Every year, an estimated 100,000 young adults or adolescents in the U.S. experience a psychotic episode.
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Illustration by Anna Vignet/KQED
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Topline:
A new approach to schizophrenia involves managing early psychosis symptoms and keeping young people in school or jobs. The treatment is effective, but private insurance plans don't usually cover it.
Only 10 to 20%, including M, find space in one of the holistic treatment programs recommended by the National Institute of Mental Health as the gold standard of care for early psychosis. That's because these programs rarely have enough slots available for the people who need there, and because health insurance companies typically refuse to cover the full cost of these programs, even when they are available.
After M graduated from high school in California, she got a job at a fast food restaurant making burgers. Her coworkers were chatting over the fryer one day when M got a weird feeling, like somehow they knew what she was thinking. It was like her coworkers could read her mind and were discussing her thoughts with each other.
"I was like, are they talking about burgers or are they talking about me?" says M, now 21. NPR has agreed to identify M by her middle initial because she fears the stigma around her mental illness could disrupt her career path.
There was one coworker in particular, a guy she had a crush on, and she was pretty sure he was watching her. She suspected he hacked into her phone so he could listen to her conversations, find out where she was and follow her around. If she was walking down the street, or hanging out in the park, she saw him. Her mom remembers M wanted to sleep with the lights on, repeatedly asking her through the night, "Mom, is someone here?"
A crisis, a hospital stay, a rare referral
One day, her mom said M got so paranoid, so scared, she locked herself in the bathroom and just screamed and screamed and screamed.
Her mom wanted to call for help. But she didn't have a job at the time. This was about a year into the pandemic, and the hotel where M's mom worked had been closed since the first lockdown. When she lost her job, she lost her family's health benefits, too. "My husband was like, 'What is that going to cost?'" her mom remembers.
M's mom called 911 anyway. In the hospital, M was diagnosed with schizophrenia and within a few weeks she was enrolled into a specialized two-year outpatient treatment program at the Felton Institute near San Francisco. Her relatively quick path into effective treatment is highly unusual for patients like her.
M is one of 100,000 young adults or adolescents who have a psychotic episode every year in the US. A psychotic episode is characterized by hallucinations, like hearing or seeing things that are not there; delusional beliefs; and paranoia.
Only 10 to 20%, including M, find space in one of the holistic treatment programs recommended by the National Institute of Mental Health as the gold standard of care for early psychosis. That's because these programs rarely have enough slots available for the people who need there, and because health insurance companies typically refuse to cover the full cost of these programs, even when they are available.
But M is considered one of the lucky ones. Through her state-based public insurance, she never paid a dime for any of the care she received at the Felton Institute's early psychosis program.
A suite of wrap-around services
For two years, M was surrounded by a team of providers looking out for every aspect of her well-being, including a physician, who prescribed antipsychotic medications and a psychotherapist, who did weekly therapy with M to work through her paranoia and delusions.
But the program also provided an occupational therapist, who would go with M to the gym, or coach her through conflicts she had with her friends; a peer specialist who had also been through psychosis and could relate on a personal level; a family support specialist who worked with M's mom; and an education and employment specialist, who helped M look for a job.
Treatment that leads to independence and a career
At first, M wasn't interested in work. Her new medications made her really tired. Fatigue is a common side effect of antipsychotics, and that was layered on top of her already low motivation, which is a common symptom of schizophrenia.
"Since I didn't really have anything to do, I would just take super long naps during the day," M recalls.
But then she met Monet Burpee, Felton's job coach. On a typical workday, Burpee will drive her clients to the local mall or downtown shopping district, charting their path according to the "Help Wanted" signs. Together, they'll chat with store managers about open positions, then sit down and fill out the applications together.
Burpee says helping her clients who have psychosis find work is about more than landing a paying job; it's also about helping them see themselves differently — as independent, career-oriented people, rather than permanent patients dependent on government support programs such as Supplemental Security Income (SSI).
"If you work, you're going to notice a huge improvement in your self-esteem," she tells them. "It has better long term, positive results versus you just sitting around on SSI."
Monet Burpee (right) talks to the manager of a restaurant in Redwood City, CA on one of the job-scouting expeditions she undertakes on behalf of patients receiving a suite of interventions and services for psychosis.
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This is what she told M, and when she was ready, the two of them went to the mall on a job scouting expedition. They filled out the applications together. "Next thing I know, I was being interviewed and I got hired," M says.
