A place of safety?, podcast on the mental health system in the UK and elsewhere! DM's open, get in touch! Email: [email protected]
Joined February 2019
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For those at the back who are unclear about the relation between the Trieste/Basaglia/Democratic Psychiatry (whatever we want to call it) and "diagnosis"... I will try to explain what the idea of putting the diagnosis "in brackets" means in relation to the current debate 🧵
It's quite unfortunate but the UK mh system and Trieste's, & to a significant extent the overall Italian mental health system are deeply offensive to each other. The first prides itself on controlling & separating patients from society, the more unwell the more ostracised.
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When the second ideology (used in the most noble sense of the term) advocates for compromise in shaping treatment, for not having a pre-determined answer for any patient, the first sees this as lack of scientific rigour and efficiency, or as lack of loyalty towards guidelines.
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Passed by a forest full of chestnut burrs... left alone to rot ☹️we really need to learn to roast chestnuts in the Uk, one of the best foods ever!
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If a staff member tells a patient on a psychiatric ward that God loves them & they should pray to "him", this is considered a serious issue,whereas staff physically assaulting patients"is just Tuesday",so to speak.
Don't get me wrong, both behaviours are a significant concern but
of the two, the second is by far a more serious boundary breach in my books.
People that follow my account know very well why I think that the whole "last resort" narrative is a farce so I won't explain why again here. Nevertheless, this situation raises an important question...
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Resolving the problems of mental health care with inquiries is the equivalent of resolving the problems of a country with inquiries. Sure, they can help us understand if rules were followed or if people were negligent but they cannot univocally tell us if the rules were good.
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One of the reasons why the argument for a system of care similar to the Trieste model is stronger than that for Open Dialogue or other non-traditional approaches is that the former is a whole system.
It doesn't apply to a selected group of patients but to all of them.
Whereas with other approaches there is an easy, perhaps lazy, argument to be made about the approach in question not being able to sustainably replace the traditional structure, the claim of a sustainable systemic proposal is far more rooted in evidence for the Trieste model.
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Absolutely agree, there's at least two sides to this. Of course, if the only way to get help is to accept top-down definitions of one's illness within a presumably healthy world then it's harmful to challenge or be in denial about the illness construct in a void. However,
& housing instability.
You can believe that mental illness is a byproduct of a fucked up society - but if you want to do something about it, the first step is not removing people's ability to access our current care systems, cause who exactly does that help other 6/7
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The idea that an official label of someone's illness obliges society to do something to help is a Sedwickan idea which is in itself idealised and rarely scrutinised. Very often being considered ill leads to a waiting list and a few useless CBT tips. The balance is hard to find...
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