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    • 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
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    • Alcoholism & the Immune System & Mental Health
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    • 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?
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  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
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  • CO HB22-1278
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  • Microglia and the Brain's Immune System
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Transitional/ Translational Justice Monday





















Juneteenth

6/22/2025

 
Racism & Mental Health
Chronic Stress, the Immune System & Psychiatric Disorders

The Ethical challenges of:  HansEn's disease and Neuro-Developmental & Psychiatric Disorders

6/22/2025

 
Val's Take/Conjecture
  • Hansen's Disease is the modern name for "Leprosy."
  • Leprosy was a disease known from ancient times and it is mentioned in the Bible -- Jesus healing many people with leprosy.
    • ​Faith healers were common in the time of Jesus.
    • See Wikipedia:  History of Leprosy
    • And there have been modern faith healers such as Oral Roberts.
It is at least arguable that the Social Stigma of Leprosy was greater than Mental Illness.  Leprosy also was often quite visible and seen as a punishment of the Gods.
​

Today, leprosy is curable with an MDT -- multi-drug therapy.  

There appear to still be issues, but things are a lot better than they were.

​Neuro-Developmental & Psychiatric Disorders​
  • Researchers more and more recognize INFLAMMATION as a kind of UNIVERSAL LANGUAGE.
Picture
​Inflammation–Nature's Way to Efficiently Respond to All Types of Challenges: Implications for Understanding and Managing “the Epidemic” of Chronic Diseases (2018)
Shared Genes & Psychiatric Disorders
Environmental Toxins & Mental Health
There's also Trauma and Intergenerational Trauma that effects us biologically.
​

On top of this, Neuro-Developmental and Psychiatric Disorders are now conceptualized as Multi-System, Neuro-Immune Disorders.
Further, most chronic diseases do have psychiatric symptoms.
  • Genetic correlation and causal associations between psychiatric disorders and lung cancer risk (2024)
    • ​"These causal associations are unlikely to be mediated solely via smoking."
  • Relation Between Diabetes and Psychiatric Disorders (2022)
  • Psychiatric symptoms in multiple sclerosis: a biological perspective on synaptic and network dysfunction (2023)
  • Psychiatric hospitalizations in a cohort of Danish polio patients (2007)
  • ​Chronic pain and comorbid posttraumatic stress disorder: Potential mechanisms, conceptualizations, and interventions (2025)
  • Patterns and prevalence of psychiatric morbidity among individuals with rheumatoid arthritis (2024)
    • ​"Psychiatric morbidity is associated with RA [Rheumatoid Arthritis] and there is a need for psychiatric services to be made available to these patients."
  • The impact of autoimmune thyroid disease on cognitive and psychiatric disorders: focus on clinical, pre-clinical and molecular studies (2025)
  • Psychiatric and cognitive symptoms of Parkinson's disease: A life's tale  (2025)
  • Demyelination in psychiatric and neurological disorders: Mechanisms, clinical impact, and novel therapeutic strategies (2025)​
Picture
​Underwood & Underwood Publishers
"Unclean! Unclean!  Wretched Lepers Outside of Jerusalem"  (1891)


also written in French, German, Spanish, Swedish and Russian
​I've viewed this picture along with others of Jerusalem many, many times through a Stereoscope that gave a 3-D effect.

It was originally my paternal great, grandfather's who I never knew.

He was a linguist and also likely had "bipolar disorder."
He gave up his academic post to become one with the land--a farmer --- of which he knew nothing about.

My great grandmother gave music lessons to keep the family from starving -- she died of cancer and was treated at the Mayo Clinic before her death.​
​Auto-Immune Disease, Polio and Parkinson's
  • Further, I don't just have a family history of mental illness  and cancer, but also auto-immune disease, polio and neuro-degenerative disease.
Picture
Transgenerational consequences of maternal immune activation (2020)
​Val's Take/Conjecture

Psychiatric Disorders are not uncommon in a wide-range of health issues and across the lifespan.

