Blog Archives

THE EFFICIENCY + RESOURCE EQUATION IN BEHAVIORAL HEALTH

8/31/2020

SEE STATE'S RESPONSE TO CHILD WELFARE AUDIT
WE'RE IN DESPERATE NEED OF MORE HOUSING & INTENSIVE SERVICES & PLACEMENTS

The ultimate EFFICIENCY in BEHAVIORAL HEALTH is BETTER TREATMENT which means:

Research
Translational Research / Medicine
Listening closely to patients -- if they say it's not working, it's probably not working

There is ENORMOUS HOPE in this area with "mental illness" and other cognitive disabilities undergoing REVOLUTIONARY SCIENTIFIC RE-CONCEPUALIZATIONS, specifically a fierce race to understand the roles of the Immune System, Endocrine System and Microbiome.

So the Treatments we have now have been the best we could do -- BUT it is HARD TO IGNORE and we argue DANGEROUS TO IGNORE that the current treatments are NOT up to SOLVING the CURRENT CRISIS.

Further it is the inadequacy of these TREATMENTS that are one of a number of powerful drivers of OUT-OF-CONTROL BEHAVIORAL HEALTH CARE COSTS.

We have over 300,000 to 1.2 million people with mental illness incarcerated around the country and THOUSANDS in Colorado.

Further, many incarcerated people are dealing with more than one cognitive disability.

That disability as a result of substance use was an often tragic attempt to deal with mental illness, brain injury and/or developmental disability --- and unfortunately in some cases ---- this caused additional cognitive issues.

What most homeless people with cognitive disabilities need more than anything else is --- A HOME. Some will need significant supports.

The States across the US and Colorado don't have enough housing, intensive services and placements for the need and for what is legally required.

We need the CO BEHAVIORAL HEALTH TASK FORCE to make recommendations and proposals that bring HOUSING, INTENSIVE SERVICES, & PLACEMENTS to SCALE ---- a one-stop shop can definitely be a part of that ---- BUT damn . . .

[Tina Seelig from Stanford: There are an INFINITE NUMBER of VARIABLES that could get a RIGHT ANSWER -- there are also an INFIINITE NUMBER of VARIABLES that could get a WRONG ANSWER or INSUFFICIENT ANSWER.

A One-Stop Shop could very easily be part of the solution to bringing Housing, Services and Placements to Scale in Behavioral Health.

A One-Stop Shop seems very UNLIKELY to be SUFFICIENT to SOLVE THE PROBLEM.]

CO Child Welfare Audit

Post Modern Jukebox, featuring Annie Bosko performing Complicated (Avril Lavigne cover)

GOV. POLIS' EXECUTIVE ORDER ON EQUITY, INCLUSION AND DIVERSITY

8/30/2020

One of the things that makes Equity, Inclusion and Diversity difficult to achieve: there are often MANY APPLICANTS or STAKEHOLDERS that are qualified for the position.

    If that's true --- then why not just pick the person who is the prettiest, the handsomest, the funniest, the youngest, the oldest, whatever -- the person I like better because that person is more like me.

  Further, "BEING MORE LIKE ME" has historically meant my skin color, my sex, etc. But more and more, we're addressing PHYSICAL DIVERSITY without addressing DIVERSITY of THOUGHT or COGNITIVE PROCESSING.

Additionally, the idea of the "MERITOCRACY" developed under Napoleon is coming under some sharp questioning and skepticism from from DIVERSE critics around the world and in the US.

What this means for employment is complicated and needs to be worked out.

For State Stakeholder Groups, we need 1/5 to 1/4 membership set aside for people who will actually be impacted by the policies --- that includes people who are incarcerated or homeless.
Another 1/5 to 1/4 need to be set aside for family members of those needing additional Services, Housing or Placements.

    If everything is going well --- nobody is that concerned about EQUITY, INCLUSION & DIVERSITY. BUT things are NOT going well --- and they are NOT going well in BEHAVIORAL HEALTH.

Half of state employees don’t think equity, diversity and inclusion are prioritized. Here’s how Colorado is responding.

The executive order is five-pronged:

It requires the Department of Personnel and Administration to guide and direct state agencies in creating long-term strategic plans around inclusivity, anti-discriminatory workplace cultures and equity in hiring, compensation and retention.
It requires that all state employees receive training on equity, diversity and inclusion.
It mandates that state agencies report their progress on equity, diversity and inclusion.
It directs the state to review buildings, systems, public meeting procedures and websites for language and disability accessibility.
It directs the state to address systemic inequities present in awarding contracts.

