Blog Posts

The Boring Truth to the State: Fix it & People will Stop bothering you

10/10/2016

   I have had more than my share of challenges with the State, probably in no small measure because we are coming at the problems faced by people with "mental illness" who are homeless and or incarcerated from very different perspectives.
To add to that there probably are some individual differences in strengths and weaknesses. From my perspective, I'm often struck by the "Rigidity of Mind" of people I really do consider very, very smart -- AND there is NOT One Right Way to Address These Problems -- Whether Substantively or Procedurally or Very Informally.
   On the other hand, I can be pretty intense and that can be an absolute barrier to the open communication I say I desire.
   Quite Frankly, if the State is on the verge of solving a problem/problems -- I think most people including myself are happy to get out the way and let them do it.
   We would like the State to reciprocate and NOT Sabotage our efforts which certainly has happened in the past. That requires a lot of communication which has also been lacking in the past.
  We are hopeful that we can move forward with our meeting with CO Medicaid Director Gretchen Hammer on Oct. 4 and we are also very appreciative to CDHS Clinical Director Patrick Fox, M.D. for his agreement to "meet and discuss" the MI AdSeg Jail Ban Issue with no pre-commitments.

It's always a dialogue

10/1/2016

Val's Take

Communication may be more contentious some times than others, depending on how people feel they have been treated -- AND it's always a dialogue.
Especially in a democracy where there is often a built-in mechanism, however ineffective, for an aggrieved party to seek a "remedy."" AND there is always Freedom of Speech and the Marketplace of Ideas.
   If people think it's important enough, they may very well be back around for "re-dress." At least that is what Cleveland County District Judge Alma Wilson thought when I interviewed her when I was a college student 30 years ago. Judge Wilson went on to become a Justice of the Oklahoma Supreme Court, she has since passed away leaving quite a legacy.
What really resonated with me at the time of my interview was then Judge Wilson's contention that Law was on the forefront of philosophical thought. Well, I had to admit that the Law probably had my Medieval Philosophy Class beat on that.
   I think Judge Wilson was right "The Law" in its broadest sense is on the forefront of philosophical thought -- and it has had to become much more Inter-Disciplinary to be effective.
      In fact, most professions have had to become much more inter-disciplinary to become effective --- and many think they are on the forefront of philosophical thought or something much superior.
   Most of us think what we do matters [or want to be doing work that matters]-- otherwise why do it?
   In fact, where trauma to individuals is concerned in our society -- it matters not only to those individuals, and those who are seeing and/or perceiving it -- but generations to come.
Hardly any pressure, right?
On the other hand, as human beings the one thing we can be counted on to do is to make mistakes -- we are NOT perfect.
     We've got some pretty serious problems that have been going on for a long time, people are trying to solve those problems, those problems are not totally fixed yet, and thousands of people with "mental illness" endure "trauma" on a pretty daily basis in Colorado and most States.
   We think the State is doing Tremendous Substantive Work and getting at some Root Causes. If we thought the State was on the verge of solving ALL this, we would do something else. There are plenty of problems in the world to solve.
Look forward to seeing Folks for the MI Olmstead Meeting Tues. Oct. 4

Oklahoma Supreme Court Justice Alma Wilson

Justice Wilson was a pretty small person and those who know me know I'm pretty short, and the fact of the matter is I'm shrinking.

I often wondered if Justice Wilson poofed her hair up to make herself look taller -- because I do. Maybe I just do that.

Anyway I like Justice Wilson's hair and I think it is important to have role models that kinda look like us -- and we are a very diverse group of folks.

Inter-generational Trauma

Clarence Darrow and William Jennings Bryan at the Scopes Trial (1925)

This picture is supposed to symbolize that we can all "dialogue" together. It is also a not so subtle suggestion that we are Clarence Darrow and the State is William Jennings Bryan. -- Hey it's still our website. We can only imagine what kind of picture the State would put up there.

P.S. We don't smoke.

