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    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • 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
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • 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]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
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  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System

Transitional/ Translational Justice Monday





















Civil Commitment  in the context of Mental Health System Reform  ---Either a Total Red Herring or Not What You Think It Is

5/14/2022

 
A lot of mental health professionals and people in the Mental Health Center System --- think the ANSWER is to AMEND the CIVIL COMMITMENT STATUTES.

A lot of it is SELF-SERVING --- BUT there are quite a few people who have a GOOD FAITH BELIEF that CIVIL COMMITMENT REFORM or MODIFICATION is at least part of the answer to our MENTAL HEALTH CRISIS.


I spend a lot of time trying synthesize the latest research --- and there's a lot of "STUFF" we should be on top of --- that we're not --- such as the relationship between NEURO-DEVELOPMENTAL DISORDERS and PSYCHIATRIC DISORDERS.

BUT what is really telling is that we're not on top of an EVIDENCED BASED TREATMENT MODALITY that was developed for people with INTENSIVE MENTAL HEALTH NEEDS ---- 

In the 1970s

I'm talking of course about --- Assertive Community Treatment 

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Red Herring:  An Argument that Distracts you from the Real Issue.

In this case, Civil Commitment Distracts us from the Real Issue:  HUGE SHORTAGES of bed space, housing and intensive services and supported employment.

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Precision Medicine & Controlled Substances:  Marijuana & MDMA

4/27/2022

 
There is considerable NEED to RAMP UP Research on Controlled Dangerous Substances such as Marijuana and "ECSTASY"
  • to DIAL BACK some of the EXCESSES of "MARIJUANA" Legalization AND
  • make available MDMA / "ECSTASY" for PTSD.
Right NOW --- Mental Health is INCOMPETENT (in some respects) and is NOT UP on the LATEST RESEARCH BUT that is primarily because we have NOT provided sufficient TRANSLATIONAL RESEARCH & MEDICINE
AND we're often asking people to WAIT DECADES and DECADES when:What they are currently getting from Mental Health isn't that great (in some respects) --- AND
People are STILL NOT LIVING FOREVER --- even if some people are SUPER AGERSThat DEATH THING is STILL A THING.
We Need PRECISION MEDICINE --- what might "WORK" or be "HARMLESS" for one person --- could be HARMFUL for someone else.
ABC 10
How A First Responder Says MDMA Helped Him Get Past PTSD

Modulating NMDA Receptor Activity Is the Key to Successful Treatment of PTSD

April 16, 2022

Neuroscience News
The Efficacy of MDMA (3,4-Methylenedioxymethamphetamine) for Post-traumatic Stress Disorder in Humans: A Systematic Review and Meta-Analysis
Background: 3,4-methylenedioxymethamphetamine (MDMA), known recreationally as “Molly” or “Ecstasy”, is a triple monoamine reuptake inhibitor. MDMA specifically acts as a weak 5-HT1 and 5-HT2 receptor agonist, targeting 5-HT2A, 5-HT2B, and 5-HT2C receptors. Its potential use for therapeutic purposes with these pharmacological profiles remains a controversial subject.

Studies have shown the potential benefits in clinical trials for post-traumatic stress disorder (PTSD). A larger amount of data has been provided for the push in support of MDMA-assisted psychotherapy in these patients. 

Objective: The aim of this article is to compute a meta-analysis and conduct a systematic review of the effects of MDMA on PTSD, discussing the potential benefits and adverse events relative to dosing and stability of treatment.

Discussion: Findings show promising evidence for the potential therapeutic use of MDMA alongside psychotherapy in the treatment of PTSD. The pharmacological profile of MDMA may provide direction for future drug developments to treat patients with treatment-resistant psychiatric disorders.

Relevancy and the FULLNESS OF TIME

4/20/2022

 
Stephen Covey really put into HIGH RELIEF this distinction between EFFICIENCY and EFFECTIVENESS.
  • This has RAMIFICATIONS in the JUSTICE SYSTEM --- and many of us are familiar with the phrase:  "Justice Delayed is Justice Denied."
  • Further, I'm going to connect EFFICIENCY to TRADITIONAL EXECUTIVE FUNCTIONING.
    • It is important
    • It is important to the JUSTICE SYSTEM
 
  • The Justice System can be HIGHLY INEFFICIENT.
    • Colorado's ACCESS TO JUSTICE COMMITTEE is recommending greater use of TECHNOLOGY and SIMPLIFICATION of PROCEDURES.
      • As many engineers can tell you, the SIMPLER the PROCESS, often the MORE SOPHISTICATED the ENGINEERING.
 
