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We're in the midst of a scientific revolution -- Our moral duties don't start after it's ended -- They're here right now

9/20/2018

The Scientific Revolution we're currently in the midst of is going right to the heart of:

The Mental Health Profession
The Legal Profession, especially the Criminal Justice System, and
Our Widespread Ideas of Bad Human Acts + "Intent" as a Justification for PUNISHMENT,
How we provide for Safety.
And what treatments are most efficacious for people with invisible cognitive disabilities such as:
- Mental Illness
- Brain Injury
- Developmental Disability
- Substance Use Issues
- Etc.

This is causing not only enormous conflict in the society BUT also enormous internal conflict as we wrestle with these issues and anticipate what may be to us unacceptable outcomes when our systems haven't caught up with the often horrific conundrums we're facing.

For example -- if the State was providing adequate bed space and intensive services -- would we really be struggling as hard as we are with getting people with invisible cognitive disabilities out of the Criminal Justice System.

We think that it was that internal conflict and anticipation of undesired consequences that led media commentator Amy Holmes to observe both that convicted criminal defendant Wanda Barzee was:

A "psychotic menace," and
"We don't know if Wanda Barzee has a mental illness or not."

But it is even more complicated than that: There's plenty of evidence that the Structure of our Criminal Justice System is FUNDAMENTALLY UNFAIR.

And the current scientific revolution is not only cutting to the heart of the significance of human "intent" --- it's taking some of those SOFT concerns about social environments and turning them into some pretty HARD biomarkers.

Two related examples are how childhood trauma and post traumatic stress disorder can affect the immune system.

Well, that's really significant because damage to the immune system can really affect the brain.

Now -- are we all the way there yet to clear biomarkers on ALL human behavior -- no, but we are on our way.

GASP!

In the meantime, we know enough to know:

We don't know it all,
We don't know enough to be making the assumptions we're making in the Criminal Justice System,
We have to have safety, and
We should be treating all people as humanely as possible.

Let's Do That -- and we're NOT DOING IT NOW.

What we're doing now in the Criminal Justice System is immoral and unethical.

"The Immune System Does Produce Behavior . . . Our Model of Healthcare is outdated"

-----------Prof Sir Robert Lechler, President of the Academy of Medical Sciences, the United Kingdom

From the Telegraph

Beckman Institute for Advanced Science and Technology @ the University of Illinois

Decision Making is Shaped by Individual Differences in the Functional Brain Connectome

--Beckman Institute for Advanced Science and Technology at the University of Illinois
19 March 2018
http://neurosciencenews.com/connectome-decision-making-8661/

[S]tudy found that these individual differences are associated with variation in specific brain networks -- particularly those related to executive, social and perceptual processes.
https://www.sciencedaily.com/releases/2018/03/180320141334.htm

Media Commentator Amy Holmes

Some of these scientific discoveries do implicate our moral and religious beliefs; although some religious people may have a leg up on the secularists in living in a world without "judging" individuals..

God of the Gaps, Criminal Liability of the Gaps

It's Kinda Funny BUT Religious Folks May Be More Adaptable to the Changing Science than Our Mental Health Profession & Legal Systems

Pope Francis

Mental Health is going to have to change a whole Lot to be effective -- & a big part of that is appreciating the large role of the immune system in Mental & brain disorders

9/17/2018

We're almost always in the position of not knowing everything.

How we deal with that has ENORMOUS MORAL & ETHICAL CONSEQUENCES for ourselves and others.

We've got a Mental Health Profession that:

Doesn't have a valid diagnostic manual;
Many treatments have stagnated or stalled;
They have a very incomplete understanding of "mental illness"
States & the Federal Government are paying Millions, Billions of Dollars for mental health treatment with pretty underwhelming results;
And yet this same profession is going into Criminal Court & testifying in criminal cases often greatly affecting the lives of very poor, traumatized disenfranchised people.

The practice of using Mental Health Evaluations as a predicate for punishment in some criminal cases has to stop, and really needs to stop TODAY on the part of both State and Private Mental Health Evaluators.

