Category: DSM 5

Personality Disorders, Developmental Differences Conceptualization Matters--- It Matters A Lot In The Criminal Justice System

5/27/2020

Personality Disorders are Largely Pejorative Labels we use for Behavior We Don't Like When We Don't have another Label

How this becomes so clear is when someone gets tagged with a "personality disorder" and the diagnosing professional has failed to actually even apply the flawed criteria in the DSM.

How are "personality disorders" treated in the Criminal Justice System (generally, anti-social personality disorder): pretty much an official and "scientific" stamp of approval of MORAL REBUKE and justification for often HARSH PUNISHMENT.

I'm not for putting anybody at risk or ignoring legitimate safety concerns, BUT a lot of what we have going on in the AMERICAN CRIMINAL JUSTICE SYSTEM amounts to TORTURE -- that is ADSEG, but it is not limited to that.

This is what is so frustrating about the AMERICAN JUSTICE SYSTEM -- in most cases (not all) the real issue is PUNISHMENT -- if we provide humane alternatives that sufficiently address safety -- a lot of these cases would go away.

INTEGRATION OF PHYSICAL & MENTAL HEALTH -- INTEGRATION OF BIOLOGICAL & ENVIRONMENTAL EXPLANATIONS OF BEHAVIOR

What we have traditionally been very sympathetic to is a history of "TRAUMA" -- often regardless of what danger or risk the person actually poses. I saw this played out in a case in which a young man had been physically abused by his step father and ultimately killed his stepfather.

The young man was acquitted -- unfortunately there were very serious needs that did not get addressed and he came back on a subsequent serious charge.

    Certainly prosecutors make moral arguments against these defendants BUT the issue is really does this person present a risk and has that risk been adequately addressed.

    Further, it is really the BIOLOGICAL CONSEQUENCES of TRAUMA that can most directly contribute to the BEHAVIOR -- and that can be very individual. I would submit that BIOLOGICAL CONSEQUENCES are the PROXIMATE CAUSE for both the act and the mental element of the crime.

    So it appears I'm really arguing in some senses for the integration of the ACTUS REUS (the act) and the MENS REA (mental element) of the crime.

    [Of course, the real practical answer is HOUSING, SERVICES and PLACEMENTS to SCALE.]

Economist Thomas Sowell is now almost 90 years old and a Senior Fellow at Stanford's Hoover Institute -- Wikipedia

Val's Take: I'm not quite so harsh as Thomas Sowell, mainly because I make plenty of mistakes and I think most people do.

On the other hand, the Mental Health Profession is really paying no price for failing to address a scientifically invalid Diagnostic Manual -- now maybe the Mental Health Profession doesn't understand the consequences of that -- BUT the National Institute of Mental Health does.

At least NIMH understands the scientific ramifications -- they probably don't know the criminal justice ramifications.

NIMH wants to completely solve this -- We're for it! BUT it appears that is going to be SEVERAL YEARS -- MEANWHILE we need INTERIM PROCEDURES to prevent further INJUSTICE.

Experts Warn There's a Huge Problem With How Mental Health Problems Are Diagnosed

3/7/2020

When creating a universal diagnostic tool for psychiatric illness, imperfection is inevitable. Now in its fifth edition, the widely-used 'mental health bible', known as the Diagnostic and Statistical Manual (DSM-5), has had a slew of controversies and some want to do away with it entirely.

As far back as 1968, experts have criticised the manual's myriad flaws, arguing that its "disjunctive" categories are "unusable in a scientific context". A detailed analysis of five key chapters in the current edition has now come to a similar conclusion.

Researchers from the University of Liverpool argue that today's diagnoses for 'schizophrenia', 'bipolar disorder', 'depressive disorders', 'anxiety disorders' and 'trauma-related disorders' are scientifically worthless as tools to identify these conditions.

Analysing chapters for these categories in DSM-5, the authors conclude that the manual's rules are inconsistent and subjective, leaving a huge amount of overlap in symptoms between diagnoses.

The results mirror a study from 2014, which demonstrated that when using both the fourth and fifth edition, two people could receive the same diagnosis without sharing any common symptoms in the majority of cases.

That very same year, another team of researchers calculated that in the DSM-5 there are 270 million combinations of symptoms that would meet the criteria for both PTSD and major depressive disorder.

