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The Consumers’ Atlas to Mental Health CONVERSATION STARTERS Vol. 1: The Medical Model Vol. 2: Entering the labyrinth: Balancing care and risk in clinical services Vol. 3: Stigma: The precarious balance between social and personal identity Vol. 4: Where mental health is made: Personal autonomy and social regulation Vol. 5: Mad Studies Vol. 6: Musings about the National Disability Insurance Scheme (NDIS): Are we in or out? Vol. 7: Holding ourselves together in time and space: Living in community Vol. 8: In the news: The wider context of mental health and illness Compiled by Merinda Epstein in partnership with Jacques Boulet The Consumer’s Atlas to Mental Health Published by Our Community Pty Ltd Melbourne Victoria Australia © Our Community Pty Ltd This publication is copyright. Apart from any fair use as permitted under the Copyright Act 1968, no part may be produced by any process without permission from the publisher. Requests and inquiries concerning reproduction should be addressed to: Our Consumer Place PO Box 354 North Melbourne 3051 Victoria, Australia Please note: The views expressed in this guide are not necessarily the views of all partners in the Our Consumer Place initiative. While all care has been taken in the preparation of this material, no responsibility is accepted by the author(s) or Our Community, or its staff, for any errors, omissions or inaccuracies. The material provided in this guide has been prepared to provide general information only. It is not intended to be relied upon or be a substitute for legal or other professional advice. No responsibility can be accepted by the author(s), funders or publishers for any known or unknown consequences that may result from reliance on any information provided in this publication. ISBN 978-1-876976-70-5 First published May 2018 Cartoons: Simon Kneebone The Consumers’ Atlas to Mental Health CONVERSATION STARTERS Vol. 2: Entering the labyrinth: Balancing care and risk in clinical services 3 The Consumers' Altlas to Mental Health 1. Purpose and intentions of the Consumers’ Atlas to Mental Health: Conversation Starters is a set of eight volumes each containing 15 statements, intended to initiate and energise conversations about mental health. They are not statements of ‘fact’; rather, they are tentative opinions to stimulate insightful conversations about the ways we understand madness, health and other services, community and mad people’s politics. We hope they will assist in exploring issues concerning mental health through conversation, supported and informed by materials ranging from the experiential, the narrative and descriptive through to research-based and theoretical work. The choice of the assembled materials is, of course, biased; some references are controversially ‘conservative’ whilst others are controversially ‘radical’. We included them because they are all part of the full story. We have, therefore, spent less time accumulating ‘mainstream’ medical material because this is easier to find and many readers would already have absorbed a great deal of this discourse in their everyday interactions with the institutions of psychiatry or, indeed, through information from mass media and other sources. 2. Eight Volumes Vol. 1: The Medical Model (published and available) Vol. 2: Entering the labyrinth: Balancing care and risk in clinical services Vol. 3: Stigma: The precarious balance between social and personal identity Vol. 4: Where mental health is made: Personal autonomy and social regulation Vol. 5: Mad Studies Vol. 6: Musings about the National Disability Insurance Scheme (NDIS): Are we in or out? Vol. 7: Holding ourselves together in time and space: Living in community Vol. 8: In the news: The wider context of mental health and illness 4 The Consumer’s Atlas to Mental Health 3. Each volume is organised as follows: 1. A series of fifteen conversation ‘starter kits’; 2. Each kit has three sections: • Entry Section: A set of five interesting, quizzical, provocative and sometimes controversial short statements accompanied by cartoons. This is the first, most direct and simplest way to enter the conversation. • Middle Section: ‘Wikipedia entries to madness’, offering 30 initial definitional understandings of the issue or the dimension of madness proposed as the main theme of the conversation. • Annotated Reference Section: References to about 15 articles, discussion papers, academic debates, research, professional psychological or psychiatric literature, newspaper and other journalistic work, different discourses, antipsychiatry literature, medical literature and associated debates. 4. General: Also available and covering all eight volumes are: • a more comprehensive explanatory introduction to this material; and • a substantial reference collection with hundreds of references, ordered in 100 ‘thematic entry-points’ to be posted on the Our Consumer Place website. 