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The Limits of "Tough But Fair," "Trauma Divorced from Risk" & "There's No Excuse"

5/31/2020

We and the World are very much moving to a Public Health Approach to Criminal Justice -- it really can't happen FAST ENOUGH.

We are so much further than we were just 10 years ago, and it's a lot clearer what we need to do -- SUPPORTIVE HOUSING, INTENSIVE SERVICES, and PLACEMENTS when necessary.

As a society we have known about "TREATMENTS" of various kinds for decades and that's seemed like the thing to do -- set somebody up for AA meetings.

If that didn't work maybe 90-day inpatient. When that didn't work 6-month inpatient, then a year -- THEN YOU'VE HAD A LOT OF CHANCES.

The EVIDENCE has really mounted up that the NEEDS of a lot of people within the Criminal Justice System are very COMPLEX -- such as Brain Injury, Substance Use, Mental Illness and Developmental Issues such as ADHD & Autism.

I've certainly watched even Defense Attorneys and Family Members want to shake "Uncle Billy" and say -- "What is WRONG WITH YOU?"

Without a PUBLIC HEALTH APPROACH -- you unwittingly set vulnerable LAW ENFORCEMENT up for CATASTROPHE as well -- on both sides of that coin.

How Many "CHANCES" did "Uncle Billy" have?
Not how many chances did he have to endanger someone or mismanage money -- BUT to stay in the TRIBE
Modern Society often conflates these.

Low-Hanging Fruit, CO HB 20-1086 & the Need to Reach Even Higher in the Time of Covid

5/30/2020

Preface
The former Hickenlooper Administration ostensibly refused to comply with Olmstead because the "UNCERTAINTY" of what was going to happen to Medicaid under Trump -- was it going to be BLOCK-GRANTED -- what was going to happen.

Well, was it that or their own political futures and ambitions -- really the ambition part BUT our system is pretty much set up for that.

Further, the "Uncertainty over Medicaid" was NOT a legally valid reason to fail to comply with Olmstead.

Most concerning, this led to STONEWALLING & BAD FAITH and NON-COMPLIANCE of DISABILITY CIVIL RIGHTS LAWS.

Did it matter -- yeah it mattered, but in a lot of ways we weren't that far a part -- WE JUST WEREN'T ON THE SAME TEAM (think Neuroscientist David Eagleman -- Empathy & the Brain).

Well, I could go on ad nauseam about my DISGUST with the Hickenlooper Administration -- and most people would be more than a little challenged to see how I could get so worked up over it.

Of course, from my perspective, the death of Michael Marshall was much more a FAILURE of STATE DISABILITY POLICY than it was failure of the Denver Sheriff's Office or the Mayor.

On the other hand, the former Hickenlooper Administration and POLITICIANS EVERYWHERE might say -- Hey, you need to get out there and ORGANIZE -- "you can do anything with public support, you can't do anything without it."

"Dilbert"

Low-Hanging Fruit & CO HB 1086,

People with Intensive Mental Health Needs Like Michael Marshall & Marvin Booker & Christopher Lopez & Thousands of Others

& the Much More Morally & Financially Challenging Position of the Conservative Mental Health Movement

What I'm calling the "Conservative Mental Health Movement" is:

the Mental Health Policy Organization,
the Treatment Advocacy Center, and
often FAMILY MEMBERS of PEOPLE with INTENSIVE MENTAL HEALTH NEEDS
some psychiatrists, most notably Dr. Torrey with the Treatment Advocacy Center

The "Conservative Mental Health Movement" has historically been distrusted by other segments of the Mental Health Community because the "Conservatives" have not been very questioning of medication and they have promoted "institutionalization."

The "Conservatives" and the "Activists" are much closer together than they once were, specifically "Activists" aren't denying there are people with mental illness in the Criminal Justice System AND the "Conservatives" are becoming proponents of SUPPORTIVE HOUSING in many cases.

The "Conservatives" on Funding the HIGH NEEDS of People with Intensive Mental Health Needs

   The funding mechanisms for the High Needs of People with Intensive Mental Health Needs must change -- and I think a lot of people understand that.

The "Conservatives" have been the first to recognize the STRONGER MORAL ARGUMENT and their FINANCIAL ARGUMENT is basically to DROP the "WORRIED WELL" from ANY TYPE of PRIORITY within PUBLIC FINANCING.

