During the past decade, the World Health Organization (WHO) has regularly promoted the goal of improving “global mental health.” While it has often told of the importance of social support and other non-drug alternatives, its efforts helped spread a biomedical standard of care. Western ideas regarding diagnoses, the biological underpinnings of psychiatric disorders, and the regular use of psychiatric drugs have been promoted. Critics of this effort speak of it as a medical colonization.

Today, June 10, the World Health Organization released a 300-page document titled “Guidance on Community Mental Health Services: Promoting Person-Centred and Rights-Based Approaches.” To a large degree, the authors embrace an agenda for change—and a reconception of mental health—that readers of Mad in America will find familiar. The best- practice services highlighted in the document include Open Dialogue as practiced in Tornio, Finland; Soteria Berne in Switzerland; Afiya House in Western Massachusetts; Basal Exposure Therapy in Norway; and Hearing Voices Support Groups, among others.

The WHO guidance emerged from a group at the United Nations led by Michelle Funk, who is head of the Policy, Law, and Human Rights unit at the WHO Department of Mental Health and Substance Abuse. Much as Dainius Pūras, during his time as the UN Special Rapporteur for Health, called for a revolution in mental health, this WHO document calls for wholesale change. The authors write:

Although some countries have taken critical steps towards closing psychiatric and social care institutions, simply moving mental health services out of these settings has not automatically led to dramatic improvements in care. The predominant focus of care in many contexts continues to be on diagnosis, medication and symptom reduction.

Critical social determinants that impact on people’s mental health such as violence, discrimination, poverty, exclusion, isolation, job insecurity or unemployment, lack of access to housing, social safety nets, and health services, are often overlooked or excluded from mental health concepts and practice. This leads to an over-diagnosis of human distress and over-reliance on psychotropic drugs to the detriment of psychosocial interventions – a phenomenon which has been well documented, particularly in high-income countries. It also creates a situation where a person’s mental health is predominantly addressed within health systems, without sufficient interface with the necessary social services and structures to address the abovementioned determinants.

As such, this approach therefore is limited in its consideration of a person in the context of their entire life and experiences. In addition, the stigmatizing attitudes and mindsets that exist among the general population, policy makers and others concerning people with psychosocial disabilities and mental health conditions – for example, that they are at risk of harming themselves or others, or that they need medical treatment to keep them safe – also leads to an over-emphasis on biomedical treatment options and a general acceptance of coercive practices such as involuntary admission and treatment or seclusion and restraint.

The WHO document lays out a three-fold approach to “rethinking” mental health services. The authors argue that countries need to adopt a human rights approach as a governing principle, adopt person-centered conceptions of recovery, and embrace services that provide environmental and psychosocial supports for people struggling with mental health issues.

Human Rights as a Governing Principle

In 2008, the UN Convention on the Rights of Persons with Disabilities (CRPD) came into force. It has now been ratified by 181 countries (but not the United States.) The CRPD declares that people with disabilities should enjoy the same rights and fundamental freedoms as everyone else, and, in essence, bans forced hospitalization and forced treatment.

However, the WHO authors note that none of the ratifiers of the CRPD have adopted policies and laws that are “fully aligned with this CRPD requirement.” A human rights approach to mental health, they state, requires the “creation of services free of coercion.” They detail the harm that comes from forced treatment:

The perceived need for coercion is built into mental health systems, including in professional education and training, and is reinforced through national mental health and other legislation. Coercive practices are pervasive and are increasingly used in services in countries around the world, despite the lack of evidence that they offer any benefits, and the significant evidence that they lead to physical and psychological harm and even death. People subjected to coercive practices report feelings of dehumanization, disempowerment, being disrespected and disengaged from decisions on issues affecting them. Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress. Coercive practices also significantly undermine people’s confidence and trust in mental health service staff, leading people to avoid seeking care and support as a result. The use of coercive practices also has negative consequences on the well-being of the professionals using them.

In the biomedical model, people with severe “mental illness” are said to suffer from anasognosia, a lack of insight into their illness, and this becomes the stated justification for forced hospitalization and treatment. This is what gives society and providers guardianship power over those with mental health issues and disabilities.

This WHO document, by urging societies to create services free of coercion and to enact laws and policies that prohibit such coercion, is supporting a radical change in global mental health services. Banning forced hospitalization and treatment would dramatically change the existing power structure that supports the biomedical model, and alter the tenor of all mental health care.

Reconceptualizing “Recovery”

The biomedical model of mental health is an “illness” model, and thus the notion of recovery is associated with a reduction of symptoms. The individual is in recovery from a disease, and psychiatric drugs are understood to be a first-line treatment to help people recover in this way.

The WHO authors argue that service providers need to adopt a different understanding of recovery, one that arises from listening to those with lived experience. What do they want for themselves? What are their goals? What do they see as their needs? They dub this a “recovery approach.”

The recovery approach does not solely depend on mental health services. Many individuals can and do create their own pathway to recovery, can find natural and informal supports among friends and family and social, cultural, faith-based and other networks and communities, and can join together for mutual support in recovery. However, introducing the recovery approach within mental health service settings is an important means to ensure that the care and support provided to people who wish to access services considers the person in the context of their entire life and experiences.

Although the recovery approach may have different names in different countries, services adopting this approach follow certain key principles. Such services are not primarily focused on ‘curing’ people or making people ‘normal again’. Instead these services focus on supporting people to identify what recovery means to them. They support people to gain or regain control of their identity and life, have hope for the future, and live a life that has meaning for them – whether that be through work, relationships, community engagement or some or all of these. They acknowledge that mental health and wellbeing does not depend predominantly on being ‘symptom free’, and that people can experience mental health issues and still enjoy a full life .

Model Programs

The WHO guidance tells of a need for societies to develop mental health services that are non-coercive and abide by the human rights principles set forth in the CRPD, and that promote the person-centered recovery described above. The publication features 22 such programs. While “none is perfect,” the authors write, “these examples provide inspiration and hope as those who have established them have taken concrete steps in a positive direction towards alignment with the CRPD.”

