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Defunding or Re-Imagining Mental Health & Forensic Mental Health Services

6/30/2020

Defunding or Re-Imagining Mental Health & Forensic Mental Health Services

By and large, THIS IS NOT A PEOPLE PROBLEM (there may be exceptions and there are definite COMPENSATION INEQUITIES within the SYSTEMS themselves that are NOT helping)
This is really about a profession that is very PARTIAL in its understanding and does not have a scientifically valid DIAGNOSTIC MANUAL. [We can't have these people handing out ANTI-SOCIAL PERSONALITY DISORDER DIAGNOSES -- anywhere, much less the CRIMINAL JUSTICE SYSTEM.]
At the same time we have an EXPLOSION in BIOLOGICAL KNOWLEDGE and knowledge regarding various cognitive disabilities that may also be the result of BRAIN INJURY, DISABILITY as a RESULT of SUBSTANCE USE, and DEVELOPMENTAL DISABILITY.
We can't go back, we can't stay where we are and we don't have PERFECT knowledge.
We need a PUBLIC HEALTH APPROACH founded on SAFETY and BEST PRACTICE, and that takes punishment out of it.

University School of Medicine (2016)

Of ‘Profound’ Importance in Proper Social Functioning, University of Virginia Discovers

• Researchers determine that the immune system affects – and even controls – social behavior.
• Blocking a single type of immune molecule made mouse brains go hyperactive and caused abnormal behavior; restoring it fixed both.
• Discovery could have enormous implications for neurological conditions such as autism and schizophrenia.
• “It’s crazy, but maybe we are just multicellular battlefields for two ancient forces: pathogens and the immune system. Part of our personality may actually be dictated by the immune system.”

Insight with John Ferrugia: Breakdown
Feb 4, 2020

Rocky Mountain PBS

A breakdown in mental health services across the state of Colorado has left law enforcement on the front lines of handling people in crisis.

OUR LAMENT

A lot of our ideas on Defunding or Re-Imaging Mental Health & Forensic Mental Health come out of:

A need to integrate our knowledge;
Get really HONEST about the GAPS in that knowledge,
and put that BURDEN on where it belongs -- THE STATE, NOT THE INDIVIDUAL
FUND RESEARCH and Translational Research necessary for COMPETENT Mental Health Practice.>>>>

[HINT: It's not competent to IGNORE US National Institute of Mental Health or international researchers regarding concerns of the DSM 5.

It is RIDICULOUS that a legal advocate is having to advise the Mental Health Profession to SCIENCE UP --- BUT that is just how INCOMPETENT we have allowed the mental health profession to become.]

Significantly, University of Virginia researchers are finding that SOCIAL BEHAVIOR is mediated by the IMMUNE SYSTEM.

Science Up

Acknowledging Progress & Demanding More

In many ways we are well on our way with INTEGRATION of "PHYSICAL" HEALTH and "MENTAL" HEALTH -- we need to speed that up.
We also have to INTEGRATE our DIAGNOSIS and TREATMENT of:
- Brain Injury
- Mental Illness
- Disability as the Result of Substance Use, and
- Developmental Disability
We are so ILL PREPARED to deal with the REALITY of who is on our STREETS and BEING RELEASED FROM INCARCERATION.
And if we are ILL PREPARED, generally somebody is going to PAY.
Generally, that is the Individual with one or multiple cognitive disabilities.
Sooner or later, many of those people with cognitive disabilities PAY with THEIR LIVES.
Sometimes it may be the LIFE of a FAMILY MEMBER or RANDOM STRANGER.

COLORADO and Other States have seen plenty of this -- IT'S TIME FOR MAJOR REFORM -- A PUBLIC HEALTH APPROACH TO CRIMINAL JUSTICE

This is both a PRO LAW ENFORCEMENT and PRO INDIVIDUAL, PRO FAMILY and PRO COMMUNITY proposal.

Defunding or Re-Imagining the Police: A Public Health Approach Could Get Us On the Same Team

6/28/2020

Head to Head COMPETITION is THRILLING --- and getting on TEAMS to BEAT the other TEAM can seem to give life PURPOSE especially when paired with some "MORAL OBJECTIVE."

Islam sometimes refers to life on this Earth as a "HOUSE OF CONFLICT." It certainly is that.

