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Transitional/ Translational Justice Monday





















Huntington's, Standing Out & the biological basis of behavior

1/18/2022

 
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Tale regarding Dr. Vince Gilmer convicted of murder and ultimately found to have Huntington's.  [Dr. Gilmer and Mr. Hyde]

Huntington's is relatively rare in the Criminal Justice System BUT it is there. 

Folk Singer Woody Guthrie had Huntington's and found himself in the Criminal Justice System although on much less serious charges.  He was diagnosed with Huntington's in 1952.


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A few years ago in Colorado, there was a man who was in one of the County Jails who not only had Huntington's but was Deaf ---- and pretty much everyone knew this man did not belong in the County Jail --- BUT the System didn't have a place for him.

One of the ways that the System knew --- He shouldn't be in Jail --- he was DIFFERENT ENOUGH to STAND OUT.


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For a lot of people who have NEURO-DEVELOPMENTAL DISORDERS such as ADHD --- that's a DIME a DOZEN in the Criminal Justice System --- :
  • So often we don't appreciate its significance, OR
  • We're AFRAID to appreciate its significance 
    • We see the Neuro-Developmental Disorder ADHD as related to Conduct Disorder and Anti-Social Personality Disorder
    • BUT we can't bring ourselves to acknowledge the BIOLOGICAL BASIS of ANTI-SOCIAL PERSONALITY DISORDER.
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Further, our Mental Health Professionals are TOO PRO SOCIALLY COMPETENT or more to the point NOT PEOPLE WITH THE RIGHT SKILLS  to QUESTION --- underlying assumptions.
  • At one point, I did think --- HOW CAN THESE PEOPLE MISS THIS --- the BIOLOGICAL BASIS of BEHAVIOR --- they're Doctors and Ph.Ds --- come on . . .
  • But missing it they are and generally it's Good Faith miss. 
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The story in the This American Life episode highlights the "process" we're using to address these issues ----
  • ​​We've got to find the SPECIFIC DIAGNOSIS in time for this SPECIFIC PERSON
  • In the meantime, we're PUNISHING this SPECIFIC PERSON as well as others.
  • ​It's a RACE WITH THE CLOCK & the CALENDAR.

Could we cut through all that if we could recognize the BIOLOGICAL BASIS of BEHAVIOR --- yeah, we could.
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Most of these horrific cases could be avoided if we could accept the BIOLOGICAL BASIS OF BEHAVIOR.
  • If that is a given --- and to some people including myself it seems REASONABLE to assume that until proven otherwise ---
  • Then we're not getting HUNG UP in the CRIMINAL JUSTICE SYSTEM on the SPECIFICS of that BIOLOGY at the initial determination of whether the person did the acts charged. 
"I've been havin' some hard travelin' ---
I thought you knowed."
I think the "Free Will vs. Determinism" debate gets us so OFF TRACK --- BUT I keep posting this video because at 1:45 Sapolsky says this:

"When you look at the number of things that we recognize now as biological --- organic -- where 500 years ago or 5 years ago we would have had a harsh moral judgment about it.

"Instead we now know oh that's a biological phenomenon.

"When we look at that, either we can say that the last 500 years of realizing  all of this biology is going to stop right here and there's never going to be a new piece of knowledge in that area ----
​"Yeah, there's areas of behavior we still can't explain biologically..

"But if all you can do is see the logical direction of where we're going with that is what we're going to get to the point of recognizing yeah, we're biological organisms. . ."
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Where the "Free vs. Determinism Debate" gets OFF TRACK --- it is running in the WRONG DIRECTION.
  • So we tend to LOOK TO THE PAST --- and say "Hey, there are all these BIOLOGICAL FACTORS and ENVIRONMENTAL FACTORS affecting BIOLOGY --- 
    • ​Therefore, there is NO FREE WILL.
 
  • At the same time (roughly), we're SLOWLY:
    • ​Learning to control our Environments
    • Learning to control our Biologies
    • Learning to peel away UNCONSCIOUS thought processes
    • Using CRITICAL THINKING to understand more COMPLICATED and INTEGRATED REALITIES.
 
