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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

red flag laws, disability civil rights laws & State hypocrisy

3/22/2019

CO ATTY GENERAL PHIL WEISER SAYS SHERIFFS THAT WON'T COMPLY WITH A RED FLAG LAW IF PASSED SHOULD RESIGN

GUESS WHAT -- WE FEEL THE SAME WAY ABOUT STATE OFFICIALS THAT WON'T COMPLY WITH DISABILITY CIVIL RIGHTS LAWS

Colorado is NOT complying with:
* OLMSTEAD
* PARITY
* MEDICAID NETWORK ADEQUACY

WHY DO WE NEED THAT RED FLAG LAW ANYWAY?

It is probably pretty simplistic to say State Failures to Comply with Olmstead, Parity and Medicaid Network Adequacy are the only reasons there is need for a Red Flag Law.

BUT those Failures to Comply with Federal Law are a much bigger part of the need for a RED FLAG LAW than State Officials have had the COURAGE to acknowledge to date.

We actually don't have an enormous objection to the RED FLAG LAW given our current reality which is:

Widespread Gun Ownership AND
Widespread State Violation of Federal Disability Civil Rights Laws like Olmstead, Parity & Medicaid Network Adequacy --- This leaves a lot of people with intensive mental health needs without access to adequate TREATMENT, HOUSING & PLACEMENTS.

BUT THE HYPOCRISY IS MAKING US PRETTY SICK

Colorado’s attorney general says sheriffs who won’t carry out a red flag bill court order “should resign” --- Colorado Sun

LET'S NOT GET CAUGHT UP IN THE "ISMS"---REALITY IS A LOT MORE COMPLICATED THAN SOCIALISM OR CAPITALISM

3/21/2019

We included the PBS News Hour Paul Solomon clip on Income Inequality because it addresses some of the Mental Health Impacts of Income Inequality.
Our caution is that this can easily devolve into debate over laissez-faire Capitalism and government controlled economies as in pure Sociallsm . The problem is that both of these extremes have largely been rejected by History.
So what has happened:

Laissez-faire capitalism was really placed on the ash bin of history in the West during the Great Depression -- and
"Socialism" has really been most successful in the Nordic Countries -- but there it is NOT Pure Socialism but a mixed market economy
Communism fell in Eastern Europe during the later part of the 20th Century, and
China is having to institute greater environmental regulations on their economic boom as "bad air days" increase.

Further, there is A LOT of Income Inequality in Colorado -- & we do think that is a factor in our Mental Health Crisis. But there are a lot of other factors, too:

the "Old Friends Hypothesis" which explains the rise of some mental illnesses and chronic disease by the loss of various parasites in Western Countries. The idea is that these parasites trained our immune systems to be more tolerant. Now we have an increase in food allergies and these chronic diseases and illnesses. Mental Illness appears to have a lot more to do with our Immune Systems than we have previously realized.

It seems as though anything that affects the Immune System has the "potential" to affect mental health. That include sleep apnea, altitude-induced sleep apnea and substance-induced sleep apnea.

Further, the increase in children with ADHD is probably in some measure the result of the increase in cigarette smoking by women during the 20th Century.

So as Dr. Cyndi Shannon Weickert, Australian pioneering schizophrenia researcher observed -- we already know there are A LOT of Causes of Mental Illness-- we are in desperate need of some improved treatments.

Until then -- we need Governments & Societies that are not afraid of the reality of:

Brain Injury
Mental Illness
Developmental Disability, and
Substance Use Issues

and that will work honestly, inclusively and creatively to bring needed and innovative Housing, Placements & Treatments to SCALE.

HEY CO STATE GOV'T -- WE NEED A COMMITMENT ON OLMSTEAD PLANNING & ACT --- TRUST BUT VERIFY

3/21/2019

We and others have gotten so much double-talk from CO State Gov't that we are not very trusting.
This really goes back multiple administrations and it certainly includes Comprehensive Olmstead Planning and Medicaid's treatment of Assertive Community Treatment as an Alternative Service that does not need to be provided to SCALE where reasonably medically necessary..
Let's talk a little bit about Olmstead Planning & Compliance -- if States were doing that there largely would not be a need for Public Sector Parity or Medicaid Network Adequacy requirements -- BUT THEY ARE NOT DOING IT.
Like everybody else, we're looking for the path of least resistance -- but we're not looking for the path of EASY DOUBLE-TALK -- we've been there, done that.

