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SOCIAL STRESS & EQUITABLE ESTOPPEL & THE CRIMINAL JUSTICE SYSTEM

10/11/2020

American Psychological Association: Race Related Stress and Aggressive Policing

There are a lot of LEGAL CONCEPTS and GENERAL EQUITABLE PRINCIPLES that could be invoked to address the bad treatment of:

people of color
indigenous people
people who are poor
people with cognitive disabilities

In the criminal justice system.

One of the THINGS that we have NOT UNDERSTOOD: SOCIAL STRESS CAUSES BIOLOGICAL CONSEQUENCES.

We tend to treat BIOLOGICAL & SOCIAL/ENVIRONMENTAL CONSIDERATIONS very separately --- BUT THEY ARE INTEGRATED.

THAT MATTERS.

IT MATTERS IN A LOT OF VENUES --

IT MATTERS IN THE CRIMINAL JUSTICE SYSTEM.

Constitutional Principles:

Due Process -- a lot of what we're doing in the Criminal Justice System IS NOT REASONABLE to deal with BEHAVIORAL ISSUES of IMMUNE MEDIATED Neuro-Disabilities, Mental Illnesses & Substance Issues.

"Equity" has a very complicated relationship to State and Federal Criminal Courts -- with "Equity" often being excluded except under narrowly tailored exceptions such as when there is no adequate remedy at law.

A lot of attorneys would probably want to rely on CONSTITUTIONAL VIOLATIONS as their main allegations.

But the principles of EQUITY are still INSTRUCTIVE, and should give us all PAUSE as to what is currently going on in CRIMINAL JUSTICE and the URGENT NEED for REFORM.

Reviving Criminal Equity --- Alabama Law Review (2019)

THE NEED FOR CRITICAL THINKING TO ASSESS A MULTITUDE OF VARIABLES-----CASE IN POINT: DIET & EXERCISE

10/10/2020

"Diet & Exercise" are important -- BUT how this plays out in any person's life and well being is COMPLICATED and INDIVIDUAL.
Case In Point: Premier Olympic Athlete and Person with ADHD Michael Phelps. Exercise has helped Phelps manage his ADHD --- it hasn't protected him from Mental Health problems.
There is a big difference between:
- This might help, and
- If you just do this it will all be OKAY.
Where this becomes a HUGE problem is when we've EXHAUSTED our KNOWN OPTIONS and there are NOT OBVIOUS VISUAL CUES of DISABILITY.
The BEHAVIOR itself is usually a pretty good clue that SOMETHING BIOLOGICAL IS OFF -- but HISTORICALLY WE HAVEN'T BEEN ABLE TO DO ANYTHING ABOUT THAT --- except EXERCISE some "JUDGMENT" and PUNISH the person if it is proven he/ she committed the acts alleged with requisite "INTENT."
NOW --- if we have a "VIABLE TREATMENT" we MIGHT do something else.
BUT --- if we don't have a "TREATMENT with a GOOD TRACK RECORD --- we're back to PUNISH that person.
I would argue the "DIET & EXERCISE" MANTRA is often LOW GRADE --- PUNISH THAT PERSON -- because we don't have anymore known options.
THE HIGH GRADE --- ANTI-SOCIAL PERSONALITY DISORDER.
SHAMING AND PUNSIHMENT are what we do when we don't really UNDERSTAND the situation.
We're NOT ABOVE IT.
BUT we need to be looking for other OPTIONS.

TODAY SHOW: Hoda Kotb and Savannah Guthrie interview Michael Phelps regarding his struggles with Depression.

Diet, Exercise & Cognitive Behavioral therapy-- for immune mediated Neuro-disabilities and mental illnesses

10/8/2020

When current medications don't work -- "Diet & Exercise" along with Cognitive Behavioral Therapy are often what one is left with.

That probably is better than nothing -- BUT it is often not very good. Further, there tends to be some "pretending" with respect to the person -- the person is just not "working" hard enough. Hmmm . . .

State and Federal governments along with private individuals and families are paying Billions of Dollars a year for underwhelming results.

What makes this even more galling is that most practitioners who tend to be very nice have not been provided the SUPPORT to stay on top of the RESEARCH.

