Blog Archives

Getting beyond the "heroic values" of the Adversary System & the Expensive Legal Edifices we've created

12/31/2018

In some respects we haven't gotten that far from the ancient Anglo-Saxon Wergeld -- if you have the money to pay for an injury you can -- if NOT -- you pay with your life.
A lot of what attorneys do in "Street Law" -- Family Law, Criminal, Landlord/Tenant, etc. -- could be automated -- a lot of it is.
It could be A LOT more.
There aren't enough pro bono attorneys for individual representation of thousands of people .
THAT IS NOT REALISTIC, and it is not really very EFFECTIVE.
Just like anything else -- what people are really interested in are results --- further, most, not all, don't want to have to deal with attorneys -- and they certainly don't want to have to pay them.
It is HARD to make things SIMPLE -- it is EASY to make them COMPLICATED.
Most people want a better, less expensive system that they are not totally stressed out by -- and if there is a way to construct this without lawyers & multiple visits to the courthouse ---LET'S DO THAT.
The attorneys who are engaged in individual representation should be employed by independent State agencies to improve the Systems & Outcomes and recommend legislative changes as necessary.
It is very hard if not impossible for people to afford lawyers during a CRISIS in their lives that often has SERIOUS ECONOMIC dimensions.
Many of us know that most of our client's greatest needs are for a:
CASE WORKER
Housing
Treatment
Placements
Supported Employment
Etc.
As attorneys we need to be constantly trying to work ourselves out of the job of Individual Representation and into the job of Creative & Innovative Systems reform that brings about REAL CHANGE that people want and taxpayers feel good about funding.

Nowhere do people lie more than in a courthouse, whether the poor person or the authority figure.

If we start taking some of the incentives out of that--- like [FEAR] ---we can build on the work that is already being done for a more COLLABORATIVE & COLLEGIAL Legal System and ultimately a BETTER SOCIETY.

Disys.com

By and large lawyers are the LEAST IMPORTANT professionals our clients need [or we should live in a Society in which lawyers are the least needed by individuals].

BUT attorneys are & SHOULD BE some of the MOST IMPORTANT ADVISORS to the SOCIETY as it CREATES, INNOVATES & MANAGES SOCIAL SYSTEMS INTEGRATION to PROMOTE THE ENDS OF HEALTH, WELFARE & JUSTICE.

CO's Care & Treatment Act: "Subject to available appropriations"

12/27/2018

CONTEXT IS EVERYTHING:

The Goebel Lawsuit

Lawsuit was instituted in 1981 and it was dismissed in 2006.
It is named for a homeless woman with Schizophrenia who died on the streets of Denver.
Her name was Ruth Goebel.

The Original Attorneys that participated in the LANDMARK CASE:

James W. Dean, Legal Aid Soc. of Metropolitan Denver, Inc.
Kathleen Mullen, Law Offices of Kathleen Mullen, Denver.

Rodney R. Patula, Pryor, Carney & Johnson, P.C., Englewood, for Colo. Lawyers Committee.

One of the legal grounds for that case was Colorado's failure to comply with the State's CARE & TREATMENT Act for people with mental illness.

Attorney Iris Eytan [Kathleen Mullins' Heir Apparent], the Colorado Lawyers Committee, & Disability Law Colorado are pursuing another COLORADO LANDMARK MENTAL HEALTH CIVIL RIGHTS CASE-- the JAIL WAIT CASE (for competency exams)
They have been pursuing this for approximately 10 YEARS.

ARTICLE 65. CARE AND TREATMENT OF PERSONS WITH MENTAL HEALTH DISORDERS

CRS 27-65-101.
Legislative declaration
(1) The general assembly declares that, subject to
available appropriations,
the purposes of this article 65 are:

(a) To secure for each person with a mental health disorder such care and treatment suited to his or her needs and to ensure that the care and treatment are skillfully and humanely administered with full respect for the person's dignity and personal integrity;

(b) To deprive a person of his or her liberty for purposes of care or treatment only when less restrictive alternatives are unavailable and only when his or her safety or the safety of others is endangered;

(c) To provide the fullest possible measure of privacy, dignity, and other rights to persons undergoing care and treatment for a mental health disorder;

(d) To encourage the use of voluntary, rather than coercive, measures to provide care and treatment for mental health disorders and to provide the care and treatment in the least restrictive setting;
(e) To provide appropriate information to family members concerning the location and fact of admission of a person with a mental health disorder to inpatient or residential care and treatment;

(f) To encourage the appropriate participation of family members in the care and treatment of a person with a mental health disorder and, when appropriate, to provide information to family members in order to facilitate that participation; and

(g) To facilitate the recovery and resiliency of each person who receives care and treatment pursuant to this article 65.

