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    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
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      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
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      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
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      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
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  Val's Blog

WHAT IS GOING ON IN BRITAIN WITH DISABILITY BENEFITS & WHY DOES IT MATTER?

2/27/2017

 
​The Government must immediately stop suspending the benefits of hundreds of thousands of claimants each year or risk soaring rates of mental health problems, experts have warned.
 

In an open letter to The Independent, doctors from Britain’s leading mental health organisations said that an urgent review of the system must be carried out to discover how deep an impact it is having.  

Ministers are facing a separate battle in Parliament over plans to slash £3.7bn of disability benefits that would go to people with mental health problems, epilepsy, diabetes and dementia.

The doctors' letter comes just 10 days before Philip Hammond’s spring budget, with the Government still struggling to bring the deficit under control and under intense pressure to spend money giving companies more business rates relief.

It reads: “We, the UK’s leading bodies representing psychologists, psychotherapists, psychoanalysts and counsellors, call on the Government to immediately suspend the benefits sanctions system.

“It fails to get people back to work and damages their mental health.”
​http://www.independent.co.uk/news/uk/politics/benefits-sanctions-letter-mental-health-crisis-british-psychological-society-a7600596.html
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From the United Kingdom
​With things like "disability" we really need to remember:
  • These terms are social constructs and have different definitions and meanings based on the context and law;
  •  For "disability benefits" there is generally a notion that one "can't work" or is not "employable"  because of one's "disability."
  • Now that can be pretty fluid because it is really what the economy is willing to support and that is something we think often gets lost.
  • If you have a relatively open economy with plenty of workers businesses often don't have just a whole lot of incentive to be accommodating for employees with disabilities, regardless of what the law says.  [Here's a great resource on the law from Disability Rights Iowa regarding "disability disclosure" http://disabilityrightsiowa.org/wp-content/uploads/2012/11/FAQ-About-Disability-Disclosure-under-the-ADA.pdf  ]
  • Well what happens -- there are a lot of people on disability.  That's a big government liability -- some people want to cut that liability down,  but if we do people will have no way to support themselves.
  • Not everybody with disabilities can work under some circumstances -- but some can -- BUT we won't provide those circumstances -- HENCE the CATCH 22 & our current dilemma:

"It fails to get people back to work and damages their mental health."

  • With Medicaid Block Granting and our budding relationship with British politician Nigel Farage -- we hope this is NOT in the US' future.

SUNDAY (OSCAR NIGHT) my THEORY OF SOCIAL CHANGE:

2/27/2017

 

  *ART:
 
OFTEN INDIVIDUAL VISION, MARGINALIZATION OFTEN SERVES AS A MUSE

 *SCIENCE:
 
ESPECIALLY IN THE MODERN WORLD, SCIENTIFIC ADVANCES IN MEDICINE, ENGINEERING, ETC. ARE SEEN AS THE KEY TO SOLVING OUR PROBLEMS

 *JOURNALISM:  OFTEN PROVIDES THE RAW DATA FOR ART, POLITICS, & LAW.

     *POLITICS: 
DYNAMIC & FREE-WHEELING -- IT CAN PRODUCE SOCIAL MOVEMENT ICONS SUCH AS MARTIN LUTHER KING, JR. WHO IS NOW A GLOBAL ICON &

     *LAW:
​  
"HAMMERING OUT DETAILS" AND "PROTECTING THE RIGHTS OF MINORITIES" HAVE TRADITIONALLY BEEN THE PROVINCE OF LAWYERS.
             THE LAW HAS REALLY FAILED A LOT OF PEOPLE ACROSS THE SPECTRUM. 
              WHILE WE WANT TO SEE A LOT MORE RESOURCES GO INTO STATE OF THE ART HIGH LEVEL SERVICE PROVISION FOR PEOPLE WITH MENTAL ILLNESS, BRAIN INJURY, ETC, --
                        WE WOULD ALSO LIKE TO SEE MANY MORE OPPORTUNITIES FOR "ROOT CAUSE ANALYSIS OF SYSTEMIC PROBLEMS"  WITH INCLUSIVE DIVERSE STAKEHOLDER GROUPS AS OPPOSED TO THE USUAL SUSPECTS FROM THE COLORADO CRIMINAL JUSTICE PROFESSIONAL WORLD -- WHO SHOULD BE INCLUDED -- BUT OTHERS NEED TO BE INCLUDED AS WELL .

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FINDING HOPE IN SERVICES OVER LAW COURTS

2/27/2017

 
 We are really hard on the mental health profession, we mean really hard.  Because the voices of psychiatric survivors get pretty much ignored.
            If you want an entity that can take on the Mental Health profession -- that is pretty much the US National Institute of Mental Health -- and they have been doing it -- if anyone has been listening -- and a lot of people in the science world have been.  [See our page Science Up]
             Now as hard as we are on the mental health profession -- we still have hope.  
              For the the legal system, well there are no shortage of reform efforts -- some national reform efforts based right here in Colorado.
              For large numbers of poor, minority, vulnerable people many with trauma and or invisible disabilities--- THE LAW COURTS -- tend to be a horrible venue.  
              And after all is said and done, do we want to pay for more Courts or do we want to pay for more and more person-centered & effective services that provide better safety.
              ​
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One Flew Over the Cuckoo's Nest (1975) for 2017 we should change that to a prison or county jail

I was born this way

2/26/2017

 
​Val's Take

​There are so many factors when it comes to "mental illness," childhood trauma is a big one & it's not the only one.

