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The Thread of Mental Health

Gina Nikkel

The fabric of Foundations funding human services forms a rich mosaic with themes as diverse as housing, education, employment, social justice issues, physical and public health.  The thread that interconnects with all of these is the mental health of the individuals and communities who are targets for support and improvement.  It can be a complicated puzzle.

An often unrecognized fact is that despite a considerable investment of private and public funding in mental health services, our disability rates have actually increased over the past 30 years in the United States.  We see ever increasing rates of childhood mental health diagnoses--as is also true in our senior population.  We are also opening our eyes to the tragic consequences of various kinds of physical, emotional and sexual trauma on life satisfaction.  Some of this is likely the result of decreasing stigma and the increasing willingness to recognize mental health challenges.  Some may be due to an increasingly commercialized interest in trying to solve problems with chemical interventions--the use of psychiatric medications has mushroomed over the past 30-40 years.  There are increasingly many insistent professionals, researchers, and people with lived experience who are asking today whether the drugs are really the answers they've been advertised to be in the face of the increasing disability related to mental health challenges.

The Foundation for Excellence in Mental Health Care was created to stimulate interest in research and programs that promote recovery rather than disability.  In this sense, EXCELLENCE seeks to be a key partner in every Foundation that seeks real life quality improvements.  Housing, education, physical health and employment outcomes significantly improve if the thread of mental health supports is interwoven to make it all come together.  Improving mental health outcomes in this country is in need of much greater attention without the bias of commercial interests or even the weight of past lowered expectations of terms like "chronic mental illness."

One example in this tapestry is our Early Psychosis Initiative in which we partner to fund recovery based programs such as Open Dialogue, an innovative, network-based approach to persons experiencing severe psychiatric crises and conditions.   Developed at Keropudas Hospital in Tornio, Finland, this way of working has garnered international attention for its outcomes with first time psychosis.  In our project “Preparing the Open Dialogue Approach for Implementation in the U.S” we have granted funds to develop the research materials — organizational and psychotherapy fidelity guides — that are the requisite scientific steps prior to undertaking a clinical study.  We have also funded a suburban clinical study and are now raising funds for the clinical studies in urban areas.  The intent is to make the research tools freely available to other researchers in the U.S. and elsewhere.

Another example is Excellence’s Hearing Voices Fund which supports the development of a network of hearing voices peer-support groups across the United States.  These groups offer a safe place for people to share their experiences of voices, visions, tactile sensations, unshared beliefs, and other distressing experiences.  By meeting together to help and support one another, to exchange information, and most importantly to learn from each other’s coping strategies, these groups can transform the lives even of people who have suffered for many years.  As a consequence, some people stop hearing voices entirely, once they understand the symbolic significance they have been serving (e.g., to preserve a memory of trauma that has yet to be worked through). Others learn to accept and “live with voices” in ways that enable them to regain more control over their lives.

The current situation in the U.S. stands in striking contrast to that of other countries.  England, for example, with a population of 54 million, has 180 hearing voices groups, whereas the U.S., with a population of 315 million, currently has only two dozen groups.  The Hearing Voices Fund is supporting a systematic program of training intended to create a network of hearing voices peer-support groups in five key regions of the U.S.  Participants are being selected using a rigorous model in which mental health professionals and voice hearers collaborate in an intensive shared learning experience that equips them to apply HVN’s concepts and methods to the creation of positive alternatives for people diagnosed with psychosis.

EXCELLENCE has a Global Scientific Advisory Committee, a committed Board of Directors, and highly skilled staff to help you with mental health research and program projects that intersect with the work you do.  Give us a call at 503-930-0349.

Gina Nikkel, PhD, is President and CEO, of Foundation for Excellence in Mental Health Care.

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