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PART II:  ​More on PBS' "Mysteries of Mental Illness" Funded by the American Psychiatric Association Foundation

6/29/2021

 

  • One of the challenges we're dealing with as a Society ---- Psychiatric Disorders EXHAUSTED THE HEALTHCARE SYSTEM years ago ----- we wouldn't put up with this for Covid --- we shouldn't put up with it for psychiatric disorders.
  • ACCURATE CONCEPTUALIZATIONS MATTER --- just as they did with Covid.
  • "Mysteries of Mental Illness" Program did make some progress on accurately CONCEPTUALIZING THE MATTER:
    • ​It recognized that the largest institutions for people with mental illness are jails and prisons, and
    • Psychiatric Disorders are not as DISTINCT as we once thought.
  • ​In addition to research involving the IMMUNE SYSTEM CONNECTION to PSYCHIATRIC DISORDERS, there is a fair amount of research regarding the DEVELOPMENTAL NATURE of such disorders and the common accompaniment of EXECUTIVE FUNCTIONING DIFFERENCES or DEFICITS.
    • ​A lot of bright, smart people are running into ENORMOUS DIFFICULTY in our AT WILL EMPLOYMENT SOCIETY that is often not prepared to make ACCOMMODATIONS or WORK AROUNDS for EXECUTIVE FUNCTIONING DIFFERENCES.
      • ​Even if those ACCOMMODATIONS are legally required.
    • Further, most employers would look to the MENTAL HEALTH PROFESSIONAL to make those RECOMMENDATIONS --- but most professionals aren't competent to do that.
 
  • So this goes to many things --- including RECOVERY and ECONOMICS OF PSYCHIATRIC CARE.
    • ​Psychiatrists may not always be happy with their role as MEDICATION MANAGER --- but by and large it is what they do best.
    • We need other professionals to address the issues of EXECUTIVE FUNCTIONING at HOME and WORK and to propose ACCOMODATIONS and WORK-AROUNDS.
    • THAT NEEDS TO BE PART OF THE SYSTEM.
 
  • A big part of the "Mysteries of Mental Illness" Program was the CONFLICTED NATURE of Public Sentiment regarding PAYING FOR care for people with mental illness.
 
  • The PUBLIC often feel that people should WORK.   That is not possible in every case, but it is possible in many cases if we provide support and incentives to employers and build on people's STRENGTHS and work around or learn to CAPITALIZE on their Executive Functioning Differences.
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PART I:  PBS' Program on "mysteries of mental illness"

6/29/2021

 
​
  • PBS "Mysteries of Mental Illness" with funding from the American Psychiatric Association Foundation was an important contribution to understanding the CONTEXT of our current CRISIS OF CARE.
  • There was a recognition that better treatments were needed.
    • ​We'd like to see a recognition that Investments in Translational Research and Medicine are desperately needed.
  • It was interesting that the program focused on innovative uses of Deep Brain Stimulation and Psychedelics BUT didn't touch on the large emerging role of the Immune System in Psychiatric Disorders .
    • ​The Immune System Connection to Psychiatric Disorders would likely not have been missed in the UK --- in fact the BBC has been all over it.
  • More generally, we need to understand Psychiatric Disorders as involving multiple systems of the body.  Brains are important, but so are Immune Systems, Endocrine Systems and Microbiomes.
  • In fairness, the program did claim there were many MYSTERIES regarding "Mental Illness" --- THAT NEEDS TO MEAN SOMETHING IN THE CRIMINAL LAW ---
    •  IT SHOULD MEAN A PUBLIC HEALTH APPROACH TO CRIMINAL JUSTICE
​2017:  BBC health reporter James Gallagher explores the increasing body of evidence that a dysfunctional immune system is responsible for the depression or psychotic illness experienced by hundreds of thousands, perhaps millions, of people in the UK.

James talks to the psychiatrists investigating this new understanding of mental illness and to people who may benefit from treatments aimed at the immune systems rather than their brain cells.

