The Importance of Addressing Executive Functioning ---- from ADMINISTRATIVE SUPPPORT to Assertive Community Treatment

• For a long time, Mental Health along with everyone just considered challenges in Executive Functioning as problems with LACK of RESPONSIBILITY.

• Where do I personally get the best appointment reminders ---my upscale Suburban Dentists' office.
  • ​I get reminded 2 weeks before the appointment.
  • 1 week before the appointment
  • And the day before
  • In the manner --- I prefer
    • ​The "WHAT I PREFER" part is important 
    • It is also challenging for any medical or health care provider
    • Some automated systems do provide for choice in manner of communication:
      • E-mail
      • Telephone 
      • Text
      • Some people may need an actual in-person contact  --- that Suburban Upscale Dentists' Office is providing a lot of personal contact just as a good business practice for the BOTTOM LINE.
• That doesn't just happen --- it's a COST
• At this point in my mental health journey, what ADMINISTRATIVE SUPPORT the psychiatrist has is MORE IMPORTANT to me  --- than who the psychiatrist is.
• I know this was a BIG ISSUE in Colorado Medicaid a few years ago and may have been at least partly resolved.
• In Private Mental Health --- the Solos are sometimes trying to perform their own Administrative Support at the same time they are charging out of network.
  • ​​I know I felt ripped off --- and I probably wasn't the only one.

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• Group practices and Corporate Mental Health generally have more in the way of Administrative Support --- but it is still often falling short of what one can get in other areas of the Society.

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• Beyond that --- it is a telling indication that the profession doesn't really understand that they should be LEADING on matters of accommodating Executive Functioning Differences and Deficits. 

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A COMMON PRESCRIPTION:  Let's try to turn this person into a NEURO-TYPICAL often doesn't work and it can EXACERBATE things.  WHY IS THAT?

• Those EXECUTIVE FUNCTIONING DIFFERENCES are at least in part often DEVELOPMENTAL.
• The BRAINS of People with Neuro-Developmental Disorders do become HYPER-CONNECTED as a way to try to COPE with various DIFFERENCES and DYSREGULATIONS.
• By the time one gets to the MENTAL HEALTH PROFESSIONAL --- that's needing to be CALMED DOWN.

For some people with neurodevelopmental and psychiatric disorders, the Executive Functioning Support they need goes beyond APPOINTMENT REMINDERS which are really going to MEMORY and some other challenges related to DOPAMINE DYSREGULATION and other issues.

​Part of EXECUTIVE FUNCTIONING is EMOTIONAL REGULATION.  ​

This is also an issue where it is NOT FEASIBLE for the Psychiatrist or Counselor to try to bear the ENTIRE LOAD of that.

PEER SUPPORT can be an EQUIVALENT of ESSENTIAL ADMINISTRATIVE SUPPORT when it comes to providing EMOTIONAL SUPPORT.

This does get to why serving people with Executive Functioning Differences can be so CHALLENGING --- we don't want to burn anybody out and we don't want to BANKRUPT our SYSTEMS either.
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That's why having a SOCIETY that is EXECUTIVE FUNCTIONING INFORMED is important.

In many cases, if we're providing A LITTLE BIT to MEDIUM SUPPORT --- IN MULTIPLE AREAS --- we can avoid the need for that total breakdown of functioning that is so costly PERSONALLY and FINANCIALLY FOR INDIVIDUALS, FAMILIES and THE SOCIETY --- to say "Hey, something isn't working here."

Further, we can't put this on just one segment of the society --- or they can breakdown too --- and that is part of what has happened with Mental Health.


On the FLIP SIDE ----  we not only have to engage others ---- we have to develop, reward and employ those UNEXPECTED STRENGTHS that often come with NEURO-DIVERSITY.

One of the reasons ASSERTIVE COMMUNITY TREATMENT is the gold standard of Intensive Mental Health Care:

• It's addressing those MULTIPLE NEEDS that EXECUTIVE FUNCTIONING Differences and Challenges can present.  

I love this video.  It is from Canada and it's on Housing and Assertive Community Treatment.

One of the points the psychiatrist makes is --- You don't just get people better by seeing a PSYCHIATRIST --- you need this whole system of support.

I would submit the reason you need that whole system of support is to address DIFFERENCES and DEFICITS in EXECUTIVE  FUNCTIONING.

If we are combining TRAUMA-INFORMED CARE with EXECUTIVE FUNCTIONING INFORMED CARE ---- we probably could do this more COST EFFECTIVELY.