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Getting honest about the DSM 5

4/7/2019

We trust the WHITE COATS --the RESEARCHERS & THE NATIONAL INSTITUTE OF MENTAL HEALTH over the mental health profession.

Holland's De Staat -- "Witch Doctor"
Warning: Language

Our complaint against psychiatry is not so much that it is finding illness where none exists [although that happens] -- we think the incidence of mental illness actually is increasing for a lot of complicated biological & social reasons.

Our complaint is that the psychiatric profession is UNABLE to competently handle this CRISIS because it's founded on a diagnostic manual that is not scientifically valid.

How can one not understand that is a HUGE PROBLEM? Well a lot of mental health professionals & people in our society don't understand that AND if they do -- they don't know what to about it.

JUST GETTING HONEST WOULD BE A BIG STEP IN THE RIGHT DIRECTION.

STAFFING RATIOS & CDPHE?

4/4/2019

Should staffing ratios be in Statute? Probably not. We do think there needs to be a State Statute directing a State Agency to set evidence-based staffing standards that ensure SAFE ENVIRONMENTS and that legally required objectives can be met.
While we don't think Staffing Ratios should be in Statute, we do think Staffing Ratios should be in Regulation. We think detailed explanatory rationale should be provided as official guidance.
The current amorphous staffing requirements are working for :

Government Funders, &
Those @ the top --- Owners, Administrators, CEOs, etc.

It is generally NOT working for:

Front-line workers
and the People with Disabilities who are SUPPOSED TO BE benefiting from numerous laws, regulations & guidance.

[Any modification to set Staffing Ratios must take into account the rights and needss of people with disabilities and of front line workers.]

A new agency may not be practical-- the most likely candidate to handle staffing ratios involving people with disabilities is the CO Dept. of Public Health & Environment with perhaps a Memorandum of Understanding with the Colorado Department of Education.

We're not just talking about Facilities & Schools -- we're talking about community providers as wel

A lot of people are going to say any agency setting Staffing Ratios needs to be COMPLETELY INDEPENDENT --and it probably does. BUT if that's not doable --- CDPHE is probably the next best choice

"Through The Keyhole" by Oringebob

Bringing "giftedness" down to earth -- so we could start recognizing it in Unlikely places

4/1/2019

Lisa Swaboda is Atlas Educational: GIFTED-I DO NOT THINK IT MEANS WHAT YOU THINK IT MEANS

"Giftedness" is really such a pretentious and arrogant term, and with the recognition of the challenges of "asynchronous development" and the extreme emotional intensity that typically comes with it -- "giftedness" is really a euphemism for a pretty MIXED BAG of BIOLOGICAL CHARACTERISTICS.

Generally, we're in favor of Strength-Based approaches and IRONICALLY the "gifted" label is getting in the way of a STRENGTHS-BASED APPROACH in the Mental Health System.
--

"Giftedness"/ a/k/a Lacking Imperfection -- sounds so OVER THE TOP -- that people can't really relate to it and mental health clinicians can't really identify it.

We're hoping that by keying in on the perceived challenges such as:

asynchronous development, &
intense emotionality

We can bring this down to REALITY .

What we're NOT saying:

We're NOT saying that Every "Gifted" Person has a mental illness.
We're NOT saying that Every Person with a mental illness is in the Criminal Justice System

Our observations have been:

There are more "gifted" people with mental illness than the Mental Health System recognizes;
There are more "gifted" people with mental illness in the Criminal Justice System than anybody seems to realize.

Further, to solve some of our deep societal problems:

we need to acknowledge REALITY
Challenge those "gifted kids/adults" in their strengths
& provide support for their challenges

[G]iftedness doesn't discriminate on the basis of race, sex, national origin, sexual orientation, etc.

Further, pretty much no one is "gifted" across the full range of human endeavor -- people may have areas or concentrations of above average ability, and be average or below average in other areas.

