Sep 12, 2012

Ordinary folks and the next big idea for mental health

When expert systems have no capacity to help, ordinary people can pitch in. It can work for mental health the same as for anything else. That's the message I've been trying to convey in this blog for the past few months. It's the same message Vikram Patel has for us in his recent TED talk.

I want to make mental illness accessible to the general public, and give ordinary people something to do about it. There is untapped capacity to deliver results below the level of our formal treatment systems, capacity that can change the whole experience of mental illness in America.

  • People in churches, schools and workplaces can learn what they need to about mental illness, and possibly even pick up a few things to do about it, in a couple of hours, sometimes less. 
  • Nothing prevents the mental health field from popularizing itself, other than its own self-imposed rules and culture. 
  • Ordinary people have always been mental health’s reformers, and they have always used the widest-reaching  popular technology of the day. Clifford W. Beers was cutting-edge. 
  • Another challenge for the mental health field is a culture focused on scarce and shrinking resources. The field has been stuck on doing less with less for decades. Even advocacy groups have chased money that comes with too many strings and interferes with true “consumer protection.” 
I believe the greatest opportunity for improving the lives of people with mental illness lies in building the strengths and capacities of ordinary non-expert people in communities across the US. We need solutions that bring recovery and successful living with mental illness within the skill level of the mass of society. We need to de-emphasize experts and allow people to support each other (as they have indeed been doing, under or above the radar, in every culture, since the dawn of time). 

We need something that delivers broad social impact at low cost or free, exactly what AA did for sober recovery.  That’s the focus of my current work. My book Defying Mental Illness focuses on how to create success instead of having one’s illness, and helps family members support people they love. The Redesigning Mental Illness blog project focuses on systems change efforts and developing skills within communities. I even have a stripped-down mini-support group concept that lets anybody support another’s mental health (or overcome other challenges). 

All my work is consensus based, and strength-based, and designed to bridge the factionalism that has plagued this work.  We need a modest infrastructure that supports broad-based social inclusion initiatives, the only kind of anti-stigma effort that actually works.

Those are my ideas – but I know that others across the US have other ideas, and the capacity to implement them. I support a social innovation model developed by NESTA in the UK called “radical efficiency.” It delivers new solutions that are different and better and lower-cost, not less-for-less or same-for-less. The basic principles of radical efficiency are:

  1. Make true partnership with users the best choice for everyone.
  2. Enable committed, passionate and open-minded leaders to emerge from anywhere.
  3. Start with people’s quality of life not the quality of your service.
  4. Work with the grain and in the spirit of families, friends and neighbors.
  5. Manage risks, don’t just avoid them.
One of the programs identified in NESTA’s report is Mental Health First Aid. I think that community-based, peer-delivered, non-medical brief respite fits in this mold, as do restorative justice programs in homeless shelters, as do many other sorts of diversion and health education initiatives. 

So take a look at Vikram Patel's video. What's your big idea for really changing the experience of mental illness in America?

1 comment:

Mental Disorder said...

Realize that you cannot know the tests until you determine the psychophysiology of the mental illness.Thanks!!