"This study provides yet more evidence that the biomedical diagnostic approach in psychiatry is not fit for purpose," says co-author Peter Kinderman, a clinical psychology researcher at the University of Liverpool.

Orchid "Reaction"

Whenever things are "WRONG" -- like the DSM 5 -- there is a tendency to pitch everything out, including an integrated physical health/mental health model of medicine.

That is what the Liverpool researchers did and it is what others have done.

Often in reaction to paradigms that don't seem to sufficiently take into account TRAUMA or ADVERSE CIRCUMSTANCES.

THE PROBLEM: That trauma and those adverse circumstances are hugely problematic because they are working on HUMAN BIOLOGICAL SYSTEMS.

It's looking more and more that we will have a piecemeal approach to biomarkers and improved treatments.

Policymakers: "Burden of Proof" and "Reason" should help us get through this. The overwhelming evidence is that the majority of criminal defendants are dealing with some type of "cognitive disability."

That doesn't mean we have great treatments for cognitive disabilities (sometimes we do) -- but we can at least have humane care.

Mental Health professionals overwhelmingly want to help -- in many cases in the criminal justice system -- they just aren't and this is one of the great ethical catastrophes of modern times.

THE HARD ISSUES REGARDING THE SHAKY FOUNDATION OF PSYCHIATRIC DIAGNOSTICS

8/16/2019

Our Mental Health Profession has so many FUNDAMENTAL logical and scientific problems.

We're NOT going to solve our Mental Health Crisis until we get the COURAGE to tackle those issues.

Russell Copelan, M.D.

August 13, 2019

By Russell Copelan, M.D.

Despite the Zero Suicide initiatives, information resources, telephone numbers, best practices, mental health first aid -- and yes, board certification and other tools distributed for safer suicide care -- from 2000 to 2017, the suicide rate in the U.S. increased to a 50-year high, and the youth suicide rate of 14.6 per 100,000 appears to be the highest it's been since the government began collecting such statistics in 1960.

Among other reasons, two of the primary and persistent puzzlements affecting these dreadful statistics include:

(1) the incongruity between society's obvious mental health needs and what society chooses to pay for suicide and violence risk assessment, and

(2) the presence of high barriers to implement innovative tools that guide clinical judgment, such as pervasive administrative resistance and special organizational interests, for example, the APAs valuable DSM property.
In part, these stupefactions stem from:

(1) the troika of ineffective access, incompetent training, and inept assessment in psychiatric emergencies,

(2) the painstaking difficulty in defining "mental illness" and suicide and, relatedly,

(3) the unsettling amorphous shape of diagnostic psychiatry.

In praise of D.J. Jaffe & SB19-222 -- the unacknow-ledged Debt the State & Traditional disability advocates owe the conserva-tiveS & Moderates & Orchid

4/26/2019

SB19-222 requires the State to strengthen and expand the behavioral health safety-net system so that individuals who are the hardest to serve do not end up in jails, caught in the child welfare system or homeless.

This really marks a major shift in policy and position -- for the State, State Government & the Disability Community.

What role if any did Orchid play in that?

How does that inform what we will be doing going forward?

What we really did was MARRY the CONSERVATIVE DISABILITY ADVOCACY of D.J. Jaffe and the Mental Illness Policy Organization & Treatment Advocacy Center with the Traditional Disability Activism & Sensiibilities symbolized by Olmstead.

We think that is the MIDDLE GROUND that the Community & Many Advocacy Organizations & Institutions can EMBRACE.

SB19-222 really embraces that and we know that some within State government and advocates are familiar with our criticisms of Colorado's Mental Health System & its "Continuum of Care Hell."

We think it is that Middle Ground that can be embraced nationally by:

Mental Health America,
NAMI
the National Disability Rights Network [the Nation's federally-mandated Protection & Advocacy Offices],
SAMHSA, &
CMS

We don't agree with everything D.J. Jaffe and the Conservative Mental Health Advocacy Movement want -- BUT they FORCED a CONFRONTATION with REALITY that the Mental Health Advocacy & Activist Community was doing its very best to ignore.

