Why We Urgently Need New Approaches to Mental Health

Emotions function like a guidepost to what we need. But if we are not aware this, we cannot understand what they are trying to convey.


Mental distress can be an unknown territory.

Consider, for example, being a 16-year-old boy and feeling like your whole world is crumbling, but not understanding why.

You are living with your parents who are constantly fighting. Your mother is overworked, working at a local factory. She is being treated badly by her boss and she cannot seem to find another job. She comes home exhausted from work and often feels overwhelmed by the tasks of taking care for two children. This sometimes fills her with anger, with her outbursts often spilling over on you and your brother. She does not really know how to handle her emotions well.

In fact, emotions are never spoken of in your family. When there are problems happening, everyone just pretends there aren’t any, until they pass. Sometimes you can hear your parents arguing late at night, though.

You often feel unwell, not really knowing why. You spend a lot of time in your room, listening to angry music. It is the only space you feel safe in.

Illustration depicting a keyhole in a person's shirt/chest. They are holding an old-fashioned skeleton key near it.

Your dad is withdrawn and away most of the time. He is exhausted working, too. He works for a local real estate company and he is under constant pressure to increase sales and profit. When he comes home, he just stares at the tv.

Home does not really feel like a safe space to you.

Things at school are not any better. Though you do have some friends, nobody seems to understand what you are going through. This makes you feel misunderstood and you start avoiding people. You spend your days on Tumblr and Instagram, even though the latter just makes you more depressed. Everybody seems to enjoy life except you.

You do not really feel like getting out of bed in the morning. You cannot seem to understand why you feel this way, but it continues. You stop doing your homework and even miss some classes.

You spend months like this. Then a year. And then another.

At one point you start feeling like you cannot breathe. You have the feeling that the air is being sucked out of your lungs.  You feel like you are going to die. At first this is light, but after some time it makes it hard for you to get through the day. You feel as if the floor under your feet is disappearing.

You do not understand what is happening. After some time, you share it with some of your friends from school and they suggest you should see a therapist.

You are a bit ashamed that you should have such problems and fear that if you go to see a therapist, someone could label you as “mentally ill.” You have seen some kids from school getting laughed at for this.

After some time, it becomes so hard to get through the day that you just desperately need any help.

Depending on where you live you are or are not lucky enough to have free access to some support.

You are able to go to psychotherapist because the area where you live provides one to young people for free. The therapist seems understanding and full of support. He tells you your problem is anxiety and helps you understand that this is related to understanding of your feelings. Your feelings have bottled up. Emotions get stored in the body and can wreak havoc there if we do not pay attention to them, you learn. This is why you sometimes cannot breathe. It is a way in which your organism is trying to tell you something.

The therapist helps you to learn that we all feel emotions. They function like a guidepost to what we need. But if we are not aware of this, we cannot understand what they are trying to convey to us. Then we cannot give ourselves what we need in certain moments.

The therapist gradually teaches you how to handle your emotional distress. He also helps you in understanding that it is not your fault your parents are having a hard time at home due to economic circumstances and lack of communication. He helps you to process your emotions.

After some time, you feel better. The floor under your feet somehow reappears. You start getting out of your room. You start feeling like going out and seeing people again. You sometimes still have trouble breathing, but you get better at understanding what happens to you and how to handle it. The problems of your parents do not stop, but you get better at handling situations. You no longer think this is your fault. You start thinking about your future and making plans for it.

Or, in an alternative scenario, your parents cannot afford therapy. You yourself do not have money to provide for it.

When you contact your GP, you just have a quick conversation with him and you are given medications.

You may or may not be labelled and get a diagnosis. They tell you your state is purely biological. Think of yourself as a malfunctioned machine, they say. The biology in your brain is messed up and you need medicine to fix it.

After this, you start viewing yourself differently. You start having lower trust in your capabilities. If the floor under your feet does not hold, what is it that you can do in life anyway?

You start getting depressed because of this, so they give you more meds. Now there is no point getting out of your room because your future seems cemented. There is no point in trying if you are malfunctioned, right?

Now let us stop and consider. Which of the two scenarios is the one we want to live in when encountering mental distress?

In one scenario, it makes every difference for that teenager to have support enabling him to understand what is happening to him. And to do so in a way that does not label human beings, but tries to understand complex states of mental distress.

