Toward an Abolitionist Practice of Psychology: Reimagining Psychology’s Relationship With the Criminal Justice System

The social justice uprisings that have stemmed from several recent highly publicized murders of Black people by police have shed increasing light on the systems of oppression, inequity, and white supremacy that have been the backbone of the United States’ policing and criminal justice systems since their inception. The American Psychological Association, along with many professional organizations across the subfields of psychology, has released its statement outlining how psychology must contribute to the eradication of systemic racism and white supremacy. In this article, we address the need for psychology and its subfields to acknowledge our complicity in certain systems of oppression, such as our ties to law enforcement and the police, our support of mental health reforms that merely increase the scope of a punitive criminal justice system, and our complicity in the harm done by our current immigration policies. We argue that the best way, in fact the only way, for the profession to move toward an antiracist psychological practice is to embrace an abolitionist framework so that we may reimagine our relationships with historically oppressive institutions and rebuild our clinical practices to promote life-affirming interventions and liberation for individuals and communities.

Interprofessional dynamics that promote client empowerment in mental health practice: A social work perspective

Summary Interprofessional practice has been broadly endorsed as a strategy which supports the delivery of high-quality health services. Few studies have addressed the dynamics inherent to interprofessional mental health practice in an era in which client empowerment is prioritised and valued. Social work perspectives are also underexplored in the studies which have been published on interprofessional health care, despite the increasingly important role of this discipline in community mental health contexts. Through a thematic analysis of 26 semi-structured interviews, this study explored the perspectives of mental health social workers located in two geographically and culturally distinctive sites (Hong Kong and Sydney), and identified a strong theme encompassing their concerns about the facilitation of client empowerment in interprofessional settings. Findings Participant accounts direct attention to the strategies required to co-constitute the shared territories of the different mental health professions. Findings also highlight the frustration with recent mental health reforms which aim to challenge power differentials in interprofessional decision-making. Strategies were proposed for supporting the construction of shared language among different professions, revealing the creativity and insight of practitioners in managing the conflicts arising from interactions between different professional knowledge systems. The comparison of Hong Kong and Sydney accounts highlights the importance of structural, political and cultural influences in supporting not only interprofessional collaboration but also the independence and effectiveness of distinct professional roles. Application This article provides unique insights which aim to strengthen the contribution of social work to interprofessional practice in the promotion of empowerment-oriented interprofessional practice and education.

W(h)ither psychiatry? Contemporary challenges in Australian mental health workforce design

Objective: To consider the changing profile of Australia’s mental health workforce and the implications, particularly for specialist psychiatry services. Method: We analyse data from a national collection that describes changes in the workforce over a decade, to 2017–2018. Results: While single practitioner-based psychological services flourish, other areas of more complex and team-based care are struggling to remain relevant. Psychiatry and mental health nursing, two areas that previously led Australia’s response to complex mental illness, are under enormous pressure. Conclusion: The shifting balance of specialised mental health workforces is affecting the mental healthcare available in each region of Australia. Questions arise regarding the desired or optimal mix of professionals we wish to deploy. What roles should each professional group play and how should they work together? What does this mean for how various groups should be trained and paid? These data challenge the role specialist psychiatry wishes to play in leading reform. Current mental health reforms risk foundering should psychiatrists fail to take up the challenge of leadership.

Perceptions of Community Involvement in the Peruvian Mental Health Reform Process Among Clinicians and Policy-Makers: A Qualitative Study

Background: The global burden of mental health conditions has led to the implementation of new models of care for persons with mental illness. Recent mental health reforms in Peru include the implementation of a community mental health model (CMHM) that, among its core objectives, aims to provide care in the community through specialized facilities, the community mental health centers (CMHCs). Community involvement is a key component of this model. This study aims to describe perceptions of community engagement activities in the current model of care in three CMHCs and identify barriers and potential solutions to implementation. Methods: A qualitative research study using in-depth semi-structured interviews with clinicians from three CMHCs and with policy-makers involved in the implementation of the mental health reforms was conducted in two regions of Peru. The interviews, conducted in Spanish, were digitally recorded with consent, transcribed and analyzed using principles of grounded theory applying a framework approach. Community engagement activities are described at different stages of patient care. Results: Twenty-five full-time employees (17 women, 8 men) were interviewed, of which 21 were clinicians (diverse health professions) from CMHCs, and 4 were policy-makers. Interviews elucidated community engagement activities currently being utilized including: (1) employing community mental health workers (CMHWs); (2) home visits; (3) psychosocial clubs; (4) mental health workshops and campaigns; and (5) peer support groups. Inadequate infrastructure and financial resources, lack of knowledge about the CMHM, poorly defined catchment areas, stigma, and inadequate productivity approach were identified as barriers to program implementation. Solutions suggested by participants included increasing knowledge and awareness about mental health and the new model, implementation of peer-training, and improving productivity evaluation and research initiatives. Conclusion: Community engagement activities are being conducted in Peru as part of a new model of care. However, their structure, frequency, and content are perceived by clinicians and policy-makers as highly variable due to a lack of consistent training and resources across CMHCs. Barriers to implementation should be quickly addressed and potential solutions executed, so that scale-up best optimizes the utilization of resources in the implementation process.

Mental Hospitals and the Carceral State

This chapter explores how in the 1940s, mental hospitals comprised land, buildings, and workforces used by the states to feed and house hundreds of thousands of people. Conscientious objectors who did service work at mental hospitals in lieu of military conscription founded the National Mental Health Foundation. They also collaborated with journalists to craft exposés about concentration camp–like conditions in hospitals. The author and former patient Mary Jane Ward published her book The Snake Pit, in which she argued against the loss of freedom that people with mental illness experienced. Policy makers responded to this anti-institutionalism by implementing mental health reforms that made hospitals larger and more therapeutic, and kept involuntary commitments intact. These initiatives made up the early stages of deinstitutionalization.

Mental health reforms in the Czech Republic

This paper describes the history and current provision of mental healthcare in the Czech Republic. After the political changes in 1989, there was an expansion of out-patient care and several non-governmental organisations began to provide social rehabilitation services, but the main focus of care still rested on mental hospitals. In recent years, mental health reform has been in progress, which has involved expanding community-based services and psychiatric wards of general hospitals, simultaneously with educational and destigmatisation programmes.