Archive for the 'Policy' Category

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Criminalizing mental health problems

Police officers sometimes must use extreme force to protect the population (us!) and themselves from harm. I get that. I am fretful, however, about their use of force in situations with people who have EBD.

As loyal readers know, I have remarked repeatedly about the potential dangers that emerge when individuals schooled in demanding immediate compliance (e.g., “Put that down right now”) issue such commands in very very domineering language to people who have learned to resist or flee in the presence of forceful commands— i.e., many individuals such as kids with Autism, oppositional disorders, and other EBDs.

So, what does an ill-trained officer do in such a situation (which she or he shouldn’t have initiated in the first place)? Well, escalate it: “I told you to put that f’ing thing down. NOW DO IT OR I’LL LIGHT YOU UP!” Then the officer might move toward the individual with EBD in a take-control sort of way. The individual with EBD, predictably, either makes a threatening movement, dives, or gets the hell out of Dodge City. The officer responds accordingly, still in domination mode.

Next? Taser…gun…? In “This is Crazy,” Brave New Media asks important questions about encounters between people with mental illness and the police. Warning some scenes may be wrenching. Please watch this film. Please share it with others.

Georgia students with EBD unnecessarily segregated and denied equal services

On 15 July 2015, The Civil Rights Division of the U.S. Department of Justice declared that the U.S. state of Georgia had been illegally segregating students with behavior disorders from their peers and failing to provide them with appropriate educational services. The case arises because of a public system in Georgia called the Georgia Network for Educational and Therapeutic Support (GNETS) Program, a statewide system of services designed for students with emotional or behavioral health needs that began in the 1970s and today serves approximately 5000 students.

According to a letter sent to Georgia Gov. Nathan Deal and Attorney Gen. Sam Olens, Georgia

in its operation and administration of the GNETS Program, violates Title II of the ADA by unnecessarily segregating students with disabilities from their peers. In addition, the GNETS Program provides opportunities to its students that are unequal to those provided to students throughout the State who are not in the GNETS Program.

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National Academies EBP guidelines

The US National Academies Press published a a booklet recommending a framework for promoting evidence-based practices in the areas of mental health and substance abuse. The focus is not expressly on children and youths or on education, which are key concerns for EBD Blog, but the emphases on evidence-based practices (EBP) in mental health and substance abuse certainly overlap sufficiently to make this report of potential interest to readers.

Because the guidelines come from the National Academies, they will carry substantial weight. For the purposes of many who work with students who have EBD, there is similar useful guidance about EBP from a work group composed of leaders from the Division for Research—Bryan Cook (chair), Viriginia Buysse, the late Janette Klingner, Tim Landrum, Robin McWilliam, Melody Tankersley, and Dave Test— of the Council for Exceptional Children (CEC). In January of 2014, the CEC group presented guidance to help consumers determine whether a practice should be considered as (a) evidence-based, (b) potentially evidence-based, (c) having mixed evidence, (d) having insufficient evidence, or (e) having negative evidence. Readers can download their own copy of the standards from the CEC Website and read the CEC press release about the standards.

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Autism encounters with law enforcement

Have you ever fretted about what would happen if someone who has not learned to comply with commands encounters someone who expects immediate compliance? Suppose further that the person who relies on immediate compliance might escalate his or her demands for compliance when the other person, say a child who has behavior problems, does not immediately comply.

In a family or a classroom we might call this a “power struggle.” In the language of Patterson and his colleagues (Patterson, 1982; Patterson & Reid, 1970; Patterson, Reid, & Dishon, 1992), it’s the reciprocal escalation that forms the coercion cycle. When it occurs between an officer of the law and a child with Autism, I’d call it a recipe for disaster, even a nightmare scenario. It’s one about which I’ve written previously, more than once.

Here’s an example of that nightmare come true, as reported by Susan Ferriss of the Center for Public Integrity:

Diagnosed as autistic, the sixth-grader was being scolded for misbehavior one day and kicked a trash can at Linkhorne Middle School in Lynchburg, Virginia, in the Blue Ridge Mountains. A police officer assigned to the school witnessed the tantrum, and filed a disorderly conduct charge against the sixth grader in juvenile court.