It would also make every difference if his parents had some sort of support to understand what is happening to them and how to handle things more constructively.

It is therefore urgent to think of another way of approaching mental health in our society. Education in emotional literacy is something we urgently need.

Recent research is showing more and more that emotion regulation is the most important dimension of emotional competence that impinges on mental health.

If this is so, doesn’t it seem a bit strange that in our educational system we are dealing with everything except emotions, so very basic for our human functioning? Why is the awareness of emotional regulation left to chance?

We need to see just how important understanding of our own emotional states is when it comes to prevention in mental health.

We need programs that will embed this into our public policies.

We need to explore ways of doing this.

Mental Health Europe, as the largest independent network organisation representing mental health users, professionals, and service providers across Europe, recommends including mental health in school curricula and the curricula of teaching staff. It also recommends providing social, healthcare and educational workers with the skills and resources to recognise mental health risk factors, provide basic support, and provide referral to mental health services when needed.

It is important to note that those services should function in the way I have described above, and not in the manner of pathologization. Instead, they should offer understanding of the basic ways in which human beings function, ways of recognizing and understanding what is happening when one is not feeling well, as well as understanding what one can do when this happens.

There are existing approaches that could be employed in this service. There are plenty of psychotherapeutic approaches that employ an existential-phenomenological understanding, which, instead of putting an emphasis on labelling people, helps them to understand their mental distress. There are also other approaches that support people in distress in a non-pathologizing manner, such as Open Dialogue. Furthermore, there are organizations such as INTAR that advocate for a different kind of mental health system.

All these approaches and organizations offer a valuable pool to assist in the development of the above-mentioned programs.

Perhaps embedding this kind of education in our current societal system seems like an expensive task. But let us return to the story of that above-mentioned boy.

In the long-term, wouldn’t it be less expensive if this boy was taught earlier in life in school the basic understanding of how human psyche works and how mental distress can be tackled in a non-stigmatizing sort of way?

Like Ben Franklin famously advised his fellow-citizens in 18th century, “an ounce of prevention is worth a pound of cure.”

This still applies today.

It would be more effective to teach us all about our own mental states and how to keep us well when growing up, rather than leave it to chance, socioeconomic status, and accessibility of therapy in the latter years. It would also be more effective to do so in a non-stigmatizing manner.

This is not to say that some mental distress will not always exist. As the COVID-19 pandemic has shown, we live in a complex world with unexpected events putting our collective mental health to the test.

Precisely because of this, it is more important than ever to understand ourselves and how to navigate it.

On a wider scale and systemwide.


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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  1. What does “urgency” mean in the culture of Croatia? On a reservation? In the operating room of a hospital? In the rhythm of the Amazon Forest? And even where the digital media may not reach or be installed yet? For even in Kentucky, the news media shows the mule being hired to pull cable over the mountains for ? ?????

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  2. We really need to stop lionizing therapists as if they have not been a huge part of the problem. Did they stand up to psychiatry when Psychiatry started handing out diagnoses like crazy and medicating everyone they encountered no matter the person’s age? I don’t remember hearing any sort of outcry from therapists. It was the opposite in fact. The therapists were completely on board with writing down another label about a patient, calling them non-compliant, telling them “I won’t see you anymore unless you are medicated”. This happened to me on numerous occasions. I was also pushed into ECT treatment by a DBT therapist. On several occasions? I had therapist spending entire appointments talking to me about medication and how I needed my medication changed or my dosage increased or another medication added — something they shouldn’t have even been talking about since they had no training in it, but that never stopped them. I had one push me into TMS treatments. It was all she would talk about for months and months.

    Let’s not rewrite the story. That is not going to help anyone. Therapists, psychologists, social workers… They have all been a huge part of the problem for decades. They have also been patient blamers, labelers, doing whatever insurance told them to do, whatever the psychiatrist who ruled the roost said they should do. Everybody wants to get paid right. Everyone wants to get along with their colleagues. What happens when a therapist sees a patient being abused by a psychiatrist, sees the patient going downhill under a cocktail of medications that the psychiatrists insists are necessary. She’s the patient gaining weight? Drooling? Developing tardive dyskinesia? Does the therapist speak up? Call the psychiatrist, ask what’s going on? Highly doubtful. Let’s tell the truth about what’s been happening.