5 6 The Consumer’s Atlas to Mental Health 1. Competitive People and their Consequences 1. Competitive People and their Consequences DO WE HAVE A PROBLEM? In mental health, the interacting meritocracy ranges from the most socially marginalised (homeless, older Australians, survivors of torture, refugees and many more) to professors of psychiatry and a group of ‘Policy Heavyweights’, including famous consumer survivor-thrivers. Between these extremes exists a gradation of (often opposing) camps of expertise. MEDICINE AND PSYCHOLOGY ATTRACT COMPETITIVE PEOPLE In each discipline, students are forced to compete amongst themselves and between disciplines. Many thrive in this environment – proven under pressure. Of course this affects their capacity to relate with those around them, the hoi polloi, their patients and clients. Clinicians need to try and disengage this competitive reflex. Unless remedied, the early competitive reflex may lead to troubling delusions. STUDYING IN SILOS There is a lack of trust in and respect for other clinical groups, even lacking understanding of what others actually do. Each discipline has very little contact with the others during their preliminary training; continuing education is too often discipline- based and when multidisciplinary, certain groups, or one group, often feel exempt from team working, whether in reality or in their collective head space. This severely curtails coordinated care.. STAGE MANAGERS Doctors assume responsibility for leadership for which, some believe, they should be rewarded with status. Perhaps they do deserve some compensation for potentially being in the firing line, but is this important enough to risk losing the support and understanding of their colleagues? Social workers, counselling psychologists, occupational therapists, counsellors, psychiatric nurses and consumer employees jockey for leverage.... and then there's the managerial class… FALSE FACTS FIGHTING FOR TERRITORY Here comes the community sector: psychiatrists sit imperiously on Boards as do other high profile clinicians. Other clinical groups can end up anywhere, competing with peer workers and ‘old fashioned’ community workers. Fighting for territory here is fierce. What happened to ‘community’ in all this? 8 The Consumer’s Atlas to Mental Health 9 A WIKIPEDIA ENTRY TO MADNESS 1. ATAR (Australian Tertiary Admission Rank): https://en.wikipedia.org/wiki/Australian_ Tertiary_Admission_Rank 2. BIOPOLITICS: https://en.wikipedia.org/wiki/Biopolitics 3. BULLYING: https://en.wikipedia.org/wiki/Bullying 4. CRITICAL MASS (SOCIO-DYNAMICS): https://en.wikipedia.org/wiki/Critical_mass_ (sociodynamics)\ 5. CLINICAL PSYCHOLOGY: https://simple.wikipedia.org/wiki/Clinical_psychology 6. DANIELLE OFRI: https://en.wikipedia.org/wiki/Danielle_Ofri 7.FEMINISATION OF THE WORKPLACE: https://en.wikipedia.org/wiki/Feminisation_of_ the_workplace 8. FEMINIST PEDAGOGY: https://en.wikipedia.org/wiki/Feminist_pedagogy 9. HAZING: https://en.wikipedia.org/wiki/Hazing 10. INTERDISCIPLINARITY: https://en.wikipedia.org/wiki/Interdisciplinarity 11. INTERPROFESSIONAL EDUCATION: https://en.wikipedia.org/wiki/ Interprofessional_education 12. LATERAL VIOLENCE: https://en.wikipedia.org/wiki/Lateral_violence 13. MEDICAL ANTHROPOLOGY: https://en.wikipedia.org/wiki/Medical_anthropology 14. MEDICAL EDUCATION IN AUSTRALIA: https://en.wikipedia.org/wiki/Medical_ education_in_Australia 15. MEDICAL EDUCATION: https://en.wikipedia.org/wiki/Medical_education 16. MEDICAL ETHICS: https://en.wikipedia.org/wiki/Medical_ethics 17. MEDICAL STUDENT’S DISEASE: https://en.wikipedia.org/wiki/Medical_ students%27_disease 18. MULTIDISCIPLINARY APPROACH: https://en.wikipedia.org/wiki/Multidisciplinary_ approach 19. OVERACHIEVEMENT: https://en.wikipedia.org/wiki/Overachievement 20. PRIVILEGE - SOCIAL INEQUALITY: https://en.wikipedia.org/wiki/Privilege_(social_ inequality) 21. RESIDENCY: http://images.pps.console.com.au/resize/portplus/stora ge/3785/3785_3094246_300816043629_5904.jpg?width=249 22. ROSENHAN EXPERIMENT: https://en.wikipedia.org/wiki/Rosenhan_experiment 23. SOCIAL STRATIFICATION: https://en.wikipedia.org/wiki/Social_stratification 24. SUICIDE AMONG DOCTORS: https://en.wikipedia.org/wiki/Suicide_among_doctors 10 The Consumer’s Atlas to Mental Health 25. THE BIRTH OF ‘THE CLINIC’: https://en.wikipedia.org/wiki/The_Birth_of_the_Clinic 26. THE MEDICAL GAZE: https://en.wikipedia.org/wiki/The_Birth_of_the_Clinic 27. TRANSDISCIPLINARITY: https://en.wikipedia.org/wiki/Transdisciplinarity 28. UNIVERSITY OF NEWCASTLE SCHOOL OF MEDICINE & PUBLIC HEALTH: https://en. wikipedia.org/wiki/University_of_Newcastle_School_of_Medicine_and_Public_Health
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