Posts Categorized: Mental health issues and autism

RESTORATION OF GUN RIGHTS AFTER INVOLUNTARY COMMITMENT-PART 2

 
Under state and federal gun laws, a person who has been involuntarily committed to a mental health facility may not possess a firearm. (NCGS§14-404(c)(4), 18 U.S.C. § 922(d)(4)) However, this prohibition may be lifted by complying with the restoration protocol articulated in NCGS§ 14-409.42.
Step 1: File and serve a petition in the same district court which adjudicated the involuntary commitment once the commitment has ended and once the mental condition which led to the commitment has been treated. The petitioner must be able to prove that he/she will not be likely to act in a manner dangerous to public safety and that the restoration of the firearm rights would not be contrary to the public interest. Petitioner must sign a release of information so the prosecutor can obtain mental health records for the hearing.
Step 2: At the hearing, the district attorney can present evidence from petitioner’s mental health records, juvenile records, and criminal history. The judge will decide the case on the following items of evidence: the petitioner’s mental health and criminal history records, the petitioner’s reputation or other character evidence, and any changes in the petitioner’s condition or circumstances since the original determination or any findings relevant to the relief sought.
Step 3: The judge will decide if the petitioner has proven that he/she is not likely to act in a manner dangerous to public safety and that the granting of the relief would not be contrary to the public interest. If the judge rules in petitioner’s favor, the clerk of court will send the order to the National Instant Criminal Background Check System (NICS) and the prohibition against firearm possession is lifted.
Step 4: If the judge rules against petitioner, the case can be appealed to the Superior Court for a new hearing. If the Superior Court denies the petition, then the applicant must wait a minimum of one year before reapplying.


PERSONS WITH MENTAL HEALTH ISSUES AND THEIR RIGHTS TO POSSESS A GUN- PART 1

The United States was created on the premise that possession of guns and the right to arm oneself was a right of the individual. This right is not without exceptions and individuals who have been adjudicated to be mentally incompetent or involuntarily committed to a mental institution cannot possess a gun.
But what about persons who have not been adjudicated incompetent or involuntarily committed? What about persons who receive Social Security disability benefits because they are autistic, bipolar, depressed or anxious to a degree that they are unable to work and a money manager handles their finances? Should they be precluded from gun ownership?
Under the Obama administration, persons receiving SSI with a representative payee, such as a person with autism who had no intellectual impairment and no language impairment, a person with agoraphobia or social anxiety disorder would have been forbidden from keeping a firearm in their home for self-defense.
The strange bedfellows of the ACLU and the NRA fought this regulation on the basis that that without a judicial determination, the constitutional rights of those with mental issues were being arbitrarily abridged. Additionally, the inability of persons to work or manage their money did not correlate to increased likelihood to commit violence. Research shows that the cohort with serious mental health issues was no more likely than the general population to use a firearm to harm others or themselves.
This order was rescinded but persons with mental health issues and especially those who depend on government aid are a particularly vulnerable group and cannot be treated as a lesser class. We must avoid disparate treatment whenever possible.

“All animals are equal but some animals are more equal than others.” (George Orwell, Animal Farm)

Part 2 of this blog will address restoration of gun rights.

Sources:
N.C.G.S.§ 14-404(C)(4),
18 U.S.C. §922(d),
20 CFR Part 421,
Dist. of Columbia v. Heller (2008) 554 U.S. 570,
Jeffrey Swanson, “The ban on mentally ill people buying guns wasn’t ever based on evidence,” The Washington Post, February 10, 2017,
Implementation of the National Instant Criminal Background Check System Improvement Amendments Act, www.regulations.gov/document?D=SSA-2016-0011-3998
www.ssa.gov/disability/professionals/bluebook/12.00-MentalDisorders-Adult.htm


