Monday, September 28, 2015

Reason # 2 to Grow Beyond the Medical Mindset of DSM Diagnosis (Essay Series on Mental Diversity vs. Mental Illness)

Trauma is Pervasive - and That Explains A Lot

In 2011, the National Council for Behavioral Health ‘broke the silence’ on the impact of trauma in behavioral healthcare. It devoted a special publication - nearly 100 pages in all - entirely to the issue of trauma in behavioral health. You can read it here:  Breaking the Silence: Trauma-Informed Behavioral Healthcare (National Council Magazine: 2011:2),

In this publication, National Council leadership called on behavioral health providers in mental health, substance use, criminal justice and public housing settings to recognize and respond to role of trauma in behavioral health. It called attention to the fact that ninety (90!) percent of clients across these public service domains are trauma survivors. Notably, A. Kathryn Power, then-Director of the Center for Mental Health Services (a division of SAMHSA) wrote: “Interpersonal violence … is widely accepted to be a near universal experience of individuals with mental and substance use disorders and those involved in the criminal justice system.” Many also have suffered serious neglect and deprivation related to basic human needs like food, shelter and protection from the elements.

The National Council is not a fringe organization. It is the premier representative of behavioral health organizations nationwide. It supports mainstream mental health providers nationwide and lobbies Congress for their interests. In calling attention to the importance of trauma, the National Council was taking an important leadership role. It was sending a message to providers nationwide: Do not ignore this issue. It is far too important to public health. We must get with the times and face these facts. We ignore them at our peril.

We Must Get With the Times

Sadly, providers overall have been slow to make the shift to a trauma-informed approach. That is not ok.

In the first place, the implications of this are vast. The emerging statistics on trauma raise a lot of questions about the the conventional 'medical illness' model of mental health. They suggest modern psychiatry could be entirely wrong. According to psychiatry, people have a pre-existing genetic or biochemical abnormality. But, in actuality, we could be seeing the after-effects of social and environmental trauma.

The treatment implications of these difference are urgent. If psychiatrist are correct - and people actually do have genetic or biochemical abnormalities - then medication and surgical treatments may make sense. In theory, such responses could actually correct something that is structurally wrong in the brain and make it better.

But, what if that is not the case? What if - as the trauma statistics suggest - many people (up to 90! percent) are actually just scared and overwhelmed? That requires a very different response.

When we are afraid and overwhelmed (not defective), we need responses that help us get out of fear. For most people, that does not mean high tech responses that involve complicated instruments or heavy duty chemicals. In the first place, we don't understand them. They act on our minds and bodies in unpredictable ways. They take us away from familiar environments and require us to navigate strange ones. They require us to put a high level of trust in people with white coats who seem very busy, and typically talk way over our heads. Such things tend to scare us more.

Secondly, a lot of current treatments may actually damage brain pathways, not help heal them. There is a lot of evidence that this is true of neuroleptics and electroshock, especially if we use them a lot over long periods of time. It may also be true of other treatments, like SSRIs, anxiolytics and psychostimulants. Whitaker, R. (2010), Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Random House.

Finally, we should not overlook the demands that medical treatments place on our brains and bodies. Every new medication is asking our body to make an adjustment.  Sometimes this adjustment may help.  But for many people, it just adds a new stress on top of the ones that already exist.  This is bad news!  We were already having trouble coping.  Now it's even worse, because the 'treatment' made it even harder.  Romme M. Escher S. Dillon J. Corstens D. Morris M. (2009) Living with Voices: 50 Stories of Recovery, PCCS Books/Birmingham City University. 

Given the high prevalence of trauma, the safest course to start with is probably kind, caring human beings.   What if - before diagnosing people - and before prescribing medications - we simply offered someone to listen?  This person could try to understand, help us make sense of what we are experiencing and maybe offer a bit of support in getting our basic needs met. This is the approach of the peer respite movement and it's getting some good results. Evidence for Peer-Run Crisis Alternatives

At the very least, this way of starting out does no harm.  Practically no one says they were hurt because of kindness or caring.  To the contrary, many people report that this made a big difference in their healing.  Some people even say that this was main thing - or the only thing - that made a difference. 

Given the prevalence of trauma, it's a much better bet than the high tech medications and hospital-based treatments. There's no sense in our government is paying out public billions for 'treatments' that can't possibly work. It's hardly a surprise that conventional treatments have such low success rates. What person with real life problems would get better from someone telling them to take a pill, sit around and accept their illness? How can people overcome their challenges in a system that won't acknowledge them?