She started out as a cashier at a new fast food restaurant and within three months she got promoted to a manager role. Now Burpee is coaching her on how to ask for a raise. "She has a brand new car," Burpee says, beaming with pride. "She's meeting new friends." For M, it was just one step in her long-term recovery plan.
"I want to focus on getting a degree, to get a better career," she says.
A revolutionary idea for treating schizophrenia
The Felton Institute's early psychosis program is one of about 50 in California and 350 in the country. They were started about fifteen years ago with what was then a revolutionary idea.
Back in the 1980 and 90s, doctors didn't really know what to do with schizophrenia, and they didn't have many options. They prescribed doses of antipsychotic medications that were so high, they turned people into zombies. They advised patients to give up on any career ambitions and sign up for disability payments instead. Even today, some doctors still see schizophrenia as a lost cause. "There's a real failure to appreciate how much potential there is to manage the illness and symptoms," says Dr. Daniel Mathalon, a psychiatrist with UCSF's early psychosis program.
Around the turn of the century, a new generation of doctors started thinking: What if we ask patients what they want and actually work with them toward full recovery?
"It's not just about stabilizing you clinically. It's about making sure we don't lose track of your future," says Tara Niendam, a child psychologist who runs the early psychosis clinic at UC Davis. "You should be in college. You should be living on your own."
With other conditions like diabetes or cancer, the sooner people get into care, the better they do. The same is true of psychotic illness. Upwards of 80 studies from early psychosis clinics show that patients see a greater reduction of symptoms, like voices or delusions, and a greater improvement in functioning at school, at work and in their social lives, compared to people who get treatment as usual.
Dr. Tara Neindam at the UC Davis Behavioral Health Center in Sacramento on Feb. 7, 2023. Dr. Niendam is a licensed clinical psychologist with training in assessment and treatment of youth at risk for, or in the early stages of, psychosis.
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There are a few reasons why earlier treatment is more effective, Niendam explains. People respond more quickly to medication given earlier and at a lower dose, so they have fewer side effects that make them want to stop taking them.
In addition, when symptoms are new, patients are more curious about their psychotic experiences, and more willing to question their delusional beliefs. And their families are also more curious, and more willing to stay involved in treatment, she says.
Building circles of ongoing support
This is one reason the early psychosis programs put a lot of emphasis on supporting the families who are supporting the patients.
M's mom found she needed almost as much help as her daughter did after the diagnosis. She blamed herself. She started meeting once a week with Mike Krechevsky, Felton's family specialist. He walked her through what schizophrenia was and wasn't, explained that it was no one's fault, and helped her manage her own feelings about it so that she didn't pass them on to M.
"When you express anxiety to your child, they don't feel as though they have any capability of going out in the world, stumbling, falling, picking themselves up, learning from their mistakes, and moving forward," Krechevsky says. "If you continue to do that, they're never going to recover."
A reverse disparity with insurance coverage
Normally, the separate and unequal health systems in the U.S. favor the wealthy. But in an unusual twist, M and her family were able to get access to such comprehensive, holistic care after her psychotic episode primarily because her mom had lost her job and her commercial insurance plan.
That's because states and the federal government, through block grants and public coverage such as Medicaid, provide most of the funding for early psychosis clinics, an investment that amounts to tens of millions of dollars every year.
Government officials believe that expenditure will save money in the long run, because without sufficient treatment, people with schizophrenia tend to deteriorate to the point that they end up on disability benefits, in a group home, on the street or in jail – all things the government pays for.
But commercial insurance companies, like Anthem or Blue Shield, don't face those risks. They don't have the incentive to cover full-scope psychosis treatment, and most of them don't.
This means low-income families with public insurance like Medicaid, which in California is called Medi-Cal, have more access to this gold standard of care, while working and middle class families covered by private insurance plans usually cannot.
"It is a reverse disparity," said UC Davis' Niendam during testimony before a state senate committee, about the impact of this disparity at the early psychosis clinic she runs in Sacramento.
"I can give the Rolls Royce of care if you walk in and you have Medi-Cal," she said. But "60% of Californians have commercial insurance. That's 60% of kids who can't get care; 60% of kids whose parents call me crying when I tell them they can't access my clinic."
