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    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
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    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
      • Brain Injury, the Immune System & Mental Health
      • Celiac Disease & Sensitivities, the Immune System & Mental Illness
      • Mental Illness & The Immune System
      • Racial Discrimination & the Immune System & Mental Health
      • Trauma & the Immune System & Mental Health
      • ***Physical Health Issues, the Immune System & Mental Health Index
    • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System

  Val's Blog

STATE COMPLIANCE WITH THE ADA--RE-IMAGINING HOMELESSNESS

4/28/2021

 
​
  • The homelessness crisis, the incarceration crisis and the police reform crisis ---- are all RELATED, CONNECTED
  • They are all RELATED, CONNECTED to COGNITIVE DISABILITY and that RELATIONSHIP is NOT REMOTE.
  • ​Whether we're talking about Constitutional Principles governing Policing or the Americans with Disabilities Act and Olmstead ---- or any LAW:
    • ​There is the need for LARGE-SCALE VOLUNTARY COMPLIANCE
  • ​It's become obvious that the US Department of Justice doesn't have the RESOURCES to EFFECTIVELY ENFORCE --- constitutional police conduct and limits the FEDERAL LEGAL ENFORCEMENT AGENCY to 25 cities a year, according to National Public Radio.
  • The RESOURCE LIMITATIONS are also true with regard to ENFORCEMENT of the AMERICANS WITH DISABILITIES ACT and OLMSTEAD.  
    • There are GREAT cases out there and settlement agreements and guidance --- BUT if STATES are by and large NOT COMPLYING and RESISTANT ---- most people with disabilities, especially cognitive disabilities, are not able to obtain the benefits of the LAW.
 
  • When it comes to paying for "HOUSING," "SUPPORTIVE HOUSING" for people with disabilities ---- that is primarily a STATE FINANCIAL RESPONSIBILITY under OLMSTEAD.
 
  • Now nobody is against support from any or multiple sources ---- BUT STATES NEED TO STEP UP and make sure SUPPORTIVE HOUSING is provided where needed to its citizens with serious disability.
    • STATES need to be providing or have a PLAN to provide HOUSING, SUPPORTIVE HOUSING to people with disabilities that are institutionalized or at great risk of institutionalization as is inherent in homelessness.
​Project UROK
Tiana Miller (@TianaTheGoblin) is a comedian and podcaster in NYC. In this video, she talks about her experiences with homelessness, mental illness, drug addiction and being diagnosed with multiple sclerosis.
​NBC Philadelphia
How Cops Cope:  Mental Health and Law Enforcement (2018)
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RECONCILING ROBERT SAPOLSKY, JOHANN HARI AND BUDDHA

4/26/2021

 
  • Religions EVOLVE --- the DEFINITION of "GOD" or "GODS" EVOLVE.
  • SCIENCE EVOLVES.
  • LAW EVOLVES.
 
  • Religion, Science & Law are a lot about CERTAINTY & PREDICTABILITY, even as they recognize INJUSTICE, RANDOMNESS and COMPLEX and DYNAMIC INTER-RELATIONSHIPS WHOSE COMPREHENSION IS NOT FULLY IN OUR GRASP.
 
  • This is about BLIND SPOTS and CAUSALITY.
 
  • IT's about FOCUS and the continual need to ADJUST OUR FOCUS to UNDERSTAND "REALITY."
 