"I believe this is one of the strongest discoveries in psychiatry in the last twenty years", says Professor Carmine Pariante of his and other research on the immune system and depression.

"It allows us to understand depression no longer as just a disorder of the mind and not even a disorder of the brain, but a disorder of the whole body. 


It shifts conceptually what we understand about depression."

Saying goodbye to the "non-biological" mental illness

6/29/2021

 
On the one hand the problem with with biological-based mental illness vs. non-biologically based mental illness seems to be a FALSE DICHOTOMY --- and it is.

BUT the real problem is not in the FORM of the construction, but the SUBSTANCE  --- and the supposition of an alternative ---the "non-biological mental illness" -----which doesn't seem to exist.

On the other hand, we do recognize that TRAUMA and other things in the ENVIRONMENT - can effect us BIOLOGICALLY. 
​
Trauma, the Immune System and Mental Health
The DSM 5, the Biological Basis of Behavior & the Need for Mitigation
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​NEW JERSEY
INDIVIDUAL HEALTH COVERAGE PROGRAM (1999)


BIOLOGICALLY-BASED MENTAL ILLNESS. A mental or nervous condition that is caused by a biological disorder of the brain and results in a clinically significant or psychological syndrome or pattern that substantially limits the functioning of the person with the illness, including but not limited to: schizophrenia; schizoaffective disorder; major depressive disorder; bipolar disorder; paranoia and other psychotic disorders; obsessive-compulsive disorder; panic disorder and pervasive developmental disorder or autism.

NON-BIOLOGICALLY-BASED MENTAL ILLNESS. An Illness which manifests symptoms which are primarily mental or nervous for which the primary treatment is psychotherapy or psychotropic medication where the Illness is not biologically-based.

​In Determining whether or not a particular condition is a Non-Biologically-based Mental Illness, We may refer to the current edition of the Diagnostic and Statistical Manual of Mental Conditions of the American Psychiatric Association.

Intermission -- Warning Explicit Material

6/28/2021

 
What's the POINT?

Maria Bamford is a Comedian that is well known for having Bipolar Disorder, but she also had OCD beginning when she was a child.

There are many people with "psychiatric diagnoses" that have more than one.


The course of this is IDIOSYNCRATIC and INDIVIDUAL even as much is recognized as shared genetic risk in Psychiatric Disorders, and not as much in Neurological Disorders.

This gets to what the National Institute of Mental Health is trying to do --- get to COMMON MECHANISMS in Psychiatric Disorders --- such as Calcium Channels which are related to the IMMUNE SYSTEM. 
​

THE DSM 5, THE BIOLOGICAL BASIS OF BEHAVIOR & THE NEED FOR MITIGATION

6/28/2021

 
  • ​The point is that there is no such thing as a non-biological mental illness ---​
    • ​But more to the point there is no such thing as HUMAN BEHAVIOR that is DIVORCED FROM BIOLOGY.

On the one hand,  the PERFECT MESSENGER for the problems with the DSM and the need to tie psychiatric disorders to the UNDERLYING BIOLOGY ---
  • would seem to be the National Institute of Mental Health ----
  • the American Psychiatric Assn. did more than blow off --- there was a lot of push back.

Since 2013 and NIMH's critique of the DSM ---- hundreds of other researchers are questioning the DSM and championing the need to tie psychiatric disorders to their underlying biological bases.

We've provided a lot of information on this website regarding NIMH's Research Domain Criteria Program (RDoC).

More recently, researchers have begun other studies or initiatives,  namely the BeCOME Study


The biological classification of mental disorders (BeCOME) study: a protocol for an observational deep-phenotyping study for the identification of biological subtypes.
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​We need policymakers, attorneys, advocates, individuals and family members to MITIGATE the DAMAGE of the flawed classification system in the DSM, especially as it plays out in Criminal Justice.

