WashPOST opinion: An autistic man caught in the criminal justice system

December 12

FOR THE apparent crime of wearing a hoodie in public, an 18-year-old black man was approached by a sheriff’s deputy in Stafford County four and a half years ago. A caller had reported that the man, sitting on the grass across the street from an elementary school, might be armed. As it turned out, the suspicion was unfounded; the man, Reginald Latson, who has an IQ of 69, was doing nothing more than waiting for a public library to open its doors.

Yet that unprovoked encounter between the deputy and the teenager, which culminated in the teenager’s arrest and felony conviction for assaulting the deputy, triggered a tragic sequence of events. As The Post’s Ruth Marcus has detailed in two op-ed columns, the story of Mr. Latson is a case study of how ill-equipped the criminal justice system is to handle people with mental, developmental and emotional disabilities.

Specialists who have examined Mr. Latson describe him as a boy in a man’s body, given to violent impulses and outbursts. State officials concluded last year that he belongs in a secure therapeutic treatment center, not a prison. They arranged for just such a placement, at a facility in Florida, and a judge signed on to that plan.

But a prosecutor in Stafford County, Eric Olsen, has pressed ahead to keep Mr. Latson in prison rather than at an equally secure facility where he could receive appropriate treatment. Last spring he brought a fresh assault charge after Mr. Latson punched a prison guard — the sort of incident that is sometimes treated as a disciplinary matter in prison, not a new criminal offense.

The effect has been to prolong a toxic cycle of incarceration, violent outbursts and criminal charges. All this for a young man whose problems would be better managed outside the prison system at a secure treatment facility.

No one is suggesting Mr. Latson should go free. But it seems clear that punishment — he has been segregated for long periods from other inmates, deprived of TV, radio, books and magazines and, at various times, Tasered (after punching the guard) and straight-jacketed into a chair — is doing no good. Since his arrest in 2010, Mr. Latson has cycled through 10 or so facilities in Virginia, including jails, prisons, group homes and psychiatric hospitals. He has had recurrent suicidal urges and has lost 40 pounds from an already-lean frame.

Yet as long as Mr. Latson faces pending charges, he cannot be transferred to the treatment facility in Florida.

Given Mr. Olsen’s insistence on further criminal charges, it appears that this senseless cycle can be broken at this point only by a guilty plea or conviction at a new trial for Mr. Latson, which is scheduled for next month. Once that happens, the judge could see that Mr. Latson is moved to the treatment facility after serving a mandatory minimum sentence in Virginia, or Gov. Terry McAuliffe (D) could immediately grant a pardon conditioned on Mr. Latson’s transfer to the facility in Florida. It’s not too late for Virginia to get its act together and recognize the distinction between disability and criminality.

original article

Continue reading WashPOST opinion: An autistic man caught in the criminal justice system

At L’Arche, those at the margins find love at the center

from the Washington Post:

by Michael Gerson, opinion writer, The Washington Post

In an older, gentrifying, suburban Virginia neighborhood — the kind with porch flags and pumpkins on the front steps — I am welcomed at an indistinguishable door to an exceptional little community called L’Arche. Here, intellectually disabled “core members” are paired with often young and intensely idealistic “assistants” who share their lives, normally for a year or two. (L’Arche has more than 140 such group homes in 35 countries.)

Hazel, who uses a wheelchair and communicates mainly with a shy smile, has helped prepare dinner. Before the meal, she shows me photographs she has taken during a recent riverside vacation. (Her more typical photographic subjects, I’m told, are babies at church.) Fritz, a middle-aged man with Down syndrome, watches videos of the rock group Queen on a computer in the living room. Before we eat, he offers an extended, emotionally intense prayer, only occasionally intelligible to listeners in the room but certainly (if there is any justice) intelligible to God.

There is a method in L’Arche’s work. Routine and consistency are important. Core members have chores and, when possible, jobs. (Fritz takes out the trash and washes cars at a city facility.) L’Arche is big on rituals of personal affirmation. When any member of the community has a birthday, the others take turns recounting his or her talents and gifts. While L’Arche is not sectarian, the atmosphere is strongly religious. After dessert, a candle is handed around, with each person expressing a prayer request as they hold it.

The assistants are given months of training before they start. But L’Arche’s goal is not primarily the provision of services. The prevailing professional model of social services involves the setting of emotional boundaries. L’Arche exists to cross those boundaries — to strive for a friendship of equals. The saintly founder of L’Arche, Jean Vanier, argues that generosity is offered from a position of power. True communion, in contrast, involves the loss of power and a willingness to be “transformed by weakness.” Assistants approach core members as teachers.

