Simplicity on the Near Side of Complexity --- PRISON BUDGETS

Polis' $1 Billion State Prison Budget Isn't the Answer Anymore than A NARROW VIEW of "DE-INSTITUTIONALIZATION" was "THE ANSWER" for Mental Health

Olmstead is about preventing the "UNNECESSARY INSTITUTIONALIZATION" of people with Disabilities.

If we don't have any sense of a CONTINUUM --- you can end up where the DISABILITY COMMUNITY was 10 years ago --

• We want people out of the Mental Institutes and
• There are very few people with disabilities in the Criminal Justice System.

In the span of a DECADE --- that has CHANGED IN A BIG WAY.

Now most disability advocates would say the primary INSTITUTIONS for people with "MENTAL ILLNESS" are JAILS & PRISONS.

Our go to expert is often Former Director of the National Institute of Mental Health Thomas Insel who says Psychiatric Disorders are some of the most complicated problems in Medicine.

RAISING THE COMPLEXITY ANTE IN CRIMINAL JUSTICE

• One of the other things that happened in the last decade was --- we started to realize how many people with BRAIN INJURY are in the Criminal Justice System
• Statistics on BRAIN INJURY in CRIMINAL JUSTICE often run higher than PSYCHIATRIC DISORDERS --

RAISING THE COMPLEXITY ANTE  EXPONENTIALLY in CRIMINAL JUSTICE

• Developmental Disability (sometimes with IQ under 70, often with an IQ over 70),
• Psychiatric Disorders
• Brain Injury, and 
• Substance Issues

Well -- that sounds really complicated --- BUT these are often DISTINCT ISSUES that are well understood and we have great treatments for:

• NOT SO MUCH
• These are often BLURRED
• Our TREATMENTS can be Medications that affect the BRAIN GLOBALLY --- and the precision medicine that's needed isn't there.
  

New Yorker:  A New Hemingway Documentary Peeks Behind the Myth

One of the things that I appreciated about Ken Burns and Lynn Novick's documentary on Hemingway was Burns & Novick showed all the COMPLEXITY of Hemingway who was a talented guy AND who was often a NUT CASE ---He had mental illness, brain injury, substance issues (and I would say probably developmental issues)

Complex Patterns

Not an insignificant percentage of people in the Criminal Justice System are dealing with MULTIPLE COGNITIVE ISSUES.

So we're often dealing with the MOST COMPLEX ISSUES in MEDICINE in MULTIPLE in COMPLEX PATTERNS ---If we want to use $1 Billion Dollars to further the transition to a PUBLIC HEALTH APPROACH TO CRIMINAL JUSTICE  --- that is probably not a bad thingBUT trying to placate a frustrated PUBLIC with more stuff that doesn't work isn't the way to go.

Jerry Lewis Telethon for Muscular Dystrophy

A lot of DISABILITY ADVOCACY is what to do when you DON'T HAVE THE "CURE"  ---It's often an EXPLICIT REJECTION of the Jerry Lewis Telethon approach to DISABILITY ADVOCACY.

CNN:  The AIDS activists of the past have more to teach us (2021)

Having said that --- AIDS ACTIVISTS did understand the importance of SCIENCE to their CAUSE and spent a lot of time ADVOCATING at the FEDERAL RESEARCH LEVEL.

When it comes to people with disabilities in the Criminal Justice System:

• We need a Comprehensive Continuum of Care, and
  • To me that is the States, Medicaid & HUD -- and we get rid of the well-intentioned Medicaid Institute of Mental Disease Exclusionary Rule that is making it hard for States to fund that Continuum of Care at higher levels of need.

UCHealth -- the picture is associated with a story on Covid --- but the University of Colorado and others are doing important work on PSYCHO-NEURO-IMMUNOLOGY

We need BETTER TREATMENTS ---

• In a PBS Special funded by the American Psychiatric Foundation --- there was an acknowledgment that BETTER TREATMENTS are needed.
• Research is probably primarily a FEDERAL ISSUE although Colorado has leading researchers and we should be CAPITALIZING on that to the MAXIMUM EXTENT POSSIBLE.