(2) To carry out these purposes,
subject to available appropriations,
the provisions of this article shall be liberally construed.

[Orchid Commentary: Good Luck with that without SUFFICIENT APPROPRIATIONS]

Photo Credit: Westword

denver posT: Lawsuit’s end restarts battle for mental HEALTH CARE [APRIL 15, 2006]

Attorney Kathleen Mullin: CO's Dorothea Dix

CO's Landmark Goebel Case

in response to the goebel case---
the CO Legislature to Attorney Kathleen Mullin, mental Health attorneys, advocates & the mental health community [paraphrasing]

So specifically what the CO LEGISLATURE did as a response to the "Goebel Lawsuit" was to limit Colorado's legal responsibilities under the CARE & TREATMENT ACT to "AVAILABLE APPROPRIATIONS."

That's about as DISCRIMINATORY as you can possibly get. [Remember, Discrimination under the Americans with Disabilities Act (ADA) does NOT require INTENT.

What is DISCRIMINATORY about a Legislative Decision to Limit the "Care & Treatment Act" to "Available Appropriations"?

Well, we really have to look @ the total scheme of treatment available for people with mental illness in Colorado. Like most states, it is a BIG JIGSAW PUZZLE MESS with:

Inadequate State authorized Medicaid funding with the State Match,
Inadequate Funding from SAMHSA, and
Inadequate State Funding.

Now, the State is trying to pool all that together into some type of coherent system that covers Coloradans BUT it is NOT working -- and it hasn't for decades. THERE IS NOT ENOUGH REVENUE FROM THE SOURCES MENTIONED ABOVE TO MAKE THIS WORK.

Now if people's mental health needs are being taken care of outside of the CARE & TREATMENT ACT -- maybe it doesn't matter. BUT there are THOUSANDS of people with mental illness in this State who are homeless or incarcerated because the State is NOT providing adequate services -- that sounds @ the very least like "GRAVELY DISABLED."

THIS ALSO HAS A LOT TO DO WITH WHAT MEDICAID WILL & WILL NOT COVER
[but that is not the whole story because Medicaid will cover A LOT Colorado isn't providing to SCALE -- think ASSERTIVE COMMUNITY TREATMENT]

TOMORROW:

We will look at CMS' [Centers for Medicare & Medicaid Services] prohibition on Medicaid funding INSTITUTES OF MENTAL DISEASE or --- The IMD RULE

Our Current Arc of Authenticity & Age of Integration of Pluralistic/& Not So Pluralistic Societies [Religion/Morality, Science, Medicine, Economies & Law]-- Part 1 The Spirituality of Imperfection

12/26/2018

As a child, we think the adults around us are perfect or at least should be -- along with the institutions of our schools, community & Country.
J.K. Rowling so brilliantly captured our disillusionment in her Harry Potter Series.
Harper Lee did too with her original version of Atticus Finch in "Go Set A Watchman" -- contrasting sharply with our heroic view of Gregory Peck in "To Kill A Mocking Bird."
Of course, ultimately that disillusionment extends most disturbingly to ourselves.
Religion/Morality are in no small measure a human attempt to tap into the TRANSCENDENT & take a crack @ TIMELESS TRUTHS while surrounded by not just harmless HUMAN IMPERFECTIONS, BUT DANGEROUS ONES AS WELL.
Are those cracks @ TIMELESS TRUTHS -- INSPIRED -- I would say so -- BUT as Joseph Campbell observed -- we really don't want to go back to that "OLD TIME RELIGION" -- it is pretty SCARY. AND ANY RELIGION or INSTITUTION is pretty SCARY if it can't change with NEW KNOWLEDGE.
RELIGIONS are often societies' most conservative institutions because they are often ANCIENT and they have withstood A LOT OF THREATS TO THEIR EXISTENCE.
Historically, RELIGIONS do change but it is based on COMPLEX POLITICAL CONSIDERATIONS NOT A MERE SHOWING OF "REASONABLE CAUSE."
Now SCIENCE & MEDICINE have their own pretty whacked out histories & THEY ARE FAR, FAR FROM PERFECT -- & they do sometimes think they are "perfect" -- just with a small "p" --- not the blazing capital letters of "PERFECT OR IMMACULATE RELIGION."
IRONICALLY, it is the INSTITUTIONS OF VARIOUS RELIGIONS that understand better than any other in our SOCIETY how imperfect human beings really are.
For these INSTITUTIONS of VARIOUS RELIGIONS to have the INFLUENCE in our PLURALISTIC SOCIETIES that we need them to have -- THEY MUST HAVE AN APPRECIATION OF THEIR OWN IMPERFECTION AS WELL.

