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A revolutionary game changer in mental health care; repositioning away from biomedical paradigm!

Updated: Oct 16, 2023

Exciting times for many in the field of mental health who are repulsed by the treatment and stigma created by capitalist societies towards those with mental health issues.

WHO announced new guidance released emploring a global change on a multi-agency level to shift away from psychiatric and medical paradigms causing infringes of human rights and abuse, to a more person-focused approach that includes understanding social factors creating natural reactive behavioral responses in adversity, rather than treating these responses as a disorder or illness requiring 'fixing'.

Link here;

There is no way I can do this document justice in such a short piece, but as I listen to it, golden nuggets here and there jump out, but I can not possibly mention them all!

Dr Jessica Taylor has however spent her precious time bullet-pointing the entire 200+ page document.

quoted below;

Here are some key takeaway points from the report:
1. WHO and UN are calling for significant shift away from the biomedical model of mental health which encourages psychiatric diagnoses, medications, forced restraints, institutionalisation, imprisonment and other oppressive medical practices – towards a trauma-informed, social, human rights, person-centred approach to mental health
2. WHO and UN highlight the current ways the biomedical model of mental health harms, oppresses, controls, isolates, stigmatises and discriminates against those who have been told they have psychiatric disorders, and who have not been validated in their traumas, distress, poverty, environments, oppression, or experiences
3. WHO and UN recognise that women and girls, people who are gay, lesbian, bisexual and transgender are more likely to be labelled as mentally ill, and more likely to face forced sterilisations, coerced abortions, coerced contraception, and conversion therapies.
4. WHO and UN recognise that there are widespread human rights violations and harm being caused by current biomedical model approaches to mental health, which includes our psychiatric hospitals, services, treatments, and approaches
5. WHO and UN recognise that people who have been diagnosed with psychiatric disorders have been positioned as dangerous, unreliable and unstable, meaning that they are stigmatised and discriminated against in multiple systems of power (including health, criminal justice, family justice, education, employment, finances and their rights)

What changes are the WHO and UN expecting to see?
1. The end of discrimination based on psychiatric diagnosis, including discrimination used to prevent access to health insurance, accommodation, and support
2. The recognition and respect for legal capacity and personhood of people using any kind of mental health services
3. The essential use of informed consent in all psychiatric services, treatments and approaches which includes accurate and truthful explanations of treatment evidence bases, side effects, withdrawal impacts, possible complications and non-medical alternatives
4. The elimination of coercive or manipulative practices in psychiatry and mental health, including the end of all forced psychiatric treatments, or treatments that are coerced or manipulative (e.g. You can only access support if you take this medication/You can only have access to your children if you accept this diagnosis and take this medication)
5. The prohibition of involuntary sectioning and hospitalisation and forced treatment
6. The elimination of forced seclusion and restraints
7. The development of trauma-informed, rights-based community support for everyone in need of support in their trauma or distress
8. The development of peer-led and peer-run support services for people in distress and trauma
9. The implementation of programmes to help the deinstitutionalisation of people who have been institutionalised for long periods
10. Accountability in all psychiatric services and provisions, which includes the establishment of independent monitoring bodies
11. Establishing a system for implementing redress, reparations and remedies where people have been harmed by psychiatry and the biomedical model of mental health

Why is this new guidance so important?
According to the document, the following reasons have been presented by the UN and WHO as to why this guidance to move away from the biomedical model is so important:
1. Stigma, discrimination and several other human rights violations occur regularly in mental health and psychiatric provisions to this day.
2. There is an overreliance on biomedical approaches to treatment options, which favour medications, and more dangerous procedures such as ECT
3. Many people with psychiatric diagnoses, particularly those who are minoritized and marginalised, are not treated equally in law
4. Access to justice for people with psychiatric diagnoses on file has commonly been restricted, affecting their right to a fair trial, denying them the possibility to contest detention, forced treatment and abuses in mental health services.
5. Psychiatric diagnoses have been used to restrict a person’s right to file a police complaint or stand trial, to be taken seriously, to be protected from abuse, to be believed, to be seen as a credible victim or witness, to give evidence, to have access or custody of their children etc.
6. People with psychiatric diagnoses on file will often be treated as if they do not have mental capacity and cannot make their own decisions about their lives or their care – including whether or not they wish to receive any care for perceived ‘mental health issues’
7. International human rights laws require non-discrimination and respect for human rights in all settings, including psychiatry
8. All humans should have the right to reject medical treatment in psychiatry and mental health, and should not be able to be forced or coerced into accepting medications or other treatments
9. There is little focus on the social determinants of ‘mental health’, as the biomedical model has been so influential. Instead there needs to be focus on the true roots of human suffering and distress including oppression, harm, violence, abuse, poverty, cultural norms, discrimination, isolation, disadvantage, exploitation, bullying, chronic illness, lack of access to services and breaches of human rights
10. There has been little acknowledgement of the racism, colonialism, homophobia, ageism, sexism, misogyny, ableism, classism or the many other factors that psychiatry has leant upon and supported over decades. Further, there is much evidence that those from poverty, those with refugee status, those who seek asylum, and those from indigenous communities and cultures are more likely to be positioned as mentally ill, dangerous, and non-credible
11. Psychiatry and the biomedical model of mental health is dominated by Western reductionist medical beliefs that people are mentally disordered and dangerous, which came from colonial rule, and the rise of the lunatic asylums via the church and the government

Dr Jessica Taylors full statement link below;

The Guidance is not just for professionals!!