Just weeks later, in November, Kayleb, who is African-American, disobeyed a new rule — this one just for him — that he wait while other kids left class. The principal sent the same school officer to get him.

“He grabbed me and tried to take me to the office,” said Kayleb, a small, bespectacled boy who enjoys science. “I started pushing him away. He slammed me down, and then he handcuffed me.”

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The rights of the unvaccinated child by Professor D. R. Reiss

Over on Shot of Prevention, Dorit Rubinstein Reiss—she’s a Professor of Law at the University of California Hastings College of the Law—has a series of articles examining “The Rights of the Unvaccinated Child.” As of my posting here, the first two of the five-part series are available. These make highly recommended reading.

  1. The Rights of the Unvaccinated Child: The Legal Framework
  2. The Rights of the Unvaccinated Child: Tort Liability

Learn more about Professor Reiss from her faculty biography at Hastings.

Insurance woes ahead?

Will changes in California’s insurance system cause children to lose their access to therapies based on applied behavior analysis? According to a story by Chris Megerian in the Los Angeles Times, families could no longer have insurance to help pay costs as the state transitions from its Children in Healthy Families insurance program to one using Medi-Cal. Earlier, Ryder Diaz of KQED had reported similar findings in “Despite Promises, Key Autism Therapy Cut from Medi-Cal.” The children who are served by the Children in Healthy Families program and are therefore at risk for losing their insurance come primarily from families who can least afford the cost of intensive behavioral therapy.

These news reports are supported by documents from the Web site of the Autism Health Insurance Project. On the page MediCal & Healthy Families, the Autism Health Insurance site reported that MediCal was excluded from California’s SB 946, legislation that and California’s Mental Health Parity Act.

US report: Up to 1 in 5 children experience a mental disorder

In a report released 16 May 2013, the US Centers for Disease Control and Prevention (CDC; 2013) indicated that as many as 13-20% of US children experience a mental disorder annually. The CDC based it’s estimate on the familiar report of the National Research Council and Institute of Medicine (2009) as well as other data gathered more recently. These are broad-scope data that incorporate a wide array of mental disorders, but they help to capture the range of issues that confront mental health services.

According to the CDC estimates,

Data collected from a variety of data sources between the years 2005-2011 show:
Children aged 3-17 years currently had:

  • ADHD (6.8%)
  • Behavioral or conduct problems (3.5%)
  • Anxiety (3.0%)
  • Depression (2.1%)
  • Autism spectrum disorders (1.1%)
  • Tourette syndrome (0.2%) (among children aged 6–17 years)

Adolescents aged 12–17 years had:

  • Illicit drug use disorder in the past year (4.7%)
  • Alcohol use disorder in the past year (4.2%)
  • Cigarette dependence in the past month (2.8%)

There is much that can be done to help. It can’t be done without the help of concerned adults who lobby, vote, and work hard otherwise on behalf of our children.

References

National Research Council and Institute of Medicine. Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academic Press; 2009.

Centers for Disease Control and Prevention. (2013). Mental health surveillance among children – United States, 2005—2011. Morbidity and Mortality Weekly Report, 62(Suppl; May 16, 2013), 1-35.

Are famous role models helpful?

Do you ever wonder whether those references to famous people with disabilities really are helpful? Do they actually inspire people with disabilities to achieve more? As I’ve often noted on LD Blog, it’s really common in the world of learning disabilities to tell children about the high-flying people with dyslexia for example. It also happens in the world of EBD.

Well, Mark Brown, who knows a thing or two about mental health issues, published a provocative question in the BBC Website’s Ouch blog 13 May 2013: “Do famous role models help or hinder?” Here are his first paragraphs to whet your appetite:

It’s Mental Health Awareness Week – cue the annual round of lists of “inspirational” public figures. But do famous role models actually make a difference?

If you’re a person who experiences mental health difficulties, as I do, you’ll be familiar with an oft-quoted list of inspirational fellow travellers, such as Winston Churchill and his famous “black dog” or national treasure Stephen Fry and his bipolar disorder.
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