Colorado Dept. of Education
Office of Gifted Education

Gifted Prisoners

When we think of intelligence --- an emotionless Mr. Spock is often what we think of.

The reality is actually often 180 degrees from that and often includes INTENSE EMOTIONALITY --

Super Talent Kanye West on being Bipolar

Brilliant Harvard Law Professor Emeritus Alan Dershowitz sounding NOT very much like Mr. Spock in an "Explosive Debate" with Political Commentator & Academic Marc Lamont Hill on Israel --

Dr. Webb discusses "asynchronous development" in the context of CHILDREN.

While the issues change across the LIFESPAN, the challenges associated with ASYNCHRONOUS DEVELOPMENT don't go away -- and can become even more complex -- requiring constant innovation in management.

Later this Week:
Wed: the biological & Psychological challenges of "giftedness"

Thurs: The sometimes ridiculous lengths the "gifted" Person/community can go to deny "mental Illness"* because they're smart and/or talented.

Fri.: Why the current mental health system is so ill-suited to the "Gifted" person

[a lot of medical patients probably do want "re-assurance" that the Doctor knows everything -- not the "gifted" mental Health patient -- in fact the mental health professional is never going to gain the trust of the "gifted" Mental health patient until the professional demonstrates that the Professional has identified all the flies in the Ointment & Understands the ramifications.]

WE'RE GOING TO CONTINUE TO BUILD OUT OUR DSM 5 "WHEEL OF FORTUNE" MANY HAVE ALREADY "SOLVED" IT -- BUT WE HAVEN'T "FIXED" IT

3/28/2019

We probably need INTERDISCIPLINARY COMMITTEE{S) led by the American Bar Association to address:

The "lack of validity" of the DSM 5
Long Term Treatment, Housing & Placements Needs as they affect Criminal Defendants with Cognitive Disabilities
Integrate into the Criminal Law a Guardianship Option with a further option to seek Involuntary Treatment & Placement where appropriate. This option does not have the threat of punishment BUT it is time limited only by the person's current NEED -- not by an arbitrary term of probation or incarceration.
There are A WHOLE LOT OF PEOPLE incarcerated because they "HAD SO MANY CHANCES." That's a CROCK. Most of them are incarcerated because they have complicated, partially understood cognitive disabilities such as BRAIN INJURY, MENTAL IllNESS, SUBSTANCE USE ISSUES, & DEVELOPMENTAL DISABILITIES.
Have some of them done BAD THINGS -- YES. Are some them going to need SECURE PLACEMENTS -- YES. Many if not of all of them will need the ability to move throughout a CONTINUUM OF CARE that is BUILT TO SCALE.
Some [not all] will need access to INTENSIVE SERVICES for the foreseeable future.
NOW "THEORETICALLY" under:
- Olmstead/Title II of the Americans with Disabilities Act
- Parity, &
- Medicaid Network Adequacy

Those "Intensive Services," Placements & Housing --- should already be there. THEY ARE NOT.

CMS/HUD --- YOU have to do more than what you're doing.

The DSm 5: A scientific & legal debacle

DSM 5 Criminal Justice Wheel of Fortune

CMS & HUD: We Need Enforcement

mental health Research involving Neuro-science, the Immune System, & the Microbiome could be a game changer

3/28/2019

PSYCHO-NEURO-IMMUNOLOGY OR

IMMUNO-PSYCHIATRY OR

AFFECTIVE IMMUNOLOGY

MAY BE THE BEST SHOT WE HAVE @ GETTING SOME MORE EFFECTIVE TREATMENTS

Researchers haven't quite figured out what to call this new branch of medicine involving the immune system and mental health-- BUT it seems A LOT more promising than where we've been. Of course, maybe we had to go through that to get HERE.

   Further, research on the Microbiome is being incorporated into research on Mental Health and the Immune System in recognition of the so-called BRAIN-IMMUNE- GUT triad.