If they had been provided that support they would know that COGNITIVE and SOCIAL ABILITIES rely on the INNATE and ADAPTIVE IMMUNE SYSTEMS.

Further, it's not only CUTTING-EDGE RESEARCH that CLINICIANS haven't been provided -- they generally don't know the first thing about REASONABLE ACCOMMODATIONS for their patients.

That's a BIG PROBLEM.

[There's also that scientifically invalid DSM 5 that the National Institute of Mental Health is "AGNOSTIC" on.]

I'm tired of the COMPLACENCY of an INCOMPETENT MENTAL HEALTH PROFESSION.

Now, maybe that isn't their fault -- but this isn't acceptable.

South Park

There are a lot of people finding their way to the Criminal Justice System via ADHD & Autism.

Substance Issues are often co-morbid
Mental Illness is often co-morbid
There are Executive Functioning Deficits often involving impulsiveness and emotional dysregulation.
There is a heightened SENSITIVITY that is often a PLUS and a MINUS.
Further, these people can be very bright or at least not someone with an obvious Developmental Disability.
Finally, the Justice System historically has not been very sympathetic to people with developmental or mental health issues who were not obviously psychotic.

TAKING SAPOLSKY'S CHALLENGE ---AND FINDING VALUE IN EDUCATION AND THE RELIGIOUS IMAGINATION

10/7/2020

Wilma Mankiller -- first female chief of the Cherokee Nation

Stanford Professor Robert Sapolsky in his book --- "Behave: the Biology of Humans at Our Best & Worst" ---- isn't just arguing for some cherry-picked "biologically based mental illnesses" controlling BAD behavior --- he is saying BIOLOGY is controlling ALL BEHAVIOR.

On top of that -- add the MICROBIOME -- which isn't even really "HUMAN" but is necessary for healthy physical and mental functioning of humans and other animals.

Kings College London Professor Graham Rook maintains we are NOT INDIVIDUALS --- but rather ECO-SYSTEMS. Rook's "Old Friends Hypothesis" goes a long way to explaining the rise of AUTOIMMUNE DISEASE and DEPRESSION in the developed world.

Further, as we are recognizing that much of Psychiatric Disorders are linked to MATERNAL IMMUNE ACTIVATION, AUTOIMMUNITY and dysregulation of the IMMUNE SYSTEM and INFLAMMATION--- there do seem to be some connections between the rise of AUTOIMMUNE DISEASE and the rise of PSYCHIATRIC DISORDERS.

We may be looking at the UNINTENDED CONSEQUENCES of the INDUSTRIAL REVOLUTION and the move away from AGRARIAN SOCIETIES.

We are now several generations into this TRANSITION with all the EPIGENETIC changes that may bring.

In the 20th Century the BIG DEAL was NOT MENTAL HEALTH --- it was HEART ATTACKS and SMOKING. For someone with a neuro-developmental disability like ADHD --- SMOKING can CALM YOU DOWN even as it's destroying your health.

One of the great LAMENTS of MODERN and POST-MODERN SOCIETIES has been how ALIENATED AND ISOLATED we feel.

It is becoming more and more SCIENTIFICALLY OBVIOUS that we are MORE CONNECTED than we ever could have imagined.

Further, it's NOT AN IMMACULATE CONCEPTION --- it's a very messy biology that CONNECTS US to the PAST and the FUTURE and to organisms SHARING THIS BIOSPHERE.

While the Copernican and Darwinian Revolutions shook the RELIGIOUS INSTITUTIONS of the TIME to their CORE, even evolutionary biologist Richard Dawkins doesn't want to live in a DARWINIAN WORLD -- further, DARWIN wasn't too thrilled with it either.

RELIGIOUS IMAGINATION (a kind of BOLD MORAL IMAGINATION) has the POSSIBILITY of IMAGING the IMPOSSIBLE.

Further, both this BOLD MORAL IMAGINATION and SCIENCE have the possibility of ending MASS INCARCERATION while providing for SAFETY and BETTER HEALTH.