WHY TEENS TAKE RISKS AND HOW TO HELP THEM MAKE SAFE CHOICES

Although teens and young adults are encouraged to act independently in the academic, employment and social world, they are not biologically equipped to do so. The amygdala, the impulsive, “flight or fight” part of the brain is in control since the prefrontal cortex which is responsible for making well reasoned decisions is not mature until age 25. Consequently, their decisions are often irrational and flawed.
Teens and young adults are “sensation seekers” which means that they actively search out opportunities to have new and risky experiences. Add to this thrill-seeking component, the need for peer approval, the availability of unsupervised free time, the American emphasis on independence and the stage is set for poor decision making.
Teens and young adults spend most of their time in groups or cliques and the approval of peers directly correlates to feelings of positive self worth. Teens and young adults erroneously credit their peers with having a much more exciting life than they actually do. The belief that others are leading a much more exciting life spurs the adolescents and young adults to engage in more dangerous and risky activities than they would otherwise. Then their acts are used by other teens to ratchet up their excitement quotient.
Studies show that intelligence and academic success is no guarantee that teens will make well reasoned decisions. Self-efficacy is confidence in one’s self-worth and decision-making skills independent of the peer group. A confident and grounded teen may be able to reject an undesirable peer suggestion on a case by case basis by creating a safe way to fit in the group without expressly rejecting the choice of the peers. Going out with peers but volunteering to be the designated driver, or using humor or other diversionary tactics to maintain peer approval while avoiding the risky activity is more socially successful than avoiding the peer activity entirely.
Making the teen/young adult’s self-regulatory behavior more automatic and less dependent on individual self-determination maximizes the opportunity for good decision-making. In other cultures, self-control and delayed gratification skills are taught at an early age and practiced in daily life. If the safer course of action is ingrained in the teen’s mind, the opportunity for independent thought is reduced as is the opportunity for a poor outcome.
Finally, minimizing unstructured time also reduces the opportunity for engaging in risky activities. In other cultures, teens do not engage in as many risky activities because structured schedules leave little time for discretionary time.


WHY DO AFFLUENT AND ACADEMICALLY SUCCESSFUL ADOLESCENT GIRLS STEAL?

ISSUE: Why would a teen aged girl on the college track and with the financial ability to buy a desired item steal?

A significant percentage of the theft cases I handle are committed by teens who consciously choose to jeopardize their academic and professional futures by stealing despite the fact that they have money. When caught, the girl who intentionally committed the theft oftentimes with premeditation and planning cannot seem to comprehend or explain why she stole. This Blog attempts to elucidate reasons for this seemingly irrational behavior. Each reason will be discussed in separate Blog chapters.

Part 1: The reasons for teen self-sabotage are:
1) Biological (brain development, hormonal and emotional) infirmities and liabilities inherent to all teens
2) Self-imposed pressure to succeed
3) Parental pressure to succeed
4) Pressure to meet society’s standards for physical beauty
5) Pressure to achieve in non-traditional fields of study and sport while still adhering to feminine norms.
6) The desire to engage in risk taking activities as an emotional coping mechanism.


How to be Resilient. Staying mentally tough in difficult situations (like when you have a pending criminal case)

The Science of Bouncing Back: Scientists now know why some people rebound so well from setbacks. They also know how the rest of us can be more like them

By Mandy Oaklander, 5/21/15, Time Magazine

Dr. Dennis Charney knows that each of his five children has hated him at some point or another–particularly when he dragged them along on one of his “semidangerous” adventure trips. He recalls a perilous hike with one of his daughters, who was 13 at the time. “Some weather came in, and there was some wildlife. When she said she despised me it came, like, from her soul,” says Charney, 64, who is now dean of the Icahn School of Medicine at Mount Sinai in New York City.

His son Alex knows the feeling. A decade ago, Charney took him on a kayaking trip to Patagonia with his best friend, Dr. Steven Southwick. It rained the entire time, the life jackets didn’t fit, and Alex had to share a broken-ruddered boat with his dad for 12-mile runs every day. When it was all over, Alex informed his father he never wanted to speak to him again.

But as a psychiatrist who, with Southwick, has studied the science of resilience for two decades, Charney knows there are benefits to forcing people out of their comfort zone. Resilience is essentially a set of skills–as opposed to a disposition or personality type–that make it possible for people not only to get through hard times but to thrive during and after them. Just as rubber rebounds after being squeezed or squished, so do resilient people.

It’s a tantalizing arena for neuroscientists, who are getting better at understanding why some people bounce back from difficult experiences–both those they seek out and those that blindside them–while others don’t fare quite so well. And thanks to modern imaging, scientists can peer inside the brain in real time to see how, and to what extent, stressful situations change the structure and functions of the brain. They are also learning that training for resilience can change the brain to, well, make it more resilient.

Much of the new evidence suggests that with a little practice, anyone can develop resilience, says Southwick, 67, a professor of psychiatry at the Yale School of Medicine. There are lots of ways to intervene so that stress or trauma doesn’t derail you, he says. No one size fits all.