Even a Dog Distinguishes between being stumbled over & being kicked

Jorge Agustín Nicolás Ruiz de Santayana y Borrás, known in English as George Santayana [1863 – 1952), was a philosopher, essayist, poet, and novelist. Originally from Spain, Santayana was raised and educated in the United States from the age of eight and identified himself as an American -- Wikipedia

We're Including this video of No Kidding, Me 2 not just as a message regarding "Mental Illness" -- BUT really the larger issue of "IMPERFECTION" in all individuals and institutions that we have a hard time coming to terms with and STIGMATIZE -- we do it too.[

We have to create a CULTURE & SOCIETY in which we can FREELY ACKNOWLEDGE our IMPERFECTIONS [both individuals & institutions} without FEAR of PUNISHMENT & with REASONABLE EXPECTATION of CARE, SUPPORT & ASSISTANCE.

Why so much on religion?

As a Mental Health Advocacy organization, why are we spending so much of our time on RELIGION?

Well -- it's interesting, BUT it is actually more than that. Much of our current criminal law has ancient roots -- including ancient religious roots.

We may think we have scrubbed RELIGION out of our modern statute books or for that matter our MENTAL HEALTHPROFESSION -- but if you look with the "trained" eye-- A LOT OF IT IS STILL THERE.

AND some of it is preventing us from making the reforms necessary. IRONICALLY, IT IS OUR CURRENT RELIGIOUS FOLKS WHO COULD LEAD THE WAY.

Even A Dog Distinguishes Between Being Stumbled Over & Being Kicked

A Holiday Message: A MATTER OF FAITH & OF SCIENCE

12/25/2018

There are the saints, spiritual gurus, wise people, etc. --- that naturally & intuitively see the good in people and build on that.
Historically, that has NOT been most of us --- especially when confronted by people behaving badly.
The FIRST thing we have to have is SAFETY -- WE GOTTA HAVE SAFETY.
Now we could just kill everybody that poses a threat to us -- and for much of human history -- that's what we did.
It's been a big step up "COMPASSION-WISE" to "imprison" people but it is not as "EFFICIENT" as just killing people -- and most people come out worse than they were before.
Of course, there is A HUGE FLY IN THE OINTMENT of both killing people, imprisonment, punishment, etc. That HUGE FLY is AGGRESSION -- so we may have gotten rid of the people who were posing the original threat --- ONLY TO TURN OURSELVES INTO THE THREAT.
Now, very nice people have been looking for alternatives to imprisonment for awhile. Some have worked better than others -- but no one has found a magic wand.

The scientific evidence is piling up that large percentages of the Criminal Justice population have "Prison Brain" or EXECUTIVE FUNCTION DEFICITS related to a number of invisible conditions affecting cognition: BRAIN INJURY, MENTAL ILLNESS, SUBSTANCE USE, DEVELOPMENTAL DISABILITY, ETC.

MANY PEOPLE IN THE CRIMINAL JUSTICE SYSTEM HAVE MORE THAN 1 OF THESE CONDITIONS.

Of course, some of those conditions are NOT as INVISIBLE as they have been during much of human history. Further, government funded scientific efforts around the world are working hard to make even more of these INVISIBLE CONDITIONS----- VISIBLE.

What should all of this mean for us NOW?

We still have to have SAFETY -- so we need to provide SUPERVISION where necessary
We need to AVOID AGGRESSION'S DOUBLE-EDGED SWORD
We need to make available evidence-based treatment where it is known;
We need to spend 80% of our time working with people in the identifying and developing STRENGTHS in people in the Criminal Justice System AND ourselves;
We need to spend 20% of our time working with people in the Criminal Justice System in identifying and developing WORKAROUNDS for WEAKNESSES in people in the Criminal Justice System & OURSELVES.