Trauma Survivor Bill of Rights

If you're a trauma survivor and no one is listening, we'd like to hear from you. Please complete our Trauma Report, which is available here: Human Rights/ Trauma Report,

We'd also like you to know that you have rights. You can read about those in other sections of this blog. In addition, your rights are recognized by the National Council for Behavioral Health and published on their website. You can get a copy here:

The Time for Change is NOW

There is no longer any excuse anything less than complete, competent trauma-informed responses to behavioral health needs. According to the National Council, universal trauma-informed care is a do-able, effective, cost-saving response. Providers can and should uniformly screen for trauma. They should also offer services that respect the rights of trauma survivors and address their needs.


The premiere organization representing behavioral health providers nationwide has spoken. Trauma-informed care is the most effective standard of care. It is the 'best buy' both monetarily and in terms of human suffering. There is no reason not to offer it. Supporting trauma recovery benefits everyone!

Mental Diversity or Mental ‘Illness’? 10 Good Reasons to Grow Beyond the Medical Mindset of DSM Diagnosis (In Progress)

Reason 1. Life is Challenging - and That Explains A Lot

Reason 2: Trauma is Pervasive - and That Explains A Lot

Reason 3: Historic Discrimination Explains A Lot

Reason 4. Fight-Flight-Freeze is Automatic - and That Explains A Lot

Reason 5: Fight-Flight-Freeze Affects Our Bodies - and That Explains A Lot

Reason 6: Fight-Flight-Freeze Affects Our Brains - and That Explains A Lot

Reason 7: When Fear Becomes Chronic That Explains A Lot

Reason 8: Diversity is Good For the Species - And That Explains a Lot

Reason 9: Fight-Flight-Freeze in Hot Pursuit is Something You Don’t Hear About Much -- But It Explains A Lot

Reason 10: The Cultural Assumptions, Power and Priviiege Also Explain A Lot

Reason #1 to Grow Beyond the Medical Mindset of DSM Diagnosis (Essay Series on Mental Diversity vs. Mental Illness)

Life is challenging - And That Explains A Lot

Death and Loss

Life is fragile. We are all vulnerable to loss and death. There is no way around it. No one we know will escape it.

Millions of people have tried. Millions have tried to offer comfort. Every religion on earth has done its level best. So have many scientists, academics and philosophers.

This includes people throughout human history, from every cultures and country in the world. Every single one of us has a stake in this. Practically everyone would give their eye teeth to find an answer that fit for everyone. Some people have devoted their entire lives to trying. A lot of people have given their lives to find answers that fit for at least some of us.

Yet, no one has succeeded. As a whole, for the human race, we still have more questions that answers. This is especially true when it comes to the really hard questions:

  • Why is there suffering?
  • Why do bad things happen to good people?
  • What happens when we die?
  • What happens our relationships with the people, animals, beings we love? 


Survival Needs

Add to this the challenge of survival. Let’s face facts, as human beings there are certain things we all need. If we don’t have them, it’s hard to be happy, healthy and reasonably comfortable.

Yet, a lot of what we need is not that easy to get. Sometimes it’s because resources really are scarce. Other times it’s because human relationships (war, greed, family loyalties) make the resources scarce.

Whatever the reason, all too often, our welfare depends on competing with each other. That means some of us end up losers. That’s a high stakes game, no matter how you cut it.

Responsible Relationships

Add to this the fact that we care about each other. Not everybody, but at least some people. If the people we care about don’t have what they need, that affects us too. That’s true for those we care about too, which creates added stress all around.


Still don’t see how life is challenging?

Take this simple quiz:

Viewing this as hard copy?  The form is below:

Life Challenges Questionnaire

    The Human Condition 
    How protected do you feel natural human vulnerabilities like suffering, sickness, loss and death?

    Personal Needs 
    How confident do you feel that, if you just relaxed and used your best judgment, you could live comfortably with the resources you have or could get?

    Relational Responsibilities 
    How confident do you feel that the people you care about will be okay, if you just relaxe and use your best judgment?

