Humane Clinic – Working with Voices and psychosis

Case Study Submitted by: Matthew Ball
Country: Australia

People who hear voices and have other unusual realities continue to be diagnosed with schizophrenia-based ‘disorders’ and offered or made to accept medication and hospitalisation. However, the recovery rate for people offered these primary interventions in the ‘developed’ world is low, stigma remains high, and little or no emphasis is placed on individuals’ life experiences and resilience in overcoming adversity and crisis.

A lack of recognition of trauma and adversity as social determinants of ending up with a psychotic disorder label, means that people are asked ‘What is wrong with you?’ instead of ‘What has happened to you?’ This leads to a dominant and failing approach to treatment that involves ‘doing to’ the person, instead of a more humane approach of ‘being with’ the person as they navigate personal distress.

An alternative approach is offered through the Humane Clinic the Humane Dialogical Project in Adelaide, South Australia, which places agency and power back in the hands and hearts of the individual and their network. This project offers hearing voices and open dialogue-informed network meetings for when a member of a network or family is experiencing phenomena that are labelled ‘psychosis’.

This service offers alternatives to biomedical models and provides hope and humane meaningful response to people in distress, often with the primary social determining factor not being an illness but a response to adversity. It reduces the need for and impact of prescribing, admission to hospital and forced treatment. Lessons learned include recognising the challenges in offering an alternative to dominant medical models, and the value of approaching human beings in distress as equal human beings, rather than patients who are sick.

The program is now being taught in local the Primary Health Care system, emergency departments, mental health units and in educational settings. This service offers a departure from current biologically driven guidelines, towards a consumer and trauma-informed approach, and the acceptance of hearing voices as meaningful human reality.

This Humane Dialogical Project is led by Matthew Ball, a mental health nurse who has lived experience of hearing voices and ‘psychotic disorder’ label in the past. Mr Ball collaborated with Nursing leadership teams, voice hearers, peer workers and clinicians from a range of disciplines, to create safe spaces for people who hear voices to make sense of their experiences. Despite significant resistance from some parts of the mental health system, and repeated requirements for justification for the use of these approaches, they have been ensuring choice and empowerment for individuals who previously would have been labelled as chronically ill.


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