Click Here for Colorado Sun Article

JAN (Job Accommodation Network)

Inclusion: Including US Dept. of Justice / State of Oregon 2016 Performance Plan addressing Inclusion in Disability Policy

A PUBLIC HEALTH APPROACH TO PUBLIC SAFETY ----COULD BE THE BEST THING THAT EVER HAPPENED FOR LAW ENFORCEMENT

8/28/2020

#1 -- We gotta figure out a way to get on the same team. This is important biologically -- we don't feel the pain of our "out-groups"

Saying we're for the "Health & Safety of Our Communities" can sound vacuous -- BUT that actually embodies a lot and could get us on the same team.

One of the things a PUBLIC HEALTH APPROACH could do is provide an EXPANDED CAREER LADDER for LAW ENFORCEMENT into HEALTHCARE.

Further, we support TUITION WAIVERS if the Law Enforcement member agrees to work with vulnerable individuals for a period of years.

A Public Health Approach to Criminal Justice/ Public Safety requires significant INFRASTRUCTURE -- we have some of that -- we need more.

For some people, Law and especially LAW ENFORCEMENT seemed that PRO-SOCIAL way to channel AGGRESSION. It turned out to be a lot more complicated than we've been willing to recognize.

The current system is not only not working for minority and poor citizens --- it's REALLY NOT WORKING for LAW ENFORCEMENT who are put in horrible situations on a daily basis without sufficient support --- and then we're all SHOCKED at the deteriorating behavior.

There is a better way for everyone and that is a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE / PUBLIC SAFETY.

Aggression: Humanity's Ultimate Double-Edged Sword

A Public Health Approach to Criminal Justice / Public Safety

MORALITY, ECONOMICS & THE CRIMINAL LAW

8/27/2020

THE NEED FOR REPUBLICANS AND DEMOCRATS TO UNDERSTAND THE DEEPER SIGNIFICANCE OF THE PRO-LIFE / PRO-CHOICE DEBATE

The 21st Century is shaping up to be a time when we stopped trying to take the SHORT-CUT of the Criminal Law to deal with COMPLEX PROBLEMS.

There are more than a million stories in the NAKED CITY --- and there are a lot of reasons why women get abortions.

Abortion wasn't legal in the 1930s, but some desperately poor women did get abortions during THE GREAT DEPRESSION.

This is about providing the SOCIAL DETERMINANTS of HEALTH and VIABLE ALTERNATIVES.

Those 2 Things will reduce the number of Abortions more than the Criminal Law ever will.

PART II: SYMPTOMS & ROOT CAUSES CHRONIC DISORGANIZATION & SOCIALIZING

8/25/2020

The Long & Winding Road

My parents were neat freaks, I wasn't BUT I appreciated the value of it.
My husband's parents were relatively neat -- his Dad probably less so.
His Mom tended to CLEAN during MANIC Episodes.
The issues with his mother were occurring while my husband was a TEENAGER and prior to the identification of LITHIUM as a treatment.
At one point his mother, put tin foil on the windows to keep out the Communists
My husband lost a scholarship to a prestigious private high school during this time.

FOR ME Growing Up - I Was Thriving as a Disorganized Person --- I lived in a very orderly environment and it served me very well.

Now in 2020, I would say both my husband and I are "Twice Exceptional" --- I wouldn't have said that in 1997 when we got married --- I'd never even heard the term.
A big moment in our relationship prior to our marriage, he showied me his House. It was a Hoarders House --- what I really thought was "Hey this guy is even messier than I am, he's really going to appreciate that I can keep things neater than this."

Well, the REALITY was many attempts at CLEANING and ORGANIZATION were HUGELY RESISTED and it was this MONUMENTAL SOURCE of CONFLICT in our relationship.

Now, things never got as bad as his Old House --- BUT I was really CINDERELLA to a Husband and Two Kids with significant organizational issues, and I had plenty of my own. Further, it wasn't like they were asking for my help BUT we did need to keep the social workers away.

Most people are not getting to the level of "hoarding" but Chronic Disorganization is much more common.

I think it is essential to get on-going assistance --- the resistance to getting help sometimes is FINANCIAL, but sometimes it isn't --- there is enormous anxiety that comes with addressing these issues.

This Is What We Tell Ourselves . . . Smart People Are Messier -- and maybe they are but IT CAN STILL BE A PROBLEM

PART I: SYMPTOMS & ROOT Causes "THERAPIES" ARE OFTEN TARGETED AT SYMPTOMS

8/24/2020

THAT'S OK -- IF WE UNDERSTAND THOSE SYMPTOMS ARE NOT THE "ROOT CAUSES" BUT WE OFTEN DON'T UNDERSTAND THAT

When we think about things like:

Diet
Exercise
Good Sleep
Socializing
Strong Relationships, and
Meaningful Work

as protectors against some kind of mental distress --- THAT'S NOT WRONG.