Sunday, September 27, 2015

Reason, Conscience and the Unaffordable Opportunity Costs of TreatmentAs Usual

[draft, still rough, comments welcome]

For decades, medical model 'treatment' has consisted largely of pressuring people to conform to dominant culture values and declaring them cured if they do.  As a culture,  we tend to favor the appearance of conformity over the development of actual capacity.  To this end, we typically 'treat' away the evidence (signs and symptoms) that people are diverging from dominant culture norms.
In this paradigm of medical supremacy, the price of admission is reason and conscience.  For far too many of us, conventional treatments impair cognition and our capacity for it. Indeed, standard fair like neuroleptics and shock (yes, they still do that) literally kill our ability to make sense of experience and learn from it.  
Long before the cortical shrinkage shows on the MRI, we know our brains are dying.  We have lost touch with what we think and feel. We no longer notice cause and effect.   The energy to care.... went...?  We are reduced to a drooling ooze that ingests and excretes, but little more. The irony is that this damage comes from the 'treatment,' not the 'illness.'  
Lets make another thing clear.  The opportunity costs are dire.  Not just for the person in question.  Also, for treaters and society at large.  It's not just individuals who are lose their capacity to make sense of experience - it's our entire culture.   

Opportunity Costs of TAU

These losses are so important, that I'm cataloguing them here:

Loss #1:  Individual Lived Experience

There is a lot of learning value in a person's experience - even an unpleasant one.  The person's reason and conscience presumably had much to tell us about their human condition as they understand it.  This includes:
  • why they were experiencing what they were experiencing
  • what factors contributed to that
  • how that led to where they are now (in terms of feeling, thinking, doing)
  • what others could have done that might have been helpful
  • how injuries could have been prevented - for them and or others
  • what could help to repair those damages now
  • what kinds of things support capacity for reason and conscience for people in their shoes; 
  • what kinds of things get in the way - or destroy it altogether. 

Loss #2:  Professional Learning

There is a lot of potential value to professionals of learning how to support people to access reason and conscience  -- especially when people are going through difficult times.  

The current assumption of the 'helping' professions, however, is that people are unreachable.  Service systems thus assume that people need to be told what to do, given clear directions and 'encouraged' to follow them. Little effort is made to learn from people who are going through distressing times how to support them to survive distressing times. 
The experience of many alternative approaches suggests that this is something that could be learned - if there were a will on the part of providers. This is a huge loss to the provider profession -  future service recipients - and society as well - are footing that bill. 

Loss #3:  Natural Supports Die an Unnatural Death

Ordinary citizens look to providers as leaders and take their cues from them.  When providers represent that people are incapable of reason and conscience, lay people usually follow their lead.  As a result, most family, friends and neighbors simply resort to doing what providers do:  They give directions, advice and push pills.
Despite longstanding loyalties, far too few in our natural social networks make a sincere effort to journey with the 'person of concern. Not help or fix or reassure or have the brilliant answers. But actually journey with -- one person to another --as fallible, vulnerable human beings on a human journey. 
That no one is sincerely making this effort with people in their hour greatest need is a travesty and a waste. Not only does it leave people essentially alone at the very times in their lives that they feel most vulnerable, it dumbs-down the supportive capacity of our whole society. Nobody learns to walk with people because nobody tries to walk with people - not as heroes or experts - but as ordinary family, friends, neighbors, schoolmates, and co- workers -- when challenges arise. 
When you think about it, this explains a lot about why relationships between families and 'identified patients' routinely go so bad. Imagine experiencing the darkest of of  life. You used to have a family that listened, took you seriously, tried their best to understand. Now all that is gone. Not because your family couldn't still do it. But because they are rotely aping what they've watched the pros do. 
On some level then, it's not really their fault. (Okay. There are exceptions). The Nuremberg standard would allow some leeway for 'just following orders.'
On the other hand, blood-tie loyalty is supposed to count for something. The typical response when outsiders break down your door, barge into your home, tackle you, shoot you up, humiliate you and prepare to drag you off on the worst day of your life is not to stand by,  take notes, and promise to help them do it again the next time you are having a hard time. Sure, Joseph eventually forgave his brothers for leaving him in the pit. But that didn't make them heroes of the Pentateuch. 

    Loss #4: Cultural Awareness to Be Gained From Mental Trials 

    We are losing our capacity as a society to think meaningfully about difficult mental experiences.  If no attempt is made to understand and make sense of difficult experiences, then meanings are not looked for and therefore not found.  This reinforces the false assumption that meaning cannot be made.  
    This dearth of initiative hurts not only current individuals, but future generations too. Literally, our kids, grandkids and great grandkids are losing out.  There is a boatload of learning that our culture could be doing now. It would help them greatly if we had the will to do it.  Instead, we're sitting around drinking industry kool-aid and watching the sugar continue to crash us.  This abdication of responsibility is not worthy of anyone.

