Blog Archives

Mass Shooting -- A rare event that underscores common shortages for High Need Cognitive Disability

3/30/2021

Another mass shooting and another gunman that may have mental health problems.

When mental health professionals talk about these problems -- they often talk about Civil Commitment Statutes. (See our analysis of Colorado's 72-Hour Hold Procedure vs. the Petition for Court-Ordered Examination)

When judges talk about these problems --- they often talk about the need for "RESOURCES, RESOURCES, RESOURCES."

With respect to Colorado's Civil Commitment Statutes, from a TECHNICAL STANDPOINT --- they're probably fine --- BUT
They do appear too complicated for many people to apply AND that's a BIG PROBLEM in these situations

HAVING SAID THAT, We are kidding ourselves and our fellow citizens if we think we just need to amend the civil commitment statutes.

This is money and a lot of it for --- beds, placements and supportive housing.

BBC News: 10 People Killed in Grocery Store Shooting in Colorado

At 3:04:

"People Are Falling Through the Cracks All THE TIME. . .

"So to think that won't then boil up at some point and end up in a tragedy --- That is JUST NAIVE, THAT'S JUST NAIVE."

--- Chicago's Cook County Sheriff Tom Dart
60 Minutes (2013)

Whenever something like the King Soopers Shooting happens, we're generally in for a barrage of MENTAL ILLNESS DENIERS IN THE NAME OF STIGMA PREVENTION
First, Mental Illness is a HUGE CATEGORY representing a 1/5 to a 1/4 of the US POPULATION --- generally, we're talking about a tiny subset.
What is really important is NOT THE LABEL although it is the superficial tag we use in the Criminal Justice System --- and it does have legal ramifications.
SUBSTANTIVELY, the issue needs to be the UNDERLYING BIOLOGY.

Getting honest about our justice System & Cognitive Disability

3/29/2021

Individualized Precision Medicine and Individualized Precision Support

We need Voluntary Assessments & Data Collection
We need Individualized Plans --- some people (not most people) probably will need a PLACEMENT as opposed to living on their own or Supportive Housing
We need to be spotting TRENDS and developing appropriate public health responses.

This is a lot about getting HONEST about what it is really going to take to address Cognitive Disability for Justice-Involved People ---- which is most of the people in Criminal Justice.

There are significant:
- Health Needs
- Emotional Support Needs
- Supportive Employment Needs, and
- Housing, Placement, and/or Intensive Services Needs.

That's significant RE-STRUCTURING and it's a significant RE-STRUCTURING when we could see destructive behavior BUT we couldn't always see or accurately conceptualize and identify the underlying biology.

That is less and less the case every year and the new conceptualizations are certainly also identifying potential novel methods of treatment, especially with respect to the Immune System & the Microbiome.

Also, if we get savvier about recognizing some of the STRENGTHS people do have and accommodating weakness (often Executive Functioning Differences) this would be a lot better for everyone.

I was on a Zoom Meeting last week with Defy Ventures Colorado
They help people "defy the odds" in coming out of incarceration.
What they have found is many of the people they work with have already started businesses (legal or illegal) at one point in their lives --- and they are very interested in ENTREPRENEURSHIP.

To me with admittedly considerable conjecture, this goes to the HIGH PERCENTAGE of People with ADHD who are NOT FITTING IN to this society --- BUT want to and probably would with targeted support.

The Effectiveness of Mental Health Courts in Reducing Recidivism and Police Contact: A Systematic Review (2019)

Abstract

Mental health courts were created to help criminal defendants who have a mental illness that significantly contributes to their criminal offense.

The purpose of this systematic literature review is to assess the current evidence to address the question, "How effective are mental health courts in reducing recidivism and police contact?"

Systematic literature searches of eight electronic databases were performed. A total of 2590 unique citations were identified. Of these, 20 studies were included in the final analysis.

The results of this systematic review suggest there is some evidence to show that mental health courts help to reduce recidivism rates, but the effect on police contact is less clear.

Results also suggest case managers or access to vocational and housing services may be important components of effective mental health courts.