That reality was largely related to the GROSS HUMAN RIGHTS VIOLATIONS against people with cognitive disabilities in the CRIMINAL JUSTICE SYSTEM & HOMELESS.

NOW the Activist Community is Embracing those concerns of people in the Criminal Justice System and Homeless and involved with the Child Welfare System.

Further, Mental Health Advocates and Disability Advocates in general had gotten so pressured into believing that the ECONOMIC CASE for SERVICES was more IMPORTANT than the MORAL CASE that the SYSTEM that was CREATED was INCAPABLE of adequately serving people with intensive needs.

AND make no mistake about it the Disability Community got co-opted by States into going along with inadequately resourced systems because there was no clear vision of a Continuum of Care just a disdain for Institutionalization.

So this brings up one of the REALLY INCONVENIENT SYSTEMS FAILURES --the Mental Health Profession itself.

Where is the LEADERSHIP in the Mental Health Profession to address this -- we don't know.

We definitely need the American Psychiatric & Psychological Associations to step up to the plate & take responsibility and remedy the DSM 5 debacle.

That could be accomplished by just acknowledging their IGNORANCE -and stop allowing themselves to be improperly used by the Criminal Justice System.

Most specifically mental health professionals need to stop handing out those DAMNING "anti-social personality disorder" diagnoses -- when they really don't have knowledge to know what's going on.

Further, the mental health profession needs to wait for the National Institute of Mental Health's Research Domain Criteria Program to reform the DSM 5.

This is necessary in order to avoid the unscientific pronouncements the mental health profession is currently making that have the potential and often reality of greatly HARMING the lives of poor marginalized people with only partially understood cognitive issues.

There does seem to be INSIGHT & LEADERSHIP in the RESEARCH COMMUNITY and the Mental Health Activist Community to address what appears to be pretty inadequate mental health care in many cases.

We are interested in MARRYING the insights of the Immune-Brain-Gut Triad with approaches such as "Open Dialogue."

We're not for letting the Mental Health Profession continue to BILL for "CARE" without any commitment to address the HAVOC caused by a SCIENTIFICALLY INVALID DSM 5.

So what we really brought to the Table over the past 5 years was:

Information
Systemic Focus
Root Cause Analysis
& a willingness to Address Reality
while respecting Individual Rights & Needs

We've said this situation with THOUSANDS of Coloradans with cognitive disabilities in the Criminal Justice System & Homeless did NOT happen because 1 System FAILED.

Multiple Systems have FAILED. We will be continuing to provide information, a systemic focus and root cause analysis regarding those SYSTEMS THAT ARE IN DESPERATE NEED OF SUPPORT EVERY BIT AS MUCH AS THE INDIVIDUALS WHO DEPEND UPON THEM.

Of course, NONE OF IT WILL WORK WITHOUT INCLUSION.

SB19-222:

Individuals At Risk Of Institutionalization
Concerning the improvement of access to behavioral health services for individuals at risk of institutionalization, and, in connection therewith, making an appropriation.

BILL SUMMARY

The bill requires the department of health care policy and financing (state department) to develop measurable outcomes to monitor efforts to prevent medicaid recipients from becoming involved in the criminal or juvenile justice system.

The bill requires the state department to work collaboratively with managed care entities to create incentives for behavioral health providers to accept medicaid recipients with severe behavioral health disorders.

The bill requires the state department to determine if seeking a 1115 demonstration waiver is the necessary response to the requirements of 42 CFR 438.6 (e) to ensure inpatient services are available to individuals with a serious mental illness.

If the state department determines it is not appropriate, the state department is required to submit a report to the general assembly with the state department's reasoning and an alternative plan and proposed timeline for the implementation of the alternative plan.

The bill requires the state department to develop and implement admission criteria to the mental health institutes at Pueblo and Fort Logan.

The bill creates a community behavioral health safety net system (safety net system) and requires the department of human services (department), in collaboration with the state department, to conduct the following activities:

Define what constitutes a high-intensity behavioral health treatment program (treatment program), determine what an adequate network of high-intensity behavioral health treatment services includes, and identify existing treatment programs;

Develop an implementation plan to increase the number of treatment programs in the state;

Identify an advisory body to assist the department in creating a comprehensive proposal to strengthen and expand the safety net system;

Develop a comprehensive proposal to strengthen and expand the safety net system that provides behavioral health services for individuals with severe behavioral health disorders;

Implement the comprehensive proposal and the funding model no later than January 1, 2024; and
Provide an annual report from January 1, 2022, until July 1, 2024, on the safety net system to the public through the annual SMART Act hearing.