Here is a brief description of each model program:

Alternatives to hospitalization: crisis centers

Afiya House in Massachusetts. This peer-run respite center opened in 2012 and supports people in distress, and thus serves as an alternative to hospitalization. It is operated by the Wildflower Alliance (formerly the Western Mass Learning Community), which is staffed by those who identify as peers, having faced their own “life-interruption challenges, such as psychiatric diagnoses, trauma, homelessness, problems with substances, and other issues.” Afiya House can accommodate three people at any one time, and people in crisis can stay for up to seven nights. Video link.

Link House in Bristol, United Kingdom. Established in 2010, Link House is a residential center for women who are experiencing a mental health crisis and are either homeless or unable to live at home due to mental health issues. The house, with a shared kitchen and garden, has space for 10 women at a time, who can stay for up to four weeks. It is designed as an alternative to admission into a psychiatric hospital. The focus is on social support, rather than “medical” care. Video link.

Open Dialogue Crisis Service in Lapland, Finland. This outpatient service provides a psychotherapy-based intervention for individuals in Western Lapland who present with a mental health crisis. The service team consists of 16 nurses, a social worker, a psychiatrist, a psychologist, an occupational therapist, and a secretary. The psychotherapy “attempts to promote the client’s potential for self-exploration self-explanation, and self-determination.” Video link.

Tupu Ake in South Auckland, New Zealand. Established in 2008, this “recovery” house, which is staffed by peers, provides an alternative to hospitalization. It can accommodate 10 people who are in crisis for stays of up to one week. It also provides a day support program for up to five people. Video link.

Credit: Wise Management Services Ltd, courtesy of Tupu Ake
Hospital-based mental health services

Basal Exposure Therapy Unit at Blakstad Hospital in Asker, Norway. This unit is equipped with six beds and provides psychosocial care called basal exposure therapy (BET) to people with complex mental health conditions who have not benefitted from conventional care. BET focuses on the acceptance of frightening thoughts, feelings and inner experiences as a way to self-regulate and cope with existential challenges; and it seeks to help patients reduce or taper from psychiatric medications. Video link.

Kliniken Landkreis Heidenheim General Hospital in Germany. In 2017, the hospital introduced a flexible, user-oriented, and community-based mental health service that has been cited for its focus on the prevention of coercion. Everyone, including those detained in the hospital, has the right to refuse medication, and from 2011 to 2016, no patient was forced to take a psychiatric drug. Since that time, due to court orders, about one person per year has been forcibly treated with medication at the hospital. Video link.

Soteria in Berne, Switzerland. In operation since 1984 and modeled after the Soteria House that operated in California during the 1970s, Soteria Berne offers a hospital-based residential crisis center for those experiencing extreme states (or who have a diagnosis of psychosis or schizophrenia.) The Berne House is located in a residential area and has 10 bedrooms for individuals and two staff members. Residents may stay for up to three months. The Soteria philosophy is that “being with” others during a crisis can be therapeutic, with low or no use of antipsychotic medication. Video link.

Community mental health centers

Aung Clinic in Yangon, Myanmar. This clinic provides an extensive array of outpatient support services that are designed to help people stay out of hospitals and long-stay institutions. The staff, which includes five peer support employees, work closely with schools, employers, and local organizations to help service users participate in community activities. Art exhibitions allow service users to sell their art. There is also a weekly cooking club and support for training in literacy, mathematics, money management, and carpentry. Video link.

Credit: Aung Clinic, Myanmar

CAPs III in Sao Paulo, Brazil. Community based mental health centers in Brazil were established to serve as alternatives to psychiatric hospitals. CAPs III in Sao Paulo provides a house-like environment where people in crisis can stay for up to 14 days. The center uses a rights-based and people-centered approach to psychosocial care that is designed to promote autonomy, address power imbalances, and increase social participation. Video link.

Phoenix Clubhouse in Hong Kong. This is part of an international network of clubhouses that provide community-based vocational and educational support to people who have used mental health services. The Hong Kong house has operated since 1998 and helps people stay out of hospitals while achieving social, financial, and vocational goals. Video link.

Peer support mental health services

Hearing Voices support groups. The Hearing Voices Movement began in the Netherlands in the late 1980s. There are now Hearing Voices networks in 30 countries. A fundamental tenet of the Hearing Voices movement is that hearing voices is a normal part of human experience, and that rather than have their voices suppressed by medication, people should be encouraged to develop their own understanding of their voice-hearing experiences. Video link.

Users and Survivors of Psychiatry in Kenya. USP-K is a national, membership-based organization that relies on peer support groups to bring together people with psychosocial disabilities and mental health conditions. The groups seek to support, promote, and advocate for the rights of individuals to live and work as ordinary members of their communities

Credit: USP, Kenya

Peer Support South East Ontario in Canada. This organization provides peer support at five hospitals in Southeast Ontario, and one-to-one peer support for people after their discharge from the hospital. The peers provide assistance, friendship, and support for up to a year after a person’s discharge, seeking to minimize the risk of rehospitalization. Video link.

Community outreach mental health services

Atmiyata in Gujarat, India. Established in 2017, this community volunteer service supports people experiencing emotional distress in rural communities of Gujarat state in western India. Shared compassion is the core tenet of their work, as they seek to build community acceptance of people struggling with mental health conditions and provide them with access to social care benefits. Video link.

Credit: Atmiyata, Gujarat

Friendship Bench in Zimbabwe. Established in 2006, the Friendship Bench relies on lay counsellors to support people experiencing emotional distress. The outreach service offers empathy, local community and cultural knowledge, and formal problem-solving techniques. The free counseling service is linked to the local primary health care center, and is usually delivered outside on a wooden bench. Video link.

Home Focus in West Cork, Ireland. Established in 2006, this service provides practical and emotional support to people with mental health conditions living in rural areas. Team members include people with lived experience. The team focuses on helping people remain active in their communities, develop independent living skills, and access education and employment opportunities.

Naya Daur in West Bengal, India. This is a flagship project of a Kolkata-based NGO, and it seeks to provide community-based support, treatment, and care for homeless people who have a mental health condition or psychosocial disability. A primary focus is helping people connect with their local communities in a supportive way and helping them develop long-term relationships. Video link.