We are not endorsing the Biologos Organization -- & we are using it as an example of how some people are confronting matters of faith & science.

Aggression: Humanity's Double-Edged Sword

Orchid Book Club

Executive Functioning & Prison Brain

Scientific Reality, a kinder gentler nation -- and making our peace with "the state of nature"

Science & Religion, Rejecting social Darwinism for a Road less travelled

its-kinda-funny-but-religious-folks-may-be-more-adaptable-to-the-changing-science-than-our-mental-health-profession-legal-systems

Faith, Criminal Justice, AND bringing religion in from the Cold

WHAT IN THE HELL----ALL TOO OFTEN IF OUR MENTAL HEALTH PROFESSION DOESN'T KNOW THE ANSWER -- THEY THINK THE ANSWER IS JAIL OR PRISON

12/19/2018

Is the Glass Half Empty or Half Full? We would be the first to acknowledge that is a HUGE MATTER OF PERSPECTIVE.

The mental health profession actually does do a lot of good things which we have a responsibility to honor.

On the other hand, we are not going to get to the root causes of our "Mental Health/Criminal Justice Crisis" if we can't acknowledge and correct the HUGE ROLE the Mental Health Profession has played in it.

That certainly includes Jaffe's "Insane Consequences" for difficult to treat "Bipolar Disorder" and "Schizophrenia."

But to us, it also includes "Anti-Social Personality Disorder" which is a pretty horrific unscientific rationalization for inadequate care.

If we don't have all the answers we need to acknowledge that --- BUT the DEFAULT ANSWER SHOULD NOT BE putting people in brutal environments in which they get worse.

WE CAN'T PUT UP WITH THAT ANYMORE.

Colorado Mental Health Centers have dumped their most difficult patients on the Criminal Justice System for Decades.

If we want that to STOP. we must do more than we are doing now.

God of the Gaps, Criminal Liability of the Gaps

Urbanization & Mental Health

12/16/2018

So urbanization has been going on for thousands of years. There are a lot of benefits to urbanization: Security, Trade, More Efficient Use of Resources being right up there.

BUT there have also been A LOT of UNINTENDED CONSEQUENCES -- from Social Problems to Disease Problems.

Selected Mental Health & Biological Issues Associated with Urbanization

Urbanization & Mental Health

Industrial Psychiatry Journal (2009)

Impact of Rapid Global Urbanization on Mental Health Outcomes

 Psychiatry Advisor (2016)

The Urbanization-Mental Health Connection
Three evolution-based reasons that humans were shaped for small-scale living

Psychology Today (2016)

Does City Life Pose a Risk to Mental Health?
Recent studies shed light on the link between urban living and psychosis

 Scientific American (2016)

Recent urbanization in China is correlated with a Westernized microbiome encoding increased virulence and antibiotic resistance genes.

 Microbiome (2017)

Meta-analysis of the human gut microbiome from urbanized and pre-agricultural populations.

 Environmental Microbiology (2017)

Gut Microbiome: Westernization and the Disappearance of Intestinal Diversity

 Current Biology (2015)

Aggression: Humanity's Ultimate Double-Edged Sword

Aggression As A Protection Against Bipolar Disorder Depression

sUPPLY & dEMAND & THE lOGICAL SONG

12/13/2018

Val's Take

Roger Hodgson of Supertramp is a very financially successful musician --- and he found it wasn't enough.

For many artists of one type or another --- the STARVING ARTIST is a reality.

Further, there are many artists who do have mental health issues -- NOT ALL.

Additionally, there are a surprising number of accomplished musicians who are homeless and people who are interested in developing their musical talents.

It is quite difficult for my family to understand why I have made the choices I have to do what I do.

I've always considered it a matter of survival.

I do have weaknesses & I do have strengths.

If the market doesn't know what to do with my strengths or the strengths of others or how to compensate for weaknesses -- that turns out to be a big problem.

We really need to figure out how to develop & create markets for all the raw, unique natural talent that is withering on the vine without more support.

STEAM: science, technology, engineering, arts & mathematics

STEM to STEAM

Scientific Reality, a kinder gentler nation -- and making our peace with "the state of nature"

12/8/2018

Some ancient societies were Matriarchal -- they weren't quite a mirror image of the dominant Patriarchal Societies of the more recent past and our experience -- BUT a lot of the focus was on the WOMAN.