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    • So true, too many of the so called “mental health,” social worker, CPS, FBI, et al, and the mainstream medical and religious industries most definitely conspire against child abuse survivors, and their legitimately concerned mothers.

      But this is all by the “invalid” DSM “bible’s” design.


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    • I relate to your mental “health” experience and I too have run the gammit from appallingly destructive therapist to brilliant. The one major turn around for me, and I managed to find this through my own research and determination to be free of the “follow the money” pharmaceutical approach that were all deadends with collateral damage…ketamine infusions. I don’t even remember how I stumbled on it but it wasn’t covered by insurance and I had to dig into my own resources. Worth every penny as in the long run the pharmacy was done for the most part. That was done in 2017 and it involved 6 infusions at our ketamine center. You need transportation as well. They recommend subsequent treatment and after all the covid nonsense and the state of affairs of the world we’re now living in. Yes, a “booster” for lack if a better word, would be a supportive therapy, but not necessarily a whole complete series. Obviously all geared to each individual patient. But the damage traditional antidepressant therapy did to my body and health were and are substantial. Totally screwed up my metabolism which resulted in unhealthy weight gain that have now left me with heart and blood pressure issues. That’s just for starters. So all I’m saying is check out this, slowly becoming accepted, approach to TRD. It was a life saver for me in so many ways. I’ve made it to 69 and it started actually back in early childhood, but the acute phase started when I was in my early 40s. I was blessed to have wonderful, kind, intelligent, supportive parents so another reason I survived. Good luck and God bless

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  3. Thanks for a good article. These common sense protocols are certainly needed however it seems many mental health professionals are more interested in what their position does for them rather than what they can do for those who come for help. I also think the lack of emotional intelligence and emotional states of the ‘mental health’ professionals are a part of the problem too. Many don’t have the humanity, compassion or empathy required for the job.

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  4. Iva what a lovely article you wrote.

    I bought two trees this week. One looks to be in fine fettle with burgeoning leaves but the other looks like a public execution. I don’t know what I did wrong. Too much water? Are tree “types” really so different? Are individual trees fussy? What is it in a human that rushes to encapsulate a species as all the same? We humans, like trees, look similar but we are all so different.

    Here is a neat trick.

    If someone says this…

    “I feel THAT I am being punished”.

    They are not FEELING a FEELING. Instead, by using the telltale word “THAT”, they then go on to describe an outward act of behaviour, either their own act or other peoples acts towards them. A “punishment” is not a FEELING. An emotion immersed statement would look more like this…

    “I feel really furious and sad because someone has punished me by throwing a cup at me”.

    Fury and sadness ARE FEELINGS. The person with such emotions knows they are feeling those feelings…and why.

    Here is another non-emotional statement…

    “I feel THAT nobody gives a damn about me”.

    This statement arrives at a logical conclusion ABOUT other peoples behaviour without tapping into the FEELING of terrible sorrow about being rejected.

    People can dip in and out of psychotherapy for decades and seem to be expressing their difficult emotions but ALL they are doing is AVOIDING feeling the full impact of the feeling. Instead; often with the therapist’s logic looking assistance, the client merely “describes” the apparent judgement of the feeling, judgement by others.

    “I feel THAT they never liked me”.
    “I feel THAT no one would miss me”.
    “I feel THAT everyone wants to shun me”.

    None of these above statements have a flicker of emotion in them. Not one tear of “sadness” or “loss” or “rage” or “grief”. It is as if the THAT word is a lid keeping all the emotions out of sight. Only the actions are mentioned, the assumed judgements or descriptions of actions from others.

    It is quite possible to spend years thinking you are an emotionally expressive person who tells all and yet you never FEEL anything. It becomes a way of using analysis and rationalizing as means of the avoidance of feelings, habitually done to logically TIDY UP messy feelings. All too often a session is a way to do this tidy analytical stuff.

    I think your boy in the bedroom was given a number of “THATS” to explain/rationalize his emotional fog. He felt this way because of THAT or THAT or THAT.

    I am more for emotions themselves being the ONLY therapist we need. They do not have to make analytical or reasonable SENSE. Our feelings can be….

    “I feel deeply sad because I am in a sad moment”.

