​In October of 2018, California’s chief prison psychiatrist released a scathing 161-page reporton mental health care in the state’s prisons. The report indicates that state officials are misrepresenting the care received by inmates with mental disabilities and are putting the health of these inmates at risk. In the report, Dr. Michael Golden states that inmates are not receiving the psychiatric care they need. 
 
Central Problem
 
One of the central problems the report focuses on is the lack of physicians in the prison system. Inmates may receive treatment from psychologists and other non-physicians rather than psychiatrists who are medical doctors. This means that medications are being managed and other crucial decisions about mental health care are being made by individuals without medical degrees. Shockingly, in some cases medical decisions by doctors are being overridden.
 
There is also a problem with accurate reporting of information to the courts and the public. For instance, the report alleges that the prisons mischaracterize the rate at which inmates are seen by psychiatrists and that fewer than 50% of inmates are seen in a timely manner. Some inmates are not receiving regular psychiatric treatment due to prison transfers. Other inmates are not receiving their treatment or doctor visits in a confidential environment, which can be a key factor in appropriate treatment. Without proper reporting of important information, the problem can’t be fixed.
 
Inmate Treatment
 
The report makes serious allegations about how mentally ill inmates are treated. The report refers to a specific incident involving an inmate with psychosis who was not given her medication and ripped out her own eyeball and ate it. The inmate had been placed on suicide watch and had been screaming for hours prior to the event. The psychiatrist on call was not contacted and the inmate did not receive her medications for four hours prior to the incident.
 
The California Department of Corrections and Rehabilitation (CDCR) denies the allegations in the report and made a statementindicating that they’ve made strides to improve the treatment of inmates with mental illness in their facilities. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​Studieshave found that women are more likely to be diagnosed with a mental illness than men. This is particularly true in the case of common mental illnesses such as depression and anxiety. Depression is twice as common in women and is the number one mental health problem suffered by women. Women are also twice as likely to be diagnosed with post-traumatic stress disorder. But what are the reasons for the higher rate of diagnosis?
 
Gender Bias in Treatment
 
While women are more likely to get a diagnosis of mental illness, they are also less likely to have their symptoms taken seriously. Women are often discredited by health care providers and their symptoms thought to be exaggerated. While labels such as “hysterical” are no longer used to refer to women with mental health issues, there is still a bias in treatment. In addition, some women are diagnosed with mental illness even when their symptoms are physical. Serious health conditions such as autoimmune disorders are sometimes diagnosed by biased health care providers as anxiety or depression. 
 
Women More Likely to Suffer Trauma and Discrimination
 
Trauma is more common among women. One in four women has faced a completed or attempted sexual assault and one in three report being abused by a domestic partner. Trauma is a risk factor for a number of mental health issues including depression and post-traumatic stress disorder. The challenges of facing gender discrimination and mistreatment of women can also be factors in undermining a woman’s mental health. In addition the expectations placed on women to do more than their fair share of housework and childcare can lead to stress which is another risk factor for mental illness. 
 
Women More Likely to Report Symptoms and Seek Help
 
Unfortunately, men are socialized not to share their emotions and to view mental health challenges as a form of weakness. Men are less likely to seek help for their mental health issues and this can result in a lower rate of mental illness diagnosis. Women are more likely to seek help when they are suffering.
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​A new survey of parents estimates that 1 in 40 children in the United States has autism spectrum disorder. The study was published in the December 2018 issue of the Journal Pediatrics. This number means that the condition was reported in 2.5% of children which amounts to approximately 1.5 million children between the ages of 3 and 17. A previous report estimated the prevalence at 1 in 59 children based on 2014 data, meaning there has been an increase in cases.
 
The more recent study collected data from the National Survey of Children’s Health which surveyed the parents of more than 50,000 children between the ages of 3 and 17. Only children who received a diagnosis of autism spectrum disorder were included in the estimate. The numbers are based on parent reporting and not on health or scientific data. Because there is no biological test for autism spectrum disorder, it can be difficult to track.
 
Access to Care
 
In addition to a higher prevalence of autism spectrum disorder, parents in the survey were also asked various questions regarding the health of their children. Parents who reported that their child was diagnosed with autism spectrum disorder were 44% more likely to report problems obtaining treatment for their child and were 24% less likely to receive help with care coordination than those families dealing with comparable such as ADHD and Down Syndrome. The parents of children with autism spectrum disorder were also 23% more likely to report that they didn’t have a designated team of caregivers for their children. 
 