Some of the issues also involve outdated statutes that do not appear to have a RATIONAL BASIS to current understandings of human behavior and the biological basis/es for that behavior.

What we know is that there is a BIOLOGICAL BASIS for Behavior, and in some cases we can describe quite specifically, in others less.

What is challenging CRIMINAL JUSTICE SYSTEMS around the world among many things is ANTI-SOCIAL PERSONALITY DISORDER with the University of Pennsyslvania arguing it is neuro-developmental and other researchers view specifically as a form of ADHD --- a neurodevelopmental disorder.


This is where we need that PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE.
​New Zealand Ministry of Justice (2009)

The title of the Policy Brief is "Biological Risk Factors for Involvement in Crime" --- but the paper at the end references THE BIOLOGICAL BASIS FOR HUMAN BEHAVIOR.
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​Biological Basis for Behavior Program
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BeCOME Study -- Biological Classification of Mental Disorders (2020)

Affiliations

1Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany. 
2Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804, Munich, Germany.
3Max Planck Institute of Psychiatry, Munich, Germany.
4Berenson-Allen Center for Noninvasive Brain Stimulation and Division for Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
5Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany.
6International Max Planck Research School - Translational Psychiatry (IMPRS-TP), Max Planck Institute of Psychiatry, Munich, Germany.
7Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, USA.


Abstract

Background
​
A major research finding in the field of Biological Psychiatry is that symptom-based categories of mental disorders map poorly onto dysfunctions in brain circuits or neurobiological pathways.

Many of the identified (neuro) biological dysfunctions are “transdiagnostic”, meaning that they do not reflect diagnostic boundaries but are shared by different ICD/DSM diagnoses.

The compromised biological validity of the current classification system for mental disorders impedes rather than supports the development of treatments that not only target symptoms but also the underlying pathophysiological mechanisms.

The Biological Classification of Mental Disorders (BeCOME) study aims to identify biology-based classes of mental disorders that improve the translation of novel biomedical findings into tailored clinical applications
.

CMHIP & The Anti-Socials

6/22/2021

 

  • At least a few years ago, there was a category of patients at the Colorado Mental Health Institute at Pueblo (CMHIP) with criminal charges and a diagnosis of "Anti-Social Personality Disorder" --- maybe with other diagnoses, maybe not.
 
  • One of those patients was Black, handsome, athletic and brilliant BUT he could also be violent and a con man.
 
  • AND like a lot of the "ANTI-SOCIALS" ---- his emotions were often normal in everyway EXCEPT --- INTENSITY.
 
  • His mother had a Bipolar Disorder Diagnosis.  
 
  • I went to the DOCS at CMHIP and said --- I think this guy has ADHD.
 
  • ​Did you know his mother has "BIPOLAR DISORDER?" 
 
  • Oh yeah, yeah --- they knew all that AND they also knew he couldn't possibly have ADHD ---
    • ​The reason why he had ANTI-SOCIAL PERSONALITY DISORDER was that his mother abandoned him when he was younger
 
  • At the time, I knew that this BIPOLAR DISORDER DIAGNOSIS meant a lot more BIOLOGICALLY than CMHIP seemed to appreciate.
 
  • Now we recognize MATERNAL IMMUNE ACTIVATION as a big part of many PSYCHIATRIC DISORDERS.

  • Further, these PSYCHIATRIC DISORDERS share common risk genes.
 
  • Additionally, ANTI-SOCIAL PERSONALITY DISORDER is now being conceptualized as a NEURO-DEVELOPMENTAL DISORDER --- and a form of ADHD. 
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Proposals that Anti-Social Personality Disorder is a Developmental Disorder
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The Anti-Socials
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FBI Admits Pseudoscientific Hair Analysis Used in Hundreds of Cases -- Smithsonian Magazine
Hair Analysis, Psychological Analysis
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Rejection Sensitive Dysphoria
The Syndrome vs. the Distinct Illness
Shared Genes & Psychiatric Disorders

A Clinical Mental Health Practice that is "Half Right"

6/17/2021

 
According to former National Institute of Mental Health Director Thomas Insel --- Mental Health Concerns are some of the most complicated problems in medicine.