  • ​When the Criminal Law "FOCUSES" on "INTENT" + "BAD ACT" --- it's being:
    • ​PRAGMATIC
    • "BAD INTENT" does often go with "BAD ACTS"
​
  • BUT IF we understand that there is a BIOLOGICAL UNDERPINNING to the BEHAVIOR of ANIMAL LIFE --- that CAUSAL ANALYSIS needs to go further.
    • ​Well, it's about the BRAIN, these people are having BAD THOUGHTS and they need some COGNITIVE BEHAVIORAL THERAPY and a more PRO SOCIAL MIND SET.
      • ​That like "BAD INTENT" is often not totally wrong, BUT it is often MISSING A LOT --- and it's becoming more and more obvious that it is missing a lot.
      • Well, its looking like our brains are being SHAPED by our IMMUNE SYSTEM.
        • ​That involves Developmental Difference at Birth
        • It involves Mental Illness that generally involves Executive Functioning Issues
        • It involves Brain Injury
        • It involves Substance Use 
        • It involves our Social Environment
        • It involves Environmental Toxins,
        • It involves TRAUMA,
        • It involves the ENDOCRINE SYSTEM,
        • It involves the MICROBIOME -- that is not "TECHNICALLY" Human, and
        • That's the Short List.  â€‹
Religion Is Nature's Antidepressant | Robert Sapolsky / Big Think (2017)
The Best Mental Health Advice I’ve Ever Heard - Johann Hari (2020)
Introduction to Buddhism | Belief | Oprah Winfrey Network (2015)
The Importance of the Immune System in Cognitive Difference & Disorder helps to RECONCILE:
  • Biological Explanations for Behavior
  • The Impact of Social Circumstances on our Biology, and
  • The need for Spiritual Paths to provide SOLACE when there is little in EMPIRICAL SCIENCE or the SOCIAL ORDER.

Finally, the new understanding that our SOCIAL BEHAVIOR is regulated by a DELICATE BALANCE of our INNATE & ADAPTIVE IMMUNE SYSTEMS underscores the importance of the SOCIAL ENVIROMENT we find ourselves in and the common need to TRANSCEND it.  â€‹

AUSTRALIAN LEGAL SCHOLAR ON US SUPREME COURT & DEVELOPMENTAL DISABILITY

4/22/2021

 
  • Most Countries are wrestling with similar issues as the US when it comes to Cognitive Disability and the Criminal Justice System.
  • When I think of Australia --- I think of Crocodile Dundee --- but it was also a former Penal Colony of the British.
  • Australia is in many cases doing cutting edge work on Brain Injury and Criminal Justice, Mental Illness and the Immune System, trying to address "Personality Disorders" both through special courts and civil commitment in some cases involving danger to others.
 
  • There's a fair amount of ADHD in the Criminal Justice System --- really all through it and at various levels, and all sides.  
  • BUT for the people who are finding themselves on the wrong side of the law, they generally (not always) have average or above average intelligence.
  • Nonetheless, they do have ADHD, AUTISM, PROCESSING DISORDERS, etc.
  • A lot them do exhibit "Rejection Sensitive Dysphoria" -- or emotions that are often normal in every way except INTENSITY.
  • Further, as bright as folks may be, they often have EXECUTIVE FUNCTIONING DEFICITS or DIFFERENCES that are made worse by STRESS.
  • Unfortunately, if one is experiencing the world so INTENSELY, it is not uncommon for STRESS to go along with that.
  • This is the part of the SPECTRUM that represents a large percentage of Justice-Involved People as does Brain Injury.
  • ​Sometimes Mental Illness and/or Substance Issues are Add-Ons to an underlying Developmental Disability / Difference or Brain Injury.​
  • ​Additionally, TRAUMA is common among Justice-Involved people and can lead to additional damage to the Immune System and in turn can damage the Brain.

Modifying Societal Behavior Towards Cognitive Disability / Difference
  • I think a BIG PART of the problem is that what we "THINK" is going on for some people with Cognitive Disability --- is NOT what IS going on.​
  • As hard as it is to believe, I don't think the fundamental issue is "LACK OF EMPATHY."
​
  • "Unconscious Bias" is in many ways IGNORANCE.
  • Ultimately, some Justice-Involved people may need an Advanced Immunologist more than they they need a Psychologist.
​
  • I'm not saying  that is available TODAY and I'm not saying that there are no roles for psychologists  ---- BUT a lot of this does have to do with the Immune System and we don't seem to be on the right track.
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Offenders with Intellectual and Developmental Disabilities: Sentencing Challenges after the Abolition of Execution in the United States (2016)

By Ian Freckelton, QC
​Barrister and Professorial Fellow in Law & Psychiatry at the University of Melbourne


Abstract

In a sequence of decisions between 1989 and 2014, the United States Supreme Court grappled with intellectual and developmental disabilities in the shadow of the imposition of the death penalty on criminal offenders. In Penry v Lynaugh, 492 US 302 (1989), it jettisoned the notion of ‘mental age’ as a tool for assessing such disabilities.