"The Guidance is intended for legislators, policy-makers, and professionals involved in mental health legislation and care. It may also be helpful to those working in related fields, such as United Nations entities, government officials, persons with mental health conditions and psychosocial disabilities, professional organizations, family members, civil society organizations, organizations of persons with disabilities, humanitarian workers, community-based organizations, faith-based organizations, researchers, academics and media representatives."

"To date, 187 countries and the European Union have ratified the CRPD1 and are thus legally bound to replace harmful practices with community-based services and support structures that enable the full exercise of human rights"

Even the note on the language used was validating to those with "lived experiences" The recommendation that those with lived experiences are an important resource in not only their own care but in legislation related to their experiences is another validation!!

We have needed this!

"Under this model, persons with mental health conditions and psychosocial disabilities are part of human diversity. The CRPD also reaffirms that all persons with disabilities have the same rights as any other person in society. Policy responses should centre on removing barriers, supporting participation and embracing diversity, as opposed to reforming people to meet societal demands. This departure from the medical model does not dismiss the importance of access to health care interventions: rather it questions many current practices within the medical sector which undermine human rights and inclusion"

Prioritizing "the person’s empowerment and active participation in their recovery"

Full document link here;

This is incredibly validating!!

For both those with lived experiences and those who have been actively fighting against the pathologicalization and medicalization of lived experiences as a result of capitalist, patriarchal, misogynistic, colonial-influenced corrupt institutions.

Both these groups experiencing varying degrees of gaslighting for diverging from 'the norm'.

The guidance recommends a gradual shift away from psychiatric institutions to community-based systems and mainstream services such as income support, housing, and PEER SUPPORT GROUPS.

This is positive in the direction I am journeying towards to use Therapeutic Photography to help encourage visual artistic expression with those struggling with mental health issues and those who have lived trauma experiences.

I am hopeful that by the time I finish my Sociology degree & Master in Therapeutic photography, pressures from these global entities will mean more funding will be available to support peer support groups, as research shows these are often far more helpful, engaging, and empowering than the institutions available and more emphasis will be on empowering those whose lived experiences impact their mental health.

As I said in a comment on Social media today "Words can not express the overwhelming emotions of excitement and hope this has invoked!"

On a more personal note,

I've personally worried about the constant threat of being institutions by my mother, who went behind my back speaking to my husband creating panic in an already worrying situation while I was away attending a court case that I might come back and need institutionalised because she remembers how "bad" I was during the first court case against my abuser and I was facing him in court a second time. My trauma was pathologicalized, when I wasn't acting "normal" I was crazy because of my past. I spent first part of healing from trauma utterly terrified that psychologist or psychiatry may give me a diagnosis that could make the difference between my mother's threats that I needed institutionalised to actually having the medical backing to do so. It took me a long time to trust psychology and counselling services enough when I had a mother challenging my mental stability and challenging my engagement with "therapy". This impacted how I healed.

I was told once by the doctor that I might be the one that needs help as apposed to my daughter when I was emotional and crying asking for support for my struggling teen daughter, even my daughters jaw dropped at the suggestion, I was triggered into silent shock only able to talk about the impact it had on me later.

No one took my concerns seriously about my daughters abuser, I was gaslit, my past trauma was blamed, my emotions said to be irrational and I started to believe it to.

I've seen women with mental health struggles stigmatised as crazy directly and indirectly;

A close friend gaslit that she was suffering postnatal depression by her abusive partner and his mother, when she went to the doctors medication was given furher enabling the gaslighting. No one asked questions about her circumstances, they just saw a highly emotional woman at crisis point and pathologicalized her experience, with out even asking what she was experiencing. It wasn't Til she fled the country and finally got support from domestic abuse agencies that she started to understand she was not suffering depression she was responding to trauma.

I've seen friends with a diagnosis not be listened to about thier childrens struggles because they are stigmatised as irrational emotional mother's with mental health issues instead of understanding the full picture of the families combined experiences.

I had to support a family member through making the difficult choice to voluntarily agree to a couple weeks of psychiatric observation or they would enforce it. Knowing that forced confinement would trigger her and make everything worse not better she chose to go voluntarily to maintain at least the illusion of freedom. Those two weeks may have helped her, but it was the lesser of the two traumas. On top of csa trauma. Without myself and a mental health advocate her complaint and struggles throughout those two weeks were not taken seriously.

Just some of the example of experiences around trauma and mental health.

so yes... We needed this!

What an incredible way to celebrate World Mental Health Day 2023!

Interesting alternative resources;

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