A week from today, I return to Italy. When I shared the news last April that the bi-annual international mental health conference was scheduled for the last week in September, I offered to guide a group back to Trieste. I expected that perhaps 15 to 20 people would be interested to attend this year. And here we are, on the precipice of leaving California, to learn more about a model that inspires the world. The delegation representing a diverse group of Los Angeles County and state leaders now stands at 39 people, including me.
So, I’ve been a bit busy – no blogs were written this past month as I have been working to coordinate this group to keep them connected and organized. (I will finish the stories about the original Hollywood Top 14!) These fellow travelers are 38 free agents, coming on their own, and I am weaving the net to connect them so we can harness their learnings and ideas for our return to California.
Looking over the program for the week — and this is a jam-packed conference with very little free time — we see that presenters will cover the basics of the Trieste model. These are the common themes: “from humanization to deinstitutionalization,” “whole system change,” “good practices,” “open dialogue.”
The Trieste model is an open door, no restraint system and there will be speakers addressing:
- Alternatives to the hospital
- Home treatment and hospitality at a 24 hr community mental health center
- Social cooperatives and citizens’ social integration
- Importance of peer support and inclusion
The International Mental Health Collaborating Network (IMHCN) is the umbrella under which “twinning agreements” are forged to allow for a relationship between the Trieste system and other countries or regions. On Tuesday afernoon, four of these collaborations will be discussed including:
— the experience in Wales
— Italy-Slovenia cross border cooperation
— reform of the mental health system in Poland
— Los Angeles — the T.R.I.E.S.T.E Pilot
What is particularly exciting about this conference is hearing from people from all over the world who are attempting to apply the lessons learned over the past 40 years in Trieste to their systems at home. People are people, no matter the country one is born into. What is stunning is to see the different responses of systems outside of the U.S. in caring for their brothers and sisters who live with a mental illness. With this in mind, everyone who makes this pilgrimage to Trieste is united in their belief that there is a better way and people deserve better.
I believe it is an American myopia to suggest that there are not take-aways we can learn from other continents when we are struggling under a system that can only be defined as broken. (Cannot tell you how many times I have had to answer the question: “why do you have to travel to Italy to find inspiration for what we need to do here?”)
It appears that some are offput by the fact that it is Italy — perhaps equated more with vineyards and pancetta. Listen: I would look under a rock if the hope were to be found thereunder.
But other countries will share their insights. We will have the opportunity to also to hear from Argentina (Por Un Pais Sin Manicomios – For a County Without Asylums), Spain (assertive community treatment and hearing voices), The Netherlands (hostel program for people with long term drug addiction), Slovenia (machines of inclusion and exclusion), Bosnia and Herzegovina (value of mental health user’s associations in promoting recovery), France (community networks), Greece (a movement for an alternative mental health system), Iran (improving standard of care in the psychiatric hospital) and Kenya (peer support groups and users and survivors of psychiatry).
I am very excited to spend the week not only with members of the global community, but also caring and courageous thought leaders from home. The delegation from CA includes representatives from the following organizations: Steinberg Institute; cities of Santa Monica and Los Angeles; Los Angeles County sheriff, department of mental health, board of supervisors, district attorney, public defender and mental health court; CA state assembly; United Way of L.A.; Los Angeles Homeless Services Authority (LAHSA); Los Angeles Police Department, Weingart Center; Ralph M Parsons Foundation; Hilton Foundation; Brilliant Corners; The Alcott Center for Mental Health; Los Angeles Times; The Center in Hollywood; CA Hospital Association; The People Concern and Chrysalis.
After the formal conference ends, members of the delegation will be divided up over the next two days to participate in site visits of the various locations where services are provided, people are housed, social cooperatives operate, user associations gather and the like.
In particular, a subset of our delegation will tour the city jail and discuss how their law enforcement system interacts with the mental health system and the community. Not only will the conference present on the open door forensic units in the region surrounding Trieste (Friuli Venezia Giulia), but delegation members will be able to visit one.
I will attempt to blog during the conference; albeit short posts, with a more thoughtful debrief upon my return. Folks who will be tweeting will use #heartforwardLA to connect our observations.