  • What is becoming APPARENT is --- WE ARE NOT AS FAR ALONG AS WE THOUGHT WE WERE.
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We're handing DIAGNOSIS & TREATMENT to EXPERTS within the PUBLIC HEALTH SYSTEM.
  • Where DIAGNOSIS & TREATMENT are more appropriate and FAR FROM PERFECT.
  • BUT it doesn't have to be PERFECT if we understand the BIOLOGICAL BASIS of BEHAVIOR (this is for the purposes of moving away from PUNISHMENT)--
    • If we don't understand the BIOLOGICAL BASIS of BEHAVIOR --- our reasoning is laborious and convoluted --- AND most importantly --- some DISFAVORED PERSON is paying the price of our IGNORANCE.
    • Is this person also going to PAY A PRICE if we don't have the right "DIAGNOSIS" or "TREATMENT" --- Yes, BUT we are MITIGATING the often HORRIFIC EFFECTS of a PUNITIVE SYSTEM that is often not SUFFICIENTLY HUMANE or SUFFICIENTLY PROVIDING FOR SAFETY.
      • ​Additionally, it is important to emphasize that this is MITIGATION and it doesn't replace the need for better DIAGNOSTICS and TREATMENTS.
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Further, we're MONITORING Treatment and Placements to ensure that they remain APPROPRIATE --- but this is more a PROCESS than an EVENT.

Finally, we're able to handle the INTEGRATIVE COMPLEXITY of INTENT that is BIOLOGICALLY DRIVEN.

The COURAGE & KNOWLEDGE to ADDRESS BIG SHORTAGES

1/14/2022

 

Understanding Psychiatric Disorders as Disorders of the Neuro-Developmental Continuum does seem like a BIG STEP UP.

Understanding that much of what we're trying to address are challenges in Executive Functioning, including Emotional Regulation --- but not limited to Emotional Regulation seems like a BIG STEP UP.  

Understanding that NEURO-DIVERSE INDIVIDUALS are bringing STRENGTHS to the table not just EXECUTIVE FUNCTIONING CHALLENGES seems like a BIG STEP UP.  

Understanding that NEURO-DIVERSE People tend to be CLUSTERED at the TOPS and BOTTOMS of SOCIETIES makes this COMPLICATED.  

THAT KNEE ON YOUR NECK PROBABLY BELONGS TO SOME OTHER NEURO-DIVERSE PERSON. 
​
​One of the things that I've found in this JOURNEY is that ONE FUZZY IDEA is connected to ANOTHER FUZZY IDEA in our SOCIETY.  So:
  • Criminal Intent
  • Anti-Social Personality Disorder
  • Unconscious Bias
  • Societal Hierarchies
  • NEURO-DEVELOPMENTAL "DISORDERS" and their relationship to PSYCHIATRIC "DISORDERS"
  • Trauma
  • Intergenerational Trauma
  • The Biological Basis of Behavior and its CONNECTION to Environment
  • Pro Social Competency Religion that it appears the Mental Health Profession has used to fill in quite a few gaps as PSYCHOTROPIC MEDICATIONS were not the ANSWER to EVERYTHING.
  • STRENGTHS and WEAKNESSES can be MORE ASYNCHRONOUS than we've recognized,
    • ​So someone like myself --- I need support in areas of organization that some people might be surprised about --- people who know me wouldn't be surprised at all.
    • On the other hand --- my abstract thinking skills are high and I do know a lot just as result of that NEURO-DIVERSITY --- of course --- it's NOT perfect.
Jacob Bronowski's  Ascent of Ma​n (1973)

​Knowledge or Certainty
ORCHID'S 2022
CO COGNITIVE
​DISABILITY 2-PAGER
​BOTTOM LINE:  Colorado and other States need to get on with it and adopt REASONABLE PLANS with MEASURABLE GOALS to address BIG SHORTAGES.
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​‘I am my brother’s keeper’, Philonise Floyd tells UN rights body, in impassioned plea for racial justice
As much as I love Science, it is holding this society HOSTAGE in LAW and PUBLIC POLICY --- as it has set itself up as the ONLY WAY of KNOWING.
  • ​Ironically, SCIENCE has been able to do this because of RELIGON's CLAIM to INFALLIBILIBITY --- it's not hard to prove that wrong, BUT
  • EMPIRICAL SCIENCE has a hard time keeping up with the MORAL CUNUNDRUMS complex societies are facing.   
If we want to call it MORAL REASONING that's fine --- it is greatly informed by various religious and philosophical traditions --- and if we were using it ----
  • ​We probably wouldn't be the MOST INCARCERATED COUNTRY IN THE WORLD.

HOTEL VOUCHERS ---and the Need for WRAP-AROUND SERVICES & SUPPORT

1/11/2022

 
​A Cautionary Tale from Vermont and a Solution in Canada
​Will Vermont hotels accept state vouchers for homeless?
​Vancouver Intensive Supervision Unit --- Finding the Person within the Illness
At 1:40 :  "What's innovative about VISU is our more grassroots approach to working with the community.

