• Inside Out, Outside In: transforming mental health practices

Inside Out, Outside In: transforming mental health practices

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ISBN 9781910919491
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Human distress has historically been understood and responded to almost exclusively either as a biological disorder or a psychological deficit. This has led to the development of powerful structures, ‘mental health systems’, that have dominated thinking and practice around mental health and been controlled by the psychiatric profession.  Despite widespread recognition that such systems are often ineffective and can even be harmful, the bio-medical ethos, with its focus on ‘mental illness’ and primary use of drug treatments, continues to prevail in mental health practices .

This book showcases current projects that offer user-centred, context-informed, non-medical ways of helping people experiencing distress and overwhelm. The first section of the book includes projects located inside mainstream services that seek to influence change from within, including the education of  future generations of practitioners. The second section describes projects that have established themselves as independent entities, outside mainstream structures and services, giving them the freedom to be truly radical in their approaches and influence by example. In a final section, the book looks at work aiming to challenge the wider societal influences that maintain the status quo and perpetuate factors that lead to mental distress and overwhelm.

Foreword by Robert Whitaker


Section 1 - Challenging from the inside 
Chapter 1. Social work education as a critical space - Lydia Sapouna 
Chapter 2. Acknowledging social Inequalities: developing competencies in community psychology in clinical psychology training - Anjula Gupta 
Chapter 3. Critical pedagogy in occupational therapy - Eoin Gorman
Chapter 4. Critical mental health nursing education - Jonathan Gadsby
Chapter 5. Reluctant revolutionaries: implementing Open Dialogue in a community mental health team - Iseult Twamley
Chapter 6. Pause before prescribing: rethinking antidepressant use in general practice - Bryan McElroy
Chapter 7. Women and power: Drayton Park Women's Crisis House - Anne Cooke, Shirley McNicholas and Andie Rose

Section 2 - Changing from the outside
Chapter 8. Sli Eile: finding another way home - Joan Hamilton
Chapter 9. Alternative approaches to mental health crisis: the Leeds Survivor-Led Crisis Service - Fiona Venner 
Chapter 10. Canerows peer support services - Paul Brewer 
Chapter 11. Place and race: an alternative black mental health service - John Wainwright and Mick McKeown 
Chapter 12. The Peertalk Network: sustainable, high-capacity social support - Stephen Normanton 
Chapter 13. Independent advocacy: challenging human rights restrictions in mental health practice - Deirdre Lillis 

Section 3 - Changing the broader context
Chapter 14. Reclaiming agency through Oor Mad History - Anne O'Donnell and Kirsten MacLean 
Chapter 15. The Power Threat Meaning Framework - John Cromby 
Chapter 16. Truth and reconciliation: a radical approach to challenging mental health systems - Mick McKeown and Helen Spandler

‘This is a very welcome book. At a time when the biomedical ideology that informs the majority of mental health work across the planet is crumbling before our eyes, the need for positive examples of alternative approaches is great. The initiatives described in these diverse chapters are united by a commitment to a way of working in mental health that is based on relationships, values and finding meaning. They demonstrate that critical mental health practice is not simply about deconstructing current orthodoxies but is also about opening up new pathways to recovery and new ways of understanding mental health and healing.’ 
Dr Pat Bracken, independent consultant psychiatrist

‘The mental health system is in crisis, starved both of funds and imagination. This is a time when we are in need of new ideas, and this book is full of them.’
Dave Harper, Professor of Clinical Psychology, University of East London

‘I would encourage anyone wanting to learn more about the limitations of current mental health care, and what to do about it, to read this book.’
Bob Diamond, clinical psychologist

‘This is a significant addition to the critical literature on mental health. The editors introduce the wider socio-political context and ideologies constraining mainstream statutory services and the changes necessary to support people experiencing mental and emotional distress. Accounts of critical pedagogy in professional education, including a Mad-identified occupational therapist, offer hope that the next generation of workers will be more informed on survivor perspectives. It offers heart-warming and inspiring accounts of survivor/peer-led supports available alongside, and outside, mainstream services. This book deserves to be read by all who have an interest in transforming and humanising care of people in distress.’
Liz Brosnan, survivor researcher

Inside Out, Outside In

Lydia Sapouna is a Lecturer in the School of Applied Social Studies, University College Cork, Ireland. Her teaching, research and community contributions are primarily in the area of critical mental health, education and practice. She is very interested in the politics of mental health and the role of social activism in changing power imbalances in mental health systems.

Lydia, along with her fellow editor Harry Gijbels, played a key role in the establishment of the Critical Voices Network Ireland and are co-organisers of the annual Critical Perspectives in Mental Health conference at University College Cork.

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Lydia Sapouna

Inside Out, Outside In

Harry Gijbels is a retired mental health nurse and academic with over 40 years of experience in challenging mental health practices and education. He continues to be actively engaged in this work, for example with the Hearing Voices Network Ireland.

Harry, along with his fellow editor Lydia Sapouna, played a key role in the establishment of the Critical Voices Network Ireland and are co-organisers of the annual Critical Perspectives in Mental Health conference at University College Cork.

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Harry Gijbels

Inside Out, Outside In

Gary Sidley worked within NHS mental health services for 33 years in a variety of nursing, psychological and managerial roles. In the 1980s he was employed as a psychiatric nurse in a large asylum in Manchester. He left nursing in 1987 to pursue clinical psychology training and subsequently worked as a clinical psychologist in a range of settings, including community mental health centres, inpatient units and GP practices. Gary opted for early retirement in 2013 and is currently a freelance writer and trainer with an interest in promoting alternatives to bio-medical psychiatry.

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Gary Sidley