Archive August 2020

Facing The BOP With: Intellectual Disabilities, Neurological Impairments, Social Deficiencies Or Autism

CorrectionalOfficer.org © 2020 – Screen Shot[i]

 

The Skills Program[i] 

Do you have clients facing incarceration in the BOP, and who are being treated for intellectual disabilities, neurological impairments, social deficiencies, or autism? If yes; which of the BOP’s ‘2’ available prison facilities are best suited for their placement? That’s right, there are only 2 locations.

I ask this is because the concept of prison officials engaging individuals with autism (for example), has its own brand of procedural issues. For those with a documented history, this could be critical for the safety of all parties; the inmate, correction officers, and the facility general population.

Increasingly, media outlets are reporting instances whereby police officers are confronting subjects on the streets and encountering behaviors of some as “resisting verbal commands” and “obstructing justice,” among others. Eventually, the presence of autism or a different disability is discovered after these police/civilian engagements. Thus, a BOP facility who at a minimum, provides this type of care at a couple of facilities, should be made part of the BOP placement request through the PSR.

Inmates with significant functional impairment due to intellectual disabilities, neurological deficits, and/or remarkable social skills deficits are considered for the program. Participants must be appropriate for housing in a low or medium security institution. Inmates must volunteer for the program.[i] While this program is conducted over 12-18 months, inmates may continue with the program at additional times.

Autism spectrum disorder

Autism spectrum disorder (ASD[ii]) occurs in all ages, racial, ethnic, and socioeconomic groups, according to the Centers for Disease Control (CDC)[iii]. Autism is generally characterized by social and communication difficulties and repetitive behaviors. Signs of autism[iv] occur in three main areas:

  • Social interactions
  • Verbal and nonverbal communication
  • Repetitive or ritualistic behaviors

A particular focus on autism-affected inmates, classified by BOP under the umbrella category as “Intellectual Disabilities, Autism Spectrum Disorders” and “Major Neurocognitive Disorders,” seeks to treat affected inmates with a multidisciplinary modality, albeit only available at two BOP locations nationwide. The Federal Bureau of Prisons amended and published (May 2014)[v] its agenda to handle/treat mentally unstable inmates while incarcerated.

Intellectual disabilities are classified by severity, [i]

  • Mild to Moderate
    • Mild
      • slower in all areas of conceptual development and social and daily living skills
      • can learn practical life skills, which allows them to function in ordinary life with minimal levels of support.
    • Moderate
      • care of themselves,
      • travel to familiar places in their community, and
      • learn basic skills related to safety and health.
      • Their self-care requires moderate support.
    • Severe
      • has the ability to understand speech but otherwise has limited communication skills ()[ii].
    • Profound (MH CARE LEVEL III [iii])
      • cannot live independently, and
      • they require close supervision and
      • help with self-care activities.
      • limited ability to communicate and often have physical limitations.

Social Deficiency[iv]; reasons why a person may have a social skills deficit.

    • inability to acquire new skills,
    • because of a competency deficit,
    • they may struggle to perform because of limited practice or inadequate feedback, or
    • external factors
      • anxiety or
      • chaotic surroundings.

Basic Communication

  • inability to listen,
  • follow directions and/or
  • refrain from speaking.

Empathy and Rapport

Interpersonal Skills

  • Those who have a social skill deficit may struggle with asking accurate and concise questions.
    • appear disinterested and even
    • anti-social,
    • they may struggle to understand proper manners in different social contexts and settings.

Problem Solving: involves asking for help, apologizing to others, deciding what to do, and accepting consequences;

  • morbidly shy or
  • clinically introverted.

Accountability, fear of being criticized in public;

  • struggle with accepting blame for problems or
  • dealing with constructive feedback.

Other neurological impairments[vi] (e.g. traumatic brain injury, Spina Bifida, Prader-Willi syndrome, Alcohol-Related Neurodevelopmental Disorders or FASD)

As a Police Officer, Cheri Maples, stated earlier, “…wisdom is being able to discern when gentle compassion is called for and when fierce compassion is called for.” That, my friends, rather sums it up.[ix]

Criminal Justice Advocacy – Screen Shot[i]

 ‘The responsibility for a client’s mental and physical health should be safeguarded to protect them from themselves and others, providing a safe environment for the duration of their incarceration.’

