Today I attended a gathering to discuss mental health for Northern peoples in Saskatchewan. I continue to be amazed by how much money can be thrown at a problem instead of doing actual community development which is so much cheapter. I am drawn to the World Health Organization studies of how much better outcomes India has for serious mental illness than the United States. What India has are intact communities and social networks, sorely lacking in North America. India lacks the money to invest in chronic medication for serious mental illness, so medications are only used for acute episodes. Indian patients must be cared for by their families, even in hospital, since money doesn't exist for nurses. Of course it's not magic, but social relationhip is important and it is so much more compatible with aboriginal ideas about mental health in which self is social and not individual. Identity is seen as the story we tell ourselves to make sense of all the stories that have ever been told about us. People's behavior is determined more by context, environment, and expectation than internal psychodynamics or psychic structures, or psychic apparatuses. When we focus on that, we realize people can change without ever coming to treatment if the community changes around them.