More Human

More Human

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I was recently recommended a book called More Human by Steve Hilton. It talks about the many ways we can design a world in which humans come first.

All our institutions – from government to business; our lives; our education; our food; our health systems – have all become too big, impersonal and industrialised. The world has become far too inhuman.

I reflect on this, after our recent world-changing mental health conference, Thrive2020. Many of the solutions to the seemingly impossible problem of mental ill-health lie in the community and in finding ways to be more human with each other.

To give you an example, there is a phrase that I really dislike, used to describe people who use our mental health service. That phrase is ‘service users’. Those who refer to people in this way are trying to create a service culture within the healthcare system – for all the right reasons. But to me, it epitomises the problem. Lack of service is not the real issue in our world. It is lack of humanity.

The professionalisation of the world has given many benefits, but also many drawbacks. Every time a suit is worn, a protocol is followed. We lose a piece of ourselves in the process.

What we need is a revolution in humanity. The creation of a world in which we can get back to community in everything we do.

  • How do we build a world in which heart and soul matter just as much as ‘head’?
  • How do we build a world in which community comes first?
  • How do we build a world in which every single human being can thrive?

The answers to these questions do not lie in the systems that govern our lives today. The answers lie in the timeless wisdom of the past merging with the very best of the technological possibilities of the future.

The great news is that people in the world are beginning to work out wonderful new ways of doing things – and our old systems are finding it harder and harder to suppress what is humanly possible.

The world of institutional control and order is beginning to crumble.  And in its place, a much more vibrant, diverse and human world is dawning.
Marc

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  1. Marc, I have no problem with your idealism, but a touch of reality would not go amiss.

    It cannot be denied that there is a lack of understanding of mental health issues in the community. However, the community cannot ever replace the expertise of the health service or meet the needs of mentally ill people, just as the community cannot meet the needs of those who have any other medical needs.

    Those presenting alternative solutions to medical problems make extraordinary claims but cannot provide the evidence required to substantiate those claims. Snake oil salesmen have always been plentiful and will always come up with wonderful new ways of doing things while depriving the weak, vulnerable and desperate of their cash.

    Mental health issues are always biological by nature. Stigma is perpetuated by the widespread misconception that people have self control over their specific and often multi faceted issues. It is relatively easy to understand if someone has a broken leg, it is visible and clearly they need specialist treatment and usually their leg will heal, however some people suffer life changing injuries that will never heal and those people will need to learn about their condition and adapt to that situation, that is very often the case for the mentally ill.

    If you are seeking community support and improved humanity then please support our mental health service which, for service users, is perhaps the only safe place where they can feel relatively understood, and not misjudged. Please respect the dignity of the mentally ill and those who are suitably qualified to assist them.

    I agree with you that lack of humanity is the real problem however that is the harsh reality and until and unless that changes, and if you want that to change, then good luck and be patient, but in the meantime, please support and please do not undermine our mental health service which is after all a community service.

    • Dr Greg Madison says:

      In fact the assumptions in the comment above, and some below, about ‘mental health issues’ or ‘mental illness’ are not based upon evidence but, sadly, only reify the institutionalisation of human distress that Marc is challenging. The medical model of mental illness has never been based upon evidence. Even the APA is reluctantly admitting this. Recent systemic reviews show no significant scientific evidence for dopamine and serotonin theories nor do they support psychiatric medications except as a short term crisis intervention. The political power of institutionalised psychiatry and the pharmaceutical industry has inhibited the development of rational and humane approaches to psychological distress. See the Centre for Evidence Based Psychistry for a review of recent studied (carried out by conventional psychiatric researchers and academics). The best outcomes for psychosis, for eg, are from Open Dialogue in Finland (now sorrowing internationally). The approach is radically democratic and deconstructs all the professional arrogance we have accrued in these ‘mental health’ professions. The evidence is increasingly clear. Marc’s comments are consistent with the emerging picture.

  2. For the avoidance of doubt I am not saying to not use professionals at all. I am calling to have them be used in a more human way in line with emerging best practices. Wanting to radically improve the mental service does not mean that I don’t support the existing service. It also doesn’t mean that I think that people shouldn’t use it in the mean time. Hopefully when the Thrive2020 talks are released on video next week you will start to see some of the consistent themes in how community and humanisation has a considerable role in improving the mental health of the population.

    • Pleased to hear that you are supportive of our professional but very human mental health service Marc and totally agree that the community has greater scope for support and assistance in preventing, understanding and caring about mental health issues, facilitated by the work you are doing and also supported by the work of Mind, the Guernsey disability alliance and other great community organisations including those mental health service users who themselves reach out to help others in the community.

