October 16, 2014

Atonement, humility, and the future of mental health care

It's no secret that there is enormous tension within the mental health community. As much as folks like to say we should all get along, row together, collaborate... it rarely works that way. We only get along when we're off in our silos not interacting or competing for the same scarce resources. We all mean well but there are actual ongoing disagreements that keep us from being on that mythical "same page" we all wish for.

Personally, I don't think we're going to move forward on mental health advocacy until we do a better job WITHIN the community on communication and consensus. Unfortunately, that is largely taboo. Conflict among us is not welcome and is seen as divisive and, worse, unnecessary. All enemies of the cause are seen as outside, other. That attitude, of course, believes the answer is in everyone getting on OUR particular page. If only everyone saw the light, if only everyone saw that I am right!

I say, let's embrace dissent and disagreement. Let's actually talk with those with whom we disagree. Meet, eat, stroll, play checkers, eat cake. Let's get it all out there openly. Is that worse, really, than the politicking and the back-chatter? I'd be glad to be wrong, actually, if it led to change. 

I have a page. I'm on that page because I am intellectually and, no doubt, emotionally invested and convinced of it. It's a complex page, not quite like anyone else's. I write it. I edit it.

Happily, my page is 
in many parts shared by others. I'd have to say as time goes on more and more people are on my page, some on more lines than others. I feel these days as if I'm in a booklet if not a book, and no longer a nuisance flyer floating in the wind.

I'm proud to say that I read very largely from NIMH Director, Dr. Thomas Insel's page. I'd probably edit a few phrases or cram some things in the margin, but it's a darn good page to start from. This annoys some people I know and admire. I guess it would be impossible to get everyone, even all the well-meaning and thoughtful folks, entirely into the same book not to mention page. But for heroes, teachers, and fresh thinking I don't think you can beat him. And, happily again, the guy is the head of modern psychiatry in this country and widely admired around the world.


I am cheering for Dr. Insel's recent statement, one that many of us need: "on Mental Illness Awareness Week, my call is for humility."
Fear and distrust -- often justified and understandable -- can make people lash out in ways they otherwise would not. Kindness, and mutual respect, can be lost in the process. I have many friends with whom I disagree in part or wholly on mental health treatment and policy. That is expected and probably necessary. But humility and plain old kindness don't have to be withdrawn. 

I do not mean that people should stop speaking up, or avoid conflict, or walk away. The opposite:  my hope is in engagement not just in spite of but BECAUSE of disagreement. We may not have a choice. It used to be that advocates and providers could exist in little islands on their own. We are now more and more connected through various networks that intersect. Our various beliefs and methods and, yes, bad habits, are all in the mix. I celebrate that. It may not always be pleasant, but none of us are in it for the fun: we want patients and their families to suffer less, thrive more, and for the public to understand and support our community.

1 comment:

  1. I especially love this part: "I say, let's embrace dissent and disagreement. Let's actually talk with those with whom we disagree. Meet, eat, stroll, play checkers, eat cake. Let's get it all out there openly. Is that worse, really, than the politicking and the back-chatter?" This is a huge problem in my family and something I carry with me. I would like to get better about it, but it is so hard! This post does inspire me to try, though.

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