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GETTING BEYOND MEDIA REPORTS OF THE "MENTAL HEALTH CRISIS"

1/7/2021

Our Understanding is that the Colorado Behavioral Health Task Force is making a major recommendation for a ONE-STOP SHOP for Housing, Services, etc. for people with "mental Illness."

That is a MAJOR STEP UP in EFFICIENCY --- but when we have the kind of SHORTAGES of HOUSING, PLACEMENTS and INTENSIVE SERVICES that Colorado has (& most States have) it's unlikely to SOLVE THE PROBLEM.

We Need:

Comprehensive Data Collection
Waitlists Moving at a "REASONABLE PACE"
A Comprehensive & Effectively Working Plan to bring Housing, Placements and Services to Scale

If that sounds like Olmstead that is because it is --- the original Supreme Court case was decided in 1999. We will be attaching the US Department of Justice's 2011 Guidance to our report.

But it's not just Olmstead, its also Parity and Medicaid Network Adequacy. But if there is any doubt -- OLMSTEAD GETS TO HOUSING.

At the Federal Level

We Need a Covid Economic Stimulus Package that assists the States to bring DISABILITY HOUSING & SUPPORTED EMPLOYMENT to SCALE by 2030.
A Major Initiative that SYNTHESIZES VAST AMOUNTS of RESEARCH across Medical Disciplines on Cognitive Disability and provides Clinical Applications where possible

[We'll also be including by reference the Recommendations from our 2020 Colorado Cognitive Disability Report]

SERVICES, Including SUPPORTED EMPLOYMENT: Strength Based Approaches & Work Arounds & Accommodations for Executive Functioning Issues

We are advocating for HIGHLY SYSTEMATIZED Approaches that can be modified and tailored as necessary.

We're not really wanting to DICTATE, BUT without ACCESS to some kind of format --- often that Strength Based Approach and/or ACCOMMODATION just never really happens.

While most of us may readily recognize the need for a ramp for someone with a wheelchair --- most of us DON'T KNOW what REASONABLE and RECOGNIZED ACCOMMODATIONS may be available for someone with EXECUTIVE FUNCTIONING ISSUES,

We'd like to see a Public Education Campaign perhaps spearheaded by the Division of Vocational Rehabilitation.

plain-speaking on covid & Olmstead ---- "You Selfish Bastards"

1/7/2021

We have 3 Major Proposals in our 2021 Cognitive Disability Report.
The Core "LEGAL" Request / Demand involves STATE COMPLIANCE WITH OLMSTEAD.
One of the documents we're including is the 2010 US Dept. of Justice (DOJ)/Georgia Settlement summary.
This is important to us because it directly addresses among other populations, people with mental illness who are chronically homeless and/or being released from incarceration.
This was an historic Settlement Agreement for DOJ and they wanted it to be a TEMPLATE for States across the nation. That hasn't quite happened yet.

There's no question that a lot of the STATE ANXIETY over OLMSTEAD is FINANCIAL. Even though nothing is required that isn't "REASONABLE" --- in the past, nobody was quite sure how that was going to be INTERPRETED.
Subsequent Caselaw and DOJ Guidance, have answered a lot of questions.
Most individuals, families and advocates want to work with the State and know that they ultimately must work with the State---- but we need States that are committed to complying with Disability Civil Rights Laws.
Colorado for all its PR hasn't been committed to Olmstead, and neither have most states.
We're interested in bringing Housing, Placements and Intensive Services to scale by 2030. That's over 30 years after the Olmstead decision, but given where we are at --- it is going to require an enormous amount of work.

Could you just comply with the damn law?

"A STRENGTH-BASED APPROACH" --- THERE'S MORE HISTORY HERE THAN YOU THINK

1/5/2021

Val's Take

When we think about how divisive things have gotten in our Country -- liberals such as myself might point to some groundless protest of a Trump supporter.

But any thought that this is limited to one side or the other really misses the point.

Just as the Legal System is trying to move to a "COLLABORATIVE PROCESS" ---- there are a WHOLE LOT OF PEOPLE (in fact an entire Country) that we got high and sometimes delusional on the ADVERSARY SYSTEM.

Now I'm not saying one shouldn't avail yourself of the courts when necessary IF YOU CAN AFFORD IT. A lot of what I do on Orchid is lay a FOUNDATION for a SUBSEQUENT LAWSUIT --- IF THE TIMING, PARTNERS & RESOURCES are right.