"We offer a guarantee to our community partners that if they work with our clients, if they take them into their buildings to house them, if there ever is a problem . . . they can call us and we will be immediately responsive."


The Vancouver Intensive Supervision Unit is connected with the Court System there --- when we're talking about people who are Homeless something like 24/7 Housing Support Unit would be more appropriate.   
​
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​Nov. 19, 2021
​RUTLAND, Vt. (WCAX) - Hundreds of homeless people are now eligible for 100 days of shelter in Vermont hotels under the state’s newly expanded emergency housing program, but can they get a room?

Under pressure from advocates -- and extended help from FEMA -- the state announced last week it would open the doors of its emergency hotel program but the state says there are at least six times more people in need of help than before the pandemic and at least some of the hotels that opened their doors last year aren’t willing to do so now.

Video on social media shows the condition of the Holiday Inn in Rutland as the hotel was cleaning up from its participation in the state’s homeless hotel program.

Staff at the hotel say rooms sustained serious damage during the months the hotels were taking state vouchers that paid for homeless people to live there.

Renovations are also underway at the Quality Inn in Rutland. The owner of both hotels said they will not be accepting vouchers at this time and are still working on a plan by next month.

The Ethical Issues in Mental Health & Law --- Greatly Exacerbated by BIG SHORTAGES & Failure to Provide Self-Determination in Evidence-Based Treatments

12/30/2021

 
Generally when we say someone is REFUSING Treatment -- it is a narrow slice of what is actually considered EVIDENCED-BASED TREATMENT.

Further, one could just go with what is on the SAMHSA website and that is much more than is available to most patients.
​

This argument is NOT going to solve all the issues out there BUT --- it could solve more than we're acknowledging.
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So ethical conundrums of Healthcare Professionals and Lawyers are CHEAPER than ADDRESSING the BIG SHORTAGES in Housing & Intensive Services for People Experiencing  Significant Cognitive Disability.
  • ​But those ETHICAL CONUNDRUMS are also NEVER ENDING if we fail to deal with the REAL ISSUES:
    • ​The need to address BIG SHORTAGES,
    • Provide rights of Self-Determination in selecting Evidenced-Based Treatments where possible, and
    • Provide STRENGTH-BASED Approaches for Neuro-Diverse People who often struggle with Executive Functioning, but often have ATYPICAL STRENGTHS that go INSUFFICIENTLY RECOGNIZED, DEVELOPED and EMPLOYED.
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Image Credit: Study.com
Conjecture:   It seems that there is a lot more going on with DYSREGULATION of the IMMUNE SYSTEM in NEURO-DEVELOPMENTAL and PSYCHIATRIC DISORDERS than one would expect. 

Most significantly, according to Top Researchers the Immune System implicates --- SOCIAL BEHAVIOR. 

Further, this isn't just "IMPLICATES" --- this is being conceptualized as the IMMUNE SYSTEM CONTROLS SOCIAL BEHAVIOR. 
University of Virginia School of Medicine
​

Shocking New Role Found for Immune System:  Controlling Social Interactions (2016)
This seems to fit into:
  • Rejection Sensitive Dysphoria --- emotions often normal in every way except INTENSITY
  • Blurred Neuro-Developmental and Psychiatric Disorders
  • Common Sensory Processing Problems and Loss of Control of Inputs, and
  • The Old Friends Hypothesis --- modern Immune Systems with lack of diversity of microbiota have become in some cases ULTRA SENSITIVE.
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Stephen Covey & Temple Grandin: 
Sometimes Great Minds Do Think Alike

All Kinds of Minds, Executive Functioning & Criminal Justice

12/25/2021

 
 Temple Grandin is talking about:
  • All Kinds of Minds, and 
  • Spectrums

I used to think and I think a lot of people still do think that people in the Criminal Justice System have Lower Intelligence --- in some kind of ABSOLUTE SENSE.

A big part of our Criminal Justice Problem is that ASSUMPTION is not true.

BUT it is true that people have EXECUTIVE FUNCTIONING DIFFERENCES that are making it difficult for the person to survive in society.

Further, as more and more of our arbitrary and racist, sexist, politically incorrect filters are having to be discarded --- Traditional Executive Functioning and "Emotional Intelligence" SEEM LIKE OBJECTIVE MEASURES --- but they are not.

The "ASYNCHRONOUS" Packages people are coming in are not only making it hard to ECONOMICALLY SURVIVE --- it is making it hard to EMOTIONALLY SURVIVE.

