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One Size Does Not Fit All

The field of Mental Health is in an historic moment , not because of a great new break through in therapy; but because of catch up regulations in funding streams. Practicing in the field for over thirty years, I would like to think we are driven by sound thinking and strong empirical data, leading to good policy and practice. The truth is, though sound thinking and good data are part of the field, funding sources and bureaucratic convenience are just as often the propeller and tiller of our ship. We are in an historic moment because powerful and well meaning people in our society are working hard to create a better more humane Health Care System. They will succeed. We will have a model that is cognitive behavioral at it’s essence as opposed to a disease model. The change brings 1950 thinking into the 21st century. This is a great leap forward. We need to remember what brought the system to this point. The disease model was the best collective thinking at the time. New ideas, therapies and approaches developed in each of the following decades. Funding streams did not keep pace with the advancement of ideas leading to a tortured system which sometimes stands in the way of best practice. If we are not careful we will set up a system which will age just as poorly as the last.

Woodley House Inc. has provided care to people suffering from mental illness since 1958. I am often asked how we are able to provide such excellent care when the field we work in has varied to such an extreme. When I think how to rationally answer this question; I think of our core values but I also think of the myriad of adjustments the agency  has gone through to continue to exist and serve. Woodley House’s stated core values are Dignity and Respect. These words have guided our Board of Trustees and our four Executive Directors through the many changes in mental health service over the last 56 years. Contained in these words Dignity and Respect is an appreciation for people as individuals and not a collection of symptoms. These values, pared with an ability to find funders who believe treatment should be individualized, has allowed Woodley House to continue to function even when its approach was not always mainstream. Recently I was reading notes from our founder, Joan Doniger, which reflected problems she was having with the “SYSTEM” during a period in 1964, when she served as Executive Director. I was amazed that although the precise problem was different the battle with bureaucracy was the same that I find today. The “one size fits all” outlook of bureaucratic policy existed then and continues to today. Once the policy is in place it fails to change as the field progresses causing antiquated funding streams and new ideas to go begging for financial support.

If todays policy drafters can resist the “ONE SIZE FITS ALL” outlook and build flexibility into the policies to allow for funding new and more effective approaches the field of mental health will take a giant step in avoiding the pitfalls of the past and the pain it delivers to consumers and families relying on caring and effective services.

More to come

Gary W. Frye

Executive Director

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