Blog Archives

WE & MANY OTHERS ARE READY TO PARTICIPATE IN A "PARTNERSHIP"WITH THE STATE

3/20/2019

CO State Gov't wants to create the best Mental Health System possible for mental health clients and they recognize that is a PARTNERSHIP between the General Assembly, the Judiciary & Stakeholders.

At the Beginning of the Day, Middle of the Day, & the End of the Day --- that must mean MORE RESOURCES.

We and Many Others Are Ready to Work with the State on Creative & Innovative Funding Strategies to bring critical & legally required services to SCALE. We know this is HARD. Believe it or not, we really do want to work with the State-- not against it -- in addressing this DIFFICULT CHALLENGE.

The reality is CO State Gov't already provides a lot of innovative mental health services --- BUT they DON'T provide intensive mental health services to SCALE or as LEGALLY REQUIRED.

"[Florida] Judge Steven Leifman gives a brief history of how we have dealt with mental illness in America since the founding of our country, from the days of Dorothea Dix, to President Kennedy, to the fractured community mental health system of today and the criminalization of people with mental illness."

struggling with MENTAL HEALTH FUNDING OVERWHELM, the Law & Morality

3/19/2019

"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

We really have all kinds of FACTORS driving an "Invisibility Disability" Crisis in our Society.
Now maybe we don't completely understand all of these FACTORS -- but our RESEARCHERS know enough -- that as a Society many of our Systems are pretty untenable --- Incarceration being right up @ the top.
BUT hey, we don't have the Intensive Treatments, Housing & Placements that people need to avoid incarceration -- on the Scale necessary -- 1000s of people.
We have made this analogy before -- with respect to the Tobacco Manufacturers. They didn't always know their product was harmful, but when they did -- they tried to hide it -- and they didn't stop hurting people.
Most people already know what we're doing is wrong -- and that includes many, many Sheriffs. BUT we're NOT providing REAL ALTERNATIVES on the SCALE needed.
Even if we view some/most/all of these Behavioral Issues as Symptoms of underlying biological problems --- we still must have Safety.

We've included a video on "Disease" in Human History by author & polymath John Green.

Now, Brain Injury, Mental Illness, Substance Use Issues & Developmental Disability are not diseases in the "classic" sense.

They are "disorders"/"disabilities"/differences that affect multiple domains of functionality.

Our inability to deal with this is causing great human suffering and negatively impacting Human History --now.

DESCARTES' ERROR & RELIGION & SPIRITUALITY, sCIENCE & lAW

3/18/2019

We keep making Descartes' error.

-- I was listening to "Meet the Press" Sunday, and they had Arthur Brooks with the American Enterprise Institute.
Brooks has written a new book entitled, "Love Your Enemies" and was railing against a "Culture of Outrage."
I'm FOR loving one's Enemies BUT the precusor to that kind of LOVE is usually FEAR & ANGER.
That FEAR & ANGER is what FUELS, TRIGGERS ---- our REASONING abilities.
In fact, as Neuro-scientist Antonio Damasio explained in the 1990s -- WE CAN'T REASON WITHOUT EMOTION.
So REASONING triggered by EMOTION is going to FIX IT Right?
We talk A LOT about "ROOT CAUSE" AnalysIs and Systemic Approaches to PROBLEMS.
Well it turns out we can never get to the ROOT CAUSE with this kind of reasoning -- BECAUSE there is ALWAYS SOMETHING ELSE. Even atheist Bertrand Russell admonished that PHILOSOPHY cannot get to 1st Causes.
NOT ONLY do we NOT have FOREVER and a DAY -- BUT EVEN IF WE DID -- It doesn't look like we would ever get to 1st CAUSES through REASON & PHILOSOPHY.
SO we have to inject quite a bit of PRACTICALITY into this --- and that's REALLY where most of our HUMAN DISCIPLINES come in -- including LAW and SCIENCE and I would include in this RELIGION & SPIRITUALITY.
At the end of the day, LAW and SCIENCE and all our other human disciplines haven't "fixed it." Maybe they made it worse, maybe they made it better -- BUT they didn't "FIX IT."
WHAT DOES IT MEAN -- NOT TO FIX IT? Well--

It could be being the most incarcerated country in the World
it could mean living in a World with over 65 million refugees & immigrants;
It could mean illness and death.