The Effects of Traumatic Brain Injury and Post-Traumatic Stress Disorder on Prison Adjustment and Recidivism among Military Veterans: Evidence from Minnesota
(Feb. 2021)

Studies also show that TBI and PTSD account for variation in prison-based and re-entry outcomes.

Despite this body of research, comparatively fewer studies have explicitly focused on how these factors affect prison adjustment for inmates with prior military experience.

We used administrative data provided by the Minnesota Department of Corrections (MnDOC) and employed a series of survival analyses to examine how prior diagnoses of TBI and PTSD (among other risk factors) influence metrics of institutional adjustment and recidivism among a sample of military veterans.

Our results indicate that the effects of TBI, PTSD, and other indicators of criminogenic risk are relevant when examining the experiences of justice-involved military veterans-especially with respect recidivism-based outcomes.

Persons With Severe Mental Illnesses and Sex Offenses: Recidivism After Prison Release (2019)

Abstract

Individuals who have committed sex offenses (ISOs) with severe mental illnesses are a complex population to serve and more research is needed to guide practice and policy, especially around community supervision, enrollment in Medicaid, housing, employment, criminal justice contacts, and reincarceration after prison reentry.

To further the literature in this area, we used logistic regression to model recidivism and admissions to violator or prison facilities among 127 ISOs with severe mental illnesses and 2,935 people with severe mental illnesses who were incarcerated in prison for other crimes.

Compared to prison releasees with severe mental illnesses who committed crimes other than sex offenses, prison releasees with severe mental illnesses who committed sex offenses were admitted to violator facilities at higher rates, when controlling for substance use, Medicaid enrollment, homelessness, and unemployment. Implications for practice, policy and research are discussed.

WE NEED FEDERAL LEADERSHIP--------THIS IS A LOT MORE THAN GUNS --------- IT'S THE HIGH COST OF HIGH-NEED COGNITIVE DISABILITY

3/27/2021

When it comes to MOBILITY, we don't have a big problem recognizing various levels of "impairment"
- One person might have gait issues,
- Another walk with a cane,
- Somebody else might have a scooter
- Another person might have a power wheelchair, and
- Someone else might not be able to get out of bed.
High Need Mobility Impairment can be EXPENSIVE -
- If you can't get out of bed even with significant help --- you may be in a nursing home.
- Many disability activists fought very hard to get ATTENDANTS.

If I hear one more physical disability activist say, "PISS ON PITY" and "I'm NOT a SAINT" --- I think I'm going to SCREAM -----

Because of course that is NOT SOCIETY's REACTION to many serious cognitive disabilities, especially among people under 60.

I'm not angry with physical disability activists --- I am angry at the society that has such hard time appropriately addressing cognitive disability, especially for people who are homeless or justice-involved.

Various levels of Cognitive Disability Need:

Public Health Information
Monthly Therapy
Weekly Therapy
Medication if tolerated and helpful (that is not a given)
Case Management
Intensive Case Management
Occupational Therapy for Cognitive Accommodations & Workarounds, especially regarding Executive Functioning Differences
Assertive Community Treatment
Supportive Housing
Assisted Living
Placement specifically for cognitive disability (non-secure)
Nursing Home open unit
Placement specifically for cognitive disability (secure)
Nursing Home locked ward
Mental Institute
Jails & Prisons
- Now, a lot of people in jails and prisons could do lower levels of INTENSIVE CARE if we had it.

U.S. President Joe Biden

I'm going to pick on Colorado Executive & Legislative Leaders

(BTW --- I can dish it out BUT I can't take it)

There are all kinds of tragedies affecting people in our communities that are implicating our fuzzy understanding of our LEGAL DUTIES AROUND COGNITIVE DISABILITY
- Shootings
- Killings of inmates with cognitive disabiity
  - Marvin Booker
  - Michael Marshall
  - Christopher Lopez
  - Suicides while Incarcerated
  - Ryan Partridge gouged out his own eyes while in the Boulder County Jail
We have been conceptualizing these issues as:
- Criminal Justice Issues
- Law Enforcement Training Issues
- Jail Staff / Prison Training Issues
- Civil Commitment Issues
Colorado State Government certainly the LEGISLATIVE is adopting progressive issues, but they don't want to pay for them in some cases --- they want somebody else to pay them -- like the Counties and Sheriffs Offices.
- Most recently this involves a great idea to limit RESTRICTIVE HOUSING (Solitary) in jails -- but they wanted the Sheriffs to pay for the DISCHARGE PLANNING.

