“Alternative approaches to first break situations: Key practice models and their operant values” –by Stastny, Chaudhary, Hagmann

I. Introduction:

The purpose of this working paper is to identify and describe key alternatives to mainstream psychiatric intervention — designed to benefit individuals experiencing a first break or early crisis episode (see definition below) — that are either currently available or have been in operation since the mid 1970s. We focus on the three programs/practice models that are most prominently represented in the literature and that stood the best chance of falling within a set of guiding principles that are based on discussions held by members of the INTAR network during its four preceding meetings (see below). We examine these alternatives in terms of their operating principles, engagement of affected persons and interested others, outcomes, and consumer satisfaction, relying on published data, with the ultimate goal of determining to what extent these programs preserve and enhance existing capabilities, offer means of operationalizing “hope,” and assist participants in early recovery and a return to a viable developmental trajectory.

We see this paper as a contribution towards developing a framework to systematically examine current and newly developed alternative modalities with respect to their potential for averting capability deprivation, enhancing recovery processes, fostering individual agency, and safeguarding the dignity and human rights of people experiencing serious mental health crises. We also hope this paper advances the discussion of just what constitutes a viable and acceptable response to a person experiencing a serious, and potentially debilitating break-down for the first time in their life. (download paper here)