Neuroscientist David Eagleman might argue that it is a "HOUSE OF CONFLICT" because human beings don't FEEL the PAIN of their "OUT-GROUPS."

Further, those "OUT-GROUPS" can be anything. In the US, it's been dark skin color for over 400 years -- BUT it can be other things.

One of the ways we get out of this is by:

adopting a PUBLIC HEALTH APPROACH to Policing and Law Enforcement and RE-ALLOCATE RESOURCES for that.

When those kids were playing COPS and ROBBERS -- they never imagined issues of PTSD, DEPRESSION, and ESCALATING AGGRESSION.

It's time for US to GROW UP.

sportsconflict.org

THE BRAIN WITH DAVID EAGLEMAN | What is Empathy? | PBS ---"Empathy" turns out to be a lot about which TEAM you're on.

When Systems Fail Us: Never Giving Up is a lot about FAITH

6/24/2020

[Originally, posted on June 22, 2020 -- the 21st Anniversary of the Olmestead Decision]

Waiting for States to comply with Olmstead for people with cognitive disabilities with the greatest need has seemed a lot like "Waiting for Godot."
We actually have come A LONG WAY since 1999 and the US Supreme Court's Olmstead Decision.
A lot of that way has been about: REASON. We've had some FUNDAMENTALLY WRONG IDEAS regarding:

who was in the Criminal Justice System.

Those FUNDAMENTALLY WRONG IDEAS came from:

Law & Order Hawks
the Disability Community, and
the Mental Health Profession

    Now, not everything these groups think (in many cases -- now THOUGHT) is WRONG, but there was/is a need to do a fair amount of parsing.

   As a HUMAN BEING, we're not some solitary animal or insect as much as we might like to be one (or sometimes feel like one -- think Franz Kafka's "The Metamorphosis").

We live in families, communities, and societies -- that are trying to build on what was left to them.

Invariably, we're NEVER talking PERFECTION -- although for me my family came a lot closer than the society --- BUT my family was NOT independent of the society.

And neither am I -- as much as I sometimes wish I were.

My Father who I admire so much and am so different from -- always seemed to see the glass half full, the long view of history, and the importance of education -- and oh yeah, he was pretty much the most organized person on the planet.

What I've found over the past 7 years of Orchid is that many times (not always) --by the time I was able to explain my ideas to others -- they were already there.

  WE JUST GOT THERE A DIFFERENT WAY.

  But it took a lot of FAITH to get there.

A Raisin in the Sun (1961)

Michael Franti & Spearhead -- This World Is F*cked Up (But I Ain't Never Giving Up On It)

Conversation & Dialogue: Integrating Science, Reason & Faith/Religion

June 22nd, 2020: The 21st Anniversary of Olmstead, our National Report and IRREPARABLE HARM Due to Lack of Supportive Housing & Placements

6/22/2020

Our National Report on Systemic Issues resulting in State Failure to Comply with Olmstead is going to address the current EMERGENCY regarding LACK OF SUPPORTIVE HOUSING & PLACEMENTS.

Our Bottom Line:

The STATUS QUO is resulting in IRREPARABLE HARM to individuals with cognitive disabilities
Specifically, that IRREPARABLE HARM is homelessness and incarceration.

The Harm of Healthcare Institutionalization

That harm with healthcare institutionalization is certainly there.
However, many but not all people with cognitive disabilities who are homeless or being released from incarceration would prefer an assisted living residence, nursing home, hospital bed to the STREETS or a DANGEROUS SHELTER.
It is very unsafe for everyone concerned to DISCHARGE or RELEASE people with cognitive disabilities to Homelessness, and it is mainly dangerous for the person.

Harm Reduction

Utilize existing Assisted Living, Nursing Home and Hospital bed space for people with cognitive disabilities pending REASONABLE WAIT TIMES for SUPPORTIVE HOUSING and PLACEMENTS if desired.