In Hall v Florida, 572 US (2014); 134 S Ct 1986 (2014), it abandoned the terminology of mental retardation and identified intellectual disability as existing on a spectrum, not being just an IQ number, to be determined by reference to various forms of evidence, lay and expert.

In Atkins v Virginia, 536 US 304 (2002), it pronounced imposition of the death penalty on persons who are ‘mentally retarded’ to be cruel and unusual punishment in breach of the Eighth Amendment to the Constitution.

Importantly, too, the Supreme Court jurisprudence has evidenced an increasing sophistication in awareness of the forensic repercussions of ‘intellectual and developmental disorders’ (IDDs).

This editorial traces the evolution of United States intellectual disability jurisprudence in respect of imposition of the death penalty, reflects on the ongoing areas of vulnerability for criminal offenders with IDDs and calls for further consideration to be given to the option for offenders with an IDD to be sentenced to reside in a forensic IDD environment as a humane containment and behaviour modification alternative to other forms of disposition.

EVOLUTION & THE IMMUNE SYSTEM & THE ENDOCRINE SYSTEM, & THE MICROBIOME & THE ENVIRONMENT​ & -------- THE BRAIN

4/21/2021

 
​
  • Every age tends to find out it doesn't know as much as it thought it did.
  • There is the INCREMENTAL or ACCELERATED accumulation of FACTS and INFORMATION --- but where that hits a speed bump is when those FACTS contradict deeply held notions of the Society.
 
  • So Human Behavior is all about the brain -- right?   Yeah ---- BUT there are trillions of other factors that are important to Behavior and involve other SYSTEMS OF THE BODY and those SYSTEMS OF THE BODY are operating in a complex ENVIRONMENT both SOCIALLY and PHYSICALLY.
 
  • So much of this is UNCONSCIOUS or outside our AWARENESS.
​
  • BUT this Century is bringing a NEW AWARENESS of Biology as FOUNDATIONAL to BEHAVIOR.
 
  • Additionally, we're recognizing the HEALTH EFFECTS of UNCONSCIOUS BIAS and SOCIAL HIERARCHIES.
    • ​We're not necessarily doing a lot about unconscious bias and social hierarchies, but we're 'talking" about them.
​
  • The knowledge that the IMMUNE SYSTEM is such a big player in BEHAVIOR is new.
​
  • The knowledge that the MICROBIOME could influence our behavior is new.  This is research in our lifetimes.
 
  • A Public Health Approach to Criminal Justice has been a long time coming and can probably be traced beyond "Mental Illness" to "Age" and other factors.
 
  • While the ideas for "A Public Health Approach to Criminal Justice" have been EVOLVING --- so have the ideas regarding ECOSYSTEMS.
 
  • ​We're facing a number of CRISES that are forcing EVOLUTION of our IDEAS in Criminal Justice, our Relationships to One Another and our Relationship to Other Species and the Natural World.
​
  • The reality is there is NOT MUCH DIVERSITY among Human Beings.   Most of the DIVERSITY we FOCUS on such as ethnicity or skin color is superficial --- most of the DIVERSITY among human beings is in their IMMUNE SYSTEMS.
2014:  Then Director of the National Institute of Mental Health:  We're all very humble --- We don't even have a parts list for the brain.
​University of Virginia School of Medicine Researchers Find Altering Link Between Brain and Immune System -- Changes Behavior (2016)
​Professor Graham Rook at University College London:  People are disturbed by the idea that they are not individuals, but they are not --- they are Ecosystems.  (2018)
​Professor Daniel Davis at Manchester University:  Genes & Immunity

It's Biology

4/19/2021

 
​
  • Even researchers can sometimes get caught up in whether a particular Behavior represents a "disease' or not or a "mental disorder."​
  • I would submit Stanford Neuro-Biologist Robert Sapolsky cut through that by recognizing that the issue was BIOLOGY.
  • So it's a lot like GRAVITY --- if you want to say there is someplace where GRAVITY doesn't operate --- the burden is on you to prove that --- because it is so well established that GRAVITY is one of the fundamental forces of the Universe.
 
  • FREE WILL v. DETERMINISM DEBATE ---- we've got to engage in some DIVERGENT THINKING and STEP OUT OF THIS.
 