Luckily, we already have some of the LAWS we need -- the Americans with Disabilities Act, the Olmstead Decision, subsequent caselaw and guidance.

As CHALLENGED as we feel by current human DIVERSITY --- we will likely ultimately find we don't have enough DIVERSITY -- and we will CONSCIOUSLY CREATE IT.

HOPE & TERROR: RESEARCHERS ARE RUNNING SO FAR AHEAD OF MENTAL HEALTH CLINICIANS

10/5/2020

What makes this chasm between RESEARCH and CLINICAL MENTAL HEALTH PRACTICE so SCARY is Mental Health Treatment is so bound up with the Criminal Justice System.

The UNDERSTANDINGS of RESEARCHERS are not perfect, they are not complete ---- and these new UNDERSTANDINGS involving the Immune System, the Microbiome, etc. feel LIGHT YEARS ahead of CLINICIANS and FORENSIC PRACTITIONERS.

  Even for the vast majority of mental health patients who are not involved with the Criminal Justice System --- having CLINICIANS so far behind the RESEARCH not only SUCKS it can be DANGEROUS.

Further, the private mental health realm is full of very nice people who are not on top of the research and want to be paid OUT OF NETWORK (meaning one is often paying more for poorer quality care than almost any other medical discipline).

  So if we did just a CAUSE IN FACT or even PROXIMATE CAUSE ANALYSIS of this sorry state of affairs --- we'd BLAME the Mental Health Clinicians (and I'm not above that).

We're big proponents of a ROOT CAUSE ANALYSIS. The practical reasons why this is sometimes RESISTED in the LAW is --- there is really no end to it.

So if we want to hold someone ACCOUNTABLE --it's problematic. On the other hand, if we want to solve problems --- A ROOT CAUSE ANALYSIS is ESSENTIAL and FAR FROM IRRELEVANT.

ROOT CAUSE ANALYSIS

We need better systems of Translational Research & Medicine in Mental Health
Those Systems "seem" better in Cancer Care. There "might" be some models to emulate.
Also, the UK is doing a lot to bring Clinicians into the Research Process
Mental Health Research is HEAVILY implicating other areas of Medicine BEYOND the traditional mental health practitioner. ---- There is a huge need to INTEGRATE Mental Health with Neurology, Immunology, Gastro-Enterology and Endocrinology.

As a society and a State we are in DESPERATE NEED of MITIGATING the INJUSTICE that gets doled out by our Justice System everyday.

We need a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE.

THE IMPLICATIONS OF A PUBLIC HEALTH APPROACH----- SPIRITUALLY AND FROM A CIVIL RIGHTS PERSPECTIVE

10/2/2020

Interestingly, human beings developed their moral sense about 50,000 years ago, according to neuro-biologist Robert Sapolsky.

Archaelogist David Whitley links the development of ART 40,000 years ago with mental illness.

Originally, Religion and Science and Art and Law were all INTEGRATED. I would submit that one of the purposes of all these endeavors is to manage a very HOSTILE STATE OF NATURE and a lot of AWARENESS.

ALL of these "DISCIPLINES" have their share of HORROR STORIES and they still do.

One of the COMMONALITIES of HORROR STORIES is some MYTH of PERFECTION.

In 2020, what would be a REASON not to "JUDGE" people --- SOCIAL BEHAVIOR is controlled by the IMMUNE SYSTEM.

THAT DOESN'T MEAN IGNORING SAFETY RISKS --- like the Catholic Church did with priests and pedophilia.

So we can be compassionate, we can provide humane treatment and still prioritize SAFETY.

The folks who initially may question a Public Health Approach to Criminal Justice are the LAW & ORDER HAWKS. However, at some point some realize this is more SAFETY ORIENTED than anything we are currently doing.

On the other hand, Civil Rights Protectors may rightly realize that the need for ETERNAL VIGILANCE didn't go away.

Stanford Professor Robert Sapolsky says we acquired our "MORAL SENSE" about 50 thousand years ago.

Orchid: We think arguments regarding FREE WILL are not running in the right direction -- they need to be running to the FUTURE not the PAST.

