Blog Archives

Some Additional Thoughts of a "Wayfaring Stranger"

5/31/2021

When we think about "De-Institutionalization" we think about what a FAILURE it was and the FAILURE to provide LARGE-SCALE SUPPORTIVE HOUSING in the Community.

But many people at the time, including many mental health professionals, thought PSYCHIATRIC MEDICATIONS would alleviate the need for all that --- and in many cases it did, BUT in many it didn't.

Therapy ---it can help AND it can hurt. Most of the premises are HALF-RIGHT (BTW Human Beings are often HALF-RIGHT). I'm going to be adding "HALF-RIGHT" to the ORCHID THEMES & SYMBOLS.

Even though most therapy is KIND and NEUTRAL OF A SORT --- the BIAS towards NEUROTYPICAL FUNCTIONING is STRONG and largely UNCONSCIOUS.

But by and large the BIAS towards NEUROTYPICAL FUNCTIONING is more than present in the person with NEURODIVERSE FUNCTIONING as well.

This is the BIG CHALLENGE because many people with "Mental Illness" started out with DEVELOPMENTAL DIFFERENCES INVOLVING EXECUTIVE FUNCTIONING.

Further, that doesn't always look like what we think ---- a disaffected adolescent. It's also a surprising number of ACADEMIC STARS (see video to the right on Bipolar Disorder --- more prevalent in top performers in the Humanities)

There likely has been a lot of work since BIRTH on the part of the person's brain to FUNCTION NEUROTYPICALLY ---- in fact they may have a HYPER-CONNECTED BRAIN as an ADULT and it's still not enough as far as the Society is concerned and maybe as far as the person is concerned.

HYPER-CONNECTED BRAINS are associated with PSYCHIATRIC DISORDERS.

To make matters even more challenging --- many of these people are HYPER-SENSITIVE to their ENVIRONMENTS through a "DELICATE BALANCE" of their INNATE & ADAPTIVE IMMUNE SYSTEMS ---- which are "CONTROLLING SOCIAL BEHAVIOR."

This is another place where I think the SOCIETY is HALF-RIGHT. Some people are choosing HOMELESSNESS --- often because it is TOO PAINFUL to stay in a NEURO-TYPICAL SOCIETY that doesn't know what to do with you or how to RECOGNIZE much less VALUE the STRENGTHS you do have.

Phillip Phillips sings, "I'm going to make this place your home" ------ A Big Step in that Direction would be making this place WELCOMING to NEURO-DIVERSITY.

Trace Adkins
Wayfaring Stranger

See 3:18: Bipolar linked to the EXCEPTIONALITIES in the Humanities -- above average, below average -- the main thing -- NOT AVERAGE.

Phillip Phillips -- Home

CBS Sunday Morning (May 23, 2021) The Ordeal of Homelessness -- Highlights Colorado

5/28/2021

I'm going to start with Republican Mayor Mike Coffman and Democratic Governor Jared Polis.

I want to start off by saying I really like both Coffman and Polis and even for all my venom directed to now Senator Hickenlooper and the Hickenlooper Administration --- it's hard to say the Hickenlooper Administration was Attila the Hun.

With regard to Coffman and Polis --- I think a lot of people know where I'm going with this:

Coffman (in the CBS Morning video above): Homelessness is a "LIFESTYLE CHOICE" for many if not most people.
Polis: unwilling to prioritize Covid Vaccines for adults that "happen to be homeless."

What I want to say is I think COFFMAN & POLIS are HALF RIGHT and it's what makes HOMELESSNESS SO CHALLENGING PRACTICALLY, FINANCIALLY and from a CIVIL RIGHTS PERSPECTIVE.

When Coffman pushes back on HOUSING FIRST and says I don't think HOUSING ALONE is going to be ENOUGH --- Coffman is probably right in many cases.

On the other hand, trying to condition HOUSING on a particular treatment or employment --- doesn't work either.

Ironically one of the reasons WHY this isn't working is because of "ANOSOGNOSIA" or "LACK OF INSIGHT" on the part of not only the person, but also the providers and the society.

NONE of THEM has the ALL THE INFORMATION they need --- but they all have some information the other needs.

There are INVISIBLE COGNITIVE DIFFERENCES which are often present in HOMELESSNESS --- Developmental Differences, Mental Illness, Brain Injury -- and Drug and/or Alcohol Habits trying to manage all of this.

Also IRONICALLY, among people with Cognitive Differences it's not uncommon to find BOTH:

"INFLEXIBLE THINKING" and
"DIVERGENT THINKING" -- generation of many different and even unlikely options.

