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An Alternative Form of Mental Health Care Gains a Foothold
http://www.nytimes.com/2016/08/09/health/psychiatrist-holistic-mental-health.html?_r=0
An Alternative Form of Mental Health Care Gains a Foothold
By BENEDICT CAREY
AUG. 8, 2016
HOLYOKE, Mass. — Some of the voices inside Caroline White’s head have been a lifelong comfort, as protective as a favorite aunt. It was the others — “you’re nothing, they’re out to get you, to kill you” — that led her down a rabbit hole of failed treatments and over a decade of hospitalizations, therapy and medications, all aimed at silencing those internal threats.
At a support group here for so-called voice-hearers, however, she tried something radically different. She allowed other members of the group to address the voice, directly:
<snip>
At a time when Congress is debating measures to extend the reach of mainstream psychiatry — particularly to the severely psychotic, who often end up in prison or homeless — an alternative kind of mental health care is taking root that is very much anti-mainstream. It is largely nonmedical, focused on holistic recovery rather than symptom treatment, and increasingly accessible through an assortment of in-home services, residential centers and groups like the voices network Ms. White turned to, in which members help one another understand each voice, as a metaphor, rather than try to extinguish it.
<snip>
Alternative care appears to be here to stay, however. Private donations for such programs have topped $5 million, according to Virgil Stucker, the executive director of CooperRiis, a residential treatment community in North Carolina. A recently formed nonprofit, the Foundation for Excellence in Mental Health Care, has made several grants, including $160,000 to start an Open Dialogue program at Emory University and $250,000 to study the effect of HVN groups on attendees, according to Gina Nikkel, the president and CEO of the foundation. Both programs have a long track record in Europe.
<snip>
In this country, there is very little collaboration. Ms. White runs a hearing voices group in the forensic psychiatry unit of a hospital in Springfield, Mass., and there is a scattering of other medical clinics that work with voices groups. But the culture gap between alternative and mainstream approaches to psychosis and other mental problem remains deep, and most psychiatrists and insurers will need to see some evidence before forming partnerships. Last month, the influential journal Psychiatric Services published the first study of the Open Dialogue program in the United States, led by Dr. Gordon and Dr. Douglas Ziedonis of the University of Massachusetts.
The results are encouraging: Nine of 14 young men and women enrolled in the program for a year after a psychotic episode were still in school or working. Four are doing well without medication; the others started or continued on anti-psychosis drugs. Insurance covered about a quarter of the overall costs.
<snip>
An Alternative Form of Mental Health Care Gains a Foothold
By BENEDICT CAREY
AUG. 8, 2016
Caroline White at the office of the Hearing Voices Network in Holyoke, Mass. The program, which relies on members supporting one another, does not use the words “patient” or “treatment.” Ms. White, who hears voices in her head, said psychiatric therapy had made her feel “hopeless, because the drugs just made me feel worse.”
HOLYOKE, Mass. — Some of the voices inside Caroline White’s head have been a lifelong comfort, as protective as a favorite aunt. It was the others — “you’re nothing, they’re out to get you, to kill you” — that led her down a rabbit hole of failed treatments and over a decade of hospitalizations, therapy and medications, all aimed at silencing those internal threats.
At a support group here for so-called voice-hearers, however, she tried something radically different. She allowed other members of the group to address the voice, directly:
<snip>
At a time when Congress is debating measures to extend the reach of mainstream psychiatry — particularly to the severely psychotic, who often end up in prison or homeless — an alternative kind of mental health care is taking root that is very much anti-mainstream. It is largely nonmedical, focused on holistic recovery rather than symptom treatment, and increasingly accessible through an assortment of in-home services, residential centers and groups like the voices network Ms. White turned to, in which members help one another understand each voice, as a metaphor, rather than try to extinguish it.
<snip>
Alternative care appears to be here to stay, however. Private donations for such programs have topped $5 million, according to Virgil Stucker, the executive director of CooperRiis, a residential treatment community in North Carolina. A recently formed nonprofit, the Foundation for Excellence in Mental Health Care, has made several grants, including $160,000 to start an Open Dialogue program at Emory University and $250,000 to study the effect of HVN groups on attendees, according to Gina Nikkel, the president and CEO of the foundation. Both programs have a long track record in Europe.
<snip>
In this country, there is very little collaboration. Ms. White runs a hearing voices group in the forensic psychiatry unit of a hospital in Springfield, Mass., and there is a scattering of other medical clinics that work with voices groups. But the culture gap between alternative and mainstream approaches to psychosis and other mental problem remains deep, and most psychiatrists and insurers will need to see some evidence before forming partnerships. Last month, the influential journal Psychiatric Services published the first study of the Open Dialogue program in the United States, led by Dr. Gordon and Dr. Douglas Ziedonis of the University of Massachusetts.
The results are encouraging: Nine of 14 young men and women enrolled in the program for a year after a psychotic episode were still in school or working. Four are doing well without medication; the others started or continued on anti-psychosis drugs. Insurance covered about a quarter of the overall costs.
<snip>
