This past weekend, I returned from an international conference called “Selling Sickness, 2013: People Before Profits.” The audience included academic medical reformers (the majority of whom were from the world of psychiatry), consumer activists, and health journalists–and a few, well maybe only one, former state mental health commissioner (me) who had never attended this conference in past years.The title well fits the reinforcement of my growing understanding of how not just the mental health field but medicine in general has been permeated at every level by an exclusive focus on “return on investment.”Read More
TWO New York City researchers, Pat and Jake Cohen, undertook a very interesting study in the early 1980s. Both were statisticians in two different departments of psychiatry in the city. Together, they had written one of the primary textbooks on multivariate analysis. In another collaborative study, they looked at the composition of physician caseloads, including, but not limited to, psychiatry. What they found was startling.Read More
Don’t throw the baby out with bathwater – even if it’s the baby that peed in the tub!
When we first realize that something is wrong – the water is yellow! – it’s all too easy for the next phase of chane to be a reflex reaction. Toss the water and there goes our baby. But what if we took the time to really understand the nature of the problem – and found it’s the baby that contaminated the water!Read More
Language appears to be one of the most accessible and simplest changes to make within a system to address recovery orientation. A person seeking care can say, “I prefer to be called a consumer!” An organization can switch out “consumer” for “guest” and feel better about how it thinks everyone will perceive the human experience before them.
Although a change of vocabulary may not reflect a true systemic change of practice, it is a valuable outlet for our urge to truly see one another and it can help us uncover a deeper issue.Read More
Most of us know all too well about the field of mental health having a middle name: Divisiveness.The Freudians fought with the behaviorists. The psychiatrists have often found conflict in their work with psychologists and social workers and counselors. Of course, the psychologists and social workers don’t always get along either. More recently there has been the professional vs “paraprofessional” or peer-delivered staff conflict.Read More
A long time ago in a galaxy far away, I was a nurse at in the neurosurgical unit at Boston’s famous Children’s Hospital. One afternoon, we received a semi-comatose patient named Charlie in our ICU. He was 15, and apparently a really good kid from a terrible neighborhood in Roxbury, a section of Boston next door to us. He and his best friend had found a gun in a trash can. They thought that they had checked the gun barrel for bullets and proceeded to play a game of Russian Roulette. The friend put the gun between his own eyebrows and pulled the trigger.Read More
Welcome to my new “Recover, Revitalize and Restore” blog, a place to open conversation and connection to remove the obstacles that we find are blocking mental health excellence in our systems, persons and culture.My passion for this topic grew to a burning need while working to connect with a guest in a Community Mental Health Center Residential facility who had struggled with the system for over twenty years – he was rejected by many, not trusted and forced to hide who he was in order to navigate the system that was supposed to be “helping”, but actually further traumatized and dehumanized him. While working to advocate for him and provide relationship-centered care, which to me translates as a true recovery mentality, I ran into the full force of the barriers that our systems present. I had already experienced these firsthand while providing care in hospital settings. In the ensuing time, however, working within a therapeutic community, advocating for eating disorder parity and education, being trained in psychodrama and experiential therapy, and adopting the personal contemplative practice grounded in the teachings Thich Nhat Hahn all fueled my belief that there is another answer and we really can provide hope and healing. The agency I work in was willing to try a new approach, so I began searching for other places and models to meet the needs I saw.Read More
One of the Foundation’s Board Members, Dr. David Healy, has written a powerful book, Pharmageddon. If you Google the title, you’ll find that on Amazon.com, it is paired with Bob Whitaker’s Anatomy of an Epidemic and I believe that is for a good reason. Both are well-documented books that anyone in the field of mental health should read and come to terms with. For that matter, everyone outside the field with an interest in modern medicine should put it on their reading list and get to it sooner rather than later. The issues raised are that important.Read More
I want to talk briefly about “recovery.” Many clinicians and program directors were trained, as I was, to think that regaining marginal improvement or downward course were the only two options open for persons with repeated episodes of serious and persistent psychiatric problems, such as the group of schizophrenias, major depressions, or bipolar disorders. However, there have been over 30 follow-up studies, both short and very long, as well as hundreds of former recipients of services all displaying carefully collected data and brilliant examples about the possibilities of significant improvement and even full recovery.Read More
The Foundation’s “tagline” is “Recovery…The New Mainstream.” I’ve thought about this for a while and began to consider what is meant by it if we were to break it down into a list of features. In a variety of conferences, seminars and informal discussions, we have all been part of a re-thinking of psychiatry and mental health concepts. But there’s been no distillation of what the new mainstream would look like, where it flows, where there are waterfalls, and where the rapids might be on the map. What I’ve tried to do in this first blog is an attempt to outline what I hear us talking about in this more detailed description of 12 features of “Recovery…The New Mainstream.” Just like Bob Whitaker’s intent in writing Anatomy of an Epidemic, my hope is that this listing will stimulate a continuing dialog about what we’re after. There will be agreement on some and maybe all of these; disagreements, additions, deletions, and clarifications–and that would be the purpose of this effort at mapping. Here they are:Read More