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    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
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      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
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      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
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      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
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      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
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  Val's Blog

CO is in DESPERATE NEED of a STATEWIDE Olmstead Housing Plan for People with Disabilities

3/30/2018

 

The Proceeds of the Lakewood Property Sale Should Go To the CO Coalition for the Homeless

We have been BIG CRITICS of the Colorado Coalition for the Homeless' [CCH's] proposal for a Segregated Housing Project in Lakewood that could ultimately house 1,000 people who are homeless.   
              That is a pretty clear violation of the Integration Mandate of Title II of the Americans with Disabilities Act [ADA] and Section 504 of the Rehabilitation Act of 1973.  Who is the violator?
               Well, if approved it could be many entities:
  • CCH
  • US Dept of Human Services
  • the State of Colorado
              On the other hand, what is CCH supposed to do?
               Lakewood residents and even Disability Advocates like ourselves, are  NOT giving them a lot of REAL ALTERNATIVES --- just moral support in varying intensities, mostly tepid.
                CCH, people who are homeless in Jefferson County, Residents, and Disability Advocates need REAL INTEGRATED ALTERNATIVES.
                 Further, while most states' problems with homelessness are decreasing, Colorado's are increasing for many, many reasons.
​                            If necessity was ever the Mother of Invention, Colorado's Homeless Problem could really be the catalyst to get a Statewide Olmstead Housing Plan for people with disabilities, including "invisible disabilities" such as mental illness, developmental disability, and brain injury that has:
  • Measurable Goals
  • Reasonable Time Frames, &
  • Funding to Support the Plan.
​                            Now Olmstead is NOT going to cover every homeless person in Colorado, but it could be a HUGE step in tackling a problem that is confronting many people and communities with untold human misery.       ​
       We propose that the US General Services Administration [GSA] Sell the Property and Give the Proceeds to the Colorado Coalition for the Homeless to Provide Integrated Housing & Services to people who are Homeless in Jefferson County. ​
​        Is the provision under the McKinney Homeless Act requiring that any Homeless Provider use the Land in Whole -- a violation of Section 504 of the Rehabilitation Act
​of 1973?
​From the US Dept. of Health & Human Services --Discrimination Based on Disability
https://www.hhs.gov/civil-rights/for-individuals/disability/index.html#

Project Management & Trying To Get Beyond The State's Polite Failure to Comply with Olmstead

3/28/2018

 
         When US Dept. of Justice Guidance on Olmstead says Olmstead Plans must have:
  • Measurable Goals
  • Reasonable Time Frames, &
  • Funding to Support the Plan
​         What is DOJ saying about the nature of Olmstead Compliance?
  • Well, first there is fair a amount to a lot of FLEXIBILITY;
  • BUT this IS NOT meant to be some OPEN-ENDED PROCESS that States engage in when they feel like it.
​                   State's don't NEED an OLMSTEAD PLAN if they are in complete compliance with Olmstead, BUT NONE of the STATES to our knowledge are complying ----So they ALL NEED Comprehensive, Effectively Working Olmstead Plans with:
  • Measurable Goals 
  • Reasonable Time Frames, &
  • Funding to Support the Plan
                     Colorado State Government advertises  jobs for Project Managers.  Why don't they hire a Project Manager(s) for Olmstead which like many LARGE PROJECTS is composed of SMALLER PROJECTS.
                            State Government is a BIGGER Project than Olmstead.
                           Colorado needs:
  • the EXPERTISE,
  • the WILL,
  • & the Commitment to the LAW to comply with Olmstead.
                           We haven't had any of the above from the Hickenlooper Administration.
                                 We have a telephone conference with the Governor's Office tomorrow -- we haven't heard anything substantive and that is pretty par for the course.
                                Polite failure to comply with the LAW is still failure to comply with the LAW.                                                             We want to know what this Administration is going to do in the remaining time left towards:
  • Measurable Goals
  • Reasonable Time Frames, &
  • Funding to Support the Plan
for an Inclusive, Comprehensive Effectively Working Olmstead Plan in Colorado.

                   
 What's Required for Olmstead Compliance?

Housing & Services, including Education & Supported Employment, to prevent the unnecessary institutionalization of people with disabilities.

If a State has thousands of people with invisible disabilities in:
  • jails and prisons;
  • nursing homes
  • homeless
  • Etc.

It is a pretty good bet that the State is NOT complying with Olmstead.

Now the compromise the US Supreme Court made is that in absence of full compliance the State could have a Comprehensive Effectively Working Plan to prevent the Unnecessary Institutionalization of people with Disabilities.

But as we say ad nauseam -- what is required is not just any plan.  A Legally-Compliant Olmstead Plan must have:
  • Measurable Goals
  • Reasonable Time Frames, & 
  • Funding to Support the Plan
The Logical Long Term Consequences of Our Failure to Provide Sufficient Access to Intensive Mental Health Treatment
Colorado Abuse & Neglect Scandals Involving People with Disabilities
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From the Project Management Institute:

What is Project Management?