Are Colorado Sheriffs Leading the Way on Residential Services?

The Polis Administration got a 2 year pass from us to see what the Behavioral Health Task Force was going to come up with.

There are good things
There is a CONTINUING PASSIVE REFUSAL to be Accountable and commit to Measurable Goals associated with Olmstead Compliance.
When I say "commit to Measurable Goals" --- I mean the IDEA of "MEASURABLE GOALS" -- not any particular "MEASURABLE GOAL"

COLORADO and all States NEED FEDERAL LEADERSHIP and it would be particularly helpful if that came with some $.

50,000 IS .86% OF COLORADO'S 5.8 MILLION POPULATION-----------------------------------------------THAT'S NOT VERY MUCH UNLESS THAT 50,000 NEEDS BED SPACE, PLACEMENTS AND/OR SUPPORTIVE HOUSING

3/27/2021

While there may be 1.2 Million Coloradans with some type of mental health diagnosis --- Colorado doesn't need anywhere near 1.2 million beds, placements, and/or supportive housing slots.

   On the other hand, we may need perhaps 50,000 intensive service living accommodations with most of that in the form of Supportive Housing.

That's a whole lot more expensive than vaccinations and the COST is the primary reason we haven't done it.

Even with a need for intensive services and living accommodations less than 1% of the population --- the SCOPE and DURATION of the need can still be daunting.

   It's not that states like Colorado aren't doing anything BUT they are certainly NOT HOLDING THEMSELVES ACCOUNTABLE TO MEET THE NEED.

We advocate a PUBLIC HEALTH APPROACH TO CRIMINAL JUSTICE --- a big part of that is for the purposes of creating more humane systems and much safer systems.

   BUT those are not the only reasons --- there's also a financial reason. WE CAN'T AFFORD LONG TERM COGNITIVE DISABILITY with EXPENSIVE INTENSIVE NEEDS of even a relatively small percentage of the population --- say 50,000 Coloradans.

When we see one of these MASS SHOOTINGS ---- we're HORRIFIED (we don't always do a lot about it, but we're HORRIFIED).

On the other hand, there are less well known tragedies happening every day in this Country and in Colorado because we don't provide sufficient resources for people with cognitive disabilities with intensive needs --- even though we're spending a lot of money.

We've got to get SERIOUS about EPIDEMOLOGICAL APPROACHES to Cognitive Disability and especially cognitive disability for those with intensive needs.

We've got to think about HARM REDUCTION.

SCATTERED SITE SUPPORTIVE HOUSING is often the GOLD STANDARD for serving people with disabilities in the community.

Are there things that we could do that would:

improve quality of life, and
public safety

that might be less expensive and that we could do NOW while we make plans and implement more permanent solutions?

One of those HARM REDUCTION MEASURES might be SUBSTANTIALLY INCREASING ACCESS to HOTEL VOUCHERS paired with GREATER ACCESS to INTENSIVE SERVICES such as ASSERTIVE COMMUNITY TREATMENT.

Colorado's Troubled History of
Gun Violence
LA Times

5,842,076 people
Colorado Population 2000-2050

The state's population is expected to reach 5,842,076 people in 2020. That means we'll have added a 1.5 million people in the past two decades, growing faster than most of the U.S. Nearly 91% of the newcomers settled in the Front Range. Jan 2, 2020

2020 forecast: Colorado is getting older and narrowing the ...coloradosun.com › colorado-population-2020-statistics

Mental Illness Prevalence

The share of adults in Colorado with any mental illness was 21.5% in 2017-2018, which was higher than the U.S. share (19.0%).

Mental Health and Substance Use State Fact Sheets ...www.kff.org › statedata › colorado

[21.5% of 5.8 million = 1,247,000]

Where are we getting the 50,000?