Even if RELIGION is as absurd as Kurt Vonnegut portrayed in "Cat's Cradle"-- it's what is left after EVERYTHING ELSE -- has failed us.
Of course, RELIGIONS & SPIRITUAL BELIEFS fail people too -- and those Religions & Beliefs EVOLVE -- and maybe they do LAG after SCIENCE. Further, LAW typically LAGS after SCIENCE.
    RELIGION/SPIRITUALITY, REASON & EMPIRICAL SCIENCE, & LAW -- ALL NEED EACH OTHER DESPERATELY.
In some senses, they are like the ONE PEOPLE of the WORLD struggling against one another -- and whose SURVIVAL DEPENDS ON THE OTHER.

"Descartes Error" could probably be stated a number of ways -- one is that there is no strict separation between Mind & Body, another is there is no strict separation between Emotion and Reason. Descartes thought there was a strict separation.

We've got thousands of people in CO's Criminal Justice System in State Custody:
Why don't we screen these people on a voluntary basis for Brain Injury, Mental Illness, Substance Issues & Developmental Disabilities.

Even more radically, why don't we treat them as best we can currently and NOT PUNISH them for WHAT WE DON'T KNOW.

A picture of Kurt Vonnegut

--"Cat's Cradle" by Kurt Vonnegut

DIALING CO STATE GOV'T: WE'VE GOT AN EMERGENCY

3/17/2019

Nederland Wildfire. Photo Credit: bouldercounty.org

WE NEED STATE LEADERSHIP ON THE CO INTENSIVE MENTAL HEALTH CARE
EMERGENCY
If we were talking about a Wildfire -- we would all understand that is an EMERGENCY.

Somehow -- No matter how many times the State gets Sued or how many BAD THINGS HAPPEN-- we don't understand that the problems of Coloradans with Intensive Mental Health Needs are an EMERGENCY.

I'll never forget a phone conversation I had several years ago with CO Legal Services Executive Director Jon Asher -- apparently trying to come through the phone to wring my neck -- when I suggested a "LEGAL NEEDS ASSESSMENT" for vulnerable elders.

[BTW -- Men can get away with that kind of stuff a lot more than women can]

Anyway, @ the time --- I was just SHOCKED! What is this guy's problem -- I'm just trying to help.

NOW, many years later --- I do understand the FRUSTRATION.  When I saw the CO Dept. of Human Services Action Plan for going forward in the Current Mental Health Crisis -- I thought I was going to SCREAM.
  https://www.rmhpcommunity.org/news/leadership-interview-camille-harding-colo-dept-human-services

    What was CDHS proposing: Another Needs Assessment & More Focus on Crisis Services. We're NOT against Crisis Services -- but if we don't build out our CONTINUUM OF CARE -- We Are Never Gonna Get Out of This.

    By and large, we need a combined workgroup of CDHS, HCPF* & the Division of Housing to:

Come up with an "Emergency Plan for People with Intensive Mental Health Needs"
We need to provide hotel vouchers for people with mental illness and other cognitive disabilities who are homeless until we have adequate housing
We need to increase reimbursement to hospitals for psych bed space in order to secure adequate bed space.
We need to make Assertive Community Treatment a Standard Service under CO Medicaid where "Reasonably Medically Necessary"

People this is an EMERGENCY. AND We Need CO State Gov't to UNDERSTAND THAT & To Deal with it as an EMERGENCY.

*HCPF: CO Dept. of Health Care Policy & Financing

CO's Mental Health Continuum of Care Hell

In Addition to Immigration & temporary camps -- we need to be promoting the "Social determinants of Health" on a Global scale

3/15/2019

The Beatles: "I'm Looking Through You"

We chose this song because of its accusatory line:  "You're Not the Same."

Change equals Stress. It is also INEVITABLE. Some people around the world are especially affected  by this stress & anxiety -- leading to paranoia & violence.

What Can We Do To Address the Emotional Needs of People Overwhelmed by Global Integration without giving in to PARANOIA?

There has been a HUGE FAILURE to address the underlying causes of the world's IMMIGRATION & REFUGEE CRISIS.
The current situation of over 65 MILLION Refugees and Immigrants is NOT VIABLE or SUSTAINABLE.
People are going to be moving around the Globe and our Societies are going to CHANGE. They are not going to look the same.
On the other hand, there must be some practical control of that movement and HUMANITARIAN ALTERNATIVES other than immigration or over-crowded refugee camps.
This really goes to our FUNDAMENTAL INTEREST in promoting the SOCIAL DETERMINANTS of HEALTH around the globe.
It has become quite impractical to move 10s of millions of people around the globe in exigent circumstances.
Further, the longer we fail to adequately address Climate Change -- the more displacements we're going to have.
Governments don't have good plans to deal with these problems -- BUT the answer isn't reactionary extremism -- the ANSWER is addressing the SOCIAL DETERMINANTS OF HEALTH of native and refugee populations in CREATIVE & SUSTAINABLE ways.