We're trying to get CONTROL of our natures and we often don't have as much CONTROL as we want. Crimes including INTENT are often EVIDENCE that the person DOES NOT HAVE SUFFICIENT CONTROL --- often evidence of DEFICITS in EMOTIONAL REGULATION.

It doesn't mean that ultimately we won't have that CONTROL or some FUTURE INSIGHT won't give us that CONTROL.

It also means that some of these ISSUES are much Longer Term than the typical criminal sentence.

So keeping people in the community --- in 2020 -- is sometimes going to require LONG TERM SUPPORT.

Evolutionary Biologist Richard Dawkins doesn't want to live in a Darwinian World.

"Archeologist David Whitley suggests that the strengths and weaknesses of humans are deeply intertwined and inter-dependent. He shares his journey, taking us back 40,000 years, to discover the origin of human artistic genius."

There are a lot of similarities between ART and SCIENCE.

One of the ANSWERS of our SOCIETY is---- INTENT is the appropriate measure for PUNISHMENT.

SCIENTIFICALLY -- that ANSWER is no longer valid.

A Public Health Approach can get us on a rationale footing in Criminal Justice.

RE-THINKING COGNITIVE DISABILITY---- THERE ARE MORE RELEVANT BODILY SYSTEMS & FACTORS THAN WE THOUGHT

10/1/2020

It can be very misleading to say "mental illness" is a "Brain Disorder" when other SYSTEMS OF THE BODY are ALSO Critical and Essential Players.

Today, Downs Syndrome is conceptualized as an Immune Disorder.

Further, many neuro-developmental issues such as ADHD and Autism are linked to Maternal Immune Activation (MIA).

The "Systems of the Body" that are currently implicated in "mental illness" are:

the Immune System
the Gut/Microbiome
the Brain/Central Nervous System, and also
the Endocrine System

So the LIST OF FACTORS leading to "mental illness" could be anything that impacts those INTEGRATED SYSTEMS of the BODY.

Further, there is not only Maternal Immune Activation (MIA) but genetic and epigenetic susceptablity some of which impacts immune system genes.

    Additionally, researchers at the University of Virginia School of Medicine recently found that the Immune System controls SOCIAL BEHAVIOR.

  That's NOT what we thought.

    BOTTOM LINE: The Immune System has a much bigger role in cognitive disorders and in behavior than we realized at the beginning of the 21st Century.

INCLUSION or EXCLUSION

The important thing is identifying the RELEVANT SYSTEMS of the BODY in Cognitive Disability and then including everything as a "POTENTIAL FACTOR" that impacts these SYSTEMS OF THE BODY -- until proven otherwise.

In fact that's what researchers around the world are doing certainly with regard to the Immune System.

That is giving us a much more complete and clear picture of what is going on with regard to cognitive disability -- even as many questions remain.

WE NEED COLORADO MENTAL HEALTH PROFESSIONALS TO RECOGNIZE "ALTITUDE" AS A FACTOR AND MORE BROADLY -- GET ON TOP OF THE SCIENCE

9/30/2020

WE CANNOT PUT UP WITH THIS LOW BAR MENTAL HEALTH PRACTICE ANYMORE

Altitude


Living High and Feeling Low: Altitude, Suicide, and Depression.

Kious BM, Kondo DG, Renshaw PF. Harv Rev Psychiatry. 2018 Mar/Apr;26(2):43-56. doi: 10.1097/HRP.0000000000000158.PMID: 29517615 Review.

After participating in this activity, learners should be better able to:• Assess epidemiologic evidence that increased altitude of residence is linked to increased risk of depression and suicide• Evaluate strategies to address hypoxia-related depression and s …


Altitude and risk of depression and anxiety: findings from the intern health study.

Kious BM, Bakian A, Zhao J, Mickey B, Guille C, Renshaw P, Sen S. Int Rev Psychiatry. 2019 Nov-Dec;31(7-8):637-645. doi: 10.1080/09540261.2019.1586324. Epub 2019 May 14.PMID: 31084447

Multiple studies suggest that the risks of depression and suicide increase with increasing altitude of residence, but no studies have assessed whether changing altitude changes these risks. ...The data suggest that moving from low to high altitude is a …

Association between altitude, prescription opioid misuse, and fatal overdoses.