Well, it wouldn't be too hard to see how men could get sick of that. Of course, women around the world today are pretty SICK of Patriarchal Societies.

Even in US Society -- we have NOT escaped our Caligulas -----who tend to be powerful men with mental, emotional and/or behavioral problems.

Of course, those problems are NOT limited to the rich and powerful.

Further, such problems are by no means limited to men but they ACTUALLY are more predominant in men for a whole lot of complicated biological reasons that make males more susceptible to developmental disabilities, illness, etc.

Now historically, the reality is that the bigger and stronger one is the greater potential threat one represents.

So when we are considering human beings with behavior problems, we would generally rank the level of threat from lesser to greater threat as follows:

Small Children
Elderly People
Women
Men

---and, of course, we have to factor in our own discriminatory and unconscious bias tendencies that may have really helped to protect the Tribe thousands of years ago --- BUT are wrecking havoc in diverse societies across the planet.

It is really hard for our society to acknowledge the widespread problem of male disability and the Criminal Justice System BECAUSE our system isn't really based on SAFETY---- it is based on PUNISHING INDIVIDUAL "INTENTIONAL" BAD ACTS with the "idea" that one is going to get to SAFETY by doing that.

The only problem is --- IT HASN'T REALLY WORKED.

A Word About Drug Use -- Legal & Illegal

As a general matter -- who goes to the trouble & expense of taking legal or illegal drugs -- PEOPLE WHO DON'T FEEL GOOD.

Those drugs absolutely have the
"potential" to make you feel even worse as well as to make one feel better.

The long term price to the individual in his or her overall cognitive well being "may be" quite high and to the society in the need for treatment and supervision.

A Word About "Mental Illness"

"Mental Illness" is a biological reality, a social construct, and "competency" and "insanity" are legal constructs -- they are currently NOT RATIONALLY RELATED in our society.

THAT IS CAUSING A LOT OF PROBLEMS.

We have gone into this in other blogs and pages on our website and we will continue to develop our ideas on this.

For most men with disabilities in the Criminal Justice System -- it is:

A [Bad Act] + B [Anti-Social Personality Disorder = PUNISHMENT

This is one of the great human rights atrocities of HUMAN HISTORY, especially given our current knowledge.

BUT it is pre-eminent scientific philosopher Thomas Kuhn who understood that the resistance to SCIENTIFIC ADVANCES is that those ADVANCES have PROFOUND implications for the Society.

We believe that the current SCIENTIFIC REVOLUTION has the potential to make our society a "KINDER, GENTLER NATION" in the words of Pres. George H.W. Bush -- and make it a SAFER one as well.

[P.S. We think history may consider George H.W. Bush--- a man, an athlete, a war hero, a President, imperfect person and a person with disabilities --- a much more consequential figure than even his eulogists imagined.]

Boys more susceptible to illness

Judith Graham, Tribune reporter
CHICAGO TRIBUNE

They're not the stronger sex after all.

From the womb through childhood, adolescence and beyond, men are more vulnerable than women, a large body of scientific research shows.

This susceptibility starts early, with significantly higher rates of premature birth, stillbirth, brain damage and congenital deformities for male fetuses.

In their first year of life, boys get sick and die more often: In 2004, the U.S. infant mortality rate (deaths per 1,000 live births) was 7.4 for boys and 6.1 for girls.

Developmental disorders such as autism are three to four times more common in infant boys than girls, and behavioral disorders are at least twice as common, observed Dr. Sebastian Kraemer, a London physician, in "The Fragile Male," a December 2000 review in the British Medical Journal.

Children of both genders get childhood infectious diseases such as the mumps and meningitis at the same rate, but boys are more prone to complications, said Torbjorn Sundkvist, an infectious disease expert from Sweden.

Growing up, boys mature more slowly than girls and are more likely to have difficulty regulating their thoughts, feelings and motor skills, making them more likely to get hurt in accidents.

"The care of boys is generally more difficult and therefore more likely to go wrong, adding to the deficits already existing before birth," Kraemer wrote. Boys require more attention from parents, generally, and it's wrong to assume that they're tougher than girls, he noted.