Personal Ombudsman, Sweden. The personal ombudsman system in Sweden was launched in 2000. Personal ombudsmen are trained social workers, lawyers, or have a background in medicine, nursing, psychology, or psychotherapy. Each personal ombudsman works with 13 to 20 clients at a time, providing assistance with family matters, health care, housing, finances, employment, and community integration. The service has been described as a “professional friendship.” Video link.

Supported living services

Hand in Hand Supported Living in Georgia. This NGO provides independent community living facilities for people with long-term psychosocial disabilities, including people who have been previously institutionalized. Hand in Hand has opened six houses in Gurjanni and Tbilisi that accommodate a total of 30 adults. Residents prepare food, take care of the house and garden, participate in hobbies, attend various cultural events, and are encouraged to interact with their neighbors. The homes were established after the country, in 2015, established a five-year plan for deinstitutionalization of its mental health system. Video link.

Home Again in Chenai, India. Founded in 2015, Home Again provides housing for women with long-term mental health conditions who are homeless or living in poverty in three states of India: Tamil Nadu, Kerala, and Maharashtra. The service is driven by a belief that living in the community in a family or home-like environment is a basic human right. People using the service are encouraged to engage with all aspects of community living, including work, leisure, recreation, and social opportunities. Video link.

KeyRing Living Support Networks, UK. Since 1990, KeyRing has provided supported living services for people with mental health conditions and psychosocial disabilities in more than 100 communities across England and Wales. Each network manages 10 or so homes within walking distance of each other so that residents can connect with each other and become more involved in the community. Video link.

Shared Lives in Great Britain and Northern Ireland. Shared Lives is a state-supported form of social care that operates throughout the United Kingdom, which provides people with support in a community environment. Shared Lives Carer Families provide supported living arrangements to people in crisis, providing an alternative to hospitalization. Video link.

A New Narrative

Although the models of “good care” identified in the WHO document operate in different environments, all share a similar philosophy: a respect for the autonomy of the individual experiencing mental health difficulties, and a belief that providing homelike shelters and a connection to the community, with opportunities for developing friendships, can help people achieve a type of recovery that is meaningful for them.

The WHO guidance doesn’t spend much energy criticizing the biomedical model of care, but there is an implicit message in all of its pages: that model of care has failed, and what is needed now is a fundamental rethinking of what is possible. The authors write:

A fundamental shift within the mental health field is required, in order to end this current situation. This means rethinking policies, laws, systems, services and practices across the different sectors which negatively affect people with mental health conditions and psychosocial disabilities, ensuring that human rights underpin all actions in the field of mental health. In the mental health service context specifically, this means a move towards more balanced, person-centered, holistic, and recovery-oriented practices that consider people in the context of their whole lives, respecting their will and preferences in treatment, implementing alternatives to coercion, and promoting people’s right to participation and community inclusion.

This is the very call for change that Mad in America has been promoting since its inception. Mad in America board member Olga Runciman is named in the WHO guidance as one of the experts who provided “strategic direction” for this policy declaration. Others who have blogged for Mad in America or have been interviewed on MIA podcasts—such as Sera Davidow and Pat Bracken—contributed to the report.

The WHO report makes for a landmark event. It tells of how the World Health Organization, following in the footsteps of the United Nations Convention on the Rights of Persons with Disabilities and the work of former UN Special Rapporteur for Health Dainius Pūras, is now calling for profound change. A global rethinking of mental health is clearly underway, and the model programs highlighted in this WHO publication, most of which are of fairly recent origin, tell of real-world initiatives that are springing up everywhere.

65 COMMENTS

  1. I have heard about the development of a farm in Ireland ‘Kyrie Farm’ as an alternative for those who are not extremely mentally ill but it has a long way to go receive full funding and I understand it is not suitable for people who have a ‘higher level of service provision’ which sounds ambiguous ‘as violence is not tolerated on the farm’.
    It would be nice to think that the creation of the centers and organisations mentioned in this article mark the beginning of a shift towards the changing of this terrible paradigm but I cannot say I am optimistic. They seem to be very small with a small bed capacity and their enlargement will depend ultimately on money (presumably government money). I cannot see governments funding that sort of model. Public health services are cumbersome and have grown up piecemeal over the years with a lot of vested interests and pay grades. How will national governments dismantle those layers of bureaucracy? The redundancy budget alone would cripple them and what would be their financial incentive to do so?

    Independent research on the efficacy of treatment in these places that would justify their enlargement would be difficult and involve additional cost – they do not have the vast pockets of the pharmaceutical companies with their armies of ghost writers and fraudulent RCA’s. As Robert Whitaker said himself recently in a conversation with Nicole Anderson on the ‘Medicating Normal – film Facebook page as long as corporations whose interests is primarily profit are involved it will be hard to change that model (I am paraphrasing but here is the link to the talk). https://www.facebook.com/medicatingnormalfilm/

    • The “Authorities” always say that this kind of intervention is “too expensive” and doesn’t get funded. Meanwhile, they spend billions on useless and destructive “treatments” that could easily be redirected toward this kind of help. It’s more like, “We can’t afford to fund this because it will take our snoots out of our comfortable troughs!”

  2. I trust nothing from WHO. If you look at how they handled COVID and you desire to have psychiatry totally abolished, this could be in your favor. If you want reforms in psychiatry this might work. However, if you are in the camp to reform psychiatry, I think a more local approach is preferable even down to county/city/jurisdiction level whether in the United States or other countries. Since, there are so many who do contribute to this site that do question the validity of whether mental illnesses actually exist, perhaps, it would be preferable if WHO or any governmental entity from any nation get out of the mental illness business. Although, many programs that have had great success and that are not primarily drug-oriented from several countries are on this list, I am very skeptical. Personally, I would prefer if WHO would get out of the health business, particularly the mental health business and leave these things to the countries, etc. who, especially in some areas, might be more attuned to their citizenry. Thank you.