WE & MANY OTHERS ARE READY TO PARTICIPATE IN A "PARTNERSHIP"WITH THE STATE

3/20/2019

CO State Gov't wants to create the best Mental Health System possible for mental health clients and they recognize that is a PARTNERSHIP between the General Assembly, the Judiciary & Stakeholders.

At the Beginning of the Day, Middle of the Day, & the End of the Day --- that must mean MORE RESOURCES.

We and Many Others Are Ready to Work with the State on Creative & Innovative Funding Strategies to bring critical & legally required services to SCALE. We know this is HARD. Believe it or not, we really do want to work with the State-- not against it -- in addressing this DIFFICULT CHALLENGE.

The reality is CO State Gov't already provides a lot of innovative mental health services --- BUT they DON'T provide intensive mental health services to SCALE or as LEGALLY REQUIRED.

"[Florida] Judge Steven Leifman gives a brief history of how we have dealt with mental illness in America since the founding of our country, from the days of Dorothea Dix, to President Kennedy, to the fractured community mental health system of today and the criminalization of people with mental illness."

struggling with MENTAL HEALTH FUNDING OVERWHELM, the Law & Morality

3/19/2019

"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

We really have all kinds of FACTORS driving an "Invisibility Disability" Crisis in our Society.
Now maybe we don't completely understand all of these FACTORS -- but our RESEARCHERS know enough -- that as a Society many of our Systems are pretty untenable --- Incarceration being right up @ the top.
BUT hey, we don't have the Intensive Treatments, Housing & Placements that people need to avoid incarceration -- on the Scale necessary -- 1000s of people.
We have made this analogy before -- with respect to the Tobacco Manufacturers. They didn't always know their product was harmful, but when they did -- they tried to hide it -- and they didn't stop hurting people.
Most people already know what we're doing is wrong -- and that includes many, many Sheriffs. BUT we're NOT providing REAL ALTERNATIVES on the SCALE needed.
Even if we view some/most/all of these Behavioral Issues as Symptoms of underlying biological problems --- we still must have Safety.

We've included a video on "Disease" in Human History by author & polymath John Green.

Now, Brain Injury, Mental Illness, Substance Use Issues & Developmental Disability are not diseases in the "classic" sense.

They are "disorders"/"disabilities"/differences that affect multiple domains of functionality.

Our inability to deal with this is causing great human suffering and negatively impacting Human History --now.

DESCARTES' ERROR & RELIGION & SPIRITUALITY, sCIENCE & lAW

3/18/2019

We keep making Descartes' error.

-- I was listening to "Meet the Press" Sunday, and they had Arthur Brooks with the American Enterprise Institute.
Brooks has written a new book entitled, "Love Your Enemies" and was railing against a "Culture of Outrage."
I'm FOR loving one's Enemies BUT the precusor to that kind of LOVE is usually FEAR & ANGER.
That FEAR & ANGER is what FUELS, TRIGGERS ---- our REASONING abilities.
In fact, as Neuro-scientist Antonio Damasio explained in the 1990s -- WE CAN'T REASON WITHOUT EMOTION.
So REASONING triggered by EMOTION is going to FIX IT Right?
We talk A LOT about "ROOT CAUSE" AnalysIs and Systemic Approaches to PROBLEMS.
Well it turns out we can never get to the ROOT CAUSE with this kind of reasoning -- BECAUSE there is ALWAYS SOMETHING ELSE. Even atheist Bertrand Russell admonished that PHILOSOPHY cannot get to 1st Causes.
NOT ONLY do we NOT have FOREVER and a DAY -- BUT EVEN IF WE DID -- It doesn't look like we would ever get to 1st CAUSES through REASON & PHILOSOPHY.
SO we have to inject quite a bit of PRACTICALITY into this --- and that's REALLY where most of our HUMAN DISCIPLINES come in -- including LAW and SCIENCE and I would include in this RELIGION & SPIRITUALITY.
At the end of the day, LAW and SCIENCE and all our other human disciplines haven't "fixed it." Maybe they made it worse, maybe they made it better -- BUT they didn't "FIX IT."
WHAT DOES IT MEAN -- NOT TO FIX IT? Well--

It could be being the most incarcerated country in the World
it could mean living in a World with over 65 million refugees & immigrants;
It could mean illness and death.