Our Final Major Idea We're Including in the Report

There are a lot of ways to provide for SUPPORTIVE HOUSING and CONTINUUM OF CARE for People with Cognitive Disabilities with the Greatest Need.
Medicaid's Exclusion Rule for "Institutes of Mental Disease" and failure to fully cover SUPPORTIVE HOUSING combined with spotty Olmstead Enforcement against the States driven by HYPOCRISY is literally killing people with Cognitive Disabilities.
That hypocrisy is pretty thick at both the Federal and State levels.
We're not terribly interested in "holding people accountable."
We are interested in SOLVING THIS PROBLEM -- NOW.
There have been efforts to loosen Medicaid's IMD rule, we need to do the same for payment of Housing in SUPPORTIVE HOUSING, not just housing-related activities.
We need CMS and HUD to coordinate with the States to do that and we need Congress to authorize that.
Where we are now is that we have largely conceptualized the full legal responsibility for Housing for people with disabilities who are institutionalized or at great risk of institutionalization -- to be on the STATES.
States are NOT providing HOUSING for people with disabilities who are institutionalized or at great risk of institutionalization at the SCALE needed.
Further, the Federal Government is NOT providing the ENFORCEMENT needed, although important cases have been brought.
We need a National Strategy for providing SUPPORTIVE HOUSING and CONTINUUM OF CARE to people with Cognitive Disabilities with the Greatest Need.
If states want to modify that and they still comply with the law, that shouldn't be a problem.
But the widespread State disregard for Olmstead's more rigorous requirements is leading to harm and irreparable harm to thousands if not millions of Americans with cognitive disabilities with the greatest need.

"Michael Marshall is dead because he was Black. Michael Marshall is dead because he was poor. Michael Marshall is dead because he was suffering from mental illness. Michael Marshall is dead because he was homeless. Four of those things are the reason why Michael Marshall is dead and we are here today."

BrotherJeff.com: SAY IT LOUD!
Black Lives Matter

Denver MLK Marade 2016: Why is Michael Marshall Dead

We will be incorporating into our National Report:

calls to "Defund the Police Re-Allocate Resources to Services People Need" and
the DESPERATE NEED for States to Comply with a 20-year old U.S. Supreme Court decision protecting the rights of people with disabilities: OLMSTEAD.

Our Uncomfortable Reality

The Reality is Most States – Talk the Talk. Minnesota is the only state that we are aware of that has been forced to develop PRECISION OLMSTEAD GOALS.

Further, Minnesota has much work to do. Most States do everything they can to avoid the MEASURABLE GOALS demanded by Olmstead even as they are singing Olmstead’s praises.

That kind of HYPOCRISY is NOT just ANNOYING, it’s DANGEROUS.

Thousands if not millions of Americans with cognitive disabilities with the greatest need are suffering its consequences.

FINAL REPORT

Orchid's National Report on Selected Systemic Issues Leading to State Failure of Olmstead Compliance (cognitive disability) 2020

NEXT UP: OUR PETITION FOR INJUNCTIVE RELIEF

Ethics for When We Don't Have All THE ANSWERS (which is pretty much ALL THE TIME)

6/21/2020

Psychology's Today's welcome article recognizing a FLAWED CLASSIFICATION SYSTEM fails to appreciate the FULL IMPORT of that INSIGHT

Psychology Today has a very interesting article this month:

acknowledging the FLAWED DSM Classification System,
moaning the lack of progress on what I'm assuming is the US National Institute of Mental Health's biologically-based RDoC intiative, and
finding the work of some anthropologists intriguing and
a classification system proposed by some at Rutgers University [which in our opinion is interesting and needs some work]

      So alrighty -- WHERE ARE WE AT IN DEALING WITH THE MONUMENTAL ETHICAL CHALLENGES REGARDING A FLAWED DSM IN THE CRIMINAL JUSTICE SYSTEM?

    The ANSWER: WE ARE NOT VERY FAR IN DEALING WITH A FLAWED DSM IN THE CRIMINAL JUSTICE SYSTEM.

Those Black Lives Matter protesters are evidence of a lot of things: To my mind -- at least in part -- they are protesting the COMPLACENCY of the SOCIETY.

    The COMPLACENCY of the Mental Health Profession and the Criminal Justice System in the face of invalid, pejorative psychiatric labels such as ANTI-SOCIAL PERSONALITY DISORDER -- is UNCONSCIONABLE.

   The US National Institute of Mental Health called out the DSM in 2013 as "lacking validity"-- that was 7 years ago.

   Can you imagine the OUTRAGE over the INCOMPETENCE in dealing with a FUNDAMENTALLY INVALID CLASSIFICATION SYSTEM -- if this were say -- COVID-19?

