Healing: Our Path from Mental Illness to Mental Health
“The people who hold the public purse strings and make decisions about funding mental healthcare and other social services need to read this outstanding book.”
Insightful and thorough, Healing: Our Path from Mental Illness to Mental Health by Thomas Insel, MD, is a must read if you want to understand what’s broken in the USA’s mental healthcare system.
Insel is uniquely qualified to write this book. Former director of the National Institute of Mental Health, he spent more than 40 years working in the mental healthcare system. Yet admittedly, his efforts did not curb the mental health issues faced by millions of Americans. As Insel puts it, that’s because he and other scientists weren’t solving the right problem.
The issues facing the American mental healthcare system, according to Insel, are multifaceted. One issue is that research often focuses on understanding how mental illness develops and how the brain works, rather than implementable solutions. Another is that the system is fractured and rife with social inequalities. A third obstacle is that symptom resolution rather than healing is the goal of many treatments. As described by Insel, the American mental healthcare system is overwhelmingly disjointed and dysfunctional.
Rather than continue to watch people die of despair, Insel wrote this book as a catalyst to infuse the American mental healthcare system with justice and hope. Change can be had if we refocus our efforts in more productive ways.
Insel lays out what’s needed. Critical to recovery are the “3 Ps.” The author describes these as “people, place, and purpose.” People is a reference to connection and a social network to provide support for healing. Place is a home, a location that is secure, safe, and hospitable. Purpose is about creating some sort of meaning, through social connection or work.
Echoing other authors, Insel describes mental illness in part as developing in isolation. People are disconnected from others in their pain, and without appropriate wrap-around services, there is sometimes little hope of recovery.
Ultimately for Insel, treating mental illness effectively is a human rights issue. Until social injustices and inequities are addressed, until all people have access to basic human needs like safe housing, it will be nearly impossible to resolve the crisis of mental illness that we have in the US.
Still, there are effective therapeutics available, if we have the willingness to offer them through insurance and for sufficient duration to make a difference. Unfortunately, there is little ability for localities to deploy these programs, or funding to pay for them. Coordinated, specialized care seems to be a pipe dream.
While an important work, Insel’s book may leave a hole in the reader’s heart. He overtly acknowledges that though there is a great deal of knowledge about what works to help those with mental illness to lead much more connected, healthier lives, there is little will to fund those efforts. Stigma around mental illness is still too strong to build a robust mental healthcare system.
The book’s best feature is the appendix describing resources for the public. These pages are a gem, describing foundations, medication, psychotherapy, neuromodulation, and recovery tools. Each of these resources could be a good starting place for families looking for help for their loved ones.
Though the situation is frustrating for mental health professionals, the mentally ill, and their families, the book Healing provides an optimistic frame. Families can find treatment for their loved ones. People with a wide array of mental illnesses can and do recover. The system is full of professionals who do the best they can for their patients, providing care and support as best they are able, using the resources at hand.
Get a copy of the book for yourself and buy one for your state and local politicians. The people who hold the public purse strings and make decisions about funding mental healthcare and other social services need to read this outstanding book.