While there has been some improvement over other surveys, it is clear that there are delays in getting a diagnostic evaluation even after signs of autism have been recognized. There is an urgent need for early diagnosis of the condition and follow up treatment, especially in lower income areas. Developmental and behavioral interventions can be helpful for children with autism spectrum disorder, parents need training and support to help their children succeed. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​Last year, in a case involving a death row prisoner named Bobby Moore, the U.S. Supreme Court found that Texas’s framework for determining whether a prisoner had an intellectual disability, and was therefore not subject to execution, violated the Eighth Amendment. The Texas courts had relied on non-clinical criteria when determining whether Mr. Moore was intellectually disabled and the Supreme Court ruled that medical standards should be used. The Supreme Court’s majority decisionnoted that Mr. Moore had serious mental and social difficulties beginning in childhood that were not taken into account by the lower court.
 
If things had gone as they should, the Texas courts should have then applied the standard set out by the Supreme Court and found that Mr. Moore was intellectually disabled and not subject to execution. However, that’s not how things are working out in Texas.
 
Texas Pursues the Case
 
After the Supreme Court decision, the Harris County prosecutors changed their tune and asked for a life sentence, agreeing that Bobby Moore was intellectually disabled and should not be executed. The Texas Court of Criminal Appeals, supposedly applying a new standard, still determined that Mr. Moore was not intellectually disabled and could still be executed. Mr. Moore, who was convicted in 1980 for his part in the killing of a man during a botched robbery attempt, has been appealing his death sentence for decades. In October, Mr. Moore’s legal team once again appealed to the Supreme Court. After the prosecutors made the rare step of siding with the defense, the Texas Attorney General’s Office asked to take over, stating the prosecutors don’t represent the entire state of Texas.
 
A group of conservatives, prominent lawyers, and former deputy attorney generals have jumped into the case and filed a 24-page amicus brief criticizing the Texas Court of Criminal Appeals for disregarding the Supreme Court and noting that Mr. Moore is clearly intellectually disabled. It is unclear whether the Supreme Court will take up the case and reverse Texas's ruling.
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​According to the Oregon Attorney General, the number of people deemed “criminally insane” and who then went on to commit new crimes was too high. Oregon law places those deemed “criminally insane” into the hands of the state Psychiatric Security Review Board for a set time not to exceed the maximum sentence for the crime. The board is required to release people who are no longer considered dangerous because of a mental disorder or no longer have a mental disorder. Only about a quarter of those released are found to no longer be dangerous by a medical professional. 
 
High Recidivism Rates
 
A Malheur Enterprise-ProPublica analysiscalculated recidivism rates based on outcomes found in the Psychiatric Security Review Board records. The analysis found that 35% of people who were released from psychiatric supervision were charged with a crime again within three years. Most often they were back in a court in less than a year. Many were found to be homeless after leaving state supervision, despite the fact that securing housing is supposed to be a priority. The analysis determined that Oregon released people found not guilty by reason of insanity quicker than nearly every other state in the nation. The state board and not a team of mental health care professionals make the determination that someone is fit to be released. 
 
Solutions
 
Oregon officials are looking to extend the time that people are kept under the supervision of the Psychiatric Security Review Board to allow more time for people to receive the correct treatment. However, there may be other solutions that could mitigate the problem. The state should ensure that the treatment given to those under state supervision is of high quality and effective. Increased funding of mental health treatment programs and other assistance, once people are released from supervision, could go a long way toward improving outcomes. In addition, looking at the criminal justice system as a whole, increasing funding for housing and community mental health programs could help prevent the problem before it even begins. Involving mental health professionals in the decision-making process when it comes to releasing someone from supervision is also important. 
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​In November, a federal judge made a finding that the Illinois Department of Corrections (IDOC) has failed to meet the needs of its mentally ill prison population. Close to a third of the state's inmates is thought to have a mental illness, so it is critical that they receive the necessary care and attention while they are incarcerated.
 
2016 Settlement
 
After a lawsuit was filed in 2007 by former IDOC inmates, the state entered into a settlement agreement in 2016. As part of the settlement, the state was required to meet 25 requirements with regard to its treatment of inmates with mental illness. According to a monitor, the state failed to meet 18 of these 25 requirements. While there has been some important progress, the state is clearly not holding up its end of the bargain when it comes to improving care for inmates. 
 