  • If there is a BEHAVIOR of an animal or person --- there's an UNDERLYING BIOLOGY driving that behavior.
 
  • Further, environments can and do effect our BIOLOGY.
 
  • If we want to get more control over ANTI-SOCIAL BEHAVIOR --- we must understand the BIOLOGY / ENVIRONMENT that drives it.
 
  • On the one hand, I'm absolutely arguing for a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE.
 
  • On the other hand, we are on the CUSP of entering a BRAVE NEW WORLD OF BIOLOGICAL KNOWLEDGE ---- and that is going to require ETERNAL VIGILANCE as LIFE often does.
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Neurobiological roots of psychopathy (2019)
​

​We observed enrichment in several immune response-related pathways.

This is an interesting finding since a recent study on adult antisocial behavior found enrichment in 7 gene sets, most of which being immune related [9].

This suggests that altered immune response contributes to the pathophysiology of antisocial behavior.
​Smarthistory

Lucus Cranach the Elder, Adam and Eve, 1526, oil on panel (Courtauld Gallery, London). 
​
Speakers: Rachel Ropeik and Steven Zucker

Anti-social personality disorder:  Observations & Australian Law Reform

4/19/2021

 
​
  • ANTI-SOCIAL PERSONALITY DISORDER harms defendants and other parties in the CRIMINAL JUSTICE SYSTEM.
  • If there is a SERIOUS COGNITIVE ISSUE that is not accurately assessed, characterized or treated --- THAT MATTERS.
  • At the ROOT of much of this is a FEAR of recognizing BIOLOGICAL EXPLANATIONS for Criminal Behavior.  BUT if you don't, the SYSTEM and the SOCIETY and EVERYONE in it are much less safe.
  • AND individuals in our SYSTEMS OF INCARCERATION often get worse -- that's according to Corrections Officials.
 
  • Australia's Civil Commitment for "Personality Disorder" in severe cases involving danger to others  --- is an attempt to recognize REALITY.
 
  • One does see people in the criminal justice system with "PSYCHOSIS" --- a so-called Stage 4 of Mental Illness --- but before one gets there one is usually talking about DEVELOPMENTAL DISABILITY and often ADHD.
​
  • ADHD is the Developmental Disability that is often being associated with "ANTI-SOCIAL PERSONALITY DISORDER."
 
  • ADHD is one of a number of common neuro-developmental disorders that are associated with acute and chronic maternal inflammation during pregnancy.  
 
  • The mechanism of maternal inflammation helps to explain the wide variety and idiosyncratic nature of these neuro-developmental disabilities or differences.
 
  • Further Inflammation and Immunity (Innate & Adaptive) go to a number of things, including SOCIAL BEHAVIOR.
 
  • ​ADHD is now commonly associated with something called "REJECTION SENSITIVE DYSPHORIA" (RSD).
 
  • Nationally recognized Colorado ADHD doctor William Dodson recognized the symptom as applying to ADHD and it had previously been identified with "ATYPICAL DEPRESSION."
    • ​"Because RSD is always triggered by some event and because the mood shift matches the nature of the trigger, the internalized RSD can be considered a normal mood in every way except its intensity."
 
  • That sounds like a lot of what one sees in the criminal justice system.
 
  • Further, it sounds a lot like what the criminal law has been trying to get at since ancient times --- OUT OF PROPORTION EMOTIONAL INTENSITY that is FUELING BAD ACTS.
 
  • I would also submit that RSD is a lot of what one sees in Police Excessive Force Cases.  An officer feels DISREPECTED --- and "goes off" on somebody --- and IT IS NOT PROPORTIONAL to the alleged insult or threat.
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Personality Disorder, the Criminal Justice System & the Mental Health System

Victorian Law Reform Commission (Au
stralia) --

On the US Dept. of Justice, Office of Justice Programs, Virtual Libraries website


Civil commitment is justified for a person with a personality disorder so severe as to render him or her functionally equivalent to a mentally ill person and also dangerous to others.


Victoria's Community Protection Act provides a mechanism for civil commitment in such cases, goes further than Mill did by requiring two criteria rather than one, and is consistent with the criteria of the Mental Health Act.