    Loss #5:  Potentially Prophetic Messages 

    We are losing our capacity as a culture to extract the meaning value from difficult experiences.  While some meanings, undoubtedly, are personal, others can speak to an entire culture. Like other creative endeavors, some of what gets labeled madness expresses the zeitgeist of an era.  This includes meanings - prophetic in nature - that we as a culture may need to become conscious of and respond to in order to survive or transform.  (Think Beatles vs the garage band next door.)
    Examples include:

    • Numerous Black activists were institutionalized as 'dangerously psychotic' during the 1960s civil rights era. 
    • The same women who needed uppers to survive 1950s gender roles were burning bras and staffing domestic violence shelters only a couple decades later.  
    • The same 'homosexual' leanings that used to get you locked up without a key now qualify you for a life partner and marriage.   

    Loss #6:  Inherent Dignity of Our Own Minds

    When difficult experience is trivialized as nonsense the price is human dignity. It does not say much for human minds if, as a species, ours are as broken and arbitrary as psychiatry maintains.  As a species, can we really feel good about ourselves - our brains and bodies - when every divergence from the normative is relegated to the realm of a meaningless, incomprehensible marker of illness? 
    Compare that with the following alternative, which seems just as plausible if not more: 
    Our experiences, while difficult, can be understood.  Our minds and bodies have a wisdom of their own. We can learn to  understand what they are trying to tell us if only we try. There is much to be gained - both personally and for our culture - from making that effort.  

    Which 'brain story' would you prefer for our species? Which of species above would you feel better about belonging to?

    Loss #7: Belief in Our Capacity for Mental Resilience

    Over the past several decades, our faith in the resilience of our species has taken a terrible dive. We have been talked out of believing in our own resilience and into believing that we need what the medical industry sells. As a consequence, we no longer see our species (overall) as capable of developing the interior qualities needed to transform and grow beyond mental difficulties.
    We believe we need a pill. Or, even if we don't, most people do. 
    The way the reasoning goes:
    Minds are disease-prone things that should not be left unwatched. The fact that people so often have difficulties 'proves' this. The appearance of difficulties shows that illness is present and biologically inescapable. You know the illness is there because you see it come up when a difficulty arises.  
    Human beings simply cannot handle the difficult mental states that arise at these times.  That is why people need pills. There is no hope of a different outcome due to how the brain is. This is why we give people pills and why people need to take the pills we give them. 
    If your 5 year old was trying to learn to ride a bicycle would you put up with this logic? What parent says: 

     I see that you had difficulty balancing when you tried to ride. That means you have a balance problem. It stems from a genetic defect that you will never overcome. We know that because you had trouble balancing when you tried to ride
    So here is the solution: So we will put  training wheels on your bike. You will need to use them for the rest of your life.  Otherwise, you will never be able to keep your bike upright. If you try, you will fall. We are certain of this. Your genetic balance problem guarantees it. 
    So make sure you ride with the training wheels on. Without them, your balance problem is sure to act up, and then you are certain to fall. 
    Suffice it to say, this is stunted logic. The difficulty proves nothing in and of itself. Neither does its continuation under the conditions prescribed. No improvement occurs because there is no new learning. No learning occurs because there is no opportunity to learn. 
    Listening to this kind of stunted logic, is stunting our growth - and not only as individuals. When individuals fail to learn, so do families, communities and entire cultures. We are literally stunting our growth as a species.  

    (Thanks to Chris Hansen of Intentional Peer Support for this example.)

    The Penultimate Loss (revisiting #5)