We're not limiting this to "mental illness" --- we're including Brain Injury, Developmental Disability and Substance Issues as well.
- Many of these are co-occurring
We're including disability homelessness and disability institutionalization such as Mental Institutes and Nursing Homes.
Most importantly, we're including INCARCERATION in Colorado Jails & Prisons
And we're asking some tough questions about some cases of RECIVIDISM
More tomorrow on how we came up with this ROUGH ESTIMATE.
BUT at the end of the day, these are tasks for STATE DATA COLLECTION EFFORTS that need to be posted publicly on a STATE WEBSITE and used for STATE Bed Space, Placement and Supportive Housing Planning as well as other planning needs.

THERAPY FOR SOCIALLY AWKWARD SOCIETIES

3/27/2021

Some of the ways to conceptualize some of the STRENGTHS that go with some Executive Functioning Differences:
- The person is much more DETAIL-ORIENTED than the average person;
- The person is much more BIG PICTURE ORIENTED than the average person.
- The person has above average abilities in a field of study
- Etc

It now seems that SOCIAL BEHAVIOR is both:

Tied to a delicate balance of Innate and Adaptive Immunity
- If you experienced a lot of childhood trauma or Maternal Immune Activation from Mom's autoimmune disease or something else ---
  - Things may be ramped up already.
And Stress can make that worse
- My experience is for most people, including myself -- it is not that people don't care --- it's that they care too much.
- Further, when people start saying "I don't care" --- they are getting very close to or have reached their limits.

Growing up --- I wasn't overly focused on what my peers thought --- I was too focused on adults and my teachers ----
- I don't know that this was the best thing in the world --- BUT I wasn't overly stressed about PEER PRESSURE either.
- I became much more racked with the impacts of PEER PRESSURE as an ADULT than I ever was growing up.

So What Is the Point?

I have many concerns regarding the PRO SOCIAL COMPETENCY EXPERTS in the Mental Health Profession --- who sometimes seem to be far behind TEACHERS in their understanding of DEVELOPMENT and SPECIAL NEEDS.
Additionally, the MENTAL HEALTH PROFESSION is not provided the TRAINING to understand the underlying dynamics or what's really going on for some people with psychiatric / developmental differences or disorders.
- Many psychiatric disorders have a strong developmental component, AND
- One of the things that is feeding additional STRESS and INFLAMMATION is a Socially Awkward Society that is not systematically recognizing strengths and compensating for weaknesses --- often Executive Functioning Differences.

Aurora Public Schools -- Aurora, Colorado (2018)

Twice Exceptional Students -- 2e

3:08: "The most important piece to remember is to identify their strengths and program for that.

"That's how a student will feel valued, engaged in the classroom and that they have a piece of the community they fit into.

"Then we can plan for their area of disability."

DSM 5 CATEGORIES ARE NOT PLATONIC FORMS AND THEY ARE NOT CORRECT

3/25/2021

ONE RESEARCHER AFTER ANOTHER HAS FOUND THAT THEIR FINDINGS DID NOT CORRELATE WITH CURRENT PSYCHIATRIC CATEGORIES

THE NATIONAL INSTITUTE OF MENTAL HEALTH SAYS THEIR FINDINGS ARE THESE CATEGORIES ARE NOT DISTINCT AND ARE "BLURRED"

The Tip of a Scary, Dangerous Iceberg

My reaction to Demi Lovato's bipolar disorder "misdiagnosis:"

*How would you know?

*There are no biomarkers, and
*No valid diagnostic manual ---
who said that PUBLICALLY in 2013 -- the US National Institute of Mental Health -- click here

There are many threads to the mental health profession competency crisis -- none of which generally involve bad people
In some ways not unlike some of their patients -- there is little insight and there is little understanding that they are in desperate need of SUPPORT -- specifically RESEARCH SUPPORT.

We're at such a crisis -- somebody should be doing a FRONTLINE DOCUMENTARY --- other exposé --- because --- this is ridiculous.

On the other hand, it's not that everything mental health professionals do has no value and in fact a good chunk of it can fit into the new paradigms regarding the Immune System and Psychiatric Disorders.