This is the responsibility of the legal defense team, court, and BOP.

The Skills Program[ii] is available at these two facilities:
FCI Coleman, FL-Medium

FCI Danbury, CT-Low

 

[i] https://www.arcnj.org/programs/criminal-justice-advocacy-program/

[ii] https://pprsus.com/bop-psychology-treatment-the-federal-presentence-report-sentencing-and-prison-placement-preparation/skills-program/

[i] https://www.ncbi.nlm.nih.gov/books/NBK332877/#:~:text=Historically%2C%20intellectual%20disability%20(previously%20termed,100%20in%20the%20population)%E2%80%94and

[ii] https://www.ncbi.nlm.nih.gov/books/NBK332877/#

[iii] https://pprsus.com/programs/bop-mental-healthcare/

[iv] https://www.masters-in-special-education.com/lists/5-types-of-social-skills-deficit/

[v] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1350917/

[vi] https://www.ninds.nih.gov/Disorders/Support-Resources

[vii] https://www.cerebralpalsyguide.com/cerebral-palsy/

[viii] https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy

[ix] https://www.correctionalofficer.org/overseeing-inmates-with-autism

[i] https://pprsus.com/bop-psychology-treatment-the-federal-presentence-report-sentencing-and-prison-placement-preparation/skills-program/

[ii] https://www.additudemag.com/autism-spectrum-disorder-in-adults/

[iii] https://www.additudemag.com/autism-spectrum-disorder-in-adults/#footnote1

[iv] https://www.additudemag.com/signs-of-autism-in-adults/

[v] https://www.bop.gov/policy/progstat/5310_16.pdf

[i] https://www.correctionalofficer.org/overseeing-inmates-with-autism

[i] https://pprsus.com/bop-psychology-treatment-the-federal-presentence-report-sentencing-and-prison-placement-preparation/skills-program/

COVID-19 Ever Increasing Long-Term Complications

Post COVID-19 Complications; the world’s medical and scientific communities are now facing an ever-increasing list of symptoms.

With the pandemic just months old, no one knows how far into the future symptoms will endure, and whether COVID-19 will spur the onset of chronic diseases. Screenshot 8/19/2020
The list of lingering maladies from COVID-19 is longer and more varied than most doctors could have imagined. Ongoing problems include fatigue, a racing heartbeat, shortness of breath, achy joints, foggy thinking, a persistent loss of sense of smell, and damage to the heart, lungs, kidneys, and brain. Screenshot 8/19/2020

8/12/2020, Long after the fire of a Covid-19 infection, mental and neurological effects can still smolder[1]

As many as 1 in 3 patients recovering from Covid-19 could experience neurological or psychological after-effects of their infections, experts told STAT, reflecting a growing consensus that the disease can have a lasting impact on the brain. Beyond the fatigue, neuropsychological problems range from headache, dizziness, and lingering loss of smell or taste to mood disorders and deeper cognitive impairment.

Doctors have concerns that patients may also suffer lasting damage to their heart, kidneys, and liver from the inflammation and blood clotting the disease causes. Additionally, between 30% and 50% of people with an infection that has clinical manifestations are going to have some form of mental health issues,” said Teodor Postolache, professor of psychiatry at the University of Maryland School of Medicine.

So far the virus appears to cause its damage to the brain and nervous system not as much through direct infection as through the indirect effects of inflammation, said Victoria Pelak, professor of neurology and ophthalmology at the University of Colorado School of Medicine.

“Strokes are larger, potentially more damaging with this disorder. Once inflammation or blood vessel problems occur within the nervous system itself, those people will have a lot longer road to recovery or may die from those illnesses,” Colorado’s Pelak said.

Doctors are also watching for a syndrome called demyelination, as in the autoimmune disease multiple sclerosis, this can cause weakness, numbness, and tingling. It can also disrupt how people think, in some cases spurring psychosis and hallucinations. “We’re just not sure if this virus causes it more commonly than other viruses,” Pelak said.

