Ad hoc list to expand goal statement for the WFMH July Board meetings in Vancouver, BC

II.3 WFMH Goals
1 To heighten public awareness about the importance of mental health, and to gain understanding and improve attitudes about mental disorders.
2 To promote mental health and optimal functioning.
3 To prevent mental, neurological and psychological disorders.
4 (Sylvia) To improve the care and treatment of those with mental, neurological and psychosocial disorders.

I was only asked to expand on item 4, but they seem seamless to me and the People Who have things to say about all of them.

wfmhgoals-subscribe@topica.com

http://www.topica.com/lists/wfmhgoals/prefs/info.html

1.     health is seamless - stop carving out mental health from health
        coordinate with WPHA
       language matters: discrimination, prejudice, stereotype (not "stigma") www.peoplewho.org/documents/wordsmatter.htm
       all information and communication material most reflect the position that recovery happens
       use information technology
      always include primary beneficiaries when presentations are made
            speaking about us without us sends the message that we can't speak for ourselves
2.    context matters: abuse, poverty, housing, employment
       public health model: community not individual
3.    address abuse and violence and trauma, including the trauma of treatment www.peoplewho.org/abuse
understand how many people have a co-occuring post-traumatic stress disorder, including from events that happen within              the system of care
        acknowledge the wound, the anger, that many continue to carry
4.    treatment without full and informed consent  is justified when, and only when, a patient is not conscious, is a child, is legally              not competent - "Human rights must not be sacrificed to achieve public health goals."  APHA International Human Rights              Commitee,   one of the Principles approved September 00
forced medication, forced electroshock, forced magnetic therapies, ... destroy any possibility of therapeutic alliance
        involve consumers and survivors  in meaningful and significant ways in all aspects of what affects them, from public                  education, policy planning, and prevention to their own emergence as self-determining people.
        involve carers when they  represent consumers who can not represent themselves
socializing newly diagnosed patients into" the mentally ill" affects self-esteem, recovery, sense of personal control,                  internalized shame and self-hatred.   This includes the confessional requirement of admitting to one's diagnosis.
people without jobs need employment before treatment
people without housing need homes before treatment
        anecdote and experience is evidence.   evidence-based interventions cannot select only one kind of evidence to validate themselves as "scientific" while not valuing less commercial interventions..  

Within WFMH:
        use the established user committee for advice
        honor resolutions adopted at the General Assembly
        maintain at least two At Large board seats for consumers and survivors
        include in the Congress contracts that consumers and survivors receive, at a minimum, Congress registration scholarships
        NZ and AU have done well in being inclusive and respectful; get guidance from them

Example: Wellness Guide  www.wellnessguide.org

Context (part of a longer document I wrote):

In the twentieth century, as advanced societies moved from manufacturing to service, the self help movement and the human rights movement parented the mental patient movement. This new movement inherited the self help principles of volunteering, mutuality, valuing the experiential, and deflating professional privilege, along with the civil rights focus of other disability rights, gay rights, and women's movement groups (Reissman, Chamberlin) and was nurtured by the politics of empowerment in an increasingly self-help oriented society (Katz, Zinman). From the beginning there was a drive to unite in hope of change, or at least raise awareness, and to release some of the feelings of anger and betrayal.

In the 60's, the mental patient movement challenged psychiatry's hold on explaining behavior and remained separatist. Madness Network News published survivor accounts and views. By the 80's, diagnosed people were changing the mental health system from within (Church). Some groups maintained a strong anti-psychiatry ideology (Emerick); society was urged to increase social acceptance of human diversity (Breggin). Some groups developed institutional collaborations or at least interactions (Emerick).

Beginning in 1985, the U S federally sponsored Alternatives conferences gathered consumers, survivors, and ex-patients who shared views as divergent as what they chose to be called. The World Federation of Psychiatric Users, later renamed The World Federation of Psychiatric Survivors and Users, was established in 1991 (del Vecchio). By the end of the 90's the U S government and three fifths of the states had consumer affairs specialist offices (Center For Mental Health Services 98-012). The 90's emphasized jobs and consumer-operated business (Church). Nearly every country and U S state has a statewide organization (Center For Mental Health Services 98-013).

How to reshape the rhetoric to affect reality is a central question (Everett). One researcher sees four themes: language, labeling, stereotyping and stigma; the medical model and how it has been accepted as the primary model for understanding mental illness; the power base of psychiatry and the criticisms of it by those in the mental health rights movement; professionalism and how this is understood by students and carers (Porter). The base of shared values remains constant: self-determination and empowerment, independence, egalitarianism, voluntariness, confidentiality, responsibility, choice, respect and dignity, peer support, hope and recovery, social action (del Vecchio). Personal competence is connected with a desire for and a willingness to take public action (Zimmerman and Rappaport). And social action and social change remain a core movement activity (Van Tosh).

The characteristics of feminist activities match movement values. Writing about the women's movement, Linton notes that the people involved are the active central focus, that activities are cooperative, that there is a recognized urge for liberation from the oppression of the status quo, that issues are identified and strategies developed, that the process is open and inclusive, that those involved are respected and valued, including their diverse experiences even when in conflict (Linton).

Still, the problem for movement advocates lies in shaping a common social identity among the diverse population of people with psychiatric disabilities (Kaufmann). For instance, the reduction in government-sponsored housing programs became uncomfortably visible when some expressed their discontent with services by choosing the streets. The twenty-first century will still pose the challenge of rights as the family movement campaigns to lessen the legal protections and increase coercive medical interventions and institutionalization (NAMI).