Turning away patients with the wrong coverage
It's the same at the Felton Institute in the Bay Area, according to early psychosis director Adriana Furuzawa. For every one person who has Medi-Cal and is eligible for care at her clinic in Alameda, she says , there are another two with commercial insurance who are turned away. In 2022, they turned about 100 people away.
"It was very difficult to think that behind each number, there is a young person, there is a family, that we're saying no to, when we have the resources right here," Furuzawa says.
So what happens to these kids? Generally, they're on their own to find a psychiatrist and therapist who accepts their insurance. Health plans will pay for these medical services. But they won't cover the other crucial components to the care: the job and education support, the peer specialist, the family coach.
This amounts to discrimination, health advocates argue. If someone has cancer, insurers would never just pay for surgery and radiation, but not chemotherapy.
"It's a package of services," says David Lloyd, former chief of policy at the Kennedy Forum. "So the idea that you can split apart the package of services and only reimburse for little components of it, really destroys the whole evidence base of what the service is."
This almost happened to M. A few months into her treatment, her mom got her job back at the hotel, and the family was again covered by her commercial insurance plan. In most counties in California, this would have meant M got kicked out of the program. Her mom said there would have been no way she could afford to pay for a job coach, a family coach, and a peer specialist on her own.
"I couldn't do it. I would definitely stop all the help," she says, even though that help was critical to keeping M healthy. Maybe she would have turned to Craigslist to find other parents to talk to, she said, or looked up mental health advice on YouTube to pass on to M. "I just hope and pray for the best."
States seek solutions to coverage gaps
In 2022, state lawmakers in California wanted to help families like M's, by forcing insurance companies to cover the full spectrum of early psychosis treatment. Lawmakers in one state, Illinois, enacted a law like this already, while those in Massachusetts and Virginia are working on a similar effort. But the proposal in California, Senate Bill 1337, died under pressure from the insurance lobby.
Historically, insurers have not covered the costs of non-medical services provided by non-licensed staff, like job or family coaches. More importantly, they do not like being cornered into covering specific treatments, said Nick Louizos, a lobbyist with the California Association of Health Plans, a trade group that represents companies like Anthem, Blue Shield and Kaiser.
"Science evolves. Research evolves. There could be evidence-based techniques that are better in the future," Louizos said during testimony at a state senate health committee hearing.
While there are scores of studies that show the treatment works in the short-term — people are more likely to stay in school, in jobs, in treatment, and out of the hospital — the treatment hasn't been around long enough to know how long the positive effects last.
"There is a lack of evidence of this model's long-term effectiveness," Louizos said.
Perverse incentives to drop private coverage
The private insurance restrictions create a perverse incentive for middle-income families who need help now. Some parents are so desperate to give their kids the best care, they actually drop them from their health plan and enroll them in Medi-Cal so they can access county-funded clinics like Felton.
Some counties, including Sacramento and San Mateo, have taken an even bolder step. Health officials there determined that denying young people the full suite of care is unethical, so they decided to use county taxpayer dollars to pay for any services that private insurers refuse to cover.
In the end, this extra support at the county level is what allowed M to stay in the Felton program.
But all of these workarounds are problematic, according to Lloyd. For-profit insurance companies are essentially making more profits by allowing the public to pay their bills.
"That's not an appropriate role for taxpayers to be picking up that burden," he says. In addition, the lack of funding from private insurance reimbursement is stifling the growth that's needed in these programs to hire more employees and provide care for all the young patients who need it.
In California, an alternate pathway to full coverage?
In California, expanded coverage and access could be arriving soon, via a different legal mechanism.
A novel 2021 California law was designed to expand the kinds of mental health care insurers are required to cover. Under this law, SB 855, health plans must make mental health coverage decisions based on expert-recognized guidelines for treatment, rather than their own internal, often arbitrary or cost-driven, criteria.
Since this story was first published last spring on KQED.org, California's largest state health regulator, the Department of Managed Health Care, finalized guidance that explicitly requires insurers to cover full-scope early psychosis care, and is incorporating that guidance into the official rules that will be used to enforce SB 855. The final version of the regulations is expected to take effect in spring of 2024.
M and her family haven't had time to follow all these legislative battles and policy changes. All they know is that the full-scope early psychosis care has been life changing.
M has struggled recently with some of symptoms at her new fast food job. The difference is that now she knows what's happening. She has new skills to help quiet the voices. She knows her mom will understand and support her. And she knows there are half a dozen providers at Felton who will pick up if she calls for help.