   Dropping the "WORRIED WELL" is not going to work, BUT NOT making people with INTENSIVE MENTAL HEALTH NEEDS a top (#1) PRIORITY has led to the CURRENT CRISIS and CRISES.

At least at this point, we don't have the ability to PREVENT our way out of this -- the more we IGNORE the HIGH NEEDS OF PEOPLE WITH INTENSIVE MENTAL HEALTH NEEDS because it is not perceived as "LOW HANGING FRUIT" -- the WORSE IT GETS.

   Now the more CRISIS-DRIVEN we become -- the easier it is to get that PUBLIC SUPPORT -- but it is usually at a pretty high price -- usually paid by one or more of the MAJORITY's perceived "OUT GROUPs."

Meanwhile we need to think about and obtain some COVID Economic Stimulus to bring:

Supportive Housing
Intensive Services, and
Placements where necessary

TO SCALE

ABC News (Sept. 27, 2016)

LeBron James: Threat of Police Violence A "Scary-A** Situation"

PBS: Neuroscientist David Eagleman: Empathy is often a pre-conscious response to perceptions of "In-Groups" and "Out-Groups"

Okay, BUT what are we going to do about it?

How many more Marvin Bookers, Michael Marshalls, Christopher Lopez', and George Floyds do we really have to have?????

CO & Other States NEED TO REACH UP for that ECONOMIC STIMULUS in a time of COVID -- and do the hard work of bringing:

Housing
Services, and
Placements

TO SCALE.

ANNUAL MENTAL WELLNESS EXAMs -- WHAT's the HARM?

There is maybe not a PERFECT analogy to be made between TRUMP & Hydroxychloroquine and the current enthusiam for Mental Wellness Exams -- but there is a RELEVANT analogy to be made.

We get on COVID 19 that we need to focus on the MOST VULNERABLE and the BEST SCIENCE.

Conceptually, we really have a hard problem with focusing on the MOST VULNERABLE & the BEST SCIENCE in mental health --

Because the most vulnerable in mental health are even more expensive than the most vulnerable with COVID-19 in the long run; and
Our mental health professionals are often floundering around because WE haven't provided them the SCIENTIFIC support they need, and
Insurance isn't interested in paying for treatments that are often of limited effectiveness.
In people with the most HIGH NEEDS -- in a significant minority of cases we're really at CUSTODIAL CARE -- individuals don't want to hear that, Insurance Companies don't want to cover that, and the STATE with the acquiesce of the FEDS has done everything they could do -- to AVOID adequately providing for very HIGH NEEDS PEOPLE WITH MENTAL ILLNESS.

If we've got limited resources and insurance companies do as well:

We need to focus on the HIGH NEEDS of People with Intensive Mental Health Needs. and
Greater Collaborations among providers, research institutions, individuals and families.

CO HB 20-1086 -- Requiring Health Insurance Companies to Cover Annual Mental Wellness Exams and the Uncomfortable Place Where We Really Are

An Aside
There's absolutely a role for PREVENTION & EARLY TREATMENT (I come at this with some experience & skepticism regarding the Mental Health Profession's ability to actually do this -- we definitely want that).

Some type of collaboration between Providers and State Research Institutions might have a greater likelihood of success.

Specifically, the concern is we have much better handle on COVID-19 than we do of much of what is termed "mental illness" -- what's your EXAM -- A Set of Questions?

It's really not good enough. We get that with Antibody Tests, but its hard for us to get that with Mental Health -- because a paucity of biomarkers is so much a hallmark of the profession.

Mental Health professionals have gotten squeezed pretty hard when it comes to reimbursement in both the public & private sector and the bill that keeps coming due to the STATES & the FEDS -- keeps growing often with little to show for it.

In fairness, professionals haven't gotten the Research & Translational Research they need.

Further, this is about as COMPLICATED as it gets when it comes to ETHICALLY dealing with Knowledge and HUGE GAPS in KNOWLEDGE that affect:

personal well being,
possibly community safety
civil commitment
homelessness, and
criminal justice involvement.

Death of George Floyd in Minneapolis:"Reason No. 1 Million & 1"

5/29/2020

US Law Enforcement is in many ways the Poster Child for WELL-INTENTIONED, JUSTIFIED AGGRESSION/FORCE GONE WRONG that is MUCH FURTHER INTO MALEVOLENCE than it realizes.
As a society, we like to make the distinction between being PASSIVE, AGGRESSIVE and ASSERTIVE.
It doesn't appear to be quite that easy or simple for human beings or other animals.