   A lot of the resources in this area are ACADEMIC in nature -- and it is pretty hard for a patient to really access this stuff outside of Pop Nutrition they might find @ Whole Foods.

Are we Psychiatrists, Immunologists or Gastroentrologists -- NO.

  BUT some mental health patients aren't satisfied with their current treatments and that's primarily because in some cases those treatments don't work that well.

Additionally, CLINICIANS can be pretty enamored of TREATMENT ADHERENCE for treatments that aren't working very well for the patient.

   While it is HUGELY ENCOURAGING that there seems to be A WHOLE LOT going on in ACADEMIA -- that largely hasn't reached CLINICIANS.

   If Federal & State Governments are OVERWHELMED by the Cost of Our Mental Health Crisis -- they better FUND EVIDENCED-BASED RESEARCH and its TIMELY TRANSLATION TO CLINICAL PRACTICE.

PsychScene Hub (2017)

Neuroinflammation Simplified – The Link Between the Immune System and The Brain - Dr Sanil Rege

Investigating the role of immune system in psychiatric disorders. [Click image for link]

Physical Health Issues, the Immune System, & Mental Health Index

Criminal Justice Is A Public Health Issue

3/27/2019

WE NEED A PUBLIC HEALTH SYSTEM THAT CAN HANDLE THE MAGNITUDE OF COGNITIVE DISABILITY IN OUR SOCIETY WITH SAFE ALTERNATIVES TO SCALE FOR THE CRIMINAL JUSTICE SYSTEM

Our Criminal Justice System is so, so painful to watch -- and the irony of it all ---is that our MORAL JUDGMENTS that are meant to PROTECT US -- are making us less safe.
I believe it was Justice Scalia who referred to a Criminal Trial -- as a GREAT MORALITY PLAY
The CIRCUS of it all has not been lost on Filmmakers and others --nor the "bad" conduct of law enforcement and prosecutors in some cases. And there are generally a lot of MORAL JUDGMENTS about that.
We do have to have SAFETY -- BUT not getting to the ROOT CAUSES of these BAD ACTS is making us less safe.
We may not be ready hear it -- BUT CRIMINAL JUSTICE IS A PUBLIC HEALTH iSSUE -- whether the perpetrator is a private citizen or a member of law enforcement.
Further, our Criminal Justice System is full of people with Cognitive Disabilities and COMBINATIONS of such Disabilities:

Brain Injury
Mental Illness
Substance Use Issues, and/or
Developmental Disabilities [including High IQ ADHD & Autism]

People around the world already make a lot of MORAL JUDGMENTS about the American Criminal Justice System -- they don't want it -- and a lot of people in the US don't want it --
BUT THEY DO WANT SAFETY.

To get rid of the horrors of our current System & Improve Safety we have to:

have Alternatives to Scale
have State COMPLIANCE with ADA/Olmstead, Parity, & Medicaid Network Adequacy; &
we need to get rid of the IMD [Institute of Mental Disease] Exclusionary Rule to deal with the practicalities of Medicaid funding of secure placements for some people in the Criminal Justice System.
Uniform Evidence-Based Risk Assessments
Detailed Criteria for each level of a ROBUST CONTINUUM F CARE for Individuals with Cognitive Disabilities.

IT IS NOT JUST GETTING RID OF THE DEATH PENALTY --WE NEED A MASSIVE INVESTMENT IN LONG TERM SAFETY

3/26/2019

The Bottom Line is that Societies are only willing to consider removal of the Death Penalty if they live in relatively safe societies.

If that starts to change, people often want the Death Penalty back. Does it really lead to greater safety NO -- BUT the Death Penalty and even other forms of PUNISHMENT are serving a lot of complex functions beyond Safety. They are also causing a CRISIS in our systems because our knowledge doesn't match up with what we're doing.

  Is the most important issue whether the person found guilty of the crime expresses REMORSE?

