Orchid Advocacy
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    • About Orchid >
      • Why Orchid?
      • ORCHID'S SYSTEMIC FOCUS & "ROOT CAUSE" ANALYSIS APPROACH TO PROBLEM SOLVING WITH A COMMITMENT TO CREATIVITY & INNOVATION
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    • Val's Blog 2
    • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
    • NEURO-DIVERSITY Wednesday
    • Olmstead Law & Order Thursday
    • Translational Medicine Friday
    • Translational Love, Relationships & Neuro-Diversity Saturday
  • Orchid's A-Z Index
    • Crisis Services in CO, the US & Around the World
    • Assertive Community Treatment & Flexible ACT Index
    • Housing & Homelessness Index
    • Criminal Justice
    • Innovation Index
    • For More: See the Main Orchid Index Page
  • US Federal
    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
  • Research & Translational Medicine
    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
      • Brain Injury, the Immune System & Mental Health
      • Celiac Disease & Sensitivities, the Immune System & Mental Illness
      • Mental Illness & The Immune System
      • Racial Discrimination & the Immune System & Mental Health
      • Trauma & the Immune System & Mental Health
      • ***Physical Health Issues, the Immune System & Mental Health Index
    • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System

Transitional/ Translational Justice Monday





















Rules of Evidence and the mess in Mental Health

10/26/2023

 
Federal Rule of Evidence 702.

Testimony by Expert Witnesses


A witness who is qualified as an expert by knowledge, skill, experience, training, or education may testify in the form of an opinion or otherwise if:

(a) the expert’s scientific, technical, or other specialized knowledge will help the trier of fact to understand the evidence or to determine a fact in issue;

(b) the testimony is based on sufficient facts or data;

(c) the testimony is the product of reliable principles and methods; and

(d) the expert has reliably applied the principles and methods to the facts of the case.


The Issue in 2022 (& Still in 2023)*
  • Often mental health providers are "reliably applying" the principles and methods to the Defendant.
  • BUT --- those methods are NOT:
    • Based on sufficient facts or data,
    • The principles and methods are NOT RELIABLE.

If someone is getting an ANTI-SOCIAL PERSONALITY DISORDER DIAGNOSIS based on criteria from the DSM 5:
  • That is scientifically suspect.
  • Now, many of these categories are now being conceptualized as "BLURRED", and
  • Often related to Neuro-Developmental Differences or Disorders.
    • THAT SHOULD MATTER.

Further, it is muddy and messy:
  • our Legal System is currently not well structured to deal with the FALLOUT ---
    • If we raise legitimate questions about the reliability of "ANTI-SOCIAL PERSONALITY DISORDER" in the context of Criminal Justice and the ASSUMPTIONS we're making under MENS REA ---
      • Where does that leave us?

Honestly, we have a system that is about 1/2 way there to a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE but doesn't have the PUBLIC HEALTH PRACTITIONERS to SEAL THE DEAL.
*This blog was originally written in 2022 and was on the homepage for over a year.
Picture
There are LOGICAL & ETHICAL PROBLEMS associated with trying to use a scientifically invalid diagnostic manual as our DICTIONARY. 
Over 600 Research Institutions Find Shared Heritability In Common Disorders of the Brain (2018) --- Contradicting DSM 5 Categories
In 2022 (& 2023)*, the BIG QUESTION is who can live:
  • In the community, with some supports
  • In the community, with intensive supports
  • In a structured placement
  • In a secure placement.

Further, these questions are NOT somehow divorced from what COMMUNITY INTEGRATION is being provided for people with:
  • Neuro-Developmental Disorders
  • Psychiatric Disorders
  • Brain Injuries, and
  • Substance Issues that are often related to one or more of the above.

Do we even know what to provide in 2022?
  • Supportive Housing, and
  • Supportive Employment

could help a lot of people.

The INTEGRATION MANDATE of Title II of the ADA which also served as the RATIONALE for the US Supreme Court's 1999 Olmstead decision could provide the LEGAL BASIS.

Science Up
Picture
“So what this is doing — is it’s starting to kind of shed light on the specific biological pathways that might be shared across these disorders; namely, these specific neurons that are sort of critical and just brain signaling pathways,” Grotzinger said.

With these findings, Grotzinger hopes to be able to identify what the specific genetic risk pathways are so an individual can be diagnosed and treated more efficiently.

