Orchid Advocacy
  • Home
    • About Orchid >
      • Why Orchid?
      • ORCHID'S SYSTEMIC FOCUS & "ROOT CAUSE" ANALYSIS APPROACH TO PROBLEM SOLVING WITH A COMMITMENT TO CREATIVITY & INNOVATION
      • Disclaimers, Limitations and An Invitation
      • Orchid Board
      • Orchid Book Club
      • Conjecture, Science & Translational Research & Medicine
      • Orchid Themes & Symbols
      • The Tipping Point
      • Orchid's Website Advertising Policy
      • Statement for Potential Website Contributors
      • Contact
  • Blogs
    • Val's Blog
    • Val's Blog 2
    • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
    • NEURO-DIVERSITY Wednesday
    • Olmstead Law & Order Thursday
    • Translational Medicine Friday
    • Translational Love, Relationships & Neuro-Diversity Saturday
  • Orchid's A-Z Index
    • Crisis Services in CO, the US & Around the World
    • Assertive Community Treatment & Flexible ACT Index
    • Housing & Homelessness Index
    • Criminal Justice
    • Innovation Index
    • For More: See the Main Orchid Index Page
  • US Federal
    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
  • Research & Translational Medicine
    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
      • Brain Injury, the Immune System & Mental Health
      • Celiac Disease & Sensitivities, the Immune System & Mental Illness
      • Mental Illness & The Immune System
      • Racial Discrimination & the Immune System & Mental Health
      • Trauma & the Immune System & Mental Health
      • ***Physical Health Issues, the Immune System & Mental Health Index
    • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System

Transitional/ Translational Justice Monday





















We're Encouraged by this Legislative Session ---BUT There are Some Scary Reminders About How Far We Have To Go

6/20/2022

 
FEDS:  WHERE ARE YOU?
In March 2022, the US Department of Justice issued a "FINDINGS LETTER" to COLORADO re:  people with physical disabilities and nursing homes.
  • There are more "FINDINGS LETTERS" that need to be issued to Colorado and most States.
  • We are on the 100-YEAR PLAN to COMPLIANCE with EXISTING FEDERAL DISABILITY CIVIL RIGHTS LAWS.
 
  • What we really need is COMPREHENSIVE TECHNICAL ASSISTANCE and EFFECTIVE UNIFORM ADMINISTRATIVE ENFORCEMENT.
 
  • I am for INDIVIDUAL STATE INNOVATION, CREATIVITY and Tailoring.
    • There is NOT just ONE RIGHT WAY to comply with:
      • The Americans with Disabilities Act (ADA)
      • Section 504 of the Rehabilitation Act
      • Mental Health Parity & Addiction Equity
      • Medicaid Network Adequacy
      • Etc.
    • The PROBLEM is there is NOT JUST ONE WAY to NON-COMPLIANCE either.
 
  • We NEED the FEDS to provide more in the way of CONTINUOUSLY IMPROVED  DEFAULT TEMPLATES.
 
  • CMS and others are providing "GUIDANCE" sort of BUT Compliance is:
    • TECHNICALLY COMPLICATED, and
    • POLITICALLY COMPLICATED, and
    • ENFORCEMENT is PATCHY.
 
  • We do need STATES to push to bring down COSTS, BUT Ironically 2 of the things that are going to bring down costs are:
    • BETTER TREATMENTS, and
    • BREAKING DOWN BARRIERS to realizing the INTEGRATION MANDATE in the ADA
 
  • Especially for Cognitive Disability, Developmental Difference with Average or Above Average IQ --- the CURRENT PATHS TO INCLUSION  are more difficult than the MAJORITY appreciates.
    • Further, those people with Developmental Differences involving Sensory Processing and Executive Functioning are more VULNERABLE TO PSYCHIATRIC DISORDERS.
    • THEIR Strengths and Weaknesses are DIFFERENT ENOUGH that the NEURO-TYPICAL MOLD won't fit.
    • If we really put some CONSCIOUS EFFORT into MAXIMIZING the STRENGTHS and WORKING AROUND the "WEAKNESSES" ---
      • We probably can realize some COST SAVINGS.
 
  • Many people are not going to get into a HOUSE without a 30-YEAR MORTGAGE ---
    • BUT EVERYONE understands that the more YEARS you add to that MORTGAGE --
      • The more you are ULTIMATELY going to pay.
 