HELL NO! Is this person safe to be the community? And the Standard of Proof shouldn't be "Proof Beyond a Reasonable Doubt" it should be "Clear & Convincing Evidence."

It is becoming increasing clear that the Community does need to be protected -- not so much from some one INTENTIONAL HORRIFIC ACT, but from people who have very complex cognitive disabilities and some of whom are not safe to be in the Society.

To really deal with that ----is going to require some REAL REFORM of our Systems and we're NOT talking about the Civil Commitment Statutes.

The Death Penalty is often a referendum on whether you think the society i s keeping you, your family and community safe.

If the answer to that is NO -- one is likely to be much more a supporter of the Death Penalty.

  Now what does it take to keep a Community SAFE? Well, we need law enforcement & a court system BUT most of the DEFENDANTS who are being arrested have:

A Brain Injury
Mental Illness
Substance Use Issues, and/or
Developmental Disabilities

What is our System for:

Screening children, adolescents & adults
Providing Treatment, Housing & Placements as necessary.

Well, not very good to say the least.

We're for getting rid of the death penalty -- BUT if we want that to STICK -- we really need State Officials and Policymakers to ENSURE that Colorado is complying with:

Federally mandated "Olmstead" Planning
The 2008 Mental Health Parity & Addiction Equity Act
Medicaid Network Adequacy

After a three-year moratorium on lethal injection in March 2018, Oklahoma lifted aforementioned moratorium. Oklahoma will now use inert gas inhalation as the primary method for death penalty executions; along with lethal injection, electrocution, and firing squad, to be used in that order.

-----Wikipedia

WHY SUPPORT FOR THE DEATH PENALTY IS RISING AGAIN IN AMERICA

August 24, 2018

The majority of Americans still approve of executing perpetrators of heinous crimes, despite the risk that an innocent might be killed. And to the puzzlement of those who think the death penalty is on its way out, the number of supporters of capital punishment is on the increase again.

https://www.economist.com/the-economist-explains/2018/08/24/why-support-for-the-death-penalty-is-rising-again-in-america

THE PRACTICAL REALITIES OF:GLOBALI-ZATION, SCIENCE, INCOMPLETE KNOWLEDGE & LIMITED BUDGETS

3/26/2019

The Olmstead Plan with:

Measurable Goals
Reasonable Time Frames, &
Funding to Support Plan

is really a great model for the World. REMEMBER: It doesn't require anything that isn't "reasonable."

BUT if we are so afraid of it -- we won't commit the time & energy it demands to have those HARD DIALOGUES -- well, a lot of bad things continue to happen with no Comprehensive Plan to solve them.
In the US it is NOT just that the Plan is LEGALLY REQUIRED -- it is --- BUT whether it is LEGALLY REQUIRED or not something like it is NEEDED to address the concerns of the people -- where-ever they may be.
Further, we're not suggesting a Plan that isn't MODIFIABLE -- BUT we need to put in the time & energy to address these hard issues @ multiple levels & include the people they affect.

The Evil Society Games Revisited: Disability Laws, ReSources, Corruption & Transparency

3/25/2019

We've Got To Get Very Transparent About the Resource Issues Plaguing Failure to Comply with Disability Rights Laws across the board.

The failure to address this systematically & honestly is leading to so much CORRUPTION in this Society -- AND its not necessary. We know we've got a problem with resources & we've got enforcement mechanisms that are often dependent on front-line workers who are economically-dependent on the entity that is supposed to be providing the resources.

We Can Do Better Than This.

The Evil Society Games Revisited

I'm working on a mandatory child abuse/neglect report separate from Orchid --- involving inadequate staffing of an elementary school AFFECTIVE NEEDS CLASS.

Probably a lot of other people should have already made a report. Why didn't they?

Our Society is FULL of BAD SYSTEMS -- NOT BAD PEOPLE.

Most of these Systems Issues ARE RESOURCE ISSUES. That makes them very hard to solve.