So it is so important to acknowledge the reality and widespread nature of adverse childhood experiences --- while at the same time, recognizing that some of us may have come pretty hard-wired for the difficulties we're experiencing or those difficulties may relate to other factors such as the gut biome, or a combination with altitude, etc.

I feel the need to say this because I don't know how many times I've been asked if I was abused as a child -- I've been asked a lot.   After a psychotic episode, you get asked these things.  AND I wasn't abused.

But what I was struggling with and didn't have a label for it -- was being 2e -- twice exceptional -- gifted with ADD.

They say that 2e kids generally hit a wall -- I didn't hit my wall until law school.  Always before, I had managed to get those As in every class.  There had been a lot of disorganization before, but law school was the first time I was to see the ADD grade spikiness -- "As" in Constitutional Law and Criminal Procedure -- a "D" in Corporations.

Well, I entered a writing competition to "write on" to Law Review which I did.

And then there were decades of frustrating and seemingly inexplicable "spikiness."   I felt very much like Shawn Mendes in "Stitches"-- beaten up and beaten down -- but there were seemingly no wounds.

One of the reasons I repeat over and over and over again: build on strengths, compensate for weaknesses is that I know in my own life it is the difference between being at the top of the heap, and not being able to keep your head above water.

I also know how important peers are  -- how important the mental health community is to me and how I seek out out twice exceptional people on the Orchid Mental Health Policy:  Global facebook page by posting relevant items.

I also think there are A LOT of FACTORS --many surprising and unusual [such as the micro-biome and altitude] when it comes to dealing with mental ill health.

Some of those factors I think I have identified, maybe rightly or wrongly, and probably some I haven't identified or maybe mis-identified.


 It's been a very unexpected journey.  I'm so glad things worked out the way they have -- there was a time I didn't think I would ever say that.

ADVICE FOR 2E ADULTS

Click Here

CONSISTENCY & SUBSTANTIVE ENGAGEMENT WITH THE STATE

2/24/2017

 
​We really love Stephen Covey's metaphor for relationship as an "emotional bank account."
       The State has really made some big deposits with:
  • the Olmstead Compliance Working Group, [Update, the Hickenlooper Administration ultimately reneged on its promise for an Olmstead Compliance Working Group---and that has led to the kind of withdrawals in trust one would expect], and 
  • the "Comprehensive" Behavioral Health Plan proposal in the State of the State

         Having said all that, we are looking for responses from the Governor's Office on our requests on:
  • ​A Working Group on Banning Administrative Segregation for Vulnerable Populations in Colorado Jails
  • A  Working Group on Parity, Olmstead, & Civil Rights Re:  Assertive Community Treatment (ACT) in Colorado
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​When we say "consistency" it is not necessarily always agreeing with us-- although that would be great.
         It is really "consistency" in:
  • ​responsiveness
  • inclusiveness
  • willingness to substantively engage
          If systems need to be put in place to do that, let's do that.

Crap Justice & cRAP sERVICES:  tHEY oFTEN GO TOGETHER

2/19/2017

 
     Trump was roundly criticized for referring to a "so-called judge" -- AND in some ways we are upping the ante although it is NOT directed to individuals but rather to deeply flawed systems that are producing what we are terming:  CRAP JUSTICE, and that is less crude than the terms used by people often subject to our horrifically unjust justice system.

         We are trying to reform this as a society and as a State, but we can't keep having results like the Ft. Collins Child Abuse Outrage and so many more.
​HTTP://WWW.COLORADOAN.COM/STORY/NEWS/2017/02/17/CHILD-ABUSE-LARIMER-COUNTY-DOUG-LEAH-DYER/97744402/

            And from our experience where there is CRAP JUSTICE -- CRAP SERVICES ARE USUALLY LINGERING IN THE BACKGROUND IF THEY EXIST AT ALL.

                 So here are the various bottom lines from our perspective:
  • The State has to have the ability to protect children from abuse & neglect: -- that wasn't done here.
  • The parents appear to have become ultimately homeless and to have had some "mental issues" -- what housing and services were provided? any?
  • On the face of it this looks like a horrible tragedy involving parents unable to cope with their daughter's needs and a system ill equipped  to address the parents' needs.
  • So now we're going to give the parents 15 years --- people who are incarcerated see this kind of "justice" meted out everyday -- the only problem is IT IS NOT JUSTICE  -- IT IS "CRAP JUSTICE" & A WHOLE LOT OF PEOPLE ALREADY KNOW IT -- CERTAINLY THOSE WHO ARE SUBJECTED TO IT.

                  

​           

         

                 
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Against a Singular Understanding of Legal Capacity:  Criminal Responsibility & the Convention on the Rights of Persons w/ Disabilities
http://www.sciencedirect.com/science/article/pii/S0160252715000667
I'd really like to go much beyond even just asymetrical competency standards in various areas of the law.

