Blog Posts

Justice and the Need to Get Beyond Crisis Management --- For the Benefit of the Community, Individuals & First Responders

3/15/2022

One of the points I've tried to make is --- this is a lot more complicated than Neuro-Developmental and Psychiatric Disorders within the Justice-Involved Population --- which are absolutely there.

The COMPLICATED REALITY is those Neuro-Developmental Issues and Psychiatric Issues can also exist among the FIRST RESPONDERS and Health and Legal Systems that are serving and protecting our communities everyday.

So some form of ADHD in that Emergency Room Doc, Paramedic, Police Officer, Criminal Defense Attorney or Prosecutor is more par for the course than we often realize --- and they themselves are quite vulnerable to PSYCHIATRIC DISORDERS and SUBSTANCE ISSUES.

Further, some in the Health and Legal Systems MAY BE MORE VULNERABLE because they're NOT EXPECTING to deal with these issues and may not realize that their "STRENGTHS" are often coming with some underlying vulnerabilities.

When we focus so much on CRISIS MANAGEMENT rather than a more ROOT CAUSE ANALYSIS ---- that makes it hard for everyone.

We can't ignore the CRISES --- but providing SUBSTANTIAL SUPPORT up front in the form of :

Supportive Housing
Intensive Services, and
Adequate Staffing

could go along way to REDUCING CRISES ---- ACROSS THE BOARD.

What is a good career for someone with ADHD?

EMTs, police officers, and firefighters must work well under pressure and make split-second decisions. These jobs allow you to work in a variety of settings, while providing the kind of adrenaline-pumping excitement that helps many individuals with ADHD focus their minds. Feb 2, 2021

16 Good Jobs for People with ADHD - ADDitude

University of Montana

In this study, firefighters had more than four times the prevalence rate of ADHD that has been identified in the general adult population in previous research.

Wildland Firefighters and Attention Deficit Hyperactivity ...

The Big Kahuna: Neuro-Diversity is a Big Source of "Mental Illness"

Burnout in Law, Mental Health, Law Enforcement --- "Boundaries" ---and the Need for Leaders and Policymakers to Continue with SYSTEMIC REFORMS

2/10/2022

World Health Organization says burnout may deserve medical attention

Is there a high burnout rate for lawyers?

Lawyer burnout is a growing but long-standing issue in the legal industry that over the past few years has become normalized and talked about in the open more often. ... With more legal professionals working remotely, it's harder than ever to create boundaries, and burnout is at an all-time high. Sep 9, 2021

Why Lawyer Burnout Is Still An Issue in 2021 - National Law ...

Mental Health Providers and Burnout

Studies estimate that anywhere between 21 percent and 61 percent of mental health practitioners experience signs of burnout (Morse et al., 2012). Burnout has been associated with workplace climate, caseload size and severity of client symptoms (Acker, 2011; Craig & Sprang, 2010; Thompson et al., 2014). Jan 25, 2018

Research roundup: Burnout in mental health providers - APA ...

Law enforcement burnout

Burnout begins when a police officer who was originally enthusiastic about the job begins to respond to the frustrations of police work in such ways as resenting superiors, drinking too much while off duty, experiencing problems at home, and ceasing to take the initiative on the job.

Burn Out - 'No One Can Imagine What the Costs Really Are'

There's a lot of OVERWHELM in our SYSTEMS.

From my standpoint --- "HE WHO SHALL NOT BE NAMED" --- is our TREATMENTS are often NOT MAGIC BULLETS.

Further, its becoming more and more apparent why our treatments for PSYCHIATRIC DISORDERS are NOT MAGIC BULLETS:

The person is often dealing with an underlying NEURO-DEVELOPMENTAL DISORDER involving NEURO-DEVELOPMENTAL INFLAMMATION and DYSREGULATION of MULTIPLE SYSTEMS of the BODY.
Further, there's widespread low-grade inflammation throughout the population.

For attorneys and law enforcement --- there's a big need for Leaders and Policymakers to modify systems to move away from "US vs. Them" Thinking.