More specifically, what is a project? It's a temporary endeavor undertaken to create a unique product, service or result.

A project is temporary in that it has a defined beginning and end in time, and therefore defined scope and resources.

And a project is unique in that it is not a routine operation, but a specific set of operations designed to accomplish a singular goal. So a project team often includes people who don’t usually work together – sometimes from different organizations and across multiple geographies.

The development of software for an improved business process, the construction of a building or bridge, the relief effort after a natural disaster, the expansion of sales into a new geographic market — all are projects.

And all must be expertly managed to deliver the on-time, on-budget results, learning and integration that organizations need.

Project management, then, is the application of knowledge, skills, tools, and techniques to project activities to meet the project requirements.

It has always been practiced informally, but began to emerge as a distinct profession in the mid-20th century.

PMI’s A Guide to the Project Management Body of Knowledge (PMBOK® Guide) identifies its recurring elements:


Project management processes fall into five groups:

  1. Initiating
  2. Planning
  3. Executing
  4. Monitoring and Controlling
  5. Closing

Project management knowledge draws on ten areas:

  1. Integration
  2. Scope
  3. Time
  4. Cost
  5. Quality
  6. Procurement
  7. Human resources
  8. Communications
  9. Risk management
  10. Stakeholder management
All management is concerned with these, of course.

​But project management brings a unique focus shaped by the goals, resources and schedule of each project.

The value of that focus is proved by the rapid, worldwide growth of project management:

  • as a recognized and strategic organizational competence
  • as a subject for training and education
  • as a career path
https://www.pmi.org/about/learn-about-pmi/what-is-project-management

"They're NOT One of Us"

3/26/2018

 
​​Getting Beyond Incomplete, Artificial Categories to the Complexity of Human Biology

Our Scientifically Invalid DSM 5 is NOT Helping


            Now the Statement above ["They're NOT one of us"] wasn't even made regarding people who had committed some heinous crime -- the statement above was made by one our best friends regarding people with "Substance Use" issues.
               The truth is there is a lot of "Dual Diagnosis" -- people with mental health issues and substance use issues.  Further, the National Drug Institute refers to Drug Addiction as a "mental illness."
                 How we consider "mental illness" is a matter of much public debate because how we define that reverberates in the Criminal Justice System and throughout our society and our definitions of "Disability" and access to financial and medical benefits.
                      There are a lot of HUGE FLIES in this OINTMENT -- one of the biggest being we don't have a scientifically valid DSM 5.  ​
                   Unfortunately, that doesn't stop us from making all kinds of scientifically invalid judgments in our society, including judgments that involve "punishment."
                        One of the hardest things for us to come to terms with is that people who engage in bad behavior or crimes are people AND ARE ONE OF US.
                                 BUT they are NOT necessarily behaving like us, and there are REASONS for that beyond the person is "bad" or "evil" -- even though it may be pretty clear that the behavior is "bad" or "evil."
                        How are we going to make decisions regarding the consequences for "BAD" or "EVIL" behavior when we have imperfect knowledge:
  • Are we going to convince ourselves that we have knowledge we don't have?
  • Do we already know we DON'T have the knowledge, but this is just the ROLE we have to play?
  • Do we think to protect the community, we have to pretend to knowledge we don't have?

         "Mental Illness,"  "Developmental Disability," and "Brain Injury" are all enormously broad constructs mixing societal concerns with imperfect human scientific knowledge.
                       In the end what we are concerned with is the COMPLEXITY of HUMAN BIOLOGY and how that plays out in SOCIETY and what we need to do to make those SOCIETIES, COMMUNITIES, FAMILIES, & INDIVIDUALS SAFE.
                        Some of our outdated contructs like the DSM 5 are really getting in the way of:
  • acknowledging the complexity of human biology; &
  • acknowledging we don't know it all.
​
      
Ironically, pretension to knowledge we don't have is making our societies, communities, families, and individuals LESS SAFE.
             The goal ultimately is to get everyone into society's "IN GROUP." 
    BUT it is pretty hard to do that if we don't recognize there are COMPLICATED REASONS FOR BAD, DANGEROUS, or EVIL HUMAN BEHAVIOR such that punishment won't get to the ROOT CAUSES.   
                    If we don't know how to get to the ROOT CAUSES, punishment is still bad because it generally makes the behavior worse.  
                              There are people who can't live in the community right now -- BUT punishment is a counter-productive remedy.
                               We really are all HUMAN BEINGS -- the best and worst of us are part of that IN GROUP.         
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Dr. Robert Sapolsky is a professor of biology, neurology and neurological sciences, and neurosurgery @ Stanford University:
 ​ "You are never really going to understand what is going on if you get it into your head that you're going to be able to explain everything with this is--
​
  • the part of the brain
  • the childhood experience
  • the hormone
  • the gene
  • or the evolutionary mechanism​
---That explains everything.