The result is a deeper, riskier relationship. The challenges of dealing with the intellectually disabled should not be sentimentalized. A core member at a L’Arche home recently became threatening and needed to be hospitalized. (“God holds that person,” says John Cook, the executive director of L’Arche in the Washington area, “but we can’t.”) Some volunteers burn out. More typically, however, assistants report being stripped down to emotional essentials and opened to something larger. “My job, what I make, meant nothing to her,” says one assistant of her core member. “She loved me, without any accomplishments, without anything I thought made me lovable. It is how God loves me.

There is a human tendency to recoil from fragility. But we are humanized by closer acquaintance with the intellectually disabled. Cook speaks of his friend Fritz with admiration: “He has the gift of companionship. He is very attuned to distress and overtly comforting. He gives people a blessing by putting his forehead against their forehead. And people come away feeling moved, like something powerful has happened to them.” At church, Hazel sits at the front by the aisle. During Communion, she greets each congregant as they come forward, receiving a kiss on the cheek, as much a part of the service as the bread and wine.

Those interested in the most efficient provision of social services would probably not design L’Arche — a program that lavishly invests a single life in a single life. Whether this is viewed as wasteful depends upon your ultimate goal. “It is a matter of ends,” says Cook. “If your end is the greatest good at the least financial cost, then some get favored and some discarded. If your end is a place where everyone has a place of honor, and where everyone lives in love, then L’Arche is experiencing it. People who get pushed to the margins are intentionally placed at the center.”

This small community accomplishes many outsize things. It vindicates the ideal of human dignity, which does not depend on normal measures of human accomplishment. It lays bare the illusion that ability means superiority. It displays the lavishness of grace, which, in Christian theology, is needed by and granted to us all. And it shows — amazingly, inspiringly, accusingly — that the beloved community might be created on any suburban street.

Published in The Washington Post October 27, 2014.


NYT: A Natural Fix for A.D.H.D.

ATTENTION deficit hyperactivity disorder is now the most prevalent psychiatric illness of young people in America, affecting 11 percent of them at some point between the ages of 4 and 17. The rates of both diagnosis and treatment have increased so much in the past decade that you may wonder whether something that affects so many people can really be a disease.

And for a good reason. Recent neuroscience research shows that people with A.D.H.D. are actually hard-wired for novelty-seeking — a trait that had, until relatively recently, a distinct evolutionary advantage. Compared with the rest of us, they have sluggish and underfed brain reward circuits, so much of everyday life feels routine and understimulating.

To compensate, they are drawn to new and exciting experiences and get famously impatient and restless with the regimented structure that characterizes our modern world. In short, people with A.D.H.D. may not have a disease, so much as a set of behavioral traits that don’t match the expectations of our contemporary culture.

From the standpoint of teachers, parents and the world at large, the problem with people with A.D.H.D. looks like a lack of focus and attention and impulsive behavior. But if you have the “illness,” the real problem is that, to your brain, the world that you live in essentially feels not very interesting.

One of my patients, a young woman in her early 20s, is prototypical. “I’ve been on Adderall for years to help me focus,” she told me at our first meeting. Before taking Adderall, she found sitting in lectures unendurable and would lose her concentration within minutes. Like many people with A.D.H.D., she hankered for exciting and varied experiences and also resorted to alcohol to relieve boredom. But when something was new and stimulating, she had laserlike focus. I knew that she loved painting and asked her how long she could maintain her interest in her art. “No problem. I can paint for hours at a stretch.” Continue reading NYT: A Natural Fix for A.D.H.D.

WashPost Op Ed: When disabled children become adults, parents often are left with few options

This summer, readers of The Post learned about the horrible conditions in which twin 22-year-old autistic men were kept in their parents’ Rockville home. It is easy to blame the parents, but it’s not entirely their fault. Publicly funded services for the disabled are substantially reduced when they reach age 18 and are virtually eliminated, beyond personal and medical care, at age 21.

What happened to the Rockville family is heart-wrenching. The parents would not be in trouble if they had simply turned the children out on the street. Their legal obligation to care for them ended when the twins turned 18. But options for full-time, residential care are limited. In-home, round-the-clock care is prohibitively expensive for most families. The waiting list for services for the disabled can stretch to many years, if they are available at all, as I experienced with my son, who has autism. Continue reading WashPost Op Ed: When disabled children become adults, parents often are left with few options

NYT Opinion: Saving a Future for Those With Disabilities

Back in the old days, when Congress did crazy things like pass legislation, a sensible bill like the ABLE Act might have sailed to the president’s desk. But today, even with a long list of positives — it’s a good idea, solves a pressing problem and has lots of bipartisan support — it’s not a slam dunk, because there’s always a way in Washington to squelch good ideas, especially those that involve tweaking the tax code and spending a little money. Continue reading NYT Opinion: Saving a Future for Those With Disabilities

NYT Editorial: How to Do Right by the Disabled

 About a year ago the Senate fell five votes short of ratifying an international treaty that would improve protections for the disabled. It was an ignoble spectacle as the opponents rebuffed Bob Dole, a former colleague and disabled veteran, who came to the Senate floor to lobby for it. The Senate now has a chance to redeem itself.

