Mental Health Reform - Call For Action - Defining the term BioPsychoSocial etc

[chibam]

I support what your aspiring to do, @Willy , but my inner pessimist doesn't like your odds of being able to outshine the visibility of the major organizations in either of our lifetimes. Maybe the best we can hope for is to lay a foundation that might bear fruit for the next generation.

More concerning, however is the prospect of building unity amongst a group that is largely ideologically divided. As you say, there are countless people who are frustrated with mental healthcare as it currantly stands (and that number is growing). But within that cluster of unhappy patients, there is a stark divide amongst those who wish for the system to keep addressing their brains as the problems that need to be corrected, and those who want the system to shift instead towards providing real-life help, and leave our brains/personalities alone.

And that is just one of the many key rifts that make us a devided people. Another one is the appropriateness of suicide, and consequently, the appropriateness of inforcing anti-suicide dogma upon those who don't believe in it.

I can't see how any organized gathering of disgruntled patients would ever be able to rally as a unified voice (and thereby gain the clout and recognition of a sizable organization) when we are so opposed on many key issues. I think you'd need to first lay out a specific charter of the values and aspirations of whatever organization you intend on forming, and in doing so, you'll almost certainly alienate a sizable portion of the disgruntled patient community.

[Willy]

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I have marked this post to the attention of all those that I am aware of who I think are interested in this topic

chibam,
I have thought long and hard about the issues you raise and I agree in general with what you say.

I have said right from the beginning that my reform agenda was not to try and dictate to people what MH treatments or practices they should or shouldn’t embrace. That would be totally opposed to my philosophy.
My initial objective was and still is to try and minimise the use of Involuntary Treatment Orders (ITO’s) and Involuntary Confinement Orders (ICO’s). I have personally been subjected to this sort of treatment throughout my adult life including a traumatising experience less than 12 months ago. I am aware of other people on this forum who have had similar recent experiences and the Victorian Royal Commission into Mental Health (2021) reported that these sorts of abusive practices were very wide spread. (ref 1). I feel confident in saying that there are at least a few people on this forum who would agree with me that enough is enough.

You have asked for a charter of values and aspirations. I believe the obvious and appropriate one is the World Health Organisation (WHO) comprehensive Mental Health Action Plan (2013 -2030) (ref 2)

Unfortunately my investigations around the world have shown that the problem is far greater than I originally envisaged. In Australia you have a significant number of people running around talking about new or updated legislation and government spending on new programs and infrastructure who appear to have very little if any understanding of what I believe is the underlying problem. There also appears to be quite a few people ever willing to try and take financial advantage of the situation at a cost to those us who are trying to cope with our mental health problems.(ref 3)

At the moment it appears that more than 80% of the world still perceive the biomedical model of psychiatric diagnosis and medication as the best or only solution to all mental health problems for everybody. It would be naive to think that any individual or group could initiate the massive underlying social changes required to alter those perceptions but given the huge and growing number of people affected by MH problems this movement is just as important as any other marginalised group struggling against oppression. These changes can and do happen albeit slowly. (ref 4)

Another problem is that as a group, people with mental heath problems appear to be very submissive and often greatly underrate their own power.

The first time I was committed to a psychiatric hospital in 1971 was a painful and traumatic experience. If you wanted to avoid physical and mental abuse or worse you quickly learnt how to kowtow to your abusers. In that place subservient obedience was equated with sanity. Since they had the power to do what they wanted and keep you there as long as they wished, you had to “prove” your sanity by being consistently subservient no matter what. It took me several months of faking sanity according to their absurd standards to get discharged. Very shortly after I left hospital and for the first time in my life, I started experiencing psychotic episodes.

While the large state psychiatric hospitals and their coercive malpractices are gone the attitude and culture have remained. It appears to have seeped into the entire fabric of the global mental health movement including of course the institutions and organisations here in Australia.

I am suggesting that over a very long period of time, the stigma of a mental health diagnosis has been used to strip us of our self esteem and dignity. This then makes it very easy for those in control to continue to use and abuse us in any way they see fit.

I believe that before any significant reform to mental health services can be achieved, this intolerant, authoritarian attitude towards those of us who experience mental illness has to change. People are already talking about it and in many cases even acknowledging what should be happening but at this stage the talk is not the walk In far too many situations, those of us who suffer from various forms of mental illness are still being treated as some sort of brain damaged incompetent subspecies instead of valid human beings who have been forced by circumstances largely beyond our control to explore and deal with issues that society, on the whole, still don’t understand and mostly don’t want to know about. We are the pioneers who have been pushed out to the edges of reality to explore the psychic landscape while the rest of humanity look on. Far too often they do so with judgement and contempt.

On a brighter note, as I talk to people around the world I am seeing more and more small groups of people stepping up, speaking up and having an impact.

As I see it, the immediate problem is to try and come up with some arrangement for people on this forum who wish to anonymously discuss mental health reform in an open, productive and ongoing way to do so.

In my opinion the existing format of the SANE forum does not adequately support this type of discussion so we need to arrange some other suitable means of doing so.

Setting up a facebook group is one easy and obvious answer but it is not anonymous.

Unfortunately I feel that the SANE management are not being co-operative or supportive towards this endeavour.

References

1. Royal Commission into Victoria's Mental Health system. Final Report. Summary and recommendations. ISBN 978-1-925789-63-8 (Print) Published February 2021
2. World Health Organisation -Comprehensive Mental Health Action Plan 2013-2030 21 Sep 2021 download- https://www.who.int/publications/i/item/9789240031029
3. Daya I, Hamilton B, Roper C. Authentic Engagement :A conceptual model for welcoming diverse and challenging consumer and survivor views in mental health research policy and practice. International Journal of Mental Health Nursing 29, 299311 2020. 16. Palmer M,
4. United Nations Human Rights Council
   Right of everyone to the enjoyment of the highest attainable standard of physical and mental health 44th session 15 June 3 July 2020

Regards

Willy

[maddison]

Hi @Willy 

Thanks for including me. You will have to excuse my reply, as I don't have any where near the skills in expressing myself & writing, as you do.