Keeping the World Safe for Democracy,
Or Keeping the Community Safe, or
Fighting Injustice

Can end up being a NIGHTMARE -- we often didn't expect.

When we think about some type of TRANSGRESSION:

Within law enforcement, it's a few bad apples -- [The reality is much more the tip of the ICEBERG]
"TRANSGRESSIONS" within the Society are very much a BAROMETER of the HEALTH of the SOCIETY. One of the reasons why its not getting adequately dealt with -- we do recognize that this requires RESOURCES to deal with.
Of course, it requires RESOURCES to deal with the issues in LAW ENFORCEMENT as well.

PsyPost (2016): Aggression generates new nerve cells in the brain

Olmstead Compliance: the Law Is Clear -- BUT the CHALLENGES ARE GROWING

5/28/2020

The big STUMBLING BLOCK to Olmstead Compliance in general and as it relates to HOMELESSNESS is RESOURCES.
Now "Olmstead" doesn't require anything that isn't "REASONABLE." BUT if States haven't been substantially complying with Olmstead for over 20 years, that "REASONABLENESS" standard should be cutting very much in favor of people with disabilities.
What's layered on top of this are:

Much greater awareness of cognitive disability, meaning
- we recognize a lot more people fitting into that category, and
- and some/most of those people may be "intelligent" and/or artistically and/or entrepreneurially talented in some way,
- they may be chronically disorganized, and
- they may be taking in a lot more information, and using emotion/reason to process it.
- So the person might appear very "emotional" and or very "detached" -- and it might be the very same person at different points of processing all that information.
Improved technology to detect brain injury
Work on blood tests for Suicidality (is Homicidality far behind?)
Our top Neuro-Biologists arguing that "It's all biology, stupid." or ---It's one consideration: Biology/Environment of the Organism -- PERSON"
Work on biomarkers for TRAUMA that may have been completely ineffable for most of human history.
Etc.

AND now we've got COVID-19 that is disporportionately affecting poor and minority segments of the population and creating its own MENTAL HEALTH CRISIS.

Getting PUSHED TO THE BREAKING POINT is generally NOT a good thing --

MEDICAID AND PERMANENT SUPPORTIVE HOUSING FOR CHRONICALLY HOMELESS INDIVIDUALS: EMERGING PRACTICES FROM THE FIELD. 8.2. OLMSTEAD COMPLIANCE AND CONSENT DECREES

"Consistent with this DOJ guidance, lawsuits and consent decrees related to Olmstead and ADA's integration mandate have often required states to invest in supportive housing and community-based services using a scattered-site approach to PSH [permanent supportive housing],

[O]r using single-site PSH models in which some units are set aside for persons with disabilities within an apartment building or development in which most of the units are affordable or market rate rental housing that is not designated for persons with disabilities."

7. May the ADA and Olmstead require states to provide additional services, or services to additional individuals, than are provided for in their Medicaid programs?

A: A state’s obligations under the ADA are independent from the requirements of the Medicaid program.

Providing services beyond what a state currently provides under Medicaid may not cause a fundamental alteration, and the ADA may require states to provide those services, under certain circumstances.

For example, the fact that a state is permitted to “cap” the number of individuals it serves in a particular waiver program under the Medicaid Act does not exempt the state from serving additional people in the community to comply with the ADA or other laws.

Personality Disorders, Developmental Differences Conceptualization Matters--- It Matters A Lot In The Criminal Justice System

5/27/2020

Personality Disorders are Largely Pejorative Labels we use for Behavior We Don't Like When We Don't have another Label

How this becomes so clear is when someone gets tagged with a "personality disorder" and the diagnosing professional has failed to actually even apply the flawed criteria in the DSM.

How are "personality disorders" treated in the Criminal Justice System (generally, anti-social personality disorder): pretty much an official and "scientific" stamp of approval of MORAL REBUKE and justification for often HARSH PUNISHMENT.

I'm not for putting anybody at risk or ignoring legitimate safety concerns, BUT a lot of what we have going on in the AMERICAN CRIMINAL JUSTICE SYSTEM amounts to TORTURE -- that is ADSEG, but it is not limited to that.

This is what is so frustrating about the AMERICAN JUSTICE SYSTEM -- in most cases (not all) the real issue is PUNISHMENT -- if we provide humane alternatives that sufficiently address safety -- a lot of these cases would go away.

