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Israel Journal of Psychiatry

Improving community mental health services: The need for a paradigm shift

Abstract

Background: It is now over half a century since community care was introduced in the wake of the closure of the old asylum system. This paper considers whether mental health services, regardless of location, can be genuinely effective and humane without a fundamental paradigm shift.

Data: A summary of research on the validity and effectiveness of current mental health treatment approaches is presented. Limitations: The scope of the topic was too broad to facilitate a systematic review or meta-analyses, although reviews with more narrow foci are cited.

Conclusions: The move to community care failed to facilitate a more psychosocial, recovery-focused approach, instead exporting the medical model and its technologies, often accompanied by coercion, into a far broader domain than the hospital. There are, however, some encouraging signs that the long overdue paradigm shift may be getting closer.

Authors: Longden, Eleanor. Read, John. & Dillon, Jacqui.

Published in: Israel Journal of Psychiatry and Related Sciences, 53(1), pp. 22-30.

Date: 10 Feb 2017

Link: https://doctorsonly.co.il/wp-content/uploads/2016/08/05_Longden_Improving-Community.pdf

Voices in the dark: Mosaic Science Podcast

Taken from the Mosaic Science Podcast podcast site: https://mosaicscience.com/story/hearing-voices

This documentary is also available on the Mosaic podcast through iTunes, RSS, SoundCloud and wherever good podcasts are found.

We all have an inner voice. But for some, hearing voices can be much more distinct and unusual.

Adam has a voice with a unique name and identity. Jacqui hears hundreds of different voices. Dolly’s voices led her to believe she was Jesus. The voices John experienced drove him to the edge.

Voice hearing is often understood to be a symptom of mental illness, but many voice hearers refute this diagnosis, believing the voices they hear are based on significant events that have shaped their lives.

Through their stories we explore what it means to hear voices and discover how the phenomenon is being understood, from medieval tales of demonic visions to childhood language cognition, a Dutch psychiatrist helping voice hearers find meaning in their voices, and a pioneering ‘avatar’ therapy using computer technology.

Beyond the Therapy Room

Hearing Voices Research and Development Fund receives $250,000 in funding

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Coming to a town near you: real help for voice hearers

The Foundation for Excellence in Mental Health Care is pleased to announce that its Hearing Voices Research and Development Fund has received $250,000 in funding for a 3-year project to bring Hearing Voices peer support groups to communities across the United States and to research the mechanisms by which these peer-support groups work.

The project will train more than 100 facilitators in 5 regions of the country and create a stronger regional and local infrastructure of Hearing Voices peer support groups across the US. People who hear voices, see visions, or experience other unusual perceptions, thoughts, or actions have long been diagnosed as psychotic and given a poor prognosis. Medications provide only partial help and their benefits typically diminish over time while destructive physical and psychological side effects become increasingly problematic.

For the past 25 years, the Hearing Voices Network (HVN), an international collaboration of professionals, people with lived experience, and their families and friends has worked to develop an alternative approach to coping with voices, visions, and other extreme states that is empowering and useful and does not start from the assumption of chronic illness (see www.hearing-voices.org, www.hearingvoicesusa.org, www.intervoiceonline.org). A large scientific literature now provides support for key aspects of this approach, and the hundreds of peer-support groups that have developed in 30 countries on 5 continents are enabling voice hearers – even those who have been chronically disabled – to learn to cope more effectively or to rid themselves of the negative effects of their voices.

The US lags far behind other countries in offering this important new approach, and the new funding provides crucial support as more and more mental health organizations across the country seek training to start their own hearing voices peer-support groups. An open competition will be launched in April to choose the 5 project regions, with participants selected using a rigorous model in which mental health professionals and voice hearers collaborate in an intensive shared learning experience that itself illustrates HVN’s concepts and methods.

Equally crucial to the project is an ongoing research component that will allow identification of the distinctive components of hearing voices peer-support groups and better explain what enables them to provide such an effective and positive alternative for people diagnosed with psychosis. “This effort promises to be a movement that will measurably advance mental wellness and recovery for people in distress, their families and the community across the nation,” said Gina Nikkel, President and CEO of the Foundation for Excellence in Mental Health Care. “Hearing voices can be truly terrifying for the person experiencing them and for their loved ones. Hearing Voices Network support groups transform the fear into understanding and then empowerment.”

The Hearing Voices Research and Development Fund is jointly administered by Gail A. Hornstein, Professor of Psychology, Mount Holyoke College, and Jacqui Dillon, National Chair, Hearing Voices Network, England. Their more than 10-year collaboration models the kind of engaged research and advocacy that the project seeks to foster. More background on the project administrators can be found here. Read their recent article on hearing voices groups here.

