What is especially frustrating to me is hearing from people who are unsatisfied with their current local service lineup and have a workable idea for a valuable service (let’s say peer-delivered respite care) — but refuse to collaborate with the medical community and with insurance systems to find ways to implement and sustain their own work. I am someone who recovered after treatment (including medication) in the mainstream mental health system. I support clinicians and care advocates who do the work every day, deliver good results for the people in their care, and respond to the concerns of their patients. But it is also true that in many settings care is sub-par by any standard. When the “recovery community” knows how to fix the system’s flaws, what is the next step? If you consider yourself an advocate or a reformer, what can you do that is practical and positive? We are missing opportunities to deliver person-to-person help in our society. We hear a lot of lip service about family members and friends supporting and giving comfort to people in crisis, helping to watch out for suicide risk, delivering friendship to combat loneliness. Who will step up and build a way to train up friends and neighbors to deliver informed kindness on demand? This is America, we live in Capitalism World. Success for an idea usually involves some measure of commercial sustainability. There is economic value around mental health reform. Who has an idea worth funding, and the willingness to make that idea palatable –or actually desirable — to doctors, insurance companies, and the other big political, social, and economic entities that distribute ideas and programs throughout our society? That’s what effective and meaningful reform looks like to me.