  • Well, the INTEREST RATE for SOCIAL EXCLUSION, INADEQUATE TREATMENTS, HOUSING & PLACEMENTS for Cognitive Disability/Difference is MANY TIMES that of the average 3O-year mortgage---
    • BOTH in TREASURE and HUMAN SUFFERING.
Picture
  • Further, we don't seem poised to REACH COMPLIANCE with EXISTING DISABILITY CIVIL RIGHTS LAWS in 30 YEARS or 60 YEARS.
 
  • In fact, it's not clear when we will reach COMPLIANCE.


 We need a Plan -- like an Olmstead Plan with:
  • Measurable Goals
  • Reasonable Time Frames, and
  • Funding to Support the Plan
In the meantime, we would like to see ON-GOING ENGAGEMENT and Yearly Reports of State Protection & Advocacy Offices with States on:
  • Olmstead
  • Parity
  • Network Adequacy
Further, State Lawyers Committees and Pro Bono Efforts should PARTNER with State P&A Offices  conduct "INVESTIGATIONS" in COORDINATION with the US Department of Justice.

Some of that is being done in States like Colorado and others.

If we are NOT going to FUND UNIFORM and EFFECTIVE ADMINISTRATIVE ENFORCEMENT --- we need to FUND P&A, Pro Bono & DOJ INVESTIGATIONS and Enforcement Efforts.

As encouraged as we all are by a new Colorado Behavioral Health Administration ---
  • the most DIFFICULT CONVERSATIONS have yet to be had, and
  • HCPF's 809.15.A.2 on Target Criteria for Colorado's MI Waiver requiring needing assistance with activities of daily living ----
    • Speaks VOLUMES about where we've been, where we still are and how far we have to go.
Picture
Cloudy Valley Morning --- photo.net

INFLAMMATION REDUCTION as a Civil Rights & Health Equity Issue

6/19/2022

 
Conjecture
  • Inflammation is something of a UNIVERSAL LANGUAGE in Animal Biology and it is coding for an enormous number of things.
  • One of the things that is OBVIOUS --- BUT is
    • Not always obvious to the LAW, or
    • MEDICAL PRACTITIONERS
  • We're NOT making ourselves out of WHOLE CLOTH.
  • We're BORN into this.
 
  • There have been a great number of books written recently on INFLAMMATION and seeing INFLAMMATION as a "ROOT CAUSE" of illness.
    • That also prompts a lot of books to promote an ANTI-INFLAMMATORY "LIFESTYLE" which is good as far as it goes.
    • IT DOESN'T GO FAR ENOUGH
 
Picture
Disparities in Susceptibility to Multisystem Inflammatory ...
https://jamanetwork.com › jamapediatrics › fullarticle

by EA Dennis-Heyward · 2021 · Cited by 3 — In May 2020, the CDC issued a national health advisory for MIS-C, which is now characterized by fever, multiorgan (2 or more) system

  • Certainly when it comes to NEURO-DEVELOPMENTAL and PSYCHIATRIC DIFFERENCES or DISORDERS --- the "ANTI-INFLAMMATORY LIFESTYLE" doesn't go far enough.
    • We have to TARGET DEVELOPMENTAL INFLAMMATION and DYSREGULATION of MULTIPLE SYSTEMS of the BODY.
 
  • I don't think a MORE FOCUSED EFFORT on addressing the UNDERLYING BIOLOGY of Neuro-Developmental and Psychiatric Disorders INVALIDATES:
    • Personal Observation
    • Family Observation
    • Social Observation
    • Professional Observation
 But it does give a much needed CROSS REFERENCE, especially for those at the BOTTOM of the HIERARCHY.

Accommodations, Work Arounds and Life Paths for Differences in Sensory Processing

6/8/2022

 
Conjecture

"Impairments in early sensory information processing have been consistently identified in patients with schizophrenia as well as in individuals at high clinical risk for developing psychosis.

"There is increasing evidence that the deficits at these early levels of information processing significantly ..."


Sensory Information Processing Abnormalities in ... - Frontiers

[Question:  Is it a DEF
ICIT or is it an EXCESS, BOTH -- INDIVIDUAL?]



"Social and emotional responses rely heavily on the brain's ability to make sense of sensory information.

"Inaccurate information from processing deficits results in aversive emotional reactions from which maladaptive behaviors grow.
"

Sensory Processing Disorder:  It's Not… Something You Outgrow

[Question Again:  Is this just
DEFICITS, is it also EXCESSES --- does it depend on how we look at it?]