The bill makes an appropriation.

"They're NOT One of Us"

3/26/2018

Getting Beyond Incomplete, Artificial Categories to the Complexity of Human Biology

Our Scientifically Invalid DSM 5 is NOT Helping

Now the Statement above ["They're NOT one of us"] wasn't even made regarding people who had committed some heinous crime -- the statement above was made by one our best friends regarding people with "Substance Use" issues.
The truth is there is a lot of "Dual Diagnosis" -- people with mental health issues and substance use issues. Further, the National Drug Institute refers to Drug Addiction as a "mental illness."
How we consider "mental illness" is a matter of much public debate because how we define that reverberates in the Criminal Justice System and throughout our society and our definitions of "Disability" and access to financial and medical benefits.
There are a lot of HUGE FLIES in this OINTMENT -- one of the biggest being we don't have a scientifically valid DSM 5.
Unfortunately, that doesn't stop us from making all kinds of scientifically invalid judgments in our society, including judgments that involve "punishment."
One of the hardest things for us to come to terms with is that people who engage in bad behavior or crimes are people AND ARE ONE OF US.
BUT they are NOT necessarily behaving like us, and there are REASONS for that beyond the person is "bad" or "evil" -- even though it may be pretty clear that the behavior is "bad" or "evil."
How are we going to make decisions regarding the consequences for "BAD" or "EVIL" behavior when we have imperfect knowledge:

Are we going to convince ourselves that we have knowledge we don't have?
Do we already know we DON'T have the knowledge, but this is just the ROLE we have to play?
Do we think to protect the community, we have to pretend to knowledge we don't have?

"Mental Illness," "Developmental Disability," and "Brain Injury" are all enormously broad constructs mixing societal concerns with imperfect human scientific knowledge.
In the end what we are concerned with is the COMPLEXITY of HUMAN BIOLOGY and how that plays out in SOCIETY and what we need to do to make those SOCIETIES, COMMUNITIES, FAMILIES, & INDIVIDUALS SAFE.
Some of our outdated contructs like the DSM 5 are really getting in the way of:

acknowledging the complexity of human biology; &
acknowledging we don't know it all.

  Ironically, pretension to knowledge we don't have is making our societies, communities, families, and individuals LESS SAFE.
The goal ultimately is to get everyone into society's "IN GROUP."    BUT it is pretty hard to do that if we don't recognize there are COMPLICATED REASONS FOR BAD, DANGEROUS, or EVIL HUMAN BEHAVIOR such that punishment won't get to the ROOT CAUSES.
If we don't know how to get to the ROOT CAUSES, punishment is still bad because it generally makes the behavior worse.
There are people who can't live in the community right now -- BUT punishment is a counter-productive remedy.
We really are all HUMAN BEINGS -- the best and worst of us are part of that IN GROUP.

Dr. Robert Sapolsky is a professor of biology, neurology and neurological sciences, and neurosurgery @ Stanford University:

"You are never really going to understand what is going on if you get it into your head that you're going to be able to explain everything with this is--

the part of the brain
the childhood experience
the hormone
the gene
or the evolutionary mechanism

---That explains everything.

"It doesn't work that way. Instead any behavior is the result of biology that occurred a second ago, hours ago, days ago -- a million years ago."
. . . .

"O000h it's complicated. Well, that's very useful.

"How 'bout, 'OOOh it's complicated and you better be really careful and really cautious before you think you understand the causes of a behavior, especially if it's a behavior you judge harshly.' "
. ------Prof. Robert Sapolsky Stanford

GLEE: "One of Us"

Fly In the Ointment
Where's that Scientifically Valid DSM?

Dr. Thomas Insel, then Director of the National Institute of Mental Health
"This Is A Time of DISCOVERY."

(Dr. Tom Insel, then head of the National Institute of Mental Health states the DSM-5 "lacks validity" :

"The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.

"In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.

"Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood thatsymptoms alone rarely indicate the best choice of treatment.

"Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system."

https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

Bishop Carlton Pearson says he received a religious message that there is No Hell.

Hair Analysis, Psychological Analysis, the Criminal Law & the Ethical & Moral Imperative to Pull Back

Even A Dog Distinguishes Between Being Stumbled Over & Being Kicked

Above is a TedTalk on a REALLY IMPORTANT topic -- the Biology of Our Best and Worst Selves. Dr. Robert Sapolsky is a professor of biology, neurology and neurological sciences, and neurosurgery @ Stanford University.

Last Updated July 27, 2022

Coming To Terms with the Criminal Justice System as the Disability Provider of Last Resort

3/11/2018

So we don't completely understand:

Mental Health
Brain Injury
Developmental Disability

BUT we have learned a lot.
If there were ever areas in which personalized medicine and services were essential -- these complicated areas are such areas.
Now -- what do we do about the Criminal Justice System in which there is a lot of "Pretense to Knowledge" regarding mental health, brain injury, developmental disability with a level of certainty that even "experts" couldn't possibly possess.
From my perspective, there are a lot of people with "DISABILITIES" in the Criminal Justice System -- whether it is:

Mental Illness
Brain Injury, or
Developmental Disabilities
Etc.

Further, many people in the Criminal Justice System have more than 1 "invisible disability."
What has made people with "mental illness" particularly unsympathetic in the Criminal Justice System is they often have above-average intelligence.
So unless someone is floridly psychotic, there's A LOT of SKEPTICISM regarding any claim of "mental illness." This is so, even though it is well documented that many people with "mental illness" have above average intelligence.
BUT we don't really have a solid definition of "mental illness" and at least according to former NIMH Director Thomas Insel -- the DSM 5 is NOT a valid diagnostic manual.
Further, we have enshrined in our LAWS some pretty demonstrably scary, uniformed ideas about "insanity." So much so that in our opinion they violate Constitutional Protections for DUE PROCESS.
We really must come to terms with the UGLY fact that the Criminal Justice System is a HORRIFICALLY ABUSIVE PROVIDER OF INTELLECTUAL & MENTAL DISABILITY SERVICES of LAST RESORT -- Especially for boys & men.
Maybe problem-solving courts are the first step in the desperate need to acknowledge the reality and complexity of disability in our Society.
BUT even they are dependent on the legally sufficient and adequate provision of:

Bed Space;
Housing; and
Community Services, including Intensive Community Services

for all people in our Community with:

Mental Illness;
Brain Injury; and/or
Developmental Disability

The Need & the Gross Violation of Human Rights are Happening --- NOW.

Inadequate access to treatment, housing, education & jobs leads to longer sentences and re-offending.

Mental Health's Tower of Babel

Social Determinants of Health

Insanity

Brain Injury in CO Jails

Traumatic Brain Injury (TBI) in the Criminal Justice System

How Unrealistic Over-Optimism Hurts People with Disabilities in the Criminal Justice System

3/9/2018

Expecting people to conform to our "pretense to knowledge" is getting us into a lot of trouble.
I'm obviously very concerned about how the "invalid" DSM 5 plays itself out in our antiquated Criminal Justice System.
I also get really concerned about all kinds of wild extrapolations regarding our "current" ability to "completely control":

epigenetic changes;
complete control of our nervous systems;
etc.

"It's all in our hands to change." Really?
I actually think we probably will get there and we are getting there. BUT we're not completely there now.
Well, what is the problem with just being a little or lot overly optimistic about that? Well, it can really affect our judgments about what individuals should be capable of controlling and doing in their lives NOW.
And that plays itself out in a lot of ways, including how we treat people who pretty clearly have not been able to sufficiently control their actions and have landed in the Criminal Justice System.
If we think that human beings currently have complete control of:

their epigentic changes
their nervous systems
their environments
their social determinants of health

Then any failure is often viewed as a moral failure of the individual justifying punishment.
Now if there is some kind of significant failure of behavioral control, we need to recognize it because it very easily could represent a threat to the safety of the community. And any violation of the law is not going to be good for the person either.
BUT if we don't acknowledge the very REAL:

Mental Illnesses;
Brain Injuries; and
Neuro-Disabilities

people are really struggling with: we've missed it. Further, many of these are created or exacerbated by bad environments in our Society.
There is reason for HOPE and CHANGE -- but if we're not realistic -- we are setting ourselves and others up for failure.
AND when that failure happens-- more often than not we blame the weakest and least sympathetic party -- and that's often the person with a mental or neuro-disability.