That’s good news, because humans get stressed far more than they realize. The hot-and-cold boss, the traffic delays, the spat with their spouse, the monthly bills–these are all registered as stress in the brain. “The vast majority of us will be faced with one or more major traumatic stressors during a lifetime,” says Southwick. But the countless smaller stresses also take a toll. Resilience, research shows, can help with that, and it’s not a moment too soon, given that nearly all our modern ills, including heart disease and possibly even brain disorders like Alzheimer’s disease, have stress as a common risk factor.

With heart disease killing far more Americans than anything else and rates of Alzheimer’s expected to double in the coming decades, scientists are hard at work to find promising ways to prepare a large, aging population for healthier ways of dealing with stress. “Resilience training can help people deal effectively with chronic disease and improve their quality of life,” says Charney. “It helps people cope.”

Forget the old adage that you won’t know what you’re made of until you’re tested; the latest science shows that if you train your brain, how you act under pressure can, in large part, be up to you.

Understanding Resilience

Studying the capacity to successfully adapt to challenges wasn’t on researchers’ radar before World War II. Ann Masten, a resilience researcher and professor of child development at the University of Minnesota, notes that the war produced no shortage of traumatized and displaced people–many of them children who were orphaned, injured or sick, which is precisely the kind of thing that puts people at risk for trouble later on. But psychologists caring for these children noticed that some fared improbably well, despite their circumstances.

Researchers wondered why, and by the 1950s, Emmy E. Werner, a developmental psychologist and pioneer in resilience research, was inching toward an answer. In 1955 she and a team from the University of California, Berkeley, began what’s considered the most important longitudinal study in the field: a 40-year project following nearly 700 children in Kauai, Hawaii, many of whom had alcoholic parents. Her research showed that a third of the most vulnerable children adapted exceedingly well over time. Werner wanted to know what makes a person thrive in the aftermath of adversity. The study found that factors like having a tight-knit community, a stable role model and a strong belief in their ability to solve problems helped children succeed.

“As soon as people began to pay more attention to positive outcomes and positive development, they realized there were a lot of children doing well,” Masten says.

Most resilience research is still done on survivors of catastrophes–floods, fires, tsunamis, drought–as well as on soldiers. But while it’s tempting to think of resilience as a skill people won’t need until they’re locked in a cell or their home is sucked into a tornado, resilience experts say those extremes are a kind of psychological exaggeration of the things the rest of us go through.

After interviewing scores of Vietnam prisoners of war, Army Special Forces and survivors of horrific tragedies, Charney and Southwick became convinced that anyone could train him- or herself to be more resilient. POWs told Southwick and Charney that with only two resources–free time and their minds–they were able to do remarkable things they couldn’t do before; one developed a knack for multiplying huge numbers in his head, while another built a house in his imagination (and then later, on solid ground). “It said to us that there’s enormous untapped capacity of the human brain,” Charney says.

Discovering why some of us fare better than others has always been at the heart of resilience research. Now techniques like functional magnetic resonance imaging make it possible for scientists to look beyond their own observations of people and into the parts of their brains that govern emotion. By observing patterns of blood flow, they can measure brain activity and see, for instance, what stress looks like in different people–which is useful because how we respond to stress is a critical part of resilience. Like the animal whose pulse returns quickly to normal once it has successfully outrun a predator, resilient brains seem to shut off the stress response and return to baseline quickly. “Resilient people seem to have the capacity to appropriately regulate the subcortical fear circuits under conditions of stress,” says Charney.

It doesn’t take a predator to trigger a stress response in modern humans. Some research shows that even feelings of social pain–like rejection and loneliness–zoom along the same neural pathways as fear. “This notion that I’m going to be rejected or fail or won’t be accepted by the group activates the same circuits as if I saw a wolf,” Southwick says. It’s an evolutionary hanger-on from when our ancestors survived only in groups.

The problem is, even though we’re no longer bumping into wolves, we’re constantly activating the same neural pathways of fear with everyday stressors–worrying about the future, fretting about the past. The more we use this neuronal superhighway, the more efficient it grows, and this mode of thinking becomes our default. But new research shows humans can train their brains to build and strengthen different connections that don’t reinforce the fear circuit. Over time, if people use this new pathway enough, it can become the new response to stress.