    • I’m not clear what you mean re: the linkage between WHO’s handling of COVID and abolishing psychiatry — maybe just the irony of WHO screwing up everything it sets out to do (assuming it’s really a screw-up)? And I’m sure you harbor no personal illusions of “reforming” psychiatry.

      But I do share your distrust of WHO and think that this article is poorly timed in that sense, as the many lies of the past year are finally being seen for what they are, and WHO’s collaboration with U.S./Chinese “gain of function” viral engineering is being exposed, along with Fauci & Co. I’m guessing you and other MIA commenters who have gone against the grain on COVID over the past year and have been attacked for doing so are feeling a sense of vindication as more & more “conspiracy theories” are being borne out — with more to come. I know I am.

      As for CRPD — it is often the international community which initiates moves to remediate crises and human rights violations when the nations affected are unwilling to do so on their own, and I see CRPD as a positive development, despite being wrapped a little too tightly in the language of “disability.” However I see no reason to bring the World Health Organization into this, as, for one, psychiatry is not about health (except for destroying it); and secondly because the World Health Organization over the past year has demonstrated its complete incapacity to safeguard the well-being of the world’s population.

      • Oldhead says:

        “I’m guessing you and other MIA commenters who have gone against the grain on COVID over the past year and have been attacked for doing so are feeling a sense of vindication as more & more “conspiracy theories” are being borne out — with more to come. I know I am.”

        There are real “conspiracies” in the world, and then there are “conspiracy theories,” which has taken on a more specific meaning in contemporary society.

        (from Wikipedia)
        “Conspiracy theories resist falsification and are reinforced by circular reasoning: both evidence against the conspiracy and an absence of evidence for it are re-interpreted as evidence of its truth,[6][9] whereby the conspiracy becomes a matter of faith rather than something that can be proven or disproven.” (from Wikipedia)

        There is ONLY ONE THEORY regarding Covid 19 that for a period of time was INCORRECTLY labeled as a “conspiracy theory,” and that particular theory was related to the actual origin of the virus – that is, a virus directly coming from animals, or an escaped virus from a lab.

        The more evidence that is revealed, indicates that Covid most likely came from a lab. But even this has not yet been definitively proven.

        As far as I know, ALL THE OTHER “conspiracy theories” related to Covid, are still proven to be false, AND are quite harmful to humanity’s efforts to eradicate this devastating disease.

        Richard

        • Richard, Unfortunately, “Wikipedia” has a strong tendency to be biased. “Conspiracy Theories” are only considered “Conspiracy Theories” until they are proven true. However, those who had considered that which was a “Conspiracy Theory” a “Conspiracy Theory” can be very reluctant to accept that as fact or truth and may still dismiss it or rationalize their way out of their “belief” it was a “Conspiracy Theory.” Additionally, I have rarely found or known a “Conspiracy Theory” to not have a degree of fact or truth in them (like the Office Rumor Mill); even those I even dismissed offhand because they did not fit my belief system on the matter at the time. It is probably not advisable to dismiss any “Conspiracy Theory” until the “facts and truth” may be actually available not hidden by frightened or greedy powers, etc. Of course, that could take generations or lifetimes. Thank you.

          • I am not sure I can agree with you. I evaluate “conspiracy theories” like any other theory: 1) given what I know, how likely/unlikely is such a theory to be true? (Occam’s Razor, for instance – is it the simplest explanation? Does it require me to assume untestable proposals? How many times?) And 2) is there actual hard evidence to substantiate the claim?

            An example would be the recent claims of a stolen election. As to 1), the simplest explanation is that Trump simply lost the election. For any other theory to hold water, it would have to have a plausible mechanism by which it occurred. The idea that millions of people “voted fraudulently” and ALL voted for Biden illegally and somehow local election officials missed it requires believing unprovable premises that contradicts many decades of experience. The idea that there was a giant conspiracy to intentionally overlook these millions of irregularities that involved life-long Republican election officials somehow joining in to get a Democrat elected requires even more unprovable and very unlikely assumptions to be true. Which moves us to 2). If I am to believe these less likely scenarios to be accurate, I will need hard evidence, and the more implausible the theory, the more hard evidence is required. Dozens and dozens of cases were brought before a wide range of judges, both Dem- and GOP-appointed, some Trump appointed, and not one case was found to have sufficient evidence to go to a full trial. So we have two unlikely scenarios requiring unprovable assumptions to be accepted, and a lack of any concrete evidence. These “theories” can be dismissed out of hand. They are simply false.

            Whereas the “lab origin” theory does NOT stretch the imagination at all – historically, lab accidents have happened, if pretty rarely, including adverse consequences (remember the Killer Bees?), and safety protocols are not infrequently ignored (look at handwashing figures at hospitals for support for that premise). When it was denied initially, there was no specific evidence against it, nor was their evidence in favor of alternate theories. It was pure speculation, and I never did buy it. On the other hand, the idea that there was an international conspiracy to release COVID into the environment intentionally was a much more difficult premise to buy (WHY would “they” do this again? To sell vaccines???), and required a number of untestable assumptions, and is FAR less probable than a lab release origin. So until and unless I see specific hard evidence to show this far less likely scenario to be more feasible, I am ignoring that as a likely cause, and am putting my bets on accidental lab release.

            An old medical saying goes, “When you hear hooves, think horses, not zebras.” Unless you’re on the African savannah, of course!

            Steve

          • “Conspiracy theory” is simply a derogatory term for an unpopular belief.

            Let’s forget about Trump, the election and other “straw man” arguments and focus on the origin of the virus. When that’s resolved THEN we can move on to considering whether or not it was intentionally released by China and/or its U.S. partners.

            As for the HOW — I still recommend Peter Breggin’s report from last October, much of which info has since been repeated in numerous “mainstream” publications: https://breggin.com/coronavirus/Final-Fauci-Treachery-Report-10.19.2020.pdf It details Fauci/NIH involvement in the “gain of function” explorations which likely led to COVID.

            This is only one domino in a chain of lies that are about to fall. (Next to be exposed in my mind should be the manipulation of PCR tests to produce such seemingly staggering death counts.)