BUT CONCEPTUALIZATION MATTERS --- & Demi Lovato is just the TIP OF THE ICEBERG with regard to the HARM caused by INACCURATE DIAGNOSTIC CATEGORIES and CONCEPTUALIZATIONS.

Researchers are certainly writing in the ACADEMIC JOURNALS --- providing "PRESCRIPTIONS" for clinicians to incorporate into their practices.

How many CLINICIANS are regularly reading these ACADEMIC JOURNALS and then further APPYING that KNOWLEDGE to their practices --- NOT MANY.

Now this is hardly a problem exclusive to mental health --- BUT the diagnostic problems in mental health are already well documented.

Is it realistic to expect Mental Health Professionals or any Medical Discipline for that matter to stay on top of all this RESEARCH by themselves --- no that is NOT REALISTIC. --- In fact it is not happening and it is likely not going to happen unless we invest much more heavily in TRANSLATIONAL RESEARCH & MEDICINE.

CMS (The Centers for Medicare & Medicaid Services) partnered with NIMH (the National Institute of Mental Health) on protocols for 1st Episode Psychosis.

We need CMS & NIMH to partner on Clinician Protocols to INTEGRATE the new understandings regarding the IMMUNE SYSTEM and Psychiatric Disorders.

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 Topics www.sciencedirect.com › topics › medicine-and-dentistry

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

Click the NIMH Logo to go to the 2015 article

Research: The Syndrome vs. The Distinct Illness

The Need for a New Integrated DSM

University of Pennsylvania proposes that "Anti-Social Personality Disorder" is a NEURO-DEVELOPMENTAL DISORDER

UNDERSTANDING THE IMPORTANCE OF MICROGLIA

3/24/2021

THE PROGRESS OVER THE LAST 50 YEARS IS AMAZING --- IT HAS JUSTICE IMPLICATIONS --- NOW

When my husband went to graduate school in the 70s for Biological Psychology --- MICROGLIA were considered the Brain's "PACKING MATERIAL" and those brain cells didn't really have any particular function.
In 50 years, things have changed a lot.

Our point at the end of the day is NOT so much that MICROGLIA are THE ANSWER TO EVERYTHING.
It's more the Stanford Neuro-Biology Professor Robert Sapolsky's argument: WHAT ANIMAL BEHAVIOR (HUMAN BEHAVIOR) IS IT THAT YOU THINK BIOLOGY DOESN'T EXPLAIN?

I sometimes listen to "It's Your Move" with Andy Stanley after SNL. Stanley is a leadership guru and pastor.
One of the things he did that I thought was BRILLIANT was he embraced EVOLUTION and the STATE of NATURE -- and he said that's why we need RELIGION.
I don't agree with everything Sapolsky says or Stanley or anybody -- BUT that doesn't mean that I think EVERYTHING they say is wrong either.

When it comes to HUMAN FREE WILL --- I would say we are trying to EXPAND IT and GET MORE OF IT.
I think it is extremely SCARY to ACKNOWLEDGE the many areas in which we don't have as much CONTROL as we would like.
MODERN SOCIETIES with all their amazing accomplishments tend to OVER-ESTIMATE the CONTROL they really have and that individuals within them really have.
Especially, in the US that got dominated by a YOUTH CULTURE of the 60s -- just the reality of DEATH is largely ABSENT -- in a focus on SUPER-AGERS.
BUT even those SUPER-AGERS are going to die in our current times.

With respect to JUSTICE --- HUMAN INTENT is IMPORTANT BUT in the 21st CENTURY that importance is largely pointing to a BIO-MARKER.

I've said this before -- I think it "may be" different RELIGIOUS TRADITIONS that are in a BETTER POSITION to handle this complex reality than our current LEGAL and MENTAL HEALTH PROFESSIONS.

I 'think" Inter-Faith and Secular People could push for the RESOURCES needed to SUPPORT:
- Translational Research & Medicine as well as
- Housing, Placements & Intensive Services for people with cognitive disabilities.

Microglia Biology:
One Century of Evolving Concepts (2019)

Abstract

Microglia were first recognized as a distinct cell population in the CNS one century ago.