Further, people in other States utilize these resources, too.

Of course, the EASY WAY would just be STATE COMPLIANCE with Olmstead, etc.

I bring this up because one of the topic areas of the 2021 Report is a STRENGTH-BASED APPROACH --- who is against that, right? Well, the previous Hickenlooper Administration couldn't bring themselves to agree to it -- because I suggested it --- or that is sure what it seemed.

Even if we are beyond a knee-jerk objection to a "Strengths Based Approach" and maybe even trying to incorporate it --- we think a FLEXIBLE SYSTEMIZED APPROACH is important to ensure a Strength-Based Approach ACTUALLY is incorporated into various treatment schemes, etc.

Now one of the many, many problems with the ADVERSARY SYSTEM --- it's often NOT the DEN of LOGIC it pretends.

In fact, the ADVERSARY SYSTEM triggers a BIOLOGICALLY POWERFUL US vs. THEM response --- that has gotten this Country into a WHOLE HEAP of HURT.

If there are SUBSTANTIVE OBJECTIONS --- let's hash that out. BUT let's try to get beyond OBJECTING for the satisfaction of OBJECTING.

PBS --- The Brain with David Eagleman
We don't "feel the pain" of our "out-groups"

Person-Centered Care

Strength-Based Approach

US

Medicare & Medicaid Regulations

42 CFR 483.21

Comprehensive Person-Centered Care Planning

Some talk at the federal level.

In 2011, the Colorado Behavioral Healthcare Council endorsed a Strength-Based Approach

Cares Act

Cares Act

IF WE DON'T HAVE A GREAT TREATMENT IN MANY CASES -----WHY ARE THE NEW CONCEPTUALIZATIONS OF MENTAL ILLNESS & PERSONALITY DISORDERS SO IMPORTANT

1/2/2021

These new heavily biological and immunological understandings of cognitive disability have a lot to say to Criminal Justice.

A fair amount of "mental illness" is really DEVELOPMENTAL DISABILITY --- acquired during pregnancy as a result of Maternal Immune Activation.

Further, there is a long list of things that can cause additional damage to the immune system and the brain, including TRAUMA..

Pointedly, researchers are now identifying "BIOMARKERS" for the evil ones --- the ANTI-SOCIALS.

Additionally, people with "mental Illness" or "ADHD" or "Autism" can have plenty of "BAD INTENT" which is generally related to significant emotional dysregulation.

All of this is HUGELY PROBLEMATIC for a Criminal Justice System that is punishing BAD ACTS & BAD INTENT as the expression of FREE WILL.

Once we're at the BIOMARKERS of ANTI-SOCIAL PERSONALITY DISORDER --- that PUNISHMENT RATIONALIZATION is hard to keep up.

BUT WE STILL HAVE TO HAVE SAFETY --- and this POLICY DILEMMA doesn't look like its going away anytime soon.

We need:

Housing
Placements, and
Services

TO SCALE.

This is a REASONABLE (& Legally Required) SOLUTION to one of our most difficult challenges.

PHYSICAL HEALTH ISSUES ---
THE IMMUNE SYSTEM, THE ENDOCRINE SYSTEM & MENTAL HEALTH INDEX

Click Here

Biomarkers and Anti-Social Personality Disorder

Biomarkers and Anti-Social Personality Disorder

Maternal Immune Activation

Three Big Take Aways

Cognitive and Social Abilities Rely on Fine-Tuned Equilibrium of Innate & Adaptive Immune Responses (2019)
Innate Immune Cells are Regulators of Brain Development & Behavioral Function (2018)
The Vagus Nerve serves as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. (2018)

Click Here

Our 2020 Report on --
Anti-Social Personality Disorder & the Criminal Justice System

Click Here

COGNITIVE DISABILITY IN THIS COUNTRY HAS ALREADY ---"OVERWHELMED THE HEALTHCARE SYSTEM"

12/31/2020

We currently have a small percentage of the Cognitive Disability Population that makes up the vast majority of the Criminal Justice Population --- a lot of that being not just "mental illness," but brain injury and developmental disability.

Further, we've got an out-of-date DSM.

Further, a lot of major research is moving in the direction of the IMMUNE SYSTEM playing a major role in "mental illness" and other cognitive disorders.