Problem Solving Courts have been a part of that effort.
There's actually if not UNIVERSAL AGREEMENT, pretty close to it that we have to have:
- COMMUNITY SAFETY, and
- HUMANE TREATMENT

For MENTAL HEALTH PROVIDERS, they need more SUPPORT from:

Translational Research Efforts
Epidemiologists
The Nation's Research and Teaching Hospitals

For attorneys, mental health providers, and law enforcement --- just because the numbers went up or the acuity level went up ----

DOES NOT MEAN THAT ANYONE GOT ANYMORE "BANDWIDTH"
We are BURNING PEOPLE OUT LEFT AND RIGHT
- We have to gain GREATER AWARENESS of what we are really asking of people ---
- As much as our HELPERS WANT TO HELP --- THEY HAVE LIMITS, TOO.

For REAL PROBLEM-SOLVING (rather than just a MOUNTAIN OF PAPERWORK) --- we have to invest TIME and RESOURCES to do that.

Further, we need our LEADERS and POLICYMAKERS to establish ON-GOING INCLUSIVE PROCESSES with ACCOUNTABILITY so we can get to VIABLE SOLUTIONS and further SYSTEMIC REFORMS.

LIKE AN INCLUSIVE OLMSTEAD PLANNING PROCESS with:

Measurable Goals
Reasonable Time Frames, and
Funding to Support the Plan

In-Groups and Out-Groups, the PAIN of SOCIAL ANIMALS & the POWER to DEFINE

2/7/2022

What those impractical philosophers and more pragmatic lawyers understand: How you DEFINE something often dictates the outcome.

When it comes to DEFINING our In-Groups and Out-Groups --- we're starting to realize that there's a certain NEVER-ENDING QUALITY to the MULTITUDE of these CATEGORIES.

Right now we're grappling with NEURO-DEVELOPMENTAL DIFFERENCES, PSYCHIATRIC DISORDERS and BRAIN INJURIES in the Criminal Justice System and the Society as a whole.

This is a SCARY discussion given where humans have been on GENOCIDE and EUGENICS.

It's been quite a long process of considering INDIVIDUAL CATEGORIES of DIFFERENTIATION.

Neuro-Diversity is a MIXED BAG --- BUT we're all MIXED BAGS --- it's just easier to SEE the further out you get on one of many SPECTRUMS --- OR GROW UP & MATURE.

Leaked Amazon memo shows how it forces out employees to hit targets (April 2021)

PBS -- The Brain with David Eagleman
In-Groups and Out-Groups

Insights From fMRI Studies Into Ingroup Bias (2018)

Intergroup biases can manifest themselves between a wide variety of different groups such as people from different races, nations, ethnicities, political or religious beliefs, opposing sport teams or even arbitrary groups.

In this review we provide a neuroscientific overview of functional Magnetic Resonance Imaging (fMRI) studies that have revealed how group dynamics impact on various cognitive and emotional systems at different levels of information processing.

We first describe how people can perceive the faces, words and actions of ingroup and outgroup members in a biased way.

Second, we focus on how activity in brain areas involved in empathizing with the pain of others, such as the dorsal anterior cingulate cortex (dACC) and anterior insula (AI), are influenced by group membership.

Third, we describe how group membership influences activity in brain areas involved in mentalizing such as the medial prefrontal cortex (mPFC) and temporoparietal junction (TPJ).

Fourth, we discuss the involvement of the lateral orbitofrontal cortex (lOFC) in increased moral sensitivity for outgroup threats.

Finally, we discuss how brain areas involved in the reward system such as the striatum and medial orbitofrontal cortex (mOFC), are more active when experiencing schadenfreude for outgroup harm and when rewarding ingroup (versus outgroup) members.

The value of these neuroscientific insights to better understand ingroup bias are discussed, as well as limitations and future research directions.

I remember when I first heard of the Greek practice of OSTRACISM --- it just didn't seem like that big a deal.

Keeping Up with the Research --- the REALITY SHOW We Shouldn't Miss

1/25/2022

Keeping Up With the Kardasians

Keeping Up with the Research is no easy task & our current systems aren't doing it.

The Future of Psychiatry and Neurodevelopmental Disorders:

A Paradigm Shift (2019)

The current understanding of these disorders, intellectual disability, ADHD, autism, Asperger’s syndrome, tics, etc., is a neurodevelopmental disorder with schizophrenia and bipolar disorder also being neurodevelopmental, and all have significant neurobiological inputs.

Some personality disorders should also be considered as being on the neurodevelopmental spectrum.

The neurodevelopmental trajectory will include the addition of more neurodevelopmental disorders, e.g., bipolar, schizophrenia and depression as the person gets older

Part of more ACCOUNTABILITY for the Public Mental Health System is going to be the somewhat UNCOMFORTABLE recognition of the high CO-MORBIDITY between NEURO-DEVELOPMENTAL DISORDERS & PSYCHIATRIC DISORDERS.