SO WE HAVE LAWS SO PEOPLE WILL BE SURE TO PROVIDE THE NECESSARY RESOURCES FOR VULNERABLE ADULTS & Children.

Generally, we do something --BUT SUBSTANTIALLY Complying with the LAW when it's going to COST -- WE OFTEN FALL SHORT -- AND SOMEONE USUALLY SUFFERS.

Whether it's nursing homes, home & community based services, mental institutes, schools or some other institution -- public or private -- the moral quandaries of doing the "right thing" are rarely acknowledged -- when the LAW & ENFORCEMENT are often ineffectual and can be horribly unjust..

IMPROVING SYSTEMS TO ADDRESS "CORRUPTION" IN DISABILITY SERVICE PROVISION

SO WHAT'S CORRUPT? IS IT SOME BAD APPLES -- WELL, JUST GET RID OF THEM.

The corruption is endemic to the System and it's based on:

Necessary Legal Responsibilities that we are NOT ADEQUATELY Funding, and
FEAR

That FEAR really extends to the HIGHEST LEVELS OF COLORADO STATE GOVERNMENT.

One of the things that was so SCARY about the HICKENLOOPER ADMINISTRATION -- they were so NICE -- but they wouldn't comply with Olmstead and Title II of the Americans with Disabilities Act.

Well, if they're not going to do it -- who will? The Polis Administration -- it's unclear.

In some ways elected officials are not that unlike that front line worker -- their jobs are on the line -- and ultimately the SOLUTION to the PROBLEM -- FAILURE TO COMPLY WITH THE LAW -- is likely to require RESOURCES and that could be unpopular.

There simply are NOT enough LEGAL RESOURCES to deal with the MAGNITUDE OF THE PROBLEM in Colorado & around the Country.

Rather than suing each other and questioning each other's integrity [we certainly questioned Hickenlooper's integrity plenty] -- why don't we change our SYSTEMS.

An Important First Step is ROUTINE INDEPENDENT STAFFING AUDITS of all services, including educational services, that are serving Adults and Children with significant disabilities.

"The Hunger Games" [2012]

The Evil Society Games

DESPERATION & IGNORANCE IN PSYCHIATRY & THE CRIMINAL JUSTICE SYSTEM MASQUERAD-ING AS: INCURABLE HUBRIS

3/22/2019

Gary Greenberg’s Atlantic Monthly article largely blames the Debacle of Modern Psychiatry on “incurable hubris.”

        Is hubris/arrogance on the part of psychiatry --part of the problem? Yeah, it sure is.

          BUT arrogance isn’t all that is going on to drive the current Scientific, Legal & Moral Crisis in our Society that is resulting from our REFUSAL to HONESTLY CONFRONT PSYCHIATRY’S CURRENT COLOSSAL FAILURES.

             Both Psychiatry & the Criminal Justice System are racked with:

Desperation, and
Ignorance
AND they can’t acknowledge either without revealing the existence of the other.

So that ends up looking like and for all intents and purposes is: INCURABLE HUBRIS/ARROGANCE.

Greenberg’s article made it sound like we don’t know anything about the biological causes of mental illness. That’s not true -- although the widespread and grossly oversimplified ideas on "chemical imbalances" can be OUTRIGHT DANGEROUS.

In a lot of ways, we know an incredible amount – unfortunately [though not surprisingly] researchers are pretty far ahead of clinicians. We're exploring the roles of the Microbiome and the Immune System -- this is even more complicated than just the Brain -- and the Brain is plenty complicated enough.

Further, we don’t have sufficient systems to bring clinicians up to speed – that’s NOT the clinician’s fault.

BUT ultimately Greenberg is right that we don’t have it all figured out. THAT HAS MORAL CONSEQUENCES THAT WE ARE DOING OUR BEST TO IGNORE.

That can’t last forever – the Cracks in Psychiatry’s Façade
were largely inflicted by the US National Institute of Mental Health[NIMH].