When her mom thinks about the generosity of those providers, or the luck of landing in a county that stepped up and paid for all of M's care, she thinks about her own father. He was a doctor in the Philippines, and none of his patients had insurance. If they didn't have money, he treated them anyway. "I remember people paying him with chicken and rice," she says.
She thinks, maybe all the help M got was because of him. Maybe it was her dad's karma paying off.
This story comes from NPR's health reporting partnership with KQED and KFF Health News.
Demonstrators recently marched around the Adelanto ICE Processing Center to demand the release of people detained there.
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Libby Rainey
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LAist
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Topline:
An LAist analysis shows that the Adelanto ICE Processing Center — the immigration detention center closest to Los Angeles — is among the top 10 facilities across the U.S. placing people in solitary confinement.
Why it matters: About 1,800 people are held at Adelanto today. In court filings, detainees there have said that isolation is used to punish them for speaking out against inhumane and unsanitary conditions at the facility.
Who’s responsible? The GEO Group Inc., a private company that operates the Adelanto ICE Processing Center, has not responded to requests for comment. In multiple statements to the media, ICE has said that the agency “is committed to ensuring that all those in custody reside in safe, secure, and humane environments.”
The backstory: In May 2025, the Adelanto ICE Processing Center had 14 people in isolation. When the Trump administration’s mass deportation effort revved up last June, the number of detainees in solitary confinement there more than tripled and has climbed since.
What's next: Earlier this year, a coalition of immigrant rights groups filed a federal lawsuit on behalf of detainees, calling for conditions at Adelanto to be improved. The coalition has since requested an emergency court order to prevent further harm. A hearing is scheduled for April 10.
Read on … for details about the use of solitary confinement at Adelanto.
The immigration detention center closest to Los Angeles has placed dozens of people in solitary confinement each month since June, according to the most recent data from U.S. Immigration and Customs Enforcement.
In May 2025, the Adelanto ICE Processing Center had 14 people in isolation. When the Trump administration’s mass deportation effort revved up in June 2025, the number of detainees in solitary confinement there more than tripled. By July, it was 73; by August, 105.
The most recent data available shows that number went down slightly in January, to 74 people.
Ranked by percentage of the detainee population in “segregation,” as it is called at immigrant detention centers, Adelanto is among the U.S.’s top 10 facilities as of January, according to an LAist analysis of the most recent ICE data.
The data shows that of 229 ICE facilities that reported holding people since October 2024, between 50 and 60 usually reported putting at least one person in segregation in a given month. Out of the facilities that did place people in solitary confinement, Adelanto tended to do so less often than others until June 2025. (The facility held just a few people from October 2024 into January 2025.) When ICE’s presence increased in L.A. in June, the number of people sent to isolation in the facility also shot up — three to five times as many people have been isolated in Adelanto compared to the average facility that used any solitary confinement.
Since June, only two facilities have sent people to solitary confinement more times than Adelanto: one southwest of San Antonio, the other in central Pennsylvania.
Both of those facilities held twice the number of detainees as Adelanto on average from October 2024 through September 2025; but the number of people held in Adelanto since then has tripled, growing larger than either of the other facilities to hold an average of 1,800 people a day since October.
How we reported this
LAist used official, publicly available data from ICE about its detentions nationwide and at specific facilities.
To calculate percentages of people held in isolation as of January 2026, LAist also used official ICE data as recorded by both TRAC Immigration and the Internet Archive that was no longer available on ICE's public website.
Records of “special and vulnerable populations” for the fourth quarter of the 2025 fiscal year and records of monthly segregation placements by facility from September 2025 were missing from ICE's data and are not reflected in LAist's analysis.
More on solitary confinement
According to ICE, detainees may be placed in segregation for “disciplinary reasons,” or because of:
“Serious mental or medical illness.”
Conducting a hunger strike.
Suicide watch.
The agency also says it might place detainees “who may be susceptible to harm [if left among the] general population due in part to how others interpret or assume their sexual orientation, or sexual presentation or expression.”
Not only is ICE holding more people in solitary confinement, but the agency's data also shows that detainees across the country are being isolated for longer periods of time. Detainees ICE considers part of the "vulnerable & special population" spent an average of about two weeks in solitary confinement each time they were isolated in 2022, when ICE first made the data available. By the end of 2025, the average stay in isolation had risen to more than seven weeks straight.