    The penultimate loss in all of this is that our reason and conscience are there for good reason. They are usually trying to tell us something. And given the nature of conscience, the message is probably important.  Most likely,?colossally important compared to the customary social value of putting up a good appearance.   
    But if people area going bonkers - whether individually or collectively - and no one tries to understand that, then we'll never know what the meaning is. We can bet that we're missing something.  We can bet that it's important. Should it really take disaster to wake us up?  That seems kinda,     erhm....  diagnosably unsound. 
    It's like the story of the three little pigs - on steroids.  Psychiatry, Pharma and Corporate America are out there reassuring us that it's just fine to build our houses out of sticks and straw.  According to them, the main purpose of life is to feel good and play.  
    While this message has a certain appeal, my conscience isn't buying it.  My gut is actually pretty clear there is a wolf coming.  Yep, wolf is a feeling that just won't shake.  
    Partly because floating over the wolf of my hallucinated world is a cloud. Inside the cloud, an endless line of zombies stagger down a two-forked path.  At the end of one fork, there is a bomb that never stops exploding.  On the other fork, the tide never stops rising. The choice of which fork does not really matter. The people that are reaching it died long ago.
    The way out of that, my reason counsels, isn't more pills.  There is also the question (pretty rationale) of whether you can trust the corporate-types and Trader Pros (who reliably push the pills) to also reliably push the zombies in the direction of a better world.  
    The clincher however goes to conscience. The fight is exhausting. Like Wreck It Ralph, there are fantasies of changing my game mid-course:  You could be a 'good-guy' too. Why not just pretend these people know what they're doing? Yanno, go along to get along?
    I could live with the grinding stomach.  But the wagging finger behind the eyes gets me every time. Don't ask me how a finger can frown, then scrunch up quizzically like a goblin face. Still, when it snorts itself into the head of a mare, and disgust kicks up from the hooves like dust, l remember...
    There's a stockpile of bricks and a house to build! 
     Aww, shucks...  No rest for the weary again today. 

    The Human Rights Path to Recovering Humanity in Mental Health Policy

    No Rights, No Recovery

    The Human Rights Paradigm offers more than critique of medical model 'mental illness'.  It offers a complete theory of how to create/ regain our health and well-being.  Thus armed, we can deliberately set out to reverse the injury to our humanity. 
    Our problems came from ignorance of human rights and the need for them. (We discussed this in depth in prior blogs) This allowed others to ignore our needs or use us for their needs.  We didn't understand how to respond in a way that would make things better, rather than worse, for us and others. 
    The solution comes from human rights awareness.  Here we develop awareness of our own nature and needs as human beings. From this vantage point, we are able to consciously think through how to build our capacity to support human rights.  This necessarily entails developing our capacity to realize our own needs and support those of others. 

    Principles of Psychosocial Well-Being

    The human rights paradigm offers several principles to guide our efforts:

    1. Human family

    This is our birthright. No matter what we do, we can never lose it. No matter who we are, we must strive to live up to it. The quality of the lives we create with each other depends on this principle.

    2. Inherent dignity

    This frames our relationships as strengths based. It means that everyone of us have worth, and something worthy of offering. Our obligation is to look for this in everyone we meet.

    3. Rights

    These are what the mental health system terms 'boundaries.' The function of boundaries is two-fold. They both keep out and keep in.

    • In keeping out, they say to each of us: Your right to dominate ends where my personhood begins (and vice versa). 
    • In keeping in, they challenge everyone to ask: How can we support each other’s access to the resources that all of us need to live, feel and be well? 

    4. Reason

    We have the ability to appreciate cause and effect. We can make sense of experience. Each of us acts in ways that make sense, based on our experience. This counsels us to judge less and question more. It helps us to listen and learn.

    5. Conscience

    Conscience is about our capacity to care. Things (called values) matter to us. We care about some values (our priorities) more than others. We express this through the choices we make. 

    Conscience is what makes us more than robots. How things affect us - and how we affect others - makes a difference to us.

    6. Reason-conscience interaction. 

    If we put them together, the principles of reason and conscience have a lot to teach us about ourselves and each other. Reason asks us to look for why something makes sense.  Conscience helps us see things as choices. 

    Viewed through this bifocal lens, every thought, feeling and action provides a clue for understanding human experience.  

    • Per conscience: Some part of someone cared to produce it. Otherwise it wouldn't exist. 
    • Per reason: The question is why? 
    • Per both in tandem: 
      • What kind of effect were we hoping for?  
      • How did that particular outcome fit with our values?  
      • Why was that value preferred over others?
      • What life experiences shaped those preferences? 
      • What conclusions were drawn at that time and why? 
      • Do those conclusions still hold true? 
      • Are there impacts we didn't foresee then that matter now?
      • Are there new options now that could be considered?  
      • With everything out on the table, does this still seem like our best choice?
      • If so, how will that impact the choices of others, including relationships we care about sustaining? 

    Get Ready for Blast Off

    On the surface, these are simple concepts.  But if you unpack them, they hold a world of potential. The implications are, truly, vast and revolutionary.
    • The most important stuff we offer each other doesn’t cost a nickel. 
    • There is no higher law. 
    • No profession can license this. 
    • No corporation can patent, bottle or sell this. 
    • No Government can withdraw our funding. 
    • It exists if we create it. 
    • We can never afford to ignore it.
    • We are never off the hook to live it.