I would submit that Temple Grandin is much more "EMOTIONALLY INTELLIGENT" than much of what I have seen on "Emotionally Intelligent People" and the "Toxic People."

​For some Neuro-Diverse People with Executive Functioning Differences, the HIGH SKILLS in some areas are never getting sufficiently challenged ----
that is leading to mental health problems.

On the other hand, the SOCIETY for all intents and purposes is NOT PREPARED to accept that intelligent  people could have EXECUTIVE FUNCTIONING DIFFERENCES. 
​
Ted-Ed -- Temple Grandin
The World Needs All Kinds of Minds
A lot of people in Criminal Justice fall into a broad category of ADHD that is in fact quite BLURRED with Autism.

Further, these DSM boxes are having more and more difficulty corresponding to empirical research.

Lex Morningstar @ 6:50:  "People with ADHD receive 20,000 more criticisms by the time they reach the age 12  than Neurotypicals.    That's a lot."

A lot of times you do have highly intelligent people, who are highly sensitive, and have executive functioning differences and a SOCIETY that is ABUSING them.

The RESULTS are not pretty.

Medicaid, Supported Employment and getting up to speed on the research

12/18/2021

 
​Integrating MEDICAID and SUPPORTED EMPLOYMENT with Criminal Justice --- It's NOT just our traditional ideas of MENTAL HEALTH.

There are 2 Ideas included here:
  • By and large we are talking about "COGNITIVE DISABILITIES" in the Criminal Justice System and that is not limited to traditional ideas of "mental illness."
  • On the other hand, these "COGNITIVE DISABILITIES" are often involving multiple systems of the body.   They are involving the brain and central nervous system, but they are involving other systems of the body as well.

CMS and states like Colorado have already started the process of INTEGRATING Physical and Mental Health Care.

The Research does continue to support this direction in care with more and more physical and mental diseases and disorders linked to CHRONIC INFLAMMATION.


[See Inflammation–Nature's Way to Efficiently Respond to All Types of Challenges: Implications for Understanding and Managing “the Epidemic” of Chronic Diseases --- Frontiers in Medicine, 2018]

In the case of "psychiatric disorders," this CHRONIC INFLAMMATION is often beginning DEVELOPMENTALLY with MATERNAL IMMUNE ACTIVATION.

Further, many people in the Criminal Justice System have developmental issues such as ADHD and Dyslexia.

Care needs to be provided, but also more sophisticated SUPPORTIVE EMPLOYMENT.  We have a number of people who have AVERAGE or HIGH IQ and DIFFERENT EXECUTIVE FUNCTIONING.

[Further, it seems to me that less controlled "INPUT" is often what is leading to BOTH a perception of HIGH IQ and a perception of LOW EXECUTIVE FUNCTIONING.]

It is only recently that we have separated out these notions of "IQ" and "EXECUTIVE FUNCTIONING" and there is very much a bias to say, "Well, if you don't have traditional executive functioning -- your HIGH IQ can't be worth very much."

BOTTOM LINE:  In 2021, that means a HIGH NEED for SUPPORTED EMPLOYMENT among people in the Criminal Justice System who are often struggling with EXECUTIVE FUNCTIONING DIFFERENCES but have average or above average intelligence.

Further, EMPLOYMENT is a big part of our lives and our mental health.  This DISCONNECT between "IQ" and "Executive Functioning" is going to require some modified approaches if we're to maintain the mental health of the people we're trying to help.
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​[What's the POINT of the Research to the right?  If we don't get up to speed with the RESEARCH that psychiatric disorders are DYSREGULATIONS of MULTIPLE SYSTEMS of the BODY --- we're going to have a hard time getting out of our MENTAL HEALTH CRISIS.

It is the Brain and the Central Nervous System ---BUT it's also other SYSTEMS of the  BODY as well.]
​Dr. Garnet Cummings is the Executive Director of Brain Care Centre in Edmonton, Alberta. He was the Chief of Emergency at the Royal Alexandra Hospital until an accident  left him with a brain injury. Here he discusses the “unhappy triad” of brain injury, mental illness and addiction.  (2015)
​Why is ADHD linked with Addiction (2021)
​Val's Note / Conjecture:  ADHD is associated with "IMPULSIVITY" and the brain.  I think it is important to note that neuro-developmental and psychiatric disorders are being recognized more and more as DYSREGULATIONS of MULTIPLE SYSTEMS of the BODY --- not just the Brain and the Central Nervous System.

Also this HEIGHTENED SENSITIVITY is not just going to REWARD but sometimes to ENVIRONMENT in general--- is the IMPULSIVITY a CAUSE or an EFFECT or BOTH.