The GEO Group Inc., a private company that operates the Adelanto ICE Processing Center, has not responded to requests for comment.
How isolation can affect immigrant detainees
UN human rights experts consider solitary confinement placements that last 15 days or more to be torture, though the U.S. Supreme Court has held that isolation doesn’t violate the Constitution.
The UN also maintains that solitary confinement should be prohibited for people “with mental or physical disabilities when their conditions would be exacerbated by such measures.”
In January, a coalition of immigrant rights groups filed a federal lawsuit on behalf of current detainees, calling for conditions at Adelanto to be improved. In addition to an unsanitary environment and a lack of healthy food and clean drinking water, detainees say solitary confinement is frequently used to punish those who speak out about conditions at the facility.
People held in immigrant detention centers are technically in “civil detention,” meaning that they are being detained to ensure their presence at hearings and compliance with immigration orders — notto serve criminal sentences.
According to the immigrant rights groups’ complaint, one detainee was placed in solitary confinement after complaining about the showers being broken. Another detainee said that, after asking a guard to “use more respectful language toward him, he was ridiculed, written up and given the middle finger by a guard who shouted, ‘Who the f--- do you think you are?’” Then, the detainee was placed in solitary confinement for 25 days.
Alvaro Huerta, the director of litigation and advocacy at the Immigrant Defenders Law Center who is representing detainees at Adelanto, told LAist that when people are placed in isolation at the facility, they’re typically in the same cell for 23 hours per day, unable to receive visits from their families.
For clients who are experiencing mental health challenges — especially those with suicidal thoughts — being placed in solitary confinement “can really exacerbate their condition,” he added.
In multiple statements to the media, ICE has said that the agency “is committed to ensuring that all those in custody reside in safe, secure and humane environments.” The agency has also said that detainees receive “comprehensive medical care” and that all detainees “receive medical, dental, and mental health intake screenings within 12 hours of arriving at each detention facility.”
Huerta called that “laughable.”
“We have countless examples of people who have said that this is not true, that they're not getting the medication that they're requesting, that they're not being seen for chronic conditions and emergency conditions,” he added. “And we know it's not true because 14 people have died in ICE custody this year alone.”
Libby Rainey
has been tracking how L.A. is prepping for the 2028 Olympic Games.
Published April 3, 2026 4:58 PM
Tickets to the 2028 Olympics in Los Angeles went on sale Thursday.
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Emma McIntyre
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Getty Images for LA28
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Topline:
As the locals-only sale kicks off and Southern Californians have their first chance to buy tickets to the Olympic Games, some fans are wide-eyed at the high fees on all tickets and the prices in general, which start at $28 but go up to more than $5,500 a pop.
Sticker shock: Lori Rovner of Manhattan Beach told LAist that one $2,100 ticket had a $505 service fee, bringing the total cost to $2,604.63.
Other prices: Some people LAist spoke with opted for only $28 or similarly priced tickets, even if it meant missing some of the biggest Olympic events. One user on Reddit said they purchased 18 tickets for around $550.
Read on … about how much fans are spending on tickets.
Lori Rovner of Manhattan Beach is a big sports fan, so there was no question that when tickets for the Olympic Games went on sale, she'd be signing up.
She scored a slot in the first ticket drop, which launched Thursday, and logged on right at 10 a.m., hoping to score tickets to the Opening Ceremonies and some finals too. After battling her computer to get through "access denied" screens and a lost shopping cart due to a 30-minute time limit, she bought 16 tickets.
It was only when she was about to purchase that she noticed the service fees, which were around 24% of each ticket. One $2,100 ticket had a $505 service fee, bringing the total cost to $2,604.63.
"It's insane," she said of the fee. "I don't understand what the service is."
As the locals-only sale kicks off and Southern Californians have their first chance to buy tickets to the Olympic Games, some fans are wide-eyed at the high fees on all tickets and the prices in general, which start at $28 but go up to more than $5,500 a pop. Opening Ceremony tickets start at $328.68
The service fees aren't a surprise add-on. The price fans see when browsing the site is the total cost, including the fee. Still, some who bought in the first phase of sales were surprised when they saw the fees add up.
One user on Reddit of shared their cart of 10 tickets, which added up to $11,264. That included $1,038 in fees alone. Commenters responded in shock and awe.