Does that cause problems well yes it does -- because we also have to reform our Criminal Justice System. Is that going to be hard -- you bet it is.

BUT LIVING THE LIE WE'RE CURRENTLY LIVING IS A SIN.

‘Drain Pipes’ in the Brain: Lymphatic Vessels Act As Pipeline Between Brain and Immune System

The Brain-Immune-Gut Triangle: Innate Immunity in Psychiatric & Neurological Disorders
https://www.researchgate.net/publication/261994663_The_Brain-Immune-Gut_Triangle_Innate_Immunity_in_Psychiatric_and_Neurological_Disorders

Oslo University Hospital, Norway

BBC:

BBC health reporter James Gallagher explores the increasing body of evidence that a dysfunctional immune system is responsible for the depression or psychotic illness experienced by hundreds of thousands, perhaps millions, of people in the UK.

James talks to the psychiatrists investigating this new understanding of mental illness and to people who may benefit from treatments aimed at the immune systems rather than their brain cells.

"I believe this is one of the strongest discoveries in psychiatry in the last twenty years", says Professor Carmine Pariante of his and other research on the immune system and depression. "It allows us to understand depression no longer as just a disorder of the mind and not even a disorder of the brain, but a disorder of the whole body.

It shifts conceptually what we understand about depression." James also talks to New York journalist Susannah Cahalan.

he began to experience paranoid delusions and florid hallucinations when her immune system made damaging antibodies against part of the molecular circuitry in her brain.

Treatment to eliminate the antibodies prevented her committal to psychiatric hospital.

Psychiatrist Professor Belinda Lennox at the University of Oxford says she has evidence that a significant proportion of people presenting for the first time with psychotic symptoms are victims of a similar autoimmune problem.

Possible linkages between Childhood Trauma -- Inflammation -- Damage to Immune System -- & Ultimate Mental Illness

Social Behavior & the Immune System

Alzheimer's & the Immune System

University of Colorado @ Denver
http://www.ucdenver.edu/academics/colleges/medicalschool/departments/neurology/clinical/rmadc/Pages/default.aspx

"Leukine stimulates immune system macrophages, which ingest and dispose of harmful microorganisms and waste products.

"Based on evidence that patients with the autoimmune disease rheumatoid arthritis do not tend to develop Alzheimer’s disease, the investigators first determined that a factor in these patients called “Granulocyte-Macrophage-CSF (GMCSF)” that stimulates production of immune system macrophages might help to protect them from developing Alzheimers.

"That possibility is consistent with recent research suggesting that patients with Alzheimer’s disease may have reduced capacity to clear away amyloid from the brain. GMCSF is the active ingredient in Leukine."
http://www.dana.org/Media/GrantsDetails.aspx?id=38876

See Also:

The Emerging Link Between Autoimmune Disorders and Neuropsychiatric Disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086677/

What Does The Environment Have To Do With Diseases Affecting The Immune System
https://ensia.com/features/environment-diseases-immune-system/

Learn more about
Psychoneuroimmunology
https://www.sciencedirect.com/topics/neuroscience/psychoneuroimmunology

Below, Prof. Wieckert is the same Professor & Researcher who just made the breakthrough that some people with Schizophrenia have more immune cells in the brain.
https://neurosciencenews.com/schizophrenia-immune-cells-9867/

Is An Overactive Immune System A Cause for Schizophrenia

Houston Medical Research Center

Summary: A major finding from researchers at Houston Methodist reveals a significant number of people diagnosed with schizophrenia or bipolar disorder may actually have a treatable immune system disorder.

The condition causes NMDA receptors to stop functioning properly and can result in symptoms commonly associated with neuropsychiatric disorders.

Source: Houston Methodist.

“We suspect that a significant number of people believed to have schizophrenia or bipolar disorder actually have an immune system disorder that affects the brain’s receptors,” said Joseph Masdeu, M.D., Ph.D., the study’s principal investigator and a neurologist with the Houston Methodist Neurological Institute.