Also what are people with ADHD RE-ACTING to -- is it just a DYSREGULATION of DOPAMINE or does it also include DYSREGULATIONS of other SYSTEMS of the BODY?
​​See:
  •  Dopamine and Cortisol
[Dopamine is a neurotransmitter in the Brain and is part of the Nervous System, Cortisol is the primary stress hormone which is part of the ENDOCRINE SYSTEM.]

  • The microbiome: A key regulator of stress and neuroinflammation  
​
  • ​MIA  (Maternal Immune Activation) and the Human Microbiome                      When the maternal immune system is activated during pregnancy, the inflammatory cytokines released affect the offspring's vagal system and consequently their CNS regulation. MIA activation also affects maternal gut bacteria, which in turn can affect the microbiome of offspring.Jun 28, 2019
    Maternal Immune Activation and Related Factors in the Risk of ...

  • ​Results from a new study suggest a pathway of communication between certain gut bacteria and brain metabolites, by way of a compound in the blood known as cortisol. And unexpectedly, the finding provides a potential mechanism to explain the characteristics of autism. Gut microbes have been in the news a lot lately.Aug 21, 2017
    Gut microbes may talk to the brain through cortisol
​​
  • Cortisol and the Immune Response  
​
  • Is psychosis a multisystem disorder? A meta-review of central nervous system, immune, cardiometabolic, and endocrine alterations in first-episode psychosis and perspective on potential models (Molecular Psychiatry, 2018)

Executive functioning and the "Justice" of work-arounds

11/27/2021

 
CONJECTURE
  • Executive Functioning -- NOT IQ is one of the BIG ISSUES driving --- HOMELESSNESS and INCARCERATION.
  • It does become even more problematic when the EMOTIONAL INTELLIGENCE folks want to say:
    • Your IQ or Talent really aren't very important
    • Pay Us to Teach You to BE LIKE US.
      • ​That can be a lot harder climb than what anybody thought --- because the EXECUTIVE FUNCTIONING DIFFERENCES are often related to DEVELOPMENTAL and EPIGENETIC DIFFERENCES.
      • ​This is the TRUE BRILLIANCE of our CURRENT APPROACH:  we're not going to give you CREDIT for your TRADITIONAL INTELLIGENCE --- but we are going to use it against you.
​ON THE OTHER HAND
  • Our great tragedies of the FALL of the BIG MAN or WOMAN are often the result of INTELLIGENT and/or TALENTED people who didn't realize they had EXECUTIVE FUNCTIONING CHALLENGES --
    • ​Life could turn into one big cover-up.
  • ​Further, if you have been in this hierarchical society -- you probably have been subject to some "SUPERIOR'S" temper tantrums.
EXECUTIVE FUNCTIONING -- The DELICATE Approach
Ironically, Executive Functioning Challenges often do come with HIGH IQ and or TALENT.
  • ​That's because a lot of the individuals do have HYPER-PLASTIC brains.
    • ​So its not that there is no NEURO-PLASTICITY going on --- there is generally much more than the average, BUT
    • The system may NOT  be sufficiently "weakening neighboring synapses" --- so there is a FLOOD of INFORMATION coming in all the time and it can "OVERWHELM" the person. (see the MIT article below right).
  • The first thing is to acknowledge the INTELLIGENCE and Talent that the  Neuro-Diverse Person 
         possesses.
  • I think it is hard for NEURO-DIVERSE people to TRUST if Neuro-Typicals can't do that.
  • Further, the truth is --- those NEURO-DIVERSE STRENGTHS are important KEYS to RECOVERY.
ADDRESSING EXECUTIVE FUNCTIONING

without Making it Worse -- WORKAROUNDS  
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​The SOCIETY is faced with a CONUNDRUM when it comes to addressing EXECUTIVE FUNCTIONING:
  • By and large we're not doing a lot of PREVENTATIVE  IDENTIFICATION and SUPPORT.
  • We tend to have a lot of CRISES
  • That has a lot of social implications -- it has BIOLOGICAL IMPLICATIONS
  • By the time one gets to the "PSYCHIATRIC DISORDER" -- you do have a HYPER-CONNECTED BRAIN.
    • ​​Well, NOW is NOT the TIME to try to CONNECT the wiring in the brain even further.
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WORK-AROUNDS
  • "Work-Arounds" are the PRACTICAL ALTERNATIVE in many cases 
  • "WORKAROUNDS"  are what Dr. Gail Saltz recommends in her book "The Power of Different."
  • We're not trying to CHANGE the person, we're trying to WORK-AROUND any DEFICITS.
  • AND MAXIMIZE Strengths.
  • That can be healing in and of itself and give the person the BREAK they need to be a valued part of the COMMUNITY.
  • The more that NEURO-DEVELOPMENTAL and PSYCHIATRIC DISORDERS are recognized as:
    • ​Often beginning In Utero and 
    • Having an Epigentic Life of their own
  • The more they won't be seen as issues of "MOTIVATION"
  • Further, the "HYPER-CONNECTED BRAINS" of people with PSYCHIATRIC DISORDERS to me tell a story of UNWITTING ABUSE.
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​MIT scientists discover fundamental rule of brain plasticity

