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

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          Abstract

          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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          Most cited references142

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          A RATING SCALE FOR DEPRESSION

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            Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

            Ilan Meyer (2003)
            In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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              The Lancet Commission on global mental health and sustainable development

              The Lancet, 392(10157), 1553-1598
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                20 June 2021
                June 2021
                : 18
                : 12
                : 6625
                Affiliations
                [1 ]Institute of Philosophy, Faculty of Philosophy, Jagiellonian University, 52 Grodzka St., PL 31044 Kraków, Poland
                [2 ]Institute of Psychology, Faculty of Philosophy, Jagiellonian University, 6 Ingardena St., PL 30060 Kraków, Poland; bartlomiej.dobroczynski@ 123456uj.edu.pl
                Author notes
                Author information
                https://orcid.org/0000-0002-7318-546X
                Article
                ijerph-18-06625
                10.3390/ijerph18126625
                8296326
                34202995
                87d2b743-7137-41ef-b620-5b2970e06aa7
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 02 June 2021
                : 17 June 2021
                Categories
                Review

                Public health
                open dialogue approach,soteria,power threat meaning framework,drug-centered approach,mental health reform,critical psychiatry

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