TAKE THE "O TRAIN" --- OLMSTEAD TRAIN ---TO CRIMINAL JUSTICE REFORM

4/19/2021

 
​
  • I've seen a number of criminal justice reform efforts that had less than spectacular results because what was needed was so UNDER-ESTIMATED.
  • 90-Day Treatment Programs or even 1-year Treatment Programs --- some of the time that works and a fair amount of the time it doesn't.
  • So we have no choice but to PUNISH the person --- THAT WOULD BE THE WRONG ANSWER.

We know there are people with complex and multiple cognitive issues, namely High IQ Developmental Difference / Disability, Brain Injury, Substance Issues, and Mental Illnesses.

Now I would say those are the primary issues, but occasionally someone with even more EXOTIC ISSUES finds their way to the Criminal Justice System such as someone with HUNTINGTON'S CHOREA.

There's an enormous amount to consider in all this.  That is why ON-GOING, DATA-DRIVEN OLMSTEAD PLANNING that is COMPREHENSIVE & EFFECTIVE is so important for CRIMINAL JUSTICE REFORM.
Picture
​When we start to appreciate the Nature and Complexity of the Challenge ---- we realize this isn't going to get resolved in 2 weeks --- it's going to require years of systematic, data-driven PLANNING ---
  • That needs to be INCLUSIVE

Further, it has to be ACCOUNTABLE with legally required:
  • Measurable Goals
  • Reasonable Time Frames, and
  • Funding to Support the Plan

If Colorado and other States are serious about Criminal Justice Reform --- they will take the "O Train" to get there in a HURRY.​
Duke Ellington
​Take the A Train


​Let's take the "O Train" (Olmstead Train) to Criminal Justice Reform
Jazz Academy at Lincoln Center (2020)

​Music scholar Greg Thomas discusses the lasting legacy of Duke Ellington's 1943 masterwork "Black, Brown, and Beige."

One of the many interesting observations of Thomas is that Ellington composed with certain musicians in mind --- understanding their strengths and weaknesses.


That complicated challenge is what we are called on to do as a Society.

COMMON COGNITIVE ERRORS OF "NEURO-TYPICALS"

4/13/2021

 
  • Fundamentally, the cognitive errors of "NEURO-TYPICALS" are the cognitive errors of most groups neuro-typical or not.
  • There are an infinite number of ways to consider the "Strengths" and "Weaknesses" of Human Beings.
  • And in many if not most cases --- what is a "Strength" and what is a "Weakness" --- depends on the ENVIRONMENT.
  • I've talked a lot about BIOLOGY & ENVIRONMENT --- it is their INTEGRATION that is important --- they are not separate in the common experience of LIFE.
​​
  • As any parent, teacher or judge probably knows --- wouldn't it be great if we could just LECTURE people or PUNISH them ---- and all those BEHAVIOR ISSUES would just go away.   Unfortunately, that is the rarely the case.
​
  • ​Behavior issues associated with a  brain injury, a developmental difference, substance issues, or mental illness are very unlikely to resolve with a LECTURE.  Further, many people with those BEHAVIOR ISSUES in the Criminal Justice System have more than one or all of those underlying biological issues.
​
  • ​It sounds out of place or out of turn to say in our Society ---- BUT PEOPLE WANT TO BE LOVED.
 
  • One of the ways we can show that LOVE is by BUILDING on people's STRENGTHS, and WORKING AROUND their weaknesses --- creating a Society and Environments that work for all of us.
​​
  • ​Paraphrasing singer-songwriter Tierra Whack -- "Let's Build Something."


Tierra Whack
Link
​Stanford's Tina Seelig:  Divergent Thinking
​Big Think:  Johann Hari:  Why Depression is a Socioeconomic Disease.

We're beating up on a lot of NEURO-DIVERSE PEOPLE and by and large we're not even aware of it.
The video to above is a POWERFUL statement by Aurora Public Schools on Twice Exceptional Students BUT the application is BROADER.

One of the TAKEWAYS from this short video is the statement by the mother who says:  "THERE IS NO SHOULD."

There are numerous important insights from the teachers as well.
​​See 3:08:  "The most important piece to remember is to identify their strengths and program for that first.

"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."