Richard Davidson, a neuroscientist at the University of Wisconsin, Madison, thinks he’s found a connection in the brain that is especially important for resilience: the path from the prefrontal cortex–the seat of cognition and planning–to the amygdala, an emotional part of the brain that responds to threats. A stronger connection means the prefrontal cortex can more quickly tell the emotional amygdala to quiet down, Davidson writes in his book The Emotional Life of Your Brain.

Scientists can see how resilient brains respond to emotion differently, found Martin Paulus, scientific director and president of the Laureate Institute for Brain Research in Tulsa, Okla. In a series of brain-imaging experiments on resilient Navy SEALs, Paulus showed the SEALs a color cue that signaled they were about to see an emotional picture. Paulus saw that their brains anticipated the emotion more quickly than the average brain, letting them jump nimbly between different types of emotions. Paulus says that in his research he has seen differences in the brains of people with anxiety or depression that suggest they have a hard time letting go of emotions and are often too engaged in emotional processes. The Navy SEALs, on the other hand, weren’t glued to the emotional experiences. Why? “They’re more resilient,” he says. And just like working your biceps or your abs, say experts, training your brain can build up strength in the right places–and at the right times–too.

The Workout for Your Brain

A good way to gauge how close you are to resilience is to consider how you react when things don’t go your way, Davidson says. His research shows that the way we cope with little stressors strongly predicts how we’ll do once the big stuff hits. Personality is not as big a factor as one might think: Pollyannas are not always more resilient than pessimists, and even stubborn curmudgeons can pick up traits associated with resilience.

What’s more, scientists have identified at least a dozen ways that people can up their resilience game, which Charney and Southwick detail in their 2012 book, Resilience: The Science of Mastering Life’s Greatest Challenges, to be updated this year with reams of new research on the topic. “For resilience, there’s not one prescription that works,” Charney says. “You have to find what works for you.”

So far, researchers have found that facing the things that scare you relaxes the fear circuitry, making that a good first step in building resilience. They have also found that developing an ethical code to guide daily decisions can help. Studies have shown that traits scientists once thought of as nice but unnecessary–like having a strong network of social support–are critical to resilience. “Very few highly resilient individuals are strong in and by themselves,” Southwick says. “You need support.” There are even neurobiological elements to social support. When people are exposed to a stressor in a lab, their heart rate and blood pressure don’t go up quite as much if a friend is in the room as they do if they’re alone.

In an interesting twist, scientists have learned that working the body’s muscles makes people’s minds more resilient as well. That’s because exercise also spurs the development of new neurons, which are quite literally damaged by stress, Southwick says. Over time, regular exercise can tamp down a person’s stress response.

The most compelling new research about resilience focuses on mindfulness–an area in which most people would do well to improve, since people spend 47% of their days thinking about things other than what they’re actually doing, a 2010 Harvard study found.

In a study published last year, Paulus and researchers at the University of California, San Diego, trained four Marine infantry platoons in an eight-week mindfulness course, and four platoons trained as usual. The Marines then spent a day at the Infantry Immersion Trainer facility, an elaborate mock Iraqi village the Marines use to prepare for deployment, where they were ambushed and otherwise stressed. A subset of both groups had their brains scanned before and after the intervention. When the experiment was over, researchers found that the Marines who trained in mindfulness returned to baseline levels of heart rate and breathing rate faster than those who hadn’t been trained.

They also showed lower activation in the region of the brain associated with emotional reactions. By the end of training, their brains actually looked more resilient, Paulus says. “We were able to show, at least in the brain, that we can train people to modify their brain processes toward the direction of resilience.”

Even though the Marines’ brains changed to reflect those of more resilient people, they didn’t report feeling more resilient. So researchers did another experiment, using Olympic BMX athletes. This time, they told them how their mindfulness course could be affecting their brains. “That’s particularly helpful for people who may initially not be as susceptible to mindfulness,” says Paulus, who led the research. “They may say, ‘Well, this may not be for me.’ But when we showed them that we can actually change their brains, it becomes much more interesting to them.”

Like the mindful Marines, the mindful BMX cyclers showed less emotional reactivity to a stressful task than they had before they took the course. Unlike the Marines, however, they also said they felt more resilient–likely because they had been primed to associate the exercise with that benefit. Shortly after the study ended, the athletes competed in a major BMX competition and swept the gold, silver and bronze medals. (Two years before, at the London Olympics, they hadn’t placed.) There’s no control group in real life, of course, and they might have done just as well without the training. “But they at least told us that it was particularly noticeable to them,” Paulus says.

