Working Beliefs and Assumptions
1. The vast majority of behavioral / emotional problems that people suffer from are the equivalent of emotional asthma where the expression of the problem is a result of constitutional vulnerability and psychosocial environmental irritants. Mental Health problems are becoming increasingly common in children, adolescents and adults because the protective structures in families, schools, communities and jobs continue to erode.
2, Mental health care is primarily geared toward tertiary prevention where the acute symptoms ( i.e. emotional wheezing) determines whether treatment is available. As a result there is monetary incentive to emphasize serious biological disorders while under appreciating the influence of psychosocial factors.
3. The relative lack of sports and arts programs in schools and communities for children and adolescents who are not particularly talented reinforces the over use of electronic entertainment as a substitute for natural world exploration and person to person engagement. Disadvantaged communities in particular have been stripped of basic, available age appropriate activities for children and adolescents.
4. The lack of Community connections and structured involvement for adults and parents creates an experience of isolation and frustration that contributes to alienation and fosters despair in families and children.
5. Parents with seriously emotionally disturbed children are confronted by the demands of work and economics and the demands of their disturbed child’s daily care and treatment. For single parents the stress can be overwhelming. The siblings in families where there is a seriously disturbed child carry an enormous burden that is difficult to address.
6. The lack of community resources and the limitations of the health care “system” have created an enormous stress on schools. Many parents have come to believe that Special Education Services can get their child the resources that otherwise are unavailable.
7. Families that are economically compromised find it very difficult to proactively structure family life because they are just trying to get by each day.
8. Conglomerate health care organizations have created partnerships with government and insurance companies that channel health care dollars into programs that are “paper perfect”, but do not necessarily connect to the authentic lives of the people in the communities served.
9. The erosion of respect for authority and institutions that represent authority has created a paradigm of cynical angry rebelliousness in children and adolescents that many parents and adults agree with and foster. Every institution in our country is under assault and children grow up with that as their belief system about the adult world.
10. There is an exaggerated belief that psychiatric medications will be the real solution to any significant psychiatric problem.
1. The vast majority of behavioral / emotional problems that people suffer from are the equivalent of emotional asthma where the expression of the problem is a result of constitutional vulnerability and psychosocial environmental irritants. Mental Health problems are becoming increasingly common in children, adolescents and adults because the protective structures in families, schools, communities and jobs continue to erode.
2, Mental health care is primarily geared toward tertiary prevention where the acute symptoms ( i.e. emotional wheezing) determines whether treatment is available. As a result there is monetary incentive to emphasize serious biological disorders while under appreciating the influence of psychosocial factors.
3. The relative lack of sports and arts programs in schools and communities for children and adolescents who are not particularly talented reinforces the over use of electronic entertainment as a substitute for natural world exploration and person to person engagement. Disadvantaged communities in particular have been stripped of basic, available age appropriate activities for children and adolescents.
4. The lack of Community connections and structured involvement for adults and parents creates an experience of isolation and frustration that contributes to alienation and fosters despair in families and children.
5. Parents with seriously emotionally disturbed children are confronted by the demands of work and economics and the demands of their disturbed child’s daily care and treatment. For single parents the stress can be overwhelming. The siblings in families where there is a seriously disturbed child carry an enormous burden that is difficult to address.
6. The lack of community resources and the limitations of the health care “system” have created an enormous stress on schools. Many parents have come to believe that Special Education Services can get their child the resources that otherwise are unavailable.
7. Families that are economically compromised find it very difficult to proactively structure family life because they are just trying to get by each day.
8. Conglomerate health care organizations have created partnerships with government and insurance companies that channel health care dollars into programs that are “paper perfect”, but do not necessarily connect to the authentic lives of the people in the communities served.
9. The erosion of respect for authority and institutions that represent authority has created a paradigm of cynical angry rebelliousness in children and adolescents that many parents and adults agree with and foster. Every institution in our country is under assault and children grow up with that as their belief system about the adult world.
10. There is an exaggerated belief that psychiatric medications will be the real solution to any significant psychiatric problem.
Paradigm considerations for Mental Health Care Reform
1. A coherent Mental Health Care Plan must be based on diagnostic formulation that addresses the the etiologic factors that are causing the enormous increase in need.
2. Unless the MHCP addresses primary prevention and secondary prevention as part of its strategic plan there will never be sufficient care for tertiary prevention.
3. The MHCP can be most effective if it strategically targets secondary prevention. By doing so the underlying primary prevention issues will be better understood and addressed, while the number of people needing tertiary referral will be minimized.
4. Treatment focus needs to strategically address the minimization of psychiatric symptoms and the augmentation of age appropriate, adaptive capacities. Each developmental stage should have established skills and capacities that should be targeted for practice during the treatment process.
5. The strategic promotion of healthy community initiatives can create the psychosocial holding environment that will decrease stress on all families and individuals by fostering increased community connectedness.
6. Although Community Health will require the collaborative efforts of a number of stakeholders, it will be important to have a specific person who is highly visible and is directly responsible for the success of the initiatives and who has a well developed strategy with administrative support.
7. Two major cohorts that need to be actively engaged in the process of Community Health promotion are High School Students and the over 55 population.
8. Children under the age of 5 must be a priority for supportive services so that each is “school ready” by Kindergarten.
9. The transition ages from 17 until 22 must be carefully and comprehensively addressed so that youth expect to get the support needed to launch them into successful young adulthood.
1. A coherent Mental Health Care Plan must be based on diagnostic formulation that addresses the the etiologic factors that are causing the enormous increase in need.
2. Unless the MHCP addresses primary prevention and secondary prevention as part of its strategic plan there will never be sufficient care for tertiary prevention.
3. The MHCP can be most effective if it strategically targets secondary prevention. By doing so the underlying primary prevention issues will be better understood and addressed, while the number of people needing tertiary referral will be minimized.
4. Treatment focus needs to strategically address the minimization of psychiatric symptoms and the augmentation of age appropriate, adaptive capacities. Each developmental stage should have established skills and capacities that should be targeted for practice during the treatment process.
5. The strategic promotion of healthy community initiatives can create the psychosocial holding environment that will decrease stress on all families and individuals by fostering increased community connectedness.
6. Although Community Health will require the collaborative efforts of a number of stakeholders, it will be important to have a specific person who is highly visible and is directly responsible for the success of the initiatives and who has a well developed strategy with administrative support.
7. Two major cohorts that need to be actively engaged in the process of Community Health promotion are High School Students and the over 55 population.
8. Children under the age of 5 must be a priority for supportive services so that each is “school ready” by Kindergarten.
9. The transition ages from 17 until 22 must be carefully and comprehensively addressed so that youth expect to get the support needed to launch them into successful young adulthood.
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