HEMINGWAY:  ​OUR JUMPING OFF POINT TO THE MESSY BIOLOGY OF COGNITIVE DISABILITY

4/11/2021

 
               One of the things the Novelist, Dramatist, Artist or Comedian knows --- all those separate and distinct aspects of HUMAN LIFE are really thoroughly INTEGRATED.  
                We tend to have a lot of seemingly ridiculous debates about BIOLOGY vs. ENVIRONMENT  --- they're NOT OPPOSITES.

                  When we think of:
  • the epigenetics of mental illness which often involves the IMMUNE SYSTEM, or
  • TRAUMA which impacts the IMMUNE SYSTEM & the BRAIN, or 
  • Concussions that lead to BRAIN INJURY and often Mental Illness

​And we look at the HUMAN BEING --- Cognitive Disability is DYNAMIC, COMPLICATED and IDIOSYNCRATIC --- and it often involves NEURO-INFLAMMATION.

How does that fit with the DSM 5?  Not well.

Living Beings and all Animals live in an ENVIRONMENT.

All Living Beings and all Animals have a BIOLOGY.

It's the THOROUGH INTEGRATION of BIOLOGY and ENVIRONMENT that make up LIFE.

We've gone from no understanding of BIOLOGY as an aspect to BEHAVIOR to some circumscribed UNDERSTANDING --- but the categories and systems we've developed don't withstand MODERN SCIENTIFIC SCRUTINY or even just BASIC PRINCIPLES OF LOGIC.

Our Society kinda believes that BIOLOGY can account for BEHAVIOR --- and kinda doesn't.

THOUSANDS OF COLORADANS and MILLIONS in the US and for that matter around the world are being sacrificed on the ALTAR OF BIOLOGICAL AGNOSTISM.

Understanding that BIOLOGY is always part of the EQUATION of BEHAVIOR-- just as ENVIRONMENT -- is crucial.

A BIOLOGICAL UNDERSTANDING provides a CROSS-REFERENCE to understand what is going on with the Behavior and to ameliorate it if necessary.

BIOLOGY gets to the INDIVIDUAL response to the ENVIRONMENT.

ENVIRONMENT is important because it can and does impact our BIOLOGY.

Further, many people in the same or similar ENVIRONMENTS will have different experiences of that ENVIRONMENT --- because of their BIOLOGIES.

This is a SCARY PLACE to go for many people with DISABILITIES --- Science has often not been our friend -- and the HORRORS OF EUGENICS always had a SCIENTIFIC GLOSS.

So you can't do what needs to be done on BIOLOGY & BEHAVIOR without a strong ETHICAL FOUNDATION that appreciates not only rugged individualism but also community responsibility --- and an EXPANDED PRO LIFE VIEW OF THE WORLD.   
​
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​Hemingway is an excellent example of Cognitive Disability, and especially the Cognitive Disability one finds in the Criminal Justice System.

He had a family history of mental illness, some family conflict, a series of concussions, a complicated and often deeply destructive society and world, mental illness of his own, and alcohol problems.
God of the Gaps, Criminal Liability of the Gaps
"Pro Life" as a Progressive Issue
Criminal Justice Policy --- Shooting in the Dark

  • A DSM 5 that is NOT BASED on the underlying BIOLOGY of mental illness, but a collection of symptoms.  Most researchers are finding those categories BLURRED.
​
  • Criminal Categories of "INSANITY" and "INCOMPETENT TO PROCEED" that don't reflect the COMPLICATED NATURE OF COGNITIVE DISABILITY / NEURO-INFLAMMATION which is both IDIOSYNCRATIC and LARGELY UNIVERSAL in the CRIMINAL JUSTICE SYSTEM.
 
  • What Stanford Neurobiologist Robert Sapolsky says:  It is NOT just BAD ACTS that BIOLOGY is behind, it's good acts and meh acts, too.
    • ​That's hard to swallow when one is responding so BIOLOGICALLY to acts of other people.
    • It is a blurred mess.
    • BUT at the end of the day, BIOLOGY is FOUNDATIONAL to BEHAVIOR
​​
  • ​We're going to have RECIDIVISM PROBLEMS if we're not dealing with UNDERLYING BRAIN INJURY, DEVELOPMENTAL DISABILITY, SUBSTANCE ISSUES and MENTAL ILLNESS.  
​
  • "DEALING WITH THAT" does include Housing, Placements and Healthcare.
​​
  • It also includes "INDIVIDUALIZED SUPPORTIVE EMPLOYMENT" which is NOT only what many Conservatives need to go along with all this -- it's also what most Individuals want.    ​