We've got LAWS that policymakers sometimes feel JUSTIFIED in IGNORING because they are spending a lot on "mental illness."

BUT we can't be afraid to get that voluntary data --- much of which is on the Streets and conveniently in State Custody.

Further we've got to have WAITLISTS for HOUSING, PLACEMENTS & INTENSIVE SERVICES --- moving at a REASONABLE PACE ---- WE DON'T HAVE THAT IN COLORADO.

We need to RECOGNIZE that "MENTAL ILLNESS" and "COGNITIVE DISABILITY" are a lot harder than COVID.

This is a much longer and harder haul in some ways.

The exciting thing is we already are starting to have those NEW SCIENTIFIC UNDERSTANDINGS that are breaking with 50 years of stagnation.

Image Credit: Inc.com

The Need for a New Integrated DSM

BEYOND MEDIA DOCUMENTATION OF THE "MENTAL HEALTH CRISIS"

12/26/2020

TO GOVERNMENT DATA COLLECTION, HOUSING, PLACEMENT & SERVICE PLANNING & IMPLEMENTATION, AND

ACKNOWLEDGMENT OF CURRENT TREATMENT LIMITATIONS AND THE DESPERATE NEED FOR MORE ADVANCED UNDERSTANDINGS AND TREATMENTS

   There have been a lot of media reports and media series on the Mental Health Crisis in Colorado as well as lawsuits.

The CHALLENGE of UNDERSTANDING the problem as a BIOLOGICAL PROBLEM that has TRAUMATIC, PSYCHOLOGICAL &/or PHYSICAL Aspects HAS BEEN PROBLEMATIC to say the least.

  Each person brings with them volumes and volumes of idiosyncratic information that have to be reconciled with our current understandings.

Our current understandings of "mental illness" have been under a lot of pressure.

  Many of these CHALLENGES in "Mental Illness" CONCEPTUALIZATION are being met by RESEARCHERS and new findings of "SOCIAL BEHAVIOR" ---- as a product of the INNATE & ADAPTIVE IMMUNE SYSTEMS.

Who Would've Thunk It.

It is also fitting into a BROADER INCREASE of IMMUNE-RELATED DISEASES, DISORDERS, SYNDROMES in the Modern, Developed World which has quickly started to rise in the Developing World as well.

Everyone is sculpted by their Mother's IMMUNE SYSTEM and their own whether they have "Mental Illness" or not. Ultimately, people want CONTROL over this.

All of this is a long way of saying we need a lot more money for TRANSLATIONAL RESEARCH and MEDICINE for the benefit of Clinicians and Patients.

Right NOW:

We need comprehensive waitlists for:

Housing
Placements, and
Intensive Services, including Assertive Community Treatment and Supported Employment

We need a Reasonable Plan to bring:

Housing
Placements, and
Intensive Services, including Assertive Community Treatment & Supported Employment

TO SCALE to meet the need that is fully implemented by 2030.

Old Friends Hypothesis

FUNDING FOR INTEGRATED IMMUNO-PSYCHIATRY CENTERS OF EXCELLENCE

12/25/2020

We've got a pretty exhausted mental health profession and a population that has a lot of "mental health problems."

Policy makers don't know where they are going to get the money for all this and we're not exactly getting on top of it either.

The Immuno-Psychiatry branch of medicine looks like the best shot we've got right now.

We would say it needs to include endocrinology and gastro-enterology and the microbiome as well.

People with mental illness deserve a better mental health profession than what we've got --- and mental health professionals certainly deserve a lot more research support than what they are getting.

ARE WE PUNISHING "T-CELL DEFICIENCIES?"

12/24/2020

IT SURE LOOKS LIKE IT, OR AT THE VERY LEAST RESEARCHERS ARE THROWING "REASONABLE DOUBT" ALL OVER OUR CRIMINAL JUSTICE SYSTEM

How many forensic psychologists and psychiatrists are well versed in the Immune System and Behavior.

Not many.

For that matter it is not just forensic mental health professionals, it is mental health professionals across the board that have not been provided ESSENTIAL TRANSLATIONAL RESEARCH and MEDICINE.

I feel the obvious --- namely, we don't have a competent mental health profession -- is going to be rejected out of hand. But it is still true.