            I’ve been studying and watching this since COVID killed my mother in 2020, and my work is pretty much done for now — at least until the rest of the world catches up to the “conspiracy theorists.”

            Jail Fauci!

        • And as I said the last time this subject came up. The origin of the virus and whether or not it is lab escaped (a theory I have thought likely from the beginning, actually) is a different subject from 1) the usefulness of masks and, 2) the effectiveness of vaccines.

          Using the first to support not participating in the others is a straw man and demonstrating a lack of logic.

          • Kindred Spirit and Steve McCrea, Sometimes it is not logic that we should turn to for answers, but what is known as “intuition.” In the case of the election, I, personally do not know what happened and so, I will wait for history to decide this one.
            As far as the Covid19 Virus thing, I, too, suspected that this probably originated in the lab, rather than nature. It made no sense for it for it to be caused by bats or any other creature. However, this question remains and will need to be answered. Was it accidental, on purpose, or as my father claimed about my sisters and my transgressions, “accidently on purpose.”
            Now also back to masks and vaccines, there are still questions out there about both their efficacy and “side effects” both short term and long term. We are still assessing the damage that may incurred due to the lockdowns, school closures, masks, plexiglass usage, social distancing, etc. We really do not know the long term effects of what has been done in the name of the controlling this virus and we are just assessing data and other information to determine if focusing on just the virus, as what was done, was worth it. Many actions were taken in the name of this virus that have never been undertaken before. It could be at a generation before we are able to assess if the right decisions were made. One thing I did notice at the beginning of this was that there seem to be a lack of asking questions Could that be out of fear? Could the environment that surrounds psychiatry, etc. be the environment that has surrounded this virus? There is so much going on here that I am very hesitant to call anything a “straw man argument” as I am also very hesitant to dismiss the possibility of something unusual in the past election; whether it affected the election remains to be seen and is likely a subject for history. If one chooses to wear a mask or not, to take the vaccine or not may or may not have anything to do with the actual origin of the virus. That is a decision only each person can make based not only on logic, but intuition, and self-knowledge. Thank you.

          • I tend to agree with you overall, but I think we need to reserve skepticism for both directions. Choosing to believe a “theory” because it “feels right” isn’t really valid, either. We need evidence. And as you describe it, it has been very difficult to get true and honest information from anyone in this COVID mess. So sometimes all we can do is gather the information we have and make the best decision we can based on what we know and our intuition. My intuition tells me that intentionally releasing a virus to create a worldwide pandemic doesn’t really benefit anyone enough to be worth the effort to make it happen. I could be wrong, but it just seems way too far fetched for me. Whereas an accidental release seems much more believable based on history and probabilities. Others will have a different take. But if we are going to have a group discussion of what is/isn’t happening, it has to start with what is known. If the answer is “little to nothing,” I suppose intuition is all that’s left to us, but it’s not really appropriate for people (I’m not referring to you, of course) to cast aspersions on others’ characters because of personal intuition. There is a very big leap from, “I’m feeling uncomfortable with the information about the last election” to “there was massive fraud, the election was stolen and we need to break into the Capitol and stop the transfer of power by violent means if necessary.” Just as an example.

          • This started as a reply to Rebel but really is not to anyone in particular, – just my thoughts on the general subject. I rely heavily on my intuition and I’ve never seen it as conflicting with logic and reason in any way. Actually, I think it’s a perfect compliment. However, I do think most people have been conditioned not to trust their gut, not to think too hard, and instead just listen to what the people on the TV news tell them. And that even those who aren’t easily led to conspiratorial thinking still struggle to find the time to be adequately informed on a wide range of subjects when the world is as busy and complicated as it has become. And really, too many people just have zero drive to be informed about anything and are averse to hearing information that conflicts with their made up minds. They believe what they believe with little to no information. As far as I’m concerned, there is little point in engaging in serious conversation with such people as there is such an imbalance in actual information held between the two parties.

            I am deeply privileged with abundant free time and a strong intellect. I don’t know anyone other than academics and journalists who spends as many hours a day as I do reading as wide a variety of news sources as I do in order to be fully informed. Being fully informed is not necessarily holding a particular belief about a subject, it actually means knowing what different sides believe as well as what they believe their opponents believe which is often drastically different from what their opponent actually believes. I particularly enjoy identifying bias and a priori messaging that is most prevalent among nearly all American news sources. I avoid television news because video tends to be emotionally manipulative with the actual intent to sway the audience to an emotional reaction instead of thinking.

            Skepticism is absolutely healthy. Low information skepticism is usually ignorance passing for informed knowledge and such conditions aren’t conducive to reasoned debate. Intuition can lead us to new information if we listen to our gut feelings when they tell us something isn’t right and heed the call to explore the subject further. But intuition is meant to be a catalyst, not an end in and of itself.

            Knowledge or wisdom, then, becomes less about who is right or what the absolute facts are (facts are often in dispute even by historical accounts), and more about integrating collected information with life experience to decide what to believe based on what seems most plausible.

            I tend to also view what is categorized as “conspiracy” with the same process that Steve described. Is there compelling evidence for what is being presented? Sometimes there is, like the potential for a lab leak in the case of Covid. And oftentimes, whether the particular conspiracy is from the Left or the Right, it gets called that not because there isn’t any evidence for it but because it goes against mainstream messaging. It goes against what powerful political leaders want you to believe in order to garner your support for their agenda. This is why following solely left or right leaning (or even solely alternative) news is so dangerous and leads to being poorly informed but highly convinced.

            Rebel brings up good points about government secrecy and the various harms that have been perpetrated in secret. The problem is that this tends to make the low information person simply distrustful and fearful and leaves them feeling like they don’t know what or who to trust any more. I believe this is entirely intentional and that there has been a concerted effort to dumb down the population in order to create more compliant and obedient workers. I am not the first to think this way. George Carlin had me beat by decades. But it still presents difficulty in having any kind of serious debate with someone who feels overwhelmed by too much conflicting information and isn’t sure what to believe any more. The tendency to then latch on to whatever fits your biases rather than think hard about information that challenges your biases is very strong. One fact has been proven repeatedly and that is the tendency by most too immediately dismiss conflicting information in order to not feel cognitive dissonance. This is why presenting new information to people who already have a strong believe one way or the other rarely works and why playing on people’s emotions is generally much more effective. This is human nature and not really related to intelligence but it also means that humans tend to be emotionally manipulable and believe things that are untrue but that feel compelling.

