Co-Presented with Lauren Milburn, MA, R-DMT for the American Dance Therapy Association Conference: Imagining Dance/Movement Therapy Beyond the Medical-Industrial Complex

Understanding Transformative Mental Health

The disease model of mental health creates a prime environment for overmedication and forced institutionalization, yet remains the standard in mental health treatment. Practitioners and advocates alike are rapidly rallying around alternative ways of understanding mental health. A recent UN Human Rights Council special rapporteur report stated “biomedical interventions, including psychotropic medications and non-consensual measures are no longer defensible in the context of improving mental health” reiterating that the disease model “has contributed to the exclusion, neglect, coercion and abuse of people […] who deviate from prevailing cultural, social and political norms”(UN, 2017, p. 4). Among many deficits, this model fails to recognize the deep impact of trauma and adversity, social and structural issues (e.g. discrimination, poverty, and forms of oppression), the impact of emotional suffering on physical and spiritual wellbeing, and the multiple ways that people make meaning of their both painful and brilliant emotional experiences.

In response, a growing base of models and practices that take a transformative approach to mental health have garnered attention in recent years. Concerned researchers, clinicians, activists and those with lived experience of mental health concerns are joining forces to bring awareness and education around an outdated model. This workshop highlights one organization, The Institute for the Development of Human Arts (IDHA), comprised of these diverse stakeholders working in tandem to advance education and critical dialogue around transformative mental health. In the context of this discussion, Transformative mental health models and practices make a pivot from the disease model in several ways.

First, transformative mental health requires rights-based approach, not only taking into account the impact of marginalization and oppression on mental health, but the need to re-define self-determination, reconsider institutions that privilege only certain kinds of knowledge (e.g. western medical professionals), and divest in diagnostic and treatment practices that are racist, classist, sexist, and heteronormative.

Secondly, a transformative model must center the lived experience of those who have been diagnosed with mental health issues, survived trauma, have been through mental health treatment or institutionalized, and can speak to the desperate need for a dramatic shift in mental health services.

Lastly, a transformative model should invoke a holistic approach to mental and emotional health, drawing on a growing evidence base of the interrelations between mental health and trauma, interpersonal relationships, society, physical health/ chronic disease, nutrition, and spiritual wellbeing. Acknowledging the complex multiple factors involved will give a more concrete foundation for providing lasting support.  

Building off of local and global movements such as mad pride and disability rights, old and new practices are emerging and being utilized both within and outside the mental health system. Examples of such promising alternatives include peer-run crisis respites and supports, network-focused dialogical approaches, voice-hearing and other mutual support groups, advance directives, and more. These alternatives have the potential to make service users agents of change rather than passive recipients of care, create space for mutual dialogue, break down power asymmetries, and consider structural factors that contribute to inequality and trauma.

United Nations, General Assembly, Human Rights Council, Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. A/HRC/35/21 (23 June 2017), available from undocs.org/A/HRC/35/21.