It has been a long time since Ive written a blog. These blogs were originally an enthusiastic exploration in an attempt to improve my work and teaching in management of mental health in General Practice. It turned into largely disillusionment about the mainstream direction of mental health care.

So often there’s a family in crisis and lots of government departments involved wanting employment, training, school attendance as outcomes… but the family doesn’t have stable accommodation. They dont have an income to pay their bills, they have an ever present threat of retribution for non compliance, and commonly other threats in the form of court orders and family violence. How does one think about completing a school assignment with all that going on? Children experience a world of disconnect and that the system doesn’t care. How does a stretched, stressed, usually single parent provide for the needs of such children when to do so risks their only source of income.

So much money is spent by this system, but never where it is needed. Ive seen these families do well when stimulus packages and cash payments relieve their stress. I saw it in the GFC and through the covid lockdown. Something must be wrong when relieving financial stress and bringing some equality through an external impact on the wealthy, makes such a difference to the people who are really suffering.

And we never look at these things that work and say to ourselves “maybe we should do more of that”

In our work with clients I think it’s the same. Something makes a difference and instead of doing more of that with this client, and being attuned to the things with each individual client, we turn our single success into a new theory and ram it down ther throats of all our clients. Just look at who is on the current lecture circuit doing just that. That’s what the system does too and it causes damage.

So I have a few proclamations from my 30 years as a doctor and from my General Practice which has specialised in mental health.

A good mental health practitioner is good with a diverse population of clients and is invested in the clients that they seem to make worse. They build strong relationships and most importantly they care. They admit their mistakes and they can apologise if their ideas caused hurt. They dont claim to have the answer. They never blame their client. They dont give up on people. They aren’t wedded to theories and they discredit unhelpful theories that clients have picked up from the broken infrastructure that have caused suffering and disempowerment.

I believe that we will look back in 100 years at our theories on mental ill health and be embarrassed. Like so many generations before us we will see that our constructs and explanations damaged people.

I value scientific exploration. But true science explores the phenomenon to be explained and if the explanation doesnt fit it is thrown out. We dont bend people to our explanataions, we must change our explanations…or better still, don’t have any explanations…at least for the next 100 years!

“I don’t believe just ‘cos ideas are tenacious it means they are worthy” Tim Minchin