Study reveals how, when a synapse strengthens, its neighbors weaken.  (2018)
​Our brains are famously flexible, or “plastic,” because neurons can do new things by forging new or stronger connections with other neurons.

But if some connections strengthen, neuroscientists have reasoned, neurons must compensate lest they become overwhelmed with input. [Val's Note:  I think some people with "Neuro-Developmental" and "Psychiatric Disorders" are getting overwhelmed with "input"].

In a new study in Science, researchers at the Picower Institute for Learning and Memory at MIT demonstrate for the first time how this balance is struck: when one connection, called a synapse, strengthens, immediately neighboring synapses weaken based on the action of a crucial protein called Arc.

Epistemology, Psychiatric Disorders & the Law

11/16/2021

 
​Temple Grandin and probably a lot of other people are going to ROLL THEIR EYES at such a $5 word as "epistemology" --- and plead -- COULD WE JUST DO SOMETHING PRACTICAL?

I probably would have been in that group most of my life and certainly before I saw the failure of the Mental Health Profession to REFORM ITSELF after the National Institute of Mental Health (and subsequently over 600 Research Institutions) called into question the scientific validity of the DSM 5.

​Ironically, the BARRIER to REFORM has been PERFECTIONISM both on the part of the American Psychiatric Association and the National Institute of Mental Health (NIMH).

I was thrilled when I heard about NIMH's Research Domain Criteria Program (RDoC) that at least initially was designed to replace the DSM.

BUT what is the MISSION of RDoC -- we have this great "MATRIX" and when we KNOW EVERYTHING --- we'll get back to you.


MEANWHILE --- DSM "categories" are alive and well -- certainly in the Criminal Justice System, most specifically in the designation and understanding or lack of understanding of "ANTI-SOCIAL PERSONALITY DISORDER."

Our understanding of "PERSONALITY DISORDERS" has been pretty fuzzy and generally not linked to "biology" -- exactly --people who just couldn't get it together -- maybe that included a bad childhood or environment.  In the case of ANTI-SOCIAL PERSONALITY DISORDER, doing bad things.

Is it any wonder that at least one prominent Historian of Psychiatry questioned whether PERSONALITY DISORDERS were Psychiatric Disorders at all.

At least, some clinicians have pointed out that the historical development of "PERSONALITY DISORDERS" didn't look SCIENTIFIC.

SUBSEQUENTLY, at least some  RESEARCHERS AROUND the WORLD are viewing "ANTI-SOCIAL PERSONALITY DISORDER" as a form of the NEURO-DEVELOPMENTAL DISORDER ADHD.

Further, NEURO-DEVELOPMENTAL DISORDERS and PSYCHIATRIC DISORDERS look BLURRED with most people with a traditional NEURO-DEVELOPMENTAL DISORDER having at least 1 co-morbid "PSYCHIATRIC DISORDER."
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Daubert Standard

Definition

This is the standard used by a trial judge to assess whether an expert witness’s scientific testimony is based on scientifically valid reasoning that which can properly be applied to the facts at issue.

Overview.  This standard comes from the Supreme Court case, Daubert v. Merrell Dow Pharmaceuticals Inc., 509 U.S. 579 (1993).

Under the Daubert standard, the factors that may be considered in determining whether the methodology is valid are: (1) whether the theory or technique in question can be and has been tested; (2) whether it has been subjected to peer review and publication; (3) its known or potential error rate; (4)the existence and maintenance of standards controlling its operation; and (5) whether it has attracted widespread acceptance within a relevant scientific community.

The Daubert standard is the test currently used in the federal courts and some state courts.  In the federal court system, it replaced the Frye standard, which is still used in some states.  

