Tending Hearts and Minds: Changing the Mental Health Paradigm in Our Schools

Readers of Mad in America recognize that the dominant “mental health” paradigm and the biomedical and carceral regimes that deliver it have largely failed to understand, address, and improve the lives of millions of people experiencing emotional and mental distress.  A group of us in Vancouver, Canada, has been actively working to change that paradigm for nearly 10 years. We know that we have had an impact, and yet we also have also learned how difficult it may be to change the larger discussion in our society.

One of our principal concerns has been the dramatic rise in the number of children and youth being labeled, pathologized, and then funneled into the mental health system with oft-times tragic results. In response to this situation, we recently organized a daylong symposium, “Tending Hearts and Minds,” at the Central Branch of the Vancouver Public Library. This symposium for educators, counselors, and the wider public was designed to:

1. present and discuss concerns about labeling kids
2. talk about the false narrative that’s being sold to the public
3. take a closer look at the lack of evidence-based research behind the drugs being used to treat children, and
4. discuss the need for alternative approaches in working with children, youth and families—in school and at home—to respond to distress or disruptive behaviours in ways that more effectively promote well-being and resilience.

This is a concern that we have experienced in our own family.

Changing the Paradigm

Our family had a brush with ADHD diagnoses when a second-grade teacher sent letters home with the three most energetic boys in her class during the first week of school in 1986.  We were instructed to take our son to the doctor for a prescription for Ritalin to “help him succeed.”  Like fools, we went to our pediatrician, who promptly told us that if we thought he was going to drug our son into a chair on behalf of a second-grade teacher, we were to find a new pediatrician.  We were relieved and our son did well without the drugs.

About twelve years later, another one of our children had a series of experiences in junior high school which led to a prolonged low mood.  A doctor in the community (who was also our daughter’s basketball coach) reproached us, saying “No child should walk the earth with so much weight on their shoulders while there are good medications that can take care of that.”  Naively believing in his professionalism, we allowed him to “help” our son. The guilt over our ignorance and passivity about that doctor’s intervention and what followed is something from which we will never recover because it began his years’-long descent into psychiatric drugging and entry into the so-called “mental health” system.

It’s an isolating, drawn-out saga well-known in the MIA community: voluntary treatment disintegrated into a fumbling polypharmacy cascade and forced treatment.  The grotesque side effects from drugs, restraints, and solitary-confinement-induced trauma he endured were explained away as unfortunate but temporary outcomes and measures. Our protests, empirical observations, and appeals for alternatives were dismissed as ill-informed and interfering. It was as if a family member had been abducted by a malign cult mesmerized by a dogma—the myth of a “chemical cure.”  And once our family member had been sectioned under the Provincial Mental Health Act, the full weight of the state backed up whatever the mental health system prescribed. During those years, we also learned we were not alone—in clinics and psych wards we met hosts of young people, veterans, young mothers, blue- and white-collar workers, refugees, and immigrants and the elderly—distressed by personal, familial, and systemic traumas and pressures—who had fallen into the net of this coercive system.

Two events in December 2010 dramatically changed the “personal” to the “public.” A young woman we knew and cared for took her life in despair when yet one more psych drug was forced on her and wreaked havoc in her body and mind. That was it, we said; enough!  They’re killing our kids. This must stop. The drugging is insane.

At about the same time, my wife Diana discovered Madness Radio, hosted by Will Hall, and an interview with someone named Robert Whitaker on the topic of “Sane Medication Policy.”  For the first time, someone was describing our experience, and doing it based on a wealth of research, outrage, and compassion.  Learning that Whitaker was speaking in Portland, Oregon, she took a train there, heard him speak, and returned saying: “We’ve got to bring him and Will Hall to Vancouver!” And so, we did.  A month later, Bob spoke at the Vancouver Public Library to a standing-room-only audience about his work and the findings in his book Anatomy of An Epidemic.  We brought him back to speak about “Medicating Children and Adolescents” and his book (with Lisa Cosgrove),  Psychiatry Under the Influence. 