INTEGRATION OF PHYSICAL & MENTAL HEALTH -- INTEGRATION OF BIOLOGICAL & ENVIRONMENTAL EXPLANATIONS OF BEHAVIOR

What we have traditionally been very sympathetic to is a history of "TRAUMA" -- often regardless of what danger or risk the person actually poses. I saw this played out in a case in which a young man had been physically abused by his step father and ultimately killed his stepfather.

The young man was acquitted -- unfortunately there were very serious needs that did not get addressed and he came back on a subsequent serious charge.

    Certainly prosecutors make moral arguments against these defendants BUT the issue is really does this person present a risk and has that risk been adequately addressed.

    Further, it is really the BIOLOGICAL CONSEQUENCES of TRAUMA that can most directly contribute to the BEHAVIOR -- and that can be very individual. I would submit that BIOLOGICAL CONSEQUENCES are the PROXIMATE CAUSE for both the act and the mental element of the crime.

    So it appears I'm really arguing in some senses for the integration of the ACTUS REUS (the act) and the MENS REA (mental element) of the crime.

    [Of course, the real practical answer is HOUSING, SERVICES and PLACEMENTS to SCALE.]

Economist Thomas Sowell is now almost 90 years old and a Senior Fellow at Stanford's Hoover Institute -- Wikipedia

Val's Take: I'm not quite so harsh as Thomas Sowell, mainly because I make plenty of mistakes and I think most people do.

On the other hand, the Mental Health Profession is really paying no price for failing to address a scientifically invalid Diagnostic Manual -- now maybe the Mental Health Profession doesn't understand the consequences of that -- BUT the National Institute of Mental Health does.

At least NIMH understands the scientific ramifications -- they probably don't know the criminal justice ramifications.

NIMH wants to completely solve this -- We're for it! BUT it appears that is going to be SEVERAL YEARS -- MEANWHILE we need INTERIM PROCEDURES to prevent further INJUSTICE.

Moving Beyond the Baby-Boomers and the Vietnam War

5/26/2020

Youth almost always REBEL against their elders in one form or another -- but what was required of the Baby-Boomers during the Vietnam War was beyond what most generations face -- in many ways beyond "The Greatest Generation."

Further, the Baby Boomers -- as a HUGE CONSUMER DEMOGRAPHIC -- have had an outsized influence on not only the economy and the culture -- but also our political life and democracy.

In one sense, it is exactly what one would expect with the inexperienced young person driving the car -- however, we largely didn't expect the unintended consequences for our democracy.

The ME GENERATION hit the Unbelievable Challenges of GLOBALIZATION -- and the resultant INCOME INEQUALITY is threatening to rip this democracy apart.

The Unequal Distribution of COVID-19 is just one in a very long line of SYMPTOMS that we don't have a healthy democracy or society.

Even back in the 1940s it was hard for even a good guy like George Bailey to make a place for Uncle Billy -- but he did it even if it pushed him to the edge.

That is where a lot of families are right now -- THE EDGE -- and so far Potter hasn't been terribly interested in bringing Housing, Services and Placements to SCALE.

SOMETHING'S GOTTA GIVE.

Frank Capra's "It's A Wonderful Life" (1946): Ma Bailey's Boarding House Scene.

One of the great burdens that George is carrying is the forgetful Uncle Billy -- and that burden could lead to scandal and even prison.

BUT what's the consequence if George doesn't carry that burden: Uncle Billy is in a Mental Institute and maybe George belongs there too, even George's own mother doesn't recognize him -- and there is no room for "strangers."

[BTW I'm aware of a prosecutor (not me surprisingly) who lost the murder weapon]

If we try to pretend that any of us is perfect -- we're often setting all of us up for failure.

One of Orchid's Symbols: The Vietnam War

Developmental Disability/Mental Illness& High IQ: The Merry-Go-Round --- 360

5/25/2020

    Whether something is a "Developmental Disability" or a "Developmental Difference" -- is largely a matter of Social Construct.

  It is NOT just families, the social community and the society in general that struggle with conceptualizing what is going on for the person with "mental illness" -- it's often the person themselves.