[There are numerous amazing scientific discoveries that researchers are working to harness for common benefit.

In the meantime, it is important to be HUMBLE about where we really are.]

Mental Health's Tower of Babel: Science, Clinical Practice, the Criminal Justice System, Politics, and Individuals with "Mental Illness"

2/24/2018

There's A LOT to be said about the current lack of:

logic,
reason, and
coherent, clear and precise definitions

in Mental Health practice and policy.

We are only scratching the surface, but we will be continuing to develop these ideas because it is so important to rational:

Mental Health practice
Legal practice, and
Public Policy discussions and decision-making.

Ultimately, this ISN'T about knowing everything. It's really about:

Honesty
Honesty about what we do know;
Honesty about what we don't know;
& the Honesty to Limit Our Actions accordingly.

WE ARE NOT DOING THAT.

We've got an incoherent mess of systems and we've lulled ourselves into believing it doesn't really matter -- EXCEPT it does matter -- A LOT.

Science: The DSM 5 is not a valid diagnostic tool because it just describes symptoms and does not get to the underlying biology.

Science Up

New Science is Amazing, and it has HUGE Moral Implications for our society -- Now

Clinicians: Rely on the DSM 5 because they largely don't have anything else. This reliance extends to reports and testimony in the Criminal Justice System.

Criminal Justice System: They have their own standards for "insanity" and "incompetent to proceed" that don't mesh well with the DSM 5 much less current scientific knowledge and lack thereof. Of course, those LAWS are largely the result of the political process.

"Even a dog distinguishes between being stumbled over and being kicked"

Insanity

Politics: The will of the majority, largely concerned with SAFETY. Public policy discussions tend to use BROAD categories like "MENTAL ILLNESS" to discuss extremely complicated issues such as gun control. Clinicians can provide some refinement, but are largely unable to provide the clarity and precision that is needed.

Housing & Service Provision for people with "mental illness" are not provided as required by LAW or as needed, but on the basis of political budgetary calculations that may not be irrational from a SHORT TERM political calculation but are irrational both with respect to the TRUE NEEDS of people with disabilities and the LONG TERM COSTS to the Society. So we have a grossly inadequate supply of:

Housing;
Bed Space;
and Intensive Mental Health Services

Even though our Federal Laws and CMS Oversight Procedures would seem to prevent the ABUSE, NEGLECT and RIGHTS VIOLATIONS of people with disabilities that are rampant in most States and in Colorado -- when we don't follow or adequately enforce the LAWS -- it doesn't prevent the ABUSE, NEGLECT or RIGHTS VIOLATIONS of people with disabilities.

Colorado Abuse & Neglect Scandals

Alicia Keys & 60 Minutes: "Cause Right Now It Don't Make Sense"

Individuals with "Mental Illness": Are probably more acutely aware than most in the society, that "MENTAL ILLNESS" is BOTH a Biological Reality and a Social Construct. Tens of Millions of people with "mental illness" in the US are vulnerable to unfair stigma and refusal of reasonable accommodations. Additionally, over 300,000 people with mental illness are in the US Justice System, and Thousands are in the Colorado Justice System.

The Mental Health Community & Mass Shootings: Are You a "Mental Illness Denier" In the Name of Stigma Prevention?

2/15/2018

Look, most people -- over 300 million in the US --- are NOT committing mass shootings.
Further, the one-fifth (1/5) to one-fourth (1/4) of the US population with a "diagnosable" mental health disorder is NOT committing mass shootings.
On the other hand, disturbing mental health indicators such as:

Suicide
School Shootings
Etc.

Are going up.

AND WE DON'T HAVE A REALLY GOOD HANDLE ON THESE PROBLEMS.

The DSM 5 is NOT VALID as a diagnostic tool -- How do you know the person doesn't have a "mental illness?"

Further, the National Drug Institute says Drug Addiction is a Mental Illness.

To talk about such a BROAD Category as MENTAL ILLNESS-- which is many MILLIONS of people in this Country doesn't make sense with respect to MASS SHOOTINGS.