Key partners in the project include Mount Holyoke College and the Western Massachusetts Recovery Learning Community, based in Holyoke, MA, which has pioneered the training of HVN facilitators in the US as part of its broader mission to “create conditions that can support healing and growth for individuals and the community as a whole.”

Keynote Talk on Demedicalising Distress in Powys, September 2013

Watch my recent talk on Demedicalising Distress in Powys on YouTube.

http://youtu.be/JHzHliy5yeQ

The Powys Mental Health team invites you to a free conference they are organising in in Llandrindod Wells.

Shaping Services Together.

  • Should the question underpinning how we shape our mental health services be “what has happened to you” rather than “what is wrong with you”?  Main Speaker Jacqui Dillon.
  • Do you use or have you ever used mental health services or are you close  to someone who has?  Do you think that your experiences of mental  health services could help change how services are planned and  delivered?
  • Do you want to know how you, no matter what your age, might become more involved in shaping our mental health services nationally and locally?
  • Key decision makers coming. Do you have something to say about the welfare benefit system and the changes?

Everyone welcome, all you need is you to be interested in the questions above. We can provide free transport to you if you live in Powys.

Lunch and refreshments will be available.

Thursday, 19th September 2013, 10:15 a.m – 4:00 p.m. The Pavilion, Spa Road, Llandrindod Wells, Powys LD1 5EY

To Book or find out more call Glynis Luke on 01597 822 191 or email her at pamhinfo@pavo.org.uk or book online here This is your opportunity to debate and communicate directly with national and local decision makers about mental health services.

Our keynote speaker is Jacqui Dillon, writer, campaigner, international speaker and trainer.

English poster here and leaflet here.  Welsh poster here and leaflet here

This is one of three conferences across Wales funded and supported by Welsh Government and Public HealtH Wales.  The other two are:

  • Thurs 12th September in Rhyl called Measuring Up.  More here.
  • Wed 23rd October in Cardiff called Know Your Rights.  More here.

These events are part of the Stronger in Partnership initiative, you can find out more about Powys Stronger in Partnership here.

You can download some information about the event here and there is more on our blog here.

Booking for the event is now open – click here.

 

Treatment Gap: The Truth about Mental Health

If you habbc_world_serviceve a mental health problem, where you live in the world makes a big  difference to the care you receive. In many lower and middle income countries,  three-quarters of people with mental health problems don’t have access to  mainstream mental health services. Even in wealthier, developed countries, the figure is close to 50%.

Claudia Hammond investigates some of the alternatives that occupy this ‘treatment gap’.

Psychiatrist Dr Monique Mutheru is one of just 25 psychiatrists in Kenya. In the absence of services to  meet the mental health needs of Kenyans, traditional healers and witchdoctors  play a crucial role in diagnosing and treating them. Claudia examines a programme which brings health workers and traditional healers together. It provides training for traditional healers to refer their severely ill patients to the clinic and avoid harmful practices that some healers carry out, such as lobotomy and bloodletting.

Even in developed countries like the United Kingdom, where mental health services are freely available, some people with mental health problems feel that the treatments do not help. The Hearing Voices Network provides support to ‘voice hearers’, through support groups, helping them to manage and engage with the voices that trouble them.

You can listen here: http://www.bbc.co.uk/programmes/p01b35lq

Psychosis Journal Cover

Hearing Voices Peer Support Groups: A Powerful Alternative for People in Distress

Psychosis Journal CoverABSTRACT:

Hearing voices peer support groups offer a powerful alternative to mainstream psychiatric approaches for understanding and coping with states typically diagnosed as “hallucination”.  In this jointly authored first-person account, we distill what we have learned from 10 years of facilitating and training others to facilitate these groups and what enables them to work most effectively in the long term. Having witnessed the transformative power of these groups for people long considered unreachable as well as for those who receive some benefit from standard psychiatric treatment, we describe effects that cannot easily be quantified or studied within traditional research paradigms. We explain the structure and function of hearing voices peer support groups and the importance of training facilitators to acquire the skills necessary to ensure that groups operate safely, democratically, and in keeping with the theories and principles of the Hearing Voices Network.  The greater use of first-person experience as evidence in deciding what works or doesn’t work for people in extreme distress is advocated; randomized designs or statistically significant findings cannot constitute the only bases for clinical evaluations.

 

The Work of Experience Based Experts

Judi Chamberlin died in January, 2010 (Hevesi 2010). This chapter consists of a shortened version of Judi’s chapter in the first edition of Models of Madness, followed by a summary on the effectiveness of user led services and an account of the Hearing Voices Movement by Jacqui Dillon, Peter Bullimore and Debra Lampshire