Ombach HJ, Scholl LS, Bakian AV, Renshaw KT, Sung YH, Renshaw PF, Kanekar S.Addict Behav Rep. 2019 Feb 18;9:100167. doi: 10.1016/j.abrep.2019.100167. eCollection 2019 Jun.PMID: 31193784 Free PMC article.

Living at altitude has been linked to greater reward benefits of other drugs of abuse, and living at altitude may also exacerbate the respiratory depression linked to opioid use. ...This increased misuse of both stimulants and opioids may increase likelihood …

Exaggerated systemic oxidative-inflammatory-nitrosative stress in chronic mountain sickness is associated with cognitive decline and depression.

Bailey DM, Brugniaux JV, Filipponi T, Marley CJ, Stacey B, Soria R, Rimoldi SF, Cerny D, Rexhaj E, Pratali L, Salmòn CS, Murillo Jáuregui C, Villena M, Smirl JD, Ogoh S, Pietri S, Scherrer U, Sartori C. J Physiol. 2019 Jan;597(2):611-629. doi: 10.1113/JP276898. Epub 2018 Nov 24.PMID: 30397919 Free PMC article. Clinical Trial.

KEY POINTS: Chronic mountain sickness (CMS) is a maladaptation syndrome encountered at high altitude (HA) characterised by severe hypoxaemia that carries a higher risk of stroke and migraine and is associated with increased morbidity and mortality. ...Systemic OXINOS was m …

Suicide and High Altitude: An Integrative Review (2018)

"All the studies found that high altitude was independently associated with suicide."

[This is a particularly interesting study because it finds these ASSOCIATIONS between ALTITUDE & SUICIDE --- and then discounts them.]

I think what some Researchers, Professionals and Advocates have tended to miss:

Even though ALTITUDE may not be the greatest cause of DEPRESSION or source of underlying NEURO-DEVELOPMENTAL INFLAMMATION ---
ALTITUDE is EXACERBATING BIOLOGICAL VULNERABILITIES that are already there.
So we tend to MINIMIZE what would seem to be a SIGNIFICANT FACTOR as well as MISS an IMPORTANT TARGET for INTERVENTION in MOUNTAIN STATES.

I'm not saying the Western Rugged Lifestyle isn't a factor ---

BUT to miss ALTITUDE at this point seems like MALPRACTICE.

High Altitude, Sky High Suicide Rates and the Need to Take Altitude into Account in Integrated Mental & Physical Health Care

Viva La Resistance -- South Park

The "Resistance" we're referring to here is on the part of the Mental Health Profession --- and it is a "com si, com sa" (so so) attitude towards concerns of:

the US National Institute of Mental Health
Researchers around the World
An explosion of research involving the immune system and the microbiome

La, La, La . . .

MEANWHILE: Our Mental Health Crisis is NOT abating and many people are finding themselves in the Criminal Justice System for behavior that is controlled by the Immune System.

From now until Oct. 10 and likely beyond, we'll be shoring up our arguments both with respect to:

Altitude, and
The Immune System

Altitude is really just one of numerous factors that can impact the immune system and ultimately the brain and behavior. These impacts can lead to psychiatric disorders.

One of the most common things may be Altitude-Induced Sleep Apnea
See Research Links Higher Altitude with Increased Sleep Apnea

American Journal of Psychiatry (2018): Screening for Sleep Apnea

Sleep Apnea Linked With Higher Levels Of Inflammation (2017)

"The severity of sleep apnea was found to be associated with high levels of inflammation.

"Inflammation is an immune response, where the white blood cells produce chemicals to fight the foreign substances."

Altitude is just one factor among many, many factors.

Colorado and other Mountain States are really outliers with sky-high suicide rates.

That's a problem.

How high altitudes could raise risk of depression, suicide (2018)

University of Utah research shows high altitude linked to depression and suicidal thoughts (2018)

Utah Women's Health Review

Utah has the highest rates of depression and suicide in the US, despite high rates of antidepressant prescriptions. People living at altitude are exposed to chronic hypobaric hypoxia, which may disrupt brain serotonin and bioenergetic function, to worsen depression and reduce selective serotonin reuptake inhibitor (SSRI) function.

