In February of 2020, the group Physicians for Human Rights released a report regarding the psychological effects of family separation. The report came after an in-depth review and psychological evaluation of 26 asylum seekers in the United States. The asylum seekers included nine children and seventeen adults who had been separated from their families.

Psychological Trauma

Physicians noted that individuals who were separated from their families under the Trump administration’s “zero tolerance” policy suffered from psychological trauma. This trauma ranged from conditions such as post-traumatic stress disorder (PTSD) to depression and anxiety. In almost every case they examined, the group noted some level of psychological trauma that required further intervention. Most of the individuals met the diagnostic criteria for at least one mental health condition. 

Many of the individuals were already suffering trauma as a result of violence or other adverse conditions in their home countries. The report concluded that the forced separation exacerbated any pre-migration trauma these individuals endured that led them to seek asylum in the first place. Children, in some cases, were afraid of strangers even after being reunited with their families. In addition, some children showed signs of regression, such as bedwetting and not being willing to leave their parent's side. Reunification was not enough to prevent the trauma. Further interventions and therapy were necessary.

People tend to think of children as being very resilient. However, the fact is that the psychological trauma of forced family separation can haunt a child for years. Family separation can damage the bonds that a parent and child have together. Trauma caused by separation can have a detrimental effect on a child’s schoolwork and social skills and impact their daily lives. 

Treatment is Necessary

The report noted that the individuals reviewed in the study most likely required further follow up and treatment for their trauma. Without treatment, the long-lasting effects of trauma could cause symptoms for years to come. The total number of children separated from their families remains unknown. At least 471 parents were deported without their children. Because this psychological trauma is the result of the government's actions, the report notes that the government should be responsible for providing the necessary treatment. In November, a U.S. District Judge ordered the government to begin providing mental health screenings and treatment to families who had been separated under the family separation policy. An appeal of the order has been withdrawn. 

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 disabilities. To schedule a consultation call (509) 991-7058.

According to a study out of Florida International University, children diagnosed with attention deficit hyperactivity disorder (ADHD) can expect meaningful real-world consequences when they become adults. Children with ADHD tend to lag behind their peers when they are younger, and this lag often continues well into adulthood. This occurs even if the symptoms of ADHD, including an inability to focus, impulse control issues, and hyperactivity, appear to have been controlled.
 
The Study
 
The study found that the consequences a child with ADHD may experience in adulthood will likely include financial struggles. The study tracked 364 adults aged 25 to 30 who had been diagnosed with ADHD as children and compared them to a control group of the same age. The study found that by age 30, individuals without ADHD were far more likely than those in the study with ADHD to have achieved the traditional markers of financial independence, including:
 

• Homeownership—42% of those without ADHD owned homes compared to 22% of those with ADHD
• Savings—the average savings for people without ADHD was $9,970 compared to $3,390 for those with ADHD
• Living Outside of a Family Member’s Home—91 % of those without ADHD versus 70% of those with ADHD.

The study also found that individuals with ADHD earned 37% less than those who did not have an ADHD diagnosis. These income disparities are similar to those found in individuals with severe mental illness. Individuals with an ADHD diagnosis were also more likely to be on public assistance. Overall, study participants with a history of ADHD were projected to earn $1.27 million less than the control participants.
 
There were limitations to the study. The small number of participants made the results less reliable. In addition, a significant number of study participants had other behavior disorders, including conduct disorder and oppositional defiant disorder. The study also did not look at participants older than 30 years.
 
Regardless of its limitations, the study does point to the fact that we need more educational support. People with ADHD should be taught life skills that may come more naturally to others. These include executive skills like planning and setting goals. These skills could better prepare them for handling their lives as adults.
 
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 disabilities. To schedule a consultation call (509) 991-7058.

​The suicide rate in California prisons reached its highest level in decades in 2019. The total number of suicides in prison for 2019 was 36. This is a rate of 28.7 suicides per 100,000 prisoners, which results in an increase over last year's rate of 26.3. This rate is well above the national average of 20 and is the highest rate since tracking of the figure began in California in 1990. The suicide rate in California prisons is more than double the rate in the general American population.
 
Failures in Mental Health Care
 
California’s suicides are most likely the result of a system that has failed for decades to properly help prisoners with mental illness. In a 1995 decision by a federal court, it was found that the inadequate mental health care in prison was so bad that it violated the constitutional rights of the prisoners. Corrections officials were forced by the court to make reforms, and the court appointed a Special Master to oversee the prison system.
It has also been reported that failures to obey policy and procedure have led to an increase in suicides. Prisoners who were at risk for suicides were not properly monitored. In addition, long wait times for mental health care and a lack of prison psychiatrists could all have contributed to the crisis.
 
Disturbingly, 10 of the 36 suicides occurred in special housing units where prisoners are kept separate from the general population, sometimes in solitary confinement. Prisoners in special housing may have psychiatric issues, have violated prison rules, or have known gang affiliations. Given the small number of prisoners in special housing, this suicide rate amounted to a shocking 203.3 deaths per 100,000 people.
 