For a long time, they were primarily considered to be phagocytes responsible for removing debris during CNS development and disease.

More recently, advances in imaging and genetics and the advent of single-cell technologies provided new insights into the much more complex and fascinating biology of microglia.

The ontogeny of microglia was identified, and their functions in health and disease were better defined.

Although many questions about microglia and their roles in human diseases remain unanswered, the prospect of targeting microglia for the treatment of neurological and psychiatric disorders is tantalizing.

We will be including Donna Jackson Nakazawa's "The Angel and the Assassin: The Tiny Brain Cell That Changed the Course of Medicine" in our Orchid Book Club.

See an interview with the author below.

The Agenda with Steve Paikin -- Feb. 2021

It's one of most paradigm-shifting and powerful stories in the history of medicine,, writes Donna Jackson Nakazawa. From MS to Parkinson's to Lupus and depression and schizophrenia the microglia, a tiny brain cell, is changing how we understand physical and psychiatric illness. Nakazawa joins to discuss her book, "The Angel and the Assassin: The Tiny Brain Cell That Changed the Course of Medicine."

"Microglia are involved in first line innate immunity of the CNS [Central Nervous System].... When activated, microglia can be potent immune effector cells, able to perform a broad range of functions, and they mediate both innate and adaptive responses during CNS injury and disease while remaining quiescent in the steady state."
Nov 18, 2009

The Role of Microglia in Central Nervous System Immunity ...www.ncbi.nlm.nih.gov › pmc › articles › PMC3786731

REJECTION SENSITIVE DYSPHORIA: THE PROBLEM ISN'T THAT PEOPLE DON'T CARE --- IT'S THAT THEY CARE TOO MUCH

3/21/2021

Conjecture

Rejection Sensitive Dysphoria is a term that now retired and internationally recognized ADHD Colorado Doc -- Dr. Bill Dodson -- dug up to describe common sensitivities of people with "ADHD"
It is now widely recognized as a common symptom of ADHD.
With the "BLURRING" of traditional psychiatric categories, I certainly think it needs to be considered for most psychiatric problems.
Many countries have already begun to recognize that a surprisingly large percentage of their prison population is made up of people with "ADHD."
Does this affect boys and men more? Yes, BUT more and more girls and women are getting caught in Criminal Justice because of Substance Problems.
So the issue is generally NOT --- did the person "INTEND" the Crime or not. The person "intended" the crime -- BUT:
- They were so wasted from various substances in an effort to NUMB THEMSELVES or
- Their INTENT was so off the "NORMAL SCALE" and/or DANGEROUS ---
- That we should be recognizing that something "BIOLOGICALLY" is off.
- If there is not another handy diagnosis -- there's always ANTI-SOCIAL PERSONALITY DISORDER --- which is responsible for a great amount of INJUSTICE in this society.
So two CRUCIAL DISCOVERIES of recent years:
- Cognitive and Social Abilities Rely on Fine-Tuned Equilibrium of Innate & Adaptive Immune Responses (2019)
- Innate Immune Cells are Regulators of Brain Development & Behavioral Function (2018)

3 Big Research Take Aways

ADHD and the Irish Criminal Justice System: The Question of Inertia (2018)

Even for people who have "ADHD" or symptoms of "ADHD" --- how this plays out depends a lot on:

what medications you can tolerate
what supports you can get, and
what environment you're in
- A super sensitive person in a racist, sexist, anti-progressive, anti-conservative, anti-religious, homophobic environment is going to have more challenges because they are picking up on more cues in the SOCIAL ENVIRONMENT -- & their reaction to it is MUCH GREATER than the average person

I do think people with ADHD are a SOCIETY'S "CANARY IN THE COAL MINE." That doesn't mean that everything they think or say is "RIGHT" --- BUT digging down to understand where that "REACTION" came from is important --- and it came from something and it often got AMPLIFIED by a lot of neuro-inflammation.

WHAT IS "MENTAL ILLNESS?"