Senator Robert Menendez, a New Jersey Democrat and chairman of the Senate Foreign Relations Committee, has revived the treaty, the United Nations Convention on the Rights of Persons With Disabilities. He has held two hearings and plans a committee vote perhaps next month. Unanimous approval leading to quick Senate ratification is warranted; 138 other countries have ratified the treaty.

The United States is the leader in promoting the rights of people with disabilities because of the Americans With Disabilities Act of 1990. But projecting that globally has been hampered by the failure to ratify the U.N. convention in the four years since President Obama signed it. As Secretary of State John Kerry said last week, when the treaty countries gather to discuss accessibility and employment standards for people with disabilities, “we’ve been excluded because we’re not a party to the treaty.”

Practically, that means America is weakened in its ability to press for fire alarms with flashing lights so people who are deaf will know when there is an emergency or for sidewalks with curb cuts for people in wheelchairs. Such advocacy does not just benefit foreigners. Disabled Americans would find it easier to travel, study and live abroad if the United States could win improved conditions.

Previously, a right-wing fringe defeated the treaty with the absurd claims that it “crushes” American sovereignty and leads to bureaucrats’ taking disabled children from their parents. It was always hard to take such nonsense seriously. Now, with a growing number of veterans groups and corporations backing the treaty, perhaps the Senate naysayers can be persuaded to do what’s right.


Editorial: Equal Coverage for the Mentally Ill

from the board of the New York Times:
A struggle over decades to force insurers to cover mental health and addiction services on the same basis as medical and surgical costs is headed for success under new rules issued on Friday by the Obama administration. The rules will cover most Americans with health insurance, including those in many employer-sponsored plans, in other group plans, in some but not all Medicaid plans, and in policies bought on the individual markets.

The rules strengthen a 2008 law that required parity in coverage — but only when an insurer actually offered mental health and addiction benefits. It did not require such benefits. The new health care law, the Affordable Care Act, does require coverage for mental health and substance abuse as 1 of 10 essential benefits in any new health plans. Combined, the two complete the job of offering both parity and coverage. Continue reading Editorial: Equal Coverage for the Mentally Ill

Letter to the Editor – “Why did Robert Saylor Die?”

Nothing that any of us can say or write can bring back Robert Ethan Saylor, or ease the pain of his family, or diminish the loss his friends are feeling. So many lessons can be learned from James Mulvaney’s March 10 Local Opinions article “Why did Robert Saylor Die?” One hopes, in particular, that Mr. Mulvaney’s phrase “to recognize that a disability is not a crime” will come across loud and clear in Frederick, Washington and beyond.

Washington Post
March 12, 2013

Letters to the Editor – Robert Ethan Saylor

Even though we all too often read of the senseless killings of people in the wrong place at the wrong time, Robert Ethan Saylor had not been in the wrong place. He simply did not have a ticket to watch a movie in a theater a second time. He also had Down syndrome which perhaps frightened the security guards who removed him so forcefully from the theater that he died.

This story in the Opinion Pages of the New York Times today, about the tragic death of Robert Ethan Saylor, should be a wake-up call for society.

Nothing any of us can say or write can bring back Robert Ethan Saylor, ease the pain of his family, or diminish the loss his friends are feeling. But a friend of mine with Down syndrome said something for us all to heed: that if we see people with disabilities like his and Mr. Saylor’s we should keep our eyes and ears open and then give them the respect they deserve.

It is incumbent upon us all to learn about people with intellectual or physical challenges, with different abilities, and perhaps with different facial structures, and that includes sensitivity training for those who work among the general population, such as police and private security guards.

It seems like such an easy task, but it might have saved Mr. Saylor’s life.

sent to the NY Times
March 19, 2013

Mary Ann Carmody
RN, BSN, AASECT-Certified Sexuality Educator

Letter to the Editor – Medicare Keeps Me Tickin’

Are any “seniors” out there as upset as I am by Robert J. Samuelson July 29 column “It’s the elderly, stupid”? It goes from the placard shown in the photograph above the text, which reads “Medicare Keeps Me Tickin’,” to casually referring to those of us over 65 who take Medicare and Social Security as “retirees” dragging down the economy with our “private pleasures.”

What’s wrong with using Medicare to keep the heart of someone over 65 “tickin’”? Did we not work for our retirement nest eggs, are we not careful of how many pleasure trips we take, do we not give generously of our time and financial aid to our churches and to disasters like Haiti, Katrina and Somalia?

Bring on the dialogue, but don’t paint with one brush those of us over 65 who spend our money carefully as enjoying “middle-class welfare.”

-Mary Ann Carmody, Washington

The Washington Post
August 1, 2011