Service fees are standard in ticket sales, but the percentage they charge can vary widely. High fees have been a source of ire for music and sports fans for years. A 2018 report from the U.S. Government Accountability Office found that the average fees on a primary ticket market were 27%.
LA28 did not respond to LAist's requests for details on the service fee, like what it pays for or why it's a percentage rather than a flat rate.
Not everyone seemed bothered by the prices. Some people LAist spoke with opted for only $28 or similarly priced tickets, even if it meant missing some of the biggest Olympic events. One user on Reddit said they purchased 18 tickets for around $550.
"I went with all $28 tickets," they wrote in the online forum about the Olympics. "I got women’s soccer, gymnastics, beach and regular volleyball, track and field, baseball and a few others."
For some, the ticket process, the prices and the dense web of events to choose from made it too hard to pull the trigger.
Jeff Bartow of Sierra Madre made a spreadsheet with some competitions he was interested in seeing before he logged on to buy tickets Friday.
"So many times, so many schedules, so many events," Bartow said. "I think I initially thought I was going to go to a bunch, but thinking about how crazy it's going to be … I might be a little more limited."
This is just the first ticket drop. There will be more opportunities to buy tickets in the months to come — and on a resale market that launches in 2027.
Some ticket-buyers told LAist they already were contemplating which tickets they'd keep and which ones they'd re-sell, just minutes after buying them.
Keep up with LAist.
If you're enjoying this article, you'll love our daily newsletter, The LA Report. Each weekday, catch up on the 5 most pressing stories to start your morning in 3 minutes or less.
In the more than two months since the Department of Justice released its latest batch of files on the investigation into Jeffrey Epstein, prosecutors have not brought any new charges based on the documents, despite federal lawmakers on both sides of the aisle continuing to demand accountability.
The backstory: Since the release of the files in 2025 and 2026, there have been no related arrests in the U.S. However, the disclosures have led to some resignations and other reputational repercussions for some high-ranking Americans. The lack of arrests in the U.S. contrasts to the fallout in the U.K., where investigators have pursued charges related to corruption, not sexual abuse, in their dealings with Epstein. Two former government officials — former Prince Andrew and ex-ambassador Peter Mandelson — were arrested on suspicion of misconduct in public office.
Lack of evidence: In the U.S., top Justice Department officials have said that they found no evidence compelling enough to pursue further charges related to Epstein, and that the public can make their own assessments based on the disclosed documents. In a statement to NPR, Justice Department spokesperson Katie Kenlein said that "there have not been additional prosecutions beyond Epstein and Maxwell because there has not been credible evidence that their activities extended to Epstein's network."
In the more than two months since the Department of Justice released its latest batch of files on the investigation into Jeffrey Epstein, prosecutors have not brought any new charges based on the documents, despite federal lawmakers on both sides of the aisle continuing to demand accountability.
The more than 3 million pages of documents include accusations by alleged victims of Epstein and Ghislaine Maxwell's abuse and thousands of emails and photos showing Epstein associated with prominent figures. The files indicate that many of these people maintained contact with the disgraced financier long after he pleaded guilty in 2008 to sex crimes that involved minors. Appearing in the files is not necessarily an indication of criminal wrongdoing.
The release of the Epstein files came after Congress passed the Epstein Files Transparency Act, which forced the Justice Department to make public all documents it held related to Epstein.
The lack of arrests in the U.S. contrasts to the fallout in the U.K., where investigators have pursued charges related to corruption, not sexual abuse, in their dealings with Epstein. Two former government officials — former Prince Andrew and ex-ambassador Peter Mandelson — were arrested on suspicion of misconduct in public office. Andrew Mountbatten-Windsor, as he is now known, has denied wrongdoing and has not been formally charged. Mandelson has also not been charged, and lawyers for Mandelson have said that the arrest was prompted by a "baseless suggestion."
In the U.S., top Justice Department officials have said that they found no evidence compelling enough to pursue further charges related to Epstein, and that the public can make their own assessments based on the disclosed documents.
In a statement to NPR, Justice Department spokesperson Katie Kenlein said that "there have not been additional prosecutions beyond Epstein and Maxwell because there has not been credible evidence that their activities extended to Epstein's network. However, if prosecutable evidence comes forward, the Department of Justice will of course act on it as we do every day in sexual trafficking and assault cases across the count[r]y."
