Make or Break Opportunities: Providing Alternatives During a First Major Crisis

Psychiatrist and author Peter Stastny presents a keynote address entitled “Make or Break Opportunities: Providing Alternatives During a First Major Crisis” at the 2012 National Association for Rights Protection and Advocacy (NARPA) Conference in Cincinnati, Ohio. For nearly 30 years Stastny was on the faculty at the Albert Einstein College of Medicine in the Bronx and has conducted several publicly funded research projects in the area of vocational rehabilitation, social support and self-help, in collaboration with individuals who had survived personal crises and psychiatric interventions.

This is latest in a series of presentations filmed at various mental health conferences around the world, which will be featured on


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. The only thing that puts me off watching this presentation is its mention of alternatives ‘during a first major crisis’. For I want to see alternatives for any and every crisis in mental health. Rather than the use of compulsory/forced treatment or ‘grabbing and jagging’ for people who don’t want to take the psych drugs.

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    • Chrys, I couldn’t agree more! And about 3 years ago I’ve had a short exchange with Peter Stastny on the matter, . However, today, after 2 years of working with people who’ve been (additionally) severely victimized, infantilized, traumatized, and brainwashed by the system, apart from also being physically/neurologically more or less severely damaged by long-term drug use, I would also agree with Peter Stastny that the “window of opportunity” unfortunately often is a lot more closed for people who’ve been in the system for years, or even decades, compared to the window of opportunity of people, who experience their first “break”. It needs a somewhat different, much more complex, approach, a lot more support put in place, and a rather profound knowledge about psych drugs and withdrawal than what for instance the original Soteria House can provide to help these people. Nevertheless, I still think, access to the “first break”/”young people” approach shouldn’t be restricted to people who are actually experiencing a first “break”, and are “young”. In my own case for instance, not even the 24/7 intensive Soteria House approach was required. To me it makes a lot more sense to distinguish between people who are hooked on the drugs (and would need a sophisticated withdrawal program), and have swallowed the system’s messages hook, line and sinker, and those who are/have not. No matter how many “breaks” they’ve had in the past, or what their age. It isn’t necessarily one’s age or the number of “breaks” which determine how open the window of opportunity is. In spite of several “breaks” in the past, and 42 years of age (certainly not “young” anymore), mine was wide open, while I would have been turned away (and drugged up by the traditional system) by any kind of help that used “first break” and “young” as its access criteria. Luckily my therapist didn’t use these criteria, but used “motivation” as hers.

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      • Thanks Marian. I know what you mean about folk being brainwashed by the system’s mantra of mental illness. I’ve come up against many folk like that here in Scotland where my previous complete recoveries from mental ill health, hospitalisation and psychiatric drugging are some sort of threat to their belief system or ‘religion’. As if I shouldn’t speak of my journey in and through the system.

        The problem with this focus on ‘first episode psychosis’ is that it reinforces the mental illness mantra and doesn’t do the recovery agenda any favours. I know that governments have hijacked recovery, I think to reduce the folk on benefits, the folk who have been told by psychiatry that they have a lifelong mental illness. But we need to reclaim recovery and make it our own again, on our own terms.

        There’s a skirmish going, as I see it, between the government and psychiatry, although it’s cosmetic. Service users are involved, in government positions, walking a tightrope between the devil and the deep blue sea. For government don’t want to reduce the social control aspect of psychiatry which gives a (false) sense of security to society. As in, the mad people are locked up therefore we are all safe. When in fact the mad people are everywhere, living next door to us even.

        And then there’s the potential avalanche of people who have been on long term psychiatric drugs, coming to the realisation that they have been conned. The labels have disabled them via the drugs. There’s no such thing as lifelong mental illness and so the mind altering brain chemicals (anti-psychotics, anti-depressants) weren’t really needed or were anti anything. Compensation claims could be never ending.

        Many of the psychiatric survivors over the years just went back into society and kept quiet, got on with their lives, never talked about their recovery and narrow escape from being sucked in to the lifelong mental illness mantra. Their psychiatric labels sit hidden in their medical notes, only coming back to haunt if they happened to have another episode in the future. Like I had in 2002, aged 50, at the menopause, 18yrs after a previous engagement with psychiatry.

        I seemed to recover quickly from the episode, hospitalisation etc, then had a relapse from getting better too quickly, from which point the system kicked in, I was given a cocktail of psych drugs, labelled and told I had the lifelong thing. Eventually, out of the fog, I managed to take charge again of my mental health and recover, but it was a battle, and I’ve been fighting ever since. Also on behalf of my sons who have been tarred with the same brush, as in “family history of ….”. Biomedical model, genetic nonsense and false labels that stick like glue.

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  2. I keep wondering where the “first episode” people are at because in two years of working in the Admissions Dept. of the hospital where I’m employed as a peer worker I’ve never met a person experiencing their fist episode, as it’s called. My hospital is filled with people who’ve been there numerous times, some as high as 30 visits. We need to turn these psych hospitals into places where people can be helped to taper off the toxic drugs and can learn life skills, since many of them have been in the system since they were kids and have never worked or taken care of themselves. I don’t think a Soteria House would be of any great help to my people. But, of course the hospitals will never be turned into places of real healing and well being. People are brought in against their will, shot up with the drugs, and then taught to once more repeat the mantra that they were given long ago: “I have a chemical imbalance. I am ill for life. I need to take my meds.” This insures that they will be back again for their uptenth “episode” assuring that the quack pychiatrists and staff will have job security and they’ll all be able to pat themselves on the back and tell themselves that they’ve done a great job of “helping” people deal with their illness! It’s not only sad, it’s totally disgusting.

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  3. I appreciate the reasonable expectation for alternatives for everyone at every stage. Nevertheless, I still feel the sense of betrayal to discover that our daughter, whom we cherished, had become devalued the moment she walked through the psych ward door to be subjected to barbarism. We thought we lived in the shadow of ‘world class” medical professionalism; We were betrayed. It hurts to recall who she was and how she was torn from us, how our protective agency was neutralized while staff were licensed to brutalize our sweet daughter. I can’t turn back the clock. Supersensitivity may have set in already. She does need a chance to wean from the levels of medication she is using which are going to kill her. But, we’ve got to turn off the “machine” so it doesn’t keep pulling people in , like a corn chopper without a safety switch.

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