DEVELOPMENTAL DISABILITY, MENTAL ILLNESS & INTELLIGENCE

4/10/2021

 
Conjecture

Val's Take
  • Questions are important. 
  • Societies tend to have FUZZY IDEAS that are connected to OTHER FUZZY IDEAS and it turns out that matters and it matters to the lives of individuals, to families and to societies.
  • Three FUZZY IDEAS in our society are "DEVELOPMENTAL DISABILITY," "MENTAL ILLNESS" and "INTELLIGENCE."
  • Historically, we have thought of them as DISTINCT, although "genius" and "madness" have been associated since ancient times.
  • What "Developmental Disability," "Mental Illness" and "Intelligence" have in common is "NEURO-INFLAMMATION."
  • Whether you have Down Syndrome, ADHD, Autism and/or are "Gifted" -- you have a higher level of NEURO-INFLAMMATION than "NEURO-TYPICALS."
​
That Neuro-Inflammation often comes with Executive Functioning Differences.

Further, the most recent research says INNATE & ADAPTIVE IMMUNITY (that are driving that NEURO-INFLAMMATION) are connected to SOCIAL BEHAVIOR -- Who would've THUNK IT?

I would submit "MENTAL ILLNESS" is much higher among people with intellectual disabilities, ADHD, Autism, Gifted, Sensory or Information Processing Disorders, Etc. --- because they already have a high level of NEURO-INFLAMMATION.

The ENVIRONMENT that many people with High IQ Developmental Disability or Difference are walking into can be akin to a BUZZ SAW.

Basically, you have many NEURO-DIVERSE people who are UNUSUALLY SENSITIVE to the JUDGMENTS of OTHERS and who are NOT "FITTING IN" for a whole host of reasons, not least of which their EXECUTIVE FUNCTIONING is significantly different than "NEURO-TYPICALS."

High IQ Developmental Disability sounds like an OXYMORON and our Society treats it like an OXYMORON.

BUT for many people with HIGH IQ Developmental Disability or Difference that lack of understanding is leading to HIGH IQ Developmental Disability & Mental Illness.


We're not facile as a society at making ACCOMMODATIONS or WORKAROUNDS for Executive Functioning Differences.

THAT IS THE BUZZ SAW MANY NEURO-DIVERSE PEOPLE ARE WALKING INTO ---- AGAIN & AGAIN & AGAIN.


​The stress of our NO EXCUSE Society is quite real.

That is also why some people charged with crimes --- choose incarceration over probation.  Probation is much harder from an executive functioning standpoint.

There are even commentators on YOUTUBE recommending people with ADHD charged with crimes --- take time so the person doesn't set themselves up for failure on PROBATION.

THAT SHOULD NOT BE THE RIGHT ANSWER.  

I'm not for putting anybody at risk, but we must UP OUR GAME when it comes to understanding and accommodating COGNITIVE DISABILITY.
Picture
Neuroinflammation as a risk factor for attention deficit hyperactivity disorder (2019)
Picture
Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017)
Picture
Inflammation and Neuro-Immune Dysregulations in Autism Spectrum Disorders (2018)
Picture
Recognizing and Treating Comorbid Psychiatric Disorders in People With Autism (2019)
Picture
“High intelligence: A risk factor for psychological and physiological overexcitabilities” (2017)

(The authors take a psycho-neuro-immunological approach)
Picture
Evolution of Neuro-Inflammation Across the Lifespan in Individuals with Down Syndrome (2020)
Picture
Psychiatric Morbidity in Adults with Down's Synd​rome
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  • Blogs
    • Val's Blog
    • Val's Blog 2
    • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
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  • US Federal
    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
  • Research & Translational Medicine
    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
      • Brain Injury, the Immune System & Mental Health
      • Celiac Disease & Sensitivities, the Immune System & Mental Illness
      • Mental Illness & The Immune System
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      • Trauma & the Immune System & Mental Health
      • ***Physical Health Issues, the Immune System & Mental Health Index
    • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System