Institute of Philosophy, Faculty of Philosophy, Jagiellonian University, 52 Grodzka St., PL 31044 Kraków, Poland.
Institute of Psychology, Faculty of Philosophy, Jagiellonian University, 6 Ingardena St., PL 30060 Kraków, Poland.
Int J Environ Res Public Health. 2021 Jun 20;18(12):6625. doi: 10.3390/ijerph18126625.
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.
本文提出了一种替代精神健康问题的系统方法和一个更人性化的精神健康护理系统的大致框架。它建议根据减少伤害的原则，将精神痛苦理解为源于生活问题，将药物作为促进心理治疗的手段，或者作为最后的手段和短期帮助。它认为，将药物理解为精神活性物质，并研究它们产生的主观效果，可以更好地利用药物，并在概念化和评估治疗效果方面有所改进。定性研究在这方面可能特别有用。它还主张彻底背离当前的诊断系统，并提出综合已经存在的替代方案，用于研究和临床目的。因此，提出了一种基于开放式对话方法、Soteria 房屋、个体和团体心理治疗、谨慎处方、帮助停药的服务、朋辈主导的服务和社会支持的替代精神健康护理系统的总体思路。这一建议可以被视为朝着开发一种能够替代当前主导方法的系统替代方案迈出的第一步，而不是专注于实施可能被当前方法所采纳的局部解决方案。
