The mental health sector, like any other, is crowded with bureaucracy, politics, standards, indicators, jargon, gossip and other day-to-day diversions. In this atmosphere it’s difficult to disentangle oneself enough to burrow down and explore the bedrock of beliefs the mental health system is based upon. These beliefs drive our thoughts and feelings, our behaviour and our systems, but we are often barely aware of them.

Occasionally I get the time to dig down into these bedrock beliefs. I doubt if I’ve got to the bottom yet, but I think I’ve hit upon some beliefs worth examining.

One is the belief that madness has no legitimacy. Most people experience major mental health problems as frightening, desolate and even destructive. The pain of madness is probably on a par with major grief, torture, surviving the trenches, or being falsely accused of a serious crime. There’s a big difference though; these other experiences have legitimacy. Society enables a pathway though them towards growth, recovery or justice. Though they are not well understood by the majority, surviving them is often regarded as admirable or heroic. Madness however, is met with pity, fear and reproach. It does not have status as a full human experience, and this has provided justification for cruelty, segregation and control. 

No society or mental health system built on this bedrock belief will ever do well for people with major mental distress. The recovery philosophy, if it has not been corrupted by the current system, undoes our traditional beliefs about madness by giving it meaning, full human status and a pathway to a better life. All social justice and anti-discrimination efforts also have a duty to undo traditional beliefs about madness. Too often they don't.

Another bedrock belief I’ve been trying to understand is the community’s abdication of ultimate responsibility for its marginalised citizens to professionals and services. In comparison to a century or more ago, people seek many more answers to human problems from state-authorised professionals and services. In some respects this has been of benefit. But dependence on deficits-oriented professionals and services, with their reputed monopoly on expertise and authority, has disabled communities and individuals. Traditionally the mental health system has perpetuated its power, resources and beliefs about madness by keeping people stuck in services.

People with mental distress as well as their communities need to start believing they hold most of the solutions to human problems, instead of professionals and services. We need to start viewing mental health professionals and services as the carriers of technologies that we may want to use at times, just like architects, plumbers and hairdressers. At the same time the mental health system needs to get real about the harm it has done. It needs to hand over control to people with mental distress and their communities, through fostering service user leadership in recovery and in services, integrating with other sectors, and engaging in community development and social justice work.