The BIG PROBLEM is NOT so much that we don't have "THE ANSWER" -- although it would be better if we had more answers.

The BIG PROBLEM is that we THINK we have to have ALL ANSWERS BEFORE we can treat the people in the CRIMINAL JUSTICE SYSTEM -- ETHICALLY & HUMANELY.

  THAT IS FALSE. The sooner the Mental Health Profession and the Criminal Justice System can WAKE UP to that -- the BETTER.

Waiting (News24)

Psychology Today Article

Science Up

Crap Justice and Crap Services: They Often Go Together

"Defunding the Police" Means Re-Allocating Resources to Services People Need

A Public Health Approach to Criminal Justice

A Public Health Approach is:

NOT pretending it has knowledge it doesn't have
Is using the knowledge it does have to further people's physical and mental health, and is
Engaged in CONTINUOUS IMPROVEMENT

"Defunding the Police," "Complying with Olmstead" AND Coming to Terms with the Monster in the Mirror

6/18/2020

Minnesota actually has a lot of the FOUNDATION for FULL OLMSTEAD COMPLIANCE to address if NOT all -- a large part of CRIMINAL JUSTICE.
The killing of George Floyd by a police officer in Minneapolis, Minnesota while other officers looked on -- puts in pretty high relief that Minnesota's Olmstead work isn't done.
Further, it also points out why OLMSTEAD PLANNING MUST BE AN ON-GOING PROCESS reasonable goals, reasonable time frames and funding to support the plan.

       Most importantly, the Cognitive Disability problems are NOT just on the Criminal Defendant side of the fence -- they are in law enforcement, prosecutors, defense attorneys and the judiciary.

    These problems run throughout the society -- BUT they sometimes get ramped up a bit in those working in the SYSTEM both because of the ENVIRONMENT -- and the BIOLOGY that draws one to the ENVIRONMENT.

The challenge is that while a lot of doctors with "ADHD" go to work in the EMERGENCY ROOM -- some LAW ENFORCEMENT and ATTORNEYS with "ADHD" -- work in the CRIMINAL JUSTICE SYSTEM.

    Further, ADHD includes Executive Functioning Deficits and challenges with Emotional Regulation. Now attorneys and judges may be BETTER at masking those issues than others. However, those who have spent much time in the Criminal Justice System realize those issues are sometimes not that far below the surface.

If we start to think about:

BLURRED LINES in PSYCHIATRIC DISORDERS such as ADHD, AUTISM, DEPRESSION, BIPOLAR DISORDER, & SCHIZOPHRENIA (as described by the US National Institute of Mental Health)
And "Bipolar Disorder" as a DEVELOPMENTAL DISORDER with highly REACTIVE CELLS.

WHAT IS THE IMPLICATION for multiplying "AGGRESSION CELLS?"

L.A. Times

Aggression: Humanity's Ultimate Double-Edged Sword

Death of George Floyd: Reason 1 Million & 1

Check out the Buttons below for:

the Minnesota Olmstead case -- Jensen
the Minnesota Court Ordered Olmstead Plan
Minnesota has created an Olmstead Sub-Cabinet that includes the Director of the Department of Corrections.
2010 US Department of Justice Settlement Agreement with Georgia involving HOUSING & SERVICES for over 9,000 Individuals with Mental Illness and Developmental Disability being released from incarceration
- We need to get out of the piecemeal and engage in ON-GOING COMPREHENSIVE, EFFECTIVE OLMSTEAD PLANNING that brings HOUSING, SERVICES & PLACEMENTS to SCALE.

Olmstead & DOJ Index

Olmstead Index

Minnesota's Jensen Case

Minnesota's Olmstead Plan

Protesting as Charades

6/17/2020

When we take our VOICE out of it -- to communicate -- it can really seem to SLOW THINGS DOWN -- but in a WEIRD WAY -- it can speed them up.
Interestingly and rather frighteningly, the mental health profession has latched onto "TONE OF VOICE" as an indicator of "mental Illness"/ "mental distress."
They're probably not WRONG about that, but as tends to be the case -- they have less than a third of the picture.
It is a lot easier for the PRO SOCIAL MENTAL HEALTH PROFESSION and SOCIETY to talk about:

