Making Impactful Changes in a Fractured System: Why I Quit Working in Public Mental Health
Making Impactful Changes in a Fractured System: Why I Quit Working in Public Mental Health
For many social workers and counselors, working in the public mental health system is unsustainable and rife with ethical violations. Many of us feel complicit in a system that can often do more harm than good. At the same time, many of us want to make changes within the system and are stuck feeling lonely, isolated, and even “crazy” for desiring to do things differently.
I’ve had the immense privilege of working both within the mental health system as a crisis counselor/assistant social worker, and as a peer specialist in both traditional and non-traditional crisis programs. I've seen firsthand the many personal and structural challenges that come with working in the mental health field. This work can often be unsustainable when we don’t have bridges built between communities both within and outside the mental health system.
Institutionalization and Systemic Oppression in Social Work
One of the main issues I encountered in my work was the over-reliance on institutionalization and the lack of support for alternative or community based forms of crisis intervention. The current mental health crisis system in the US, hyper-focuses on symptom management and often fails to meet the needs of individuals in crisis, especially those from marginalized communities. I repeatedly saw how racism and oppression play a significant role in mental health treatment and outcomes. Diagnosis and treatment plans are often based on a Western medicalized approach that ignores trauma, systemic violence, and the retraumatization that the field itself can perpetuate.
Moral Injury and Clinical Ethics
Many of us working within the mental health system witness systemic oppression everyday, and the moral injury can have huge impacts for our own mental health and our capacity to create change. What’s most important is that we find ways to stay connected to our values and integrity.
I discuss some of the strategies I used in the podcast episode, including seeking outside supervision, challenging clinical language and protocol, and advocating for clients' needs. I also share ways in which we can make small but impactful changes in the mental health system, such as promoting community-based crisis interventions and advocating for needs-based approaches.
As mental health workers and advocates, we have a responsibility to not only address the immediate needs of those in crisis but also work towards systemic change. This episode sheds light on some of the challenges and opportunities in the mental health field and offers strategies for making a positive impact.
What You’ll learn in this episode:
what it can be like to work in the public mental health system
issues with US mental health crisis services and why we lean so heavily on institutionalization
ways in which racism and oppression permeate mental health diagnoses, treatment, and outcomes
what you can do as an advocate or mental health worker to make small but impactful changes
DEPTH Work - A Holistic Mental Health Podcast
This is a space for those who love to dive into the underbelly, to revel in the mystery, question assumptions about what is normal, play in the both/and, and honor the wide range of human emotions.
As a complex trauma survivor, holistic counsellor and co-founder of a mental health institute, I learned that there is immense wisdom in our pain and what we call crazy is just what we are yet not willing to understand and explore. Let’s dive in!
Links:
Institute for the Development of Human Arts - https://www.idha-nyc.org/
1:1 mentorship for healers and practitioners - https://www.jazminerussell.com/store/vv800gul8gykqyp6zikpfo091207vs
Research
Social Workers rejecting calls to replace police: https://theappeal.org/social-workers-are-rejecting-calls-for-them-to-replace-police/
ODD, ADD & Racism : https://journals.sagepub.com/doi/abs/10.1177/1044389419842765
Role of Peer Specialists: https://citylimits.org/2019/02/13/cityviews-is-new-yorks-mental-health-system-listening-to-people-whove-lived-it/
Parachute Program in NYC for first episode of psychosis: https://www.theguardian.com/society/2015/oct/20/parachute-therapy-psychosis-new-york-uk
Open Dialogue Approach to Psychosis: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1545-5300.2003.00403.x
GROUNDING PRACTICES:
FOR ALLEVIATING FEAR, ANXIETY & DISSOCIATION
12 SIMPLE GROUNDING PRACTICES TO HELP YOU COME BACK TO YOUR BODY