“If true, those people have diseases that are completely reversible – they just need a proper diagnosis and treatment to help them return to normal lives.”
Houston Methodist Research Center
http://neurosciencenews.com/schizophrenia-immune-disorder-bipolar-8179/

Immune System linked to Alcohol Drinking Behavior
http://neurosciencenews.com/immune-system-alcohol-7494/

University of Adelaide, Australia

Childhood Trauma Can Result in Chronic Inflammation which can affect the Immune System (2012)
http://www.medicaldaily.com/childhood-trauma-can-result-chronic-inflammation-241114

Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Post-Traumatic Stress Disorder (2014)
http://www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00457-0/fulltext

University of California @ San Francisco, Dept. of Psychiatry & VA

https://www.cam.ac.uk/research/news/mind-and-body-scientists-identify-immune-system-link-to-mental-illness

New Science is Amazing: It has Huge Moral Implications Now

Immune System & Mental Health

Trying to reform Colorado's crappy mental health System---The first step is recognizing the problem(s)

9/16/2018

It was really Mental Health America's report ranking Colorado 48th in Child Mental Health Care that is in large measure spurring the current reform efforts in State Government.
Data is really critical for reform in modern society, anecdotal reports are often not enough and individuals and advocates often don't have access to the information that is needed -- and sometimes that's because the State isn't collecting it.
We were really pleased to see some of the questions on OBH's Roadmap to Reform Children's Mental Health.
While people can certainly play with the numbers, our experience is that fair-minded data collection CALMS THINGS DOWN A LOT.
Then one can really get down to creative problem solving and there are generally pretty complicated reasons for problems.
Being able to agree that:

There is a problem, and
We need to solve it

really saves enormous time and energy right there.
It looks like that is happening in Children's Mental Health with a collaborative approach among OBH, HCPF [CO Dept. of Health Care Policy & Financing] and stakeholders.
The same needs to happen in Adult Mental Health. That's where we think a Tiered System could transform our dangerously inadequate system of intensive mental health services.

“The State of Mental Health in America” report. 

OBH's Questionnaire on the Roadmap to Reform Children’s Mental Health -- Deadline Sept. 19, 2018

https://mailchi.mp/state.co.us/provide-feedback-on-the-roadmap-to-reform-childrens-mental-health?e=cfc778e7cc

The Colorado Health Institute is another option for State Government and Stakeholders when it comes to non-partisan data collection and analysis.
https://www.coloradohealthinstitute.org/research/behavioral-health-colorado

Colorado's Mental Health Crisis--Solving it the "hard way"

9/11/2018

Well, let's just say I think John Elway's quote regarding solving problems [in our case, the mental health crisis] the hard way --- is applicable to:

The Centers for Medicare & Medicaid Services (CMS)
The US Department of Housing & Urban Development (HUD)
State Governments like Colorado's that do good things, and fail to comply with Federal law, and are afraid of the data else it further erode the state government's claims of "plausible deniability."
Advocates, family members, individuals, and even the US Department of Justice that are making a lot of progress ---and still don't have Comprehensive Olmstead Plans for people with Disabilities in Colorado and for that matter Most States.

Governor Hickenlooper's Community Living Coordinator is preparing a public report on among other things "LESSONS LEARNED."
We're not asking the State to include in that report that it has violated Olmstead, the ADA, Mental Health Parity & Medicaid Network Adequacy -- even though they have in their polite, cordial ways.
BUT what we do want is some POLITICAL COURAGE to seriously include recommendations on:

Data Collection
Development of Clear Eligibility Criteria Across the Mental Health Continuum of Care
The Development of Mental Health Waitlists for specific services. Such waitlists are also critical for planning.
A recommendation for a comprehensive plan to bring housing and services for Coloradans with Disabilities to Scale within the next 5 to 10 years.

We've been really tough on this Administration, but more like a relentless parent who really believes in her child than a true adversary [sort of]. If that has caused resentments, I apologize.