diet and exercise, and
childhood abuse

Than the widespread DYSFUNCTION IN THE SOCIETY and how that is DRIVING many health problems, including cognitive health problems, in the Society.
As is often the case, REAL LEADERSHIP in the SOCIETY comes from the BOTTOM -- and the people at the TOP CHANNEL that.
PROTESTS are a way to CUT THROUGH ALL THE HIERARCHY we've created. By and large, the people in that HIERARCHY whether at the top, the bottom or the middle --didn't CREATE IT.
SOCIAL DETERMINANTS of HEALTH and HEALTH INEQUITIES are big ideas that have been around for awhile. SOCIAL DETERMINANTS of HEALTH has been around for over a 100 years.
Ironically, some of the people who need more SUPPORT in this ECONOMY are some of its most CREATIVE, ENTREPRENEURIAL and INNOVATIVE.
Surely we can work something out.

Social Determinants of Health

Crap Justice & Crap Services: They Often Go Together

Public Health Approach to Criminal Justice

Defund the Police Means Re-Allocating Resources from Law Enforcement to Services People Need

Jimmy Fallon: The Best of Celebrities Play Charades

The Guardian: Rayshard Brooks: protesters set fire to Wendy's after black man shot by police

Cool Hand Luke (1967) -- Luke (Paul Newman) is returned to prison after his first escape attempt.

FAILURE TO COMMUNICATE SCENE.

Mental Health, Cellular "Reactivity"/ Sensitivity & Demonstration Projects

6/16/2020

The Federal CURES bill was such a big step in starting to address the FUNDING NEEDS of Mental Health Research
Mental Health has really struggled with the ENORMOUS COMPLEXITY of "MENTAL ILLNESS'
- THE BRAIN
- The HUMAN MICRO-BIOME -- Trillions of little creatures that impact our health and mental status far beyond anything we could have imagined; and
- THE IMMUNE SYSTEM -- this is HUGE -- and we're just starting to unpack it.
Further, a lot of "MENTAL ILLNESS" looks very related to DEVELOPMENTAL DIFFERENCE in the Immune System and more SENSITIVE/ "REACTIVE" cells.
Mental Illness really is pushing the understanding of who and what we are with the 2/3 addition of:
- the Human Microbiome, and
- the Immune System
Are Human Beings running up against some LIMITS regarding the Immune System, Sensitivity to the Environment/Reactivity to the Environment, & Cognition? -- Is there a Catch 22 -- there?

Blurred Lines

Physical Health, the Immune System, Mental Health, etc..

Calcium Channels and Psychiatric Disorders

Epigenetic Changes, Immune System, Psychiatric Disorders

University of Michigan says "Bipolar Disorder" appears to be DEVELOPMENTAL and people with the "disorder" have more "reactive" or sensitive cells.

What Are the Implications of "CELLULAR DIFFERENCE?"

We're starting to get to something that feels a lot more like a ROOT CAUSE of "mental illness"
There are these seemingly INFINITE number of factors within the PHYSICAL & SOCIAL ENVIRONMENT that these CELLS are "reacting" to in a more pronounced way than "CONTROL" cells.
{This is a call-out to Colorado & Mountain States: You NEED to look at ALTITUDE as one of those many, many FACTORS]
It seems like there could be some ADVANTAGES to cell sensitivity/reactivity, and some DISADVANTAGES to that. [Did Van Gogh maybe have some super human ability to perceive "TURBULENCE" -- maybe, but he also cut off his own ear and ultimately killed himself]
To really build on the promising research that is out there:
- Researchers
- Clinicians
- Individuals, and
- Policy-makers

must work together.

That can and should include States using MEDICAID for Demonstration Projects to BUILD on:
- The work of the National Institute of Mental Health regarding:
  - Calcium Channels as well as Epigenetic changes to the Immune System across psychiatric categories, and
- The work of the University of Michigan regarding Bipolar Disorder and cell reactivity.
- Psychiatric Disorders as a Neuroglial Failure

The Tiny Brain Cells That Connect Our Mental and Physical Health A new understanding of long-overlooked cells called microglia is challenging the assumption that body and brain function are completely independent.

