Open dialogue


Last week I was at a surprisingly interesting training session at the Milwaukee Mental Health Complex by Dr.   Gregory Jerenec an Associate Professor at the Wisconsin School of Professional Psychology. His  topic was schizophrenia: what is it, what’s it like to have it and what to do about it.

Dr. Jerenec gave the standard description of schizophrenia as a brain disease. However, in his discussion about what to do he seemed to break new ground. He described our current mental health system as a medical model that often creates an adversarial relationship between the helpers and the consumers. I understand there are many politically correct words to describe persons living with mental illness, but consumers is concise and fits my purposes. In this case people are consuming medications designed to alter their brains  He said that many of the anti-psychotic medications will make people drowsy.

Clinicians spend a lot of time trying to force people to take these medications, which results in repeated hospitalizations. These hospitalizations create an atmosphere that is counter to the notion of recovery. He would like to create a therapeutic alliance that does not place the main focus on medication but instead helps people mobilize their own resources while remaining connected to their communities and other resources. As I have learned from life experience and course work, many people living with mental illnesses want what everyone else wants and needs. Someone to think well of them, to listen and to build relationships including love. There are many people living outside the case management system who are living normal healthy lives.

There are models, according to Dr. Jerenec, that should be tested in the United States and considered  for application. There are some tests underway to help determine the feasibility of using this approach. Even Dr. Jerenec has some hesitations. There may be some persons who have been in the current system so long that they have been trained to expect forced medication and hospitalization. There might be others who have poisoned their social support networks. There could be people are are flourishing and recovering. All of these factors need to be considered.

Milwaukee County is supposed to be resigning its mental health system to be more community based. I hope we have the political will and the financial resources to look at some truly innovative techniques to assist people.

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