Ms. Fay, many of your criticisms of our mental system are valid. There is over-diagnosis, sometimes enabled by DSM 5 criteria that can be interpreted broadly, or mis-interpreted. But there are two long-standing strengths that could be tapped to bring us to a Recovery Mental Health system. Because the first has been neglected since the 1980s, the second is not as effective as it could be. In the early 1970s I was one of many who implemented the radical Community Mental Health System. We were helping patients live in the community, connect with family and other resources; we provided community residences, community-based crisis intervention services, including suicide prevention. Part of my role was to partner with police to provide crisis intervention that could prevent criminalization, prevent re-hospiatlization, or ensure short term stabilization with planful return to the community support network via the Screeening-Linking-Planning Conference method. We were demonstrating success, but by the late 1980s, we were losing the funding to sustain our community-based system. The public did not understand mental health, or how critical our budget was. And voters supported political candidates who did not care about mental health like the Kennedy's had. So gradually our new, efficacious system degraded. That was right about the time our second strength came along: Evidence Based Practices. As we were losing funding, our scientist-practitioners were finding cognitive-emotional-behavioral treatment methods that worked when matched to the right diagnoses. And though you may not want to hear this, there were also new medicines that were more effective with fewer side effects. We knew what we were doing, but there was no political will amongst voters or amongst politicians to follow-through. So today you're free to criticize, and you think you've got a new way, "Recoverey Mental Health". I really wish we had you with us back in 1973.
Your experience and all you’ve done is amazing. Thank you. I’ve read about the radical Community Mental Health movement and it’s truly something we should be continuing. Thank you so much for reading and sharing here.
Thanks for sharing. I've seen the psychiatry field as akin to the metaphor of the blind men and the elephant. If we focus exclusively on brain biochemistry, or parenting, or one's cognitions, or the social environment, we miss the big picture of the whole person -- and opportunities for recovery.
I have been disabled my whole life with multiple disabilities. The mental health peer advocacy is different animal than the general disability advocacy that I do now. In my mental health it has always been about fixing/curing the person. I don't want to be cured I want a society that provides adequate supports for all disabilities. And doesn't criminalize individuals with mental health disorders.
Thank you for this important history and perspective.
I particularly resonated with your point that personal recovery is harder to measure than clinical recovery – but just as important, if not more.
Shmuel! I just saw you on Notes. It’s so, so good to see you. And personal recovery really is harder to measure.
Yes, I'm back there (for now).
Great to hear back from you again too, and of course I've been following along your great work on both of your Substacks!
Ms. Fay, many of your criticisms of our mental system are valid. There is over-diagnosis, sometimes enabled by DSM 5 criteria that can be interpreted broadly, or mis-interpreted. But there are two long-standing strengths that could be tapped to bring us to a Recovery Mental Health system. Because the first has been neglected since the 1980s, the second is not as effective as it could be. In the early 1970s I was one of many who implemented the radical Community Mental Health System. We were helping patients live in the community, connect with family and other resources; we provided community residences, community-based crisis intervention services, including suicide prevention. Part of my role was to partner with police to provide crisis intervention that could prevent criminalization, prevent re-hospiatlization, or ensure short term stabilization with planful return to the community support network via the Screeening-Linking-Planning Conference method. We were demonstrating success, but by the late 1980s, we were losing the funding to sustain our community-based system. The public did not understand mental health, or how critical our budget was. And voters supported political candidates who did not care about mental health like the Kennedy's had. So gradually our new, efficacious system degraded. That was right about the time our second strength came along: Evidence Based Practices. As we were losing funding, our scientist-practitioners were finding cognitive-emotional-behavioral treatment methods that worked when matched to the right diagnoses. And though you may not want to hear this, there were also new medicines that were more effective with fewer side effects. We knew what we were doing, but there was no political will amongst voters or amongst politicians to follow-through. So today you're free to criticize, and you think you've got a new way, "Recoverey Mental Health". I really wish we had you with us back in 1973.
Your experience and all you’ve done is amazing. Thank you. I’ve read about the radical Community Mental Health movement and it’s truly something we should be continuing. Thank you so much for reading and sharing here.
Thanks for sharing. I've seen the psychiatry field as akin to the metaphor of the blind men and the elephant. If we focus exclusively on brain biochemistry, or parenting, or one's cognitions, or the social environment, we miss the big picture of the whole person -- and opportunities for recovery.
In my Substack I focus on a particularly misunderstood condition, and how limited views about it have blocked progress to recovery. https://drsullins.substack.com/p/not-hysterical-just-regretful
I have been disabled my whole life with multiple disabilities. The mental health peer advocacy is different animal than the general disability advocacy that I do now. In my mental health it has always been about fixing/curing the person. I don't want to be cured I want a society that provides adequate supports for all disabilities. And doesn't criminalize individuals with mental health disorders.