BUT IT ALSO DOESN"T MAKE SENSE to be in a sense a "MENTAL ILLNESS DENIER" in the name of STIGMA PREVENTION.

Because there is a HOLOCAUST going on in the US Mental Health Community, and especially for those with intensive mental health needs ---- that impacts them, their families, the people they are around, and the ENTIRE COUNTRY.

Now most people with intensive mental health needs do not commit school shootings---- BUT we really have to question why we are going to SUCH LENGTHS to DEFINE people out of the HUGE MENTAL ILLNESS category who seem so clearly a part of it --- even if just a tiny, tiny fraction of it.

Hmmm . . . . BUT Doesn't It Depend On How We Define Mental Illness? ---------

Should we do more about gun control -- ABSOLUTELY. BUT Mental Health is having a HARD TIME coming to terms with REALITY -- AND if we can't do it -- someone's going to do it for us.

AND that could be VERY BAD for people with MENTAL ILLNESS.

Science Up

Drug Addiction Is A Mental Illness

A Strength-Based Approach Could Get Us Out of the "Twilight Zone"

1/30/2018

To the right is a clip from the old "Eye of the Beholder" episode from the Twilight Zone.
I think with ART one is generally making a point in very broad strokes. Even if the ART is a little more "nuanced" or a lot more "nuanced" than this --- STILL we're NOT getting into the down and dirty details for the most part of addressing say "DIVERSITY" in our society.
Maybe all we can do in a short episode of the "Twilight Zone" is recognize the PAIN and ABSURDITY in not appreciating and recognizing people for who they are. THAT'S A LOT.
This little clip on the oppressiveness of society to have people CONFORM is a lot more POWERFUL than much of what has been written on the topic.
BUT what are some of the other consequences of this "OPPRESSIVENESS" or "DISCRIMINATION"?
Well, according to studies discrimination can lead to physical and mental health problems.
AND certainly mental health problems can lead to more discrimination.
So there's a pretty SCARY positive feedback loop going on.
By the time one gets to the well-meaning mental health professional --- that has plenty of medications and motivational interviewing to bring about the desired CHANGE -- well, at that point one may very well feel like one is in the TWILIGHT ZONE.
Of course, ART points to and reflects reality -- It's not reality.
SO it's not so much that people who are different are "PERFECT" -- it's that they often have STRENGTHS that are NOT being:

Recognized,
Developed
Employed, or
Rewarded.

for any number of reasons, including because one is "DIFFERENT" -- others don't get it (just don't UNDERSTAND the person or the person's talents), the person may just be discriminated against because of race, ethnicity, sexual orientation, or "disability," etc.
By the time one attracts the attention of Institutional Players within the Society such as the Court System and/or the Mental Health Profession, etc.--these entities are often focused 100% on Addressing Weaknesses -- well, there is not going to be time for:

STRENGTHS DEVELOPMENT,
REAL RECOVERY, &
As well meaning as all this is, it has the very real potential to make things worse. Sometimes a lot worse.

AND if it gets worse, there's going to be MORE DISCRIMINATION and more and more INTENSE ATTEMPTS to FIX THE PERSON.

Well, at this point this is even scarier than THE TWILIGHT ZONE -- and you add to it a Mental Health Profession with an out-of-date DIAGNOSTIC MANUAL in the DSM 5 and that is pretty oblivious to the limits of its own knowledge base -- and one has the makings for the GROSS HUMAN RIGHTS VIOLATIONS we see in Colorado and across the Country on a daily basis.

Advocacy for Mental health can be the binder that brings together different groups that have experienced discrimination to form a majority to bring about the massive changes in:

Medicaid
Housing
Employment,
Education
Etc.

to comply with the LAW and to SAVE OURSELVES AND OTHERS.

Because what we have in common is that we are ALL DIFFERENT.

Positive Feedback Loop --Causal loop diagram that depicts the causes of a stampede as a positive feedback loop. --- Wikipedia

Dr. Saltz' General Rule: Time spent on addressing Mental Health Issues should be divided as follows:

80% of the time on Developing Strengths, and
20% of the time on Work-Arounds for Weaknesses

Racism & Mental Health

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