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In: Peter & Stastny & Peter Lehmann (Eds.): Alternatives beyond psychiatry, Berlin / Eugene / Shrewsbury 2007, pp. 359-366; ebook 2018
Laurie Ahern, Peter Stastny and Chris Stevenson
INTAR The International Network Toward Alternatives and Recovery (1)
The International Network Toward Alternatives and Recovery was founded in 2003 by a group of U.S. practitioners and advocates in mental health recovery, including world renowned psychiatrists, people who have recovered from mental distress, psychologists, family members and other mental health professionals. (see www.intar.org) The international organization grew out of the shared experience and expert body of research that demonstrates a strong need to promote non-medical humane, non-coercive ways of helping people in emotional crisis. INTAR is a key international organization dedicated to advancing the knowledge and availability of alternative approaches for individuals experiencing severe mental distress.
In an era of so-called
Individually, INTAR members have experienced substantial success in advancing self-help programs and alternate clinical approaches that help put the person's distress into context, thereby respecting and acknowledging the entirety of the person and the experience. As a result, the work of INTAR members has assisted people to regain control over their lives without debilitating treatments meant to cure them. One INTAR member, a recovery researcher, described the drastic difference in outcomes when a non-medical, person-centered approach is used to help a person through distress:
The participants in the INTAR meetings expressed a common belief. In their research, practices or advocacy they try to provide safe, caring and non-stigmatizing assistance to those in crisis or emotional distress. Although the work of INTAR participants from around the world is as diverse as the countries they are from, they espouse the same values and can frequently demonstrate better outcomes than traditional psychiatric treatment. During the first international INTAR summit held in the U.S. in November 2005, practitioners from Canada, Finland, Germany, Ireland, U.K., Austria and the United States came together to share information, research findings and their own personal experiences in non-medical approaches in helping people in extreme emotional states. As one INTAR member stated:
Over the course of the three-day summit, INTAR members found affirmation for what they knew (i.e., for the values and beliefs that guide their individual work). Specifically, these include, among others:
The second international summit in Ireland produced a network of work groups to explore a variety of practices/processes. The most important outcome of both summits was the conviction that there is a critical and pressing need to continue the work of the group and to continue sharing information on alternative practices and approaches.
To that end, the participants in the third international summit in Canada in May 2007 focused on formulating concrete ways in which INTAR could disseminate the groups' collective experience and knowledge to a wider audience. Additionally, INTAR held a public panel discussion at Malaspina University in Nanaimo, British Columbia, which again demonstrated the public's hunger for alternatives to traditional mental health services.
What are the Opportunities and Challenges for Promoting Alternatives through the Work of INTAR?
First of all, practitioners in alternative methods are very busy making sure that they can sustain themselves and their organizations. They have little time to promote their own approaches on the world psychiatric stage, much less engage in general advocacy to promote humane alternatives of many kinds. It is quite characteristic of many alternatives that they remain the sole example of their generally quite successful approach. For example, after 15 years of operation, there is still only one substantial Windhorse program in operation (in Northampton, MA), with three much smaller programs in Vienna, Austria; Lambsheim near Ludwigshafen, Germany; and Boulder, CO. The Runaway House in Berlin is still the only example of its kind in Germany, and probably in the world. Related approaches have been established in New Hampshire (Stepping Stone). A family-outreach program that does not espouse the medical model has been established in Toronto, Canada, but so far has not been replicated elsewhere. With INTAR, there is the possibility that these efforts will cross-fertilize and their positive results will become disseminated to a wider audience, thus encouraging further dissemination.
It is also possible that these often fairly insular approaches require charismatic leadership for their own successes, and that such leadership cannot be easily transplanted. Windhorse and the Runaway House have taken many years and a highly dedicated group of people to become relatively firmly established. It is possible that the necessary ingredients (beyond charismatic leadership) of these approaches can be identified and disseminated more easily. The obstacles that alternatives are facing in most communities have less to do with the lack of buy-in to the principles they are espousing, but are rather tied to a whole host of economic disincentives that are exceedingly difficult to overcome. In the USA, for example, hospitals and psychiatric emergency departments have totally cornered the market on crisis intervention, especially in urban communities (with few notable exceptions: San Francisco and San Diego, CA). This is the primary reason why programs such as SOTERIA that provide non-hospital, largely drug-free interventions for individuals experiencing psychosis, have rarely been replicated successfully. It is our hope that organizations such as INTAR can affect a turning of the tide by affirming that there are safe and effective alternatives to hospital-based/bio-medical interventions.
How Will INTAR Synthesize Charisma and Successful Alternatives to Traditional Psychiatry for More General Consumption?
INTAR embodies wisdom, creativity and practical experience, but without
being self-congratulatory. The group is not homogeneous; it represents
diversity in hearts and minds and language. The group has hands across
oceans and a shifting population; as new alternative projects come on
board, that adds to the diversity. Through this, INTAR is a spring of
richness. Thus far, INTAR functions in a supportive and formative way.
It breathes life into and feeds the soul of those who are fighting the
good recovery fight, whether experts by experience or those offering a
service, or those who are in both positions. The people who constitute
INTAR make human to human connections and talk about their different treatment
alternatives. As the group works with a flattened hierarchy we
all have expertise but there is no single expert there is a pattern
of operation tentative, deeply respectful, tolerant and patient.
There is a sense of the group
It remains a challenge to galvanise a loose collective towards producing outcomes. But much is at stake. If there is no concerted effort to proffer rational arguments for these and many other successful alternatives, then they are fated to remain the exceptions that prove the rule: hospitals and psychiatric drugs will remain the only available options for individuals experiencing acute psychiatric problems. Peer support and psychotherapy will be seen as nothing more than adjunctive interventions that are likely to be priced out of the market, especially for people considered to have serious psychiatric conditions. Holistic alternatives and techniques will remain the purview of rich self-payers and never reach the vast majority of those who could benefit from them. Therefore, an organization like INTAR must lead the way in providing the following essential services:
Update (October 2013)
Since the original publication of this book, INTAR has co-sponsored two large conferences in New York City (2009) and Toronto (2011). In 2014, an INTAR conference will take place in Liverpool. The first one was dedicated to the topic of Alternative Responses to First Breaks and brought together international experts from a number of countries who addressed this important topic from personal, clinical and research perspectives. This conference was the springboard for the a collaboration between the New York City Department of Health and Mental Hygiene (see www.nyc.gov/html/doh/html/mental/parachute.shtml) and the Center for the Study of Recovery in Social Contexts (see www.nyc.gov/html/doh/html/mental/parachute.shtml) which resulted in the funding of a major grant to implement the Scandinavian Need-Adapted Model in combination with Crisis Respite Centers and Intentional Peer Support in New York City (Parachute NYC) (see http://fphny.org/whatsnew/grants).
This chapter represents exclusively the personal views of the authors, and should not be construed as a statement by the organization or any other participant in the 2004 and 2005 INTAR meetings. Acknowledgment: The authors wish to thank Will Hall and Kim Hopper for their helpful comments regarding this manuscript.
SourceAderhold, V., & Stastny, P. (2007). Full disclosure: Toward a participatory and risk-limiting approach to neuroleptic drugs. Ethical Human Psychology and Psychiatry, 9(1), 35-61.