Robert Whitaker’s book, Anatomy of an Epidemic, has provoked all manner of responses. Some outraged, dismissive, but many supportive and relieved to hear the clear voice given to concerns that many have had for years. To keep the momentum going the website (madinamerica.com), was established and greatly enhanced over recent months. I find that I read the blogs and news daily. It has become a “go to” spot to find information consistent with what so many of us have known the evidence and our personal experience to show.
While many of the blog spots focus on the untruths of chemical imbalances, the problems with psychiatry, Big PhRMA, etc. there has not been as much focus on where we go from here or “next steps”. Let’s agree that the story Bob and others are telling is true. What do local systems of care do with this information? How do we go about undoing a mental health system whose fundamental assumptions are false? What’s the best way to remake a system of care based on what we do know?
It is to this end; Bob has graciously agreed to allow me to post about the work going on in Ashland County Ohio. I have the great pleasure of working for what Ohio calls a “Mental Health Board.” Boards represent all 88 counties in the State and were statutorily created to be the local, planning, funding, monitoring and evaluative bodies for federal, state and local mental health services. In short, Boards are in a position to make a difference.
What I hope to show over a series of postings is the work our specific Board has started, how we’ve done it, where we may have gone right and wrong, and where we think we’re headed. We’re hopeful that other policy makers with similar roles in other states who also have become convinced of the evidence written about by Bob will be able to find use in what we’re doing and apply it to their local situation. We understand that what we talk about will not “fit” for every system of care and some things you may just find silly. I look forward to reading the comments to see just how silly you think we are!
I understand for some this blog will have little to no appeal and that’s fine. Not everyone can be interested in the same things. We need the passion of the recovery stories, the advocacy blogs, the news stories and spotlight on international efforts. Bob has done a nice job giving voice to many perspectives. However, I think we need a blog for those interested in making administrative and policy changes too. We need ideas about how to pay for services that really work and are respectful of a person’s choices. We need to talk about fee-for-service versus capitated systems, productivity and paperwork.
In short, we need a blog to talk about how to make the mental health system “sausage.” For the uninitiated, yes, it really does smell that bad. We really do have to consider local, state and federal guidelines/mandates even when they seem to be counterproductive. Consideration has to be given to a County’s local politics, quality of provider network, degree of motivation for the changes we’re trying to bring about, etc. For those of you experienced in making the “sausage” that is mental health policy, I hope the blog can serve as a way to share recipes and invent new and creative ways to bring about the change we all seem to be seeking.
Why Can’t They Hear Our Truth? We Have a Cure
What a new role for psychiatrists might look like
How entrepreneurial thinking can improve mental health advocacy
Why We Need Mental Health Social Entrepreneurship
Getting From Here to There: David Ross writes about the efforts in Ashland, County Ohio to move its mental health and drug/alcohol system towards a recovery-oriented system of care, one that puts into practice the core principles of recovery, medication optimization and trauma-informed care.