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Community Mental Health Re-Discovered: Volume ii

Together, in our lifetime, we will witness the last discharge of a person with a mental health condition from a hospital and make psychiatric prisons a thing of the past.

Universal Access and Inclusion of Mental Health Treatment in the Community. Simply put, access to all available mental health treatment without entering the walls of the hospital. There is no question of the benefits to this level of access to treatment for people carrying a mental health diagnosis. This article will explore the benefits of universal access in the community and make recommendations on how to implement treatment in the community for practitioners interested in this long-overdue concept which might launch mental health treatment into modern times.

On a functional and needs-driven assessment, there can’t be two systems at play in mental health. Economic trends and insurance models demand a single system to make reimbursement possible, and lawmakers require one system to demand quality of care to uphold the rights of all those in treatment. With that said, the time has come to shut down the hospitals and in-patient units housing patients with inadequate and archaic treatment. We need to set a deadline for the government and office of mental health to evacuate the units and discharge all people back to the community once and for all. Once a deadline is set lawmakers, policymakers, and all stakeholders in mental health can really begin drafting a new law for universal inclusion of treatment in the community.

Universal treatment goes beyond providing enhanced services in the community. It means more than lots of ACT teams and community integration teams to make sure people stay connected to care to reduce the risk of hospitalization. On the premise hospitalization is no longer an option, treatment will no longer target hospital aversion and crisis intervention to maintain people living in the community. Instead, treatment will hinge on relapse prevention, and take on a preventative mental health model based on a philosophy that not all symptoms can be managed or eliminated, and people will have moments of instability. The target of care and treatment will be to prepare people for these moments in their recovery and arm them with the skills and knowledge they need to survive these challenging moments ahead. The era of the hospital is over, mental health’s bandaid to the psychiatric condition.

Providers, peers, and all people in mental health can expect major shifts in outcomes and people’s quality of life. Unquestionably there will also be a shift in power dynamics between patient and professional. People with a diagnosis will no longer fear being locked away given non-compliance or disagreements on response to treatment. Indeed, the road ahead has many obstacles before universal treatment can be implemented, but these challenges must be met head-on if we are to move mental health treatment forward into modernity. Allies and advocates must lobby and community-based services standing benefit and expand need to take up this cause and incorporate it into the very structure of their organizations. Together, in our lifetime, we will witness the last discharge of a person with a mental health condition from a hospital and make psychiatric prisons a thing of the past.

Edited: Autumn Tompkins

J. Peters

J. Peters

Max Guttman '08, MSW '12, is the owner of Recovery Now, a private mental health practice. Through his work as a Licensed Clinical Social Worker, therapist and disability rights advocate, Max fights for those without a voice in various New York City care systems. He received a 2020 Bearcats of the Last Decade 10 Under 10 award from the Binghamton University Alumni Association. Guttman treats clients with anxiety and depression, but specializes in issues related to psychosis or schizoaffective spectrum disorders. He frequently writes on his lived experiences with schizophrenia. "I knew my illness was so complex that I’d need a professional understanding of its treatment to gain any real momentum in recovery," Guttman says. "After undergraduate school and the onset of my illness, I evaluated different graduate programs that could serve as a career and mechanism to guide and direct my self-care. After experiencing the helping hand of my social worker and therapist right after my 'break,' I chose social work education because of its robust skill set and foundation of knowledge I needed to heal and help others." "In a world of increasing tragedy, we should help people learn from our lived experiences. My experience brings humility, authenticity and candidness to my practice. People genuinely appreciate candidness when it comes to their health and recovery. Humility provides space for mistakes and appraisal of progress. I thank my lived experience for contributing to a more egalitarian therapeutic experience for my clients."
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