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I really like some of the new platforms upon which people have been suggesting that we move forward.  Taking more consideration for the individuality of each person, encouraging growth no matter where the patient is starting, and facilitating the ability to live up to potential.   These all seem to me to be less wrong than where we started and less-wrong than the current model that is used in most of healthcare today. 

However, I have one little bone to pick with these models.  Thinking of mental health and its treatment as a journey or a process, to me, implies that there is a destination or eventual goal.  In my mind this becomes an issue.  If we are going to measure the success of something by the amount of change, then we have to define which direction the change moves.  It's not satisfactory to say that it is a journey without direction.  

For example, take two hypothetical patients.  First, a previously happy, "healthy" banker has a psychotic break because of the current economy, gains 75 pounds, takes up drinking, and leaves his wife and kids.  Second, an insomniac who finally gets his sleeping habits in order and begins sleeping through the night.  I think most people would argue that patient one has experienced a greater change in his life.  I also think most people would argue that patient two has moved in a healthier direction than patient one.  

My point is that with the journey model of mental health, we eventually run into the same problems that we had before.  As healthcare providers we are defining, arbitrarily, where it is we want our patients to go.  It doesn't matter if you define that as "fulfilling their personal potential."  We are still defining what that potential is.

I would like to suggest a solution to this problem.  What if, instead of adopting change and growth as the cornerstone of our new model of mental health, we adopted acceptance?  So, as healthcare providers, instead of encouraging patients to push forward towards some arbitrarily defined goal or potential, we encourage them and help them to accept and find peace in their current condition.  The real attraction of this idea, for me, is that it allows us to transcend the need to set a goal or define a duality of "there vs. here."  It is just "here."  

Just to be clear, I am not suggesting that we encourage patients to suffer.  As I understand it, change is an inherent characteristic of our brains.  It's going to happen no matter what a patient or physician does.  I wonder what would happen if patient and provider stepped back and allowed the change to happen on its own instead of trying to shape it into desired pathways.  

I acknowledge that this does not move us any closer to solving the practical issues of how to change a broken healthcare system (costing etc.).  If nothing else, maybe acceptance could be used as a first step to facilitating some other desired change.  That is, if a patient fully accepted their condition, maybe it would help other changes come about more elegantly.