Managed care and access to information have helped invert the health care pyramid. Instead of first consulting a health expert in person, today health needs are first met by data gathering (Ferguson). Those who use the Internet have an important tool for all health, including mental health. At the end of 1998, Alta Vista Internet searches found 19 million hits for health, 292 thousand for mental health and 57 thousand for mental illness.

Almost all current mutual support and advocacy of people who experience moods swings, fear, voices, and visions are supported by local and national mental health systems and associations, drug manufacturers, and grants. Some believe that this kind of funding dulls the philosophic edge of the grass roots user movement and supports biomedicine instead of healing and autonomy (Caras, 1994). On the other hand, increasing intensity of competition among consumer organizations is anticipated as groups struggle to secure a niche in the social movement industry (Kaufmann).

Citations are at:  http://www.peoplewho.org/sylvia/om/bibliography.htm

Basis of mental illness

From: wayne smyth <waynesmyth@hotmail.com>
From a site at:  http://www.PAB2000.org Full citations there

The U.S. Congress, Office of Technology Assessment of the United States Congress (1992) published a report titled The Biology of Mental Disorders.  The report concludes: "Research has yet to identify specific biological causes for any of these disorders" (p. 14).

In a psychopathology textbook used for second-year medical students, the authors state, "psychiatry is the only medical specialty that...treats disorders without clearly known causes" (Maxmen & Ward, 1995, p. 57).

Colin Ross, discussing the chemical imbalance model for schizophrenia, claims that the "dopamine theory of schizophrenia is a political strategy" with the goal of obtaining additional research grants (Ross, 1995, p.108).

Peter Breggin, M.D. (1997), author of Brain Disabling Treatments In Psychiatry, declares that "there are no known biochemical imbalances in the brain of typical psychiatric patients" (p. 5b).

In a recent consensus conference sponsored by the National Institutes of Health (NIH) in November of 1998, the panel of experts concluded, "there are no data to indicate that ADHD is due to a brain malfunction" (p.2). In their report they went on to state that the same can be said for "most psychiatric disorders, including disabling diseases such as schizophrenia" (p.2).

Dr. William Wirshing (1999), a researcher and professor of psychiatry at UCLA, stated to a room full of psychiatrists that we have been lying to everyone for years concerning the chemical imbalance model. No one in the audience challenged him.

In an article approved for continuing education by the American Psychiatric Association, the author states, We don’t know how psychotropic medications really work (Khan, 1999).

"Child sexual abuse is associated with a substantial increased risk of psychopathology, whether or not it occurs as part of a larger syndrome of childhood adversities.  The results of this study suggest the need for publich health prevention programs both to reduce the prevalence of child sexual abuse and to develop efficacious treatments.   Public health practitioners should note, however, that it is not only high-risk families with a constellation of adversities that should be targeted. We have shown that child sexual abuse that occures in relatively health families can also be damaging.  Thus primary prevention approaches targeting all children and families as being potentially at risk should be continued and rigorously evaluated.   These programs should go beyohnd grou-based personal safety instruction to include perpetator prevention stragegies and parenting workships.  Additionally, evaluation should ensure that primary prevention efforts are not doing harm.  ...  From an epidemiolgoic perspective the results of this study suggest that the prevention of child sexual abuse may also be an important strategy for reducing psychopathology."

Molnar et al, Child Sexual Abuse and Subsequent Psychopathology, American Journal of Public Health, May 2001, 915, p 758

 We've already selected violence as the theme for World Mental Health Day in 2002.   Educating about child sexual abuse is a strategy that fits neatly.

 

 

RELATIONAL WORLDVIEW AS AN ORGANIZING MODEL

The relational worldview, sometimes called the cyclical worldview, finds its roots in tribal cultures. It

is intuitive, non-time oriented and fluid. Balance and harmony in relationships is the driving principle of this

thought system, along with the interplay of spiritual forces. The relational worldview sees life in terms of

harmonious relationships; health or wellness is achieved by maintaining balance among the many interrelating

factors in one’s circle of life. Every event relates to all other events regardless of time, space or physical

existence. Health exists only when all elements are in balance or harmony.

In the relational worldview, helpers and healers are taught to understand problems through the

balances and imbalances in the person’s relational world. We are taught to see and accept complex

(sometimes illogical) interrelationships that can be influenced by entering the world of the client and

manipulating the balance contextually, cognitively, emotionally, physically and/or spiritually.

Interventions need not be logically targeted to a particular symptom or cause, but should be focused

on bringing the person back into balance. Nothing in a person’s existence can change without all other

things being changed as well. Hence, an effective helper is one who gains understanding of the complex

interdependent nature of life and learns how to use physical, psychological, contextual and spiritual forces to

promote harmony.

 

Volume I: Cultural Strengths and Challenges in Implementing a System of Care Model in American Indian
Communities  http://www.air.org/cecp/promisingpractices/Default.htm

 

The relational
model describes mental health as a balance among context, mind, body, and spirit.

 

 

For decades now the disability rights movement has tried to

shift the focus from the disabled body to social

discrimination.  Rather than simply "fix" the individual

body according to a "medical model," disability advocates

argue that the discriminatory attitudes and structures need

to be changed. 

 
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