            So, in terms of politics or religion or any of the other areas where folks tend to believe very strongly with positions based on faith rather than having gathered a wealth of quality information, it’s mostly not worth the effort to attempt a rigorous discussion.

            My only real complaint then become when those people present their beliefs as facts. Such as the belief that there is a Creator, that he is male and omnipotent and all loving and yet also vengeful, that he knows everything and there is a divine plan and yet humans have free will. None of it makes any sense except to those who have a need to feel like there is some grand protector out there because the idea that everything is basically random is a scary prospect, especially for those who are otherwise low information. And this is why the more educated one becomes, the less likely one is to believe in deities of any kind.

            Again, this is not really directed at anyone specific but just is my thoughts on why so many of these conversations here are largely unproductive and will likely continue to be so.

    • I like to use the term “differently abled” rather than “disabled”. This is how I view myself. Even those who are “enduringly sick” often have a great deal to contribute if they were afforded the supports to do so. But often supported housing or employment are offered in very coercive ways and many reject these supports in order to retain agency even if it means homelessness or being unemployed and otherwise dependent. Our concepts about ability/disability are extremely binary and largely harmful.

  3. thanks so much for this…a quality mix of direct quotes and some thoughtful analysis. much appreciated.

    and yet…not to play the part of Debbie Downer and/or Bummer Bob, but…I do hope and think that these changes may very well be implemented all over, in places…that are -not- the United States. 🙁

    I don’t know what the “deal” with US psychiatry is, honestly. I’m not one to complain lots about “US culture,” per se, its just…wow. wow. FDA says “please put a warning label on ‘antidepressants’ about a possible suicide risk,” and organized US psychiatry says “you’re killing them! you’re killing the children!”

    that’s just -1- example. maybe its the neoliberalism that’s taken over since the 70s or so…and is now threating to turn fascist? sick societies=sick people, and neoliberalism has definitely sickened US culture, at all strata. Plus…now that the only people who really “matter” are those in the top 20% or so…why even bother pretending to be the least bit compassionate? -nobody cares-

    and yet…”keep hope alive,” etc. 🙂

  4. In the various links and reports, where is the section that shows the nature of how to realize the business of a non-profit as well as for profit? For in talking about “cost-savings” attributed to the industry of mental health care, there seems to be a gross lack of disucssions that convey the monitization by which one can either track and contribute time, monies and knowledge to a non-profit or create a business. The issue may be one of trauma that we are carrying that crosses generations of people along with the tragedy of power that is controlling rather than liberationg? Seemingly, the queston may become one of having the conversation, not just a typed in respnse to the box, the awareness for listening (at times I may not be able to do this very well) for I sense an urgency tied to each letter I speak and type whle trying to comprehend the reasons I am still here. Be well and create some fun while discovering our value and values.

  5. The Swedish ombudsman concept speaks to me. Although I have grave concern about the potential loss of personal agency and how that type of support might make it more difficult (at least in the US) to withdraw from the psych drugs against medical advice. In essence, I can see it being a tool of forced treatment in the US. But it still is the sort of support I’ve wished I had at least at certain points along the way.

    • I used to serve as an Ombudsman for those living in nursing homes and other facilities for the elderly and disabled. It’s actually a great model! Unfortunately, there were never anything close to enough Ombudsmen to go around. Not a lot of funding for holding the powerful accountable!

      • Humana would get started with a singular nursing home! Sitting on the Mental Health Advisory Committee to Ky Protection and Advocacy, we wouid have a pesentaton by the Nursing Home Ombudsman. To understand the health needs by that stage didn’t quite sink in, though later at a LEED conference (energy conservation in design and building) in Hot Springs, the designer from Hot Springs would explain how the long hall desgin wears down staff. There was no labor shortage essentially, but the design of the facilities is a killer. Hence, how does one hold the powers of government accountable, taht generates policies, that generates generations of ……………….?

        • Ombudsmen can stand up for individuals in oppressive systems, and can collect data and stories relating to oppressive patterns that transcend individual cases. But advocates alone can’t create system change – I think it requires the “consumers” to stand up and demand different “solutions.” And some systems are simply too corrupt or ill-intended to start with and resist any effort to “reform.” Such systems need to be discarded and a new plan built from scratch.

  6. Added leverage for the CRPD can’t be a bad thing. Wiping up the mess caused by all these new fangled “mental ill health treatment” programs, on the other hand, on top of the violence of the more traditional approaches, is a little more problematic. I realize, however. that the service industry would be nowhere without the manufactured “need” that comes of labeling and treating “patients”, people being too strong a word to use in such a context, and not, of course, supported by law. Tell me, how do we get “the problem” to be a little–Okay, a lot!–less global. Much change, no doubt, would be, for lack of a better word, godsend.

  7. Steve McCrea, First as far as the election goes, all I say is perhaps we need to suspend judgement. I am afraid all the evidence may not be quite in and even it is ever in, it might not change anything except for the future generations’ understanding of history. The reason I say all the evidence is not quite in, is historically the government and other entities do have a tendency to hide important information. This, I learned as a child growing up in in the Vietnam and post Vietnam era. Of course, that is same with the virus; as information on this seems to trickle in. Tragically, there are those who really would intentionally release a virus or any deadly chemical to terrorize and get what they want; which is usually some sort of power, control, etc. I do hope that this is just an accidental release. I still reserve judgement until all the evidence is in. Unfortunately, this is a world nothing can be ruled out and even if it’s not ruled in, it still can’t be ruled out. Oh well, this is confusing. I have just learned over time to always maintain a healthy skepticism that anything can happen. Actually, two, maybe even more, contradictory thoughts or two, maybe even more contradictory pieces of evidence that are still true and fact can be held in the mind and in reality at the very same time. We have a tendency to forget that and that’s when we get into trouble. Thus, when this does happen, we get anxious and worry, etc. when we really need to learn to accept that as natural. We probably forgot this because of the influence of, of course, psychiatry and all its drugging, therapizing and what notism, etc. Thank you