On the other hand --- it is often NOT ASKING THE NEXT QUESTION --- What BARRIERS is this person facing to any of those things?

WHAT BIOLOGICAL/ ENVIRONMENTAL BARRIERS is the person experiencing to any of those things?

That turns out to be COMPLICATED and INDIVIDUAL --- and it can be EXACERBATED by FAILURE TO ASK THE QUESTION.

PICKY EATING & TASTE SENSITIVITIES

My daughter told me that one of her friends had gone through "Food Therapy" --- they didn't have that when I was a kid --
I was a profoundly picky eater -- so much so that my mother had spoken to the pediatrician about it. The pediatrician said -- she's still alive. (I've improved, but . . .)
Picky Eaters not surprisingly have greater incidence of mental health problems.
BUT what was driving the PICKY EATING ---- extreme disgust at certain food textures so much so that I would cry -- not as a toddler but as an elementary school kid.
Further, how many ancient people were experiencing this, probably not many -- is this somehow related to Graham Rook's Old Friends Hypothesis.

A lot of people with "mental illness" have:

Some increased sensory input --- but not to the degree of Carly Fleischmann in the video above.
On the other hand, they also may have had some early life success -- and it is later in life that it is more obvious to others the person may be struggling.
That Early Life Success can be very misleading to everyone concerned, including the person.
We're really talking about SENSITIVITY TO STIMULI in many cases --- and it can be and is a good thing and a challenging thing.

The Trials and Tribulations of the canary in the coal mine

8/23/2020

I really do think that a lot of people with "mental illness" who may be developmentally more "reactive" to their environment may be the CANARY in the COAL MINE when it comes to problems in the larger society.

The only problem is -- we don't look like CANARIES --- we look like everyone else. We look like that miner right next to us that may or may not be struggling --- BUT isn't FEELING IT, like we're FEELING IT.

One of the CONUNDRUMS that needs to be tackled for the TWICE EXCEPTIONAL PERSON with ADVANCED ABILITIES, SOME CHALLENGES and a lot of EMOTIONAL INTENSITY ---- those are TRADITIONALLY, the Society's:

Artists
Writers
Philosophers, and I would argue even
Historians
Activists
Some Mathematicians
Entrepreneurs who may need administrative support
Politicians
Others?

[It's not that we don't have JOBS utilizing these skills but we have some of those jobs in the THOUSANDS in the US and we may need them in the MILLIONS.

Further, if we can't ACCOMMODATE for those EXECUTIVE FUNCTIONING DEFICITS -- it doesn't work anyway]

How many jobs do we have for those people, especially if TWICE EXCEPTIONALITY is a lot more common than we think?

Is TWICE EXCEPTIONALITY a driving force in some of the DISHONESTY and "COVER-UPS" that we see in our society --- and people feeling the need to pretend they are something they are not.

JOBS turn out to be a HUGE issue for the TWICE EXCEPTIONAL person:

If they can't use their considerable strengths they can't maintain their mental health
If their weaknesses aren't accommodated they can't maintain their mental health either -- life is an ANXIETY ROLLERCOASTER --- and that ANXIETY generally makes things worse.

JOBS are a lot like ROMANTIC RELATIONSHIPS in that you're looking for a good complementary relationship.

All of that is made MORE COMPLEX by TWICE EXCEPTIONALITY -- and it was plenty COMPLEX for most people to begin with.

More and more families are ADHD Familities or TWICE EXCEPTIONAL Families.

My parents used to say: "Someday some little person is going to give you a taste of your own medicine." THAT DAY CAME.

I came out of COLLEGE with no sense of the CHALLENGES that I was to face for the NEXT 35 years.

That had a profound impact on my life. FOREWARNED really is FOREARMED.

The Mental Health Profession as lovable as they are, take years if not decades to make a correct diagnosis --- and many people are doing it themselves.

Further, most mental health professionals are NOT TRAINED in the REASONABLE ACCOMMODATIONS people with "mental illness" or "cognitive differences associated with mental illness" may need.

Further, it is not clear what a "correct diagnosis" means without a scientifically valid diagnostic manual.

I want the Society our kids are going into to be much more:

Knowledgeable and competent when it comes to dealing with COGNITIVE DIFFERENCE.