To be really obnoxious about it, many of us have lost loved ones to smoking -- so if you do smoke-- we don't want to lose you, consider clicking the button below for the Colorado Quitline:

Colorado Quitline

The Deep & Persistent problems in Pueblo

10/1/2016

Lee Smolin, American Theoretical Physicist & Professor

It is pretty hard to have institutions for people with Intellectual and/or Mental Health Disabilities in Non-Metropolitan areas and have access to:

Sufficient Number of Adequately Trained and Experienced Staff, and
For the State to Provide Sufficient On-going Support to those Institutions.

   I brought this issue up before on the website (see Pueblo -- Location, Location, Location).
   Prior to that I had brought it up when I was at the Legal Center for People with Disabilities & Older People (now, Disability Law Colorado) in a conversation with CMHIP Administrators.
   Then Superintendent Bill May, who is now in Hawaii, was quite frank in acknowledging that location was a problem in obtaining and retaining staff.
   Recently, people are complaining of essentially "Neiberger" concerns out at CMHIP, staffing, but not only staffing, a lack of real "treatment," and people getting stuck there which at least in some respects is an Olmstead issue.
   Not everyone agrees that the problem is location, and I'm not suggesting it is the only problem or issue.
   AND I do think it is a very significant problem and it makes other problems more difficult to resolve.
For the most part, Ft. Logan doesn't have the magnitude of issues that CMHIP does -- in a lot of ways that is not surprising they are smaller, different populations, Ft. Logan has access to the labor pool of the Denver metro.
We would respectfully suggest that there needs to be some planning to build up Ft. Logan and scale down CMHIP.

CMHIP: Colorado Mental Health Institute @ Pueblo

The Look of Silence. Colorado Style

9/22/2016

Note: This was actually written a few months ago during our brief lawsuit and the State's unconscionable failure to substantive discuss the issues.

In actuality we learned the hard way we were not going to be able to prosecute our MI Olmstead Class Action by ourselves against several attorneys in the AGs Office in addition to some practical problems of keeping track of our plaintiffs.

We are waiting to see what we are able to accomplish if anything this legislative session before approaching other legal entities for another go at it if we feel that is the best course of action.

The Arguments around the Substantive Systemic Issues have always been strong and is one of the many reasons we strongly favor Administrative Enforcement of Olmstead through the Centers for Medicare and Medicaid Services (CMS) & Housing & Urban Development (HUD) with technical assistance from the US Department of Justice (DOJ).

Val's Take

The State of Colorado so doesn't want to deal with our main claim of Housing and Assertive Community Treatment for people who qualify for the Medicaid Community Mental Health Services (CMHS) Waiver.
That failure leads to incarceration and homelessness of thousands of people with mental illness in the State of Colorado.
I wonder if I took a little pair of optometrist measuring glasses with me and used them on State officials, if Director Joshua Oppenheimer would make a documentary about what is happening to people with mental illness here and how State Officials are both comically and tragically trying to avoid responsibility.
Like BBC Reviewer Mark Kermode after watching "The Look of Silence," after coming back from visiting someone at the jail or going to a court date -- I need to emotionally recuperate.
This isn't a situation where we don't know any better, there are no evidence-based practices, we have to re-invent the wheel -- WE DON'T.
That makes the State's failure all the more painful.

Colorado G-ddamn

9/21/2016

Val's Take

Well, the principles in the 2010 DOJ Georgia Comprehensive DD & MI Settlement Agreement should be enforced administratively against all the States as is our opinion of the 2010 DOJ Findings Letter to Delaware.

The problems with incarceration and homelessness and lack of intensive community services and housing for people with mental illness are well documented in Colorado and across the country.

Further, there is a pretty Standard Department of Justice Template as it relates to the Solution.

We are focusing on:

Housing
Assertive Community Treatment
Assistance in Accessing Services & Benefits (As one therapist with the St. Francis Center said, "You need a caseworker, to get a caseworker.")
Drug Treatment/Addiction Care
Etc.