The COVID-19 infection might also act as a “priming event” for problems to resurface in the future said Teodor Postolache. Psychological stress could reactivate behavioral and emotional problems that were initially triggered by the immune system responding to the virus. “What we call psychological versus biological may actually be quite biological,” he said.

Ely of Vanderbilt suggests three things to do now.

  1. “We can open the hospitals back up to the families. That’s important,” he said.
  2. “We can be aware of these problems and tell the families about them so that the families will know that this is coming. [And]
  3. we can do counseling and psychological help on the back end.”

8/12/2020, MIT Technology Review:[2] Covid-19 “long haulers” are organizing online to study themselves.

Slack groups and social media are connecting people who have never fully recovered from coronavirus to collect data on their condition.

Gina Assaf was running in Washington, DC, on March 19 when she suddenly couldn’t take another step. “I was so out of breath I had to stop,” she says. Five days earlier, she’d hung out with a friend; within days, that friend and their partner had started showing three classic signs of COVID-19: fever, cough, and shortness of breath.

Assaf had those symptoms too, but a full month after falling ill, she attempted to go to grocery shopping and ended up in bed for days. In those first few months, Assaf found a legion of people in situations similar to her own in a Slack support group for COVID-19 patients, including hundreds who self-identified as “long-haulers,” the term most commonly used to describe those who remain sick long after being infected.

It wasn’t until late July that the US Centers for Disease Control published paper recognizing that as many as one-third of coronavirus patients not sick enough to be admitted to the hospital don’t fully recover. So Assaf, a technology design consultant, launched  Patient-Led Research for Covid-19[ii], released its first report[iii].

The Body Politic COVID-19 Support Group[iv]

8/12/2020, Wes Ely, a pulmonologist and critical care physician at Vanderbilt University Medical Center who studies delirium during intensive care (watch video)[22] stays. “The problem for these people (when coming off ventilators), is not over when they leave the hospital.”

Long term effects are health issues that are caused by an illness, disease, or treatment that lasts for several months or years after infection. Long-term effects can be physical, mental, or emotional and can occur even if the initial illness or disease is no longer present in the body.[23].

This applies to post COVID-19 patients (Long-Haulers), as physicians and scientists from around the globe begin to study these patients post-hospitalization.

The long haul | Science science.sciencemag.org Screenshot

Also found in my LinkedIn: Compassionate Relief – COVID-19 Emerging Long-Term Complications 

[1] https://www.statnews.com/2020/08/12/after-covid19-mental-neurological-effects-smolder/

[2] https://www.technologyreview.com/2020/08/12/1006602/covid-19-long-haulers-are-organizing-online-to-study-themselves/

[3] https://docs.google.com/forms/d/e/1FAIpQLScM2EeJhgisTUdo5Op6euyx1PYu8O-aNeDVYhXuPFa_Gs9PnQ/viewform

[4] https://patientresearchcovid19.com/

[5] https://docs.google.com/document/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/edit

[6] https://docs.google.com/document/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/edit

[7] https://docs.google.com/document/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/edit

[8] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[9] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[10] https://www.medpagetoday.com/neurology/dementia/87543

[11] https://health.ucdavis.edu/health-news/newsroom/covid-fatigue-is-hitting-hard-fighting-it-is-hard-too-says-uc-davis-health-psychologist/2020/07

[12] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[13] https://health.ucdavis.edu/health-news/newsroom/covid-fatigue-is-hitting-hard-fighting-it-is-hard-too-says-uc-davis-health-psychologist/2020/07

[14] https://www.ptsd.va.gov/covid/COVID_effects_ptsd.asp#:~:text=PTSD%20Symptoms%20Can%20Be%20Affected,things%20most%20people%20consider%20safe.

[15] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[16] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain#:~:text=A%3A%20Cases%20around%20the%20world,Seizures

[17] https://www.frontiersin.org/research-topics/14627/impact-of-the-coronavirus-pandemic-covid-19-on-mood-disorders-and-suicide#:~:text=During%20the%20coronavirus%20COVID%2D19,problems%20and%20perceived%20social%20isolation.

