From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress

Abstract

The article proposes a rough outline of an alternative systemic approach to mental health issues and of a more humane mental health care system. It suggests focusing on understanding mental distress as stemming from problems in living, using medications as agents facilitating psychotherapy, or as a last resort and short-term help, according to the principles of harm reduction. It argues that understanding drugs as psychoactive substances and studying the subjective effects they produce could lead to better utilization of medications and improvements in terms of conceptualizing and assessing treatment effects. Qualitative research could be particularly useful in that regard. It also advocates a radical departure from current diagnostic systems and proposes a synthesis of already existing alternatives to be used for both research and clinical purposes. Accordingly, a general idea for an alternative mental health care system, based on a combination of Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support is presented. The proposition could be seen as a first step towards developing a systemic alternative that could replace the currently dominating approach instead of focusing on implementing partial solutions that can be co-opted by the current one.

Boundaries of Stigma. Anti-Stigma Campaigns as Social Control and a Source of Self-Stigma

“…This is, however, the prevailing narrative about schizophrenia, most often portrayed as a "progressive brain disease" that requires life-long medication (Zipursky et al, 2013). Similarly, the popular view about depression created by the media and the pharmaceutical industry is that it is caused by a chemical imbalance in the brain, though there is little evidence for that (Lacasse & Leo, 2005); on the contrary, a substantial body of evidence points to its psychological, cultural, social or economic causes and the effectiveness of non-pharmacological interventions (Stupak & Dobroczyński, 2021). Though the official paradigm of psychiatry is usually described as a biopsychosocial one, Sharfstein (2005), as president of the American Psychiatric Association, gave an honest description of the actual situation: "we have allowed the biopsychosocial model to become the bio-bio-bio model".…”

Introducing Peer-supported Open Dialogue in changing mental health care

“…At the moment, the necessary transformation of mental health care (MHC) toward person-centered, recovery-based, and network-oriented care is receiving increasing attention across the globe ( Stupak and Dobroczyński, 2021 ; von Peter et al, 2021 ; WHO, 2021 ; Galbusera et al, 2022 ). This transformation entails a paradigm shift beyond the biopsychosocial model (diagnosis, medication, and symptom reduction) to a more holistic approach including an existential component ( van Os et al, 2019 ; Galbusera et al, 2022 ) that conceptualizes recovery as a personally unique ongoing process encompassing all aspects of human life and concerned with gradually rehabilitating a sense of agency and meaning in life ( Anthony, 1993 ; Slade et al, 2014 ).…”

How can the subjective well-being of nurses be predicted? Understanding the mediating effect of psychological distress, psychological resilience and emotional exhaustion

“…, 2017). Scholars tried to identify and evaluate the factors that threaten the mental health of employees in order to increase organizational productivity by minimizing the factors that affect the health and well-being of employees (Stupak and Dobroczy'nski, 2021; McAllister et al. , 2014).…”