  • On the other hand, the American Justice System while it  has its SUCCESSES --- has been a CAUTIONARY TALE to the WORLD.
    • It's taken a former KGB murderer who heads the Russian Government and has unleashed WAR CRIMES in UKRAINE to push the American Justice System off the RADAR SCREEN.
 
  • This may sound like AMERICAN EXCEPTIONALISM --- BUT the fact of the matter is we have a ROBUST HISTORY of WRESTLING with SOME COMPLEX PROBLEMS in the provision of Justice.
    • JUSTICE is NOT THE STATE of NATURE --- the STATE of NATURE is MIGHT MAKES RIGHT and the STRONG KILL THE WEAK.
 
  • One of the places where WESTERN JUSTICE tends to go OFF THE RAILS --- is ironically it's NOTION of RELEVANCY.  
 
  • I think we need to EXPLICITLY CONNECT our IDEAS of RELEVANCY with our IDEAS regarding DUE PROCESS OF LAW.
    • Of course, that is done ALL THE TIME --- BUT it seems to me we need a MORE SEAMLESS and DIRECT CONNECTION.
    • Both for purposes of EFFICIENCY and EFFECTIVENESS.
  

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Under Federal and State Rules of Evidence --- Relevancy is generally anything that would ASSIST THE TRIER OF FACT. 

See Federal Rule of Evidence Rule 401 (Test for Relevant Evidence) and 402
(
General Admissibility of Relevant Evidence)


 AND there is generally a caveat that the EVIDENCE can't be "UNFAIRLY" PREJUDICIAL (it can be "prejudicial" --- just not "unfairly prejudicial.")

See Federal Rule of Evidence Rule 403

(Excluding Relevant Evidence for Prejudice, Confusion, Waste of Time, or Other Reasons)

 So far, so good.
BUT what happens when you have a FACT that ---
  • Criminal Defendant Bob, Jesus or Jamal has a BRAIN INJURY or DEVELOPMENTAL DISORDER or SUBSTANCE ISSUE or PSYCHIATRIC DISORDER or HISTORY of CHILD ABUSE or TRAUMA.

ABC NEWS:  Top 20 "Whitest" and "Blackest" Names
FURTHER, what happens if you have EVIDENCE that MOST CRIMINAL DEFENDANTS have BRAIN INJURY, DEVELOPMENTAL DISORDERS, SUBSTANCE ISSUES, PSYCHIATRIC DISORDERS and HISTORIES of CHILD ABUSE or TRAUMA-----Significantly greater than people not involved in the criminal justice system and at more SEVERE LEVELS.
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"ALL OF A SUDDEN"  -- over many years and decades ---- Our notions of PUNISHMENT don't seem to comport with DUE PROCESS of LAW and FUNDAMENTAL FAIRNESS --- even as the SAFETY CONCERNS REMAIN.
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THIS does require the WISDOM of SOLOMON --- which we don't have BUT we are SLOWLY MOVING IN THE RIGHT DIRECTION.
UNDERSTANDING that many of the "FACTS" of Cognitive Disability that we write off as "IRRELEVANT" and "NO EXCUSE" ---
  • Are actually highly relevant and
  • Would be much more EXPLICITLY THE SUBJECT MATTER of a PUBLIC HEALTH APPROACH TO CRIMINAL JUSTICE.

NEURO-DIVERSE ACCOMMODATIONS --- ACCOMMODATING NON-TYPICAL COMBINATIONS of STRENGTHS and WEAKNESSES.