The Biopsychosocial Model of the 1970s advocated for a more HOLISTIC view.
​Ironically, the BIOLOGY was actually given short shrift because they didn't have access to it -- or they thought what they had access to was more than it was.

We are undergoing a BIOLOGICAL RESEARCH REVOLUTION that is INTEGRATING Developmental, Physical & Mental Health.
Picture

Reasoning to reform without perfect information

6/22/2025

 
Val's Take
  • ​Those of us living now will not see the full benefit of research on Neuro-Developmental and Psychiatric Disorders that is such a long- term, multi-generational effort.

  • In 2025, most people can live in the Community with current treatment but some can't.

  • It's time to get rid of Medicaid's Exclusion of Payment for Institutes of Mental Disease (IMD) Rule while also:
    • Bringing Intensive Community Supports to Scale.
I posted the study to the right because it represents a different take on the research.

The point is not so much the Conclusion --- as that the researchers are still working on this and it is not done.

On the other hand, we have plenty of people with Schizophrenia and other Neuro-Developmental and Psychiatric Disorders incarcerated.

We have substantial reason to believe we are punishing people for a not sympathetic underlying biology.

It's not like we're not doing anything, but we're not doing enough.
Picture
Genetic contribution to microglial activation in schizophrenia (2024)
"We conclude that microglia of the patients with SCZ (Schizophrenia) have gene expression aberrations related to inflammation response and extracellular matrix without contributing to increased microglial activation."

Do we have the right professional?  From PSYCHOLOGY to integrative immuno-biology

6/21/2025

 
​Val's Take/Conjecture
  • When all the research gets sorted out ---- Societal Responses won't be the Ethical & Moral Nightmare they are today.
  • BUT right now the research continues to corroborate Developmental  multi-system Neuro-Immune Disorders.
  • ​Further, that is a refinement from a decade ago.
​What has not been corroborated by the research is the DSM categorical system.
Perfectionism, and the failure to adequately address an out-of-date DSM --- we need interim procedures
Picture
Science Up
NAMI Montana
It's Time to Improve the Mental Illness Diagnostic Process
(2013)

TRANSLATIONAL JusTICE as "A THING"

6/21/2025

 
Val's Take/Conjecture
  • ​The article to the right addresses Translational Justice in Healthcare.
  • When I'm referring to "TRANSLATIONAL JUSTICE" --- I'm generally referring to the need to appreciate the ramifications of Medical Research through a Criminal Justice Lens.
    • ​Might also be Translational Justice in Criminology or Translational Criminology.
Burden of Proof
Nothing About Us Without Us: Criminal Justice Edition
Inclusion: Nothing About Us Without Us
Picture
​Building Better Medicine: Translational Justice and the Quest for Equity in US Healthcare (2025)
​Affiliations
1Mayo Clinic.
2University of Toronto.
3University of Miami.
4Case Western Reserve University.
5University of Pennsylvania.
6ETH Zurich.
7Stanford University.

"Micro-Credentialling" in Behavioral Health & the crying need for more advanced care in immuno-psychiatry

6/20/2025

 
Val's Take/Conjecture
  • ​The Colorado Community College System is promoting "micro-credentialing" in Behavioral Health.
  • There have been work force problems in mental health for a long time --- and there are immediate, practical issues and needs.
  • Providing a more thorough understanding of Neuro-Developmental and Psychiatric Disorders with New and Modified Paradigms is also critical to addressing "work force" issues.
​​
  • Neuro-Developmental and Psychiatric Disorders are more and more seen through a lens of "Neuro-Immunology" and "Brain, Behavior & Immunity."
Jonathan Kipnis
Pioneer in Neuro-Immunology
​This isn't to say that everyone should be a world-renowned researcher --- but if you want to--- go for it.

Kipnis talks about how ideas can become entrenched and self-perpetuating even if they are wrong --- and that is a problem in Mental Health.

