Reform of " Anti-Social Personality Disorder" in Criminal Justice

Problem solving courts and Anti-social Personality Disorder

11/23/2021

Some countries are more explicitly embracing the "BIOLOGICAL BASIS OF BEHAVIOR" than others.

The US isn't treating mental health disorders with HYENAS but . . .
We have been loathe to comply with DISABILITY LAWS even when we knew what to do, much less all those times we haven't been sure.

WHAT "ANTI-SOCIAL PERSONALITY DISORDER," SUBSTANCE PROBLEMS & "MENTAL ILLNESS" all have in COMMON is

NEURO-INFLAMMATION -- often DEVELOPMENTAL NEURO-INFLAMMATION

When we start to appreciate how DEVELOPMENTAL this is -- we start to appreciate what a MULTI-GENERATIONAL PROBLEM we have.

Most people have somebody / somebodies in their BIOLOGICAL or CHOSEN FAMILY that has serious mental health, substance and or criminal justice problems.

Having said that, MENTAL & PHYSICAL HEALTH aren't INTEGRATED THOROUGHLY --- we've just started that process.

That's important because a lot of these CLASSIC and NOT SO CLASSIC NEURO-DEVELOPMENTAL DISORDERS involve not only psychology and psychiatry BUT ALSO:

IMMUNOLOGY
ENDOCRINOLOGY
the MICROBIOME
etc.

With all this FLUX, I "think" the PUBLIC is going to want the SECURITY of a COURT to oversee a PIVOT to a PUBLIC HEALTH APPROACH to "Anti-Social Personality Disorder."

In these PROBLEM-SOLVING COURTS --- EPIDEMIOLOGISTS should have an IMPORTANT ROLE in Leading DATA COLLECTION efforts.

John Prine's "Summer's End"

Substance Use is often associated with "Anti-Social Personality Disorder"

Mental Health Courts Pro and Con

Anti-Social Personality Disorder and Australian Law Reform

Wilma Mankiller was the First Female Chief of the Cherokee Nation.

Some background on our ideas regarding reform of "Anti-SOCIAL PERSONALITY DISORDER" within criminal justice

11/18/2021

Back to our Letter to the American Bar Association on Anti-Social Personality Disorder, the DSM and Criminal Justice

We may be breaking this up into 2 Letters:

Revising Understandings of Anti-Social Personality Disorder in the Criminal Justice System (Beyond the DSM 5)
Executive Functioning Differences / Deficits in the Criminal Justice System)

This LEVEL of IGNORANCE in MENTAL HEALTH is ONE OF MANY BIG PROBLEMS with FORENSIC PSYCHOLOGISTS & PSYCHISTRISTS testifying in Criminal Court where the potential outcome is PUNISHMENT and often SEVERE PUNISHMENT --- and that DEFENDANT may not be SYMPATHETIC to most people including our PRO SOCIAL COMPETENCY MENTAL HEALTH PROFESSION.

NOW HOLD ON -- YOU SAY --- These forensic mental health professionals do find people INCOMPETENT TO PROCEED and NOT GUILTY BY REASON of INSANITY ---

BUT that is a MASH-UP of STATUTORY and MENTAL HEALTH CATEGORIES -- including the SCIENTIFICALLY INVALID DSM
And it seems to ASSUME that some HUMAN BEHAVIOR is BIOLOGICALLY BASED and SOME ISN'T
- ENVIRONMENT is Important --- and one of the big reasons for that is it AFFECTS our BIOLOGY.
  - That Environment Could Be:
    - MATERNAL IMMUNE ACTIVATION IN UTERO
    - It could be a TRAUMATIC CHILDHOOD
    - It could be a TOXIN like LEAD
    - ALL of the ABOVE and MORE

ON THE OTHER HAND, if we don't have a SOLID UNDERSTANDING & GUARANTEED TREATMENTS ---- that raises ADDITIONAL CIVIL RIGHTS QUESTIONS --- there are people who would prefer an ARBITRARY TERM of YEARS to an INDEFINITE COMMITMENT.

We are making PRACTICAL ADJUSTMENTS such as Mental Health Co-Responders and Medicaid for Justice-Involved People --- there is plenty of work to be done there.

Another area is PROBATION --- often a TRAP for the PERSON with EXECUTIVE FUNCTIONING DIFFERENCES or DEFICITS.

We'd like to see PROBATION lay the FOUNDATION for Supported Employment or Supported Entrepreneurship by:

Identifying and developing STRENGTHS and
Identifying and implementing REASONABLE WORKAROUNDS and ACCOMMODATIONS for Executive Functioning Differences and/or Deficits.

Clinicians and Evaluators for Adults have been put in some exceedingly DIFFICULT positions in this society, especially when it comes to CRIMINAL JUSTICE.
By and large these smart and compassionate people have done the best they could with what they had --- BUT that has NOT BEEN CONSISTENT-- and it has become more and more obvious that they were missing significant PARTS TO THE PUZZLE --- in fact over 1/2 the PUZZLE has been missing in terms of an UNDERSTANDING of the BIOLOGICAL BASIS of PSYCHIATRIC DISORDERS.

Guess What? It matters if you are missing 1/2 the PARTS to the PUZZLE.
On the other hand, we NEVER have all the PARTS to the PUZZLE and we often have to go with what we've got.
I think that is what the Mental Health Profession did with Personality Disorders, especially Anti-Social Personality Disorder --- they went with what they had.
Further, Mental Health's PRO-SOCIAL COMPETENCY SECULAR

RELIGION --- was NECESSARY given the incomplete state of knowledge and the state of the society.

BUT all knowledge --- SCIENTIFIC, MORAL, TRADITIONALLY RELIGIOUS or SECULARLY RELIGIOUS -- has to be REVISED based on new insights and knowledge --- and that's where we are with PSYCHIATRIC DISORDERS and COGNITIVE DISABILITY GENERALLY.
WE NEED TO REVISE.

We don't even know where all the circuits are or even how to DEFINE A CIRCUIT --- Insel (2014)

"Much more extraordinary than anything we can imagine"

--- In 2021, RESEARCH UNDERSTANDING of "PSYCHIATRIC DISORDERS" is more extraordinary than anything even Insel could imagine ----

because RESEARCH UNDERSTANDINGS have expanded beyond the BRAIN and the CENTRAL NERVOUS SYSTEM to the IMMUNE SYSTEM, the ENDOCRINE SYSTEM & the MICROBIOME.