CMS & HUD: WE NEED ENFORCE-MENT

3/15/2019

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY.

WE NEED ENFORCEMENT

The reality is: if we provide the SUPPORT [one of our new themes] that the STATES need to COMPLY with theses laws --- there is NOT going to be the CRYING NEED for ENFORCEMENT that we currently have.
There is ENORMOUS TALENT in the STATES & @ the FEDERAL LEVEL. BUT often -- THOSE STRENGTHS AREN'T THE SAME -- and the TIME which is always finite is ALLOCATED IN DIFFERENT WAYS.
It is REALLY AMAZING HOW MUCH has already been anticipated @ the Federal Level -- & recognizing where the SYSTEM isn't really COHERENT -- and starting to address that "SYSTEMICALLY."
But the reality is we have THOUSANDS of people with COGNITIVE DISABILITIES in the CRIMINAL JUSTICE SYSTEM because our Systems are not built to handle them.

The IMD[Institute of Mental Disease] Exclusionary Rule is causing more HARM than GOOD
CMS has to provide detailed templates for addressing the Crisis of People with Cognitive Disabilities within the Criminal Justice System, including:
- Brain Injury
- Mental Illness
- Substance Issues, and
- Developmental Disabilities
HUD has to provide detailed templates to address Supportive Housing Needs
Both HUD & CMS MUST withhold FUNDS from States that are not in compliance with:
- Olmstead
- Parity
- Network Adequacy

Unless there is a viable PLAN OF CORRECTION, CMS & HUD funds should be withheld from States.

Now that may seem drastic --- BUT when did the US Supreme Court decide Olmstead --- 1999.

Proposing Nursing Homes & Medicaid community transition -better than jails -- to do housing, placement & Service Planning for inmates w/ brain injury, mental illness, & Developmental disabilities

3/14/2019

NURSING HOMES -- THE BANE OF DISABILITY ADVOCATES EVERYWHERE

ARE NURSING HOMES PART OF THE ANSWER TO THE DISABILITY/ CRIMINAL JUSTICE CRISIS?

WE'RE PROPOSING ROUTINE 90-DAY PLACEMENT IN NURSING HOMES FOR PEOPLE WITH DISABILITIES INVOLVED WITH THE CRIMINAL JUSTICE SYSTEM TO ALLOW FOR COMPREHENSIVE PLACEMENT & SERVICE PLANNING

So what are some of the problems/issues we're trying to solve:

people in the Criminal Justice System have a lot of different types & combinations of cognitive disabilities -- NOT just classic "mental illness", but brain injury, substance use issues, & developmental disabilities [including high IQ ADHD or Autism.]

further, Brain Injury may be even more common than mental illness within the Criminal Justice System -- although they often go together.

It is a hassle and a half for professionals to get in & out of detention and/or correctional facilities even with special procedures. If there are real reasons why the person can't be transferred to a healthcare facility -- okay --- but we don't believe that's most people.

Of course, most importantly detention & correctional facilities are pretty inhumane environments --- maybe we didn't always know there were options. That's not really true today -- even if we're still struggling to fund those options.

If we can do some real triage -- maybe it will shrink our bed space shortage.

Help us get a handle on the true need for placements & services for individuals with disabilities involved in the Criminal Justice System.

The Mental Health Centers, Community Centered Boards, Substance Use Providers,& Brain Injury providers have not had the resources and in some cases the expertise to address the complex needs of those in the Criminal Justice System.

Part of it is determining the need/level for SUPERVISION.

Sometimes people DIDN"T DO the crime alleged, sometimes things get OVERCHARGED.

But if there is little dispute that the person DID the crime alleged or some lesser crime--- then there probably is a pretty good bet there is some need for SUPERVISION @ some level.

What we've been doing: incarceration, probation & parole is really a NIGHTMARE for a lot of people with disabilities and executive functioning problems and can turn into a pretty unwitting SADISTIC MERRY-GO-ROUND. Some of the most ABUSIVE people toward individuals with disabilities I've ever seen were prosecutors and judges -- but also even defense attorneys who sometimes didn't understand why this person just couldn't -- "GET YOUR SHIT TOGETHER."

Of course, that is probably NOT the first time the person has been chastised for bad behavior and/or being an idiot--- we often take that to mean -- THE PERSON HAS HAD A LOT OF CHANCES. It is more likely the sign of a cognitive disability.

