New Paradigms for Behavioral and Mental Health - Day One - “I Wouldn’t Start from Here...”

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Dec 08, 2014
by Louise Hallman
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New Paradigms for Behavioral and Mental Health - Day One - “I Wouldn’t Start from Here...”

Building better mental health services Session Chair Robert Drake and Salzburg Global Program Director, John Lotherington

As the old joke goes: There was a man lost in the countryside and he asks a passing farmer for directions to the city; helpfully he responds, “Well, I wouldn’t start from here!”

If we were to design an ideal mental health care system, we probably wouldn’t start from “here”, admitted Salzburg Global Program Director, John Lotherington in the opening session of the Salzburg Global Seminar program New Paradigms for Behavioral and Mental Health.

Mental health service provision has come a long way since the days of Victorian “insane asylums”, but the Western model (especially that of the USA) of “over-diagnosis, over-treatment, and over-medication” is hardly one to be emulated by developing countries which are expanding their mental health services provision.

Even if Western medicine were the best example to follow, much evidence-based mental health care is based on the dominant cultural group of the country in which the research has been conducted, and as such should not be necessarily be applied wholesale to other minorities, communities or cultures.

Individualization of care is important; there should not be a one-size-fits-all approach.

So, where would be the best place to start building a better mental health service? Answers from the 70 participants – who include psychiatrists, policy makers and patients – gathered in Parker Hall included: avoid big costly hospitals, provide more community housing and support for families, introduce better information on mental health and education in schools, and ensure patients keep their sense of agency.

One of the greatest challenges within mental health is stigma that the patients and their families often face in their communities and workplaces. One possible way to help reduce that stigma would be to integrate mental health better into the broader health field and to focus on mental “wellness” instead of mental “illness.”

Over the next five days, through panel discussions, role play and group discussions, Fellows will consider best practices from across the world and how best to apply these to their home contexts, looking closely at human rights, patient-centeredness, new systems, existing resources and cultures, and new technologies. But they should avoid searching for a modern day panacea – even much-heralded “big data” is no silver bullet.