, including action figures, educational activities, bicycles, puppets, video and board games. The fair, the largest of its kind in the Western Hemisphere, began Sunday and lasts through Wednesday.

Toy analysts are already taking bets on likely trends.

One major buzzword? Construction playthings, and not just in the form of boys' building blocks.

Build-your-own robots and action figures and do-it-yourself doll backdrops helped the building sets sector grow 19.7% last year — the largest revenue gain of any toy category, according to NPD. Analysts expect another boost in 2013.

Parents want toys that their children can create themselves and customize instead of the "watch me" products that attempt to entertain kids with the push of a button, said Jim Silver, editor in chief of TimetoPlayMag.com.

"Especially with the economy the way it is, they're looking for toys that offer value through rebuilding, that kids can play with over and over again," he said.

Hasbro showed off Transformers Construct-Bots, which kids can build out from a robot frame foundation using armor, weapons and accessory parts. The company's new Iron Man Assemblers action figures can be compiled using a variety of arm, torso, leg and other body parts into hundreds of combinations.

Hot Wheels, owned by El Segundo company Mattel Inc., will soon enable children to construct their own track sets and create unique toy cars with special molds and accessory stickers.

"We live in a world of youth empowerment, where kids are used to an environment that they can control," Hasbro's Frascotti said. "They can already go to an iPad and design whatever they want, so why can't they do that in an analog world too?"

Toys that cross gender barriers are also gaining traction.

At the New York show, Hasbro debuted a silver-and-black version of its usually pink-and-purple Easy-Bake oven. The company, which was recently petitioned by tens of thousands of people for a boy-friendly Easy-Bake, said it has worked for more than a year on a more gender-neutral version of its 50-year-old cooking toy.

Last year, Zing Toys debuted a pink-and-purple bow-and-arrow set called the Air Huntress. At the show, Hasbro demonstrated its Nerf Rebelle Heartbreaker archery toy, a product packaged with darts covered in funky feminine patterns.

Lego used its small blocks to create life-sized models of girls in soccer uniforms and karate belts to exhibit its female-focused Lego Friends line. Spin Master adopted technology from its popular AirHogs flying toys in its new Flutterbye Fairy, a winged doll that launches off a charger modeled after a jewelry box and follows hand motions to stay aloft.

Mega Bloks stacked a pile of Barbie Build 'n Style play set suites — including blocks made up like kitchens or bedrooms — in a corner of its booth. The girl-centric construction product line launched in December and also includes pool party, fashion boutique and pet shop options along with figurines with interchangeable hair.

The market also is headed toward an "abundance" of old-school products featuring nostalgic, vintage or classic elements — "like the equivalent of bell bottoms or neon colors for toys," said Adrienne Appell, an analyst with fair organizer Toy Industry Assn.

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Venice program gives the homeless a place to keep belongings

Bone-chilling fog swirled along Venice Beach one recent afternoon when Robert and Nani Valencia and Ana Maria Reyes stopped by the long, metal storage container beside the sand.

After they showed IDs and claim checks, a volunteer wheeled out two blue recycling bins in which the three recent arrivals from Texas had stashed their suitcases. They pulled out toiletries, sweaters and blankets and stuffed them into reusable grocery bags.

"It makes us feel a lot better to store our things here," said Nani Valencia, 37. "When you have all your [suitcases] with you, people treat you like you have rabies."

With bags in hand, she, her husband and his 64-year-old mother joined dozens of others waiting for a bus to take them to a shelter. The three would rest, eat dinner and have a shower that night at the West Los Angeles National Guard Armory on Federal Avenue; most of their meager possessions would remain locked up at the beach.

In the wake of court rulings that bar cities from randomly seizing and destroying homeless people's property, communities such as Venice are seeking long-term storage options to keep their streets and alleys clean.

"We're not going to let [homeless people] keep items on the beach anymore," said Los Angeles Councilman Bill Rosendahl, who represents Venice. "We're going to bag and tag [them]. We want to make it inconvenient but within the law."

Contributing to the problem was a rule governing use of the city's Westside winter shelter.

Homeless individuals who choose to sleep at the shelter are allowed to take with them only the items they can carry on their laps. And some were reluctant to leave their possessions for fear they would be stolen or seized. That meant many of the shelter's 160 beds went unused.

Rosendahl and a local social services agency — Venice Community Housing Corp. — launched a pilot program late last month called Check-in Storage. The initiative allows individuals to store personal belongings in the container for a week at a time and retrieve them between 3 and 5 p.m. daily. (The program is slated to end March 1, when the shelter closes.)

To publicize the service, volunteers and social service agencies distributed bright orange fliers: "If your stuff will fit into a big trash can," they read, "bring it to our storage container." The flier noted that the program would not accept medicine, identification, weapons or "anything illegal."

The storage option, said Steve Clare, executive director of Venice Community Housing, is modeled on successful programs in downtown L.A.'s skid row and cities including San Francisco, San Diego and Costa Mesa.

In September, a federal appeals court ruled in a lawsuit filed against the city of Los Angeles that seizing and destroying property left temporarily unattended on public sidewalks was unconstitutional. Personal possessions may be removed only if the items pose an immediate threat to public safety or health or constitute criminal evidence, a panel of the U.S. 9th Circuit Court of Appeals found.

Even then, the city must notify owners where they can pick up their property.

On the afternoon the Valencias and Reyes retrieved some items, about half of the 25 bins were in use. Also there for safekeeping was a Schwinn bicycle. Its owner, Love Sha Un of Nigeria, came by to check on his $215 purchase and thank the volunteers. Without the storage option, he said, "it might have gone missing."

Not everyone is pleased with the program.

Mark Ryavec, a Venice resident who lobbied against overnight parking by RV dwellers, said the city should have sought a permit from the California Coastal Commission before plopping a storage container at the beach. Marc Saltzberg, vice president of the Venice Neighborhood Council, said the program was implemented without a public process that would have enabled residents and other interested parties to weigh in.

Rosendahl said he hoped to notify street denizens of a new location by the end of February and have a new program up and running by March. He said he was working with the Los Angeles city attorney's office to ensure that any seizures of items would be done legally.

martha.groves@latimes.com

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Beyonce covers Vogue's March issue

NEW YORK (AP) — Beyonce calls the making of her upcoming HBO documentary "Life is But a Dream" a therapeutic process.

She tells the March issue of Vogue, "this movie healed me in so many ways" and thinking about it makes her "want to cry."

The film addresses topics that the notoriously private singer normally doesn't address in public. It chronicles her 2011 decision to no longer have her father Matthew Knowles as her manager, her miscarriage and even the rumors that she was faking her pregnancy with daughter Blue Ivy by really using a surrogate.

"That was very odd," says the singer.

"Life is But a Dream" airs Feb. 16 on HBO.

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Online:

http://www.vogue.com/

http://www.hbo.com/

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For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

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