"It doesn't work that way.  Instead any behavior is the result of biology that occurred a second ago, hours ago, days ago -- a million years ago."
.  . . .

"O000h it's complicated.  Well, that's very useful. 

"How 'bout, 'OOOh it's complicated and you better be really careful and really cautious before you think you understand the causes of a behavior, especially if it's a behavior you judge harshly.' "

.                                                                                                                                                                  ------Prof. Robert Sapolsky                                                Stanford
GLEE:  "One of Us"
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Fly In the Ointment
Where's that Scientifically Valid DSM?

Dr. Thomas Insel, then Director of the National Institute of Mental Health
"This Is A Time of DISCOVERY."

 (Dr. Tom Insel, then head of the National Institute of Mental Health states the DSM-5 "lacks validity" :

              
"The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.

"In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.

"Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood thatsymptoms alone rarely indicate the best choice of treatment.

​"Patients with mental disorders deserve better.   NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system."

  https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml 
​

Bishop Carlton Pearson says he received a religious message that there is No Hell.
Hair Analysis, Psychological Analysis, the Criminal Law & the Ethical & Moral Imperative to Pull Back
Even A Dog Distinguishes Between Being Stumbled Over & Being Kicked
Above is a TedTalk on a REALLY IMPORTANT topic -- the Biology of Our Best and Worst Selves.  Dr. Robert Sapolsky is a professor of biology, neurology and neurological sciences, and neurosurgery @ Stanford University. 
Last Updated July 27, 2022

We Get "Symptoms" & "Root Causes" Confused A Lot in Our Society  ---We Think That Is What is Happening In the Criminal Justice System

3/24/2018

 

​* Gerrymandered Definitions of "Mental Illness" and "Insanity,"
*
Perverse Incentives, 
*How focusing on "Neuroplasticity" might help &
*"Just Because You Can't See It, Doesn't Mean It Isn't There"
Val's Take
​

            There are a lot of reasons for our fuzzy definitions of "Mental Illness":
  • the Science is incomplete;
  • DSM 5 is NOT a "valid" diagnostic manual according to former National Institute of Mental Health Director Thomas Insel -- it only addresses symptoms not BIOLOGICAL causes;
  • How we define "Mental Illness" reverberates in the Criminal Justice System;
  • We want to maintain the "Integrity" of the Criminal Justice System and we're afraid if too much is recognized as "Mental Illness" or exculpating Brain Injury or Developmental Disability -- the "Integrity" of the Criminal Justice System will be undermined.
  • We're trying to be "Compassionate" to the Tens of Millions of People with "Mental Illness," etc. who are NOT violent.
  • We are one of the Tens of Millions of People with "Mental Illness," Brain Injury and or "Developmental Disability" --- and we DON'T want to be identified with people who are violent or lawbreakers.
  • Further, most people, including people with "Mental Illness," Brain Injury and or Developmental Disability are MORALLY DISGUSTED by violent or even non-violent behavior that victimizes others.
  • So what do we do?  We engage in some pretty impressive MENTAL GYMNASTICS to DEFINE OUT the VAST MAJORITY of people who commit crimes from any exculpatory defense to enable us to PUNISH them.
  • BUT what if the issues aren't FACTUAL BASIS, EXCULPATORY MENTAL STATE &/OR PUNISHMENT --- RATHER:
  • ​FACTUAL BASIS FOR THE CRIME
  • SAFETY OF THE COMMUNITY
  • TREATMENT NEEDS OF THE VICTIMS +
  • TREATMENT NEEDS OF THE DEFENDANT 
​     The fact of the matter is we are already more than 1/2 the way there. 
       Unlike many of my civil rights compatriots -- I don't have a problem with Civil Commitment of Dangerous Sexual Predators.  I think we have to have REALISTIC ASSESSMENTS of danger if we're going to protect the community.
        BUT unfortunately for some people and their victims and the community -- some of this behavior seems beyond their control.
         NOW this is where our FIXATION on PUNISHMENT really does SO MUCH HARM and makes our Societies LESS SAFE.  Because PUNISHMENT is based on the notion that you can CONTROL your BAD BEHAVIOR-- you just WON'T.
            So this creates ALL KINDS of PERVERSE INCENTIVES:
  • NO 1:  To Lie
  • To Threaten People who might tell the FACTUAL BASIS of one's BAD BEHAVIOR
  • To really have little ability to EMPATHIZE with anyone else, because no one is EMPATHIZING with you;
  • Try to AVOID the REALITY of your BAD BEHAVIOR, because the Society REALLY CAN'T HANDLE THE REALITY OF YOU;
  • Try to avoid PUNISHMENT;
  • Etc.
                What if people who had "Mental Illness," Brain Injury, Developmental Disabilities, and people we label with "Personality Disorders" or just "Bad" or "Evil" -- were NOT PUNISHED, BUT WE DID MAKE PLACEMENT DECISIONS BASED ON SAFETY.
                 We would submit that our assumptions and presumptions are WRONG when it comes to people's ability to control "BAD BEHAVIOR."
                  The "Factual Basis"  of the crime is more often than not evidence that the person cannot effectively control his or her behavior.
                   With "NEUROPLASTICITY" there is hope and possibility [although not guarantee at this time] that the person could develop control over the "BAD BEHAVIOR."   
                     We think this is where the mental element of the crime or MENS REA needs to go in the 21st Century -- and we are already much of the way there.  
​
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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
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New Science is Amazing and it has huge moral implications NOW
It's Kinda Funny BUT Religious Folks May Be More Adaptable to the Changing Science than Our Mental Health Profession & Legal Systems
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CO Injustices & the Need for An Inclusive CO Olmstead-Stat  Addressing Among Many Other Things -- "Dangerous" Behavior

