A place of safety? Podcast (@apospodcast) header
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A place of safety?, podcast on the mental health system in the UK and elsewhere! DM's open, get in touch! Email: [email protected]

Joined February 2019
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For those at the back who are unclear about the relation between the Trieste/Basaglia/Democratic Psychiatry (whatever we want to call it) and "diagnosis"... I will try to explain what the idea of putting the diagnosis "in brackets" means in relation to the current debate 🧵
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One of the reasons why the argument for a system of care similar to the Trieste model is stronger than that for Open Dialogue or other non-traditional approaches is that the former is a whole system. It doesn't apply to a selected group of patients but to all of them.
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Whereas with other approaches there is an easy, perhaps lazy, argument to be made about the approach in question not being able to sustainably replace the traditional structure, the claim of a sustainable systemic proposal is far more rooted in evidence for the Trieste model.
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This is by the way exactly what the problem has been in previous failures to improve UK mental health care with new, well intentioned ideas: they get easily absorbed by the surrounding structure. The only credible way forward is a structural change at the institutional level.
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Absolutely agree, there's at least two sides to this. Of course, if the only way to get help is to accept top-down definitions of one's illness within a presumably healthy world then it's harmful to challenge or be in denial about the illness construct in a void. However,
Replying to @jaunty_aphorism
& housing instability. You can believe that mental illness is a byproduct of a fucked up society - but if you want to do something about it, the first step is not removing people's ability to access our current care systems, cause who exactly does that help other 6/7
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The idea that an official label of someone's illness obliges society to do something to help is a Sedwickan idea which is in itself idealised and rarely scrutinised. Very often being considered ill leads to a waiting list and a few useless CBT tips. The balance is hard to find...
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This balance imo is not to be found in the veracity or not of diagnostic constructs but by looking at the role that diagnosis has in our society & at how power operates alongside it. It's not about diagnoses being true or false, it's about their power & truth at different levels.
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Never a word against the private clinics that your allies work for! Surely they are at least just as complicit in furthering the exclusionary goals of capitalism as the Psychiatrists who offer what in many cases is indeed questionable care, but often free of charge?
Psychiatry takes perfectly understandable responses to social dysfunction – anxiety, depression, psychosis – and frames them as diseases of the mind. If psychiatrists had any integrity, they would be at the front lines protesting the social structures that make us crazy.
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Psychology and scarcity 🧵the unspoken truth on how Psychological interventions & training are organised in the UK is that they're tailored around efficienciently making use of limited resources. This is labelled as excellent care but there's an equivocation, excellent for what?
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A better posture in the face of inadequate resources is to reject the premise. We do not want to work in line with a model of scarcity aimed at maximising the productivity of patients, we want to work in a system that responds to people's needs.
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To get there,it is essential that mystifications are de-mystified. It's essential that what is presented as excellent is contextualised as being excellent for the capitalist structure & dismal for humans.This is the biggest challenge for anyone interested in clinical psychology.
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A place of safety? Podcast retweeted
"I said that I don't know what madness is. It can be everything or nothing. It's a human condition. Within us, madness exists and is present as is reason. The problem is that society, to call itself civilised, should accept both madness and reason" Franco Basaglia
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In a lot of job interviews in the UK mh field and beyond there will be a role play exercise, at the end of which they will ask you how you think the other felt. Cool, but the answer could mean anything... two people can feel in opposing ways based on the same intervention. 1/3
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Ignorance of this is regrettably what often informs who gets employed based on the assumption that if the interlocutor felt good, it was a good intervention. On the one hand there's a dismissive attitude towards those with Psychology degrees as "we are all a bit Psychologists",
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on the other we have a form of pseudo-psychological knowledge which has taken root in services and has taken the place of actual knowledge, becoming the benchmark to which professionals are held accountable. If this does not concern UK Psychologists, I don't know what does! 3/3
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