Even if RELIGION is as absurd as Kurt Vonnegut portrayed in "Cat's Cradle"-- it's what is left after EVERYTHING ELSE -- has failed us.
Of course, RELIGIONS & SPIRITUAL BELIEFS fail people too -- and those Religions & Beliefs EVOLVE -- and maybe they do LAG after SCIENCE. Further, LAW typically LAGS after SCIENCE.
    RELIGION/SPIRITUALITY, REASON & EMPIRICAL SCIENCE, & LAW -- ALL NEED EACH OTHER DESPERATELY.
In some senses, they are like the ONE PEOPLE of the WORLD struggling against one another -- and whose SURVIVAL DEPENDS ON THE OTHER.

"Descartes Error" could probably be stated a number of ways -- one is that there is no strict separation between Mind & Body, another is there is no strict separation between Emotion and Reason. Descartes thought there was a strict separation.

We've got thousands of people in CO's Criminal Justice System in State Custody:
Why don't we screen these people on a voluntary basis for Brain Injury, Mental Illness, Substance Issues & Developmental Disabilities.

Even more radically, why don't we treat them as best we can currently and NOT PUNISH them for WHAT WE DON'T KNOW.

A picture of Kurt Vonnegut

--"Cat's Cradle" by Kurt Vonnegut

DIALING CO STATE GOV'T: WE'VE GOT AN EMERGENCY

3/17/2019

Nederland Wildfire. Photo Credit: bouldercounty.org

WE NEED STATE LEADERSHIP ON THE CO INTENSIVE MENTAL HEALTH CARE
EMERGENCY
If we were talking about a Wildfire -- we would all understand that is an EMERGENCY.

Somehow -- No matter how many times the State gets Sued or how many BAD THINGS HAPPEN-- we don't understand that the problems of Coloradans with Intensive Mental Health Needs are an EMERGENCY.

I'll never forget a phone conversation I had several years ago with CO Legal Services Executive Director Jon Asher -- apparently trying to come through the phone to wring my neck -- when I suggested a "LEGAL NEEDS ASSESSMENT" for vulnerable elders.

[BTW -- Men can get away with that kind of stuff a lot more than women can]

Anyway, @ the time --- I was just SHOCKED! What is this guy's problem -- I'm just trying to help.

NOW, many years later --- I do understand the FRUSTRATION.  When I saw the CO Dept. of Human Services Action Plan for going forward in the Current Mental Health Crisis -- I thought I was going to SCREAM.
  https://www.rmhpcommunity.org/news/leadership-interview-camille-harding-colo-dept-human-services

    What was CDHS proposing: Another Needs Assessment & More Focus on Crisis Services. We're NOT against Crisis Services -- but if we don't build out our CONTINUUM OF CARE -- We Are Never Gonna Get Out of This.

    By and large, we need a combined workgroup of CDHS, HCPF* & the Division of Housing to:

Come up with an "Emergency Plan for People with Intensive Mental Health Needs"
We need to provide hotel vouchers for people with mental illness and other cognitive disabilities who are homeless until we have adequate housing
We need to increase reimbursement to hospitals for psych bed space in order to secure adequate bed space.
We need to make Assertive Community Treatment a Standard Service under CO Medicaid where "Reasonably Medically Necessary"

People this is an EMERGENCY. AND We Need CO State Gov't to UNDERSTAND THAT & To Deal with it as an EMERGENCY.

*HCPF: CO Dept. of Health Care Policy & Financing

CO's Mental Health Continuum of Care Hell

In Addition to Immigration & temporary camps -- we need to be promoting the "Social determinants of Health" on a Global scale

3/15/2019

The Beatles: "I'm Looking Through You"

We chose this song because of its accusatory line:  "You're Not the Same."

Change equals Stress. It is also INEVITABLE. Some people around the world are especially affected  by this stress & anxiety -- leading to paranoia & violence.

What Can We Do To Address the Emotional Needs of People Overwhelmed by Global Integration without giving in to PARANOIA?