    • Welcome to the human family.
      There is no other.

    But, It Can’t All Be Human Rights …Right?

    If you’re asking this question, you’re in good company. In fact, there are a lot of questions we need to be asking. For years now, we’ve been hearing that there is a ‘brain disease’ called ‘mental illness’ which results from a ‘chemical imbalance’ that only psychotropics and neuroleptics can help. We’ve also been told that poverty, addiction, violence, and crime are primarily individual rather than community responsibilities. We frequently hear arguments, some of them ‘scientific,’ that certain groups of people are irresponsible, anti-social or just plain ‘bad.’

    So where do we draw the line? How much can we explain in terms of personal, biological or moral short-comings? How much can we attribute to human rights - and the impoverished relational quality of the communities we live in?

    We Don't Really Know  

    The problem is that we don’t really know… Mental health professionals mostly focus on signs and symptoms. But, these could easily be after-effects of human rights deprivations.

    As a case in point, we now know that pre-existing childhood trauma (violence, sexual abuse, neglect, conflict, bullying, discrimination, poverty, homelessness, hunger) is a fact of life for as high as ninety (90!) percent of public mental health clients.  The same (90!) is true for those in substance use, criminal justice and hard to house contexts. (1)

    'Mentally Ill' or Just Scared? 

    Human rights deprivations like these can cause a lot of distress.  But it doesn't just stop in the mind. The body takes that distress and expresses it physically. This plays out in the nervous system as the survival response of ‘fight-flight-freeze.’ (2) 

    So how do we know if someone is ‘mentally ill’ or just getting really upset because important needs seem threatened? The following examples illustrate how hard it is to tell the difference: 
    • We currently call a lot of people manic, oppositional, defiant, borderline and antisocial - especially if the person is angry, intense or expressing something strongly. But what if many of us are just fighting back or hanging on the best way we know how? 
    • We often pathologize common expressions of fear, sadness - like 'paranoia', 'panic attacks', anxiety and depression. We also pathologize common ways that many people try to cope with uncomfortable feelings, including 'obsessions', 'compulsions', addiction and avoidance. But how does that square with the reality that a lot of us have painful, terrifying, overwhelming problems that no one would want to face?
    • As a society, we have marginalized and shunned a huge number of people who we claim are 'schizophrenic', 'psychotic', 'catatonic', 'dissociative' or 'disorganized.'  But, what if freezing off awareness - or creating a different one - is just what humans do sometimes in order to protect ourselves from trauma of unbearably painful proportions? 

    No one has a clue...

    How many people could be misdiagnosed for reasons just like this? No one has a clue. The possible impact of human rights has been almost entirely overlooked! 

    Years after research made clear that huge people are experiencing the effects of trauma, nearly everyone is still being treated and labeled as having primary ‘mental illness.’ To make matters worse, trauma is often a euphemism. It's healthcare lingo that obscures the social and relational nature of the violations that people experience.  The harsh underlying reality, all too often, is that someone human rights were violated - and not with good effect.  Yet, virtually no effort at all is made to assess for contributing human rights concerns or to assist people to resolve them. 

    Science should be scientific

    This is bad, irresponsible science. (3)   It is also bad, irresponsible healthcare. (4) 

    This must change.

    Human rights concerns could be playing a huge role. We need to find this out. You can’t expect people to engage in treatment designed for illnesses they do not have. You can’t expect people to progress when the system of ‘care' ignores their real problems.

    Reputable behavioral health researchers have an ethical duty to ask -- and answer -- these questions. So do providers of mental and behavioral health services. So do politicians and our government.  So does everyone who says they care and means it.

    It's time to move beyond a mediocre mental health system.  We have to get to causes and concerns.   We need to research the impact of community human rights deficiencies.  We need to understand how, why and to what extent, human rights concerns affect individual health and wellbeing.

    We also need to research the effect on outcomes:
    • What happens to 'mental illness' when we help people recover their human rights? 
    • If people are supported to live and be well, does 'mental illness' occur at all?  
    • If it occurs, does it stick?  For how many people, how much of the time?
    • What are the relative short and long-term costs?  
    • Does it pay to keep drugging people as a primary strategy?  
    • Would we be better off in investing in resources  - like housing, transportation, wellness clubs, childcare, quality food and education - that remedy existing societal deficits?
    It's time to start asking the right questions.  That means asking the 'rights' questions.