In any case, we know the Hickenlooper Administration can do this, and we don't know what is coming down the pike.

This Mental Health Crisis isn't going to solve itself.

Olmstead Planning, whole-person Healthcare, & Whole-System Analytics

9/10/2018

There's a lot of irony in starting a blog on Colorado's overwhelm with the numbers of Coloradans with invisible disabilities with the quote to the right ----from "My Simple Life"

BUT one of the ways we do get over that overwhelm is by Olmstead Planning that is grounded in massive data collection and analytics.

States, including Colorado, have been in a lot of DENIAL about the scope of the need for Housing & Services, and the State's LEGAL responsibility to provide it to people with disabilities to avoid unnecessary institutionalization or the great risk of institutionalization inherent in homelessness.

A HUGE part of that planning is understanding:

how many people with disabilities need housing;
how many people need services, and what types
do the housing placements & services work -- are they in fact preventing institutionalization [including incarceration] and homelessness
what modifications to housing placements and service arrays need to be made based on the data.
what's the cost and can modifications be made without sacrificing efficacy and realize cost savings;
recognizing when essential services are not being provided to save cost and efficacy has been sacrificed, leading to institutionalization [including incarceration] and homelessness.

Some advocates may disagree with the statement below, but I expect fewer than 5 years ago, especially after Colorado's Jail Wait Case, pursued by the Colorado Lawyers Committee & Disability Law Colorado.

I believe short term institutional placements for people with invisible cognitive disabilities are a part of Olmstead Planning and can in fact prevent the long term institutionalization, incarceration, and homelessness of people with invisible cognitive disabilities.

Prevention is costly, but it is nothing compared to what we doing now.

https://startasimplelife.com/an-unsimple-phase-in-my-simple-life/

Our Slough of Despond in only partially recognizing that human behavior is biologically based --- Biology is involved in all of it

9/7/2018

The National Institute of Mental Health's response to the "scientifically invalid" DSM 5

Our opinion is that we have a deeply entrenched lack of competency in the clinical mental health profession that is widespread and systemic.

We are not however anti-psychiatry or anti-science -- and we understand why some people are.

There are so many reasons for our current mental health crisis, but one of the most uncomfortable is the lack of competency in the mental health profession -- this is really up and down the line, whether clinicians from prestigious schools or not so prestigious schools.

Certainly, "personality disorders," most specially "ANTI-SOCIAL PERSONALITY DISORDER" is really a HOLOCAUST in the Criminal Justice System.

Judges and prosecutors really take it as CODE for BAD/EVIL person -- and for that matter clinicians seem to as well.

Some very smart clinicians traffick in that drivel and it needs to be called out.

Certainly the National Institute of Mental Health is focusing on the "underlying biology" of "mental illness."

And storied academics like Neuro-Scientist Robert Sapolosky are free to tell it like it is.

Orchid's Book Club

CLINICIANS ARE less sympathetic to biological explanations

Effects of biological explanations for mental disorders on clinicians’ empathy

NIMH -- Trying to get to the underlying biology

According to Dr. Cuthbert [head of the National Institute of Mental Health's Research Domain Criteria Program:]

'[W]e now understand that the categories [of mental illness] are not specific diseases (like Lyme’s Disease or influenza)

[B]ut rather are broad syndromes – loose collections of symptoms that tend to occur together to some extent, and involve dysregulation in multiple domains.' "

https://www.nimh.nih.gov/news/science-news/2017/different-approaches-to-understanding-and-classifying-mental-disorders.shtml

The Slough of Despond from John Bunyan's "Pilgrim's Progress" [from this World to that which is to Come] -- (1678)

For our purposes, the Slough of Despond is the seemingly interminable Free Will vs. Determinism debate and it's relation to the Criminal Justice System.

John Bunyan's Slough of Despond is a deep bog in which Christian sinks under the weight of his sins and his guilt for them. -- Wikipedia

New Jersey

Under Timothy's Law the following disorders are classified as biologically based mental illness:

---Wikipedia

Timothy's Law appears among other things to attempt to circumscribe the State's liability for Federal Mental Health Parity requirements.