4/5/2022

 
CONJECTURE

This is really about MINORITY RIGHTS and PEOPLE with COMPLICATED COMBINATIONS of STRENGTHS and WEAKNESSES that can be on opposite ends of various SPECTRUMS ----

  • ​For Example, Frank Sinatra or Einstein or Sylvia Plath
  • Often we think of Ethnic and Racial Minorities, Gender and LGBTQ+ Rights when we think of MINORITY RIGHTS 
 
  • Neuro-Diversity cuts across​ these CATEGORIES.
​
  • Because Neuro-Diversity directly implicates COGNITION and EMOTIONAL REGULATION it is important to UNDERSTAND.
    • ​It also often comes with some BIG STRENGTHS in one or more areas. 
 
  • There generally are challenges in EXECUTIVE FUNCTIONING and EMOTIONAL REGULATION
    • ​The Ramped Up Sensory Processing that is fueling the perception of some of these STRENGTHS is also fueling the perception of these CHALLENGES.
 
  • The STRENGTHS and WEAKNESSES are TOO INTEGRATED to address UNCONCIOUSLY or INDIRECTLY.
    • ​Trying to RAM that Round Peg in a Square Hole can create more problems than it solves.  ​​
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The idea of "FLOW" is based on a BALANCE of STRENGTHS and WEAKNESSES.

When you or someone else is coming in a more UNUSUAL COMBINATION of STRENGTHS and WEAKNESSES --- that BALANCE has to be achieved MORE CONSCIOUSLY.  

We do know ourselves in part by our observation of OTHERS --- BUT if we have significant differences --- we may have a hard time understanding what we need and standing up for ourselves------ and others may have a hard time understanding what we need.

Mihaly Csikszentmihalyi --- "FLOW"

FLOW:  A BALANCE OF "CHALLENGES & SKILLS"
You Won't Have To Worry About Lazy Adults if you go with the flow
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Platypus --- An Animal So Strange ---- It Almost Doesn't Look REAL.
  • We do need EXPERTS that can address these issues from an ACCOMMODATION STANDPOINT
    • Working just on the TRADITIONAL EMPLOYMENT end --- may not always work.
    • Neuro-Diverse people are quite frankly often needing a lot of things REASONABLY ACCOMMODATED and INDIVIDUALLY TAILORED.
      • ​The LAW provides for it so long as it is "REASONABLE"--- but asking the INDIVIDUAL to fight that BATTLE is sometimes not realistic and it can result in a PYRRHIC VICTORY ---- you won the battle but you lost the war --- you're still in a HOSTILE WORK ENVIRONMENT.
        • ​AND for people SENSITIVE to their ENVIRONMENTS & STRESS --- that is not going to be a good thing.
​
  • ​Incentivizing Entrepreneurs to Incorporate Neuro-Diverse people in the work force is a possible option.
 
  • Some technically minded Neuro-Diverse are IN DEMAND in HIGH TECH --- BUT not all Neuro-Diverse people are technically minded.
​
  • We are talking about how to INCENTIVIZE people to broach the LEARNING CURVE of NEURO-DIVERSE ACCOMODATIONS.
 
  • A lot of Neuro-Diverse people  assumed the UNBALANCED VIEWS of THEMSELVES reflected in others.
 
  • Once Neuro-Diverse people get that HARD WON more BALANCED VIEW of themselves with COMPLICATED STRENGTHS and WEAKNESSES --- that can drive a lot of improvement, too.
 
  • Supported Entrepreneurship is  important.
 
  • ​The WORKFORCE SHORTAGE is an INCENTIVE to get on that LEARNING CURVE to TAP into the STRENGTHS of Neuro-Diverse people without BURNING THEM OUT.   ​​

When I refer to "Neuro-Diverse" --- I am generally referring to people who fall within current categories of ADHD, Autism, Gifted and Dyslexia or other Neuro-Developmental Conditions often:
  • Sharing Some Genes
  • ​Often subject to Maternal Immune Activation during Pregnancy
  • Possibly Ramped Up Epigenetic Positive Feedback Loops, 
  • Increased Sensitivity to the Environment --- that is probably once again related to this Ramped Up Sensory Processing.
  • HYPER-CONNECTED BRAINS

They tend to be more VULNERABLE to PSYCHIATRIC DISORDERS. 

JUSTICE, IGNORANCE & the BIOLOGICAL BASIS of BEHAVIOR

3/24/2022

 
We use our MORAL and ETHICAL JUDGMENTS to protect ourselves --- BUT those JUDGMENTS look very different across time ----
  • often based on NEW INFORMATION, or
  • MORE THOROUGHLY INTEGRATING EXISTING INFORMATION.

