Mary O’Hagan, author of Madness Made Me: A Memoir, has prepared a Wellbeing Manifesto (with a New Zealand orientation), subtitled “A submission to the Government Inquiry into Mental Health and Addiction”.
The manifesto includes seven wellbeing priorities, plus a listing of foundational principles of wellbeing and twelve core Big Community suggested responses to improve life and health outcomes across the lifespan. But its introduction begins by describing “The Problem“:
“Big Psychiatry (our medical-led mental health and addiction system) was created around 200 years ago in an historical moment that established the construction of madness as an illness. The new profession led a medicalised, institutional and coercive system, where even the best intentions led to routine harm and poor outcomes.
“Big Psychiatry still sits at the hub of our mental health and addiction system … Its medical lens and expensive, narrow interventions focus on symptom reduction and short-term risk rather than holistic wellbeing and long-term outcomes …”
Despite the closure of the old psychiatric hospitals and the addition of some community support services, Big Psychiatry still sits at the hub of our mental health and addiction system, where it shapes the world view and draws on most of the available resources. Its medical lens and expensive, narrow interventions focus on symptom reduction and short-term risk rather than holistic wellbeing and long-term outcomes …
New Zealand led the world by taking the first significant steps in the transformation from Big Psychiatry to Big Community (a multi-sector, community-led wellbeing system) in the 1990s and 2000s, through the closure of the large psychiatric hospitals and growth in community support services.
However, in the last decade a crisis has developed from persisting inequality, loss of leadership, lack of investment in Big Community and a complex, inflexible and fragmented system. There is widespread public concern about levels of distress and suicide, especially among Māori and youth. Many people cannot access help until they are in a deep crisis. People who use services are poorly served, with increasing rates of coercion, traumatising crisis interventions and a paucity of comprehensive responses.
More of the same will not fix the problem …”
Read more (and optionally download the Manifesto as a pdf) here.