What does that mean for SERVICE DESIGN?

Does it help explain why the Mental Health Centers have been such a DISASTER?

Further, while genes are important --- Maternal Immune Activation may be more illuminating.

Additionally, SOCIAL BEHAVIOR as a delicate balance between INNATE and ADAPTIVE IMMUNITY --
Might help explain the "OVERCITABILITIES" in giftedness and the mental and physical health problems associated with the Hyper Brain, Hyper Body.

Additionally, the UNCONSCIOUS BIAS that seems to be rampant in our descriptions and surface understandings of Gifted Overexcitabilities, Sensitivity and Reactivity...

WHO is exhibiting the behavior and where they are in the SOCIAL HIERARCHY is a part of how the society is REACTING to the behavior.

And that is DE-STABILIZING things even further.

People at the BOTTOM of the SOCIAL HEAP are suffering more
Low social status 'can damage immune system' --- BBC News

Big Think --- Jordan Peterson --- Inequality & Hierarchy Give Life Its Purpose

Further, those "shared genes" across psychiatric disorders are often going to the immune system and epigenetics.

Perhaps most challenging, these NEURO-DEVELOPMENTAL DISORDERS and PSYCHIATRIC DISORDERS are represented throughout the population.

The DIAGNOSTICS and TREATMENTS are in need of improvement for everyone ---
The truth is NEURO-DEVELOPMENTAL DIFFERENCES are not all bad, but if you and everyone around you DON'T HAVE A CLUE -- it can get a lot more than BAD.

The lost girls: ‘Chaotic and curious, women with ADHD all have missed red flags that haunt us’

After multiple burnouts, in my early 30s I finally knew why life sometimes felt harder for me. It made perfect sense, so why had no one noticed before? (2020)

I'm not sure ADHD and other NEURO-DEVELOPMENTAL DISORDERS are so obvious especially given assumptions regarding developmental disabilities and intelligence ---- and the fact that many people are quite BLURRED versions of the DSM 5 diagnostic categories.

That is one of the BIG INSIGHTS of the 21st Century

REFORM of MENTAL HEALTH has to include SUPPORT to TRANSLATE these new understandings and paradigms into IMPROVEMENTS in:

Diagnostics
Treatments, and
Systems

A BIG PART of this is CONSCIOUSLY addressing SENSITIVITY & REACTIVITY and the IMMUNE MEDIATED SENSORY PROCESSING OVERLOAD that is often behind it.

A link between sensory neurons activation and the immune system (2020)

Migraine as a Sensory Processing Disorder and an Inherited tendency to lose control of inputs.

Medical News Today:
What to know about ADHD and sensory overload (Sept. 2021)

What I and the author of the Guardian article know ---
Mental Health is FAR OFF TRACK -- and some of us have paid a big price for that.

Huntington's, Standing Out & the biological basis of behavior

1/18/2022

Tale regarding Dr. Vince Gilmer convicted of murder and ultimately found to have Huntington's. [Dr. Gilmer and Mr. Hyde]

Huntington's is relatively rare in the Criminal Justice System BUT it is there.

Folk Singer Woody Guthrie had Huntington's and found himself in the Criminal Justice System although on much less serious charges. He was diagnosed with Huntington's in 1952.

A few years ago in Colorado, there was a man who was in one of the County Jails who not only had Huntington's but was Deaf ---- and pretty much everyone knew this man did not belong in the County Jail --- BUT the System didn't have a place for him.

One of the ways that the System knew --- He shouldn't be in Jail --- he was DIFFERENT ENOUGH to STAND OUT.

For a lot of people who have NEURO-DEVELOPMENTAL DISORDERS such as ADHD --- that's a DIME a DOZEN in the Criminal Justice System --- :

So often we don't appreciate its significance, OR
We're AFRAID to appreciate its significance
- We see the Neuro-Developmental Disorder ADHD as related to Conduct Disorder and Anti-Social Personality Disorder
- BUT we can't bring ourselves to acknowledge the BIOLOGICAL BASIS of ANTI-SOCIAL PERSONALITY DISORDER.

Further, our Mental Health Professionals are TOO PRO SOCIALLY COMPETENT or more to the point NOT PEOPLE WITH THE RIGHT SKILLS to QUESTION --- underlying assumptions.