Some of this is INTEGRATING the Poetic Understanding of a Seamus Heaney with the BIOLOGICAL BASIS OF BEHAVIOR --- the "STREAM OF LIFE" we all find ourselves in.

The "INTEGRATIVE COMPLEXITY" of that "STREAM of LIFE" is putting PRESSURE on our current systems.

It has put pressure on systems in the past and it probably will continue to do so in the future --- since comprehension of this "STREAM OF LIFE" is not currently fully within our grasp.

In 2022, we're much more AWARE of :
  • Neuro-Developmental Differences and Disabilities
  • Neuro-Psychiatric Disabilities
  • Substance Issues, and
  • Brain Injuries as well as Brain Tumors and Lesions 
as affecting Human Behavior and for that matter the behavior of other animals.

Something that is poised to change our concept of the Human Being ---- MICROBES that are NOT HUMAN that appear to be ESSENTIAL for NORMAL HUMAN BEHAVIOR and for the behavior of other animals.

What is JUSTICE in such a "STREAM OF LIFE" --- ?
Seamus Heaney reading
St. Kevin & the Blackbird ---

"in love's deep river"

Cognitive Changes in Patients with Brain Tumors 
​ Memorial Sloan Kettering
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Michael Specter is an American journalist who has been a staff writer, focusing on science and technology, and global public health at The New Yorker since September 1998.  He has also written for The Washington Post and The New York Times. ---Wikipedia

Law & Reason as a BRIDGE between Science and Faith

3/24/2022

 
​The Problem of a Mitigating Discipline based on a Scientifically Invalid Diagnostic Manual
When we think about the great intellectual problems of the last several hundred years --- the conflict between SCIENCE and RELIGION is right up there and RELIGION has sometimes shot itself in the foot by its REFUSAL to acknowledge the AMAZING DISCOVERIES of EMPIRICAL SCIENCE.

BUT in MODERN TIMES, we have an AMAZING FAITH in Empirical Science as the ANSWER to Every Question.

And in FAIRNESS --- maybe EMPIRICAL SCIENCE is NEEDED for many if not most questions.

BUT we've gotten ourselves into quite a CONUNDRUM because SCIENCE is often LAGGING BEHIND ---and sometimes FAR BEHIND ---- the demands to make MORAL and ETHICAL DECISIONS in the MOMENT.

In fact, EMPIRICAL SCIENCE may be LAGGING DECADES or MORE BEHIND our need to make those DECISIONS and in fact EMPIRICAL SCIENCE  may be LAGGING BEHIND one or more GENERATIONS.

So when we look at our use of MENTAL HEALTH KNOWLEDGE and LACK THEREOF in the Criminal Justice System --- IT IS A MESS:
  • We've put all our "FAITH" in Empirical Science ---
    • But the DSM 5 is scientifically invalid at least according to pronouncements from the National Institute of Mental Health in 2013.  
    • Further, over 600 Research Institutions have found that genes are shared across diagnostic categories and the DSM categories do not appear to coincide with EMPIRICAL RESEARCH and SCIENCE.

Well --- the ANSWER is we need MORE EMPIRICAL  RESEARCH and SCIENCE --- In fact, that is one of the RIGHT ANSWERS --- the only problem is IT IS NOT SUFFICIENT to address our CURRENT PROBLEMS.

The LAW and Public Policy have been surprisingly SLOW in using "REASON" to make REASONABLE DEDUCTIONS and INFERENCES regarding:
  • the Biological Basis of Behavior, and
  • the Biological Effects of "Environment"


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​As well as the need in some to many cases to get beyond PUNISHMENT for INDIVIDUAL BAD ACT or BAD INTENT and move to a Public Health Approach that can handle BAD ACTS and BAD INTENT stemming from CHRONIC CONDITIONS such as:
  • Neuro-Developmental Disorders
  • Psychiatric Disorders
  • Brain Injury, and or
  • Substance Issues that are often related to one or more of the above.​

Is "REASON" needed as a BRIDGE between our "FAITH" in Empirical Science or our Religious and Spiritual Beliefs?