So what does this have to do with ACCOMMODATIONS. WORK-AROUNDS and LIFE PATHS?

  • Differences in Sensory Processing are often something you are BORN with:
    • By and large, the PATH OF LEAST RESISTANCE is just to try to fit in as best you can --- on some level MOST EVERYONE is doing that.
    • The PROBLEM comes when YOUR NEEDS and the SOCIETY'S NEEDS or other PEOPLE'S NEEDS are coming into CONFLICT.
 
  • Further, HOW MUCH AWARENESS do YOU, EXPERTS or the SOCIETY really have with regard to MORE FUNDAMENTAL "ROOT CAUSES" of these CONFLICTS?
 
  • Because this is COMPLICATED --- one of the ways we have "RESOLVED" these CONFLICTS is with SYSTEMS of HIERARCHY.
 
  • Those "SYSTEMS of HIERARCHY" are under SCRUTINY by many people and groups of people, including many NEURO-DIVERSE people.

Many psychiatrists now would say ADHD is not an ATTENTION DEFICIT --- it's an ATTENTION EXCESS.

I would say that ATTENTION EXCESS is the RESULT of a SENSORY EXCESS.

Further, we process information through our senses in part by using our EMOTIONS.

On the one hand, we don't REASON without EMOTION --- EMOTION is A PART of the REASONING PROCESS.

On the other hand --- EMOTION is NOT NECESSARILY the END PRODUCT --
  • UNDERSTANDING and AWARENESS can bring CALM
  • A FACADE of Understanding and Awareness --- has its limits
  • And that I think is what PUSHES Human Understanding and Awareness.
  • I don't think 40 years ago the DSM was a FACADE -- it was imperfect BUT it was the best we could do.
  • Today in 2022 the DSM is a FACADE for a profession that is not getting SUFFICIENT TRANSLATIONAL RESEARCH SUPPORT.
  • I think if we're not considering the role of DEVELOPMENTAL DIFFERENCES/DISORDERS involving SENSORY PROCESSING as they relate to PSYCHIATRIC DISORDERS and SUBSTANCE USE DISORDERS,
    • We're not likely to be EFFECTIVE, and
    • It won't be COST EFFECTIVE
Florence  + The Machine
Free

Florence Welch is Neuro-Diverse --- she has Dyslexia.

I think a lot of people who are Neuro-Diverse with HYPER-CONNECTED BRAINS but not necessarily DYSLEXIC --- can RELATE to this idea of FEELINGS and EMOTIONS HITTING ALL AT ONCE.

GO WITH THE FLOW
  • Neuro-Diverse people are processing often MORE SENSORY INFORMATION
  • I think that is what makes it EASIER for NEURO-DIVERSE people to PICK UP PATTERNS in DIVERSE DISCIPLINES
    • they have MORE EXAMPLES
  • BUT it takes them LONGER to PROCESS MORE INFORMATION ---
    • Einstein didn't talk until he was 3 --- and most of us aren't Einstein
    • BUT we are bringing our UNIQUENESS to the TABLE
    • Further --- all that INFORMATION in the UNIVERSE is NOT SOMEHOW IRRELEVANT ---
        • Saying you don't have the BANDWIDTH to CONSIDER something
        • Is SIGNIFICANTLY DIFFERENT than saying it is IRRELEVANT.   Leonardo da Vinci was right --- IT IS ALL CONNECTED
  • For many people, processing ENORMOUS AMOUNTS of Information:
    • The Arts
    • Entrepreneurship
    • Social Entrepreneurship
    • Various Forms of Teaching
Can Work.
Neuro-Diverse people can seem CONTROLLING but they are trying to maintain a pretty elusive HOMEOSTASIS.
  • If you are at the TOP of some PYRAMID (PYRAMID SCHEME) -- then maybe you're able to keep it together (sort of)
  • If you are at the BOTTOM of some PYRAMID (PYRAMID SCHEME) -- it is going to be NEXT TO IMPOSSIBLE.
    • Neuro-Diverse people need a lot of CONTROL over their ENVIRONMENTS because they are SO SENSITIVE to those ENVIRONMENTS.

Further, the important thing about NEURO-DIVERSITY is the DIVERSITY.  

It's often Neuro-Diverse people who are in CONFLICT while those NEURO-TYPICALS are trying to figure out what all the FUSS is about.
This is about "Equality" and "Fairness" ---
  • But it is not EQUALITY in the sense of we're CLONES -- it's EQUALITY in the sense that we're all living beings and we need ENVIRONMENTS that work for us and there are DIFFERENCES.
  • We have to NEGOTIATE those DIFFERENCES on  an EQUAL FOOTING.