At one point, I did think --- HOW CAN THESE PEOPLE MISS THIS --- the BIOLOGICAL BASIS of BEHAVIOR --- they're Doctors and Ph.Ds --- come on . . .
But missing it they are and generally it's Good Faith miss.

The story in the This American Life episode highlights the "process" we're using to address these issues ----

We've got to find the SPECIFIC DIAGNOSIS in time for this SPECIFIC PERSON
In the meantime, we're PUNISHING this SPECIFIC PERSON as well as others.
It's a RACE WITH THE CLOCK & the CALENDAR.

Could we cut through all that if we could recognize the BIOLOGICAL BASIS of BEHAVIOR --- yeah, we could.

Most of these horrific cases could be avoided if we could accept the BIOLOGICAL BASIS OF BEHAVIOR.

If that is a given --- and to some people including myself it seems REASONABLE to assume that until proven otherwise ---
Then we're not getting HUNG UP in the CRIMINAL JUSTICE SYSTEM on the SPECIFICS of that BIOLOGY at the initial determination of whether the person did the acts charged.

"I've been havin' some hard travelin' ---
I thought you knowed."

I think the "Free Will vs. Determinism" debate gets us so OFF TRACK --- BUT I keep posting this video because at 1:45 Sapolsky says this:

"When you look at the number of things that we recognize now as biological --- organic -- where 500 years ago or 5 years ago we would have had a harsh moral judgment about it.

"Instead we now know oh that's a biological phenomenon.

"When we look at that, either we can say that the last 500 years of realizing all of this biology is going to stop right here and there's never going to be a new piece of knowledge in that area ----
"Yeah, there's areas of behavior we still can't explain biologically..

"But if all you can do is see the logical direction of where we're going with that is what we're going to get to the point of recognizing yeah, we're biological organisms. . ."

Where the "Free vs. Determinism Debate" gets OFF TRACK --- it is running in the WRONG DIRECTION.

So we tend to LOOK TO THE PAST --- and say "Hey, there are all these BIOLOGICAL FACTORS and ENVIRONMENTAL FACTORS affecting BIOLOGY ---
- Therefore, there is NO FREE WILL.

At the same time (roughly), we're SLOWLY:
- Learning to control our Environments
- Learning to control our Biologies
- Learning to peel away UNCONSCIOUS thought processes
- Using CRITICAL THINKING to understand more COMPLICATED and INTEGRATED REALITIES.

What is becoming APPARENT is --- WE ARE NOT AS FAR ALONG AS WE THOUGHT WE WERE.

We're handing DIAGNOSIS & TREATMENT to EXPERTS within the PUBLIC HEALTH SYSTEM.

Where DIAGNOSIS & TREATMENT are more appropriate and FAR FROM PERFECT.
BUT it doesn't have to be PERFECT if we understand the BIOLOGICAL BASIS of BEHAVIOR (this is for the purposes of moving away from PUNISHMENT)--
- If we don't understand the BIOLOGICAL BASIS of BEHAVIOR --- our reasoning is laborious and convoluted --- AND most importantly --- some DISFAVORED PERSON is paying the price of our IGNORANCE.
- Is this person also going to PAY A PRICE if we don't have the right "DIAGNOSIS" or "TREATMENT" --- Yes, BUT we are MITIGATING the often HORRIFIC EFFECTS of a PUNITIVE SYSTEM that is often not SUFFICIENTLY HUMANE or SUFFICIENTLY PROVIDING FOR SAFETY.
  - Additionally, it is important to emphasize that this is MITIGATION and it doesn't replace the need for better DIAGNOSTICS and TREATMENTS.

Further, we're MONITORING Treatment and Placements to ensure that they remain APPROPRIATE --- but this is more a PROCESS than an EVENT.

Finally, we're able to handle the INTEGRATIVE COMPLEXITY of INTENT that is BIOLOGICALLY DRIVEN.

The COURAGE & KNOWLEDGE to ADDRESS BIG SHORTAGES

1/14/2022

Understanding Psychiatric Disorders as Disorders of the Neuro-Developmental Continuum does seem like a BIG STEP UP.

Understanding that much of what we're trying to address are challenges in Executive Functioning, including Emotional Regulation --- but not limited to Emotional Regulation seems like a BIG STEP UP.

Understanding that NEURO-DIVERSE INDIVIDUALS are bringing STRENGTHS to the table not just EXECUTIVE FUNCTIONING CHALLENGES seems like a BIG STEP UP.

