Conversation is vital.

Not sound bites. Not flame throwing.

Many voices build momentum for change.

What world are we living in?!  Hundreds of thousands of people live on the street. Our safety net is threadbare. There are real and imagined fears of a slippery slope in ‘reinstitutionalizing’ people who can and should live in community — while at the same time, families and neighbors have experienced up close a level of danger when a loved one refuses medication and becomes violent that is intolerable (these are a minority but a very palpable risk that must be addressed — preferably NOT through the criminal justice system). Affordable housing has become an endangered species!

It is time to re-examine our social contract, including our most vulnerable.  This includes children and their families, those with disabling conditions, the elderly, and the homeless with serious mental illness and addiction. It is time to incorporate all we have learned, including the impact of anosognosia (lack of insight into one’s own illness) on how we approach breaking the cycle of untreated disability and homelessness.

Since deinstitutionalization some seventy years ago, we have neglected to adequately envision a healing community that welcomes most people with serious mental illness. Too often we applaud islands of excellence that are really isolated trees in an apocalyptic landscape.

It’s time to reassess how we approach and act on the many problems at hand.

How can we reach across currently polarized divides – the ‘pro’ and ‘con’ for involuntary care? What guardrails do we put in place to prevent inappropriate mandates?  At the same time, how do we assure that people are not ‘dying with their rights on?’ How do we keep families and communities safe from the relatively few, potentially dangerous and endangered people with serious mental illness? 

How do we understand that there is a spectrum of ability and need when considering compulsory treatment or care?

How do we develop an effective advocacy arm to foster legislation and care that brings people from the edge of a cliff to more robust lives in community? We cannot be successful with warring factions that split our energies.

How can we better measure accountability, efficiency, and successful outcomes? And what is the necessary and appropriate role of government?

Integrus Health Group proposes a series of key topics that inform the development of a vision for the future. By entering into conversations that include divergent voices we hope to put forth important questions, and answers, that move mental health planning and policy forward.

How are we going to do this?

Through podcasts, interviews, and face-to-face meetings with divergent voices, we’ll investigate hard issues and the people tackling them. Many individuals and organizations will be invited to participate as we forge a path towards a sustainable mental health landscape that heals.

Along the way, we welcome your contributions and feedback.

Housing & Connectivity That Heal

What is the role of housing? Sanctuary vs sanatorium. How can and should meaningful work play a part in a ‘robust living in community?’ What is the Clubhouse Model and how does it lend itself to this? How do we enhance and support the use of peers while recognizing the vital importance of medical treatment?

Treatments & Supports

We’ll discuss not only early intervention into psychosis, but also ongoing care with proper medication, and evidence-based therapies. How do we facilitate much earlier access to Clozapine?  How do we catalyze research into newer medications and their use?

What constitutes appropriate and adequate hospital or residential stays?  Fifty percent of those who are seriously mentally ill have anosognosia, the lack of awareness of being ill.  How does this affect our interventions?  What is the wisest use of CARE courts, Assisted Outpatient Treatment, and conditional release?

Work & Creative Endeavor

Let us focus on work for a spectrum of skill levels. Facilitating work rather than the decades’ old discouragement by SSI.

Let’s explore the role of creativity  – both in and out of treatment.   Music.  Visual arts. Theatre. Ceramics. Dance.  Poetry.  Writing.  How do non-verbal approaches engage people more readily? How does the creative process, whatever its form, contribute to positive outcomes and a more meaningful life? How do we ‘see’ creative endeavor beyond treatment?

Governments Role & Ours as Informed Advocates

What do we ask of government? What is its role in all of this? And what is our role as informed advocates?

Government should be expected to work with impacted populations and communities to define and prioritize problems, develop standards and plans, assure protective guardrails (including oversight of the expanded ‘grave disability’ criteria in California) and use data competently to budget public funds that pay for outcomes.

Government can play a unique role in repurposing existing resources. This may encompass unused schools, factories, office buildings, and green space.

Government also must handle financing and benefits in the public sector together with new or modified legislation to better align funding with outcomes and accountability. 

But without our informed and fierce unified advocacy, government lacks accountability to the people.