By Dennis Archambault
I recently had an opportunity to discuss psychotherapy and analysis with a young psychiatrist with a successful practice. He was confident that proper therapeutic intervention really improves the well-being of his patients, many of whom suffer deeply from psychological distress. One of the modalities we discussed was psychoanalysis, an expensive process that has shown to help people recover from severe psychological problems. To be effective, psychoanalysis requires multiple sessions on a weekly basis, often for a long time.
I explained to the psychiatrist that I represent an organization that promotes population health among low income, vulnerable populations where there isn’t sufficient access to mental health services and a lack of financial resources to afford more involved therapies like psychoanalysis, not to mention access to transportation to reach a psychoanalysis. He acknowledged the cost issue, but went further to confirm that people living in the lower economic strata of society endure such depth and breadth of cumulative trauma, that individual psychotherapy wouldn’t be effective.
That message came out of a conference on “Building a Resilient Community,” sponsored by Starfish Family Services http://www.starfishfamilyservices.org/ earlier this year. One of the concepts discussed was a form of community psychology, “trauma-informed community building.” While individual counseling is helpful , care must come through the ongoing reinforcement of a healthy community – specifically family and neighbors.
The State of Michigan offers a good resource list on “Building Trauma Informed Communities” http://www.michigan.gov/mdhhs/0,5885,7-339-73971_4911_69588_80205—,00.html. One of the sources cited was a Robert Wood Johnson Foundation program in Washington, promoting the “self-healing” of the community, which promotes collaboration across sectors of resources, empowers local leadership to think systemically, use data to focus initiatives, and ultimately “instill a real sense of hope in communities that had given up on the prospect of a better world for their children.”
In the absence of a progressive health policy at the national level, local solutions like trauma informed communities and support networks are worth pursue. But, to reference a familiar adage, it will take a village.
Dennis Archambault is vice president, Public Affairs, for Authority Health