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Rolling the Rock - Page 4

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Why would anyone choose a career in community mental health today?

By David Dan


Seizing Opportunity

Even as I was being introduced to this work, a seismic shift in the community mental health system was under way. Early in his first term, President Reagan oversaw the repeal of the Mental Health Systems Act, thereby ensuring that a nationwide network of federally funded, fully staffed, multiservice clinics would be dismantled. Instead, funding would be sent to states as block grants, to be distributed to local social service agencies, which would then compete for scarce resources, like undernourished siblings. The only reliable source of federal funding that remained was Medicaid, which meant that mental health services would move from a community based, public health model to an individually-based, medical treatment model.

The good thing about a government bureaucracy is that after it announces bad news, it generally takes a long time to act on it. So, for a few more years, community mental health remained a vital enterprise. What strikes me now about my early days in this field was the environment of creative spaciousness and intellectual freedom in which we worked.

At my next placement, a child-guidance clinic in Queens, we had the time and resources for weekly, individual supervision, as well as meetings with consultants on a rich smorgasbord of therapeutic approaches. My learning curve accelerated as I discovered family therapy and its bold array of strategies. I wrote paradoxical letters to fathers who missed sessions, congratulating them on their ability to maintain detachment in the face of family crisis. I tried out Peggy Papp's Greek Chorus approach, enlisting my colleagues to support client resistance and the unlikelihood of change. I asked parents and children to switch seats. I employed circular questioning.

It's hard to describe adequately the camaraderie and sense of shared quest I experienced during that period. I was a member of a rich, fertile learning laboratory, wherein curiosity was valued, questions flew, unorthodox ideas were floated, and a young therapist could grow. Perhaps most important, I was allowed—practically encouraged—to make mistakes.

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Last modified on Monday, 30 July 2012 10:36

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