A NEED FOR:ADDITIONAL PHILANTHROPIC & STATE PARTNERSHIPS TO PROVIDE DISABILITY HOUSING

8/22/2020

States aren't starting at Ground Zero when it comes to Scattered Site Disability Housing --- BUT most people at various levels of Public Service are well aware THERE IS NOT ENOUGH HOUSING.

Housing is an Olmstead requirement for people with disabilities who are:

Institutionalized and Housing with Supports is a medically viable option
Being Released from Jails or Prisons and Housing with Supports is a medically viable option, and/or
At Great Risk of Institutionalization such as the risk presented by Homelessness, and Housing with Supports is a medically viable option.

A Landscape by Claude Monet

THE LANDSCAPE

STATES

States have failed to develop and implement comprehensive and effectively working Olmstead Plans in general, and with respect to Housing specifically.
Housing PROPER is currently NOT covered by Medicaid -- we think that does amount to DISCRIMINATION.
In the meantime, States do SOMETHING on Housing with NO COHERENT PLAN to bring Housing to SCALE for people with disabilities in the categories mentioned above.
Things look even BLEAKER with COVID and shrinking revenues and growing need.

FEDS

May very well pass legislation that provides funding for Disability Housing and serves as an Economic Stimulus.
This is unlikely to meet the need for Disability Housing in most States.
BUT it will HELP if enacted.

ADDITIONAL FEDERAL & PHILANTHROPIC SPURS TO OLMSTEAD HOUSING PLANNING & IMPLEMENTATION

We think the Philanthropic Community could engage Federal and State Partners both part of an interim and long term plan for Disability Housing to be reviewed at least yearly.
The Philanthropic Community could provide Hotel Vouchers for people with disabilities in the categories above with Federal and State Governments working to meet benchmarks for a COMPREHENSIVE and EFFECTIVELY working Housing Plan for People with Disabilities.
Additionally, the Hotel Vouchers would be serving as much needed ECONOMIC STIMULUS for the HOSPITALITY INDUSTRY.

When your Bleak House is a Jail or Prison or
No House

Double V

Social Impact Bonds

New Zealand's Fierce Debate Over Social Impact Bonds

Housing Chronically Homeless in Denver Saves Money & Lives

Proposed Federal Housing Infrastructure Act with $2.5 Billion for Disability Housing and $2.5 Billion for Senior Housing

TOWARDS A MORE PERFECT UNION WITH OVER 300 MILLION IMPERFECT PEOPLE

8/21/2020

Political parties, politicians and public citizens are trapped in a system that was STATE OF THE ART in the late 18th Century --- it is starting to show considerable wear and a need to EXPAND on some of the original insights and principles.

We really are encouraged to pit politicians against each other as GLADIATORS and are SHOCKED, SHOCKED, SHOCKED that the process doesn't UNIFY the Country.

    Further, we're also encouraged to accept the PROCESS as the STATUS QUO --- while SCAPEGOATING various POLITICIANS from both major political parties.

Now, some individual politicians may be more problematic than others -- but how did they get elected -- often out of DESPERATION and a desire to SHAKE THINGS UP.

Disability LAW & POLICY may not surprisingly have hit on a VITAL addition to the 3 BRANCHES of GOVERNMENT --- the INCLUSIVE PROBLEM-SOLVING STAKEHOLDER GROUP often associated with OLMSTEAD PLANNING.

By and large, the POWER needs to be in those GROUPS and Politicians as often GREAT COMMUNICATORS can channel the CONSENSUS.

  Diverse groups can be better problem-solvers, especially if they are not afraid to be TRULY INCLUSIVE.

If there is a concern, it should be brought to the INCLUSIVE GROUP to ADDRESS.

    We can keep SCAPEGOATING IMPERFECT POLITICIANS, or we can EMPOWER our IMPERFECT SELVES and OTHERS to do the real PROBLEM-SOLVING this country needs.

   That includes taking advantage of much more INSIGHT, LIFE EXPERIENCE and STRENGTH as well as ability to compensate for weaknesses.

How do we get out of the long-standing political trap -- that ensnares both politicians and citizens? Inclusive problem-solving groups contemplated by Olmstead might be a big part of the answer.

A BIG CAVEAT: Colorado has had MIXED SUCCESS with STAKEHOLDER Groups.

It would be worth analyzing the BARRIERS to a successful and effective Stakeholder Group.

Further, the former Hickenlooper Administration had a habit of acting in BAD FAITH in failing to address concerns and shunting people off to some group -- not to be heard from again.