Source:  Cornell Law School Legal Information Institute ​
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​"Legal epistemology examines when and why evidence has a probative value; that is, it investigates how evidence makes a litigated claim more likely. It illuminates what reasons—moral, political, economic, practical, epistemic—justify excluding probative evidence."  Feb 27, 2019

Legal Epistemology - Philosophy - Oxford Bibliographies
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​The RATIONAL PROBLEMS in Criminal Justice with respect to "ANTI-SOCIAL PERSONALITY DISORDER" are beyond DISTURBING.

And yet we don't have PERFECT KNOWLEDGE and we're unlikely to have PERFECT KNOWLEDGE in our lifetimes or the lifetimes of those victims and defendants relying on the LEGAL SYSTEM for JUSTICE.
We do have MORE KNOWLEDGE.

If we wait for the LEGAL SYSTEM to solve this by themselves --- it is going to be akin to waiting for RDoC.

We need something more practical in terms of ramping up a PUBLIC HEALTH APPROACH TO CRIMINAL JUSTICE that could be greatly facilitated through Olmstead Planning.  
​
I'm not against RDoC (I'm for it) and I'm not against the Legal System (I'm for it) --- but we need to address the problem of CRIMINALIZING NEURO-DEVELOPMENTAL DISORDERS --- NOW ---while ensuring and improving SAFETY --- NOW.

The JUSTICE EQUATION in MENTAL HEALTH

11/9/2021

 
(in the US we should have Parity, Olmstead & Medicaid Network Adequacy -
BUT those LAWS are not effectively enforced at a practical Federal Administrative Level)

On top of that, we have a Mental Health Profession using an OUTDATED diagnostic manual.
 There's a lot driving the Mental Health Crisis in:
  • ​Colorado
  • Nationally, and
  • Globally
​
Further, there are local and regional drivers --- everything from:
  • ​War to
  • Complications associated with High Altitude
​ ​ ​

Seemingly two of the BIG DRIVERS involving the IMMUNE SYSTEM are:
  • ​The Old Friends Hypothesis, and
  • DEVELOPMENTAL INFLAMMATION
    • ​To make matters more complicated, DEVELOPMENTAL INFLAMMATION (low grade inflammation is associated with "intelligence")
      • ​General intelligence is associated with subclinical inflammation in Nepalese children 
SIGNIFICANT DEVELOPMENTAL INFLAMMATION is associated with NEURO-DIVERSITY
  • Maternal acute and chronic inflammation in pregnancy is associated with common neurodevelopmental disorders: a systematic review (ADHD, Autism & Tourette Syndrome) ​
​SOME SPECIAL ABILITIES
  • 6 Strengths & Benefits of ADHD (Medical News Today)
  • Five Research-Based Strengths Associated with Autism (Stages Learning)
  • ​Strengths of Tourette Syndrome (Univ. of Florida)​
PSYCHIATRIC DISORDERS
  • ​ADHD Comorbidities & Related Conditions (ADDitude online)
    • "​Roughly 80 percent of those with ADHD are diagnosed with at least one other psychiatric disorder sometime during their life."
  • Autism’s Clinical Companions: Frequent Comorbidities with ASD (Children's Hospital of Philadelphia)
    • ​"As many as 85% of children with autism also have some form of comorbid psychiatric diagnosis, and 35% are taking at least 1 psychotropic medication as treatment."
  • Tourette syndrome and other neurodevelopmental disorders: a comprehensive review  (Child & Adolescent Psychiatry & Mental Health)
    • "The available evidence suggests the following: (1) neurodevelopmental comorbidities in TS are the rule, rather than the exception; (2) attention deficit/hyperactivity disorder (ADHD) is the most frequent; (3) there is a continuum from a simple (TS + ADHD or/and learning disorder) to a more complex phenotype (TS + autism spectrum disorder)." ​
So generally as a population we've liked the special abilities and NOT the psychiatric disorders.
  • ​​​But we've been selecting for those "SPECIAL ABILITIES" and there are now more and more people with BOTH those "SPECIAL ABILITIES" and "PSYCHIATRIC DISORDERS."
    • ​Those "SPECIAL ABILITIES" can be academic, athletic or creative.
    • The "PSYCHIATRIC DISORDERS" are generally not distinct as presented in the DSM 5 -- but tend to be "BLURRED" -- which makes sense if a common mechanism is often MATERNAL IMMUNE ACTIVATION.
    • Both the "SPECIAL ABILITIES" and "PSYCHIATRIC DISORDERS" appear to be related in part to differences in Sensory and Information Processing.
Picture
​MENTAL HEALTH BY THE NUMBERS
​​The scope of the burden of "psychiatric disorders" in Colorado, the US and the World is HUGE.
  • So when the State of Colorado is proposing 62 new beds and Mental Health Colorado says we need over 2,800 new beds --- we see the problem.
  • Further, we need thousands more SUPPORTIVE HOUSING SLOTS ---- it cost the State of Colorado over $1.5 million dollars for 25 new Supportive Housing apartments.
  • In the LONG TERM -- we've got to have better UNDERSTANDINGS and TREATMENTS and it appears that's coming and may be here for the NEXT GENERATION.
  • In the meantime, we've got to get better at working with what we've got:
    • ​Often people with SIGNIFICANT EXECUTIVE FUNCTIONING CHALLENGES, and
    • ABILITIES in select areas that are often higher than the NORM.
Picture