3/23/2018

 
            Human beings do terrible things and we do have to protect vulnerable people, ourselves, and our communities from dangerous behavior.
                 We do need to get really worked up about this to do what needs to be done.
                 But the ENERGY spent in punishing people for "bad" or "dangerous behavior" largely:
  • doesn't work,
  • is counter-productive,
  • often leads to additional trauma for people who already traumatized, and 
  • turns the perpetrators of some of the worst behavior into BIZARRO CELEBRITIES -- think Charles Manson.
​                     I think it is pretty normal to want to understand "Bad" or "Dangerous Behavior," and it is really a wonderful calling for those who try to provide treatment.
                      A serious problem comes when we don't have good treatments --- THEN WE REALLY DEMONIZE PEOPLE.
                       Further, we have come up with about a dozen pretty UNSCIENTIFIC PERSONALITY DISORDERS to register our DISGUST with certain behavior while @ the same time largely having LITTLE INSIGHT into appropriate treatment.
                        Well, what about that -- people who are behaving really badly and we don't have good treatments?
                          Is the logical conclusion that those people just belong in prison?
                          Well, that is and has been our conclusion for sometime in many cases [especially, regarding anything more subtle than florid psychosis]-- except, it doesn't work very well. 
                          It also doesn't work very well to have people who are abusing or harming family members or strangers in the community.
​                         What happens when somebody in the Criminal Justice System pretends to be "psychotic" for an incompetency to preceed or insanity evaluation?     
                           Well, most of the time they are NOT successful -- BUT in a few cases they are.
                           What happens when they have been in the hospital a long time, and they want to get out?  Typically, they are not released because they have a "mental defect."
                             So there's a lot more going on with people than what our Criminal Laws and Justice System will recognize as a defense.
                              AND we think that is because we're afraid people would get away with the crime.
                               The truth is there may be some people who are pretty seriously dangerous, we don't have good treatments -- and a term of years for an individual act of violence or depravity is really pretty disconnected from the long-term issues presented.
                               BUT does it logically follow that punishment is appropriate?  No, it doesn't logically follow that punishment is appropriate, BUT SAFETY is ESSENTIAL if we are going to have a healthy, vibrant community.
                               That means a much greater recognition of "invisible disabilities," the social determinants of health, and the mind-boggling immensity of factors affecting human behavior.
                                If you've got that recognition, you probably already know how important:
  • the Social Determinants of Health,
  • Community Mental Health,
  • Sophisticated therapy for Brain Injury,
  • Community Supports for People with Developmental Disabilities
  • the Integration of Physical & Mental Health
  • Communities that are Physically & Emotionally Accessible & Inclusive
  • Housing
  • Institutional Mental Health,
  • Supported Employment
  • Inclusive Olmstead Planning
​
---REALLY ARE.  Colorado is doing a lot, BUT not enough to prevent the incarceration of thousands of Coloradans with "Bad" or "Dangerous Behaviors"

              We can't ignore those behaviors -- but we can't ignore the injustices wrought be many of the sentences that are handed down in Colorado Courtrooms everyday. 

              We need to turn C-Stat into an Inclusive CO Olmstead-Stat and get @ the ROOT CAUSES of these problems.




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Kenisha Godin sentenced to 8 years for abandoning her children in a locked room for days.

https://www.denverpost.com/2018/03/19/kanesha-godin-child-abuse/
​
​
Crap Justice,
​ Crap Services
Personality Disorders
C-Stat



Above is a REALLY LONG video on a REALLY IMPORTANT topic -- the Neuroscience Behind Behavior.  Dr. Robert Sapolsky is a professor of biology, neurology and neurological sciences, and neurosurgery @ Stanford University:

  ​ "You are never really going to understand what is going on if you get it into your head that you're going to be able to explain everything with this is--
​
  • the part of the brain
  • the childhood experience
  • the hormone
  • the gene
  • or the evolutionary mechanism​
---That explains everything.

