This article (written for a magazine for systemic family therapists) by David Harper has been published in Context Magazine. It “considers the following questions. Why do we have the kinds of mental health systems that we have? What positive changes have occurred in recent years and what problems still remain? How might we develop a new vision, one where there is real change?” The article begins:
“Systemic therapists are well-used to considering the multiple layers of context within which are lives are embedded so I thought I’d use the invitation to write an article on alternatives to traditional psychiatric practice as an opportunity to look, from a societal perspective, at the issue of psychological distress and conduct which others find troubling – the kinds of things which might be currently labelled as ‘functional psychiatric diagnoses’. Why do we have the kinds of mental health systems that we have? What positive changes have occurred in recent years and what problems still remain? How might we develop a new vision, one where there is real change?
Let’s begin with a thought experiment. Imagine you’re sat down with a blank sheet of paper in front of you. Forget the current structures, kinds of professions and interventions we currently offer to help people in distress. Try to step back from currently culturally dominant constructions of distress. What would be the key elements in designing a society-wide response? What kinds of societal measures would we need to take to address the inequalities that are the ‘causes of the causes’ of distress? What kinds of help would be available for those who have experienced hurt in their lives? In what context would this help be given? At a neighbourhood or community level or in hospitals and clinics primarily designed to help people with bodily disease? Would this help be primarily expert-driven or be available from peers? Would it be primarily individually- or family- or community-focused? What ideas about distress would circulate in the media and popular culture? Would it be seen as a health-related concern or viewed some other way? What would be the place of medication? Would there be therapies available and, if so, what kinds and how would they be accessed?…”
You can download the entire article for free from here.