These are such basic human rights that they should NOT be contingent on private enforcers AND to our minds do NOT need to be, nor at this time is there any reason the vast majority of State Systems could not be reviewed administratively through the Centers for Medicare & Medicaid Services (CMS) and Housing & Urban Development (HUD) with technical assistance from DOJ.

WHERE'S EVIDENCE-BASED SENTENCING ---MENTAL HEALTH TREATMENT AS A REWARD FOR A CLEAN RECORD -- WRONG ANSWER!!!

9/21/2016

  Val's Take

One of the things that can be so frightening about the American Justice System is that it can go to incredible lengths to meet legal notions of Procedural Due Process such as timely hearings while being completely oblivious to the fact that the underlying Substance is Inherently Unfair, and does not satisfy Substantive Due Process or Fundamental Fairness.
   I am specifically speaking of racial, ethnic, and disability prejudice that is rampant in our criminal justice system.
   It is well documented and acknowledged by the World Health Organization, the Centers for Disease Control, the National Institutes of Health, the National Institute of Mental Health, and the Colorado Department of Public Health and Environment, that Social Determinants of Health affect our physical and mental health.
   Further, according to reporting by the Denver Post, there are approximately 5,700 people with mental illness in the custody of the Colorado Department of Corrections.
   Let me just say here -- I am a very conservative mental health advocate, a former Assistant District Attorney many years ago from a State some may consider to be the most conservative in the Country -- Oklahoma. If there is one thing I believe in -- it is Safety -- because it's in Everybody's Interests.
   Having said that, our current policies do anything but promote safety. Further, affording Mental Health Treatment to individuals based on whether they have a clean record is grossly unfair to those who have experienced a lifetime of discrimination often both racial and disability discrimination.
States like New York do afford Assertive Community Treatment to people with felony offenses. Good Community Mental Health Treatment isn't Cheap. The Human and Financial Toll would be less than what we are currently paying.

Jefferson County Courthouse

Attorney Kathleen Mullen -- CO's Dorothea Dix

9/3/2016

        Let me first say -- I'm NO Kathleen Mullen. I remember when I was Colorado Legal Assistance Developer for the Elderly and went to a national conference sponsored by the Center for Social Gerontology -- one of the first things the Center's founders wanted to know was if I knew Kathleen Mullen.
   Whether it was spear-heading the "Goebel" case involving access to mental health care for homeless people or the Neiberger case involving the Colorado Mental Health Institute @ Pueblo (CMHIP) she has done more than anyone to reform Mental Health care in the State and to show how it could be done across the nation.
Unfortunately, sometimes that work never stays done.
I think there is an impatience about being an attorney or just seeing so clearly how the law requires it to be done NOW to serve the needs of people who are suffering irreparable harm.
   It's not that other people don't see it too -- in fact, many are asking why we aren't filing more lawsuits. For those who are familiar, we dismissed our MI Olmstead Class Action without prejudice to be filed if necessary another day -- after the 2017 Legislative Session with more legal partners.
   Kathleen, now 74, is once again concerned about CMHIP.
   It's probably going to take me a few tries to do the same thing that Kathleen did in 1, but like Kathleen I'm nothing if not persistent.
   While my focus is on people with mental illness who are incarcerated or homeless with mental illness, the Olmstead issues are much the same for people @ CMHIP and Ft. Logan -- people need access to Housing and Intensive Services to avoid unnecessary institutionalization.
Oh BTW -- It is going to take a lot of us to add up to 1 Kathleen Mullen.

Attorney Kathleen Mullen: Colorado's Dorothea Dix. Photo Credit: Westword

ADHD, Reciprocity, Rejection Sensitive Dysphoria, & Differences in Intensity

8/21/2016

I think one of the things that makes "Rejection Sensitive Dysphoria" so challenging is that we largely assume that people are experiencing emotions in relatively the same intensity we are.
When that is not the case, that also has implications for our hard wired notions of fairness and reciprocity.
   When we think of "Draconian Laws" such as "An Eye for an Eye, and a Tooth for a Tooth" -- we think -- "How primitive." But at the time it was a big step up and it was really trying to reflect true reciprocity in punishment, rather than over-the-top punishment.
Well, if one experiences "Rejection Sensitive Dysphoria" or any number of intense feelings
[and the gifted claim intensity of feeling is one of the hallmarks of giftedness],
then what is this going to mean for "reciprocity" and "punishment"
[-- and let me assure you there are a lot of "gifted people" on the judicial bench and in the legal profession]?

