Challenges and Visions for the “Mental Heatlh” System


I envision a world where there is no need for a mental health field/system because communities are strong and we have a holistic understanding of health. Still, there are definite needs for support at times in life when there are transitions, spiritual breakthroughs and loss (amongst other things), and for some of us these times may be more frequent, even constant. Since we are all unique individuals, the most important elements of a support system are personal choice and respect for diversity while keeping the needs of the community in mind.

Currently the system rarely acknowledges how mental diversity strengthens community. Instead it isolates individuals by labeling them with disorders, which is not a holistic or community strengthening practice. Community strengthening needs to value all characters in a community, including the hermit, artist, visionary, or person who’s strongest place is in solitude. History confirms that hermits, spiritual seekers and prophets return when it is the right time and have tremendous gifts that live on well beyond their lives and support the spiritual strength of future generations. I like the Open Dialogue model, which brings the whole family and/or community into the conversation. Choice is key in supporting someone since what will help one will harm another and vice versa. The old adage, “First Do No Harm” must be brought back as currently the first course of treatment is psychiatric drugs which do harm even if in some cases they suppress “symptoms.” Harmful substances and behaviors (legal or illegal) might always be part of the picture but the system itself advocates practices that cause obvious harm (psychiatric drugs and electroshock therapy, among others) while criminalizing and pathologizing behaviors that cause less harm (other drugs, certain harmless extreme states like hearing voices that are positive, spiritual or supernatural).

These are the primary challenges in the system, a paradigm that focuses on pathology and not root cause, strength building or choice. There are also many tools in place that can and will be used to overcome these challenges such as peer support, WRAP plans, advanced directives, Open Dialogue and similar methods, holistic health care, and health insurance (access and coverage for wider options need to improve).

There is a need for centralized “top down” support and, just as important, a need for grassroots organizing and anarchistic change on a small scale. This means people connecting with their local communities in simple ways, going back to basics and common sense- sharing meals, connecting with the earth, valuing and making space for creativity and other simple things that make a big difference.

Perhaps the greatest cause of what we call mental illness is the mental health system itself, for our challenges are not respected as sacred passageways in this model. What I would like to do is continue to create bridges, roadways, bike paths, foot trails, and road maps between the alternative, life serving systems being developed on a large scale and the organic communities of neighbors, friends, families and co-workers. In this time of so much technology, we have challenges in reconnecting intimately with each other, as well as more hope than ever for learning across borders and advancing our capacities to learn from, grow with and value each other. And that means all of us.