I would submit that "INFLEXIBLE THINKING" often represents the contours of that COGNITIVE DIFFERENCE or DEFICIT --- that may not be "CHANGING" anytime soon.

On the other hand, a SYSTEMATIC STRENGTH-BASED APPROACH with WORK-AROUNDS for COGNITIVE DIFFERENCES in a NEURO-TYPICAL SOCIETY -------could prevent TOXIC STRESS and additional DAMAGE.

EXECUTIVE FUNCTIONING

5/28/2021

AND SOME MORE CONJECTURE

When we talk about NEURO-PLASTICITY -- we think about the PRESENT or the FUTURE and how we're going to USE PLASTICITY to "CORRECT" some "COGNITIVE ISSUE."

BUT our BRAINS are re-wiring themselves relatively AUTOMATICALLY to address perceived "DEFICITS."

The BRAINS of people with PSYCHIATRIC DISORDERS are often "HYPER-CONNECTED."

Much of EXECUTIVE FUNCTIONING is "AUTOMATIC" --- for some people, including myself --- for that "EXECUTIVE FUNCTIONING" TO LOOK "AUTOMATIC" [and many people would say it doesn't look automatic]--- my BRAIN needs to be HYPER-CONNECTED.

BUT even with all that "HYPER-CONNECTIVITY" --- it's at least sometimes about "REASONING THROUGH" blasts of "EMOTION" and "INFORMATION" that are hitting all at once.

University of Virginia School of Medicine (2016)

Role of the Immune System in Social Behavior via experiments on Mice with Hyper-Connected Brains

Hyperconnectivity in a Brain Circuit May Predict Psychosis (2018)

Nebraska has an Olmstead Planning Law --- Colorado & Other States could use one

5/23/2021

Nebraska has an Olmstead Planning Law --- is it everything it should be --- probably not, BUT it is becoming MORE & MORE OBVIOUS that Colorado and Other States need a quick, easy reference within their own Statutes and Regulations to both comply with Federal Law and tailor Olmstead to their own needs.

Now if states don't include Federal Legal Requirements in their States' Laws ---- that doesn't mean those Federal Legal Requirements went away.

The 2011 US Department of Justice (DOJ) Olmstead Statement is meant to summarize the law on Olmstead ----- BUT most States are not aware of this "Statement" and if they do become aware of it ---- they are not sure whether they are bound by it ---- and they don't want to voice an opinion on it.

As of Feb. 25, 2020 --- DOJ did make clear that the 2011 Statement was NOT BINDING outside of Statute, Regulations and Judicial Precedent.

We've previously suggested that the DOJ Statement be incorporated into Regulations.

Measurable (specific) Goals are in the Caselaw --- BUT it's not helping that so much has to be PIECED TOGETHER.

(where might one find some caselaw on Measurable Goals (or not) --- the 2015 National Association of State Mental Health Program Directors --- Olmstead Risk Assessment & Planning Checklist --- ya gotta love it)

NOT A DIFFERENT BEAST------EXECUTIVE FUNCTIONING, DEVELOPMENTAL DIFFERENCES & "MENTAL ILLNESS"

5/22/2021

What I'm NOT Buying:

"Mental Illness" is a completely DIFFERENT BEAST than DEVELOPMENTAL DIFFERENCE involving Executive Functioning and Information and Sensory Processing.

Further, I'm not buying that "personality disorders" are somehow unrelated to HUMAN BIOLOGY even as they may be related to HUMAN ENVIRONMENTS.

Additionally I'm not buying that:
- "Gifted" emotional overexcitabilities, and
- Emotional Dysregulation, and
- "Reactivity"

-----are somehow unrelated

BUT I DO AGREE with "Gifted" Experts:

Often if you provide an environment that meets the person's intellectual and emotional needs ----
Many problematic behaviors will be greatly reduced.

Further, there is SELF INTEREST in "PRETENDING" that an ENVIRONMENT that works for the "MAJORITY" is going to work for everyone:

For people in which the CURRENT ENVIRONMENT is working ---
- The RISK of CHANGE --- is HIGH
For people in which the CURRENT ENVIRONMENT is NOT WORKING ----
- The RISK of CHANGE ---- is LESS

Executive Functioning & 5 "Disorders"

ADDITUDE Mag
Autism Speaks
Journal of Affective Disorders (Bipolar Disorder)
Expert Review Neurotherapeutics (Depression)
Frontiers in Psychiatry (Schizophrenia)

National Institute of Mental Health: 5 Disorders Share Common Genes (2013)

"Now that doesn't match with the idea that these are distinct."