This increase in suicides in California prisons may result in increased federal scrutiny of the system, which is already under the microscope. Suicidal people behind bars in California are clearly not getting the help they need. In order to improve the system, serious changes must be implemented or the crisis will worsen.
 
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 disabilities. To schedule a consultation call (509) 991-7058.

​It is a well-known fact that the faithful companionship of a dog can help with an individual’s emotional well-being. Now a new study out of Johns Hopkins University suggests that exposure to man’s best friend at a young age may decrease a person’s chance of developing schizophrenia.
 
The Study
 
The study looked at patients at Sheppard Pratt Health System in Baltimore. These adult patients consisted of 396 people with schizophrenia and 381 with bipolar disorder. The individuals were compared to 594 healthy controls. Participants in the study reported whether they had a dog or a cat when they were growing up.
 
More than half of the study subjects reported having dogs before their 13th birthdays. About a third reported having cats. Researchers, accounting for other factors, found that exposure to a dog at any time in childhood led to a 24% decrease in the incidences of schizophrenia. Subjects exposed to dogs at birth were 55% less likely to have schizophrenia than those individuals who had no exposure at all. There was no significant effect with exposure to cats, and neither animal affected the development of bipolar disorder.
 
Researchers adjusted their study results to account for other known risk factors. However, there are limitations to the study due to the reliance on participants self-reporting their childhood exposure to dogs. There should be more research to determine whether there is a direct correlation between dogs and schizophrenia.
 
Reasons for the Results
 
While the study did not pinpoint the reasons why there may be a correlation between exposure to dogs and the development of schizophrenia, there are some possible theories. Previous studies have shown early life exposure to dogs can alter the immune system. It could be that effects on allergy responses, contact with animal bacteria, changes in a home's microbiome, and pet-induced stress reduction could alter an individual's brain chemistry. This change in the immune system may alter the risk of developing psychiatric disorders to which a person is otherwise predisposed.
 
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 disabilities. To schedule a consultation call (509) 991-7058.

​According to the Centers for Disease Control and Prevention (CDC), approximately 1 in 59 children in the United States has autism spectrum disorder. About 1 in 6 children has severe intellectual and developmental disabilities. In addition, people with disabilities are 2.5 times more likely to be victims of violent crime. However, roughly one-third to almost half of all people killed by law enforcement suffer from a disability.
 
Dealing With the Differences
 
Many police officers have difficulties dealing with people with autism or other differences. Most of this is due to a lack of appropriate training. This situation was brought to the forefront in the summer of 2019 when an off-duty police officer shot and killed a man who was nonverbal and developmentally disabled. Most police officers don’t understand the symptoms of conditions like autism and other mental disabilities. They look at behaviors such as self-stimulation, delusions, anxiety, and anger as criminal behavior.
 
Not a Crime
 
It is critical that police officers are trained that having a mental disability is not a crime. Police departments across the country are now finding that they have a problem when it comes to how they deal with the disabled. Many are now conducting Crisis Intervention Training, which is conducted by mental health experts. This training can help police officers recognize the symptoms of autism and learn practical ways to approach individuals with a mental disability. The officers can learn how to deescalate a situation rather than making matters worse. During this training, police officers should also be taught that not everyone with autism behaves in the same manner, and they should be prepared for any situation.
 
Training that encourages police officers to interact with the autism community can be especially helpful in gaining a better understanding of the disorder. Communicating with families and advocates can help police officers gain perspective. A real-life connection to individuals with disabilities can bridge the communication gap and lead to better encounters.
 
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 disabilities. To schedule a consultation call (509) 991-7058.

​In December of 2019, the American Academy of Pediatrics released a report on autism. The report was an extensive document that summarized 12 years of research and clinical activity. Researchers noted that one key message of the report was the emphasis on early identification and treatment of autism spectrum disorder. The report noted that treatment should begin even if a diagnosis of autism is only suspected but not confirmed. The earlier treatment begins, the better the outcomes.
 
Early Diagnosis
 
The average age of autism diagnosis is age four. However, researchers note that the goal should be to get a diagnosis under two years of age. Children who are at high risk, such as those with siblings that have autism, should receive close screening and attention. Unfortunately, many specialty clinics have long waits, and it can take months to see someone to receive a diagnosis. The authors of the report are hopeful that more pediatricians can refer families to early intervention services before a specific diagnosis has been confirmed.
 
Types of Treatment
 
There are various treatments available to children with autism. The most intense treatment is Applied Behavior Analysis (ABA). This treatment addresses specific behaviors, identifies triggers, and rewards children when they behave in the desired way. Cognitive-behavioral therapy and occupational therapy have also proved helpful. In some cases, medication treatment may be necessary. Regardless of the type of intervention, the earlier the treatment is begun, the more effective it will be.
 
There are also a host of other medical, behavioral, and psychiatric conditions that children with autism may have. These conditions can affect a child’s overall functioning. Addressing these conditions early with medication or therapy can also be extremely helpful.
 
Growing Up
 
With the use of early treatment, some children with autism reach an optimal outcome to where all of their symptoms are under control. However, for many, work on transitioning into school and then adulthood must be considered. Early diagnosis and treatment can help make these conversations possible and lead to more successful planning for the future.
 
