Blog Archives

"ANTI-SOCIAL ---PERSONALITY--- DISORDER"

7/31/2022

The Immune System, Neuro-Developmental Differences/ Disorders, Ramped Stress Responses, the Challenge of Double Empathy, Social Behavior, Ramped Up Sensory Processing, Epigenetic Changes and ---

SOCIAL ENVIRONMENTS &
INACCURATE MAPS

Conjecture

Neuro-Developmental Differences/Disorders, Psychiatric Disorders, and "Personality Disorders" [now starting to be CONCEPTUALIZED as Neuro-Developmental Disorders] are often papering over DEEPER INDIVIDUAL & GENERATIONAL IMMUNE ISSUES.
- Further, this is also occurring in the CONTEXT of CHRONIC DISEASE PROBLEMS --- CANCER and AUTO-IMMUNE DISORDERS ---
  - Those PHYSICAL PROBLEMS may be more ACCEPTED by the SOCIETY in 2022 (they weren't always accepted) --
  - BUT they too OFTEN come with their own PSYCHIATRIC DISORDERS.

How that SHAKES OUT can REVEAL a lot of UNCONSCIOUS BIAS.

And how HIERARCHY was maybe a PRAGMATIC APPROACH to dealing with the CHALLENGE of COMPLEX INDIVIDUAL DIFFERENCES in COMPLEX SOCIETIES.
- You didn't necessarily have the BANDWIDTH to UNDERSTAND or ACCOMMODATE everyone --
- So you did your best to UNDERSTAND & ACCOMMODATE the KING & HIS CRONIES.
- Or whoever is in POWER.
- In MODERN DEMOCRACIES -- your POLITICAL GROUP.

Einstein: You CAN'T SOLVE PROBLEMS at the SAME LEVEL THEY WERE CREATED.

"I think everybody's crazy, and if I'm the one being a little direct about it, that's fine by me."

----------Ezra Miller, American actor

Professor Daniel Davis, University of Manchester
The Greatest Human Diversity is Within the Immune System

CO Medicaid & Homeless Coloradans w/ Mental Illness

7/20/2022

Issues of Harm Reduction, Level of Care, Choice and Economics

THE ISSUE

Some Coloradans with Mental Illness who are HOMELESS meet the criteria for CO MEDICAID Long Term Care
BUT they don't need assistance with activities of daily living. This requirement for the CMHS (Community Mental Health Supports) Waiver was put in rule at 8.509.15.A.2

There has been a lot of PLAYING GAMES in Colorado Medicaid Mental Health because it is SO POLITICAL, SO EXPENSIVE & the NEED IS SO GREAT..

There are a lot of moving parts --- BUT this doesn't look like PARITY to us.

We would like to see a STATE STAKEHOLDER GROUP that specifically addressed the needs of Coloradans with Mental Illness who meet the LEVEL OF CARE for Medicaid Long Term Care BUT don't need help with activities of daily living.

With special attention to Coloradans who are Homeless and or being released from Jail or Prison.

Further

Medicaid Long Term Care generally opens up the possibility of:
- Nursing Home Care
- Assisted Living Care
- In Home Care

Medicaid Home & Community Based Services "Waivers" such as the Colorado Community Mental Health Supports (CMHS) Waiver are designed for people who meet the level of care for a "nursing home" but can be served in the community.

There are many younger people with mental illness in Nursing Homes because there are insufficient services in the Community -- both on locked wards and open wards.

There are even more younger people with mental illness who are homeless and/or incarcerated because there are insufficient services in the Community.

What a Tangled Web We Weave --- What Was Really Going On In HCPF's Change of Targeting Criteria

CO's Mental Health Continuum of Care Hell

Fixing HCPF's Fair Housing Problem

Nursing Homes & Housing

8.509.15 ELIGIBLE PERSONS

A. HCBS-CMHS services shall be offered to persons who meet all of the eligibility requirements
below: . . .

2. Level of Care AND Target Group.
Clients who have been determined to meet the level of care AND target group criteria
shall be certified by the Utilization Review Contractor (URC) as functionally eligible for
HCBS-CMHS. The URC shall only certify HCBS-CMHS eligibility for those Clients:
a. Determined to meet the target group definition, defined as a person experiencing
a severe and persistent mental health need that requires assistance with one or
more Activities of Daily Living (ADL);

i. A person experiencing a severe and persistent mental health need is
defined as someone who:

1) Is 18 years of age or older with a severe and persistent mental
health need; and

2) Currently has or at any time during the past year leading up to
assessment has a diagnosable mental, behavioral, or emotional
disorder of sufficient duration to meet diagnostic criteria specified
within the Diagnostic and Statistical Manual of Mental Disorders
(DSM -5); and
a) Has a disorder that is episodic, recurrent, or has
persistent features, but may vary in terms of severity and
disabling effects; and
b) Has resulted in functional impairment which substantially
interferes with or limits one or more major life activities.

ii. A severe and persistent mental health need does not include:
1) Intellectual or developmental disorders; or
2) Substance use disorder without a co-occurring diagnosis of a
severe and persistent mental health need.

b. Determined by a formal level of care assessment to require the level of care
available in a nursing facility, according to Section 8.401.11-15; and

c. A length of stay shall be assigned by the URC for approved admissions,
according to guidelines at Section 8.402.50.

Our backward debates & Justice

7/11/2022

In Mental Health and Criminal Justice --- there is enough to know our Diagnostic Categories are WRONG or at the very least RESEARCHERS have raised "REASONABLE DOUBT" about them.

As hard as it is to accept, those INACCURATE DIAGNOSTIC CATEGORIES are RELEVANT to the LEGAL CATEGORIES we've set up in Criminal Justice.

Further, this isn't about going back to the FREE WILL vs. DETERMINISM DEBATE.

This requires a much more sophisticated PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE than what we've got.

Over 600 Research Institutions Question DSM Categories

The US "Mental Health" Debate --- Where it "IS" and Where We'd Like to See It Go

PBS NewsHour July 8, 2022
Brooks & Capehart

This is an analysis of the National Debates on Abortion & Gun Rights.

I'm posting this for the troubling discussion of "MENTAL ILLNESS" in the context of the Gun Debate.

What's troubling to me is the DISMISSIVE nature of "MENTAL ILLNESS" and more broadly "COGNITIVE DISABILITY" in the context of GUN VIOLENCE ----

Unfortunately that dismissiveness appears to be based on discussions with "MENTAL HEALTH EXPERTS."

What do we mean by "MENTAL ILLNESS"?
- The DSM according to NIMH (the National Institute in Mental Health) in 2013 isn't a valid diagnostic manual ---
- And more and more PSYCHIATRIC DISORDERS are being associated with NEURO-DEVELOPMENTAL DISORDERS.

Additionally, it is well documented that BRAIN INJURY is prominent in criminal justice populations around the world, including the US.

I'm sorry BUT this GUN VIOLENCE is NOT just the result of EVIL PEOPLE even though the acts are EVIL.

We need experts who understand there is an UNDERLYING BIOLOGY to these violent acts even if we don't call it --- "MENTAL ILLNESS."

Transitional/ Translational Justice Monday

"ANTI-SOCIAL ---PERSONALITY--- DISORDER"

CO Medicaid & Homeless Coloradans w/ Mental Illness

Our backward debates & Justice

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