One of the important issues that were brought to light was the need for adequate staffing. As part of the settlement, IDOC was required to hire a significant number of mental health personnel to provide better services to the inmates. IDOC failed to do so meaning that many inmates with mental illness were not receiving the proper oversight and care. IDOC has faced challenges in hiring adequate staff to work in the prison system. The state is currently short on the 65 psychiatrists it was required to hire and cites challenges in recruitment and retention as a source of the problem. 
 
IDOC has also faced problems with medication management, ensuring timely evaluations and treatment plans, and putting plans in place to deal with inmates in crisis. The judge found that a lack of proper monitoring of psychotropic medication created a dangerous situation for the inmates. He also found that mentally ill inmates in segregation fare worse than those in the general population. While IDOC has taken some steps, it is clear that further improvements are essential. 
 
Treatment of Inmates with Mental Illness
 
This ruling by a federal judge comes months after an incidentinvolving an IDOC inmate named Larry Earvin. Mr. Earvin, who had schizophrenia and bipolar disorder, died weeks after an altercation with prison guards. Mr. Earvin died from blunt abdominal trauma, and an investigation into the incident is ongoing. IDOC had a responsibility to ensure, not only that their employees acted appropriately, but that Mr. Earvin received all necessary treatment for his mental health conditions.  
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​Community groups and healthcare providers urged the Chicago City Council to pass a budget amendment that would allow for $25 million in funds to pay for mental health services aimed at long-term trauma care. It would include funding to reopen the previously closed city-run mental health clinics and expand the services already provided by nonprofits, clinics, and hospitals across the city. The amendment was supported by multiple aldermen and a number of community organizations.
 
Budget Cuts
 
The amendment did not make it into the final budget that was passed in November. Chicago government continues to turn a blind eye toward the need for better mental health care. In 2012, six city-run mental health clinics were closed due to budget cuts. There is a dire need for increased funding. The facilities that currently exist are understaffed and lack staff with training in trauma. A studyfound that in the Southwest side of the city, there were only 67 clinicians to serve the area. This means there are 0.17 clinicians per 1,000 residents. 
 
City officials said that any increases in the budget would likely not be used to reopen the closed state-run facilities and the city would likely use the funds to expand the existing network of providers. As it stands, many clinics have long waiting lists, and access to services is not guaranteed.  
 
Further Problems
 
Meanwhile, Federal authorities announcedthey would be pulling funding from a Chicago psychiatric center amidst reports of physical and sexual abuse of young patients. Chicago Lakeshore Hospital receives a majority of its funding from Medicaid and stands to lose that funding if they fail to comply with federal regulations. Without federal funding, the facility will close, further reducing the availability of mental health care in the city. It is important that mental health care is available and of a high enough quality so that patients aren't placed in danger. The problems with Chicago Lakeshore highlight the impact that cuts in mental health funding place on the community.
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​As we better understand the prevalence of mental health issues such as depression and anxiety, many people turn to their phones to help aid in their mental health. Our phones contain apps that help us with everything from shopping to entertainment, so why shouldn’t they help with our mental well-being? 
 
Mental health apps have become so advanced and popular that they are even being recommended by therapists and other clinicians for use by their patients. The apps can be used by people who don’t have the time, money, or inclination to participate in in-person treatment, or as a useful tool to be used between therapist visits. Some of the most popular mental health apps include: 
 
Talkspace
 
For a weekly fee, Talkspace allows users to connect virtually with a licensed therapist. Users can contact the therapists through video sessions, chat, or via text messaging. A free consultation is provided with a “matching agent” that helps find the appropriate therapist for the user. 
 
BetterHelp
 
Another online counseling app, BetterHelp connects users with licensed therapists for a monthly fee. Therapy services are provided through web-based interaction as well as phone and text messaging. 
 
7 Cups
 
7 Cups is an app that connects people with free, confidential, and anonymous chats text chats with “trained listeners,” therapists, and counselors. The app is free and provides on demand, 24/7 assistance.
 
Happify
 
Through the use of research-backed activities and games, the Happify app claims to help users overcome stress, anxiety, and negative thoughts. Using techniques based on cognitive behavioral therapy, positive psychology, and mindfulness, the app attempts to help user break free from unhealthy patterns and move forward.
 
Headspace
 
Headspace is an app that assists users with mindfulness and meditation. Individuals can use the guided meditation app for a few minutes a day get access to meditations meant to relieve stress and anxiety or to help with sleep and focus.
 
Calm
 
Named by Apple as the 2017 App of the Year, Calm offers people experiencing stress and anxiety, guided meditations, calming music, sleep stories, and breathing programs. 
 