By adolescence, far more young men indulge in violent behaviors that can cause bodily harm and commit suicide than young women. Among 15- to 19-year-olds, suicide rates for boys were more than three times higher than for girls, according to the U.S. Centers for Disease Control and Prevention.

Although women are more prone to depression, anxiety and connective tissue disorders, adult men have elevated rates of heart disease, diabetes, alcoholism, substance abuse and certain kinds of cancer.

By the end of life, women outlive men by a substantial margin across the world.

Most likely, men's status as the weaker sex is rooted in genetics. Several experts hypothesize that men are hampered by not having the second "X" chromosome that helps protect women against disease. Hormones and the environment also may contribute in ways not yet understood.

"For some reason, girls seem to do better, but we're not sure why," said Dr. Rosemary Higgins of the neonatal research network at the National Institute of Child Health and Human Development.

"There is probably a biological difference that gives females an advantage or that makes males more vulnerable, but we don't know what it is yet."

This vulnerability is apparent in male mammals of all species, indicating a likely evolutionary explanation, said Dr. Tonse Raju, a medical officer at the National Institute of Child Health.

"It may well be," he suggested, "that nature invests so heavily in females because the survival of the species depends on them and that males are more expendable."

ORCHID
Of course, we know that no one is expendable ---
Our mothers, our fathers, our spiritual leaders, our scientists, our artists, our accountants, our teachers, our healthcare providers, our plumbers, -- all of us.

AND that includes people who are struggling the most in our society. Those BAD ACTS are evidence and part of it is a superficial evidence of INTENT --- but it is also evidence of so much more IF we have the COURAGE to see it.

UPDATE: Sept. 2021

Study shows DHA supplement may offset impact of maternal stress on unborn males

"We believe differences in metabolic requirements for male and female embryos as early as the first trimester, combined with dynamic differences in the way the male and female placenta reacts to environmental factors, contributes to the increased risk for male neurodevelopmental disorders later in life," said senior author David Beversdorf, MD, a professor of radiology, neurology and psychology at MU (Missouri University).

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Limitations, working together & -- We're #1

12/6/2018

I remember from my days working @ The Legal Center for People with Disabilities & Older People [now Disability Law Colorado] that 90% of the calls were from people wanting services we didn't provide and we weren't very clear about what we did and didn't do.

So, of course, people assumed we didn't do anything -- and nothing could be further from the truth.

So different entities have different problems and concerns when communicating their Limitations.

For the Government, they may be concerned about communicating the true state of their limitations because they have legal obligations to meet such as Parity, Medicaid Network Adequacy, Time Frames for Competency Exams, the larger crisis and shortage not only in psych beds but Medicaid Intensive Community Mental Health Services, Olmstead Compliance, etc.

Other entities like advocacy groups or innovation centers --- like to puff themselves up [we're not immune to that ourselves] --- "We're the Best, We're Number 1." And in one respect or another -- those claims are not necessarily untrue, but they generally fall far short of the extravagant claims -- and when they do--- people can feel misled.
A lot of it really comes down to clarity.
- If you are focusing on "Technology and Mental Health" and a lot of things are going to be put on the back burner -- you probably need to say that -- especially if you are advertising yourself as a "National Mental Health Innovation Center" -- CU we mean you.

The BOTTOM LINE:

People will forgive A LOT if others are responsive to them -- when they are not -- & the CU Innovation Center has not been responsive to us -- the judgments can be pretty harsh -- even when the entity may be doing good things.

P.S. I think we just got struck by lightning . . .

MAKING THE SUCCESSFUL HANDOFF FROM THE CRIMINAL JUSTICE SYSTEM TO INTEGRATED PHYSICAL & BEHAVIORAL HEALTH AND PUBLIC HOUSING OR RESIDENTIAL SERVICES

12/5/2018

Assertive Community Treatment & Flexible ACT Index

From my standpoint, the Criminal Justice System has been looking for alternatives to incarceration for decades.

I graduated from law school in 1988 and worked for 3 years @ the Oklahoma County District Attorney's Office. Even then in a conservative state, prosecutors were very open to considering drug or alcohol treatment or other appropriate treatment.

Later, in private practice, I represented a 16-year-old young man who was charged with Robbery with Firearms. He was certified to stand trial as an adult. The State recommendation was 25 to do. We entered a "Blind Plea" and the judge ordered him to a 90-day Program of "Regimented Inmate Discipline" [RID] and then a 5 year deferred sentence -- but if he came back the judge wrote that he was looking @ 45 years to do.

