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.
Highlights
We will propose a few principles around which a more humane mental health care system could be organized and a rough outline of a possible solution. This system could be based on a combination of the Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support
This may reflect the role of the United States agencies, and indirectly that of American Psychiatric Association (APA) and American Psychological Association, in shaping the global mental health discourse and practice
Precision psychiatry heralded as a solution to some of the problems of the biomedical model seems to be based on the same flawed assumptions [49]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Even though it would be tempting to focus on criticizing the current model, we would like to instead turn our attention predominantly towards arguing for specific systemic solutions. We will propose a few principles around which a more humane mental health care system could be organized and a rough outline of a possible solution. This system could be based on a combination of the Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support. We will argue for understanding mental distress as stemming from problems in living and transforming the research agenda by utilizing the Power Threat Meaning Framework [12,13] and focusing on specific complaints [14]. The role of language will be very shortly addressed in appropriate sections later in the text
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