Understanding that NEURO-DIVERSE People tend to be CLUSTERED at the TOPS and BOTTOMS of SOCIETIES makes this COMPLICATED.

THAT KNEE ON YOUR NECK PROBABLY BELONGS TO SOME OTHER NEURO-DIVERSE PERSON.

One of the things that I've found in this JOURNEY is that ONE FUZZY IDEA is connected to ANOTHER FUZZY IDEA in our SOCIETY. So:

Criminal Intent
Anti-Social Personality Disorder
Unconscious Bias
Societal Hierarchies
NEURO-DEVELOPMENTAL "DISORDERS" and their relationship to PSYCHIATRIC "DISORDERS"
Trauma
Intergenerational Trauma
The Biological Basis of Behavior and its CONNECTION to Environment
Pro Social Competency Religion that it appears the Mental Health Profession has used to fill in quite a few gaps as PSYCHOTROPIC MEDICATIONS were not the ANSWER to EVERYTHING.
STRENGTHS and WEAKNESSES can be MORE ASYNCHRONOUS than we've recognized,
- So someone like myself --- I need support in areas of organization that some people might be surprised about --- people who know me wouldn't be surprised at all.
- On the other hand --- my abstract thinking skills are high and I do know a lot just as result of that NEURO-DIVERSITY --- of course --- it's NOT perfect.

Jacob Bronowski's Ascent of Man (1973)

Knowledge or Certainty

ORCHID'S 2022
CO COGNITIVE
DISABILITY 2-PAGER

BOTTOM LINE: Colorado and other States need to get on with it and adopt REASONABLE PLANS with MEASURABLE GOALS to address BIG SHORTAGES.

‘I am my brother’s keeper’, Philonise Floyd tells UN rights body, in impassioned plea for racial justice

As much as I love Science, it is holding this society HOSTAGE in LAW and PUBLIC POLICY --- as it has set itself up as the ONLY WAY of KNOWING.

Ironically, SCIENCE has been able to do this because of RELIGON's CLAIM to INFALLIBILIBITY --- it's not hard to prove that wrong, BUT
EMPIRICAL SCIENCE has a hard time keeping up with the MORAL CUNUNDRUMS complex societies are facing.

If we want to call it MORAL REASONING that's fine --- it is greatly informed by various religious and philosophical traditions --- and if we were using it ----

We probably wouldn't be the MOST INCARCERATED COUNTRY IN THE WORLD.

HOTEL VOUCHERS ---and the Need for WRAP-AROUND SERVICES & SUPPORT

1/11/2022

A Cautionary Tale from Vermont and a Solution in Canada

Will Vermont hotels accept state vouchers for homeless?

Vancouver Intensive Supervision Unit --- Finding the Person within the Illness

At 1:40 : "What's innovative about VISU is our more grassroots approach to working with the community.

"We offer a guarantee to our community partners that if they work with our clients, if they take them into their buildings to house them, if there ever is a problem . . . they can call us and we will be immediately responsive."

The Vancouver Intensive Supervision Unit is connected with the Court System there --- when we're talking about people who are Homeless something like 24/7 Housing Support Unit would be more appropriate.

Nov. 19, 2021

RUTLAND, Vt. (WCAX) - Hundreds of homeless people are now eligible for 100 days of shelter in Vermont hotels under the state’s newly expanded emergency housing program, but can they get a room?

Under pressure from advocates -- and extended help from FEMA -- the state announced last week it would open the doors of its emergency hotel program but the state says there are at least six times more people in need of help than before the pandemic and at least some of the hotels that opened their doors last year aren’t willing to do so now.

Video on social media shows the condition of the Holiday Inn in Rutland as the hotel was cleaning up from its participation in the state’s homeless hotel program.

Staff at the hotel say rooms sustained serious damage during the months the hotels were taking state vouchers that paid for homeless people to live there.

Renovations are also underway at the Quality Inn in Rutland. The owner of both hotels said they will not be accepting vouchers at this time and are still working on a plan by next month.

The Ethical Issues in Mental Health & Law --- Greatly Exacerbated by BIG SHORTAGES & Failure to Provide Self-Determination in Evidence-Based Treatments

12/30/2021

Generally when we say someone is REFUSING Treatment -- it is a narrow slice of what is actually considered EVIDENCED-BASED TREATMENT.

