From Protesting to Taking Over: Using Education to Change Mental Health Care

Ron Unger, LCSW
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As we develop critical awareness about the mental health “treatments” that don’t work and that often make things much worse, the question inevitably comes up, what can those who want to be helpful be doing instead?

I believe that one key to successful change is going to be making effective training in alternatives widely available, so that those working in the field who hear our protests and criticisms with an open mind will be able to get support in then transitioning to doing things differently.

One example of an initial effort in that direction is an “online conference” I’ve help produce titled “Therapy on the Wild Side – Depathologizing and Working with “Psychosis” and Extreme States of Consciousness”  Through this conference, professionals in the US can earn continuing education credits while learning methods like Voice  Profiling and Voice Dialogue, discovering how to use understandings from the field of hypnosis to work with altered states within “psychosis,” and becoming able to frame altered or extreme states as human and sometimes even helpful, rather than as definitely “illness.”

I’m hoping that in a few years, it will be possible for people all over the US to easily learn ways of helping that are both respectful and likely to lead to long term improvement.  Such forms of helping may include everything from setting up peer self help such as that provided by hearing voices groups, to one on one support such as the better forms of therapy, to more systematic/team approaches like Open Dialogue and Soteria houses.  Only when we have lots of people thoroughly educated in what to do differently will we be able to “take over” the mental health system and then more consistently provide real help instead of oppression to those who are distressed!

My personal mission is to be a part of making such education happen.  This mission has evolved out of my own experience of first having my own encounter with “extreme states” and seeing family members with similar states get mistreated by the system, then getting involved in protest, then learning to be a mental health provider so I could start developing and offering something better, and then becoming an educator so as to inspire others do something different as well.   (My personal story is available in more detail here.)

For about a decade, my educational efforts have involved providing seminars at various locations mostly on the west coast (and also graduate school teaching at PSU):  but these only reach people who happen to be available at the right time and place.  I’d like to reach a much wider audience, and also help other educators of like mind reach a wider audience as well.  I believe web based education may be one good way to get this going on a wider scale.

It does seem we may possibly be at a point where “the tide is turning.”  I was struck by a comment I received last week, made by someone who attended one of my seminars a few months ago.  She had been quite critical of my views during the seminar (which was on ethical dilemmas around possible treatment induced harm), and said she believed me to be a “crazy man” at the time!  However, she was provoked by some of the things I had to say, so she decided to read “Anatomy of an Epidemic.”  Then she wondered if she should trust that what she read was a fair review, not cherry picking etc., so she turned to a psychiatrist she knew for an “expert” opinion.  Then, in a surprising but hopeful (for us) turn, the psychiatrist both read the book and acknowledged it was basically correct, he admitted that people start taking the drugs and then get stuck on them, etc.  The end result was that my formerly very critical student decided that these issues were so important that “Anatomy of an Epidemic” would now be required reading in the classes that she herself teaches!

It is the possibility of such “domino effects” that gets me excited about the possibilities of more widespread progressive education for professionals.  The “system” is not entirely a monolith, and changing the perspective of some people changes the treatment those individuals provide, and also changes how they in turn educate others.

Anyway, you should be hearing more from me about this education piece in the future!  In the meantime, here’s some more about the currently offered online conference:

Hearing voices can be experienced as bizarre and disorienting, so it often seems to make sense to try to suppress the voice or distract attention away from it.  Unfortunately, this is often ineffective, and efforts to suppress the voice may inadvertently suppress the person or increase problems overall.  Two presentations in this conference address an alternative approach which involves studying the voices (voice profile) and exploring the perspective of the voice (voice dialogue).  The presenters for this part are Ron Coleman, Karen Taylor, and Rufus May, all of whom are leaders in the international Hearing Voices Movement.

“Psychotic” or extreme states seem to involve “dissociation” but so do the deliberately induced altered states such as those involved in hypnosis.  Gabrielle Peacock, MD from Australia is trained in Ericksonian hypnosis, but you don’t have to be a hypnotist to learn and benefit from her approach of working with extreme states as a form of spontaneous trance.  I think you will enjoy her methods, as they honor these individuals abilities in ways that shamans or witch doctors do in other cultures, so as to “bring clarity, enlightenment and peace to an individual who feels lost in our western world devoid of such useful cultural guides.

My presentation in the conference is called “Understanding Extreme States and “Psychosis” as Attempts to Solve Problems:Integrating Perspectives on Trauma, Spirituality and Creativity.”  I focus on how to shift away from attempts to suppress “psychotic” experiences (efforts which often backfire), and instead explore ways of understanding and making peace with such experiences.

There are other presentations as well.  You can hear more about the conference and the speakers, as well as check out some previews of what is offered, on the conference website, where of course you can also register!  Once you register, you can access the presentations whenever you want, or download them to your computer.  6 CE credits are available as well, for no additional fee.

I hope you check it out!  Let me know about any questions you have.  And if you want to register, don’t procrastinate:  this conference is likely to be available for only a few weeks.

Also, please do contact me if you want to discuss or to be involved in other online educational efforts.  I hope to have some of these be both live and recorded, and they can include things like interviews, panel discussions, role plays of actual treatment, etc.  I’m currently very involved in studying the technology and methods of internet education, and I hope to make what I learn available to others in our movement.