This isn't about bringing individuals to account, it's about bringing SYSTEMS to account and reforming them responsibly.

Not surprisingly, the mental health profession and system of care are related to other systems in our society such as the Criminal Justice System.

If researchers are bringing to the table a radical new understanding of human behavior that involves the IMMUNE SYSTEM --- it is hard to see how that doesn't impact the Criminal Justice System.

T Cells and Neurons Talk To Each Other (Oct. 2020)

Conversations between the immune and central nervous systems are proving to be essential for the healthy social behavior, learning, and memory.

How the Immune System Controls Social Behavior (2016)

Researchers have found a new mechanism that could explain the link between social dysfunction and immune dysfunction.

And in terms of treating and understanding social dysfunction associated with disorders, the immune system is “easier to target than synapses in the brain,”

See 26:26: Deficiency of T-Cells related to anti-social behavior.

The RIKEN Center for Integrative Medical Sciences in Japan

Activation of immune T cells leads to behavioral changes (2017)

Immune Cell Signaling to the Brain Regulates Anxiety-Like Behaviors (Sept. 2020)

Aggression, Social Stress, and the Immune System in Humans and Animal Models (2018)

We argue that while depression and aggression represent two fundamentally different behavioral and physiological responses to social stress, it is possible that some overlapped, as well as distinct, pattern of immune signaling may underlie both of them.

We also argue the necessity of studying animal models of maladaptive aggression induced by social stress (i.e., social isolation) for understanding neuro-immune mechanism of aggression, which may be relevant to human aggression.

SENSORY &/OR INFORMATION OVERLOAD ---ARE PSYCHIATRIC PROBLEMS A SECONDARY SYMPTOM?

12/22/2020

We are dealing with "BLURRED" psychiatric categories according the the National Institute of Mental Health.
Specifically, NIMH found calcium channel disruptions in ADHD, Autism, Bipolar Disorder Depression and Schizophrenia.
Further, there seems to be an immune system link or dysregulation involved in all these disorders.
We would argue that among other things people are struggling with information and sensory overload -- it is taking considerable emotion/reason to process.
Further, I think this is a lot more than we all need to take time to "process our emotions."

This can be almost a 24/7 endeavor and many people are looking to shut down sources of stimulation because they are already overloaded.

Star Institute. The Star Institute is located in Centennial, Colorado.

Virginia Spielmann, Associate Director at STAR Institute talks about Sensory Processing Disorder and anxiety from an Occupational Therapy perspective and whether anxiety is a secondary symptom.

Acclaimed neuroscientist Antonio Damasio: The Brain is the Servant of the Body.

Damasio is author of a number of books, including "Decartes Error" in which he argues among other things that Emotion is necessary for Reason.

What happens if you have much more information and sensory data to process than the average person has to process?

IS THAT GOOD OR BAD?

It seems more and more obvious that we DO NOT have UNLIMITED CAPABILITIES to process INFORMATION and SENSORY STIMULATION.

Further, immune dysregulation may be an underlying factor in information and / or sensory overload.

This ENLIGHTENING 20/20 episode on Carly Fleishmann with non-verbal autism --- was posted on YouTube by the Star Institute in 2012.

Ted-Ed: This fascinating exploration of TURBULENCE within Van Gogh's painting -- hints at the unexpected information overload he may have been dealing with.

Was Van Gogh the sensitive creative of song writer Don McLean's imagining or a smelly alcoholic jerk in the assessment of English art critic Waldemar Januszczak?

The reality for many people with psychiatric disorders can be very much --- ALL OF THE ABOVE.

And many people with psychiatric disorders are looking to temper the downsides and get more control of the gifts -- just as much as the Society is as well.

Dr. Gail Salz in her Book "The Power of Different" -- the Link Between Disorder and Genius -- was a welcome recognition of the substantial gifts of many people with "disorders."

I would submit the link is a not very mysterious access to greater information and /or sensory stimulation.

A NEW ROLE FOR THE American Psychiatric Association

12/21/2020

THE OUT-OF-DATE DSM IS BEING REFORMED & REPLACED BY THE WORK OF RESEARCHERS AND MEDICAL ACADEMICS

There's another article in Medscape regarding the Trials & Tribulations of the American Psychiatric Association's (APA's) DSM 5.

Old Soldiers never die according to Gen. MacArthur -- they just fade away. That may very well be true for the DSM as well.