Further, one could just go with what is on the SAMHSA website and that is much more than is available to most patients.

This argument is NOT going to solve all the issues out there BUT --- it could solve more than we're acknowledging.

So ethical conundrums of Healthcare Professionals and Lawyers are CHEAPER than ADDRESSING the BIG SHORTAGES in Housing & Intensive Services for People Experiencing Significant Cognitive Disability.

But those ETHICAL CONUNDRUMS are also NEVER ENDING if we fail to deal with the REAL ISSUES:
- The need to address BIG SHORTAGES,
- Provide rights of Self-Determination in selecting Evidenced-Based Treatments where possible, and
- Provide STRENGTH-BASED Approaches for Neuro-Diverse People who often struggle with Executive Functioning, but often have ATYPICAL STRENGTHS that go INSUFFICIENTLY RECOGNIZED, DEVELOPED and EMPLOYED.

Image Credit: Study.com

Conjecture: It seems that there is a lot more going on with DYSREGULATION of the IMMUNE SYSTEM in NEURO-DEVELOPMENTAL and PSYCHIATRIC DISORDERS than one would expect.

Most significantly, according to Top Researchers the Immune System implicates --- SOCIAL BEHAVIOR.

Further, this isn't just "IMPLICATES" --- this is being conceptualized as the IMMUNE SYSTEM CONTROLS SOCIAL BEHAVIOR.

University of Virginia School of Medicine

Shocking New Role Found for Immune System: Controlling Social Interactions (2016)

This seems to fit into:

Rejection Sensitive Dysphoria --- emotions often normal in every way except INTENSITY
Blurred Neuro-Developmental and Psychiatric Disorders
Common Sensory Processing Problems and Loss of Control of Inputs, and
The Old Friends Hypothesis --- modern Immune Systems with lack of diversity of microbiota have become in some cases ULTRA SENSITIVE.

Stephen Covey & Temple Grandin:
Sometimes Great Minds Do Think Alike

All Kinds of Minds, Executive Functioning & Criminal Justice

12/25/2021

Temple Grandin is talking about:

All Kinds of Minds, and
Spectrums

I used to think and I think a lot of people still do think that people in the Criminal Justice System have Lower Intelligence --- in some kind of ABSOLUTE SENSE.

A big part of our Criminal Justice Problem is that ASSUMPTION is not true.

BUT it is true that people have EXECUTIVE FUNCTIONING DIFFERENCES that are making it difficult for the person to survive in society.

Further, as more and more of our arbitrary and racist, sexist, politically incorrect filters are having to be discarded --- Traditional Executive Functioning and "Emotional Intelligence" SEEM LIKE OBJECTIVE MEASURES --- but they are not.

The "ASYNCHRONOUS" Packages people are coming in are not only making it hard to ECONOMICALLY SURVIVE --- it is making it hard to EMOTIONALLY SURVIVE.

I would submit that Temple Grandin is much more "EMOTIONALLY INTELLIGENT" than much of what I have seen on "Emotionally Intelligent People" and the "Toxic People."

For some Neuro-Diverse People with Executive Functioning Differences, the HIGH SKILLS in some areas are never getting sufficiently challenged ----
that is leading to mental health problems.

On the other hand, the SOCIETY for all intents and purposes is NOT PREPARED to accept that intelligent people could have EXECUTIVE FUNCTIONING DIFFERENCES.

Ted-Ed -- Temple Grandin
The World Needs All Kinds of Minds

A lot of people in Criminal Justice fall into a broad category of ADHD that is in fact quite BLURRED with Autism.

Further, these DSM boxes are having more and more difficulty corresponding to empirical research.

Lex Morningstar @ 6:50: "People with ADHD receive 20,000 more criticisms by the time they reach the age 12 than Neurotypicals. That's a lot."
A lot of times you do have highly intelligent people, who are highly sensitive, and have executive functioning differences and a SOCIETY that is ABUSING them.

The RESULTS are not pretty.

Medicaid, Supported Employment and getting up to speed on the research

12/18/2021

Integrating MEDICAID and SUPPORTED EMPLOYMENT with Criminal Justice --- It's NOT just our traditional ideas of MENTAL HEALTH.

There are 2 Ideas included here:

By and large we are talking about "COGNITIVE DISABILITIES" in the Criminal Justice System and that is not limited to traditional ideas of "mental illness."
On the other hand, these "COGNITIVE DISABILITIES" are often involving multiple systems of the body. They are involving the brain and central nervous system, but they are involving other systems of the body as well.