Guess what -- my guy ended up loving RID. The problem is many folks involved with the Criminal Justice System have extremely complicated difficult issues that are unlikely to get resolved in 90 days or even 180 days. In fact, my guy did end up picking up another charge.

When we make that hand-off to the Healthcare System we need to understand that we are making a potential LIFETIME COMMITMENT -- this isn't a term of years. That means using appropriate certification and substitute decision-making procedures when appropriate -- we don't want providers handing the person back to the Criminal Justice System. [There should also be an inclusive stakeholder group to oversee the use of such procedures]

It has been absolutely shocking to see Medicaid Mental Health Residential Service providers call law enforcement on minor matters when theoretically they should be able to initiate a 72-hour hold or petition the Court for an evaluation. Further, mental health patients who are just annoying as opposed to dangerous are @ great risk of this type of Mental Health Provider behavior.

Whether people with invisible disabilities or Mental Health Providers behaving badly -- in one sense, the problem is the same --- people are NOT getting enough support.

We can make this transition from INCARCERATION to HEALTHCARE -- BUT everybody needs to understand -- the State, providers, the Criminal Justice System, individuals, the Disability Community--that if providers do not seek appropriate certifications and or assisted/substituted decisionmaking when needed -- this is not going to work for many people.

On the other hand, providers must learn to deal with ANNOYING BEHAVIOR without resorting to the path of least resistance -- calling law enforcement. Note, most of this annoying behavior DOES NOT satisfy certification criteria for dangerousness; although most people in Medicaid Mental Health Residential arrangements probably do meet the criteria for "GRAVELY DISABLED" if they are not provided that residential support .

MOST PEOPLE WANT "HELP." MOST PROVIDERS WANT TO HELP. Not all providers are competent to handle every person. Throwing some providers in WAY OVER THEIR HEADS -- isn't helping anyone -- not the person, not the provider.

So we are aware of a situation in which the Mental Health Center washed its hands of the person, and a PROPERTY MANAGER was left to deal with someone with very complex needs.

We must provide a ROADMAP to providers to deal with these difficult situations & that probably needs to be in Volume 8 of the regulations for the CO Dept. of Health Care Policy & Financing.

Providers-- what support do you need to make the transition from Incarceration to Healthcare?

Complex Behavioral Problems are often NOT SOLVED on the Time Table provided by the Criminal Justice System

One of the reasons ACT is considered the GOLD STANDARD in Intensive Community Mental Health Treatment -- IT IS NOT TIME LIMITED

Val's Blog

Getting beyond the "heroic values" of the Adversary System & the Expensive Legal Edifices we've created

CO's Care & Treatment Act: "Subject to available appropriations"

in response to the goebel case---
the CO Legislature to Attorney Kathleen Mullin, mental Health attorneys, advocates & the mental health community [paraphrasing]

Our Current Arc of Authenticity & Age of Integration of Pluralistic/& Not So Pluralistic Societies [Religion/Morality, Science, Medicine, Economies & Law]-- Part 1 The Spirituality of Imperfection

Why so much on religion?

A Holiday Message: A MATTER OF FAITH & OF SCIENCE

WHAT IN THE HELL----ALL TOO OFTEN IF OUR MENTAL HEALTH PROFESSION DOESN'T KNOW THE ANSWER -- THEY THINK THE ANSWER IS JAIL OR PRISON

Urbanization & Mental Health

sUPPLY & dEMAND & THE lOGICAL SONG

Scientific Reality, a kinder gentler nation -- and making our peace with "the state of nature"

Limitations, working together & -- We're #1

MAKING THE SUCCESSFUL HANDOFF FROM THE CRIMINAL JUSTICE SYSTEM TO INTEGRATED PHYSICAL & BEHAVIORAL HEALTH AND PUBLIC HOUSING OR RESIDENTIAL SERVICES

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​ ​ ​ ​​in response to the goebel case--- the CO Legislature to Attorney Kathleen Mullin, mental Health attorneys, advocates & the mental health community [paraphrasing]

Why so much on religion?

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in response to the goebel case---
the CO Legislature to Attorney Kathleen Mullin, mental Health attorneys, advocates & the mental health community [paraphrasing]