In summary, calcium seems to play a central role in the activation of cells of the immune system. When the cells are stimulated, [Ca2+]i generally increases as a result of entry from the external medium, as well as mobilization of calcium from intracellular membrane-bound compartments.

Calcium homeostasis and the activation of calcium channels ...www.ncbi.nlm.nih.gov › pmc › articles › PMC1807782

Calcium channels are membrane-spanning proteins that regulate the intracellular concentration of calcium ions (Ca2+). After entering the cell, Ca2+ activates specific calcium receptor proteins, e.g., calmodulin, troponin-C, or calcium-activated calcium, potassium, and chloride channels.

Calcium Channel - an overview | ScienceDirect Topicswww.sciencedirect.com › topics › medicine-and-dentistry

Neuroinflammation and cognition across psychiatric conditions (2019)

Archive | Disorders Share Risk Gene Pathways for Immune, Epigenetic Regulation

The Lancet Psychiatry

Epigenetics: The missing link in understanding psychiatric disorders? (2018)

Psych Scene Hub

Epigenetic Mechanisms in Psychiatric Disorders – Major Depression, Psychosis and Addiction (March 2021)

Olmstead Legal Requirements and Co's 2018 Community Living Update

5/16/2021

There seems to be a FUNDAMENTAL MISUNDERSTANDING of the nature of the 2018 Community Living Update on the part of the Polis Administration.

The 2018 Update was NOT an Olmstead Plan or a REVISION of the 2014 Plan. The Hickenlooper Administration had rejected a Revision of the Olmstead Plan and a CONCILITORY UPDATE was the Consolation Prize.

That "Update" shouldn't be used as the BASIS for OLMSTEAD COMPLIANCE MEASURES in Colorado today, even if the Update is not totally ignored.

Maybe most of us do believe in the Rule of Law --- BUT when it's NOT CLEAR --- it causes CONFLICTS and Lawsuits People with Disabilities CAN'T AFFORD.

Colorado State Government has contracted with the Colorado Health Institute
------ "We are holding 25-minute interviews over the next two weeks and would appreciate if you would share your perspectives about the state’s progress towards accomplishing the goals of the 2018 Community Living Report Update. "

That sounds good right? EXCEPT the 2018 Update doesn't have Measurable Goals and doesn't comply with the LAW.

Is the State taking a POLL as to whether or not State Officials should comply with the LAW?

I haven't necessarily seen it necessary to insist the State say it is out of compliance with the LAW --- if it was CLEAR the State was going to comply in the immediate future.

States around the country have a FRUSTRATING HABIT of FAILING TO COMPLY on "MEASURABLE GOALS."

Federal Judge Donovan Frank threatened the State of Minnesota with Sanctions due to their DELAYS and INSUFFICIENT OLMSTEAD PLANS.

I'm not sure that is where we're at here BUT it seems the State is NOT CLEAR on the LEGAL REQUIREMENTS.

THE "BIG ROCKS" ARE OLMSTEAD LEGAL REQUIREMENTS

5/16/2021

The Polis Administration has refused to DIRECTLY address the LEGAL ISSUES around Olmstead Planning
- Are they in AGREEMENT or do they feel bound by ---- 2011 US Department of Justice Guidance?
  - Who knows, they refuse to answer DIRECT QUESTIONS on the matter.
- Are they in agreement or feel bound by subsequent CASELAW --
  - It's NOT CLEAR

The REALITY is there are plenty of POLITICAL CONCERNS that States can incorporate into OLMSTEAD PLANNING ---- if they are CLEAR & COMMITTED to the Big Legal Rocks.

BUT we have to start with a CLEAR UNDERSTANDING of the LEGAL FRAMEWORK because that should determine what else goes in ---- NOT the 2018 Update.

Now, Colorado can consider the 2018 Update as much as it wants to --- SO LONG AS --- the Legal Framework is CLEARLY IN PLACE.

The Legal Framework for Olmstead Planning in Colorado is NOT CLEARLY IN PLACE.

As of Feb. 25, 2020 --- DOJ did make clear that the 2011 Statement was NOT BINDING outside of Statute, Regulations and Judicial Precedent.

We've previously suggested that the DOJ Statement be incorporated into Regulations.

Measurable (specific) Goals are in the Caselaw --- BUT it's not helping that so much has to be PIECED TOGETHER.

(where might one find some caselaw on Measurable Goals --- the 2015 National Association of State Mental Health Program Directors --- Olmstead Risk Assessment & Planning Checklist --- ya gotta love it)

TRUSTED MESSENGERS

5/14/2021

It used to be that there was one trusted human messenger in "ADVANCED SOCIETIES" --- Pharaoh, the King.
- That didn't work out very well.
Then there were Royal Families and people connected with those royal families.
- That didn't work out very well.
In Europe and the US, a landed gentry.
- That didn't work out very well.