      • Whoever gets into office after the election has won the election, no!? Mostly the opposition concede proving the point.
        Okay, maybe these days it’s whoever funds the person who gets into office, yes?
        In USA the votes are as they are in most places mostly a reliable guide to votes cast – there is evidence for this statement, none against it except at those points of exception. Biden beat Trump – Uniquely Trump disputed the result when there existed no doubt as to the result, He’s a huge improvement dlont you think, even if far from ideal? – Gore conceded despite the almost certain reality that he had got more votes in Florida, but presumably he thought the ongoing charade of hanging Chad’s was an embarrassment.
        The major impediments to democratic legitimacy is a lack of an actual choice, usually most of the competent candidates represent one or other wing of the business party, but this still gives some choice, in America of course the biter roles are manipulated, people are denied their votes, congressional boundaries are gerrymandered and media (both mainstream and non) are owned and controlled by business and are usually heavily biased for manipulating and entertaining.
        This stream perfectly illustrates this most comments stray very far from the point of this site – to promote social justice for t by evoctims of psychiatry.

          • I don’t know that Robert would identify MIA as a “social justice site,” but it certainly provides a safe space for survivors to have a voice, and the forums here are populated primarily by survivors, and we have discussions that center on issues that would get commenters tossed off of a lot of “mainstream” sites. And there are many articles posted by survivors, such as Christine’s this very week. I think it is exceedingly unfair to call MIA a forum for “liberal mental health professionals.” There is a hell of a lot more going on here than that. In fact, I seem to recall certain “liberal mental health professionals” either changing their tunes or stopping posting here because they could not handle the intensity of the appropriate feedback from the survivors who are the core of the commenting communities. So I respectfully and firmly disagree with your assessment.

  8. Thank you for this article. Although there are a million things wrong with our issues being classified as having to do with health, and although the idea of “services” to me indicates the need for some people to make money off other people’s misery, it’s still great to see a listing of non-coercive entities, not to mention any recognition anywhere that force and coercion do not constitute help.

  9. Of course, like me, anyone who is compelled to “comply” with “treatment” is now armed with this beautiful phrase “Are you prepared to comply with WHO guidelines and CRPD”.
    As of yet I’ve yet to hear anything in relation to a demand for compliance in return for a bed, (*WTF!!!*). Maybe their reading the document upin SA headquarters, who knows,? I shall keep ye all posted.
    (*The plan is to pump so much neurotoxic poison into me that almost total functional Disability is the result (I’ll be barely able to get out of bed except maybe to eat.)

    ****×***************,
    As for conspiracy theories, yes they do exist. You can spot them by noticing that certain assertions are made in the absent of convincing or even any evidence and often in the presence of compelling rational for their falsity.
    For instance, the hypothesis of ‘mental illness’, in these pages much evidence is gathered from time to time, as it is elsewhere (eg. the emperors new clothes, schizophrenia:a scientific delusion, the PTMF etc.) that persons suffering so called ‘mental ill health’ are actually really reacting to adversities, trauma, deprivation etc. (assuming they have any so called ‘clinically’ significant levels of distress which it seems is increasingly rarely the case now (frequently merely ticking a few of the wrong boxes on a form or a rather grossly twisted and distorted interpretation of an expression nowadays). The theory of ‘mental illness’ is do obviously flawed, it hasn’t a single compelling line of reason to defend it, (that’s why they have to impose it forcefully or manipulatively, does it qualify for dismissal as a conspiracy theory (It wuz me genes wut did it yur honor) ?

    But since even scientifically trained people cling stubbornly to a concept in the absence of evidence and the presence of confounding evidence let’s just say this—

    The presence of Covid in our midst is being ruthlessly exploited by the powers that be by all accounts (which are usually far from front page news) ruthlessly exploited by the powers that be. Is not indulging theories about the origins of Covid not just another distraction from the reality of an ongoing decades old assault on the public space, assaults which are frequently quite artfully hidden from veiw. Theories of Covids origins exist in the absence of any evidence (available to us normal folk unversed in epidemiology) other than the simply fact that deadly virus’s frequently emerge quite naturally due to the normal processes of mutation.

    • The theory of ‘mental illness’ is do obviously flawed, it hasn’t a single compelling line of reason to defend it

      “Mental illness” CANNOT exist. Attempts to prove that it does or doesn’t both miss the point. This is a linguistic issue, not a medical one. Abstractions (such as “mind”) do not and cannot have physical characteristics such as disease period.

      • Yes Oldhead, no need to repeat yourself. The idea and practices exist. This is a social justice website is it not?
        So people reading (andtexting) here often find ourselves coerced, forced, bullied into meeting the “mental state examiners” looking for any excuse to defraud and force their “services” (aka. brutality) on unwilling “consumers” (aka. vulnerable persons (its long since past time that it was safe to assume any actual distress whatever its cause) marks).
        In recent weeks I myself have been, forced, manipulated dumped into appalling circumstances. Last week I was promised a room and went to meet people who turned out to attempt to compel me to ‘comply’ with unspecified instructions for unspecified reasons, partof which included “agreeing” to ingest massive quantities of neurotoxins, otherwise I might be forced to wander the streets, lossing all my possessions and maybe my life. I’m in a real battle for my existence Oldhead, not here to just mouth off. I was able to use this phrase in my armory “Is the SA prepared to comply with WHO guidelines” – They obviously didn’t like it, but already marked as a troublemaker for making sensible suggestions, it’s use somewhat disarmed them.
        The WHO is a ‘respectable’ organization even if truly expert advise is ignored these days quite widely in deference to greed.
        You can’t simply wish psychiatry out of existence, it’s actually rapidly expanding in its extent. And while many ignore it the few who fall into its tentacles are finding increasingly difficult to escape back to life. So I and millions of others must find the means to minimizing its impact on our life. They want to destroy people Oldhead, particularly those who know what their upto, selling drugs and other servic
        Es which at best waste your time, or provide a bit off company amidst a lonely stigmatized existence. We have to getour priorities in order to deal with it, we can’t just wish it away.