​I would maintain that "REASON" is needed as a BRIDGE to BOTH.

Justice and the Need to Get Beyond Crisis Management  ---  For the Benefit of the Community, Individuals & First Responders

3/15/2022

 
One of the points I've tried to make is --- this is a lot more complicated than Neuro-Developmental and Psychiatric Disorders within the Justice-Involved Population --- which are absolutely there.

The COMPLICATED REALITY is those Neuro-Developmental Issues and Psychiatric Issues can also exist among the FIRST RESPONDERS and Health and Legal Systems that are serving and protecting our communities everyday.

So some form of ADHD in that Emergency Room Doc, Paramedic, Police Officer, Criminal Defense Attorney or Prosecutor is more par for the course than we often realize --- and they themselves are quite vulnerable to PSYCHIATRIC DISORDERS and SUBSTANCE ISSUES. 

Further, some in the Health and Legal Systems MAY BE MORE VULNERABLE because they're NOT EXPECTING  to deal with these issues and may not realize that their "STRENGTHS" are often coming with some underlying vulnerabilities.

When we focus so much on CRISIS MANAGEMENT rather than a more ROOT CAUSE ANALYSIS ---- that makes it hard for everyone.

We can't ignore the CRISES --- but providing SUBSTANTIAL SUPPORT up front in the form of :
  • Supportive Housing
  • Intensive Services, and
  • Adequate Staffing

could go along way to REDUCING CRISES ---- ACROSS THE BOARD.



​

​
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​What is a good career for someone with ADHD?

EMTs, police officers, and firefighters must work well under pressure and make split-second decisions. These jobs allow you to work in a variety of settings, while providing the kind of adrenaline-pumping excitement that helps many individuals with ADHD focus their minds.  Feb 2, 2021


16 Good Jobs for People with ADHD - ADDitude
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University of Montana
In this study, firefighters had more than four times the prevalence rate of ADHD that has been identified in the general adult population in previous research.

Wildland Firefighters and Attention Deficit  Hyperactivity ...  ​
The Big Kahuna: Neuro-Diversity is a Big Source of "Mental Illness"

Burnout in Law, Mental Health, Law Enforcement --- "Boundaries" ---and the Need for Leaders and Policymakers to Continue with SYSTEMIC REFORMS

2/10/2022

 
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World Health Organization says burnout may deserve medical attention
Is there a high burnout rate for lawyers?

Lawyer burnout is a growing but long-standing issue in the legal industry that over the past few years has become normalized and talked about in the open more often. ... With more legal professionals working remotely, it's harder than ever to create boundaries, and burnout is at an all-time high.  Sep 9, 2021


Why Lawyer Burnout Is Still An Issue in 2021 - National Law ...
Mental Health Providers and Burnout

​Studies estimate that anywhere between 21 percent and 61 percent of mental health practitioners experience signs of burnout (Morse et al., 2012).  Burnout has been associated with workplace climate, caseload size and severity of client symptoms (Acker, 2011; Craig & Sprang, 2010; Thompson et al., 2014).   Jan 25, 2018

Research roundup: Burnout in mental health providers - APA ...
Law enforcement burnout
​
​Burnout begins when a police officer who was originally enthusiastic about the job begins to respond to the frustrations of police work in such ways as resenting superiors, drinking too much while off duty, experiencing problems at home, and ceasing to take the initiative on the job.

Burn Out - 'No One Can Imagine What the Costs Really Are'
See also:
Intensity & Burnout in Autism, ADHD & Giftedness

There's a lot of OVERWHELM in our SYSTEMS. 

From my standpoint --- "HE WHO SHALL NOT BE NAMED" --- is our TREATMENTS are often NOT MAGIC BULLETS.

Further, its becoming more and more apparent why our treatments for PSYCHIATRIC DISORDERS are NOT MAGIC BULLETS:
  • The person is often dealing with an underlying NEURO-DEVELOPMENTAL DISORDER involving NEURO-DEVELOPMENTAL INFLAMMATION and DYSREGULATION of MULTIPLE SYSTEMS of the BODY.
  • Further, there's widespread low-grade inflammation throughout the population.

