Opinion Piece: The case for establishing a minimal medication alternative for psychosis and schizophrenia

Cooper, Ruth; Mason, J. P.; Calton, Tim; Richardson, John M.

doi:10.1080/17522439.2021.1930119

Cited by 17 publications

(23 citation statements)

References 61 publications

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“…“Recovery in the bin” and the Hearing Voices Network are other signs of growing alternative approaches to distress. Public medicine-free inpatient treatment is carried out some places in Norway (Cooper et al, 2021 ). Service users' right to influence their treatment and to participate in research about mental health has been recognized in official documents in different countries.…”

Section: From Psychiatrization To De-psychiatrization?—are the Times ...mentioning

confidence: 99%

The Lost Social Context of Recovery Psychiatrization of a Social Process

2022

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From being a concept questioning the core of psychiatric knowledge and practice, recovery has been adopted as a guiding vison for mental health policy and practice by different local, national, and international organizations. The aim of this article is to contextualize the different understandings of recovery and its psychiatrization through the emergence of an individualizing and de-contextualized definition which have gained a dominant position. It ends with an attempt to formulate a new definition of recovery which integrates people in their social context. Research results from various follow-up studies showing the possibility of recovery from severe mental distress have stressed the importance of societal, social and relational factors as well of the person's own agency when facing their distress and reactions from their environment. These researches were published in the 1970s and 80s; a period of struggle for liberation from colonialism, of struggle by women and black people for their civil rights, and a time of de-institutionalization of services directed toward the poor, elderly, handicapped, prisoners, and people with mental health problems. Recovery research pointed at the central role of individuals in their recovery journey and it was understood as a personal process in a social context. However, with neo-liberal political agenda, the personal role of individuals and their own responsibility for their well-being was stressed, and contextual understandings and the role of social, material and cultural changes to promote recovery faded away. Thus, during recent decades recovery has been mostly defined as an individualistic journey of changing the persons and their perception of their situation, but not of changing this situation. Contextual aspects are almost absent. The most quoted definition accepts the limits posed by an illness-based model. This kind of definition might be a reason for the wide acceptance of a phenomenon that was initially experienced as a break with the bio-medical paradigm. Recently, this dominant individualized understanding of recovery has been criticized by service users, clinicians and researchers, making possible a redefinition of recovery as a social process in material and cultural contexts.

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Section: From Psychiatrization To De-psychiatrization?—are the Times ...mentioning

confidence: 99%

The Lost Social Context of Recovery Psychiatrization of a Social Process

2022

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“…Over the last 30 years, there has been an increasing realization that people can and do recover from these disorders and that recovery can take many forms (Anthony & Ashcraft, 2010). People can live meaningful, productive lives with episodic or even chronic symptoms of psychosis; however, standard medical care was insufficient for many people to achieve recovery (Cooper et al, 2021; Jääskeläinen et al, 2013).…”

Section: Wellspace As a Peer‐led Spacementioning

confidence: 99%

WellSpace: Peer‐led groups for first‐episode psychosis before and during the COVID era

Murphy

Fedele

Öngür

2022

Early Intervention Psych

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Aim: Coordinated specialty care (CSC) is a collaborative-team based approach that has been shown to be helpful for patients with first-episode psychosis. Peer support is an important component of CSC. Here, we describe the development and implementation of peer-led group programming (McLean WellSpace) that was loosely affiliated with a CSC (McLean OnTrack). We discuss how we adapted this program to the challenges imposed by COVID-19.Methods: WellSpace was developed to have minimal barriers to entry other than a self-reported history of recent onset of psychosis. It is free for participants with minimal restrictions about who may attend. WellSpace and WellSpace groups are largely administered by peer specialists who align with the recovery movement. WellSpace has been a virtual program since March 2020. Results: McLean WellSpace participants include many people who are not patients ofMcLean OnTrack, suggesting that such programs may have greater reach than standard medical programs. We transitioned to virtual programming and saw average group attendance and unique participants increase during the pandemic.Conclusions: Our experience suggests that peer-led group programming for firstepisode psychosis is well-accepted by patients, including many who are not engaged with a CSC. This may be related to our efforts to minimize barriers to entry and our peer-led, non-medical orientation.

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“…It may seem that, in reality, the possibility to have a comfortable, caring, respectful conversation with another person is what is most important and helpful in a vast majority of cases [113,114] In cases where a patient decides to use drugs long-term on a regular basis, the system should also offer regular screening for possible side and adverse effects and services to those people who later decide they would like to reduce doses or discontinue drug use. In developing and providing these, a close collaboration with service user initiatives is crucial [115].…”

Section: Individual and Group Psychotherapymentioning

confidence: 99%

From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress

Stupak

Dobroczyński

2021

IJERPH

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The article proposes a rough outline of an alternative systemic approach to mental health issues and of a more humane mental health care system. It suggests focusing on understanding mental distress as stemming from problems in living, using medications as agents facilitating psychotherapy, or as a last resort and short-term help, according to the principles of harm reduction. It argues that understanding drugs as psychoactive substances and studying the subjective effects they produce could lead to better utilization of medications and improvements in terms of conceptualizing and assessing treatment effects. Qualitative research could be particularly useful in that regard. It also advocates a radical departure from current diagnostic systems and proposes a synthesis of already existing alternatives to be used for both research and clinical purposes. Accordingly, a general idea for an alternative mental health care system, based on a combination of Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support is presented. The proposition could be seen as a first step towards developing a systemic alternative that could replace the currently dominating approach instead of focusing on implementing partial solutions that can be co-opted by the current one.

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Opinion Piece: The case for establishing a minimal medication alternative for psychosis and schizophrenia

Cited by 17 publications

References 61 publications

The Lost Social Context of Recovery Psychiatrization of a Social Process

The Lost Social Context of Recovery Psychiatrization of a Social Process

WellSpace: Peer‐led groups for first‐episode psychosis before and during the COVID era

From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress

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