Neuroglial Failure and Psychiatric Disorders

Unfinished Business: "All Men Are Created Equal," Environment, & GOING 360

6/14/2020

THE IMPORTANCE of ENVIRONMENT

"School" can sometimes be a much more NURTURING ENVIRONMENT for Girls than Boys.
On the other hand, the ADULT WORLD as it is CURRENTLY OPERATING -- tends to work a lot better for MEN than WOMEN

When an ENVIRONMENT is well suited to us -- we think -- "Hey, I've got what it takes -- I'm SPECIAL."

BUT the people who are not doing so well in that ENVIRONMENT -- know something we don't -- If the Environment is changed to FIT "THEM" -- we're NOT so SPECIAL anymore, and "THEY" are.

BUT MAYBE WE DO SUB-CONSCIOUSLY KNOW THAT -- and many History Professors would tell you "CHANGE EQUALS STRESS."

There's a lot at stake when we start talking about the NEED to CHANGE the PHYSICAL or SOCIAL ENVIRONMENT. Not to put too fine a point on it, this is LIFE or DEATH.

It's a COMMITMENT to "EQUALITY"-- that gives us the POWER to EFFECTIVELY and FAIRLY CHANGE the ENVIRONMENT. The FOUNDING FATHERS knew that -- even as their COMMITMENT TO EQUALITY was quite IMPERFECT.

There is a SYMBIOTIC RELATIONSHIP between RECOGNIZING "EQUALITY" and the ability to provide OPTIMAL ENVIRONMENTS for DIFFERENT INDIVIDUALS.

We hear this term ALL THE TIME: "360"-- "going 360" -- "A 360 Perspective" -- it's pretty hard to do -- BUT that's what we're moving to.

AND the FACT IS -- WE CAN'T GET THERE BY OURSELVES.

Anderson Cooper 360

XBOX 360-- Nascar -- Jeff Gordon

The View: Whoopi Goldberg, Meghan McCain, Abby Huntsman, Joy Behar and Sunny Hostin

What Makes Them "Well?"

6/13/2020

Art, Philosophy, the Humanities, Whatever -- A Strength-Based Approach -- Channeling that Sensitivity & Emotion for NOT ONLY Internal Change -- BUT EXTERNAL CHANGE AS WELL

  There is an ENORMOUS AMOUNT of INFORMATION packed into "EMOTION."
I do think in some respects the MENTAL HEALTH PROFESSION is "Right" -- you're trying to "DE-ESCALATE" this, but more importantly "UNPACK IT" and "CHANNEL IT" -- NOT just for INTERNAL CHANGE -- but for EXTERNAL CHANGE as well.
    If you see some Black LIves Matter Protesters -- LET ME GIVE YOU SOME COPING MECHANISMS for SYSTEMIC RACISM --WTF???
Can that Mental Health Professional understand the "LANGUAGE" of the Protester -- they probably can. Can they understand the "LANGUAGE" and "MENTAL DETERIORATION" of the person in  -- the Criminal Justice System --- sometimes, often NOT -- "We've got a NAME for YOU PEOPLE -- ANTI-SOCIAL.' "

   There have been NO SHORTAGE of DRAMATIC DEPICTIONS of the CRIMINAL JUSTICE SYSTEM -- even Justice Scalia said it is our great "MORALITY PLAY."
If you are "SENSITIVE" to what's goin' on in that SYSTEM -- it's pretty frightening.

I think the interest of some people with AUTISM in math, science, engineering, etc. and "FIXING THINGS"-- is to calm all that STIMULI down.

We are definitely moving to a "PUBLIC HEALTH APPROACH" to Criminal Justice -- and more broadly a TRUE PROBLEM SOLVING APPROACH to some of our most DIFFICULT PROBLEMS.
   You can just say "LAW & ORDER" so often before people REALIZE -- YOU"RE NOT SOLVING THE PROBLEM.

Law & Order Theme Song: 1990-1991

Ted-Ed: The Unexpected Math Behind Van Gogh's "Starry,, Starry Night" -- Natalya St. Clair

What kind of "Sensitivity to the Environment" must Van Gogh have had?

"Sensitivity to the Environment" sounds like such a WONDERFUL THING -- but if most people can't understand what you're saying -- IT"S VERY ISOLATING.

FOX 31: Inmates as Actors -- University of Denver Takes Theater to Colorado Prisons

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