"It doesn't work that way.  Instead any behavior is the result of biology that occurred a second ago, hours ago, days ago -- a million years ago."
.  . . .

"O000h it's complicated.  Well, that's very useful. 

"How 'bout, 'OOOh it's complicated and you better be really careful and really cautious before you think you understand the causes of a behavior, especially if it's a behavior you judge harshly.' "

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

3/22/2018

 
          Certainly, two of the biggest historical scientific revolutions were the Copernican Revolution and Darwinian Evolution.
               Now, both those Scientific Revolutions really implicated our Religious beliefs.
                      The Scientific knowledge we're gaining regarding:
  •  "Immune-Gut-Brain Triangle" or the "Brain-Gut Axis,"
  • "The Functional Human Connectome,"
  • Biological Predispositions to Certain Harmful Substances
  • The role of discrimination in Harming Physical & Mental Health
  • The role of Trauma in Immune System Damage, and ultimately Cognitive Damage
  • Etc.
​
     --really implicate our Mental Health and Legal Systems -- and in many ways our Religious Beliefs are ahead of the game.

             The Neuroscience Revolution & the Microbiome Revolution, of course, may ultimately represent one of the great ironies of human history.

​                     As I mentioned in a previous blog, Ancient Greek Historian Thucydides saw the benefits of religion -- he also saw its downsides in Superstition and how that could play out in the Society.

                                 Well, the reality is "SCIENCE" is a lot more complicated than we often like to acknowledge and that was really one of the things that Philosopher of Science Thomas Kuhn demonstrated in his book, "The Structure of Scientific Revolutions" and further developing the concept of the "Paradigm Shift."

                                        From our perspective, the evidence has been around for some time that at the very least we were making pretensions to knowledge we couldn't possibly have, especially when it comes to understanding "bad human behavior."

                                               At the same time, we have to have safety. 

                                  The very real possibility that we are further traumatizing already traumatized people and further damaging their immune systems and their cognition -- may take the mental health & legal systems quite awhile to come to terms with.

                                 BUT our Religious folks may be able to do this much more quickly.  Are they the ones who are really ready for the 21st Century?
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Saint Augustine
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Robin Williams
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New Science Is Amazing & It has huge moral implications for our society -- now
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Pope Francis
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Religious Historian Karen Armstrong
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Arthur Schlesinger, Jr. -- great American historian who worked from 1939 to 2006 -- Wikipedia

Society, Religion, Science & Mental Illness

3/21/2018

 
              From my perspective, it's the SOCIETY that has some of the greatest responsibility for our current Mental Health Crisis.  AND that's VERY COMPLICATED with NUMEROUS FACTORS playing out UNIQUELY in INDIVIDUAL LIVES.       
             I think the role of "RELIGION" in SOCIETY and MENTAL HEALTH has always been COMPLICATED.
              In "The History of the Peloponnisian War," Ancient Greek Historian Thucydides really makes the case for the Crazy Glue of Religion -- that it binds a society together and it can tear it a part -- and I think the same could probably be said of Science when it comes to Modern Society.
               I think the Princeton Professors to the right are right when they identify that something is going on with the popularity of Evangelical religious denominations in the US-- but I think they have missed a lot.
                 First, evangelical denominations are NOT just gaining in popularity in certain parts of the US, but also Latin America.   Further, even Pope Francis has recognized that evangelical religions are offering people something the Catholic Church most recently has not.
                     Colorado is NOWHERE NEAR  as evangelical as my home state of Oklahoma -- in fact, Colorado isn't very evangelical as far as I can tell -- yet we have SKY HIGH SUICIDE RATES -- so how these factors play out in any individual community or person's life is REALLY, REALLY COMPLICATED.
                     i'm not evangelical but I know a lot of people who have been or are or converted -- and I can say that like most religions, most things, it's a "MIXED BAG."
                           One of my best friends in High School joined the Pentecostal Church, and it probably got him off drugs and saved his life.  Later, he ended up leaving a Bible College because they couldn't accommodate his questions. 
                            Further, two of my very best friends from College one of whom became my Maid of Honor-- go to a Humongous Southern Baptist Mega Church in Oklahoma and it's a really positive aspect of their lives, probably a crucial aspect of their lives.