We have a MENTAL HEALTH CRISIS --- we haven't been able to get a handle on it. 

In some cases we can MITIGATE THE DAMAGE, but often as we're MITIGATING SOME DAMAGE we're unintentionally creating additional DAMAGE.

How many people would have INTUITED where the RESEARCH is on PSYCHIATRIC DISORDERS:
  • PSYCHIATRIC DISORDERS often start out with MATERNAL IMMUNE INFLAMMATION
  • it's not just ADHD and AUTISM that are NEURO-DEVELOPMENTAL --- it's Bipolar Disorder and Schizophrenia as well.
  • Further, some researchers are trying to re-classify ANTI-SOCIAL PERSONALITY DISORDER as a DEVELOPMENTAL DISORDER related to ADHD.
  • Psychiatric Categories are NOT DISTINCT and are BLURRED.
  • The Immune System "controls" social behavior
  • The genetics and epigenetics of psychiatric disorders often involve the IMMUNE SYSTEM.
  • People with PSYCHIATRIC DISORDERS often have EXECUTIVE FUNCTIONING DIFFERENCES or DEFICITS.
  • International Bipolar Disorder experts are calling for Researchers to immediately address the VASCULAR CONNECTION with the disorder.
  • The brains of people with psychiatric disorders are HYPER-CONNECTED.

So what I'm trying to say is there is a MUCH GREATER NEED for the Society and the Profession to CHANGE than the person with a PSYCHIATRIC DISORDER --- if for no other reason than we're often talking about DEVELOPMENTAL ISSUES and DISORDERS.

"RESILENCE TOOLBOXES" and "COPING SKILLS" ---- would be fine, EXCEPT they are often missing THE MOST IMPORTANT TOOLS & SKILLS:
  • Workarounds for Executive Functioning Differences or Deficits
  • Strategies to maximize the person's ability to exercise their STRENGTHS --- those STRENGTHS may be ABOVE THE NORM, just as some of those EXECUTIVE FUNCTIONING DIFFERENCES may be BELOW THE NORM. ​
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Click Here

"Nothing is related"

6/14/2021

 
"NOTHING IS RELATED"
  • What is A Tribe Called Red up to in this video:  
    • ​While there are indigenous vocalizations --- we don't see "indigenous" people in the video
    • The main characters are Black and seemingly Arab.
​
  • "PROBLEM SOLVING COURTS" are our Legal System's attempt to see the PUBLIC HEALTH CONNECTIONS. 
  • It would be a lot easier if STATE OFFICIALS authorized housing, intensive services and placements needed by JUSTICE-INVOLVED people.

​
​The Song

A Tribe Called Red (now known as The Halluci Nation) is a  Indigenous Music Group in Canada --- they are not neuroscientists.

BUT I think the song R.E.D. is about getting EVERYONE into the SAME HUMAN TRIBE and into the same "IN GROUP."

For The Halluci Nation that is being done for SACRED REASONS.
The Law:  "Nothing is Related" --- Some of the MOST RELEVANT FACTS are routinely deemed "IRRELEVANT"
  • Whether TRAUMA or a Brain Injury --- people are used to Courts deeming those things "IRRELEVANT" to the disposition of a criminal case.

BUT what is really driving those MYOPIC  LEGAL  DECISIONS is a STATE FAILURE to provide INTENSIVE  SERVICES including Supported Employment , HOUSING & PLACEMENTS at the SCALE NEEDED for Justice Involved People.
​PBS / Neuroscientist David Eagleman
We Don't Feel the Pain of Our Out-Groups
​PBS / Neuroscientist David Eagleman
Massacre at Srebrenica
A Tribe Called Red have changed their name to The Halluci Nation.