[We pick on the former Hickenlooper Administration a lot because that's what we know -- not because they were unique.]

We don't want that.

A lot of this has to do with FRAMING and including the ELEMENTS that could bring about real change:

DIVERSITY & INCLUSION
DATA COLLECTION
BUDGET ANALYSIS
ETC.

A STRENGTHS-BASED APPROACH & WEARING MASKS: GOVERNMENTS & PEOPLE DON'T LIKE TO BE TOLD WHAT TO DO

8/21/2020

THE DELICATE ART OF PERSUASION, LAWSUITS & PROTESTS IN THE STREETS

Whenever I hear government officials laying into people for failure to wear masks, I always think:

I think some of the objection doesn't have anything to do with the masks, and
We really just need to build relationships and
It will all work out.

THEN I think About CO STATE Gov't under the Hickenlooper Administration and its refusal to even consider a STRENGTH-BASED APPROACH -- 4 years ago --

was it really about a strength-based approach -- NO,
It was really about a POWER STRUGGLE

In a lot of ways it STILL IS ABOUT A POWER STRUGGLE and its transferring some of that POWER to at least FORMALLY SUGGEST:

Data Collection
Programmatic Reforms
Services
Housing and
Placements

to the Governor and the Legislature.

Some of that Power needs to be TRANSFERRED to an INCLUSIVE, OLMSTEAD PLANNING GROUP.

That could be done in the 2021 Legislative Session.

Strength Based Resilience Questionnaire

SAMHSA ----
Strengths & Priorities

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Val's Blog

THE EFFICIENCY + RESOURCE EQUATION IN BEHAVIORAL HEALTH

SEE STATE'S RESPONSE TO CHILD WELFARE AUDIT
WE'RE IN DESPERATE NEED OF MORE HOUSING & INTENSIVE SERVICES & PLACEMENTS

GOV. POLIS' EXECUTIVE ORDER ON EQUITY, INCLUSION AND DIVERSITY

A PUBLIC HEALTH APPROACH TO PUBLIC SAFETY ----COULD BE THE BEST THING THAT EVER HAPPENED FOR LAW ENFORCEMENT

MORALITY, ECONOMICS & THE CRIMINAL LAW

THE NEED FOR REPUBLICANS AND DEMOCRATS TO UNDERSTAND THE DEEPER SIGNIFICANCE OF THE PRO-LIFE / PRO-CHOICE DEBATE

PART II: SYMPTOMS & ROOT CAUSES CHRONIC DISORGANIZATION & SOCIALIZING

PART I: SYMPTOMS & ROOT Causes "THERAPIES" ARE OFTEN TARGETED AT SYMPTOMS

THAT'S OK -- IF WE UNDERSTAND THOSE SYMPTOMS ARE NOT THE "ROOT CAUSES" BUT WE OFTEN DON'T UNDERSTAND THAT

The Trials and Tribulations of the canary in the coal mine

A NEED FOR:ADDITIONAL PHILANTHROPIC & STATE PARTNERSHIPS TO PROVIDE DISABILITY HOUSING

TOWARDS A MORE PERFECT UNION WITH OVER 300 MILLION IMPERFECT PEOPLE

A STRENGTHS-BASED APPROACH & WEARING MASKS: GOVERNMENTS & PEOPLE DON'T LIKE TO BE TOLD WHAT TO DO

THE DELICATE ART OF PERSUASION, LAWSUITS & PROTESTS IN THE STREETS

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Val's Blog

SEE STATE'S RESPONSE TO CHILD WELFARE AUDIT WE'RE IN DESPERATE NEED OF MORE HOUSING & INTENSIVE SERVICES & PLACEMENTS

THE NEED FOR REPUBLICANS AND DEMOCRATS TO UNDERSTAND THE DEEPER SIGNIFICANCE OF THE PRO-LIFE / PRO-CHOICE DEBATE​

THAT'S OK -- IF WE UNDERSTAND THOSE SYMPTOMS ARE NOT THE "ROOT CAUSES" BUT WE OFTEN DON'T UNDERSTAND THAT

THE DELICATE ART OF PERSUASION, LAWSUITS & PROTESTS IN THE STREETS

Author

Archives

Categories

SEE STATE'S RESPONSE TO CHILD WELFARE AUDIT
WE'RE IN DESPERATE NEED OF MORE HOUSING & INTENSIVE SERVICES & PLACEMENTS

THE NEED FOR REPUBLICANS AND DEMOCRATS TO UNDERSTAND THE DEEPER SIGNIFICANCE OF THE PRO-LIFE / PRO-CHOICE DEBATE