But according to NIMH those classifications may not make any sense.

Scientific American (2015)

Mad Science: The Treatment of Mental Illness Fails to Progress

Recent questions about the validity of diagnostic criteria for mental illness have raised deeper questions about the current state of psychiatry

Click Here

So this is from the movie "Divergent" which we often use as a metaphor for Divergent Thinking.

What we are referring to here is not getting caught up in the DEEP BOG of the Free Will vs. Determinism debate.

Many evils have been perpetrated on both sides of that debate and the reality is we can side-step it -- and still get to a rational, compassionate System of Justice that provides for safety.

New Science is Amazing and it has HUGE Moral Implications for Our Society -- NOW

We need Diagnosis standards set by the National Institute of Mental Health [Nimh]

9/4/2018

Dr. Thomas Insel, former Director of the US National Institute of Mental Health

"So this year on Mental Illness Awareness Week, my call is for humility.

"We need to be aware that mental disorders are immensely complex—too complex for scientists, clinicians, patients, or families to solve alone.

"Prevention, recovery, and cure—the NIMH vision—need a collective effort.

Beyond the day—or week—of atonement, we need a massive campaign to transform diagnosis and treatment.

See also "The Rats of N.I.M.H." from the New Yorker
https://www.newyorker.com/tech/elements/the-rats-of-n-i-m-h

In one way it is a testament to the mental health profession and the research community that things have progressed so much that the current process for formulating a diagnostic manual is wholly out-of-date and obsolete -- and quite frankly, dangerous.

It doesn't make sense for a professional association ----the American Psychiatric Association (APA) ---- to be responsible for the diagnostic manual.

This is really a responsibility for the National Institute of Mental Health (NIMH) where they are on the cutting edge of research and knowledge regarding these issues.

In fact, someone has already thought of this: a National Brain Diagnostic Research Center. See NAMI Montana's video below

NAMI: "It's Time To Improve the Mental Illness Diagnostic Process"

Supporting a National Brain Diagnostic Research Center, to be managed by the National Institute of Mental Health & funded by the Centers for Medicaid & Medicare Services.

Below is a critical Law Journal article on the DSM and proposals to reform it. We agree with the concerns, we would not put responsibility for diagnostic standards with the US Department of Health & Human Services, we think it should be with NIMH.

Houston Journal of Health Law & Policy (2012)

THE REALITY OF THE DSM IN THE LEGAL ARENA:

A PROPOSITION FOR CURTAILING UNDESIRED CONSEQUENCES OF AN IMPERFECT TOOL

By Cia Bearden

If a medical diagnostic publication is to exist in this capacity, there should be federal regulations setting forth acceptable practices in its formation and methodology.

. . .

Rather than allowing the APA to defer to the influence of contributor’s opinions simply because of lack of funding or time or any other reasons alleged, a publication that is intended to be used by the medical community as a diagnostic tool should be based on actual scientific evidence.

As such, a guideline for the threshold amount of empirical or historical evidence should be required for the inclusion of each and every diagnosis.

. . .

As for the DSM’s function in the legal system, the APA’s current approach is to attempt to protect themselves from liability by including a caveat warning against such uses.

Given the particular difficulties in understanding and applying mental illness, the DSM’s continued use in the legal community is reasonably foreseeable.

Moreover, the APA is or should be fully aware of its use, regardless of their warning language.

Instead of trying to shield themselves from liability for unintended use, the APA and anyone else producing a medical diagnostic tool should work to create a manual that court proceedings accept as scientifically verifiable.

Currently, the DSM affects eligibility for insurance and disability benefits, culpability in

civil and criminal proceedings,
injury in civil proceedings and worker’s compensation claims,
competency of a defendant to stand trial,
the possibility that a defendant will be forced into a lifetime of psychiatric commitment in addition to serving his sentence,
and in the most extreme cases, the difference between life and death for a person convicted of a capital crime.