Because I am the minister of a large Unitarian congregation in Vancouver, we had access to resources (a building, meeting rooms, media, and some funding from an anonymous donor—though most events recouped costs through donations at the door) that helped us to mount a series of free public education events and programs from 2011 to the present.  Partnering for several years with the West Coast Mental Health Network, we did our best to take the lead from survivors and consumers of psychiatry in choosing events to sponsor.

We also hosted three meaningful years of community building through twice-monthly Madness Radio listening and discussion potlucks in the church basement. All of us had questions about the coercion, confusion, debilitating effects of meds, and/or humiliation of experiencing psychiatry.  We were all seeking clarity and alternatives. Our intention was to share information, the information we lacked that had led to grief in our collective loss of informed consent and the lack of humane alternatives to what we saw and experienced.

The Madness Radio archives introduced us to many survivors, academics, and alternative and reform-minded health professionals.  We invited a number of them to Vancouver for speaking engagements or a workshop at the church, public library, and/or local hospital.  Some of our speakers included:

• Will Hall, who gave a sermon at the Unitarian Church of Vancouver (UCV) on suicidality and led a workshop for teenagers on tolerating uncertainty
• Laura Delano, who gave a sermon at UCV on diagnosis and identity and led several tapering workshops
• Ron Coleman and Karen Taylor, who gave Hearing Voices Network workshops to people who work in healthcare and to people who hear voices and their families
• Ron Unger, who presented a sermon at UCV, spoke at the library and at a mental health clinic on finding meaning in psychosis and a path to recovery
• Tina Minkowitz, who spoke at the library on the impact of international law on mental health legislation
• Daniel Mackler, whose gift of putting his documentary movies into the public domain gathered enthusiastic audiences at UCV to view and discuss his films.

We soon learned that we had rich local resources on drug safety, real evidence-based research, and tapering expertise through Vancouver’s Therapeutics Initiative, part of the Cochrane Collaboration.  Our work was also greatly influenced by the work, insights, and support of investigative journalist Rob Wipond and psychiatric survivor, activist, and author Irit Shimrat.  Rob and Irit have been a significant part of our collaborative efforts since Whitaker’s first visit in 2011.

We also experimented with offering our home as a hospital respite, creating our own community treatment teams to get people out of forced hospitalizations, and forming a projects team that ultimately hoped to create a Soteria-like respite house. These more personal experiments were beautiful when they worked, but more often there were too few of us to share the labour.  We also didn’t have enough experience in knowing how to navigate so much ambition, personality, and expectation.

“Tending Hearts and Minds”— Origins and Organization

In September 2016, we invited Dr. Sandra Steingard to present Grand Rounds on “Slow Psychiatry: A Way Forward,” at the Vancouver General Hospital.  After the presentation, a handful of eager healthcare professionals asked her where they could be trained in slow psychiatry. Sandy referred them to us—Yikes!  Since then, these people have been meeting at our house for what we refer to as “slow-psy” dinners.  Meeting and working together over food, lively critiques of their work, and generous sharing of ideas, they have organized alternative workshops for colleagues and traveled to alternative workshops and conferences.

The school counselor in our “slow-psy” group has been struggling for years with the alarming trend of pathologizing “bad behaviour” and funneling school kids into the “mental health” system.  We asked this person to help us design a professional development day symposium for school counselors and teachers. The result was “Tending Hearts and Minds: A Thoughtful Discussion About Mental Health Education and Intervention in Our Schools—For Educators, Counsellors and Parents”

We designed the symposium on the model of the “Psychosis 2.0 Conference” held in Toronto in 2014—a one-day, one-room event we thought was highly effective because of both the quality of the presentations and the shared learning and experience for everyone who attended.

We partnered with the staff of the Vancouver Public Library—they know us from years of organizing public education programs together.  The Downtown Central Branch Library rooms were rent-free, and the program and tech staff ably assisted us in logistics and with video/audio recording.  (The Vancouver Public Library has been an invaluable, cost-effective, and supportive resource.  Use your public libraries!)