For attorneys and law enforcement --- there's a big need for Leaders and Policymakers to modify systems to move away from "US vs. Them" Thinking.
  • Problem Solving Courts have been a part of that effort.
  • There's actually if not UNIVERSAL AGREEMENT, pretty close to it that we have to have:
    • ​COMMUNITY SAFETY, and
    • HUMANE TREATMENT

For MENTAL HEALTH PROVIDERS, they need more SUPPORT from:
  • Translational Research Efforts
  • Epidemiologists
  • The Nation's Research and Teaching Hospitals

For attorneys, mental health providers, and law enforcement --- just because the numbers went up or the acuity level went up ----
  • DOES NOT MEAN THAT ANYONE GOT ANYMORE "BANDWIDTH"
  • We are BURNING PEOPLE OUT LEFT AND RIGHT 
    • ​We have to gain GREATER AWARENESS of what we are really asking of people ---
    • As much as our HELPERS WANT TO HELP --- THEY HAVE LIMITS, TOO.

For REAL PROBLEM-SOLVING (rather than just a MOUNTAIN OF PAPERWORK) --- we have to invest TIME and RESOURCES to do that.

Further, we need our LEADERS and POLICYMAKERS to establish ON-GOING INCLUSIVE PROCESSES with ACCOUNTABILITY so we can get to VIABLE SOLUTIONS and further SYSTEMIC REFORMS.

LIKE AN INCLUSIVE  OLMSTEAD PLANNING PROCESS with:
  • Measurable Goals
  • Reasonable Time Frames, and
  • Funding to Support the Plan

In-Groups and Out-Groups, the PAIN of SOCIAL ANIMALS & the POWER to DEFINE

2/7/2022

 

What those impractical philosophers and more pragmatic lawyers understand:  How you DEFINE something often dictates the outcome.

When it comes to DEFINING our In-Groups and Out-Groups --- we're starting to realize that there's a certain NEVER-ENDING QUALITY to the MULTITUDE of these CATEGORIES.

Right now we're grappling with NEURO-DEVELOPMENTAL DIFFERENCES, PSYCHIATRIC DISORDERS and BRAIN INJURIES in the Criminal Justice System and the Society as a whole.

This is a SCARY discussion given where humans have been on GENOCIDE and EUGENICS.

​It's been quite a long process of considering INDIVIDUAL CATEGORIES of DIFFERENTIATION.

Neuro-Diversity is a MIXED BAG --- BUT we're all MIXED BAGS --- it's just easier to SEE  the further out  you get on one of many SPECTRUMS --- OR GROW UP & MATURE.  
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​Leaked Amazon memo shows how it forces out employees to hit targets (April 2021)
PBS -- The Brain with David Eagleman
In-Groups and Out-Groups

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Insights From fMRI Studies Into Ingroup Bias (2018)
​Intergroup biases can manifest themselves between a wide variety of different groups such as people from different races, nations, ethnicities, political or religious beliefs, opposing sport teams or even arbitrary groups.

In this review we provide a neuroscientific overview of functional Magnetic Resonance Imaging (fMRI) studies that have revealed how group dynamics impact on various cognitive and emotional systems at different levels of information processing.

We first describe how people can perceive the faces, words and actions of ingroup and outgroup members in a biased way.

Second, we focus on how activity in brain areas involved in empathizing with the pain of others, such as the dorsal anterior cingulate cortex (dACC) and anterior insula (AI), are influenced by group membership.

Third, we describe how group membership influences activity in brain areas involved in mentalizing such as the medial prefrontal cortex (mPFC) and temporoparietal junction (TPJ).

Fourth, we discuss the involvement of the lateral orbitofrontal cortex (lOFC) in increased moral sensitivity for outgroup threats.

Finally, we discuss how brain areas involved in the reward system such as the striatum and medial orbitofrontal cortex (mOFC), are more active when experiencing schadenfreude for outgroup harm and when rewarding ingroup (versus outgroup) members.

​The value of these neuroscientific insights to better understand ingroup bias are discussed, as well as limitations and future research directions.
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​I remember when I first heard of the Greek practice of OSTRACISM --- it just didn't seem like that big a deal.