                         Just to make things more complicated, Hyper-Religiousity is a part of some mental illnesses.  My mother-in-law who was diagnosed with Bipolar Disorder in her early 50s -- lived into her 90s, she and my father-in-law went to Mass every morning, they were active members of their Church, and my mother-in-law was even a lay member of the Carmelite Order of Nuns.
                          Now, even the Priests and Nuns would sometimes ask my mother-in-law if she needed to see the doctor due to some of her out there religious ideas.
                          Now my mother-in-law also had gut problems, specifically
 diverticulitis --inflammation of a diverticulum, especially in the colon, causing pain and disturbance of bowel function -- which often occurs after 40, according to the Mayo Clinic.
                       I'm really big into Philosophy and Logic and Science -- and, of course, LAW & EVIDENCE -- and that's really one of the reasons why my Husband married me.  And I was so DIFFERENT than his mother. 
                     Well, you know what ---in my mid-40s, I had a psychotic episode that included hyper-religiousity.  Well, as I went over the edge it almost sent my husband over the edge.
                         Of course, the other thing was that I have been a LIFE-LONG PICKY EATER, and unfortunately for me -- picky eaters tend to have a higher incidence of mental illness.  See 
Study says picky eaters are more likely to have mental health issues  .
​                         BTW, both my mother-in-law and I were valedictorians of our high school classes.

                        So when we see these things -- we're seeing SYMPTOMS -- we're NOT really seeing ROOT CAUSES.   And that is REALLY, REALLY IMPORTANT.
                             We've got to get to the ROOT CAUSES.
              It just simply is NOT IRRELEVANT that we have a DSM that addresses SYMPTOMS & NOT ROOT CAUSES.  
                    Not recognizing our lack of knowledge and pretensions to knowledge we don't have -- is doing so much harm in our society.
                           Maybe the religious and scientific folks in our society can fix it.
​                               
                                    
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 (Dr. Tom Insel, then head of the National Institute of Mental Health states the DSM-5 "lacks validity" :

              
"The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.

"In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.

"Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood thatsymptoms alone rarely indicate the best choice of treatment.

​"Patients with mental disorders deserve better.   NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system."

  https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

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"Does a decades-long rise in suicide among white Americans signal an emerging crisis for U.S. capitalism and democracy?

Nobel prize-winning economist Angus Deaton, and his wife, fellow Princeton Prof. Anne Case, share their provocative theory with Wall Street Journal's Jason Bellini in this episode.  

Altitude
Part of that theory contrasts Evangelicalism as an Individual pursuit of a relationship with Jesus with Catholicism and mainline Protestantism and more perceived communitarianism and the question is asked does this have anything to do with Suicide rates, etc.  -- From my perspective, this is pretty far off the track.
​BUT I have my own ideas that people might find off track -- and without sufficient RESEARCH & TRANSLATIONAL MEDICINE -- how do we know?

Are People in the Rocky Mountain "Suicide Belt" -- the Canary of the Carnaries in the Coal Mine because of Altitude?
Environmental Toxins
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Steven Morgan with Soteria Vermont:  We don't have this stuff figured out perfectly.

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Dr. Peter Attia, speaking in a TedMed Talk on Obesity science -- but we think equally relevant to Mental Health:

"Personally, I can't afford the luxury of arrogance anymore, let alone certainty."
TedTalk: Jen Brea on becoming progressively ill with myalgic encephalomyelitis, commonly known as chronic fatigue syndrome -- and the Medical Profession that had a hard time saying:  "I don't know."

We would submit that is very similar to Mental Health today.

​See 3:18:  Bipolar linked to the EXCEPTIONALITIES in the Humanities  -- above average, below average -- the main thing -- NOT AVERAGE.

       
     ---- Dr James MacCabe of the Institute of Psychiatry in London
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Social Determinants of Health
New Science is Amazing & It Has Huge Moral Implications -- NOW

Are We Seeing the "Failure of Elites To Do Their Jobs" on Olmstead?

3/19/2018

 
​ This Sunday morning on "Meet The Press," a "Politico" reporter ended the show with bemoaning the "Failure of Elites to do their jobs"  She was referring among others to the Ivy Leaguers @ Facebook.
      BUT we would submit, it is NOT just Ivy Leaguers and it is not just Facebook.
       We have many if NOT most State Governments that are "Failing To Do Their Jobs" on Olmstead.
         The Hickenlooper Administration could really DISTINGUISH itself by voluntarily  'Doing Its Job" on Olmstead with an Inclusive, Comprehensive, Effectively Working Olmstead Plan :
  • Measurable Goals 
  • Reasonable Time Frames 
  • & Funding to Support the Plan 
​
See related information on:
  • the 2011 US Department of Justice Guidelines on Olmstead, and Olmstead Plans;
  • the Minnesota Court Ordered Plan
  • Statements of the Federal Judge in the Minnesota Case;
  • the Rhode Island & Oregon Settlement agreements involving people with Intellectual Disabilities Bob Lawhead, Policy Advisor for the Colorado Developmental Disabilities Council, referenced below.
Minnesota's Olmstead Plan is Continually Being Updated
Minnesota's Olmstead Plan Subcabinet Created A Primary Committee on "Abuse & Neglect" & a Primary Workgroup on "Community Engagement"
Minnesota's Community Engagement Workgroup