Because of our intended primary audience (teachers, school counselors, and administrators), we knew that we had to address in-school emotional and behavioural issues; the rise of the medical model and its government-funded takeover of “mental health” education and de-funding of social support programs in our schools; the false bio-medical narrative; the risks incurred by drugging our children and youth; and alternative approaches.  And so with help from our colleagues, Diana lined up an excellent roster of presenters: Janet Currie and Dr. Jim Wright on drug safety and evidence-based medicine, Rob Wipond and Dr. Elia Abi-Jaoude on marketing the conventional story and critical thinking about diagnosis and psychiatric drugs, and Noel Hunter and Michael Gilbert on trauma awareness and in-school alternative programming solutions. (For details on presenters, topics, and links, see below.)

Though the “Tending Hearts and Minds” symposium was free, seating was limited to 175 people, and so we opted for advanced registration.  On the day of the symposium, about 115 registrants attended with an additional several dozen non-registrants showing up for the opening keynote session.  (In retrospect, we think advance registration was a mistake.  Better to have just opened it up to educators, counselors, and the public and focused more on widely advertising the event, as we had done with more success in the past.)

The presentations were excellent. The audience was engaged and keen to participate in the discussion sessions.  By the end of the day, an unusual level of trust and respect had been built among us—this can be heard in the candid, critical, and sympathetic exchanges between panel members and between the audience and the panel.  There was also a great deal of informal conversation and idea-sharing throughout the day.  It was a learning experience for all of us.  How and in what ways will all this be translated in the classroom and school system?   We don’t know but hope that seeds for change were planted.

It is clear that educators, school social workers, and counselors are mourning what has been lost: “For years, we had social programs and supports for our young people in the schools—things that worked,” it was said.  “But money and programming have been taken away from the schools by governments and administrators that have been seduced by medical ‘solutions’ to what are, in reality, psycho-social and systemic problems—poverty, hunger, unaffordable housing, intergenerational trauma, violence, and more.”

Our school professionals are under constant pressure to help funnel children into the mental health system and ultimately—and tragically for many—toward psychotropic drugs. Class sizes are often large and difficult to handle, children and youth are struggling with many kinds of distress, school counselors are overburdened, long-term non-drug therapies aren’t covered by the public health system, some parents and kids actively seek medical solutions, and so on.  A doctor in the audience asked: “What am I supposed to do with the many families referred to me by the schools—families that expect diagnoses and prescriptions?”

So, what alternative resources exist to help school counselors, teachers, administrators and doctors grapple with the many issues and challenges that get labeled as “child mental health problems”?   We would love to be able to pass along more resources to the participants of our symposium. If you know of any good books and resources that offer effective, innovative approaches for professionals working in the school system, please post them in the comments section below.

Lessons Learned

Looking back at almost a decade of activism, we can’t say that we’ve changed the paradigm—the narrative, the standard of care, the priorities and policies of the Ministry of Health in British Columbia.  That said, face-to-face with one person in a psych ward or home, meetings with discussion groups in a church basement, viewing and talking about films together, attendings workshops and being with 200-plus people in a library excited to hear Bob Whitaker and others—all of this has changed us, it’s changed other people, and it’s given us some active hope.

Some of us in Vancouver have explored alternative narratives that allow us to reframe and critically analyze our mental health crisis.  Others have discovered alternative programs like the Hearing Voices Network and learned to be more accepting of diversity in behaviour, thought, and emotions.  We know more about how and how not to support each other—people caught in the system for years, children at risk of entering the system, and those whom we love and care for.  It seems to us that with very modest funding (perhaps just the faith that folks will give what they can at the door) and some volunteer support, a small group of people—with access to a library, a community centre, a church basement, a park with picnic tables, a backyard, or a table and some chairs and access to a laptop—can probably do at least as much as we’ve done.  It also takes some goodwill and rudimentary manners—something we take turns at having more of or less off—hopefully more.

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To listen to audio of the “Tending Hearts and Minds” keynotes and view slides from the presentations, visit this page.