The Indigenous electronic producers say the name is inspired by the works of Indigenous poet and activist John Trudell, who died in 2015.

He was also the inspiration for their 2016 concept album "We Are the Halluci Nation."  Apr 18, 2021
​

A Tribe Called Red officially Change Their Name to "The Halluci ...https://www.cfweradio.ca › news › alberta-news › a-tribe-...

The 1920s Tulsa Race Massacre and the Osage Murders  ---- ECONOMIC INJUSTICE & HISTORY --- $$$$

6/6/2021

 
This kind of stuff will affect your mental health.  

We recommend REPARATIONS and a Public Health Approach that includes the Social Determinants of Health. 


  • I grew up in Oklahoma --- one side of my family made the run into Oklahoma and were poor farmers.
  • Another side of my family settled in and around Tulsa and at least some extended family had some significant OIL MONEY -- this would be in the 1920s.
  • We claim some "CHEROKEE ANCESTRY."
 
  • I went to  School in Oklahoma City under a court-ordered busing plan from 4th Grade through High School.
  • I learned about numerous terrible, horrific events from the TRAIL OF TEARS to SLAVERY in my history classes over the years, including OKLAHOMA HISTORY.
 
  • But I didn't learn about the TULSA RACE MASSACRE or the OSAGE MURDERS.
 
  • WHY WAS THAT?
 
  • The Tulsa Race Massacre got BURIED because it was more PROXIMATE in time than the TRAIL OF TEARS ---- and it screams out for DAMAGES, REPARATIONS --- ECONOMIC COMPENSATION.
 
  • What's it going to take to compensate for that? 
​​
  • And if you do COMPENSATE for that --- is that all that needs to be compensated for?
 
  • Both the Tulsa Race Massacre and the Osage Murders were about SOCIAL HIERARCHIES and enforcing those SOCIAL HIERARCHIES with MURDER.
 
  • This was and is about MONEY and SOCIAL HIERARCHIES --- and the many ways we are called to CHANGE even as we are embracing ENTREPRENEURSHIP.
           ​
Tulsa Race Massacre
Today Show
Osage Murders
BBC News

The Reality of Veteran Homelessness & the Need to End it

6/2/2021

 
Monday --- Memorial Day
​May 31, 2021

Veteran Homelessness --- This is NOT a "LIFESTYLE CHOICE" and our HEROES didn't just happen to be HOMELESS.
Fox 2 -- St. Louis
Local middle schoolers serving as advocates to end veteran homelessness
​(May 4, 2021)
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​This is not clear but the map estimates 1,044 Homeless Veterans in Colorado in 2020.

That's not undo-able even if it is OUT OF REACH for most INDIVIDUALS.

That community of Local, State and Federal Government as well as non-profits, business and the amazing energy of young people could come together and BUILD NOT ONLY THAT HOUSING BUT ALSO THAT COMMUNITY THAT OUR VETERANS NEED AND WE NEED AS WELL.

Of course, a lot of work is being done on the issue of Veteran Homelessness.

If we provided greater and broader support to those efforts, we could end VETERAN HOMELESSNESS.
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​Ted Talk (2016)
​Sebastian Junger:  Our lonely Society makes it hard to come home from war.
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"The totals mean that of every 10,000 veterans in the United States, 21 were experiencing homelessness at the start of last year. 

"Veterans make up about 6 percent of the population of the United States but 8 percent of the country's homeless population."
Mar 18, 2021


The number of veterans experiencing homelessness rose
...https://www.militarytimes.com › news › 2021/03/18 › the...

    VAL'S BLOG 2
    ​
    Val Corzine

    Executive Director of Orchid Mental Health Legal Advocacy of Colorado, Inc.

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    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
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    • Immunology & Mental Health >
      • Alcoholism & the Immune System & Mental Health
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  • 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
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  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
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  • 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
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