Once immediate safety concerns and placement and/or housing needs are taken care of ---- THE FOCUS HAS TO BE ON DEVELOPING, NURTURING & EMPLOYING STRENGTHS.

Are you ready for a shocking statistic?

50% to 80% of people in the criminal justice system have a Traumatic Brain Injury.

In the general public, that number is less than 5%. So perhaps there’s a good reason many people can’t escape the revolving door of criminal justice.

Armed with this knowledge, brain researcher Kim Gorgens set out to find a solution – and she did. Dr. Kim Gorgens is a professor of Psychophysiology, Clinical Neuropsychology, and Psychology of Criminal Behavior at the University of Denver.

She manages a portfolio of brain injury-related research--studying the reported history, cognitive function and brain biomarkers of probationers, inmates and college athletes.

Her mission is to better understand the short and long-term impacts of injuring our most vital organ.

She has a fridge filled with human brains, and a love of zombie movies (coincidence?). Simply put, Kim cares more about your brain than you do.

Tayyab Rashid is a licensed clinical psychologist at the Health and Wellness Centre at University of Toronto Scarborough (UTSC).

His expertise includes positive clinical psychology, strength-based resilience, positive education, post-traumatic growth and multicultural counseling.

Author of numerous scholarly papers and recipient of several honors', Tayyab has trained mental health professionals and educators internationally and consults with several non-profit organizations.

He has also worked with Asian tsunami survivors and flood relief workers in Pakistan. Tayyab's work has been featured in Wall Street Journal, Psychology Today, Toronto Star, The Globe and Mail and at the Canadian Broadcasting Corporation (CBC).

Influenced by Sufi and yogic philosophy, Tayyab advocates active and realistic search for the half-full portion of the proverbial glass to re-order the ordinary.

The Economic challenge OF PEOPLE WITH COGNITIVE disabilities

3/13/2019

So we do NEED STATES TO COMPLY with those Disability Civil Rights Laws with which we are currently partially complying:

Americans with Disabilities Act/Olmstead
the 2008 Mental Health Parity & Addiction Equity Act
Medicaid Network Adequacy
Etc.

Of course, we don't have unlimited resources & we already have about a quarter of the US population with some type of mental health problem.

We must INTEGRATE RESEARCH & CLINICAL practice much more than we currently have.

The UK doesn't have a great mental health system either -- but they are experimenting with such INTEGRATION :

The country's top mental health researchers and clinicians are joining forces to solve some of the greatest mental health challenges facing the UK public.

https://www.nihr.ac.uk/news/the-uks-leading-mental-health-experts-unite-to-solve-treatment-challenges/9193

2000 Projection by the Rand Corporation

The global mental health crisis could cost the world $16 trillion by 2030.

---World Economic Forum 2019

"IN THE TIME OF JEFFERSON"--- OUR INFORMATION EXPLOSION & CURRENT SCIENTIFIC REVOLUTION IN BIOLOGY HAVE PROFOUND IMPLICATIONS FOR OUR SOCIETY & OUR CRIMINAL JUSTICE SYSTEM

3/11/2019

I remember once hearing Political Columnist & Commentator George Will say it must have been so COMFORTING to live in the time of Jefferson when it was still possible [although not probable] for 1 Individual to master the known base of knowledge.

Those days are long gone.

But we have experts, right? Yeah, but those experts are just beginning to integrate their limited knowledge bases.

I got my informational e-mail from "Neurolaw News" -- & what struck me was both how amazing it was and how incomplete it was.

"Neuroscience" alone is NOT going to get us to a complete understanding of human bad behavior.

We're IN THE PROCESS of INTEGRATING & UNDERSTANDING the relationships between:

Physical & Mental Health
Beginning to understand the HUGE IMPORTANCE of:
- The Immune System
- The Microbiome
- The Gut
- The Endocrine System
- Social Determinants of Health
- Etc., Etc., Etc.

So who are we putting the BURDEN on: poor, marginalized, often traumatized people often with cognitive disabilities.

  And let's just say a word about that trauma: sometimes it is from child abuse or war BUT sometimes it is from a SOCIETY that is still finding its way.

I don't know how many times I've listened to Judges lecture criminal defendants & thought:  "What a frickin' waste of time."

Of course, the truth is it is a "frickin' waste of time" for us to lecture the Criminal Justice System -- They need a lot more support to make the fundamental, structural changes that are necessary just as the people do who are coming before them.