What’s Up
 
What’s Upis a free app that provides users with tools to cope with depression, anxiety, anger, and stress. The app also allows users to connect with others via discussion forums.
 
If you or a loved one has a mental disability and has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses. To schedule a consultation call (509) 991-7058.

​Most individuals diagnosed with autism spectrum disorder (ASD) never interact with the criminal justice system and more likely to be victims of crime than commit crimes. However, people with ASD are seven times more likelyto come in contact with the criminal justice system than those without the disorder. 
 
People with ASD who get in trouble with the law may not even realize that they have committed a crime. Actions such as inappropriate sexual advances, threats, aggressive behavior, stalking, and involvement as an accomplice with false friends can definitely lead to situations that would seem to deserve criminal punishment. But this assumption fails to take into account the unique challenges faced by someone with ASD. 
 
Interactions with Criminal Justice Professionals
 
Individuals with ASD may have some behaviors that predispose them to criminal charges. Lack of social and communication skills, some degree of naivete, aggression triggered by a disruption in routine or social misunderstanding, and obsessive behavior can all lead to alleged involvement in criminal behavior. Positive interactions with law enforcement could help curb some of these issues. Tools such as autism ID cards and special training for law enforcement could help prevent interactions from escalating and leading to criminal charges.
 
Once in the criminal justice system, people with ASD Social and communication issues such as failing to make eye contact can lead criminal justice professionals to believe that someone with ASD is being deceitful. A lack of communication or failure to respond to questions can be seen as rude and disrespectful. In addition, standard interrogation techniques can confuse someone with ASD and lead to misleading statements and false confessions. Inappropriate laughter or a loud vocal tone could lead to a judge believing that someone with ASD is a guilty and remorseless person. Criminal justice professionals across the board should be trained on how to respond to individuals with ASD.
 
Sentencing Considerations
 
Sometimes it is clear that the person with ASD did commit the crime in question. Depending on the situation, diversion programs or a probation program may be the right solution. However, people with ASD can have issues complying with such traditional probation programs. A person with ASD may not be able to sit through a group therapy session or communicate personal information. Consideration of the challenges faced by a person with ASD should be taken into account when crafting an appropriate sentence. 
 
If a person with ASD is sent to jail, they face risks to their safety due to their symptoms. Corrections officers and other inmates may see the person with ASD as rude and uncontrollable. Corrections professionals should receive proper training on how to prevent negative interactions with inmates with ASD.
 
If you or a loved one with a mental disability has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses and intellectual and developmental disabilities. To schedule a consultation call (509) 991-7058.

​Two studies were recently published showing that individuals with autism spectrum disorder (ASD) have a shorter life span than the general population. A 2017 American studypublished in the American Journal of Public Healthfound that the average lifespan for individuals with ASD was 36.2 years. A Swedish studypublished in the British Journal of Psychiatryshowed that individuals with ASD who had an intellectual disability had a life expectancy of 39.5 years compared to 70 years for the general population. Individuals with ASD who did not have an intellectual disability had an average lifespan of 58 years. 
 
Causes of Earlier Death
 
The American study found that a significant number of individuals with ASD died as the result of an injury. Suffocation was found to be the leading cause, followed by asphyxiation and drowning. A child with ASD was 160 times more likely to die from drowning compared to other children. This may be because children with ASD are more likely to wanderaway from caregivers, especially towards the water, when faced with anxiety.  
 
According to the Swedish study heart disease, seizures, and suicide were the three main causes of death in those with ASD. People with ASD are more likely to suffer from epilepsy than the general population. Frequent and intense seizures that are poorly controlled by medication can be fatal. Congenital heart disease genes are also linked to ASD. In addition, individuals with mild to moderate ASD also suffer from depression at a higher than average rate which can lead to increased suicidal behavior. 
 
What Can Be Done
 
Families and caretakers of those with ASD can take steps to help prevent early death. Parents can make sure that their children with ASD take swimming lessons and learn water safety to decrease the incidence of drowning. Closely monitoring children with ASD to prevent drowning and other injuries is also important. People with ASD and epilepsy should ensure that they are properly treated and medicated to prevent and control seizures. They should also be tested and treated for any heart disease. Early diagnosis and treatment of depression and other mental illness in individuals with ASD is also an essential part of preventing early death.
 
If you or a loved one with a mental disability has been arrested or convicted of a crime, you need an experienced criminal defense attorney on your side. Elizabeth Kelley specializes in representing individuals with mental illnesses and intellectual and developmental disabilities. To schedule a consultation call (509) 991-7058.