  3. Judy Hayman says:

    Don’t give up Marc. I can feel a distinct feeling of depression building up in me as I read the above comments

  4. Snake oil salesmen? Is that psychiatry?

  5. I’m not sure I fully understand Cathy’s idea that “mental health issues are always biological by nature.”

    Always is a very big word to use in this context. My personal experience has been one or recovering from emotional events which present as biological effects. I’m using biological in the sense that the effects are experienced by my body.

    My understanding is that Marc is pointing out that emotion is a cause, the effects of which manifest across a wide spectrum of human experience.

    To be clear I fully support the helping professional who are doing a wonderful job of caring for some of our most vulnerable citizens. I personally believe we can all benefit from the viewpoints Marc is offering.

    Keep up the good work Marc.

  6. Think you make a good point here. I haven’t got much experience of mental health services except for in substance misuse, but the idea that it’s big systems rather than the individual practitioners within them we here the problem lies chimes with me. Let’s take as an example some of the cancer treatment protocols. In spite of much recent (underfunded and suppressed) research doctors are in a protocol ‘straight jacket’ and would get struck off if they didn’t advocate the ‘gold standard’ of surgery, radiation and chemo. We know that chemo and radiotherapy don’t kill the stem cells that may cause the cancer to return but it’s prescribed anyway. Very little attention is paid to diet or other lifestyle factors and if the patient wants to explore other options the door is slammed in their face. And whose self interest is behind this? Big Pharma. Who gets I’ll or ever killed by chemo? The patient.

  7. Thanks Marc,

    Good stuff-I believe Mental health is more determine by community assets than by the medical compact. There is no evidence whatsoever that the medical compact is capable of unilateral mental health production. To claim otherwise is unscientific and dangerously delusional. You piece Marc is therefore timely, and grounded in the fact that it takes a village to create mental health. If of interest I write more on this subject here: http://blog.nurturedevelopment.org/2013/10/14/it-takes-a-village-to-co-create-and-sustain-mental-health/

    I feel strongly that we need a conversation around citizenship within this domain, and also what it means to be a civic professional in service of communities and not recruiting and fix broken clients. An analysis of power desperately required, apparent once again in some of the comment above. Keep on keeping on! Cormac

  8. I am a physician. Can we imagine we are personally ill with a mental disorder, then ask what should the community ‘look like’ that would optimally care for me in the context of my family, my work, my faith community,my personhood….? What would the distribution of costs look like? What would the backup plan look like if and when things aren’t going towards wellness and reintegration? Who gets to choose the preferred interventions, assign community supports…..By what method does the community decide for its members on how they will be cared for: consensus, democratic majority, learned experts…..Communities are wonderful and messy things, aren’t they.

    • 1. What should it look like? Like this-
      http://www.gov.gg/disabilitystrategy
      Still not implemented in Guernsey.

      2. Who and by what method? Service users get to choose under advice of learned experts. Everything else is amateur self help, sadly.

      • Yes we need experts! However they need to be experts in their expertise. A degree or diploma in something vaguely medical does not cut it! Experience of the patient’s situation does. Medicate if appropriate but listen and love more. Guernsey will be the best place to be to treat all diseases if we stop and listen and learn. There are major nutritional deficiencies which need to be addressed here. The states should employ therapists who use holistic approaches, dieticians to help with food issues, and use people who have the time to love and listen and connect. Instead of harsh drugs to dumb us down teach us ways to live life to the full. Lets improve the amateur self help lobby and make Guernsey the best place to live.

        • I expect our mental health service practitioners would agree with everything you have said.

          1. Consultant Psychiatrist –
          Medical degree – 5 years
          Foundation training – 2 years
          Speciality training – 6 years

          2. Primary care mental health and wellbeing service provides talking (or listening) therapies to all in the community.

          3. Nutritional guidance is delivered.

          4. Numerous therapeutic pursuits delivered to improve quality of life.

  9. Interesting comments on this blog. I agree with your view on ‘service users’ as a definition, Marc. I can’t think of an alternative yet though. I also agree on changing how we as a society view and treat ‘services users’. Phil Borges’ ‘Crazywise’ offers a very thought provoking contrast.

  10. morning Marc, been one of those so called service users it does slightly make me giggle when I use that name .Looking forward to my bipolar ( another label ) chat with you next week , all these words are a general label the world wants to give us , for myself I am unique and there is no other person in this universe like me and I am here for a reason . Cant wait to share my Vision with you but not to the world not just yet .

  11. Although I’m not tangata whenua myself, I think your values are Maori values. Ie if you really want to help someone you need to approach them on their own level as a friend.

  12. Im very pleased with your work.

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