    (1) National Council Magazine (2011:2): Breaking the Silence: Trauma-Informed Behavioral Healthcare),

    (2) Fight or Flight Response

    (3) Whitaker, R. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (Crown 2010) It is also bad, irresponsible healthcare. 

    (4) Whitaker, R. & Cosgrove, L, Psychiatry Under the Influence: Institutional Corruption, Social Injury, and Prescriptions for Reform (Palgrave Macmillan 2015); 

    Human Rights and Mental Distress - It’s Time We Made the Connection

    Missing human rights can cause a lot of distress. Think about what it’s like to be treated unfairly, go hungry, be thirsty, have nowhere safe to sleep at night or no meaningful way to make a living. Think about what it’s like to be disrespected, hurt, called names, beaten up, pushed around, held somewhere you don’t want to be, or forced to do something you think is bad for you.

    These kinds of things are highly distressing for most of us. When human rights are violated or insecure, nobody does well. We don’t have what we need to live and feel well. Our survival is at risk in some important way – physically, emotionally, spiritually, socially… We may even be literally fighting for our lives.

    Our normal response when our rights feel threatened is anxiety and concern. If nothing changes, this can grow into full-blown mental distress. A lot of time this is what people are talking about when they say “I have an anxiety disorder” or “I’m depressed.”

    Intense, prolonged mental distress can lead to even more extreme states. We can end up totally disconnected from ourselves, others and the communities we live in. We can stop feeling like a part of things. We can stop feeling human. We can even stop feeling like living or being alive.

    We may also stop caring how our actions affect others. We may look for anything we can that deadens the pain. We may become so physically or emotionally reactive that we lose our capacity to think or be aware.

    Once these things get set in motion, they may stay that way for a very long time. We may get called “suicidal”, “borderline”, “addict”, “chronic”, “unmotivated”, “help-seeking”, “anti-social” - or even “psychotic”, “psychopathic”, “delusional” or “schizophrenic.”

    Seeing Ourselves Differently

    If that happens to us, it is important to look beyond the labels. We need to remember that the root cause is not our “mental illness.” It is not our “addict nature.” We are not 'inappropriate', 'impulsive' or 'manipulative.'  

    These surface appearances are merely effects. We can predict they will happen when human beings are overwhelmed by pain and have limited options for how they can cope.

    To see the real root cause, then, we have to look deeper.  Once we get beneath the surface there are things we start to see:

    Something we needed was missing, disrespected, or threatened. There was no one to help us find our way.  While some people may have tried, they didn't really understand. Their help wasn't all that helpful. Things got worse instead of better. 

    In the final analysis, we were on our own and continuing to fall. Eventually, we were in so deep that we didn’t know if we’d ever get out. True, every so often a passerby might come along and poke their nose in our hole. But, as soon as they saw how low we'd dropped, they’d turn up their nose and high-tail it on their way.

    This kind of disconnection – both from the things we needed and from other people -- undermined our confidence in life itself. Neither the Universe nor those in it felt the least bit welcoming or worthy of trust.

    This insult to our humanity was the real root cause. 

    Where to go from here?

    If this has happened to you, you are not alone.  It's happened to far too many of us.  

    But that's hardly the end of our story.  Now that we can see where we've been, we can begin to see where we are going.  We have a life to live, and we can decide to make it count.  

    One life, one vote. Each of us, no exceptions.  Let's vote for a better world.  Let's recover our humanity. 

    Our birthright is human family. It's time to stake our claim. 

    It's About Human Needs, Not Labels

    'Labels are for cans. Human beings have needs and rights.'
    Anonymous Activist
    The human rights framework takes a deep and thoughtful look at human experiences that many people find difficult, confusing or troubling. This includes phenomena that are currently labeled “mental illness” – things like mental distress, intensity, extreme feelings or moods, unique ideas or beliefs, loss of memory or awareness, and private realities, images, visions, voices, and tastes, smells or touch that others don't seem to experience.

    Instead of labeling people as sick or ill, we take to human rights values to heart. We see everyone as worthy of respect and dignity. We see everyone as capable of reason and conscience. We honor people’s right to think, see, believe and express themselves in ways that may seem strange or irrational to us. 

    Together, we ask:
    • How might such experiences make sense in terms of the physical, mental, social or moral human rights deprivations a person has endured? 
    • How can these deprivations be repaired? 
    • How might "illness" and "symptoms" change once human rights are restored and made secure? 
    This approach is very different from jumping to judgment. Instead of assuming we ‘know’ better, we ask what we can learn. We engage in honest inquiry around areas of human difference. We work to make sense of experiences rather than acting to suppress or exclude what we don’t understand.

