Towards a Radical Re-visioning
Radically reimagining the mental health landscape for people with serious mental health and substance abuse conditions
We are at a turning point. It is time to radically reimagine what needs to take place in our public space for people with serious mental illnesses (SMIs), including addiction. It is time to see a new vision.
Such a vision has in fact been seen and has been tested in a handful of private settings (what we call ‘alternate realities’) in the United States - and elsewhere (see here and here).
We need to extract the critical elements from these alternate realities and apply them more equitably across the public and private sectors.
It is the purpose of this website to create a forum for sharing that vision and for fostering a series of critical conversations on topics that generate polarization. We will do this through establishing several venues for these conversations, bringing people of differing opinions together – on podcasts and audio-visual formats.
Seeing how we can build on what we know into a different future is the essence of creating new paradigms
Reinvent a different paradigm for people with serious mental illness and related conditions
Develop critical conversations with reader/listener input on topics relevant to building and sustaining that future (through written and oral formats)
Support awareness of best practices in treatment of these conditions -- together with a better understanding of the barriers to wider, more rapid implementation
Generate public awareness and the belief that we can do this
Be an alternative to the post-apocalyptic landscape that has emerged in the decades following deinstitutionalization
Make use of the unique opportunities in our own present, generating ideas on how we may repurpose resources – from conversion of empty buildings for housing to the selective use of skilled retirees in the workforce
Goals
A root cause of the disaster that now surrounds us is the absence of a life re-affirming community in the face of these serious conditions.
* Endemic lack of decent affordable housing
No necessary connection to skills and jobs
Absence of a creative outlet thru the arts – music, dance, visual arts, theatre - or through community engagement (environment, political, or other)
Treatment as one of several pillars – not an end in itself
No necessary connection to skills and jobs
Absence of a creative outlet thru the arts – music, dance, visual arts, theatre - or through community engagement (environment, political, or other)
Treatment as one of several pillars – not an end in itself
What has been lacking – with all the array of services and supports?
PARADIGM FOR LIVING IN COMMUNITY WITH A SERIOUS MENTAL ILLNESS
Community: stabilized, permanent housing in relationship to work
Treatment: a combination of medical, counseling, and alternative therapies; with emphasis on early intervention for psychosis
Connection thru arts, nature, or other social endeavor
What do we mean by community?
A place and space that welcomes people with serious mental illness (SMI), substance use, and other physical conditions.
Not an asylum, but a sanctuary
A place and space that provides a meaningful role, paid and non-paid, within community maximizes the strengths and gifts of each member. Occurs in dedicated housing [ex: Oxford House] built around a selected industry [ex: Gould Farms - dairy farming]. In urban settings, this might include repurposed office building for hydroponic farming; or bakeries and cafes. In rural settings, this might include farms; solar panel production; wind farms; industrial crafts.
Who will people the community?
SMI/Peers
A Spectrum of Income Groups
Some Families of those with SMI
Artists
Craftspeople
Work & Education: Must Be Meaningful
Meaningful work is a core pillar for healthful life in any community. Whether one or multiple industries can identify and support roles for people with SMI – from entry level to complex based on gifts, preferences and skills and allowing for exacerbations of illness over time
What do we mean by ‘meaningful’ work?
• Work that is part of community life
• Work that provides roles at varying levels of complexity and responsibility
• Work where participation is part of living in this community (it is not welfare without work)
• Education and skill development to buttress and support that role.
Early identification and intervention program/s – to begin Rx at the earliest point in the development of psychotic illness
Sophisticated use of medication, with improved access to clozapine
Clinical therapies, including counseling with cognitive behavioral approaches and alternative therapies (such as non-verbal/dance, art, music, and theatre, writing)
Movement in and out as needed of more intensive therapeutic environment
Use of Assertive Outpatient treatment (AOT) and Crisis Response Teams (CRT for children and youth) reserved for those unable to make use of fully voluntary treatment (link to T.A.C.)
What does ‘treament’ refer to?
We have a large existing BASE of outpatient treatment – that can and should be used in conjunction with this paradigm.
Why are creative or relational endeavors a Core pillar?