The goal is to be able to give an individual one diagnosis and treatment for the disorders they have instead of multiple, if possible.

Currently, an individual cannot be diagnosed with bipolar and schizophrenia disorder.

However, these two disorders have an overlap in their genetic makeup — meaning that an individual can experience symptoms from both disorders.

Grotzinger hopes in the future diagnoses can be made “a little less sort of by the book.”

In addition, there also may be a possibility of treating certain diagnoses with psychotherapy versus prescription medicines.

The research team only analyzed the genetic variation that showed up in at least 1% of the population.

“That really rare stuff might be really important.

And it’s something that we’re just now getting to the point that we can start to look at,”
Grotzinger said.
Daily Camera Article --- CU Research

The CURRENT NECESSITY AND Trap of "Confidentiality"

10/17/2023

 
If We Get Out of Punishment --- and Move to
  • Safety
  • Health, and
  • Problem Solving
 
[which we are doing as we are able]


We can further "MODIFY" some of the more PROBLEMATIC aspects of the ADVERSARY SYSTEM.

Ironically, that ADVERSARY SYSTEM according to Judge Leifman in Florida is moving to a COLLABORATIVE SYSTEM.

"CONFIDENTIALITY" is a strangely problematic aspect of both Mental Health and Criminal Justice.


The perceived need for "CONFIDENTIALITY" --- is at the ROOT of much Mental Health Stigma.

Now, confidentiality ungirds healthcare as well --- but the perceived NEED FOR CONFIDENTIALITY is often a BAROMETER of whether the SOCIETY "HAS GOT THIS" or Society's understanding is SHAKY.

This is a very complicated dance --- we don't want to subject anyone to PUNISHMENT, EMBARRASSMENT or RIDICULE.  
People are coming out of the MENTAL HEALTH CLOSET and our UNDERSTANDINGS and TREATMENTS are getting better.
Coincidence & Remembrance on this Veteran's Day
The World War II Veteran I spoke to wanted to be FORGIVEN by God and as many people as possible.
Further, if one person is struggling with something --- it's pretty likely there are others.

It's not necessary to have identifying information --- BUT some people do want to be seen, provided help as available and their challenges to be treated for what they are --- HEALTH CHALLENGES.

We have created some very expensive systems that are not addressing the underlying problems as well as they might --- and sometimes they are EXACERBATING those problems.
Maria Bamford --- at the Psych Ward
and the strange mix of feelings raised in some patients by professionals who promise they would never tell anyone.
  • It really gives the message that this is so SHAMEFUL that the patient shouldn't tell either.

Bamford has also said that she openly talks about mental illness in her acts and interviews --- because --
"IT MAKES IT LESS OF A FREAK SHOW."

We're currently not putting people in prison for SUICIDE ---- so Bamford's SUICIDAL IDEATION is NOT THE HARD CASE.

HOMICIDAL IDEATION is the HARD CASE --- BUT we can address that if the person is on the EXTREMES --- IF WE'RE BEING HONEST ---
  • Incompetent to Proceed and Insanity are already there in US Law and many other Countries.

The harder case is the PERSON with a NEURO-DEVELOPMENTAL DISORDER, no obvious PSYCHOSIS, ramped STRESS & PAIN RESPONSES who seems to be EXACTLY the person the CRIMINAL LAW was meant to address

---
WITH OUT OF PROPORTION BAD INTENT & BAD ACTS.
ADHD, Reciprocity, Rejection Sensitive Dysphoria & Differences in Intensity
BUT going deeper than MORE OBVIOUS bad acts and bad intent ---

We can start to move more to PREVENTION by SCREENING for not only problematic mental states but also:
  • SLEEP DISTURBANCES
  • PERIODONTAL DISEASE
  • MIGRAINE
  • BRAIN INJURY
  • AUTO-IMMUNE DISORDERS
  • CANCER
  • etc.
Stroke & ADHD

DOJ Sues Colorado for Disability Civil Rights Violations

10/10/2023

 
The US Dept. of Justice is focusing on the INSTITUTIONALIZED NURSING HOME POPULATION with "PHYSICAL DISABILITIES" in Colorado and alleging Colorado is not providing sufficient HOUSING and SERVICES for them in the Community.

From my perspective, Colorado is a very interesting RICH STATE/POOR STATE budget case.


Not all but a lot of DOJ's Disability Rights Cases are filed in POOR STATES --- Colorado is a VERY AFFLUENT STATE with a RESRICTED STATE BUDGET under TABOR and other measures.