But what about those people with ADHD and "Rejection Sensitive Dysphoria" -- experiencing "rejection" like a physical wound.

What's reciprocity for them? You can see how this could become dangerous?
AND also why telling someone to be more sensitive -- is NOT necessarily going to make a lot of sense to someone who perceives he or she is not being treated "fairly" or in a "reciprocal" manner.

This necessarily involves educating the person and the community that we do have different emotional intensities.

   The people I know with ADHD are some of the kindest, most compassionate people I have ever met in my life -- and they are very sensitive even if they have tattoos up and down their arms.

   I provided some information to someone I came across, a big burly guy, about "Rejection Sensitive Dysphoria," and it brought him to tears.

For those of us who have lived it -- it is quite real -- and I think it is one more piece in the puzzle as to why some people with ADHD wind up in the Criminal Justice System.

To Put A Finer Point On It: CO Olmstead Betrayal

8/13/2016

CO State Gov't was very solicitous of the disability community, including the mental health community, in their efforts a few years ago to put together an Olmstead Plan. And by and large, we think it was initially in all good faith.

The problem is the Plan not only isn't perfect it's not legally sufficient.

Okay -- that doesn't have to be a huge frickin' deal if we can just substantively discuss and hopefully correct it with the State.

BUT NOW the State doesn't want to talk about that and hasn't for over a year and 1/2.

Of course, this is such a betrayal of everything real "Olmstead Planning" is all about, but more importantly it is a betrayal of the community.

If you think we feel the mental health community was used by the State for its own purposes and then dismissed when it no longer served them -- You're DAMN RIGHT!

There are reasons for these Olmstead plans -- people's lives depend on them -- and they need to be specific enough and comprehensive enough to do what they need to do -- like include criminal justice, and have a reasonable plan to bring to scale to meet the need for housing and assertive community treatment with specific targets.
When we try to discuss these things with the State, they ignore us or search desperately for technicalities that will prevent them from having to deal with the issue.
This isn't the Colorado State Government we thought we knew. Maybe, we hardly knew them.

Federal judge rebukes Minnesota on plan to reform disability services

State faces sanctions over too vague Olmstead plan.

http://www.startribune.com/federal-judge-rebukes-minnesota-on-plan-to-reform-disability-services/302812441/

Pushing More for the Age of Authenticity & Why Our Lives Depend Upon It

7/4/2016

Authenticity has been an issue for human beings in no shortage of contexts whether it is social climbing, passing for white, passing for straight, passing for "normal," whatever.

We have been having something of a revolution in American society that has really spanned decades. While the Civil Rights Movement is ostensibly about Black Civil Rights, and the Women's Movement about Women's Rights, and Hispanic Movement about Hispanic Rights, and LGBT Movement about LGBT Rights, they are also all representative Human Rights Movements.

Interestingly, the LGBT Movement rightly and successfully argued that being gay or lesbian was not a mental illness. That may have played a big part in their ultimate success as a Movement.

From our perspective, whether one is at the top of the Totem Pole or at the bottom of it, people are going to make mistakes --- our Society has a real problem with that. Because when you become an adult, or a politician, an attorney, a clinician, plumber, whoever --you should know better. Unfortunately, that leads to all kinds of bad things in the Society -- cover-ups, litigiousness, loss of integrity, acrimony in the community, incredible misuse of resources, etc.

With the Mental Health Movement We Really Want to Push It Even More To the Age of Authenticity.

We still have a lot of little scary myths in our society:

You really become an adult at 18 years old (the brain is still developing, and a lot of this is very individual)
Our Criminal Justice System is Fair
Social Determinants of Health are Really Irrelevant

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