CMS and states like Colorado have already started the process of INTEGRATING Physical and Mental Health Care.

The Research does continue to support this direction in care with more and more physical and mental diseases and disorders linked to CHRONIC INFLAMMATION.

[See Inflammation–Nature's Way to Efficiently Respond to All Types of Challenges: Implications for Understanding and Managing “the Epidemic” of Chronic Diseases --- Frontiers in Medicine, 2018]

In the case of "psychiatric disorders," this CHRONIC INFLAMMATION is often beginning DEVELOPMENTALLY with MATERNAL IMMUNE ACTIVATION.

Further, many people in the Criminal Justice System have developmental issues such as ADHD and Dyslexia.

Care needs to be provided, but also more sophisticated SUPPORTIVE EMPLOYMENT. We have a number of people who have AVERAGE or HIGH IQ and DIFFERENT EXECUTIVE FUNCTIONING.

[Further, it seems to me that less controlled "INPUT" is often what is leading to BOTH a perception of HIGH IQ and a perception of LOW EXECUTIVE FUNCTIONING.]

It is only recently that we have separated out these notions of "IQ" and "EXECUTIVE FUNCTIONING" and there is very much a bias to say, "Well, if you don't have traditional executive functioning -- your HIGH IQ can't be worth very much."

BOTTOM LINE: In 2021, that means a HIGH NEED for SUPPORTED EMPLOYMENT among people in the Criminal Justice System who are often struggling with EXECUTIVE FUNCTIONING DIFFERENCES but have average or above average intelligence.

Further, EMPLOYMENT is a big part of our lives and our mental health. This DISCONNECT between "IQ" and "Executive Functioning" is going to require some modified approaches if we're to maintain the mental health of the people we're trying to help.

[What's the POINT of the Research to the right? If we don't get up to speed with the RESEARCH that psychiatric disorders are DYSREGULATIONS of MULTIPLE SYSTEMS of the BODY --- we're going to have a hard time getting out of our MENTAL HEALTH CRISIS.

It is the Brain and the Central Nervous System ---BUT it's also other SYSTEMS of the BODY as well.]

Dr. Garnet Cummings is the Executive Director of Brain Care Centre in Edmonton, Alberta. He was the Chief of Emergency at the Royal Alexandra Hospital until an accident left him with a brain injury. Here he discusses the “unhappy triad” of brain injury, mental illness and addiction. (2015)

Why is ADHD linked with Addiction (2021)

Val's Note / Conjecture: ADHD is associated with "IMPULSIVITY" and the brain. I think it is important to note that neuro-developmental and psychiatric disorders are being recognized more and more as DYSREGULATIONS of MULTIPLE SYSTEMS of the BODY --- not just the Brain and the Central Nervous System.

Also this HEIGHTENED SENSITIVITY is not just going to REWARD but sometimes to ENVIRONMENT in general--- is the IMPULSIVITY a CAUSE or an EFFECT or BOTH.

Also what are people with ADHD RE-ACTING to -- is it just a DYSREGULATION of DOPAMINE or does it also include DYSREGULATIONS of other SYSTEMS of the BODY?

See:

Dopamine and Cortisol

[Dopamine is a neurotransmitter in the Brain and is part of the Nervous System, Cortisol is the primary stress hormone which is part of the ENDOCRINE SYSTEM.]

The microbiome: A key regulator of stress and neuroinflammation

MIA (Maternal Immune Activation) and the Human Microbiome When the maternal immune system is activated during pregnancy, the inflammatory cytokines released affect the offspring's vagal system and consequently their CNS regulation. MIA activation also affects maternal gut bacteria, which in turn can affect the microbiome of offspring.Jun 28, 2019
Maternal Immune Activation and Related Factors in the Risk of ...
Results from a new study suggest a pathway of communication between certain gut bacteria and brain metabolites, by way of a compound in the blood known as cortisol. And unexpectedly, the finding provides a potential mechanism to explain the characteristics of autism. Gut microbes have been in the news a lot lately.Aug 21, 2017
Gut microbes may talk to the brain through cortisol

Cortisol and the Immune Response

Is psychosis a multisystem disorder? A meta-review of central nervous system, immune, cardiometabolic, and endocrine alterations in first-episode psychosis and perspective on potential models (Molecular Psychiatry, 2018)

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