  10. Kindred Spirit; Everyone has the right to believe as they see fit, get their news or whatever from what source they see fit, etc. As they say, this is still a “free country” although there are many days I am getting more concerned that that statement might be less true.
    I do consider my intuition as valid as logic in verification of facts and/or truths. I consider it this, because my intuition is a direct line to God, My Creator.
    Which gets me to another point, you make. To think that “education or knowledge” will wean oneself from believing in God, because they will learn He is not fact and they will no longer a “protector” very sadly, sounds like Marx, in which he falsely called, “religion, the opiate of the people.” In a way this seems like inverted self-righteousness. I say inverted because righteousness is usually associated with the religious. A person’s education, abilities, or knowledge status have little to do with one’s belief in God. I have no Ph.D. nor do I desire one, but, if even if I did I would still believe in God. In fact, I believe in God, because my life has depended on it and continues to depend on it. If I must be considered a weakling, an uneducated oaf, then so shall it be, for I shall not deny God and Jesus, especially, at this critical time in history. God and Jesus saved my life from the evils of psychiatry, its drugs, therapies, etc. and from so much more. One more point, although, legally, I am considered “disabled” I would not be comfortable thinking of myself as “differently abled” as that could bear the stigma or even give people the wrong idea about me. What I am saying is that I do not consider myself abled or disabled. Why, because both of those terms have been used against me. I am “differently abled” has similar problems. Therefore, I am just me and although, I have a questionable day here and there, that is all I really want to be-just me.
    Thank you.

    • “Everyone has the right to believe as they see fit, get their news or whatever from what source they see fit, etc.”

      Of course you do. I never said otherwise.

      My point about being differently abled is one of empowerment. I have physical limitations that preclude me from committing to going into a job on a set schedule. But that doesn’t make me completely useless. I have many skills and I contribute strongly as a competent member of my household. Our cultural way of viewing disability is very binary and we as a collective people tend to treat those labeled as disabled as if they have nothing at all to contribute. But those with disabilities have fought hard to be valued as contributing members of society even if we don’t have full time paying jobs. I have value beyond that. That’s what differently abled means to me. It means celebrating all the things I CAN do, which is a lot more than the things I can’t, and not getting too caught up in the tunnel vision our economic system has on being monetarily “productive” in creating wealth for the owner class.

      Again, I offer these ideas for whoever might find them useful.

      I’m not reengaging in further discussion of matters of faith, which are inherently unprovable and highly personal.

      • Whatuser, Actually, I already have. Amongst other things, it was my Intuition and my Imagination that made me a prime candidate for these psychiatrists and their buddies. I spent way too many years being drugged, therapized, and enduring many of their other cock-eyed treatments. But, now, I am free of them, despite the residual brain damage and other adapting I must do after my many years in their horrible clutches. Strangely, it appears that the parts of my brain that were not damaged was my Intuition and my Imagination, the parts that kept me alive, etc. before the drugs, etc. But, I wonder, if I was more prone to logic, facts, evidence, etc. just maybe I would not have had to endure that terror. So many times, I have cried myself to sleep because I wasn’t more logical. But, I can not be whom I can not be. So, I’m trying anymore. And thus, I stand with the “anti-psychiatry movement” so others like me can have a fighting chance in this world? Thank you.

  11. Oldhead, I agree with most of what you said. I am still not sure who won the 2000 election and that’s not the only election, to me, that remains in doubt. 2020, I guess, is just another in a long list of these election. As far as Republicans being dictatorship-like oriented. I would say, this seems to swing back and forth from both Democratic to Republican almost hourly. Still, I have my own opinion of which I will keep to myself.
    You are right about the covid thing. I think there is much to be hidden from us and much is wrapped up in describing it as conspiracy things to make us feel stupid, etc. for desiring just to know the truth and the facts. On this one, I have been relying on my intuition. In time, I believe, that the truth and the facts will vindicate and verify my intuition. Agreed on fauci. Thank you.

    • Democrats & Republicans are a pendulum of sorts, swinging from Coke on one end to Pepsi on the other. Some might call it good cop/bad cop. Right now the Democrat/neoliberal end of the spectrum is in sway, and is the more totalitarian of the two (and looks like it will be for some time) but this changes from time to time and is mostly a question of style. The only way out is to sweep them all away.

  12. Thanks for the coverage on this site Bob, it’s truly validating to have reports such as the WHO guidelines referring to possibilities that so many closed minds dismiss.
    The recognition of CRPD plus the detailed reports of on the ground work that at least attempt a process that can potentially develop a dignified, meaningful and rewarding life (outside of one or other variant of a sick role).
    It now empowers me to first ask if any intervention shall comply with WHO guidelines. It’s unlikely they will but it shall at least put the cat amongst the pigeons giving me some space Thank You.

  13. I haven’t read the 300 page WHO guidance report but have read Robert Whitaker’s summary and listened to Mad in America podcast interview with Michelle Funk.
    Did the report actually call out Psychiatry on its misappropriation of medical angnosogosia? Psychiatry’s “angnosogosia” reminds me of a joke John Read told: They say they have a drug that will make you agree with your psychiatrist.

    I think the WHO’s guidance report officially ends blaming the failed mental health system on the least powerful people in it. That seems to be the trend which I see in different areas, not just “mental health,” if it doesn’t get censored.

    According to Michelle Funk, the work has just begun and with demand from countries. I can remember when we couldn’t have these conversations and barely among ourselves much less a paradigm shift with trainings in different countries and proposed policy and legal changes.

    • Do kids get angnosogosia?
      No because someone tells them they need to take drugs for their defective brains which cause them to act defectively within the normal environments 🙂

      I wonder if I can take ADHD drugs while pregnant. Or does that interfere with the baby and developing brain? When is it safe to drug a child? Or perhaps I can just buy speed and drug my kid myself, at the dosages that seem appropriate where he no longer acts out in the normal environment laid out for him.

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