   PERSON

I don't have a "mental illness -- I'm smart, talented --whatever
The brilliant attorney who is managing his ADHD by smoking outside the Courthouse.
The "healthy" attorney who is managing her ADHD by drinking a case of Diet Coke a day.
The "healthy" attorney who couldn't take ADHD medication because it gave her Tardive Dyskinesia and a similar thing is happening with Aspartame Diet Coke -- has moved on to Splenda Diet Coke.

The FAMILY & SOCIETY OF 50/60 YEARS AGO

a lot more Heart Disease
a lot more people were smoking and using that to calm themselves and focus -- it worked -- AND it killed a lot of people
Now smoking is way down, but we have a "Mental Health Crisis"
BTW Smoking during pregnancy can increase the risk for ADHD by 4 Times -- and that may not go away in future generations whether subsequent Mom smokes or not.
Is Correlation, Causation --No. But it is often where you start when trying to understand what's going on.
Further, other social changes leading to the decimation of diversity within the human microbiome led Kings College London Professor Graham Rook to the "Old Friends Hypothesis," and the widespread low grade inflammation in modern populations across the globe.

Mental Health Professionals -- "Hey, I didn't sign up to work with people with DD"

It wasn't that long ago that Colorado's Medicaid Mental Health Centers refused to work with people with developmental disabilities who also had "mental illness."
The great irony is that most people with "Mental Illness" have Developmental "Issues."
I love Hozier's "Take Me to Church" and the line: "I'll tell you my sins, and you can sharpen your knife."
I don't know that Chronic Disorganization is a huge sin in the Society at large, but it is certainly a huge sin in the professional world and the marketplace.
As an attorney, it is a pretty scary sin to confess -- how I got into this profession -- I'm not sure -- I was concerned about justice, I still am.
As a person with a disABILITY -- I sometimes take out my knives too -- and that is often the ADA.
Of course, a lot of the conflict is pretty unnecessary and generally arises when the issue is "unexpected."
We have to do a lot better job of SYSTEMATICALLY "EXPECTING" these issues.

Parents & Family Members

Sometimes kids "fall far from the tree," sometimes they don't, and often its variations on a theme -- sometimes more "intense" variations on a theme.

THIS IS REALLY IMPORTANT: NIH-funded researchers discovered that people with disorders traditionally thought to be distinct -- autism, ADHD, bipolar disorder, major depression and schizophrenia ----share common genes.

NIMH (2015): Disorders Share Risk Gene Pathways for Immune, Epigenetic Regulation--- Genome-wide findings add to evidence blurring traditional psychiatric categories

The Americans with Disabilities Act (ADA) is great if you know what the "Reasonable Accommodation" is -- sometimes it's not clear (see Job Accommodation Network for a lot of ideas that can be adapted outside of employment).

National Institute of Health (2018)

Developmental Origins of Brain Circuit Architecture and Psychiatric Disorders (Day 1)

[This is over a 7 hour video -- the point is mainly it is out here and NIH and NIMH are taking the Developmental Aspects of Psychiatric Disorders very seriously]

Hozier: "Take Me To Church"

The Consequences of the Developmental Aspects of "Mental Illness"

5/24/2020

Two of the great insights within Dr. Gail Saltz' book "The Power of Different" are:

Move to an 80% focus on STRENGTHS, and
Compensate for WEAKNESSES -- largely by finding WORKAROUNDS -- not the often futile task of trying to change people.

  For someone with Downs Syndrome, generally we wouldn't try to impose a lot of CONSEQUENCES to MAKE THEM TAKE PERSONAL RESPONSIBILITY. Largely, we have more INSIGHT than that.

  That is often NOT TRUE for Mental Illness and other Cognitive Disabilities where the person may not only APPEAR to have "average" but "above average" intelligence.

BUT this is what is so CHALLENGING, FRUSTRATING & even SOUL-DESTROYING for the person:

There are often DEVELOPMENTAL ISSUES that until recently have been seemingly INEXPLICABLE
- Emotional Dysregulation that at least in the case of "bipolar disorder" is linked to over-active cells from early development (Further, ADHD, Autism, Depression, Bipolar & Schizophrenia are much more blurred and not as distinct as we might think -- according to the National Institute of Mental Health.)
- Information/Sensory Overload: Why would you be really interested in LOGIC, MUSIC or ART -- you're trying to understand ALL THIS STUFF and communicate it to other people. So on the one hand, you may very well have some greater access to original insight just because you have greater access to MORE INFORMATION because of lax filters or whatever -- BUT you still don't have an UNLIMITED ABILITY to PROCESS ALL THAT.

