In combo with 'red flag' ERPO laws to take away guns fiscal and budget policy ERPO 'red flags' are needed

    The following column linked to this study to support the claim 3-5% of people with mental illness are likely to commit a crime.  That’s the only part of the mental illness community social libs and fiscal cons support spending tax money to treat. Everyone else ‘must’ pay, not seek ‘other peoples’ money’ (taxes) in financial aid.  Instead 95-97% of people *must* (sarcasm alert) help themselves with individual empowerment, mindfulness and self advocate/consumer-survivor operated community organizations. People *should* (sarcasm alert) have freedom to succeed or fail, where failure means to live a descent into deeper poverty.  At least the free sovereign individual is participating in free markets living under a republican form of government, without democracy, to build a nation around. (End sarcasm alert)


  In this study 29% of family murders and 7% of murders are related to SMI and that’s the only population the Manhattan Institute-paid fellow prescribes as worthy of public spending. Any other needs should be privatized.  Instead of surveillance and compulsion leading to involuntary in-patient commitment or involuntary (assisted) outpatient treatment elected legislators at local, state and federal levels should put the money into expanding benefits counseling to help patients and families struggling to navigate confusing state and local systems of care (paid for with federal funds to states) before people deteriorate into a crisis. 









  Fuller Torrey-founder of TAC, that released the paper DJ Jaffe cites, support of forced commitment or outpatient treatment that for-profit insurance is too greedy to pay for unless required joins the Manhattan Institute from a more fiscally liberal or economically-populist viewpoint.  Get the most needy helped even if it costs more in local, state or federal taxes to pay for the help that individuals in need cannot pay for.  

Fuller Torrey did call out insurer Bill McGuire of United Health Care greed


   Fuller Torrey in this 1998 "Brain Storm" article (reprinted from the Washington D.C. City Paper) called out managed care 'one size fits all for efficiency for profit' practice of medicine and even United Health Care CEO Bill McGuire’s $6.1 million 1 year  ($1 Billion in UHC CEO career) salary.



Over the course of two hours, Torrey rails against federal funding schemes for mental health care and attacks civil liberties lawyers for preventing sick people from getting well. He takes some potshots at John Mack, the Harvard psychiatrist who bills insurance companies for psychotherapy treatment for people who've been abducted by aliens. He skewers "mangled care" companies for paying CEOs multimillion-dollar salaries at the same time that they deprive the mentally ill of treatment. After noting that in 1994 William McGuire, CEO of United Healthcare, received $6.1 million in compensation, Torrey says, "If any of you think William McGuire is going to give back $1 million to open a clubhouse [a successful day program for the mentally ill], see me afterward and I'll give you a prescription for Haldol."


   The Manhattan Institute elevated DJ Jaffe's views into the WaPo
because the piece didn’t call out for-profit insurance company greed because the fellowship grantor Manhattan Institute (employer of D.J. Jaffe for purposes of pay for writing the column) has a mission that is too-individual supremacist and supportive of small government to call to improve the commons paid for by all levels of government.  

   The books P.C. M.D., "SHAM How the Self-Help and Actualization Movement Made America Helpless" described here try to show that helping people ration themselves out of seeking help for less acute, or chronic, problems with mindfulness is a failure.


   Instead of shifting costs for 95-97% of people with MI symptoms who may be dually-diagnosed with Developmental Disability without Intellectual Disability, or prevent 29% of family murders and 7% of all murders help the person in desperate need before they harm without surveillance and stigma. Expand public discourse and medical classification concept of dual diagnosis beyond substance abuse to DD without ID, formerly mental retardation before Rosa’s Law.  Expand availability of help with independent living issues, that will require ‘someone else’s money,’ at all government levels with a policy ERPO (extreme risk protection order AKA a 'red flag') to build an electoral imperative (people demand their 'electeds' authorize spending in budgets) to increase and reprogram (divert from what hasn't worked to what works) spending on public mental health programs. 
 







   Even socially-liberal California isn't yet fiscally-liberal or economically-populist enough 



 Williams said the ability of one-third of the legislature to block any form of taxation prevents those working to prevent gun violence from coming up with new solutions.
“One-third of the legislature blocks all forms of taxation, including ones that could make us safer, including ones that could provide revenue that is otherwise unavailable to make basic improvements in either our data basing, our investigations, our law enforcement,” Williams said. “I can tell you that most of our communities do not have adequate funding for law enforcement, and a tax on ammunition to fund that sort of investigation is a great idea and one that I would support.”


...

“We can’t get a two-thirds vote on almost any tax, and, frankly, there is not a single Republican vote I can think of in the legislature that would support any implementation of any limitations on firearms and certainly not imposing a tax.” Jackson said. “That’s double negative for the Republican party, a tax and then doing anything to challenge the gun lobby.”



to lessen individual surveillance to limit gun ownership rights or even tax bullets (ammunition) to increase state spending on LTSS in HCBS.
  