"White Supremacy" --- the EXTREME FRUITS of a WIN/LOSE Society

5/16/2022

 
  • One of the REVELATIONS of being ENLIGHTENED or "WOKE" or a "REDNECK" is you start to realize that WHO WINS depends on HOW THE GAME IS DESIGNED and STRUCTURED.
  • Further, there is a kind of ROUGH DIALOGUE between the MIDDLE and the EXTREMES.

  • Sometimes people with EXTREME EMOTIONS are "LATCHING ONTO" some "IDEA" in the ENVIRONMENT and taking it to its "LOGICAL EXTREME."
 
  • HEY THAT'S NOT WHAT WE MEANT!!!!
Journalist Sebastian Junger
TedTalk (2014)

"Civilians don't miss war. But soldiers often do. Journalist Sebastian Junger shares his experience embedded with American soldiers at Restrepo, an outpost in Afghanistan's Korengal Valley that saw heavy combat.

"Giving a look at the  'altered state of mind' that comes with war, he shows how combat gives soldiers an intense experience of connection. In the end, could it actually be "the opposite of war" that soldiers miss?"

Junger makes the DISTINCTION between FRIENDSHIP and BROTHERHOOD.


The COMPETITIVENESS of a GLOBAL ECONOMY and various DIVISIONS have put into HIGH RELIEF the need for BROTHERHOOD and need to bring EVERYONE into a view of the HUMAN FAMILY.

RELIGION, SPIRITUAL TRADITIONS and SCIENCE are a part of this   --- and they all EVOLVE.

SmartHistory
The Law Code Stele of King Hammurabi



What's the Point? 
  • 4,000 Years Ago ---An EYE for An EYE --- was actually a BIG STEP UP, More Proportional & Compassionate than where some of the PUNISHMENT had been.

Conjecture
  • The challenge of people with EXTREME EMOTIONS going off on Others I would submit is NOT A NEW CHALLENGE.
  • Further, our System of Criminal Justice is focused on the "idea" of PUNISHING EXTREME INTENT when it is accompanied by EXTREME ACTIONS.

HISTORY as A CONVERSATION ACROSS TIME
  • if you look at the CODE OF HAMMURABI -- it is both AMAZING and it SUCKS by MODERN STANDARDS.
  • Understanding ourselves as A PART OF HISTORY that is WOVEN into the FABRIC of TIME ---
    • Can give LIFE MEANING
    • AND it can also take some of the pressure off
      • Whatever we are doing now is the best we can do and all things considered probably is AMAZING or ---
        • With greater knowledge and insight ---- WELL, NO WONDER.
  • Bringing ourselves to scale in the SCHEME OF THINGS, allow us to understand and accept imperfection, keep going and continue to MAKE SAFE SPACES for ourselves and others in an IMPERFECT HUMAN FAMILY.

Civil Commitment  in the context of Mental Health System Reform  ---Either a Total Red Herring or Not What You Think It Is

5/14/2022

 
A lot of mental health professionals and people in the Mental Health Center System --- think the ANSWER is to AMEND the CIVIL COMMITMENT STATUTES.

A lot of it is SELF-SERVING --- BUT there are quite a few people who have a GOOD FAITH BELIEF that CIVIL COMMITMENT REFORM or MODIFICATION is at least part of the answer to our MENTAL HEALTH CRISIS.


I spend a lot of time trying synthesize the latest research --- and there's a lot of "STUFF" we should be on top of --- that we're not --- such as the relationship between NEURO-DEVELOPMENTAL DISORDERS and PSYCHIATRIC DISORDERS.

BUT what is really telling is that we're not on top of an EVIDENCED BASED TREATMENT MODALITY that was developed for people with INTENSIVE MENTAL HEALTH NEEDS ---- 

In the 1970s

I'm talking of course about --- Assertive Community Treatment 

Picture
Red Herring:  An Argument that Distracts you from the Real Issue.

In this case, Civil Commitment Distracts us from the Real Issue:  HUGE SHORTAGES of bed space, housing and intensive services and supported employment.