Further, out-dated paradigms are not irrelevant to the mental health profession's work force problems.

It's not just access To care ---​It's access to Up-to-Date Translational medicine

6/19/2025

 

RE-allocating resources Responsibly

Val's Take/Conjecture
  • There are news reports of 500 mental health professionals in Colorado being laid off and 3 mental hospitals being closed.​ ​
  • Mental Health does need SIGNIFICANT TRANSFORMATION and INTEGRATION with the rest of Health Care.
    • ​​Better Systems and Support to Keep Up with the Research.
For me this is akin to the "Defund the Police" or "Cost Shift to the Police" debates and realities --- BUT re-purposing law enforcement to gain even more safety and humane treatment --- yes, that is worthy of doing.
  • ​And perhaps providing law enforcement an expanded career ladder into Public Health and Medicine.
Picture
Decision Lab --- Status Quo Bias
​I am not for FUNDING THE STATUS QUO in mental health.

On the other hand, I'm not for people summarily losing their jobs either.

That's a lot of chaotic, unpredictable stress that is not going to be good for patients, clinicians or the community.
Scapegoating not necessarily the innocent, but the closest link in the chain of causality
The evil society games
When the wrong antidote is like a bone in the throat
One Thing Leads to Another
Why is MIchael Marshall Dead?

Neuro-Developmental Disorders, Criminal Justice & An Emerging Global Consensus

6/16/2025

 
​Val's Take/Conjecture
  • The Connection between ADHD and greater risk of Criminal Justice involvement has been around at least since the 1990s.
  • Sweden led this at one point.
  • ​There has been more and more work on this in the UK and with this latest 2025 article in the International Journal of Law & Psychiatry --- Italy.
It does seem that European academic articles and government reports are asking more interesting questions:
  • What should the law be?
  • What should the range of services be?
​
American Academic articles can get bogged down in the finer points of Not Guilty by Reason of Insanity and Competency ---
  • We can' ignore current law.
  • But we need to be thinking about what "ought to be" not just what "is."
On the other hand, the American Legal System by and large would be happy to hand over the oversight of Defendants with various aspects of "ADHD" and "Co-Morbidities" to the Public Health System ----
  • Not only are the RESOURCES not there to handle that in PUBLIC HEALTH;
  • The UNDERSTANDINGS are getting a lot better but they're not perfect and it's not clear that you can get out of some kind of "CUSTODIAL CARE" in every case.
  • It's exceedingly inconvenient to know that there are actual biological mechanisms.
  • Further, these "Social Concerns" affect people's biology, too and are often diverse forms of "Chronic Stress."
Picture
ADHD in adults and criminal behavior: The role of psychiatric comorbidities and clinical and sociodemographic factors in a clinical sample (2025)
​

[Italian Researchers]
​Conclusions: Adult ADHD, particularly in males, with combined presentation and in the presence of comorbidities such as oppositional defiant disorder and alcohol use disorder, is associated with an increased risk of criminal behavior.

The findings highlight the need for personalized and multimodal interventions to mitigate these risks.

​Future studies should adopt longitudinal designs to explore causal dynamics and evaluate the effectiveness of therapeutic strategies in forensic contexts.
Picture
Offending and clinical characteristics of adults with autism spectrum disorder: Experience at forensic psychiatry center in Türkiye between 2012 and 2022 (2025)
​

​[Turkish Researchers]

The Challenge of dealing with the inequities in mental Health without scapegoating

5/23/2025

 
​Val's Take/Conjecture
  • ​What I most appreciate is a relatively newer mantra by researchers saying we need PRECISION MEDICINE --- the right treatment, at the right time, for the right patient.
  • That is no easy trick in Mental Health whose patients are often NEURO-DIVERSE.
    • Neuro-Diverse people are more different from one another than Neuro-Typical people are different from one another.
​The APA (American Psychiatric Association) Foundation helped to fund a NOVA episode on the "Mysteries of Mental Illness."
  • The APA Foundation could be helpful in engaging National and Local News Outlets on the RAMIFICATIONS of emerging research to public policy, especially with regard to Homeless and Justice-Involved people.
The Menninger Clinic
Dr. Peter Fonagy --- Improving the Delivery of Mental Healthcare in the U.K. (2013)
​Dr. Fonagy is talking about getting Research to the Clinicians ---- FASTER.

