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

​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.

​[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  

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• ​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

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• Cortisol and the Immune Response  

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• 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)