   How about a budget ERPO, or 'red flag' fiscal policy, to spend more, not cut and shift to individuals directly and indirectly-affected, spending for voluntary services where people live? In 2002 a county Blue Ribbon Commission documented similar problems after CPC Health, owner-operator of Chestnut Lodge, closed ultimately becoming more luxury housing in 15 years.  No follow up on what happened to former patients
who may or may not have found adequate individual help from its replacement was done.  Policies to maintain confidentiality conceal inequity and inequality after austerity.  Another commission renewed study of the Mobile Crisis Teams and 24-7 walk-in centers paid for by the public mental health system and released a 2019 Annual Report.  One of the last sentences in the 2019 Annual Report is not hopeful, by the emphasis on relationship between MI and substance use and addiction,  for improving LTSS in HCBS for Marylanders with SPMI (severe persistent mental illness) dually-diagnosed with DD without ID such as autism spectrum disorder without intellectual disability.

It is the hope of the Commission that by addressing the critical issue of mental and behavioral health, including its relationship to substance use disorder and the opioid epidemic, that the State will be able to better deliver services to its most vulnerable citizens, improve outcomes, and save lives.

Inequities in quality of life improvement from neurodiversity acceptance can only be helped by expanding public social and human services not rationing to low functioning/intense needs

  AOT (assisted outpatient treatment), where an individual living with a disability is forced to take the assistance, is worthless if there isn't quality treatment to force someone into.  The person in need of help had intersectional (dual diagnosed) autism & MI symptoms. #ActuallyAutistic people should avoid knee-jerk dismissal of the column because the author used the archaic term ‘idiot savant autistic."


    
And then there are the hidden wounded, the too-often voiceless who are treated as though they are the living dead. They don’t seem to matter. Those whose souls are tormented, those with delusions, with post-traumatic stress disorder.
The mentally ill fight a battle every day — they battle to want to live, to not hurt others so they may live, to run from those who would take their life because the hidden wounds of mental illness are too often misunderstood.
These men and women often stay in the ER and triage area until the elusive open bed in a psychiatric ward is found. When that coveted prize the mentally ill need so desperately does appear, it is available for only a brief stay. And while in the psychiatric ward, patients with mental illness often are given a round of very serious medications — but they do not get to stay long enough to see whether those medications work.
On Dec. 27, I took my son to the emergency room. After 9 p.m. on the third day, we were still waiting for that promised treasure — the psychiatric bed. My son, a musically gifted soul in his early 20s, chose to go to the hospital, trying to be safe from himself, from the demons that cause havoc in his head.


The process for getting help for the people with mental illness in Prince George’s County is like running on a treadmill: It never ends. Nothing is ever easy or organized. I know Prince George’s isn’t the worst place for mental-health care, but it is where my son and I live, so it is of paramount importance to us.
While we were waiting in the emergency room, my son did not get his normal round of psychotropic medications (which I hate, but they supposedly keep him stable and sane), so I constantly had to remind the ER nurse about the reasons for his agitation and the mania phase of his bipolar and schizophrenic conditions. He is idiot savant autistic — musically, so he always has music in his head, sometimes accompanied by racing thoughts. This traffic in his head is what leads to the episodic series that plays out in the emergency room.




    The use of an archaic term is a result of one more parent not being helped by #neurodiversity #selfadvocacy equitably as much as other autistics without LTSS provided in HCBS who may have been forced to monetize their skills to earn income on patreon, ko-fi.com, substack.com or with #pitchwars mentorship.  


   Some #selfadvocates promoting #neurodiversity even deny they are disabled severely enough to perceive a personal need to seek services preferring to use the private messaging functions of facebook and twitter to stay in contact with real people they know in their personal social and professional networks. Using crowdfunding sites like patreon, substack or #pitchwars mentorship were last resort solutions after federal austerity to programs like Medicaid trickled down to local (county and municipality) and state government austerity that likely killed funding for supported or customized employment programs.  


   Federal Education department funds from OSERS (Office of Special Education and Rehabilitation Services) to state VR (vocational rehab) programs has also been grossly inadequate as well as not coordinated with ODEP (Office of Disability Employment Policy) at the Labor Department to adjust to changing labor market skill demands and job creation.  Those who didn’t raise enough money to live or lost #pitchwars mentor competitions are the practical equivalent of consumers who lose supports. Poverty has claimed another victim. Don’t disregard the author’s perspective because of knee-jerk language objections.  Current usage of an old term "idiot savant autistic" shows inequity and inequality in LTSS access in HCBS that self-advocate run organizations informed by #neurodiversity will never replace safety net with. The organizations don’t even try to. Instead self-advocate operated organizations attempt to narrow demand for expanded LTSS services in HCBS settings by stopping people from identifying themselves as severely disabled enough to apply, because they believe they don’t qualify, for services.

