Obama’s Mental Health Policy Recommendations: Expect a little Good and lots of Bad and Ugly 01/22/2013Posted by ALT in Children's Mental Health, Mental Health Policy and Inititatives, Patient Rights and Advocacy.
Tags: mental health, Mental Health First Aid, mental health recovery, Newtown, President Obama, Project AWARE, The Time Is Now, WRAP
A life lesson: Whenever someone says they’re “doing it for the kids,” you can expect very little Good and LOTS of Bad and Ugly.
Doing it for the kids
A week ago Wednesday, surrounded by adoring children, President Obama presented his plan to protect our children and communities by reducing gun violence.
Part 4 of that four-part plan was entitled “Increasing Access to Mental Health Services,” which says:
If even one child’s life can be saved, then we need to act. Now is the time to do the right thing for our children, our communities, and the country we love.
That’s right, folks: this time we’re doing it for the kids.
Spare no expense when you’re doing it for the kids!
Obama’s proposals come with a big price tag: $55 million!
And they seem geared towards one basic thing: get more children into professional mental health treatment (he even sets a specific goal of 750,000 children — pretty nice for Johnson&Johnson, Eli Lilly, et al to have advance notice of the number of new potential lifelong customers, eh? ).
What’s wrong with encouraging young people to seek treatment?
My parents did what millions of American parents have been taught to do: they saw how much emotional pain I was in, and they sought “help” for me in the “mental health” system. They had no idea that my entrance into a psychiatrist’s office as a young teenager would end up stripping me of my health, my hope, and my sense of Self. Today, we are able to come together as a family with forgiveness, acceptance, love, and gratitude, to talk about how counterintuitive my journey into a system of proclaimed “healing” ended up being; indeed, as the result of being “shielded from harm” by the “mental health” system, I experienced more harm than I could have ever imagined for myself.
—Laura Delano, in her essay “Free from Harm? Reflecting on the Dangers of the White House’s Proposed ‘Now is the Time’ Gun Control Plan” (you should read it… it’s good)
In other words, Obama’s placing the spirit of America’s youth on the altar.
Do it for the kids.
Mental Health First Aid: The Good?
So what exactly is the government buying with $55 million of my —and my fellow Americans’— hard-earned cash?
One of the proposed interventions, “Mental Health First Aid,” is a 12-year-old evidence-based practice (that’s on the verge of a lucrative adolescence, it seems). Developed and initially implemented in Australia, it’s a 12-hour course for the layperson that teaches people to:
- know the signs of mental health problems
- provide first aid for mental health crises (like suicidal behaviors, panic attacks, etc.)
- promote and enhance recovery.
These don’t sound like bad goals at all. And, really, much of the documentation on Mental Health First Aid is helpful, non-stigmatizing, very human (as opposed to institutional) stuff. For example, the Mental Health First Aid sheet on “psychosis” says:
How can I be supportive?
Treat the person with respect. You should try to empathize with how the person feels about their beliefs and experiences, without stating any judgments about the content of those beliefs and experiences…
Should I encourage the person to seek professional help?
You should ask the person if they have felt this way before and if so, what they have done in the past that has been helpful. Try to find out what type of assistance they believe will help them. Also, try to determine whether the person has a supportive social network and if they do, encourage them to utilize these supports.
Respect, dignity, being non-judgmental, activating a social support network of peers, friends, family, and asking the individual what sort of assistance he or she would prefer — quite frankly, that sounds fantastic!
That sounds like self-advocacy! That sounds empowering!
Actually, it sounds a lot like the principles of WRAP [Wellness Recovery Action Plan] – a wellness tool developed in part by Mary Ellen Copeland that has helped so many individuals reclaim their right to define wellness, and to find the resources they need for achieving it inside themselves…
Unfortunately, the emphasis on self-advocacy/determination and peer support is spotty at best when you examine the entire body of Mental Health First Aid literature. The truth is these folks are just as intent as Obama on directing people towards the “necessary professional help,” with self-care and self-help an optional second.
The Bad and the Ugly
Things go from bad to worse when you take a look at the Manual for Mental Health First Aid. In here, we learn that:
The symptoms of depression are thought to be due to changes in natural brain chemicals called neurotransmitters. These chemicals send messages from one nerve cell to another in the brain. When a person becomes depressed, the brain can have less of certain of these chemical messengers. One of these is serotonin, a mood-regulating brain chemical.
And a few pages further in the manual, we find these ugly sentiments:
A team of Australian mental health researchers has reviewed the scientific evidence for the effectiveness of a wide range of treatments for depression. The following rating system was developed to show the treatments whose effectiveness was best supported by the evidence:
☺☺☺ These treatments are very useful. They are strongly supported as effective by scientific evidence.
☺☺ These treatments are useful and are supported by scientific evidence as effective, but the evidence is not as strong.
☺These treatments may be useful and have some evidence to support them. More evidence is needed that they work.
Since when is a therapy that’s been shown to be no more effective than placebo [antidepressants] rightfully classified as ”very useful,” and “strongly supported…by scientific evidence”?
And they’re giving three smiley faces for electroconvulsive therapy, too?!
Electroshock devices still have not been thoroughly reviewed for safety by the FDA (if they were, they’d have to nail down that nasty little statistic of how many deaths by ECT per 100,000?), and many studies counter the “three smiley faces” rating, including this large literature review, whose authors state:
The cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.
—John Read and Richard Bentall in “The effectiveness of electroconvulsive therapy: A literature review“
Moreover, firsthand accounts of electroshock are often anything but “smiley.” In the words of Ernest Hemingway, a shock survivor:
Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient….
Imagine an alternative
Imagine an alternative. Imagine that the President recommended a course of action that emphasized self-reliance, empowerment, and advocacy, an “evidence based practice” that was steeped in the philosophy of respect and dignity for all (rather than just a semblance of it). One that emphasized treatments that were cost-effective or even free (rather than relying on very expensive, “appropriate professional help”), and one that pointed people towards achieving their visions for their lives, their wellness.
In other words, what if the president had set aside $55 million for the teaching of WRAP [Wellness Recovery Action Plans], or something like it, to anyone who so desired?
Those might be the last few dollars ever spent on so-called “mental health care”— with a population empowered to embrace its own humanity and resilience, there’d be no more need for it.