The Meditation Miracle?

It might seem too touchy-feely to believe that becoming tougher has everything to do with tuning into the mind, the body and the present moment. But that’s precisely what Davidson from the University of Wisconsin is finding. In 1992 he wrote a letter to the Dalai Lama asking if he could study Tibetan Buddhist monks to see how meditation changes the structure or function of their brains. To his surprise, the Dalai Lama wrote back with a request that Davidson devote as much time to studying the effects of kindness and compassion on the brain as depression, anxiety and fear.

Since then, Davidson has used brain imaging to watch the brains of all kinds of people while they’re in meditation states, from novices to Buddhist monks. He’s found that consistent practice changes how the brain looks as well as how it operates. The more experienced the meditator, the more quickly the brain recovers from stress. Another recent study shows that meditation can even help decrease expression of pro-inflammatory genes.

“The changes we see aren’t just changes during the meditation state itself, but they’re changes that persist beyond the meditation state,” Davidson says. “They transform our baseline.” And a solid baseline state is what we really need when the waters get rough, he says.

That’s why Charney and Southwick emphasize again and again the importance of finding resilience-building skills you’ll stick with. When Charney lost his granddaughter and Southwick’s mother died, each leaned on the other to get through it–a case of resilience-building social support in action.

And while you won’t find Charney joining Southwick in meditation, and you won’t spot Southwick bench-pressing next to Charney in the med students’ gym at Mount Sinai, you’ll almost certainly find them building resilience together and apart. Because as they’ve learned, this stuff really pays off when you need it.
This appears in the June 01, 2015 issue of TIME.


OBSERVATIONS ABOUT EXISTING GROUP HOME OPTIONS AND WHY I FEEL THAT MY SON DESERVES BETTER

BuildingABetterGroupHome.org was created to address the dearth of acceptable placements for developmentally disabled autistic persons. My son, Jackson, has autism, ADHD combination which means that he is hyperactive and inattentive and is mild to moderately mentally retarded. As a parent, I did not want Jackson living at home until the end of my life. I did not want to thrust the responsibility on his siblings. I felt it was imperative that he have a life separate and apart from his family so when his father and I pass away, he will already have his own home and an independent existence. My hope is that he will be able to sustain a happy, independent life as an adult.

As a young teen, I had Jackson placed in a group home for approximately eight months and moved him to a different placement for approximately one year. I then brought him home where he has lived continuously thereafter. I observed that the lack of qualified staff was the largest issue. Staff was paid the minimum wage, were independent contractors, getting no benefits, vacation or sick time or health insurance. The turnover rate was high. When staff gained experience, got to know the routines of the home and residents, they quit for higher paying jobs.

In both homes, no one prepared healthy food. Processed frozen food products were heated for meals. Frozen or canned vegetables were substituted for fresh. Fruit rolls from a box were served in lieu of fresh fruit. In neither home was there any person who knew how to cook.

Jack had a very sedentary life in both houses. An activity had to be free or inexpensive so as not to cut into the profit margin. Walking around the block or to the shopping mall or Walmart constituted an outing. For the most part, he sat and watched television or played on his computer. On the alternate weekends when we did not pick him up for a home visit, I was informed that he sat in the living room waiting…just in case we unexpectedly showed up.

It has been four years since he left the last group home and absolutely every time he is informed that he is going somewhere, he verbalizes his day’s schedule before he leaves that house to confirm that he will always return “to Jack’s home.”

My concern for Jackson’s future is no different from that of any other parent in the same position- and there are a lot of parents in this position. According to the Center for Disease Control (CDC), the numbers of persons diagnosed with autism has increased 119.4%. In 2000, the ratio of prevalence of autistic individuals was 1 in 150; the latest CDC ratio in 2014 is 1 in 68. Approximately, 1% of the world’s population or more than 3.5 million Americans are on the autism spectrum. Autism is the fastest growing developmentally disability in the United States. Obviously, not all autistic persons will need to live in a group home but many will. Every parent wants the best for their child and the goal of this nonprofit is to create a happy, loving, stable, healthy and active home for my child but also to create a transferable model to pave the way for the creation of a similar home for yours.