[18] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[19] https://www.healthline.com/health-news/the-covid-19-symptoms-most-people-could-miss

[20] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[21] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[22] https://www.icudelirium.org/

[23] https://www.talktomira.com/post/what-are-the-long-term-side-effects-of-coronavirus-covid-19

[i] https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html?deliveryName=USCDC_2067-DM35559

[ii] https://patientresearchcovid19.com/

[iii] https://docs.google.com/document/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/edit

[2] https://www.technologyreview.com/2020/08/12/1006602/covid-19-long-haulers-are-organizing-online-to-study-themselves/

[3] https://docs.google.com/forms/d/e/1FAIpQLScM2EeJhgisTUdo5Op6euyx1PYu8O-aNeDVYhXuPFa_Gs9PnQ/viewform

[4] https://patientresearchcovid19.com/

[5] https://docs.google.com/document/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/edit

[6] https://docs.google.com/document/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/edit

[7] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[8] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[9] https://www.medpagetoday.com/neurology/dementia/87543

[10] https://health.ucdavis.edu/health-news/newsroom/covid-fatigue-is-hitting-hard-fighting-it-is-hard-too-says-uc-davis-health-psychologist/2020/07

[11] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[12] https://health.ucdavis.edu/health-news/newsroom/covid-fatigue-is-hitting-hard-fighting-it-is-hard-too-says-uc-davis-health-psychologist/2020/07

[13] https://www.ptsd.va.gov/covid/COVID_effects_ptsd.asp#:~:text=PTSD%20Symptoms%20Can%20Be%20Affected,things%20most%20people%20consider%20safe.

[14] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[15] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain#:~:text=A%3A%20Cases%20around%20the%20world,Seizures

[16] https://www.frontiersin.org/research-topics/14627/impact-of-the-coronavirus-pandemic-covid-19-on-mood-disorders-and-suicide#:~:text=During%20the%20coronavirus%20COVID%2D19,problems%20and%20perceived%20social%20isolation.

[17] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[18] https://www.healthline.com/health-news/the-covid-19-symptoms-most-people-could-miss

[19] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[20] https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-does-coronavirus-affect-the-brain

[21] https://www.icudelirium.org/

[22] https://www.talktomira.com/post/what-are-the-long-term-side-effects-of-coronavirus-covid-19

[i] https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html?deliveryName=USCDC_2067-DM35559



Entering the BOP, ease your client’s medication fears

To someone entering prison for the first time, they assume that they will still get medical care. The assumption may be that they will also get the same medications that they got on the outside, which is likely not the case.

  • Medication availability (~ 3000 different drugs), falling into 3 categories.
    • 1st) On Formulary -Available: These medications are available for BOP healthcare providers for inmate’s use.
    • 2nd) Non-Formulary -These require a lengthy Preauthorization Process-: These medications while they are stocked, they are not immediately available for your use. The prescribing BOP Physician or other healthcare provider needs to go through a lengthy Pre-authorization process to get permission to provide this to you.
    • 3rd) Similar equivalents- When there are no other options, here similar or equivalent substitutions are used. Should the need for a required drug be used where there is no equivalent substitute; this medical problem should be brought up before the sentencing hearing, and hopefully get the backing of the US Attorney, and finally the court.
  • Examples of medication confusion;
    • Cholesterol Control: PCSK9 Inhibitors vs. Statins. Statins are a popular treatment that has been available since the 1980s. PCSK9 inhibitors, on the other hand, are a new type of cholesterol drug. They were approved by the Food and Drug Administration in 2015.
      • But these Cholesterol generics look very different, and may not look like what the defendant has been taking – adding to their stress level.

        Cholesterol Generics:(multiple colors and shapes, while having similar ingredients)

        Generics

        • These are the drug of choice for the BOP as they are cheaper than brand name medications.
        • It may be beneficial to inform your client ahead of time that, while they’ll be taking a generic medication since there are many manufacturers who each produce similar generic drugs that may differ in color and shape; they should be appropriate.
        • Nobody likes surprises, especially if they are entering prison for the first time.
        • Examples of Lipitor (the generic name is atorvastatin)
        •     Generic Lipitor-Dr Reddy’

 

 

 

 

                                                              Generic Lipitor Good Rx