    Babies are the best at allowing their feelings to be their own experts. Babies never use the THAT word, nor rationally explain their ever changing states. They never feel they “have to” make any sense at all. And fully feeling a feeling quicky brings so much healing that there is nothing more needed.

    As such our feelings do not need to be ABOUT and action at all. Our feelings are schooled into “having to” be explanatory because LOGIC is a GREAT BIG BULLY systemically that says we must ALWAYS look like we make PERFECT rational sense…because if we do not then we are behaving like babies or mad women and that is NOT allowed in grown up employable populations. The myth of the perfectly fixed human is a religious salvation we all have to play along with. Look saved or salvagable by logic even when you are inexplicably, as the baby is, “sad” or feel “loss” or feel “grief” or feel “rage”.

    My understanding of boy one is he does not feel any feelings at all, he is numbly discontent and he just lives in a climate of explaining his feelings to avoid ever feeling them. But what he may explain most is the state of having no connection to his feelings. So he will be explaining numbness and alienation and disturbance and unrealness and all the many consequences of blocking the normal flow of emotionality.

    But I do not like the “idea” of “teaching” anyone “how to” have their own private feelings. All the talk about “emotional regulation” sounds to me like some external expert monitoring your babyish feeling of just sadness or just loss or just exuberance.

    The problem in the world is not one of what to do ABOUT feelings. Feelings fix feelings by being left alone to be felt. The problem in the world is one of allowing logic to mock feelings into numb blockage of feelings and that lidded numb sensation then being experienced as “numb deadness” or “explosiveness”. Neither of those are healthy or balanced.

    I must be away now. Things to do. I just flew in for a natter (chitchat).

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    • https://youtu.be/Ol-6c-Ob04E

      I felt very perplexed this morning. Even low. When quite by chance this song came on.

      I would add to my previous comment that in life it is more often the magic of the UNEXPECTED that sets a person back together again. This factor of unexpectedness is woven into the tapestry of nature so much that you cannot go for a walk in a wilderness without meeting the miraculous unexpectedly. These unexpected moments accumulate as treasures you can never replicate. The rareness of them, by the way they cannot be reproduced, enriches the spirit.

      This is often overlooked as an important medicine. Sometimes it proves lifesaving. And often arriving with sychronous humour.

      You cannot put it in a book or treatment model. Yet it is often only this that saves us.

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  5. Our “medical system” is based on charging for services and turning the patient into consumers who buy products or use products like medical devices and drugs. And psychiatric drugs have reached a wall and now you are seeing articles in major magazines and newspapers (funded and promoted by PR companies) is the next phase which is medical devices and implants for people suffering from failing to “respond” to psychiatric treatments who are in a much worse condition than when they entered the never ending treatment in psychiatry.

    Poor psychiatric outcomes will spawn the next profit center in psychiatry in the next few years. They will call it the “brain implant device revolution” stage with all the same claims and go through another 20 years of disaster and then admit to failure.

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  6. Hello Iva,
    I very much enjoyed reading your article. I share the same perspective. Mental Health delivery needs to change in a Humanistic direction.
    I believe the brain has a natural mechanism for dealing with stress and trauma. Francine Shapiro documented her revelation about the healing effect of REM Brain activity in 1989 in the Journal of Traumatic Stress. This was one of the greatest moments in the history of psychology. She developed EMDR therapy, and then grew it into a Worldwide organization worth multi-millions. Therapists are trained in it at the cost of thousands of dollars. They then charge their clients one to three hundred dollars per session. Meanwhile those without the financial resources (the majority) are unable to get this treatment that for many are completely life changing. Untreated trauma is likely a percentage of most human tragedies, most murders, assaults, domestic violence, child abuse, suicides, addictions, road rage, many medical conditions have roots in untreated trauma. The brain’s attempt to deal with these traumas is REM sleep. But, just as the body needs outside help to aid the immune system when it has an infection, so we will take an antibiotic, the brain needs additional stimulus and longer sessions of REM brain activity to diminish the effects of stress and trauma. There are many programs that deliver REM audio stimulation of the brain to help people heal. This is just the beginning of the awareness that many people can heal themselves without spending thousands of dollars. Take care, David B., LCSW (retired trauma therapist at: Se-REM.com
    Self effective – Rapid Eye Movement)

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