Minnesota's Olmstead Workplan -- Updated Feb. 26, 2018


Minnesota's Olmstead Plan with "Measurable Goals" -- February 2017


​Lane v.  Brown (formerly Lane v. Kitzhaber)  (Oregon Supported Employment Case) (2015) Fact Sheet


Settlement Agreement in Oregon Case -- Lane v. Brown (2015)

PictureFederal Judge Donovan Frank
​"In a blunt ruling issued Wednesday, U.S. District Judge Donovan Frank said the state's revised blueprint — known as an Olmstead plan -- failed to meet his earlier demands for precision and measurable goals. The 158-page plan, nearly three years in the making and crafted with input from eight state agencies, has been revised three times without passing court muster.

"The decision is an embarrassing setback for Gov. Mark Dayton's administration and could delay efforts to improve access to community-based jobs and housing for thousands of Minnesotans with disabilities and mental illnesses."

"This order is a wake-up call," said Roberta Opheim, the State Ombudsman for Mental Health and Developmental Disabilities. "How long will [the state] continue to get by with noncompliance before the court requires them to pay a price?"

http://www.startribune.com/federal-judge-rebukes-minnesota-on-plan-to-reform-disability-services/302812441/

The above is a news article written prior to Minnesota's landmark Court-Approved Olmstead Plan with Measurable Goals.

There's a lot of education that needs to be done around these issues. 

One way or another we want to get to specific measurable or numeric goals and reasonable plans to bring housing and services to scale to meet the needs of people with disabilities who are institutionalized or at great risk of institutionalization such as homelessness.

United States v. Rhode Island (2014) Fact Sheet


United States v. Rhode Island (2014 ) Consent Decree

2011 US DEPT. OF JUSTICE GUIDANCE ON OLMSTEAD -- WITH THE REQUIREMENTS FOR MEASURABLE GOALS, REASONABLE TIME FRAMES, & FUNDING TO SUPPORT THE PLAN

Will We Ever Get Beyond the Hickenlooper Jive Talkin' on Olmstead?Inquiring Minds Want To Know

3/18/2018

 

Our March 16, 2018 E-mail to the Governor's Office

Thanks for your e-mail. I really get the sense that the Administration is not prepared to get down to brass-tacks on Olmstead Planning and do whatever can be done on:
• Measurable Goals
• Reasonable Time Frames 
• & Funding to Support the Plan

There is nothing wrong with providing “information” and “answering questions”—BUT we’re beyond that at least in some respects.

We want that information provision and question answering to take place in the context of a commitment to use this for an inclusive Olmstead Plan with:
• Measurable Goals
• Reasonable Time Frames 
• & Funding to Support the Plan

I think this Administration would generate enormous goodwill if they could make a commitment to do what the Law requires, namely an Inclusive, Comprehensive, Effectively-Working Olmstead Plan with:

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

We want to hear that the State is going to do more than information dissemination and answering questions.

It doesn’t look like the State is there yet, and this Administration is coming to a close.
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Jack Canfield is co-author of the "Chicken Soup for the Soul" series.

The Legal System, Trauma-Informed Care & The Living Hell of   Catch-22s

3/17/2018

 

   Author Joseph Heller popularized the term “Catch-22” in the book of the same name which he picked up in his experiences in World War II.
    Catch-22 is really a LIVING HELL.  If you’re an attorney --- you’ve probably been in many Catch-22s or LIVING HELLS, but you’ve probably been in a Catch-22 if you’re a human being – it’s a pretty common part of the Human Experience and operating in our imperfect societies and systems.
     So I think ONE of the Catch-22s of legal practice is that sometimes:
  • People exhibit behavior that doesn’t rise to the level of “imminent danger” BUT that behavior is nonetheless, pretty out there;
  • At least in some cases those behaviors are a result of abuse or other injustices [or it might be the result of a Brain Tumor, Sleep Apnea, it MIGHT be the result of A LOT of THINGS];
  • Now even in cases of extreme SOCIAL STRESS on the person, this can and often does affect the person BIOLOGICALLY.
  • So what’s an attorney to do – GET THE PERSON SOME HELP – we say as an ENLIGHTENED ATTORNEY.
  • BUT HERE’S WHERE THE CATCH-22 COMES IN
  • Taking away AGENCY & SOCIAL VIEW OF COMPETENCY increases SOCIAL STRESS AND MAKES THE PERSON WORSE.
  • Any talk of “TRADITIONAL OR NON-TRADITIONAL MENTAL HEALTH HELP” or a Limited Legal Representative, EVEN talk of a Limited Something with the Person Retaining Decisional Control – MAKES THE PERSON DEMONSTRABLY WORSE.
Well, how does this play out in the Criminal & Civil Justice Systems?
        Well, one of the big arguments in the “Mental Health Community” is are people with mental illness “PERPETRATORS” of crime or “VICTIMS” of crime and injustice. 
         Well, the sad is truth is they are well-represented in BOTH CATEGORIES and sometimes if not often in the same person.  VICTIMIZATION pretty predictably leads to TRAUMA and that can lead to a whole host of mental complaints, NOT just Post-Traumatic Stress Disorder (PTSD).
         This is why we need to have some PRETTY SOPHISTICATED TRAUMA-INFORMED CARE in both our Civil & Criminal Justice Systems.
 