On Thursday, President Trump announced that Attorney General Pam Bondi is out of the top job at the Justice Department, following bipartisan criticism over her handling of the Epstein files.
NPR asked four former prosecutors and one former law enforcement officer why there may not have been enough evidence to levy additional charges. Here's what they said.
Prosecutors must prove guilt "beyond a reasonable doubt"
Prosecutors must prove to a jury that a person committed a crime "beyond a reasonable doubt," according to Barbara McQuade, a professor at the University of Michigan Law School.
"One of the biggest misconceptions people have is how difficult it is to charge and convict somebody for a criminal case," said McQuade, who served as the U.S. attorney for the Eastern District of Michigan.
A prosecutor's ethical responsibility is to charge cases only if they believe there is enough evidence for a conviction, McQuade said. Documents, including emails, jokes, and even plane itineraries, can be a place to start, but, alone, they are not enough to prove guilt, McQuade said.
"What you would need [is] rock solid evidence," McQuade said. "You can't charge someone for a crime without sufficient evidence, and I have yet to see evidence of a crime involving an Epstein associate that has gone uncharged."
Based on his understanding of the case, Paul Butler, a professor at Georgetown Law, said he agreed that prosecutors who investigated Epstein's alleged associates "may have believed that they couldn't persuade a jury beyond a reasonable doubt." He said problems with witness credibility or certain forensic evidence can prevent a case from moving forward.
The U.K. cases are focused on corruption
In the U.K., the two people arrested are being investigated on suspicion of "misconduct in public office." McQuade said the U.S. does not have a single equivalent federal law. Instead, the U.S. prosecutes public corruption through statutes that focus specifically on crimes such as bribery and extortion.
After the release of the latest files, British police began investigating Andrew's correspondence with Epstein when Andrew was a U.K. trade envoy. At that time, Andrew allegedly shared government itineraries, investment plans and notes from official foreign trips with Epstein. The information may have been covered by the United Kingdom's Official Secrets Act.
Similarly, Mandelson has been accused of passing confidential government information to the late sex offender when Mandelson was a U.K. Cabinet minister.
Meeting the burden of proof is especially challenging for sex crime cases
Victim statements are essential for establishing basic elements, such as the timeframe of events, required to build sexual assault cases, said Diane Goldstein, a retired police lieutenant from California and the executive director of the Law Enforcement Action Partnership. But a victim may be reluctant to come forward because of a fear of retaliation, not believing the police can help, believing it is a personal matter, or not wanting to get the perpetrator in trouble.
McQuade noted that in some sex trafficking cases, especially those in which a perpetrator is in a position of power, victims may experience intimidation or threats that prevent them from speaking out.
Victims also may be hesitant to move forward with allegations because they fear having to testify at trials where defense attorneys may attempt to poke holes in their allegations, McQuade said.
Goldstein said that for sex crime cases to advance, investigators need to follow certain policies and procedures. "If you don't have a legitimate police investigation to start, you're not going to get any type of criminal filing," Goldstein said.
Other potential charges are also a difficult path
Prosecutors may have considered pursuing charges of criminal conspiracy related to sex trafficking against people associated with Epstein, said Jessica Roth, a professor at Cardozo School of Law. FBI documents in the files relating to its investigation into Epstein's crimes identify certain people as "co-conspirators."
But Ankush Khardori, a senior writer and columnist at Politico magazine who worked as a federal prosecutor on financial fraud cases, told NPR those identifiers are not "formal accusation[s]" and are simply part of "interim documents."
"The FBI does not determine who is a co-conspirator," Khardori said. "That is a legal judgment that prosecutors make."
But for those conspiracy cases, "criminal intent," in particular, is difficult to establish, said Roth, who worked as a federal prosecutor in the U.S. attorney's office for the Southern District of New York for seven years. Criminal conspiracy charges "would require knowledge and intent on the part of each individual who was charged," Roth said. If a person who communicated with Epstein had some suspicion that he was engaged in illegal activity, that alone would not be sufficient evidence to press charges, she said.
Investigators may have considered charges related to criminal tax violations, McQuade said. But the statute of limitations has likely ended on those cases, she said, meaning that prosecutors can no longer bring charges.
The current evidence lacks context
Legal experts say the haphazard way the documents were released and redacted makes it difficult for the public to understand why no additional charges have been filed.
