Radically Change Mental Health Services
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We call on all members of staff in mental health services and citizens who use those services to to sign up to the following manifesto:
Manifesto for the Reconfiguration of Mental Health Services
From our own personal experiences, our years of working in services, and our understanding of the research literature we maintain the following to be self- evident:
- That the causes of severe difficulties that get labeled mental illness are predominantly: sexual and physical abuse, emotional abuse, chronic neglect of physical and emotional needs, bullying, scapegoating, trauma, and living in unsafe environments where people are unable to develop secure attachments. This applies to childhood and adulthood. Social factors such as poverty, inequality and racism often underlie and exacerbate the impacts of these experiences.
- Re-labelling the effects of trauma as mental illness (e.g. schizophrenia, personality disorder, depression) obscures the fact that what we should be focusing on is reducing the amount of harm we inflict on each other, trying to heal the effects of that harm, and bringing about a safer and fairer society in order to minimise trauma and abuse.
We call on governments, mental health services and all citizens to:
- Acknowledge the causal role of damaging life experiences in all types of mental health presentation (e.g., severe abuse increases the risk of being diagnosed with psychosis by a factor of nearly 50).
- Reconfigure services so that healing of the impacts of these traumas is put at the heart of every aspect of services. This implies the abandonment of psychiatric diagnoses and the renaming of services (e.g. from ‘Early Intervention in Psychosis’ to ‘Early Intervention’) as well as fundamental changes in ethos and practice across the board, with relationship-based interventions prioritised over technological quick fixes.
- Change the physical and psychosocial environments of services and communities to ones that enable people to attain a sense of safety (as the core difficulty of hurt people relates to difficulties in feeling safe).
- Work to reduce the social inequalities that allow all kinds of abuse to flourish, in order to build a safer and more just society.
This manifesto appeared at the end of a special edition of the Journal of Critical Psychology, Counselling and Psychotherapy on complex reactions to severe trauma. Originally written by the authors of articles in that journal, a mix of professionals and mental health activists and trainers (Jacqui Dillon, Guy Holmes, Lucy Johnstone, Eleanor Longden, Anthony Morgan, Anna Perrin and Tony Wright) it has been acknowledged by hundreds of people as a blueprint for the future of mental health services.
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