          So a lot of VICTIMS of crime or some type of civil injustice never get their day in Court or Alternative Dispute Resolution Process – not only because they don’t have the money [which they don’t] but they often don’t have it together enough EMOTIONALLY for an attorney to work with them under many common PROFESSIONAL ETHICS RULES.
      
           Well what’s the attorney going to do?  Seek a Legal Representative?  Even talk of that makes the person much worse.  Even talk of a very Limited Something makes the person much worse.
            So I don’t have the COMPLETE ANSWER to this right now.  I do think it has a lot to do with a STRENGTH-BASED APPROACH, EDUCATING OURSELVES & OTHERS REGARDING THE LATEST SCIENCE, & LISTENING.
             As with most Catch-22s – this is where we need to PAY ATTENTION the most if we want to get out of our LIVING HELLS.
​
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Alan Arkin as Yossarin in "Catch-22"
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​Effects of Social Stress on Mental Health
  • "Social Stress Leads To Changes In Gut Bacteria" -- Georgia State University ​http://news.gsu.edu/2018/03/08/social-stress-leads-changes-gut-bacteria-study-finds/​
  • Social Stress & Addiction -- from the Journal of Neuropsychopharmacology, reported on mentalhealthtreatment.net.
​http://mentalhealthtreatment.net/blog/social-stress-addiction-connection/


The Gut & Microbiome
  • Gut microbiota’s effect on mental health: The gut-brain axis (2017) -- published in Clinical Practice.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/​​
  • ​A CU Boulder-led study showing that injecting beneficial bacteria into mice can make them more resilient to stress has been named among the “top 10 advancements and breakthroughs” of 2016 by the nation’s leading non-governmental funder of mental health research.

​Now, lead author Christopher Lowry, an associate professor in the Department of Integrative Physiology, is moving forward with clinical trials to see if altering the microbiome, or composition of resident bacteria, in military veterans with post-traumatic stress disorder can be beneficial.
​http://www.colorado.edu/today/2017/01/05/study-linking-beneficial-bacteria-mental-health-makes-top-10-list-brain-research​


Immune System & Mental Health
  • Mind and body: Scientists identify immune system link to mental illness -- University of Cambridge (2014)
​ http://www.cam.ac.uk/research/news/mind-and-body-scientists-identify-immune-system-link-to-mental-illnes 
  • Groundbreaking study links immune  system to mental health (2016) -- University of Sidney and Perth-based Charity Meeting For Minds [M4M], reported on Australian ABC News site.​ 
 http://www.abc.net.au/news/2016-05-27/mental-health-study-a-boon-to-patients-immune-system/7455310​
  • The Brain-Immune -Gut Triangle:  Innate Immunity in Psychiatric & Neurological Disorders (2013)  -- Oslo University Hospital & University of Debrecen, published in Current Immunology Reviews
https://www.researchgate.net/publication
/261994663_The_Brain-Immune-Gut_Triangle_Innate_Immunity_in_
​Psychiatric_and_Neurological_Disorders
  • Gut Bacteria Drives Auto-Immune Diseases (2018) Yale University --reported in the magazine "Science" and on the website Neuroscience News
​​http://neurosciencenews.com/gut-bacteria-autoimmune-disease-8614/
​
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I chose this cartoon by Matt Groening in his "Life in Hell" comic strip series as a metaphor for some our approaches in Mental Health.

But the fact is I can also relate to it quite literally.   My arms don't straighten completely and as a child I was taken to the Bone Specialist.

The Bone Specialist advised my parents that the medical staff could break my bones and re-set them -- but it probably wasn't worth it -- and advised my parents not to worry about it.  My parents thought that was pretty good advice -- and so do I.

Yet there was time when I was working as a Hostess @ a very popular Restaurant, Bar and Music Scene in Oklahoma City and an uncommonly disturbed patron asked me if I couldn't do something about my arms -- it was making it so he couldn't eat and proceeded to tell me what he thought had happened in the womb.

Well when I say "disturbed patron" -- who does he remind of -- my clients -- no -- many aspects of the Criminal Justice System -- YES.

There are things that aren't as innocuous as arms that won't straighten; nonetheless and maybe especially-- we need a strength-based approach.
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    Val Corzine
    Executive Director
    Orchid Mental Health Legal Advocacy of Colorado

    Out there on that neuro-diversity spectrum

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