Picture

Precision Medicine & Controlled Substances:  Marijuana & MDMA

4/27/2022

 
There is considerable NEED to RAMP UP Research on Controlled Dangerous Substances such as Marijuana and "ECSTASY"
  • to DIAL BACK some of the EXCESSES of "MARIJUANA" Legalization AND
  • make available MDMA / "ECSTASY" for PTSD.
Right NOW --- Mental Health is INCOMPETENT (in some respects) and is NOT UP on the LATEST RESEARCH BUT that is primarily because we have NOT provided sufficient TRANSLATIONAL RESEARCH & MEDICINE
AND we're often asking people to WAIT DECADES and DECADES when:What they are currently getting from Mental Health isn't that great (in some respects) --- AND
People are STILL NOT LIVING FOREVER --- even if some people are SUPER AGERSThat DEATH THING is STILL A THING.
We Need PRECISION MEDICINE --- what might "WORK" or be "HARMLESS" for one person --- could be HARMFUL for someone else.
ABC 10
How A First Responder Says MDMA Helped Him Get Past PTSD

Modulating NMDA Receptor Activity Is the Key to Successful Treatment of PTSD

April 16, 2022

Neuroscience News
The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
Background: 3,4-methylenedioxymethamphetamine (MDMA), known recreationally as “Molly” or “Ecstasy”, is a triple monoamine reuptake inhibitor. MDMA specifically acts as a weak 5-HT1 and 5-HT2 receptor agonist, targeting 5-HT2A, 5-HT2B, and 5-HT2C receptors. Its potential use for therapeutic purposes with these pharmacological profiles remains a controversial subject.

Studies have shown the potential benefits in clinical trials for post-traumatic stress disorder (PTSD). A larger amount of data has been provided for the push in support of MDMA-assisted psychotherapy in these patients. 

Objective: The aim of this article is to compute a meta-analysis and conduct a systematic review of the effects of MDMA on PTSD, discussing the potential benefits and adverse events relative to dosing and stability of treatment.

Discussion: Findings show promising evidence for the potential therapeutic use of MDMA alongside psychotherapy in the treatment of PTSD. The pharmacological profile of MDMA may provide direction for future drug developments to treat patients with treatment-resistant psychiatric disorders.

Relevancy and the FULLNESS OF TIME

4/20/2022

 
Stephen Covey really put into HIGH RELIEF this distinction between EFFICIENCY and EFFECTIVENESS.
  • This has RAMIFICATIONS in the JUSTICE SYSTEM --- and many of us are familiar with the phrase:  "Justice Delayed is Justice Denied."
  • Further, I'm going to connect EFFICIENCY to TRADITIONAL EXECUTIVE FUNCTIONING.
    • It is important
    • It is important to the JUSTICE SYSTEM
 
  • The Justice System can be HIGHLY INEFFICIENT.
    • Colorado's ACCESS TO JUSTICE COMMITTEE is recommending greater use of TECHNOLOGY and SIMPLIFICATION of PROCEDURES.
      • As many engineers can tell you, the SIMPLER the PROCESS, often the MORE SOPHISTICATED the ENGINEERING.
 
  • On the other hand, the American Justice System while it  has its SUCCESSES --- has been a CAUTIONARY TALE to the WORLD.
    • It's taken a former KGB murderer who heads the Russian Government and has unleashed WAR CRIMES in UKRAINE to push the American Justice System off the RADAR SCREEN.
 
  • This may sound like AMERICAN EXCEPTIONALISM --- BUT the fact of the matter is we have a ROBUST HISTORY of WRESTLING with SOME COMPLEX PROBLEMS in the provision of Justice.
    • JUSTICE is NOT THE STATE of NATURE --- the STATE of NATURE is MIGHT MAKES RIGHT and the STRONG KILL THE WEAK.
 
  • One of the places where WESTERN JUSTICE tends to go OFF THE RAILS --- is ironically it's NOTION of RELEVANCY.  
 
  • I think we need to EXPLICITLY CONNECT our IDEAS of RELEVANCY with our IDEAS regarding DUE PROCESS OF LAW.
    • Of course, that is done ALL THE TIME --- BUT it seems to me we need a MORE SEAMLESS and DIRECT CONNECTION.
    • Both for purposes of EFFICIENCY and EFFECTIVENESS.
  

Picture
Under Federal and State Rules of Evidence --- Relevancy is generally anything that would ASSIST THE TRIER OF FACT. 

See Federal Rule of Evidence Rule 401 (Test for Relevant Evidence) and 402
(
General Admissibility of Relevant Evidence)


 AND there is generally a caveat that the EVIDENCE can't be "UNFAIRLY" PREJUDICIAL (it can be "prejudicial" --- just not "unfairly prejudicial.")