   Empowering individuals and focusing on strengths, to divide working and middle class even by unrealized aspirations not weaknesses, should be regarded by more people as code phrases for diversion of demand for social services to preserve what little is left for people who 'truly' need the services.  Confidentiality protects the inequity and inequality.  Telling people to have gratitude for what little one has is the spiritual, in the form of self-help rather than systemic help, not religious, opiate of the masses to silence calls to expand services by widening eligibility criteria.


  When I interviewed Maya Angelou for my book Bouncing Forward, she advised me to develop “an attitude of gratitude. You could have died last night, you know. Be grateful. Stand on the good foot. People like you better. And you like yourself better.”  













 

Sligo Ave in Silver Spring and Church Street in Frederick both discourage single poor tenants in new housing

      Most of the apartments to be built in on Sligo Avenue in Silver Spring are 35 2 bedroom and 18 three bedroom apartments.  Only 18 one bedroom units to be built.  Only 54 parking spaces (less than one car per unit) would be built.  The greater numbers of larger and more expensive units will likely price people out of the option of car ownership and housing.  That meets the nimby pretext against ADUs voiced by @mocomillenial 'Helene" or "Keep calm and dance lezginka" that crowding was more about keeping new cars, rather than new people, out of single family neighborhoods. 



   Even in Frederick, where Montgomery County Executive Marc Elrich prefers to create more jobs for the displaced former Montgomery residents to find to avoid congesting roads like 270 and 355 connecting to Montgomery county reducing demand to meet in Montgomery County for both transportation and housing units, greater resistance to new housing for single adults than new affordable housing for families is showing.  Only 10 of 83 units planned to be built in the Ox Fibre apartments at 400 West Church Street in a former Goodwill Industries building will be affordable for tenants earning $34,000 per year (40% of Frederick County AMI).  51 one bedroom, 26 two bedroom and six three bedroom units were the planned unit mix.  A payment in lieu of taxes PILOT will be paid by the developer to reduce the rent $31/month per unit.  More one bedroom units but only 10 affordable for the lowest income tenants.  


   A pattern in two projects in two counties is apparent though.  The least welcome new residents, for whatever reason, are single tenants, without spouses or children, at lower incomes.  The lack of school impact or road impact, if the new single residents don't own (can't afford) cars don't accrue acceptance in more willingness to support building more housing affordable to new single residents. 

  When Montgomery County was discussing the ADU bill that eventually became law an amendment (Bill 20-19) by District 1 Councilmember Andrew Friedson proposed waiving the $571 application fee and $101 annual license fee if the ADU tenant had a verified disability.  Many people with disabilities looking 'in the market' for an accessory dwelling unit of usually under 800 sq feet are single adults.  This is a good start by Councilmember Friedson to start to de-stigmatize single adult tenants some of whom happen to live with disabilities.   

Institutionalized or not #PwDs all have LTSS needs worthy of HCBS social safety net funds

    This article  served to divide union direct service workers from people with ID/DD (formerly called 'mental retardation') served.
It was amplified on twitter (to get more clicks and impressions-numbers of readers) by linking to a local PA struggle to close the Polk Center and White Haven ID/DD institutions without a clear plan to provide equity for deinstitutionalized #PwDs and the direct service providers who do the work of providing the care.  



   The local op-ed writer is running for the 36th House District in Pennsylvania as the first openly-autistic state legislator.    Voters of all neurologies (autistic and neurotypical/non-autistic hope Jessica Benham is as supportive of deepening the inclusion of autistics who have fortunately been able to avoid institutions as well as ‘freeing our people’ (hat tip h/t ADAPT Americans Disabled for Attendant Programs Today or Accessible Public Transportation) from institutions.  Inclusion can be deepened by creating more supported and customized employment programs for autistics with less intense needs who don’t require institutional living.  Less intense needs autistics are still kept in degrees of poverty still living with families until parental death creates crises of urgently needed housing transitions to avoid another person experiencing homelessness.  


   The WaPo (Washington Post) and Pittsburgh Current op-ed columns erased the fiscal intersectionality of unionized direct service worker fears for their futures as lower-paid community based non union (thanks Harris v Quinn) workers with only annual help from state and local ARC chapters’ advocacy days that have now gone ‘national’ in scope   to raise DSP pay to avoid turnover that still is the norm.  The inclusive rhetoric to demand benefits that are hopefully more inclusive than the past history of ID/DD self-advocacy, that failed to deepen the fiscally marginalized social inclusion as well as ending service provision in institutional environments, will continue in 2020 with a jointly sponsored conference.

   The migration of the advocacy for higher DSP pay from state to federal levels shows how slow the pace of progressive change is by annual activists’ self-advocacy demands that are inadequately met.  Equity in systemic change is needed for ppl with ID/DD and the support workers.