Criminal Justice, Executive Functioning & Neuro-INFLAMMATION

10/28/2021

 
Picture
This Diagram shows the COMPLICATED nature of NEURO-INFLAMMATION

"Neuroinflammation: the devil is in the details" 
Journal of Neurochemistry (2016)
CONJECTURE

​Three things are becoming more apparent:
​
  • ​​*The Criminal Justice Population has differences / deficits in Executive Functioning;
​
  • Executive Functioning Differences/Deficits are linked to INFLAMMATION.
  • INFLAMMATION is linked to numerous sources in psychiatric disorders, most notably MATERNAL IMMUNE ACTIVATION and TRAUMA.
    • ​A Mountain State like Colorado has a higher suicide rate because ALTITUDE is piling on INFLAMMATION for people who likely already have a lot of INFLAMMATION--- but ALTITUDE is not necessarily the major source of INFLAMMATION
High Altitude, Sky High Suicide Rates
​Much of our focus as a society has been on youth and people with "IQs" below 70 who found themselves subject to the Death Penalty.

More recently, we've been concerned about people with "MENTAL ILLNESS" in the JUSTICE SYSTEM.

As far as "PSYCHOTIC ILLNESS" --- which is definitely on our streets and in the CRIMINAL JUSTICE SYSTEM --- it is often a PROGRESSION of NEURO / IMMUNE DYSREGULATION that started out as DEVELOPMENTAL INFLAMMATION.

Many of the men and women in the CRIMINAL JUSTICE SYSTEM are not currently psychotic (some are), BUT most are NEURO-DIVERSE with significant DEVELOPMENTAL INFLAMMATION, EXECUTIVE FUNCTIONING CHALLENGES and often ABILITY that is very hard to exercise when the price of admission is TRADITIONAL EXECUTIVE FUNCTIONING.
Maternal immune activation and neuroinflammation in human neurodevelopmental disorders --- Aug. 2021
Inflammation Disrupts the Brain Network of Executive Function After Cardiac Surgery
Brain changes in a maternal immune activation model of neurodevelopmental brain disorders --- 2019
Increasing Role of Maternal Immune Activation in Neurodevelopmental Disorders --- 2018
<<Previous
Forward>>

    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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  • About Orchid >
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    • ORCHID'S SYSTEMIC FOCUS & "ROOT CAUSE" ANALYSIS APPROACH TO PROBLEM SOLVING WITH A COMMITMENT TO CREATIVITY & INNOVATION
    • Disclaimers, Limitations and An Invitation
    • Orchid Board
    • Orchid Book Club
    • Conjecture, Science & Translational Research & Medicine
    • Orchid Themes & Symbols
    • The Tipping Point
    • Orchid's Website Advertising Policy
    • Statement for Potential Website Contributors
    • Contact
  • Val's Blog
  • Val's Blog 2
  • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
  • NEURO-DIVERSITY Wednesday
  • Olmstead Law & Order Thursday
  • Translational Medicine Friday
  • Translational Love, Relationships & Neuro-Diversity Saturday
  • Crisis Services in CO, the US & Around the World
  • Assertive Community Treatment & Flexible ACT Index
  • Housing & Homelessness Index
  • Criminal Justice
  • Innovation Index
  • For More: See the Main Orchid Index Page
  • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
  • Medicaid & Supportive Housing & Housing-Related Services
  • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
  • National Take
  • Immunology & Mental Health >
    • Alcoholism & the Immune System & Mental Health
    • Brain Injury, the Immune System & Mental Health
    • Celiac Disease & Sensitivities, the Immune System & Mental Illness
    • Mental Illness & The Immune System
    • Racial Discrimination & the Immune System & Mental Health
    • Trauma & the Immune System & Mental Health
    • ***Physical Health Issues, the Immune System & Mental Health Index
  • University of Chicago: Institute of Translational Medicine
  • 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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