Fonagy also makes the point that mental health patients PUT UP WITH more bad treatment quality than most patients.
No Good Deed goes unpunished
Personality Disorders, Developmental Differences --- Conceptualization Matters and It Matters A Lot in the Criminal Law

Why the dsm 5-TR fails --

5/17/2025

 
​Val's Take/Conjecture
Picture
​Metabolome subtyping reveals multi-omics characteristics and biological heterogeneity in major psychiatric disorders (2023)

*Chinese Researchers
​Abstract

Growing evidence suggests that major psychiatric disorders (MPDs) share common etiologies and pathological processes.

However, the diagnosis is currently based on descriptive symptoms, which ignores the underlying pathogenesis and hinders the development of clinical treatments.
​This highlights the urgency of characterizing molecular biomarkers and establishing objective diagnoses of MPDs.

​Here, we collected untargeted metabolomics, proteomics and DNA methylation data of 327 patients with MPDs, 131 individuals with genetic high risk and 146 healthy controls to explore the multi-omics characteristics of MPDs.

First, differential metabolites (DMs) were identified and we classified MPD patients into 3 subtypes based on DMs.
​The subtypes showed distinct metabolomics, proteomics and DNA methylation signatures.

Specifically, one subtype showed dysregulation of complement and coagulation proteins, while the DNA methylation showed abnormalities in chemical synapses and autophagy.

Integrative analysis in metabolic pathways identified the important roles of the citrate cycle, sphingolipid metabolism and amino acid metabolism.
​Finally, we constructed prediction models based on the metabolites and proteomics that successfully captured the risks of MPD patients.

Our study established molecular subtypes of MPDs and elucidated their biological heterogeneity through a multi-omics investigation.

These results facilitate the understanding of pathological mechanisms and promote the diagnosis and prevention of MPDs [Major Psychiatric Disorders].
Shared Genes & Psychiatric Disorders
Picture
​DSM-5-TR: overview of what’s new and what’s changed (2022)
​​"The American Psychiatric Association continues to welcome empirically-grounded proposals for change. Guidelines for submitting such proposals can be found at www.dsm5.org."
​If the APA is not embracing the "underlying biology" --- it is making an attempt to endorse "empiricism."

Further, there does seem to be a recognition that the DSM 5-TR is not the last word --- and that is a good thing. 

Additionally, the APA is working on DSM 6.

What is missing are the more fundamental criticisms of the DSM and a loss of "Faith" as a result of "Empiricism" in the category structure --- even with some updates.
Picture
​Precision Psychiatry Is the Future.  Europe Can Lead the Way (2023)
​"Today, the field is held back by a nosology that has good inter-rater reliability, but that has seen no validation of any diagnostic entity by specific biomarkers that would inform diagnosis, possibly irrespective of existing diagnostic entities.

"The lack of progress in the development of drugs is largely due to the fact that patients are seldom prescreened for specific biomarkers before being included in clinical trials.
"Neither are they commonly prescreened for the pathology, subgroup, and/or dimensions of interest to potentially respond to a specific drug.

"Both clinicians and regulatory agencies still work under the notion of “one size fits all,” which has induced errors and failures of clinical trials in past decades."

[This is ironic --- Rice University is in Texas]
Picture
​Towards a consensus roadmap for a new diagnostic framework for mental disorders (2024)
"In general, the meeting indicated a crucial need for a biology-informed framework to establish more precise diagnosis and treatment for mental disorders to facilitate bringing the right treatment to the right patient at the right time."
<<Previous
Forward>>

    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
  • 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