The APA cannot simply ignore its role in these circumstances by issuing a cautionary statement. Instead, they must work to create a scientifically valid manual.

Lord Byron

Atonement
(Oct. 2014)
By Former NIMH Director Dr. Thomas Insel

As it turns out, Mental Illness Awareness Week this year began with Yom Kippur, the Jewish Day of Atonement.

Which begs the question: what do we (in the mental health community) need to atone for?

There are so many answers.

For some, it may be the culture of blame and shame perpetuated for years by clinicians who explained all mental illness as being caused by trauma and evil parents.
For others, it may be the singular reliance on medication and modifying behavior rather than holistic care and the provision of skills.
Others will name the paternalistic structure of mental health care, which can undermine rather than empower individuals and their families.
The list goes on.

Maybe it would take a week, not just a day, to capture the many complaints.

My own favorite atonement issue for Mental Illness Awareness Week this year is the lack of humility in our field.

Mental disorders are among the most complex problems in medicine, with challenges at every level from neurons to neighborhoods.

Yet, we know so little about mechanisms at each level. Too often, we have been guided more by religion than science.

That is, so much of mental health care is based on faith and intuition, not science and evidence.

On the plus side, we put a premium on listening and compassion. We help people to change through understanding.

But not enough of our care has been standardized to a high level of quality, as expected in the rest of medicine.

On the research side, it’s easy to lose humility.

. . .

But, and this is a humbling caveat, we simply have not been able to translate this revolution in neuroscience to diagnostics or therapeutics for people with mental disorders.

https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2014/atonement.shtml

Science Up

New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW

Quantity of ASSERTIVE COMMUNITY TREATMENT UNDER CO MEDICAID & Measurable goals

9/1/2018

Colorado has several thousand people with mental illness in jails, prisons, nursing homes, homeless, and in mental institutes.

Our rough estimate is 6,000 to 10,000 -- & those people are more than likely on Medicaid or eligible to get on Medicaid upon release from an institution.

The GOLD STANDARD of Intensive Mental Health Treatment is Assertive Community Treatment (ACT), and we've also championed the less expensive episodic Flexible Assertive Community Treatment (FACT) where appropriate.

Further, not everybody needs ACT, and even for those people who do -- if there is something equally effective -- GREAT!

BUT Colorado State Government -- can't have a bunch of people with mental illness in prisons, jails, nursing homes, homeless and mental institutes ---- AND claim it is doing enough -------

When it doesn't make housing & ACT available where reasonably medically necessary.

[Parenthetically, we know Medicaid doesn't cover Housing -- BUT States are still responsible for providing it for people with disabilities under Title II of the Americans with Disabilities Act, the Olmstead decision, subsequent caselaw & guidance.]

Colorado like most States has some ACT and they have been trying to increase it.

In Colorado we've been trying to do this under TABOR -- I don't have a problem with TABOR if officials will seek a tax increase when it's needed -- it's just politicians have been afraid of that political hit -- and now they want to take it for Transportation.

Colorado Mental Health probably needs hundreds of millions of dollars to address the need in housing and intensive services.

We don't expect it to happen tomorrow -- but it needs to happen as part of a Comprehensive Olmstead Plan over the next 5 to 10 years.

That Plan needs to have:

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

It's a puzzlement -- A life with executive functioning deficits

8/29/2018

It is a pretty common experience to look at jail inmates and think: "You look just like everyone else."

Further, our criminal law is largely focused on whether or not someone appreciates the nature and consequences of his actions.

That has really led us to a pretty narrow view of human behavior.

Even though "insanity" is not limited to psychosis-- as a practical matter it often is.

That's a big problem, since in many cases it appears that criminal behavior is the result of "executive functioning deficits" that may be the result of:

Mental Illness
Brain Injury,
Developmental Disabilities,
Etc.

It is not that the person didn't understand that the acts were wrong, but his or her self control was impaired, sometimes greatly impaired.

While most people with invisible or cognitive disabilities [millions and millions] are not involved in the criminal justice system, a huge percentage of those involved with the criminal justice system have some type of invisible or cognitive disability.