See Federal Rule of Evidence Rule 403

(Excluding Relevant Evidence for Prejudice, Confusion, Waste of Time, or Other Reasons)

 So far, so good.
BUT what happens when you have a FACT that ---
  • Criminal Defendant Bob, Jesus or Jamal has a BRAIN INJURY or DEVELOPMENTAL DISORDER or SUBSTANCE ISSUE or PSYCHIATRIC DISORDER or HISTORY of CHILD ABUSE or TRAUMA.

ABC NEWS:  Top 20 "Whitest" and "Blackest" Names
FURTHER, what happens if you have EVIDENCE that MOST CRIMINAL DEFENDANTS have BRAIN INJURY, DEVELOPMENTAL DISORDERS, SUBSTANCE ISSUES, PSYCHIATRIC DISORDERS and HISTORIES of CHILD ABUSE or TRAUMA-----Significantly greater than people not involved in the criminal justice system and at more SEVERE LEVELS.
Picture
"ALL OF A SUDDEN"  -- over many years and decades ---- Our notions of PUNISHMENT don't seem to comport with DUE PROCESS of LAW and FUNDAMENTAL FAIRNESS --- even as the SAFETY CONCERNS REMAIN.
Picture
THIS does require the WISDOM of SOLOMON --- which we don't have BUT we are SLOWLY MOVING IN THE RIGHT DIRECTION.
UNDERSTANDING that many of the "FACTS" of Cognitive Disability that we write off as "IRRELEVANT" and "NO EXCUSE" ---
  • Are actually highly relevant and
  • Would be much more EXPLICITLY THE SUBJECT MATTER of a PUBLIC HEALTH APPROACH TO CRIMINAL JUSTICE.

NEURO-DIVERSE ACCOMMODATIONS --- ACCOMMODATING NON-TYPICAL COMBINATIONS of STRENGTHS and WEAKNESSES.

4/5/2022

 
CONJECTURE

This is really about MINORITY RIGHTS and PEOPLE with COMPLICATED COMBINATIONS of STRENGTHS and WEAKNESSES that can be on opposite ends of various SPECTRUMS ----

  • ​For Example, Frank Sinatra or Einstein or Sylvia Plath
  • Often we think of Ethnic and Racial Minorities, Gender and LGBTQ+ Rights when we think of MINORITY RIGHTS 
 
  • Neuro-Diversity cuts across​ these CATEGORIES.
​
  • Because Neuro-Diversity directly implicates COGNITION and EMOTIONAL REGULATION it is important to UNDERSTAND.
    • ​It also often comes with some BIG STRENGTHS in one or more areas. 
 
  • There generally are challenges in EXECUTIVE FUNCTIONING and EMOTIONAL REGULATION
    • ​The Ramped Up Sensory Processing that is fueling the perception of some of these STRENGTHS is also fueling the perception of these CHALLENGES.
 
  • The STRENGTHS and WEAKNESSES are TOO INTEGRATED to address UNCONCIOUSLY or INDIRECTLY.
    • ​Trying to RAM that Round Peg in a Square Hole can create more problems than it solves.  ​​
Picture
The idea of "FLOW" is based on a BALANCE of STRENGTHS and WEAKNESSES.

When you or someone else is coming in a more UNUSUAL COMBINATION of STRENGTHS and WEAKNESSES --- that BALANCE has to be achieved MORE CONSCIOUSLY.  

We do know ourselves in part by our observation of OTHERS --- BUT if we have significant differences --- we may have a hard time understanding what we need and standing up for ourselves------ and others may have a hard time understanding what we need.

Mihaly Csikszentmihalyi --- "FLOW"

FLOW:  A BALANCE OF "CHALLENGES & SKILLS"
You Won't Have To Worry About Lazy Adults if you go with the flow
Picture
Platypus --- An Animal So Strange ---- It Almost Doesn't Look REAL.
  • We do need EXPERTS that can address these issues from an ACCOMMODATION STANDPOINT
    • Working just on the TRADITIONAL EMPLOYMENT end --- may not always work.
    • Neuro-Diverse people are quite frankly often needing a lot of things REASONABLY ACCOMMODATED and INDIVIDUALLY TAILORED.
      • ​The LAW provides for it so long as it is "REASONABLE"--- but asking the INDIVIDUAL to fight that BATTLE is sometimes not realistic and it can result in a PYRRHIC VICTORY ---- you won the battle but you lost the war --- you're still in a HOSTILE WORK ENVIRONMENT.
        • ​AND for people SENSITIVE to their ENVIRONMENTS & STRESS --- that is not going to be a good thing.
​
  • ​Incentivizing Entrepreneurs to Incorporate Neuro-Diverse people in the work force is a possible option.
 