We have not fully appreciated the implications of "mental illness" being "highly genetic." It's as if we think it's like the coronavirus -- you have it or you don't.

It seems in many cases, we're really talking about cumulative damage from multiple sources to a biological system that was OVER-ACTIVE to begin with.

"Maybe -- A Farmer's Tale"

University of Michigan: Cells of People with Bipolar Disorder are Developmentally Different than those without Bipolar Disorder

Aristotle on Anger. For a lot of people with cognitive disabilities, anger is a big issue -- who we allow in the society to be "angry" is an issue. Privilege isn't always a blessing.

On the other hand, with anger -- there is often both:

A substantive issue that needs to be addressed, and
Some calming for everyone involved

If you try to just calm things down without addressing the substantive issue, you'll FAIL at both.

Blurred Lines

Mental Health & Cognitive Disability: From A Distance

5/20/2020

COVID-19 is challenging the World as one of the great PANDEMICS of History. Are we doing this PERFECTLY -- NO -- are we doing this pretty well considering everything -- YES. Now there are a lot of qualifications to that and it very much depends on who one is, not unlike a lot of issues.

Mental Illness and Cognitive Disability in the last 60 years or so have presented Societies across the world with some pretty challenging "Conundrums" -- Hell on Earth problems:

A lot of people FORGET that it was mental health advocates and people with mental illness who were originally the great champions of "Psychotropic Medication."
- Medication is very complicated, very individual -- and for some people the "sicker" they appear -- the more challenging finding any effective medication regimen maybe -- maybe because their guts, immune systems, and brains are even more idiosyncratic [this is related to the "ANNA KARENINA PRINCIPLE"].
- We have to be able to deal with 2 very complicating facts at the same time: the person may not be well, and the medication may not work well for them.
- Our Substance Use Problem in the US and around the World is very tied to COGNITIVE DISABILITY -- and people wanting to "feel better" or at the very least "not feel."
You've got the Big 5 of Psychiatric Disorders ADHD, Autism, Depression, Bipolar Disorder and Schizophrenia being very "BLURRED" according to the National Institute of Mental Health -- and likely not as DISTINCT as we think.
- EMOTIONAL DYSREGULATION is often a characteristic of these "disorders" and there is often a fair amount of OVERLOAD going on whether it is SENSORY and/or EMOTIONAL OVERLOAD.
- This really brings us back to some of our ideas about "RECIPROCITY" and how that can play out in the Criminal Justice System.

Cognitive Disability: The WHO* & US

We want to live our best lives and by and large we see it in our interests for everyone else to live their best lives as well.

Many Americans might be surprised at how SOPHISTICATED many people in Developing Countries are with regard to Mental Health & Cognitive Disability.

If we include in this what we are learning about "AGGRESSION" and its MULTIPLYING EFFECTS -- there's the makings of a FOUNDATION for profound reforms in PUBLIC HEALTH.

There have been efforts in Somalia to move away from TREATMENT by HYENA -- this isn't that different than our struggling efforts to move away from TREATMENT BY CRIMINAL JUSTICE SYSTEM.

*WHO: World Health Organization

Forced Medication

The Anna Karenina Principle: Oregon State University Building On Tolstoy

Blurred Lines

Reciprocity

"I'm Too Sensitive"

Aggression: Humanity's Ultimate Double=Edged Sword

More on "BOUNDARIES" -- This is A Fire Alarm IF We've Got the Courage to Hear It

5/19/2020

In 2019 -- we had "Joker" a brilliant view of the complexities and failures of mental health in the US. In 2020, Joker won an Academy Award for Best Actor -- Joaquin Phoenix.

Now in May 2020 -- we've got "Fourteen" and the decision of a young woman to set some "BOUNDARIES" with her long time friend who has mental illness.

Whether in a personal sense or a professional sense, setting those "BOUNDARIES" is both an act of SELF PRESERVATION and often FAILURE, and in mental health and cognitive disability often CATASTROPHIC FAILURE.

Now whose FAILURE is it? That's pretty complex.

In so many areas of 21st Century life we are wrestling with what is SUSTAINABLE.

The BOTTOM LINE:

People do have the right to emotional self preservation, AND
Generally, these FAILURES and CATASTROPHIC FAILURES in Mental Health & Cognitive Disability MUST BE ADDRESSED SYSTEMICALLY & THROUGH PUBLIC POLICY.

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