I do believe that the ADA and other Federal Law TRUMP TABOR --- but I don't want to start a CIVIL WAR over it.

DOJ doesn't have the resources to file every ADA case out there and they don't --- I think it is significant that they finally filed against COLORADO.


Federal Reports have shown that there are many people with "MENTAL ILLNESS" institutionalized in Nursing Homes.
  • How people FEEL about that depends on the person.
  • I am aware of one white young man in SOLITARY with developmental disabilities and mental illness and substance issues in the Denver Jail that came to Colorado because he heard MARIJUANA was legal.
    • Mr. Universe, an older black man in his 50s with mental illness who had been homeless since he was 11 ----
      • begged and begged for me to help this young man until I finally relented.
      • GIVEN the options and there weren't many --- the young man wanted to go to the NURSING HOME.
        • But he really did want to go to the nursing home and it was a lot better than SOLITARY in the Denver Jail.
    • Mr. Universe is now serving over 20 years in a Colorado prison at least in part because he was tagged with "ANTI-SOCIAL PERSONALITY DISORDER" at CMHIP.
      • I hope the IRONY of that does not escape you --- because it does not escape me.
DOJ ADA Enforcement --- Colorado
Picture
See Also
  • Department of Health and Human Services
      OFFICE OF INSPECTOR GENERAL
      JANUARY 2001 --
OEI-05-99-00700
      YOUNGER NURSING FACILITY
      RESIDENTS WITH MENTAL ILLNESS:
         Preadmission Screening and Resident Review (PASRR) Implementation and Oversight


Especially when it comes to addressing COGNITIVE DISABILITY ---

There's all kinds of COMMONALITY OF INTEREST in more effectively and comprehensively addressing COGNITIVE DISABILITY:
  • Brain Injury
  • Mental Illness
  • Developmental Difference/Disability
  • Substance Issues that are often related to one or more of the above.
Findings of Fact & Conclusions of Law --- March 2022
Complaint --- Sept 2023
We'd like to see DISABILITY LAW COLORADO, Colorado's federally funded Protection & Advocacy Office for People with Disabilities, investigate Colorado's Compliance with Title II of the ADA and Olmstead in relation to:
  • Homeless People with Cognitive Disabilities and
  • Justice-Involved People with Cognitive Disabilities being released from Incarceration.

We'd like that report to be made public as well as delivered to the US Department of Justice.

    Transitional Justice is a term used by the United Nations and others to describe measures to REDRESS MASSIVE VIOLATIONS of HUMAN RIGHTS.

    ​​Translational Justice as we're using it refers to a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE and is meant to echo TRANSLATIONAL MEDICINE.

    ​
    Translational Justice also means listening to those people impacted by our justice policies

    That means going 360
    ° -- that's hard work
    ​



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  • Home
    • About Orchid >
      • Why Orchid?
      • ORCHID'S SYSTEMIC FOCUS & "ROOT CAUSE" ANALYSIS APPROACH TO PROBLEM SOLVING WITH A COMMITMENT TO CREATIVITY & INNOVATION
      • Disclaimers, Limitations and An Invitation
      • Orchid Board
      • Orchid Book Club
      • Conjecture, Science & Translational Research & Medicine
      • Orchid Themes & Symbols
      • The Tipping Point
      • Orchid's Website Advertising Policy
      • Statement for Potential Website Contributors
      • Contact
  • Blogs
    • Val's Blog
    • Val's Blog 2
    • ​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY
    • NEURO-DIVERSITY Wednesday
    • Olmstead Law & Order Thursday
    • Translational Medicine Friday
    • Translational Love, Relationships & Neuro-Diversity Saturday
  • Orchid's A-Z Index
    • Crisis Services in CO, the US & Around the World
    • Assertive Community Treatment & Flexible ACT Index
    • Housing & Homelessness Index
    • Criminal Justice
    • Innovation Index
    • For More: See the Main Orchid Index Page
  • US Federal
    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
    • National Take
  • Research & Translational Medicine
    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
      • Brain Injury, the Immune System & Mental Health
      • Celiac Disease & Sensitivities, the Immune System & Mental Illness
      • Mental Illness & The Immune System
      • Racial Discrimination & the Immune System & Mental Health
      • Trauma & the Immune System & Mental Health
      • ***Physical Health Issues, the Immune System & Mental Health Index
    • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System