3/13/2021

IF WE RECOGNIZED NEURO-DEVELOPMENTAL & AFTER AQUIRED INFLAMMATION AS THE KEY DRIVERS OF "MENTAL ILLNESS" ----

COULD WE STOP HAVING SOME OF OUR RIDICULOUS DEBATES ABOUT MENTAL ILLNESS & CRIME

Neuro-Developmental Inflammation is largely UNIVERSAL --- the simplified issue is more HOW MUCH & WHERE?
This involves general intelligence
It involves Developmental Disabilities such as Down Syndrome
It involves Developmental Disabilities / Psychiatric Disorders such as ADHD / Autism
It involves Psychiatric Disorders such as "Bipolar Disorder," "Depression," and "Schizophrenia."

Further, Inflammation is also acquired during the course of a person's life.
Additionally, it is often inflammation that is a significant factor in the cognitive issues of BRAIN INJURY.

The issue of BEHAVIOR CHALLENGES is a profoundly HUMAN, maybe even MAMMALIAN, ISSUE --- it is NOT somehow an issue of ALIEN people with "MENTAL ILLNESS."
It is about the BRAIN BUT it is the Brain's INTERACTION with:

The Immune System
The Gut Microbiome, and
The Endocrine System -- at a minimum

So on the one hand --- people with Behavioral Challenges are NOT aliens ---
On the other hand, the PROOF is IN THE PUDDING --- if that person is having Behavioral Challenges --- something is very likely wrong with the biological system that should be SUPPORTING their BEHAVIOR.

CRIMINAL JUSTICE REFORM IN COLORADO --- WE'RE FOR IT . . . BUT

3/8/2021

IF CO STATE GOV'T DOESN'T TAKE MORE FINANCIAL RESPONSIBILITY ---
CRIMINAL JUSTICE REFORM WILL LIKELY HAVE SOME HARMFUL UNINTENDED CONSEQUENCES IF NOT LEAD TO A HUGE BACKLASH

There is a substantial MUTUALITY OF INTEREST between Low Crime Rates and Humane Treatment.
Many places have already started taking a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE, including Colorado.
That will likely ACCELERATE this decade as more and more research is attributing behavior issues to NEURO-DEVELOPMENTAL and AFTER ACQUIRED INFLAMMATION. --- Is that a SOCIAL JUSTICE and EQUITY issue --- you bet it is.
We are left in 2021 with quite a CONUNDRUM ----- someone with a cognitive disability being forced to stay in Jail or Prison is NOT the same thing as having to stay in the Hospital (and of course Colorado doesn't have sufficient mental health beds, supportive housing, placements or intensive services anyway.)

SB21-062

It's easy to tell others what they should be doing --- I do it all the time --- BUT the REAL KEY to CRIMINAL JUSTICE REFORM is State & Federal Funding of:

Supportive Housing'
Placements, and
Intensive Services.

That is not easy. But if Colorado tries to BY-PASS that, they could create a mess that is hard to clean up.

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Val's Blog

Mass Shooting -- A rare event that underscores common shortages for High Need Cognitive Disability

Getting honest about our justice System & Cognitive Disability

WE NEED FEDERAL LEADERSHIP--------THIS IS A LOT MORE THAN GUNS --------- IT'S THE HIGH COST OF HIGH-NEED COGNITIVE DISABILITY

50,000 IS .86% OF COLORADO'S 5.8 MILLION POPULATION-----------------------------------------------THAT'S NOT VERY MUCH UNLESS THAT 50,000 NEEDS BED SPACE, PLACEMENTS AND/OR SUPPORTIVE HOUSING

THERAPY FOR SOCIALLY AWKWARD SOCIETIES

DSM 5 CATEGORIES ARE NOT PLATONIC FORMS AND THEY ARE NOT CORRECT

UNDERSTANDING THE IMPORTANCE OF MICROGLIA

REJECTION SENSITIVE DYSPHORIA: THE PROBLEM ISN'T THAT PEOPLE DON'T CARE --- IT'S THAT THEY CARE TOO MUCH

WHAT IS "MENTAL ILLNESS?"

CRIMINAL JUSTICE REFORM IN COLORADO --- WE'RE FOR IT . . . BUT

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