In our zeal to identify people by their “real problems” how often do we lose the real people?
Most people I know simply dont fit cleanly and neatly into any label, group or classification. Something seems to always be left hanging out.
We are not collections of syndromes, disorders, and diagnoses. We are not puzzles put together with the pieces we have been cut up into. Our explanations of people are not the people we explain. If you dont realize that fundamental truth then you are lost. There is a world of difference in saying you treat mental illness and saying you treat people with mental health issues. In the first instance knowledge is the only key that really matters. It is a question of who knows better and knowing better in the end gives you power over the people who “need” your knowledge. No psychiatrist really believes anything is a matter of opinion and if you find one who does he certainly doesnt think your opinion is as good as his. In the second instance “care’ is the important variable and while knowledge may still be very important it takes a substantial backseat to the quality of your relationship with the person you are trying to help. There is a substantial difference in treating people who are”sick” and caring for those who are hurting. Do you believe the problems in life are due to illness or to injury? The answer to that question sets the tone for all you do.
Many people (and they would be horribly offended to hear me say it) simply believe that the basic problem in the mental health system is that people who are ”mentally ill” are simply not very obedient. They dont cooperate with the people (professionals) who “know better.” And if they became more obedient then there life would get much better. If they dont cooperate it seems to be the frequent conclusion that the reason they dont cooperate is that they don’t want to. They are not motivated or dont try hard enough to do the “better things” that people who know better tell them to do. And from there it is a very short step to believing that if they wont cooperate the right thing is to make them. Coercion in the service of “better things” from people who “know better” seems the best thing. Then much of your idea about mental health treatment revolves around finding someone to make it more muscular, more forceful. It starts with believing that people are what we call them. A small but deadly step.
Then when treatment becomes something you do to people instead of with them you have become full circle. And we wonder why people who seem to so desperately need help simply dont come to get it like common sense seems to dictate they should.
And finally a point repeated several times on this blog in various ways. The biggest problem with the mental health system is not how they address the problems people have. It is how they address the people with problems. When that happens mental health treatment will be about treating people as people, people who may be hurting and in extremely significant distress. It will not be a vertical relationship based on who knows more, but a horizontal relationship focused on how people can care more. And that will be real mental health reform.