I am encouraged by your stance. I strongly believe in many, if not all the issues you raise.

I'm not sure if you intimated this within your post - I have a strong sense that many who work in MH, make decisions on the basis of 'this is what the protocol always is.'

It is difficult for me to express, sorry. 

I am optimistic in the sense that I believe many professionals actually have a desire to help others - not all.

My thoughts on the issue are that if or when, offered an alternative 'protocol' changes appear.

I do believe there can be dramatic changes in how MH operates within my lifetime. As you said - it must occur, we are at crisis point. This cannot continue.

I believe many professionals are unfortunately stuck within an 'industry' mindset. I believe many professionals - know as well, or perhaps more than we do - this current model we are relying on is broken. I believe many MH workers want change too.

In a way, they are trapped within a system more than we are. We are fighting them. They are fighting an unchallenged system from inside. Everyday they see how their position is failing to support those in crisis. And ecsaserbating. Everyday they must challenge their colleagues & the system, whilst concurrently standing alongside it.

It is very confusing & I'm not entirely sure I'm making sense 

I see the potential for change coming in the form of creating a new inertia.

I am having difficulties expressing myself at the moment. Perhaps you can try to read my reply from an overall perspective, instead of specific s - & please overlook things I have failed to express adequately.

I'm trying to offer a general sense of my thinking.

Whether I am overly optimistic, or naive? Change must occur.

[Willy]

Hi @maddison 
You are expressing yourself perfectly.
I fully understand where you are coming from and agree with you 100%.

Thanks for making the effort to respond.
I love real people.

Regards

Willy

[maddison]

@Willy 

Safe, affordable, easily accessible housing.

Mental health crisis would be solved overnight.

Thankyou - so much - I love real people too.

[Willy]

@maddison 
Housing is certainly a factor, especially for young people in the 15-25 age group who often need supervised accommodation, not hospital or being left to "couch surf ".
The housing issue doesn't however explain the  prolific administrative abuse problems that are happening to many people who are in no way a "danger to society".  Many people are being given forced medication treatment against their consent and some are being subjected to confinent, often for resisting or not complying with the forced treatment. This is what nearly happened to me recently. I could very easily have been locked up for the rest of my life because I refused to comply with the idiotic and irresponsible demands of incompetent bureaucrats.
And I live in a perfectly good, comfortable, clean, well kept home. I even manage to pay my bills on time (lol).

Regards

Willy 

[Eve7]

Thanks for the tag @Willy  but having been on an ITO as recently as last week I am too fragile to even begin to process your proposal.

[Patchworks]

Hi and thanks for the tag @Willy 

In NZ your question is about to be tested by the law in a court case (sorry for the long link):

https://theconversation.com/were-taking-the-government-to-court-to-challenge-new-zealands-outdated-m...

I've been a voluntary patient in a psychiatric unit and had the mental health act slammed down on me so then I can't leave. My latest inpatient experience was an example of that. I don't begin to understand why the drs think they can hold us against our will. I'm sure there's arguments for and against but as the article linked says, it's a human rights issue.  People with disabilities still have rights. Your statement about our being stripped of our self esteem was interesting and challenging. I agree with you it's the stigma and the way we get treated that combined leave us feeling less. Somehow we've ended up highly stigmatised especially us with schizophrenia spectrum disorders. 

I'm tired of it, the illness is difficult enough without all that additional burden. Having something to do about all this sounds like a good idea. I'm not sure what we can do but even if we reduce the stigma a bit, it's progress

[chibam]

@WillyI meant to come back and apologize for the bleak cynicism in my last post which seemed, for a while, to have stopped this conversation dead in its tracks. You've probably realized by now that I have trouble telling when I'm supposed to keep bleak perspectives to myself.

I'm glad to see that things have gotten rolling again, however. 🙂

From yours and others' recent posts, along with the documentation you provide (especially that WHO plan), this topic seems to mostly be focussed on the evils of the psych ward, and the ways those evils have begun to seem out into the broader community, e.g. through the stripping of rights, ect. .

That's (thankfully) an area I don't have any personal experiance in; so I don't know what I could contribute to that conversation.

My personal focus has always been the considderably 'tamer' evils that go on in the small, everyday therapy clinics, which although less grievous then the matters you're talking about, still ruin peoples' lives on a daily basis.

Obviously, the inhumane conduct you (and others here) talk about needs to be stopped. And I've always supported those who have been fighting to put a stop to it. But I've always had this ongoing niggling concern that, in the course of remedying those evils, the lesser evils that afflicted me, and still afflicts many others, may get neglected, and be aloud to persist. Because they aren't as visable; they aren't as shocking to people who discover them; and, IMHO, there is much less noise being made about them. Perhaps rightfully so. But it's hard to not have a sore spot for the wrongs you've personally endured, you know?

[chibam]

---

@maddison wrote:

@Willy 

Safe, affordable, easily accessible housing.

Mental health crisis would be solved overnight.

---

Quite so, @maddison .

But, to reiterate some stuff I said on one of the group chats did come weeks/months ago, for some people, a home is made out of bricks and mortar, for others it's made out of people.

So I think there needs to be a keen awareness, and constant public acknowledgement from our leaders that, in the interest of addressing the homelessness crisis, some people might need to be given a building; others will need to be given a family.