  • Some technically minded Neuro-Diverse are IN DEMAND in HIGH TECH --- BUT not all Neuro-Diverse people are technically minded.
​
  • We are talking about how to INCENTIVIZE people to broach the LEARNING CURVE of NEURO-DIVERSE ACCOMODATIONS.
 
  • A lot of Neuro-Diverse people  assumed the UNBALANCED VIEWS of THEMSELVES reflected in others.
 
  • Once Neuro-Diverse people get that HARD WON more BALANCED VIEW of themselves with COMPLICATED STRENGTHS and WEAKNESSES --- that can drive a lot of improvement, too.
 
  • Supported Entrepreneurship is  important.
 
  • ​The WORKFORCE SHORTAGE is an INCENTIVE to get on that LEARNING CURVE to TAP into the STRENGTHS of Neuro-Diverse people without BURNING THEM OUT.   ​​

When I refer to "Neuro-Diverse" --- I am generally referring to people who fall within current categories of ADHD, Autism, Gifted and Dyslexia or other Neuro-Developmental Conditions often:
  • Sharing Some Genes
  • ​Often subject to Maternal Immune Activation during Pregnancy
  • Possibly Ramped Up Epigenetic Positive Feedback Loops, 
  • Increased Sensitivity to the Environment --- that is probably once again related to this Ramped Up Sensory Processing.
  • HYPER-CONNECTED BRAINS

They tend to be more VULNERABLE to PSYCHIATRIC DISORDERS. 

JUSTICE, IGNORANCE & the BIOLOGICAL BASIS of BEHAVIOR

3/24/2022

 
We use our MORAL and ETHICAL JUDGMENTS to protect ourselves --- BUT those JUDGMENTS look very different across time ----
  • often based on NEW INFORMATION, or
  • MORE THOROUGHLY INTEGRATING EXISTING INFORMATION.

Some of this is INTEGRATING the Poetic Understanding of a Seamus Heaney with the BIOLOGICAL BASIS OF BEHAVIOR --- the "STREAM OF LIFE" we all find ourselves in.

The "INTEGRATIVE COMPLEXITY" of that "STREAM of LIFE" is putting PRESSURE on our current systems.

It has put pressure on systems in the past and it probably will continue to do so in the future --- since comprehension of this "STREAM OF LIFE" is not currently fully within our grasp.

In 2022, we're much more AWARE of :
  • Neuro-Developmental Differences and Disabilities
  • Neuro-Psychiatric Disabilities
  • Substance Issues, and
  • Brain Injuries as well as Brain Tumors and Lesions 
as affecting Human Behavior and for that matter the behavior of other animals.

Something that is poised to change our concept of the Human Being ---- MICROBES that are NOT HUMAN that appear to be ESSENTIAL for NORMAL HUMAN BEHAVIOR and for the behavior of other animals.

What is JUSTICE in such a "STREAM OF LIFE" --- ?
Seamus Heaney reading
St. Kevin & the Blackbird ---

"in love's deep river"

Cognitive Changes in Patients with Brain Tumors 
​ Memorial Sloan Kettering
Picture
Michael Specter is an American journalist who has been a staff writer, focusing on science and technology, and global public health at The New Yorker since September 1998.  He has also written for The Washington Post and The New York Times. ---Wikipedia

Law & Reason as a BRIDGE between Science and Faith

3/24/2022

 
​The Problem of a Mitigating Discipline based on a Scientifically Invalid Diagnostic Manual
When we think about the great intellectual problems of the last several hundred years --- the conflict between SCIENCE and RELIGION is right up there and RELIGION has sometimes shot itself in the foot by its REFUSAL to acknowledge the AMAZING DISCOVERIES of EMPIRICAL SCIENCE.

BUT in MODERN TIMES, we have an AMAZING FAITH in Empirical Science as the ANSWER to Every Question.

And in FAIRNESS --- maybe EMPIRICAL SCIENCE is NEEDED for many if not most questions.

BUT we've gotten ourselves into quite a CONUNDRUM because SCIENCE is often LAGGING BEHIND ---and sometimes FAR BEHIND ---- the demands to make MORAL and ETHICAL DECISIONS in the MOMENT.