In the 19th Century, Napoleon instituted the "Meritocracy" in the French Military.
- This is a STEP UP.
- Why would anybody be against it?

I'm for VACCINES and I've gotten my Covid Vaccine BTW --- BUT why would anyone be against VACCINES recommended by an EXPERT who had risen through the "MERITOCRACY" ?

Most people have had the experience of dealing with "EXPERTS" who were demonstrably wrong or were afraid to admit they were wrong.

Further, many people have had the experience of being IGNORED and BLOWN OFF on matters that were important to them.

HIERARCHY has historically been a CORNER-STONE of ADVANCED SOCIETIES --- but it brings a lot of weaknesses and sometimes its own destruction.

SciShow (Jan. 2021)
The Untold Story of the First Vaccine

One of the things we are starting to appreciate is the VALUE of Everyone's Perspective to the Process of Problem Solving and Public Health.

Experts do have a role BUT it is OVER-VALUED in our society, and the role of LAY PEOPLE is UNDER-VALUED.

THE NEWLY DISCOVERED WORLD OF NEURO-DEVELOPMENTAL INFLAMMATION & EXECUTIVE FUNCTIONING DIFFERENCES

5/12/2021

Conjecture

It's looking like PSYCHIATRIC DISORDERS are starting out as NEURO-DEVELOPMENTAL DIFFERENCES affecting EXECUTIVE FUNCTIONING:
- I would submit that some of these DIFFERENCES are NOT ALL "BAD" and many have CONSIDERABLE STRENGTHS.
- On the other hand, there are some REAL CHALLENGES that are not necessarily best addressed by CONVENTIONAL THERAPY.
  - Why would that be? We're talking about Developmental Differences.
    - We need a systematic assessment of executive functioning;
    - We need workarounds and accommodations

Also we need a STRENGTH-BASED APPROACH --- for that to mean anything --- it needs to be FORMALIZED and SYSTEMATIZED
- How many Mental Health Professionals are against that? Probably none.
- How many Mental Health Professionals are implementing a SYSTEMATIZED STRENGTHS-BASED Approach ----- not many.

This NEW WORLD of COGNITIVE DIFFERENCE / DISABILITY

The "EQUATION" got a lot more COMPLICATED
It's NOT just the BRAIN as COMPLICATED as that is:
- It's the IMMUNE SYSTEM
- The ENDOCRINE SYSTEM, and
- The MICROBIOME

Who first told me they thought "Mental Illness" was "SYSTEMIC" throughout the body ---

Internationally known Colorado Based Mental Health Visionary --- Amy Smith.

FOREWARNED IS FOREARMED

5/11/2021

My mother told me, "You won't make my mistakes, you'll make your own."
I've told my children the same thing.

Tolstoy lamented that the values of CHILDHOOD were often not reflected in ADULTHOOD.

I think there are a lot of reasons for that. One of the reasons is that CHILDHOOD involves EDUCATION and the ASSIMILATION of HUMAN KNOWLEDGE that was often gained the HARD WAY.

There's a certain amount of being the "SACRIFICIAL LAMB" and adding to the HUMAN KNOWLEDGE BASE of which you may never benefit, and the hope is POSTERITY does benefit.

One of the things that seems sorta understood and sorta not understood --- We're often talking about a CONTINUUM between DEVELOPMENTAL DISABILITY/ DIFFERENCE and MENTAL ILLNESS.

See: Evolving Notions of Schizophrenia as a Developmental Neurocognitive Disorder (2017)----

Affiliations

Harvard Medical School, Department of Psychiatry
Massachusetts Mental Health Center Division of Public Psychiatry
Beth Israel Deaconess Medical Center,Boston,Massachusetts.

Walter Reed National Military Medical Center,Bethesda,Maryland.

Further, it's often the DEVELOPMENTAL DIFFERENCE that is PRIMARY.

It often involves the IMMUNE SYSTEM and MATERNAL IMMUNE ACTIVATION.

Additionally, the Immune System has been identified with mating.

Recent research on Neuroscience News is that 50% of partners of a person with Schizophrenia or Bipolar Disorder have their own mental health issues.

The IDEA is that this is NOT A RANDOM PAIRING.

GIFTEDNESS, ADHD, AUTISM --- Those are SPECIAL NEEDS POPULATIONS in our Society BECAUSE they are coming with EXECUTIVE FUNCTIONING DIFFERENCES, and the Individuals and the Society are often not well prepared for those differences.

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