No simple answers.
This article is by Michael Friedman.
I have read many things by this author and often disagreed. This is worth reading though and thinking through whether you agree with all of it or not.
What I got was this:
Saying the system is broken implies it was once not. It has never worked.
Beware simple answers. Anybody who tells you it is just about one thing is wrong. There is not a mental health system. There are many many mental health systems that are tied to many levels of government and private efforts. Much of what it is has to do with who pays, how much do they pay and what they pay for. Many things that don’t necessarily work well are well paid for. Other things particularly if they fall outside the narrow purview of “medical necessity” are either not paid for at all or poorly paid at best.
Even more than that mental illness (feel free to substitute any word that meets your standards of political correctness… Mental illness is his term) is not one thing. People believe if they can call a bunch of things one thing it means they are all that one thing. It is perhaps the largest of human conceits and a major source of human misery. The author talks about what we call mental illness as being different groups of people at different points in life dealing with different circumstances with differing degrees of difficulty with differing needs and challenges. To look at it all and see only one thing is to be like the blind man with the elephant who knows that the elephant is nothing but it’s tail because that is all he has touched.
And because it is not one thing it is not just about one thing…
For some people it may be about treatment but it is not just about treatment…
For some people it may be about medication but it is not just about medication….
For some people it is about trying to survive meds that are more problematic than the problems they are supposed to solve….. But it is not just about that.
For some people it is about peer support and recovery…. But it is not just about that..
For some people it is about not being able to access the help they need and finding out something bad can become something terrible… But it is not just about that.
For some people it is about being in a system that disregards their human rights supposedly in their best interest… But it is not just about that.
For some people it is about trauma and injury… But for others it is not.
For some people it is about finding out that the diagnosis they have been given changes the way others treat them and the way they treat themselves. But it is about more than that.
For some people it is about trying to make it through the day alive…. But thank God for most it is not.
For some people it is about hunger and poverty and homelessness… But for many it is not….
And for some people it is about being put into categories that have nothing to do with them and treatment that hurts more than it helps and being told by a system that failed them that they were the failure. But for some people it doesn’t.
I don’t know that the author would agree with everything I said but I don’t know I agree with everything he has said either.
He says there will be no major transformation of the mental health system. It is too many things and trying to do one thing isn’t going to touch much. Mental health is about far more than the mental health system is about. It is about life and no treatment, no therapy cures life.
The article is long but worth trying to read. Dont expect to agree with everything but do expect it will make you think.
It did me.
He left some hope. Perhaps we can’t make it “good” but I think he believes we can make it better. And I do too.
That’s where I want to leave it. There is hope. What we do matters. And a better today is our best hope for a better tomorrow.