The Village

Mental health services in this country have become a real money making scheme. Especially when it comes to the use of heavy psychopharmacological agents--psychotropic medications--pills to control people's behavior. No, I am not at all against mental health practitioners or the use of medications when needed. But I think that we, the mental health providers have created a culture of us (the healers) and them (the sick ones). There seems to be no room in between, and no fluidity between the two roles. People with persistent, serious mental illness move into the system against their will and never leave it. There has to be a better way.

I am currently enrolled in a seminar that is taking place at The Village in Long Beach. This is a novel community mental health center in which people who seek services there are referred to as "members." Note that this connotes ownership and self-determination, not passive compliance with what someone else recommends. Members are given education about their condition and invited to weigh in on creating options for treatment. Mental health practitioners help members decide what they need and then act as consultants while the member takes responsibility for their progress at their own pace. There are discussions about how to cope with life in very practical ways: how to get a job--that's a huge issue; how to find living arrangements that are safe and off the street; how to get their children back and provide for them; how to get and keep relationships. The use of what is called "Natural Supports" is facilitated. This means incorporating friends, families, and peers--other mentally challenged individuals who are in recovery--in planning and supportive roles. Putting people in their own homes and helping them find working arrangements that they can sustain are healing in and of themselves. So many mentally ill people lose respect for themselves as they see everything they own and care about drift away, and for a multitude of reasons.

Language, behavior, and interactions must reflect freedom of determination, the member's sense of pacing, support of people whom they trust, and meaning for living by conventional standards. When these things are lacking, mental health too often becomes manipulative, pathologizing, and debilitating people in terms of their own sense of mastery and personal power.

A group of educators and front line mental health providers have been invited to The Village to learn how their Recovery System works. It is truly amazing. On Thursday I will be going out on the street, to Skid Row, to do "home visits" for the homeless people who live there and who struggle with motivation to change their circumstances. I will report in after I have been out with the case worker.

The way we have been doing mental health for those with persistent, chronic mental illness, hasn't worked. I think this might.