NIMH and other researchers who are responsible for those CRACKS are ultimately going to be responsible for REPAIRING them and TEACHING clinicians and probably the Criminal Justice System too --- to be HUMBLE – which in this case is another word for being HONEST.

Gary Greenberg's Atlantic Monthly article:

"Psychiatry’s Incurable Hubris--

The biology of mental illness is still a mystery, but practitioners don’t want to admit it."

April 2019 Issue of the Atlantic Monthly

Your Brain Is More Than A Bag of Chemicals

Cal-Tech Neuroscientist David Anderson's welcome talk on among other things the reason why many psychiatric medications do not work very well and can even do damage -- they are not targeted to specific neural circuits but to the brain globally.

Science Up

New Science Is Amazing & It has Huge Moral Implications Now

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Val's Blog

Getting honest about the DSM 5

STAFFING RATIOS & CDPHE?

Bringing "giftedness" down to earth -- so we could start recognizing it in Unlikely places

WE'RE GOING TO CONTINUE TO BUILD OUT OUR DSM 5 "WHEEL OF FORTUNE" MANY HAVE ALREADY "SOLVED" IT -- BUT WE HAVEN'T "FIXED" IT

mental health Research involving Neuro-science, the Immune System, & the Microbiome could be a game changer

PSYCHO-NEURO-IMMUNOLOGY OR

IMMUNO-PSYCHIATRY OR

AFFECTIVE IMMUNOLOGY

MAY BE THE BEST SHOT WE HAVE @ GETTING SOME MORE EFFECTIVE TREATMENTS

Criminal Justice Is A Public Health Issue

WE NEED A PUBLIC HEALTH SYSTEM THAT CAN HANDLE THE MAGNITUDE OF COGNITIVE DISABILITY IN OUR SOCIETY WITH SAFE ALTERNATIVES TO SCALE FOR THE CRIMINAL JUSTICE SYSTEM

IT IS NOT JUST GETTING RID OF THE DEATH PENALTY --WE NEED A MASSIVE INVESTMENT IN LONG TERM SAFETY

WHY SUPPORT FOR THE DEATH PENALTY IS RISING AGAIN IN AMERICA

THE PRACTICAL REALITIES OF:GLOBALI-ZATION, SCIENCE, INCOMPLETE KNOWLEDGE & LIMITED BUDGETS

The Evil Society Games Revisited: Disability Laws, ReSources, Corruption & Transparency

DESPERATION & IGNORANCE IN PSYCHIATRY & THE CRIMINAL JUSTICE SYSTEM MASQUERAD-ING AS: INCURABLE HUBRIS

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Val's Blog

PSYCHO-NEURO-IMMUNOLOGY OR IMMUNO-PSYCHIATRY OR AFFECTIVE IMMUNOLOGY ​ ​MAY BE THE BEST SHOT WE HAVE @ GETTING SOME MORE EFFECTIVE TREATMENTS

​WE NEED A PUBLIC HEALTH SYSTEM THAT CAN HANDLE THE MAGNITUDE OF COGNITIVE DISABILITY IN OUR SOCIETY WITH SAFE ALTERNATIVES TO SCALE FOR THE CRIMINAL JUSTICE SYSTEM

WHY SUPPORT FOR THE DEATH PENALTY IS RISING AGAIN IN AMERICA

Author

Archives

Categories

PSYCHO-NEURO-IMMUNOLOGY OR

IMMUNO-PSYCHIATRY OR

AFFECTIVE IMMUNOLOGY

MAY BE THE BEST SHOT WE HAVE @ GETTING SOME MORE EFFECTIVE TREATMENTS

WE NEED A PUBLIC HEALTH SYSTEM THAT CAN HANDLE THE MAGNITUDE OF COGNITIVE DISABILITY IN OUR SOCIETY WITH SAFE ALTERNATIVES TO SCALE FOR THE CRIMINAL JUSTICE SYSTEM