13 COMMENTS

  1. Look whats going on now.

    Charges were 2.5 times higher than the hospitals’ reported costs to deliver care. Reimbursed amounts indicated by MarketScan were similar to the reported costs to deliver care. The average cost to deliver care was highest for Medicare and lowest for the uninsured: schizophrenia treatment, $8,509 for 11.1 days and $5,707 for 7.4 days, respectively; bipolar disorder treatment, $7,593 for 9.4 days and $4,356 for 5.5 days; depression treatment, $6,990 for 8.4 days and $3,616 for 4.4 days; drug use disorder treatment, $4,591 for 5.2 days and $3,422 for 3.7 days; and alcohol use disorder treatment, $5,908 for 6.2 days and $4,147 for 3.8 days.

    http://www.ncbi.nlm.nih.gov/pubmed/22588167

    Maybe if alternatives are cheaper someone will listen.

    • In 2009, UHS generated a net income of $260.4 million on total revenues of $5.20 billion. This represents a 30.6% increase in net income on a 3.6% increase in total revenues from 2008, when the company earned $199.4 million on revenues of $5.02 billion.

      Behavioral Health Services (25% of revenues): This segment consists of 102 centers, including residential facilities for teenagers, psychiatric hospitals, and substance abuse hospitals. Because average patient stays at these facilities are longer than in traditional hospitals (15.4 days in 2009 compared to 4.4 days in UHS’s hospitals) and their occupancy rates higher (73% in 2009 compared to 58% in UHS’s hospitals), Behavioral Health has much higher profit margins than its sister segment.

      http://www.wikinvest.com/stock/Universal_Health_Services_%28UHS%29

      I was mistreated in a UHS hospital , that lead me to MIA. This site is dedicated to all the people who were harmed or killed in UHS facilities. They speak for those who have no voice, to protect others from experiencing the pain they endured.

      http://watchinguhs.wordpress.com

  2. Why on earth do you want to “take over” or even replace the “mental health” system with another
    collection of “professional” overseers? The entire system is a rotting and corrupt carcass. Yes, we
    need to go beyond protest, to ignoring that system altogether!

    • To heal from “lacking in validity” disorders, I agree, one does need to ignore “the system.” As to how to fix a broken system, I still believe a lot of people went into health care to actually help others. But you also have those who only went into it for the money, power, and prestige. There are ethical and unethical within the medical profession.

      It strikes me the psychiatrists, and some of the psychologists, have largely rendered themselves “irrelevant to reality,” due to their belief in not listening to the patients’ actual problems, but instead just defaming patients with unscientifically proven “disorders” and tranquilizing patients, based on lists of “irrelevant to reality” DSM symptoms.

      Plus, I think overcoming my disgust at the betrayal of people claiming to be from medical professions promising to “first and foremost do no harm” may be somewhat similar to overcoming the betrayal of paying for an education within a completely fraudulent medical specialty. But I do hope some of those within those medical specialties will become enlightened, and realize the error of their ways.

      Please try to enlighten them, Ron. And please remind them that force medicating people for concerns of child abuse (with medical evidence) and belief in God and the Holy Spirit is actually unwise, and illegal in the US. Apparently some psychologists and psychiatrists in this country aren’t intelligent enough to understand such crimes against patients are actually illegal in this country. Thankfully, that is not true of all in the medical community.

  3. Ron — I readily agree with you that the system is not entirely a monolith, it’s also a pernicious fungus, and poison will, and a web of lies. But, all that aside, Wayne’s choice of words–“Being the change you want to see” and perhaps that you can foresee, to some extent, pays off in your persuasiveness.

    I really respect your intentions and believe that theoretical groundwork eventually will get laid that bolsters such innovations. Getting this academic community and these professionals to work toward such integration is definitely also an offshoot of dynamic efforts like you have hopes of implementing.

    Without hearing voices myself, I can say that the language you are putting to your approach appears rich enough to accomodate objectivity for working up data sets, however informally or systematically you go about including such a purpose. Good luck and thanks for the postivie energy.

  4. This is the main thing Ron isn’t it. If psychiatry is wrong whats the alternative? ‘Peer’ is good because people that have been in similar life situations have the real knowledge, and they are motivated to help, not to exploit.

    My experience is that extreme states run out of steam, and that its what’s behind them that matters. I suffered from an underlying anxiety condition, and it is possible to do something about this. When I reduced medication, everything terrified me (I was then chemically programmed to break down).

    This was when a ‘CBT’ type approach was useful because it explained to me what was happening, and what I could do about it. When I come to terms with the raw anxiety, I think I also come to terms with old trauma too, even if I can’t say where it comes from.

    I have remained in one piece for years, so it did work.

  5. What interests me is the realization that people can heal themselves if they have a place to do it, the info they need , and free access to what they need in an environment of medical freedom and financial stability. It is underestimated and under recognized what psychiatric system survivors could bring to the table of healing others as a result of their own innovations forged through their harrowing oddesys freeing themselves from psychiatric oppression. If only they would be given a fair hearing with out being told of the necessity of double blind studies etc. which are really just ways to take science out of the hands of everyday people were it belongs, and making it instead a corporate monopoly. Wake up. I’ll take lived experience of people I judge as sincere over corporate pseudo science any day of the week .I’m starting to talk about a real revolution along side protesting ,that actually has a chance of throwing all the DSM manuals into a bonfire and leaving psychiatry in the dust bin of the history of crimes against humanity, where it belongs.

  6. I also think that the hospital hoppers that tend to enjoy trips to the ER, even the ones that are suicidal and get angry when they decide they are fine or the druggies are just going to get better at playing the game… the surveillance style health care and all that is a tad creepy to me and some come off meds at their own pace…

    this is one of those creepy programs:
    http://www.healthit.gov/policy-researchers-implementers/resources-ltpac