From my perspective, especially in the criminal law-- we just so need to get away from "punishment" and lay a foundation with the community to do that.

That can sound pretty namby pamby and maybe in some respects it is -- BUT NOT IN SAFETY -- which is what it is really all about.

AND we get away from "pretending" we have knowledge we don't have at a high level of certainty, and use the knowledge we do have to the best of our abilities to address issues like:
  • "mental illness"
  • "substance abuse"
  • "developmental disability"
  • "brain injury"
  • "trauma"
  • etc.
and help people as much as possible and at the same time focus on safety.

Further, our historical arc is moving towards greater and greater authenticity -- and we all need people subject to the criminal justice system and services providers and others feeling free to speak openly about mistakes, their true needs and what is working and what isn't without fear of "punishment."        
         
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HOW MANY COMPETENCY EXAMS CAN DANCE ON THE HEAD OF A PIN?

2/12/2017

 
​      The headline above is not a perfect analogy to the infamous medieval scholastic debate involving how many angels could dance on the head of a pin -- but it's close.
   
​       SB 17-12
Competency Restoration Services and Education 
http://act.mentalhealthcolorado.org/mentalhealthcolorado/app/bill/823647

The bill addresses various issues relating to the restoration of competency for juveniles and adults in the juvenile and criminal justice systems, including:
  • Requiring the court to consider whether restoration to competency services should occur on an outpatient basis if the defendant is on bond or summons;
  • Requiring that, in addition to providing competency restoration services in the least restrictive environment, the provision of such services and a juvenile's participation in those services occur and are reviewed by the court in a timely manner;
  • Establishing the unit within the department of human services that administers behavioral health programs and services, including those relating to mental health and substance abuse, also known as the office of behavioral health (office), as the entity responsible for the oversight of restoration education and the coordination services necessary to competency restoration; and
Setting forth the duties of the office related to competency restoration services and education.
     ​Let's just say at the outset that our objections are structural AND are NOT going to get remedied in this Legislative Session.

         AND in some respects they are in the process of getting remedied -- AND we need to speed that up.

          SB 17-12 is in effect a very rational response to the Criminal Justice System's fixation on bright-line notions of "competency" which we would maintain are NOT rational.

           Further, a whole lot of resources can be expended/wasted on competency exams and education that we believe would be much better served on:
  • risk assessment,
  • enhanced treatment (what about that Treatment Mall @ CMHIP?), and
  • risk reduction

          We would much rather see a State of the Art Risk Assessment, Risk Reduction, & Enhanced Treatment Unit @ CDHS.

          If wishes were horses .  .  .

TRIAGING REFUGEESROHINGYA MUSLIMS ARE NOT FROM THE BANNED COUNTRIES & THEY ARE FACING GENOCIDE

2/12/2017

 
       ​ One might say gee -- we can't even get Colorado Medicaid to cover Assertive Community Treatment where "reasonably medically necessary" AND you're talkin' about Rohingya Muslims?
           Well, yes we are.  We don't live in a vacuum and we take bold positions like, "Genocide is Bad for Your Mental Health" and its bad for the mental health of those observing it -- So in such an inter-connected world It Matters.
            Even before Trump and his infamous executive order, the US was pretty slow to admit refugees from Syria.  We're NOT saying the US shouldn't or that it shouldn't reunite families -- but if the US has fears about some of these countries (irrational as they maybe) there are no shortages of desperate refugees in this world and maybe the US and the other countries should triage them.
            To rehabilitate the US' reputation that it is NOT discriminating against Muslims AND to shore up everyone's mental health -- the US should prioritize Rohingya Muslim immigrants from Myanmar and Bangladesh, and possibly other countries.


7 Countries on the Banned List

Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen

REBUTTAL/ THOUGHTS ON BLOCK GRANTING MEDICAID

2/6/2017

 
​ If the only consideration is lowering the federal Medicaid budget line item, block granting Medicaid or capping it will do that. 
         It is not going to get to the "root cause" of Medicaid growth which is need.
         Further, it is pretty tortured logic to think that reducing the Federal contribution is going to result in greater reimbursement to Medicaid providers.
          Block granting was a disaster for mental health under SAMHSA [Substance Abuse & Mental Health Services Administration].
           Under President Ronald Reagan in 1981, the Omnibus Budget Reconciliation Act repealed President Carter's community health legislation and established block grants for the states. Federal mental-health spending decreased by 30 percent. 
​http://www.motherjones.com/politics/2013/04/timeline-mental-health-america
          Two big drivers of Medicaid costs and also great need are:
  • Long Term Care, and
  • Mental Health
           We need to be investing even more in dementia and mental health research with possibly some collaborations with CMS to safely lower costs with better treatments rather than arbitrary fiats.  [Of course, Congress also just passed the Cures Bill].
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We don't agree . . .

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​http://thefederalist.com/2017/01/31/president-trumps-plan-block-grant-medicaid-good-idea/

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    Val Corzine
    Executive Director
    Orchid Mental Health Legal Advocacy of Colorado

    Out there on that neuro-diversity spectrum

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