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 disabilities. To schedule a consultation call (509) 991-7058.

​In New York State, suicide is the second leading cause of death among adolescents. With adequate mental health care, perhaps many of those deaths could have been prevented. However, in the face of rising teen suicides, New York State plans to reduce access to mental health care for children.
 
At the end of 2019, New York State cut reimbursement rates for behavioral health services for children and families eligible for Medicaid. These services were provided through a program called Children and Family Treatment and Support Services. Medicaid provides healthcare coverage to roughly one-third of the state. That number includes more than 200,000 children and adolescents with mental health problems.
 
Already a Struggle
 
Children across the state already struggle to get the mental health care they need. Many languish on waiting lists for care. They regularly wait for weeks or even months to receive care for sometimes serious mental illness. For every 10,000 children in New York, there are only two child psychiatrists. In much of the state, mental health care is provided by small community programs that will not be able to provide assistance if their reimbursement rates are cut.
 
These community centers are already struggling. The new reimbursement rates will cover face to face visits with children but will not provide funding for travel, taking case notes, laptops, and back-up staff. Many small health care providers will be destroyed by the cuts in funding.
 
In New York, as in most places, mental health programs struggle with high turnover and unfilled positions. This is due to the low pay and intense workload required by these providers. Further cuts will be devastating to the mental health care system, and it is the children of New York who will suffer. Many families will be forced to turn to local hospitals for their care. Community-based programs provide the most effective mental health care. Cuts to these programs will be harmful.
 
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 disabilities. To schedule a consultation call (509) 991-7058.

​A federal judge found that California prison officials intentionally filed misleading data with the court regarding how often prison inmates were receiving mental health care. U.S. District Court Judge Kimberley J. Mueller in a Sacramento federal court stated that the California prison system would continue to be overseen by the court until it can demonstrate that it can provide adequate mental health care.
 
Whistleblower
 
The judge's order validates claims by Dr. Michael Golding, the top psychiatrist in the state's prison system, who compiled a whistleblower report that accused the state of providing false and misleading data to the court to coverup for woefully inadequate mental health care. The judge found that, in order to get out from under years of court oversight of mental health care services, the state manipulated data regarding how frequently mentally ill inmates were seen by psychiatrists. The state also fudged data on the amount of care mentally ill inmates were receiving. Dr. Golding has remained in his job at the California Department of Corrections and Rehabilitation (CDCR) but claims that he has faced retaliation for his report. This is despite the court’s order that no action be taken against him. 
 
Misleading Data
 
In her order, the judge noted that it was clear that the state had offered misleading data to the court. The judge could not find that this misleading data amounted to fraud and noted that it might be the result of a broken system. Some of the misleading data may have stemmed from the fact that officials changed the requirement that inmates see a psychiatrist every 30 days to now requiring it every 60 days. This made it seem as though mentally ill inmates were receiving adequate care. Dr. Golding also noted in his testimony that the state relied on treatment from clinicians rather than psychiatrists. The state will now have to do a mountain of work to regain the confidence of the court and others in 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 disabilities. To schedule a consultation call (509) 991-7058.

​Jurisdictions across the country are looking for ways to reduce the use of solitary confinement. In the wake of several lawsuits, jurisdictions are realizing that solitary confinement can lead to mental health problems and exacerbate mental illness. The practice is inhumane. Now some counties in California are taking new approaches toward solitary confinement, and it is leading to fewer inmates in confinement.
 
New Criteria
 
Counties such as Santa Clara, Contra Costa, and Sacramento are establishing new criteria for when inmates are placed in solitary confinement. Rather than using solitary confinement for nonviolent nuisance infractions where an inmate is caught with contraband or disobeys orders, solitary confinement is reserved for inmates who exhibit continued violent behavior. The new criteria have gone a long way toward reducing the number of inmates in solitary confinement. In 2019, Contra Costa County began the year with 100 people in solitary, and by December, there were only six individuals in confinement. Sacramento County cut its solitary confinement population by half. Santa Clara went from 400 inmates in solitary to only 26 by December after implementing the new criteria.
 
These California jails are also taking different approaches to handle nonviolent infractions. Rather than jumping to confinement or more violent actions, jails are working toward using reward systems and positive reinforcement to encourage better behavior. Individuals are offered more snacks or more TV time to encourage them to follow the rules. The approach is surprisingly working.
 
In addition to reducing the use of solitary confinement, jails are also working toward reducing the amount of time an inmate is in solitary. The longer an individual is in solitary confinement, the more detrimental it can be to their mental health. The jails are using systems like placing inmates with smaller populations and having them agree in writing not to be violent.
 
Other Jurisdictions
 
Other jurisdictions across the country are also working on reducing the use of solitary confinement or segregation. Hampden County in Massachusetts now relies on alternative sanctions and positive reinforcement. New Jersey’s Middlesex County has been reducing the amount of time individuals are in solitary and letting them out of their cells more frequently. In Cook County, Illinois, troublesome inmates are no longer kept in solitary and are instead placed in small groups of inmates.
 
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 disabilities. To schedule a consultation call (509) 991-7058.