Our new theme:  SUPPORT. We are taking as our first illustrative symbol: THE GREEK COLUMN -- a classic symbol of:

WESTERN CIVILIZATION,
MARVEL of ENGINEERING & BEAUTY
STRONG ENOUGH TO PROVIDE SHELTER TO FUTURE GENERATIONS

George Will -- It Must Have Been So Comforting To Live In The Time of Jefferson

Erechtheion in the Acropolis in Athens

The Jail Wait case: THE SPECIAL MASTER "GOT IT" -- CAN THE STATE GET IT?

3/10/2019

Well, we're still reviewing the Special Master's Report, and what we've seen so far should leave individuals , family members, advocates and we believe Concerned Coloradans cheering.
Understanding the "interconnectedness" & "relevancy" of the whole mental health system to the "Jail Wait" Case is INDISPENSIBLE to a fair and long term resolution.
Are those people @ the State just idiots that they don't understand the "interconnectedness" of all this?
No, far from it --- pretty much all of them are incredibly talented intelligent people.
But we don't have the Systems in place to ensure compliance of:

State Competency Exam requirements
Parity
Medicaid Network Adequacy
ADA/Olmstead

Further, we need to get our Mental Health System on a 3-year schedule of Independent Audits by the CO State Auditor with regard to the requirements listed above.
CO doesn't get a passing grade for this Mental Health System that provides the most inadequate services to those with the greatest needs. See D.J. Jaffe's "Insane Consequences."
We have commented to some that one of the most HEINOUS things a State can do is to put the Community @ Risk and Sacrifice Someone with a Cognitive Disability to the Criminal Justice System because the state refuses to adequately fund placements, housing & services.
If we provide the Systems ensuring States can't do that anymore --- they won't do that anymore.

SPECIAL MASTER IN THE JAIL WAIT CASE:

Consistent, long-term compliance with the Settlement Agreement can only occur by improving the broader system of mental health care.

Any steps to attain compliance that undermine a broader system of care—even if they “succeed” in the short term—tend to exacerbate the problem, or create new problems, in the long term.

Our bias in reviewing this plan is to favor strategies that help foster a broader, integrated system of care conducive to long-term compliance and to disfavor strategies that undermine other mental health services.

Why? Because a state mental health system—like a home plumbing system--is necessarily interconnected.

Hasty efforts to reduce pressure in one pipe may create more pressure in others, resulting in new breakdowns, and even more difficult and expensive repairs in the
future.

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Val's Blog

WE & MANY OTHERS ARE READY TO PARTICIPATE IN A "PARTNERSHIP"WITH THE STATE

struggling with MENTAL HEALTH FUNDING OVERWHELM, the Law & Morality

"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

DESCARTES' ERROR & RELIGION & SPIRITUALITY, sCIENCE & lAW

We keep making Descartes' error.

DIALING CO STATE GOV'T: WE'VE GOT AN EMERGENCY

In Addition to Immigration & temporary camps -- we need to be promoting the "Social determinants of Health" on a Global scale

CMS & HUD: WE NEED ENFORCE-MENT

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY.

WE NEED ENFORCEMENT

Proposing Nursing Homes & Medicaid community transition -better than jails -- to do housing, placement & Service Planning for inmates w/ brain injury, mental illness, & Developmental disabilities

NURSING HOMES -- THE BANE OF DISABILITY ADVOCATES EVERYWHERE

The Economic challenge OF PEOPLE WITH COGNITIVE disabilities

"IN THE TIME OF JEFFERSON"--- OUR INFORMATION EXPLOSION & CURRENT SCIENTIFIC REVOLUTION IN BIOLOGY HAVE PROFOUND IMPLICATIONS FOR OUR SOCIETY & OUR CRIMINAL JUSTICE SYSTEM

The Jail Wait case: THE SPECIAL MASTER "GOT IT" -- CAN THE STATE GET IT?

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Val's Blog

​"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

We keep making Descartes' error.

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY. WE NEED ENFORCEMENT

NURSING HOMES -- THE BANE OF DISABILITY ADVOCATES EVERYWHERE

Author

Archives

Categories

"LET'S JUST DO A LITTLE BIT @ A TIME -- REGARDLESS OF WHAT THE LAW SAYS"

CMS & HUD: WE NEED DETAILED TEMPLATES & TECHNICAL ASSISTANCE CENTERS FOR STATES TO COMPLY WITH OLMSTEAD, PARITY, & NETWORK ADEQUACY.

WE NEED ENFORCEMENT