    Rinse, Repeat for Behavioral Health

    We apply this same basic human rights approach to the difficult or confusing things that human beings sometimes do. This includes behaviors that are commonly labelled "addictive", "self-harming" "unhealthy" or "anti-social." Even if something is against the law – like drug use, violence, sexual trafficking or theft – we don’t simply stop at the conventional thinking that calls something as ‘abusive’ or ‘criminal.’ Rather, we seek to understand the underlying human needs, concerns and social dynamics that have shaped its expression.
    The human rights paradigm thus seeks to place important social concerns in a larger context of human experience. It provides a straightforward, reasoned, ecumenical framework to understand much of what is happening in human hearts and minds. It offers a way to orient ourselves, reflect deeply, and mine the information value of human differences.

    Surprised by Gems in the Rough

    The more we approach people in this way, the more we learn -- not only about others, but also about ourselves as human beings. We also discover - and come to deeply appreciate - the value of what we might otherwise have rejected or thrown away. Much to our surprise, many of the rocks we used to trip on start to look like "gems in the rough." It may take a long time, and some of us will choose to keep our edges. But polished or unpolished, if you know what to look for, the treasures abound.

    A Deeper Look at Human Rights, Wellness and Recovery

    “Human rights”, essentially, are socially agreed upon “human needs.” People worldwide have agreed that certain things are so important that human beings can’t, don’t and won’t usually function well without them. We call these things “human rights.”

    Human rights include things as basic as access to clean water, breathable air, shelter, food, clothing, physical safety, healthcare, the means to make a living and support a family. Human rights also acknowledge that human existence is more than material things. We need to belong, form relationships and feel like a part of things. We also need the freedom to be ourselves. We want to explore, learn, develop and express our ideas, convictions, creativity and potential.

    So, what does this have to do with wellness and recovery …?

    Almost everything! Human beings everywhere do best – physically, mentally, socially, spiritually - when we can count on certain basic needs being met. That’s why the human community has decided to recognize these needs as “human rights.” No one does well without them.

    When human rights are denied or overlooked, it’s bad for everyone. We don’t have what we need to live well - or sometimes at all. This triggers concern and anxiety in most of us. If not addressed, it can grow into full-blown mental distress – like anxiety or depression. It can also lead to mental and behavioral extremes. This includes intense, prolonged ‘fight-flight-freeze’ responses that can disconnect us from ourselves, each other and the communities we live in.

    When that happens, we definitely need to work on recovery. But, not from an illness, brain disease or clinical diagnosis... 

     We need to recover our human rights!

    Human Rights Are Mental Health

    It's not just that human rights are important in mental health. They are mental health. People talk as if these are different concepts. But in practice, principle and ultimate impact, they are one and the same.
    --Sarah Knutson, Organizer, Wellness Recovery Human Rights Campaign
    Most people have heard about the need for mental health recovery. Very few have considered the need for ‘human rights recovery.’ Yet, they are inextricably intertwined.

    While seeking much the same ends, the starting points are radically different. Mental health recovery is seen as an individual obligation: A private problem develops. The 'person of concern' is expected to address it. It is their job to make progress and stop imposing their 'stuff' on unwilling others.
    Human rights recovery challenges this worldview. It argues that mental health, fundamentally, is a shared responsibility. It stems from the quality of respect and support for human rights in the community relationships that affect our lives. These relationships are the work, not just of individuals, but also of families, schools, employers, neighborhoods, organizations and governments. 

    When the community-at-large fails to nurture these connections, injuries result and continue to mount. The underlying dynamics damage the quality of life, not just for individuals, but for entire community. The first person to break down merely is a harbinger of further wreckage to come.
    The human rights paradigm was articulated in 1948 to steer a different course. It arose in the wake of Nazi Germany, with a global commitment to ‘never again.’
    The human rights paradigm is intended not only for nations, but for everyone, everywhere. It represents the consensus of people worldwide as to what human beings need in order to live and be well. It helps to us understand who we are - and how we need to treat each other. It shows us how to recover our humanity as individuals, families, neighbors, co-workers and communities who affect each other deeply. It supports us to build relationships that foster health and wellbeing - instead of distress and disability - for all of us. Universal Declaration of Human Rights,