People -- this isn't some kind of accident.

A number of articles and even some books have recently been written about the connection between executive functioning deficits and involvement in the criminal justice system.

Getting to know ourselves and others is not for the faint-hearted -- but it is one of the best ways to strengthen ourselves, our society, and move beyond the ancient legal concepts that are holding us back and actually making us less safe.

Many years ago my mother asked me, "Don't get mad at me but how can such a smart girl be so messy?"

At the time, I said, "I dunno -- just lucky I guess."

I should have said ------
IT'S A PUZZLEMENT.

After 55 years, it is finally not such a puzzle anymore.

UPDATE June 24, 2022

What I mean by "impairment":

Basically, the flip side of greater or different SENSORY PROCESSING.
There are a lot of benefits ---

BUT

If we can't manage the FATIGUE
If we aren't taking care to manage EMOTIONAL OVERWHELM, and
We're not clued in that we are more subject to MELTDOWNS and BURNOUT ---

That brain and system that may be doing such great work --- actually need more REST and SPECIAL CARE.

If not -- EXECUTIVE FUNCTIONING DIFFERENCES will be EXACERBATED.

Now there's a lot of HIERARCHY and UNCONSCIOUS BIAS when it comes to who gets away with this and who doesn't.

I'm not sure that it's good for anyone to "GET AWAY" with it ----

BUT we need to have more WIDESPREAD KNOWLEDGE about these DIFFERENCES ---
And better ways to manage them.

Most state officials will not be leaving @ the Change of Administra-tions Where do we go from here?

8/27/2018

State Mental Health Advocacy in Colorado is a whole lot like living in a small town:

There Are A Lot Of Conflicts of Interest -- a whole lot of people getting a little bit or a lot of state money that comes with all kinds of strings attached regarding their mental health advocacy efforts.
And there has not been an effective check on the State's polite and law-breaking ways.
And oh yeah, there's a lot of hypocrisy.

I think politeness is important -- BUT we don't want another 4 years of Hypocrisy as high as a Colorado Fourteener.

Everybody knows this is hard-- including many of the people who are suffering the most.

Further, most of us know the State has done a lot of good things BUT they haven't complied with the law.

If the State can really open up in this upcoming report on Community Living and get real about the known need we are facing and what we don't know---

That is going to generate enormous good will and trust.

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Val's Blog

We're in the midst of a scientific revolution -- Our moral duties don't start after it's ended -- They're here right now

Mental Health is going to have to change a whole Lot to be effective -- & a big part of that is appreciating the large role of the immune system in Mental & brain disorders

Trying to reform Colorado's crappy mental health System---The first step is recognizing the problem(s)

Colorado's Mental Health Crisis--Solving it the "hard way"

Olmstead Planning, whole-person Healthcare, & Whole-System Analytics

Our Slough of Despond in only partially recognizing that human behavior is biologically based --- Biology is involved in all of it

CLINICIANS ARE less sympathetic to biological explanations

Effects of biological explanations for mental disorders on clinicians’ empathy

NIMH -- Trying to get to the underlying biology

We need Diagnosis standards set by the National Institute of Mental Health [Nimh]

Atonement
(Oct. 2014)
By Former NIMH Director Dr. Thomas Insel

Quantity of ASSERTIVE COMMUNITY TREATMENT UNDER CO MEDICAID & Measurable goals

It's a puzzlement -- A life with executive functioning deficits

Most state officials will not be leaving @ the Change of Administra-tions Where do we go from here?

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CLINICIANS ARE less sympathetic to biological explanations ​Effects of biological explanations for mental disorders on clinicians’ empathy

NIMH -- Trying to get to the underlying biology

Atonement(Oct. 2014) By Former NIMH Director Dr. Thomas Insel

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CLINICIANS ARE less sympathetic to biological explanations

Effects of biological explanations for mental disorders on clinicians’ empathy

Atonement
(Oct. 2014)
By Former NIMH Director Dr. Thomas Insel