The ‘System’

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The Mental Health ‘system.’

For most consumers under its auspices, we mental patients just call it the system. The truth is there are many ‘systems of care’ around the United States. Social security, Department of Social Services are examples of other systems. No system is more archaic, coercive, and outmoded than the public mental health system. The public mental health system is complex, repressive, and misunderstood.

I hope to make sense of the public MH system through a dual perspective. I am a clinician and peer advocate. The biggest delinquency is rooted in failure to provide adequate person-centered care. As a mental health provider and peer, I have witnessed various attitudes towards consumers, most not person-centered. I define person-centered here as holding a stance towards consumers that allies with their recovery and creates a culture and environment of healing.

I have worked at various levels of the mental health system. Working in the community mental health clinic (e.g., freestanding clinics NY-Article 31), community centers, schools, and conducting home visits providing in-home therapy, my experiences are fairly diverse.

All of my experiences have provided an opportunity to work with other systems. Systems which intersect the mental health system stunned me. Remarkably, the most person-centered attitudes I have observed while working in mental health were in OTHER systems (e.g., D.S.S & Social Security, Schools & other community organizations ).

I have been told this is because mental health patients have a high rate of recidivism to renter the system after “graduating” or from not qualifying for services. Strangely, as if patients are set up to fail when the support is pulled from underneath them. Too often, when left to their own devices to succeed without support, symptoms activate without wanting and success is never realized.

Processing the lack of compassion in the system was even more sobering. The Mental health system’s so-called person-centered care is as rife with inequity as it is with racism, bias, and stigma. As s community practitioner and peer, I would have thought mental health has the most advanced person-centered perspective. I would hazard to say we have not yet reached the limits of applying a single theory to our practices. How wrong I was…

As an example just think about this dynamic. After years of support, suddenly, people carrying a mental health diagnosis improve in their condition. Then, the folks working hard to heal are dropped from services to survive without help. Many of whom were subject to conditioning, in some cases, hand-holding, and in others, learned helplessness. This happens all the time in the public mental health system.

The struggle I am describing sets the stage for the bigger dilemma in mental health. How to be transparent, authentic, and accurate for the best interest of the consumer’s care, treatment, dignity, and right to the best practice) Despite the challenges, there are options for health professionals handle this complex aspect of proving stigma and bias free treatment.

Being a social worker and peer means building empathic connections with clients and colleagues. Peers know what it’s like to be sick. Peers also know what it’s like to be treated for a Illness. Bridging this gap is fundamental in providing the best possible care available in mental health. Let’s face it; human biographies are deep and complex and require authentic peers comfortable with life’s journey. ‘

The most intimate and supportive relationship in a system centered around suffering and deep pain has got to be even more powerful and healing. In the face of such suffering, restoring the human aspect of care in human services is critical.

The system needs supervisors, clinicians, and administrators who understand how to support and hold space, while challenging the fear of the unknown. Call it ‘Treatment, Case Management, Peer Support,’ we are all looking to resolve the mental health issues of our clients and patients.

About the Author

J. Peters

J. Peters is the Editor-in-Chief of Mental Health Affairs.

Award-winning book author and Bold 10 Under ten award recipient J. Peters, LCSW. Through his work as a Licensed Clinical Social Worker. Mental health therapist and disability rights advocate Mr. Peters fights for those without a voice in various care systems, such as the New York City Department of Social Services, the New York State Office of Mental Health, or the city's Department of Corrections.

Mr. Peter's battle with Schizophrenia began at New London University in his last semester of college. Discharged from Greater Liberty State Hospital Center in July 2008, Jacque's recovery was swift but not painless and indeed brutal after spending six months there.

He has published several journal articles on recovery and mental health and three books: University on Watch, Small Fingernails, and Wales High School. He is also a board member of the newspaper City Voices. Mr. Peters currently sits on the CAB committee (Consumer Advisory Board) for the Department of Mental Health and Hygiene in NYC and the Office of Mental Health (OMH) as a peer advocate.

Owner of Recovery Now in New York, a private psychotherapy practice, Mr. Peter's approach is rooted in a foundation of evidence-based practices (EBP). Jacques earned a master's degree in Social Work from Binghamton University and worked as a field instructor for master's and bachelor's level students in NYC.

He is blogging daily on his site mentalhealthaffairs.blog, Mr. Peters regularly writes articles relating to his lived experience with a mental health diagnosis.

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