Roth, the Cardozo law professor, said the information is in "isolation," without the appropriate context. "We'll see an individual photograph that looks perhaps incriminating. We'll see an email that looks incriminating, but we don't necessarily have everything that was said before and after that email and that exchange," Roth said.
One document that could explain why no charges were pursued, according to Butler, is a heavily redacted DOJ memo naming "potential co-conspirators" of Epstein. "The parts that should indicate why the department declined prosecution on any alleged co-conspirators other than Ghislaine Maxwell [are] redacted," said Butler, the Georgetown law professor and a former federal prosecutor.
Butler said those redactions are "unusual" because they do not appear to follow the permissible reasons for redactions in the Epstein documents. Those reasons include confidentiality for Epstein's alleged victims, or anything that would compromise an ongoing investigation, Butler said.
"When the Justice Department grudgingly releases information when pressed by politics or forced by Congress, it also creates the impression that they have something to hide," Butler said. "That there is some cover-up going on."
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Nearly 30% more students in Los Angeles County experienced homelessness from 2022-23 to 2023-24, making it the county’s highest rate in the past five years and far outpacing the rate of homelessness across the state in the same timeframe, as the resources to identify and support this student population have decreased.
Norwalk-La Mirada Unified: Researchers found that Norwalk-La Mirada Elementary Unified School District had the highest rate of student homelessness in the county — 1 in 3 students, meaning that over 4,700 students were identified as experiencing homelessness during the 2023-24 school year out of a total cumulative enrollment of about 15,600.
Underidentifed students: Researchers also found that the Transformation of Schools focuses on the lack of dedicated funding for school staff to identify and support homeless students. Students and families facing homelessness do not always self-identify, whether due to fear, shame or being unaware that their housing situation is considered homelessness
Nearly 30% more students in Los Angeles County experienced homelessness from 2022-23 to 2023-24, making it the county’s highest rate in the past five years and far outpacing the rate of homelessness across the state in the same timeframe, as the resources to identify and support this student population have decreased.
Researchers found that Norwalk-La Mirada Elementary Unified School District had the highest rate of student homelessness in the county — 1 in 3 students, meaning that over 4,700 students were identified as experiencing homelessness during the 2023-24 school year out of a total cumulative enrollment of about 15,600.
The city of Norwalk, where the district is located in the eastern region of the county, was sued by the state in 2024 for banning emergency shelters and other support services for people experiencing homelessness. Last year, the state reached a settlement with the city, which was forced to overturn the ban and put $250,000 toward building affordable housing.
Student homelessness is defined differently under the McKinney-Vento Homeless Assistance Act, a federal law that requires every public school to count the number of students who are living on the street, in shelters, in motels, in cars, doubled up with other families, or moving between friends’ and relatives’ homes.
As a result of this expanded definition, McKinney-Vento includes doubled-up students in the count of homelessness. Doubled-up is a term used to describe children and youth ages 21 and under living in shared housing, such as with another family or friends, due to various crises.
There were a few other patterns seen in the L.A. County data analyzed by the UCLA researchers:
Latino students were disproportionately more likely to experience homelessness: they represent 65% of the county’s student population, but 75.5% of student homelessness
A third of homeless students were in high school
Many districts with the highest rates of homelessness had higher school instability but lower dropout rates
While McKinney-Vento has an expanded definition that includes more types of homelessness than several other definitions, identifying students remains difficult.
The second report from the UCLA Center for the Transformation of Schools focuses on the lack of dedicated funding for school staff to identify and support homeless students. Students and families facing homelessness do not always self-identify, whether due to fear, shame or being unaware that their housing situation is considered homelessness under McKinney-Vento.
“A lot of these young people are dealing with a lot of trauma, so they don’t want to be identified. They don’t want to be pointed out; sometimes it’s scary for them, because they think we’re going to report them to the Department of Children and Family Services,” said L.A. County Office of Education staff interviewed for this report.
School staff, known as homeless liaisons, who work with homeless students received a historic influx of federal funds during the Covid-19 pandemic — $98.76 million for California, out of $800 million nationwide, from the American Rescue Plan-Homeless Children and Youth.
That funding has since ended, and there is no other dedicated, ongoing state funding set aside solely for the rising number of homeless students. This has led districts in California to “heavily depend on highly competitive and unstable federal streams,” the UCLA researchers wrote. Those federal streams have become increasingly precarious as the federal administration last year sought policy changes that would shift how they are structured.