From our perspective, a propriety professional organization such as the APA SHOULD NOT be in charge of a "DIAGNOSTIC MANUAL."

But 40 years ago -- there was nobody else to do it.

Further, when the US National Institute of Mental Health (NIMH) in 2013 found the DSM lacking scientific validity --- the response was the RDoC Program --- the Research Domain Criteria Program.

RDoC is important, it is continuing --- but it wasn't the rapid replacement of the DSM that many had hoped.

In the meantime, findings have been flooding out of the world's major research institutions and academics have been writing books on psychiatry and immunology, endocrinology, the microbiome, etc.

So in a lot of ways that replacement for the DSM is already here and it looks a lot more like a TRADITIONAL MEDICAL DISCIPLINE.

THAT VITAL ROLE for the APA

Advocate for MASSIVE TRANSLATIONAL RESEARCH & MEDICINE
Advocate for Integration of Psychiatry with other Medical Disciplines, including Neurology, Immunology, Gastroenterology, Endocrinology, etc.

This is good for patients and its good for mental health professionals.

There is a great irony in "mental disorders" that are connected to so many systems of the body -- would be ISOLATED and MALTREATED or INAPPROPRIATELY TREATED for most of HUMAN HISTORY.

It's because of the APA and others that we are on the cusp of a much more INTEGRATED and EFFECTIVE TREATMENT of "MENTAL DISORDERS."

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Val's Blog

GETTING BEYOND MEDIA REPORTS OF THE "MENTAL HEALTH CRISIS"

plain-speaking on covid & Olmstead ---- "You Selfish Bastards"

"A STRENGTH-BASED APPROACH" --- THERE'S MORE HISTORY HERE THAN YOU THINK

IF WE DON'T HAVE A GREAT TREATMENT IN MANY CASES -----WHY ARE THE NEW CONCEPTUALIZATIONS OF MENTAL ILLNESS & PERSONALITY DISORDERS SO IMPORTANT

COGNITIVE DISABILITY IN THIS COUNTRY HAS ALREADY ---"OVERWHELMED THE HEALTHCARE SYSTEM"

BEYOND MEDIA DOCUMENTATION OF THE "MENTAL HEALTH CRISIS"

TO GOVERNMENT DATA COLLECTION, HOUSING, PLACEMENT & SERVICE PLANNING & IMPLEMENTATION, AND

ACKNOWLEDGMENT OF CURRENT TREATMENT LIMITATIONS AND THE DESPERATE NEED FOR MORE ADVANCED UNDERSTANDINGS AND TREATMENTS

FUNDING FOR INTEGRATED IMMUNO-PSYCHIATRY CENTERS OF EXCELLENCE

ARE WE PUNISHING "T-CELL DEFICIENCIES?"

IT SURE LOOKS LIKE IT, OR AT THE VERY LEAST RESEARCHERS ARE THROWING "REASONABLE DOUBT" ALL OVER OUR CRIMINAL JUSTICE SYSTEM

SENSORY &/OR INFORMATION OVERLOAD ---ARE PSYCHIATRIC PROBLEMS A SECONDARY SYMPTOM?

A NEW ROLE FOR THE American Psychiatric Association

THE OUT-OF-DATE DSM IS BEING REFORMED & REPLACED BY THE WORK OF RESEARCHERS AND MEDICAL ACADEMICS

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Val's Blog

TO GOVERNMENT DATA COLLECTION, HOUSING, PLACEMENT & SERVICE PLANNING & IMPLEMENTATION, ANDACKNOWLEDGMENT OF CURRENT TREATMENT LIMITATIONS AND THE DESPERATE NEED FOR MORE ADVANCED UNDERSTANDINGS AND TREATMENTS

IT SURE LOOKS LIKE IT, OR AT THE VERY LEAST RESEARCHERS ARE THROWING "REASONABLE DOUBT" ALL OVER OUR CRIMINAL JUSTICE SYSTEM

Author

Archives

Categories

TO GOVERNMENT DATA COLLECTION, HOUSING, PLACEMENT & SERVICE PLANNING & IMPLEMENTATION, AND

ACKNOWLEDGMENT OF CURRENT TREATMENT LIMITATIONS AND THE DESPERATE NEED FOR MORE ADVANCED UNDERSTANDINGS AND TREATMENTS