The Relationship Between Systems Change and Being Present with Others


If you’ve come here to help me, you’re wasting your time. But if you’ve come because your liberation is bound up with mine, then let us work together.

— Lilla Watson

Man cannot be one thing in one area of his life  and another thing in another area of his life.

— Mahatma Gandhi

Despite the hiring of peers, the mental health system still has not implemented the recovery and trauma-informed values advocated by both SAMHSA and by people with the lived experience of mental health recovery. The New Freedom Commission (2003), Olmstead Decision (1999), and IOM Report Crossing the Quality Chasm (2006), have all called for a transformation of the mental health system from a focus on maintenance to a vision of recovery of a life in the community but the old system chugs along increasingly out of touch with common sense approaches that inspire hope, self-determination, empowerment and so much of what every human being longs for.

Person-centered planning requires a system-wide shift in communication, as well as adaptation of recovery-oriented, trauma-informed values. Tomorrow, Dan Fisher, W. Reid Smithdeal and I are offering a free webinar that will provide administrators, managers, providers of mental health services and others with some essential communication tools needed to transform their systems to being recovery-based, trauma-informed and empowerment focused. A system-wide shift in communication is needed and we must move away from the hierarchical, one-size-fits-all way of thinking to instead practicing mindfulness and presence with every one… We are changing the conversation and re-defining mental health service and support delivery systems. And for that matter- we are moving beyond systems to community building. However, for the purpose of this webinar we will focus on transforming mental health and behavioral health systems.

The webinar will use Emotional eCPR (eCPR), a primary prevention public health education program that teaches anyone to support another person through an emotional crisis as a foundation for how to bring about a fundamental shift in our culture – be it organizational culture, or family or community culture. The principles and dynamics are transferable anywhere. eCPR is a powerful tool for enhancing interpersonal communication and cultural empathy. It teaches everyone how to implement the values of recovery on a one-to-one basis. What is instilled on the individual level has ripple effects on the group level and on the system level. Speakers will discuss how some of the components of eCPR are being taught in community mental health centers enabling providers to embody the values of recovery such as the importance of every voice, of respecting the whole person, of being nonjudgmental, and of sharing one’s humanity with persons in distress.

We need to bring compassionate listening into our conversations and open up the dialogue, welcoming different perceptions because that is how we build alliances and heal and grow as a community, as an organization, and as a human being.

We will address the chasm between “staff” and “persons served.”

We will wrap our minds around the concept of the wounded healer, of leveling the field and respecting that we are all teachers, we are all students, and we learn together.


Daniel B. Fisher, MD, PhD:  who co-founded the federally funded National Empowerment Center and serves as its executive director. He was a commissioner on the President’s New Freedom Commission on Mental Health, 2002-2003.

W. Reid Smithdeal, MSW, LCSW : the Recovery Services Manager for Meridian Behavioral Health Services where
he coordinates clinical services

Lauren Spiro, MA: . A schizophrenia survivor, associate director of National Coalition for Mental Health Recovery and author of Living for Two: A Daughter’s Journey From Grief and Madness to Forgiveness and Peace.

* * * * *

Click here for instructions for joining the webinar, June 4, 2014, 1:30pm – 3:00pm EDT, (12:30 CDT, 11:30 MDT, 10:30 PDT)



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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Lauren Spiro
Lauren’s vision of social justice and mental health liberation focuses on developing our capacity for feeling deeply connected, appreciating the vast creative intelligence of the human heart and mind, and inspiring compassionate action. Her life’s mission is to embody inner peace to co-create global peace, thus she curates transformative learning experiences. She co-founded two non-profit corporations and Emotional CPR ( a public health education program that teaches people how to support others through an emotional crisis. She is a multi-media artist, a 20+ year practitioner of yoga and meditation, the first Director of the National Coalition for Mental Health Recovery, has been featured on national media, and consulted on numerous federal projects. Her memoir paints a poetic picture of her journey into madness and her pathway home. She has an M.A. in clinical/community psychology. For more information see


  1. This should be taught not only to mental health providers but also to cops and other people who often are “first responders” for people in emotional distress and usually are responsible for part of the trauma in psychiatric surviviours. Personally, I had better experiences with cops than with psychiatrists (but for one incident) but I’ve heard many stories of people being mistreated even before they got to the hospital.

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  2. Thank you for working to bring about change, Lauren. I hope it happens. Believing the DSM stigmatization system is a “bible” created the worst form of “religion” the world has ever known – one that believes picking out and making up flaws in other human beings and treating others in the antithesis of how you’d like to be treated is “appropriate medical care.” Defaming and torturing other human beings with mind altering and damaging drugs has nothing to do with proper medical care. I hope the psychiatric practitioners overcome their “delusions of grandeur” and god complexes. It was truly insane to deal with them.

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