Keeping Up with the Research --- the REALITY SHOW We Shouldn't Miss

1/25/2022

 
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Keeping Up With the Kardasians 

​Keeping Up with the Research is no easy task & our current systems aren't doing it.
​The Future of Psychiatry and Neurodevelopmental Disorders:

A Paradigm Shift
 (2019)
​The current understanding of these disorders, intellectual disability, ADHD, autism, Asperger’s syndrome, tics, etc., is a neurodevelopmental disorder with schizophrenia and bipolar disorder also being neurodevelopmental, and all have significant neurobiological inputs.

Some personality disorders should also be considered as being on the neurodevelopmental spectrum.

​The neurodevelopmental trajectory will include the addition of more neurodevelopmental disorders, e.g., bipolar, schizophrenia and depression as the person gets older
​Part of more ACCOUNTABILITY for the Public Mental Health System is going to be the somewhat UNCOMFORTABLE recognition of the high CO-MORBIDITY between NEURO-DEVELOPMENTAL DISORDERS & PSYCHIATRIC DISORDERS.

  • What does that mean for SERVICE DESIGN?
 
  • Does it help explain why the Mental Health Centers have been such a DISASTER?  
Further, while genes are important --- Maternal Immune Activation may be more illuminating.
  • ​Additionally, SOCIAL BEHAVIOR as a delicate balance between INNATE and ADAPTIVE IMMUNITY --
  • Might help explain the "OVERCITABILITIES" in giftedness  and the mental and physical health problems associated with the Hyper Brain, Hyper Body. 
Additionally, the UNCONSCIOUS BIAS that seems to be rampant in our descriptions and surface understandings of Gifted Overexcitabilities, Sensitivity and Reactivity...
​
  • WHO is exhibiting the behavior and where they are in the SOCIAL HIERARCHY is a part of how the society is REACTING to the behavior.
And that is DE-STABILIZING things even further.
​
  • People at the BOTTOM of the SOCIAL HEAP are suffering more 
  • ​Low social status 'can damage immune system'  --- BBC News

  • Big Think --- Jordan Peterson --- Inequality & Hierarchy Give Life Its Purpose
Further, those "shared genes" across psychiatric disorders are often going to the immune system and epigenetics.
Perhaps most challenging, these NEURO-DEVELOPMENTAL DISORDERS and PSYCHIATRIC DISORDERS are represented throughout the population.
  • ​The DIAGNOSTICS and TREATMENTS are in need of improvement for everyone ---
  • The truth is NEURO-DEVELOPMENTAL DIFFERENCES are not all bad, but if you and everyone around you DON'T HAVE A CLUE -- it can get a lot more than BAD.
Picture

​The lost girls: ‘Chaotic and curious, women with ADHD all have missed red flags that haunt us’

After multiple burnouts, in my early 30s I finally knew why life sometimes felt harder for me. It made perfect sense, so why had no one noticed before?  (2020)
I'm not sure ADHD and other NEURO-DEVELOPMENTAL DISORDERS are so obvious especially given assumptions regarding developmental disabilities and intelligence ---- and the fact that many people are quite BLURRED versions of the DSM 5 diagnostic categories. 
  • That is one of the BIG INSIGHTS of the 21st Century
REFORM of MENTAL HEALTH has to include SUPPORT to TRANSLATE these new understandings and paradigms into IMPROVEMENTS in:
  • Diagnostics
  • Treatments, and
  • Systems
A BIG PART of this is CONSCIOUSLY addressing SENSITIVITY & REACTIVITY and the IMMUNE MEDIATED SENSORY PROCESSING OVERLOAD that is often behind it.

A link between sensory neurons activation and the immune system (2020)

Migraine as a Sensory Processing Disorder and an Inherited tendency to lose control of inputs.  


Medical News Today:
What to know about ADHD and sensory overload  (Sept. 2021)


What I and the author of the Guardian article know ---
​Mental Health is FAR OFF TRACK -- and some of us have paid a big price for that.
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    Transitional Justice is a term used by the United Nations and others to describe measures to REDRESS MASSIVE VIOLATIONS of HUMAN RIGHTS.

    ​​Translational Justice as we're using it refers to a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE and is meant to echo TRANSLATIONAL MEDICINE.

    ​
    Translational Justice also means listening to those people impacted by our justice policies

    That means going 360
    ° -- that's hard work
    ​



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