In fact, EMPIRICAL SCIENCE may be LAGGING DECADES or MORE BEHIND our need to make those DECISIONS and in fact EMPIRICAL SCIENCE  may be LAGGING BEHIND one or more GENERATIONS.

So when we look at our use of MENTAL HEALTH KNOWLEDGE and LACK THEREOF in the Criminal Justice System --- IT IS A MESS:
  • We've put all our "FAITH" in Empirical Science ---
    • But the DSM 5 is scientifically invalid at least according to pronouncements from the National Institute of Mental Health in 2013.  
    • Further, over 600 Research Institutions have found that genes are shared across diagnostic categories and the DSM categories do not appear to coincide with EMPIRICAL RESEARCH and SCIENCE.

Well --- the ANSWER is we need MORE EMPIRICAL  RESEARCH and SCIENCE --- In fact, that is one of the RIGHT ANSWERS --- the only problem is IT IS NOT SUFFICIENT to address our CURRENT PROBLEMS.

The LAW and Public Policy have been surprisingly SLOW in using "REASON" to make REASONABLE DEDUCTIONS and INFERENCES regarding:
  • the Biological Basis of Behavior, and
  • the Biological Effects of "Environment"


Picture
​As well as the need in some to many cases to get beyond PUNISHMENT for INDIVIDUAL BAD ACT or BAD INTENT and move to a Public Health Approach that can handle BAD ACTS and BAD INTENT stemming from CHRONIC CONDITIONS such as:
  • Neuro-Developmental Disorders
  • Psychiatric Disorders
  • Brain Injury, and or
  • Substance Issues that are often related to one or more of the above.​

Is "REASON" needed as a BRIDGE between our "FAITH" in Empirical Science or our Religious and Spiritual Beliefs?

​I would maintain that "REASON" is needed as a BRIDGE to BOTH.
<<Previous
Forward>>

    Transitional Justice is a term used by the United Nations and others to describe measures to REDRESS MASSIVE VIOLATIONS of HUMAN RIGHTS.

    ​​Translational Justice as we're using it refers to a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE and is meant to echo TRANSLATIONAL MEDICINE.

    ​
    Translational Justice also means listening to those people impacted by our justice policies

    That means going 360
    ° -- that's hard work
    ​



    Archives

    June 2025
    May 2025
    April 2025
    March 2025
    February 2025
    January 2025
    December 2024
    November 2024
    October 2024
    September 2024
    August 2024
    July 2024
    April 2024
    March 2024
    February 2024
    January 2024
    December 2023
    October 2023
    August 2023
    June 2023
    May 2023
    February 2023
    January 2023
    December 2022
    October 2022
    September 2022
    August 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    January 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021

    Categories

    All

    RSS Feed


Orchid:  Email

Crisis Services in Colorado, the US & Around the World

​Copyright 2025  Orchid Mental Health Legal Advocacy of Colorado, Inc.
Web Hosting by iPage
  • Home
    • About Orchid >
      • Why Orchid?
      • ORCHID'S SYSTEMIC FOCUS & "ROOT CAUSE" ANALYSIS APPROACH TO PROBLEM SOLVING WITH A COMMITMENT TO CREATIVITY & INNOVATION
      • Disclaimers, Limitations and An Invitation
      • Orchid Board
      • Orchid Book Club
      • Conjecture, Science & Translational Research & Medicine
      • Orchid Themes & Symbols
      • The Tipping Point
      • Orchid's Website Advertising Policy
      • Statement for Potential Website Contributors
      • Contact
  • Blogs
    • Val's Blog
    • Val's Blog 2
    • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
    • NEURO-DIVERSITY Wednesday
    • Olmstead Law & Order Thursday
    • Translational Medicine Friday
    • Translational Love, Relationships & Neuro-Diversity Saturday
  • Orchid's A-Z Index
    • Crisis Services in CO, the US & Around the World
    • Assertive Community Treatment & Flexible ACT Index
    • Housing & Homelessness Index
    • Criminal Justice
    • Innovation Index
    • For More: See the Main Orchid Index Page
  • US Federal
    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
  • Research & Translational Medicine
    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
      • Brain Injury, the Immune System & Mental Health
      • Celiac Disease & Sensitivities, the Immune System & Mental Illness
      • Mental Illness & The Immune System
      • Racial Discrimination & the Immune System & Mental Health
      • Trauma & the Immune System & Mental Health
      • ***Physical Health Issues, the Immune System & Mental Health Index
    • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System