There has been a HUGE FAILURE to address the underlying causes of the world's IMMIGRATION & REFUGEE CRISIS.
The current situation of over 65 MILLION Refugees and Immigrants is NOT VIABLE or SUSTAINABLE.
People are going to be moving around the Globe and our Societies are going to CHANGE. They are not going to look the same.
On the other hand, there must be some practical control of that movement and HUMANITARIAN ALTERNATIVES other than immigration or over-crowded refugee camps.
This really goes to our FUNDAMENTAL INTEREST in promoting the SOCIAL DETERMINANTS of HEALTH around the globe.
It has become quite impractical to move 10s of millions of people around the globe in exigent circumstances.
Further, the longer we fail to adequately address Climate Change -- the more displacements we're going to have.
Governments don't have good plans to deal with these problems -- BUT the answer isn't reactionary extremism -- the ANSWER is addressing the SOCIAL DETERMINANTS OF HEALTH of native and refugee populations in CREATIVE & SUSTAINABLE ways.

CMS & HUD: WE NEED ENFORCE-MENT

3/15/2019

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY.

WE NEED ENFORCEMENT

The reality is: if we provide the SUPPORT [one of our new themes] that the STATES need to COMPLY with theses laws --- there is NOT going to be the CRYING NEED for ENFORCEMENT that we currently have.
There is ENORMOUS TALENT in the STATES & @ the FEDERAL LEVEL. BUT often -- THOSE STRENGTHS AREN'T THE SAME -- and the TIME which is always finite is ALLOCATED IN DIFFERENT WAYS.
It is REALLY AMAZING HOW MUCH has already been anticipated @ the Federal Level -- & recognizing where the SYSTEM isn't really COHERENT -- and starting to address that "SYSTEMICALLY."
But the reality is we have THOUSANDS of people with COGNITIVE DISABILITIES in the CRIMINAL JUSTICE SYSTEM because our Systems are not built to handle them.

The IMD[Institute of Mental Disease] Exclusionary Rule is causing more HARM than GOOD
CMS has to provide detailed templates for addressing the Crisis of People with Cognitive Disabilities within the Criminal Justice System, including:
- Brain Injury
- Mental Illness
- Substance Issues, and
- Developmental Disabilities
HUD has to provide detailed templates to address Supportive Housing Needs
Both HUD & CMS MUST withhold FUNDS from States that are not in compliance with:
- Olmstead
- Parity
- Network Adequacy

Unless there is a viable PLAN OF CORRECTION, CMS & HUD funds should be withheld from States.

Now that may seem drastic --- BUT when did the US Supreme Court decide Olmstead --- 1999.

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Val's Blog

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

red flag laws, disability civil rights laws & State hypocrisy

CO ATTY GENERAL PHIL WEISER SAYS SHERIFFS THAT WON'T COMPLY WITH A RED FLAG LAW IF PASSED SHOULD RESIGN

GUESS WHAT -- WE FEEL THE SAME WAY ABOUT STATE OFFICIALS THAT WON'T COMPLY WITH DISABILITY CIVIL RIGHTS LAWS

LET'S NOT GET CAUGHT UP IN THE "ISMS"---REALITY IS A LOT MORE COMPLICATED THAN SOCIALISM OR CAPITALISM

HEY CO STATE GOV'T -- WE NEED A COMMITMENT ON OLMSTEAD PLANNING & ACT --- TRUST BUT VERIFY

WE & MANY OTHERS ARE READY TO PARTICIPATE IN A "PARTNERSHIP"WITH THE STATE

struggling with MENTAL HEALTH FUNDING OVERWHELM, the Law & Morality

"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

DESCARTES' ERROR & RELIGION & SPIRITUALITY, sCIENCE & lAW

We keep making Descartes' error.

DIALING CO STATE GOV'T: WE'VE GOT AN EMERGENCY

In Addition to Immigration & temporary camps -- we need to be promoting the "Social determinants of Health" on a Global scale

CMS & HUD: WE NEED ENFORCE-MENT

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY.

WE NEED ENFORCEMENT

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Val's Blog

​"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

We keep making Descartes' error.

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY. WE NEED ENFORCEMENT

Author

Archives

Categories

"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY.

WE NEED ENFORCEMENT