The Impact of Living at Altitude on Depression and Anti-depressant Function in Utah Women: The Need for Novel Antidepressants (2019)

This blog last Updated July 24, 2022

The Tyranny of Positivity

9/29/2020

We're contrasting John Green's cartoonish Crash Course on Voltaire's "Candide" with Benjamin Clementine's "I Won't Complain."

  One of the things we're constantly told is: Positivity makes us feel better and if we can just convince ourselves that everyone who might criticize us or the SYSTEM we're pushing is TOXIC ----maybe we do feel better.

    The thing about criticism --- it is often brought by people who don't feel heard. So there maybe some "REFERRED PAIN" --- but there is generally a kernel of truth in the criticism --- and that's what HURTS --- and that's why we want the critical person to be more POSITIVE.

We advocate for Positive Strength-Based Treatment Approaches --- 80% of the time developing Strengths and 20% of the time identifying Work-Arounds for Weaknesses.

A Strength-Based Approach is not about denying weaknesses.

When we think about Human Societies we often think: those people in History were IDIOTS, we're so much smarter now, and if things aren't perfect we have self-correcting mechanisms that will REMEDY INJUSTICE.

  That really hasn't been the reality for many people. Further, the problem with all 3 branches of government --- they are TOO EXPENSIVE for most people.

AND that really brings into HIGH RELIEF --- ECONOMICS -- which is a SACRED GOLDEN COW in this society. Nobody's saying this isn't COMPLICATED.

    But Modern forms of POSITIVITY often serve the same functions as OLDER FORMS of POSITIVITY or OPTIMISM--- maintaining the STATUS QUO by trying to de-legitimize criticism.

  Further, just listening to criticism has it limits -- ultimately, we have to substantively address criticism and bring people into the problem-solving process.

That is about recognizing that we don't live in "the best of all possible worlds" --- and there is a lot of INCLUSIVE Problem-Solving that needs to be done.

IN THE CRIMINAL JUSTICE SYSTEM: MANIC, DESPERATE SHORT-TERM REHAB OR RECOGNITION OF LONG TERM NEEDS

9/27/2020

   The Criminal Justice System for 30 or 40 years at least has been trying to incorporate various "TREATMENTS" into SENTENCING.

It probably hasn't been a HUGE FAILURE in ALL CASES, but clearly has not solved all the problems.

Further, there is often a predictable TRAJECTORY some of these cases take ---- "We've given you every opportunity to turn your life around -- you've squandered those opportunities --- you leave us no choice but to send you to prison for a long time."

   Hmmm . . .

One of things that is coming out strongly in the 21st Century is that behavioral issues, social behavior and substance issues often involve INNATE IMMUNITY, meaning immune system anomalies we were BORN with.

So --- nobody knew that --- and maybe a lot of that knowledge hasn't TRICKLED DOWN to most CLINICIANS but it is certainly there in the research.

Well --- it is starting to become more and more clear why some of these SHORT TERM TREATMENT Programs aren't working to address incredibly complex INNATE IMMUNITY issues.

Further, it also may be one explanation as to why a lot of mental health treatment for ANYBODY tends to stay on the SURFACE of the EMOTIONAL DISTRESS --- and the MEDICATIONS that are sometimes trying to get to UNDERLYING BIOLOGY are sometimes a MIXED BAG.

BACK TO THE CRIMINAL JUSTICE SYSTEM: Even without this new research identifying prominent roles for the Immune System and the Microbiome in Human Behavior -- the TREATMENTS were not adequate in many cases and the understandings Clinicians had were not sufficient.

  SO WHAT TO DO? A fair number of people in the Criminal Justice System may need Long Term Care until we get better treatments.

Long Term Care can be in the Community in most cases -- and it should be whatever level of care people need.

Nature Immunology (2017):

Scientists at Riken Center for Integrative Medical Sciences in Japan found that T cells -- immune cells that help to protect the body from infections and cancer -- change the body's metabolism when they are activated, and that this activation actually leads to changes in behavior.

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