Why not spin the wheel?

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Above: We should be prepared to innovate in the mental health system in order to help people like this sufferer of JPSPS (Jigsaw Puzzle Stock Photo Syndrome)


The plan to trial social bonds in the mental health system has been roundly attacked, but in my view a lot of the criticism is unwarranted. Here is a plan to try something new, to see if we can achieve better outcomes by doing things in a different way. Shouldn’t we be celebrating the fact that the government is prepared to be creative in finding solutions to difficult problems, rather than resort to kneejerk outrage and negativity?

Shouldn’t we give this plan a chance before we pass judgment?

We really have no right to criticise something that has never been tried before in this country. Nobody can be certain whether or not this social bonds plan will succeed, so let’s give it a go. Let’s see what happens. It might be the best thing that ever happened to the mental health system.

Some people reckon we should just stick with the current system. But that’s just not good enough. People are falling through the cracks. Our system is stretched to its limits, and people are suffering. We must do better.

We must be prepared to experiment, to innovate, to be bold.

It doesn’t have to just end with social bonds. There are a whole range of ideas and initiatives waiting to be trialled. Things that have never been tried before. Schemes that may sound adventurous or daring, or even reckless to some. But until we try them, how can we possibly judge them?

We must make mental health policy based on the best clinical evidence available. But very often the only way we can gather that evidence is to conduct experiments and trials.

For example, forcing mental health patients to eat seed cakes, while making them stand on one leg on the roof of the Auckland War Memorial Museum and sing Oh, what a beautiful morning! could have positive outcomes for participants. But we don’t know for sure, because it’s never been tried before. Maybe it’s time we gave it a go.

Another idea perhaps worth trialling is the outsourcing of mental health services to local Rotary and Lions clubs around the country. Allowing Hutt Valley Rotary Club members to dispense prescription medicines to the mentally ill may well lead to a deterioration in the health and wellbeing of some patients, and possibly even deaths. But this idea has never been tried before, so we cannot be absolutely sure. The potential efficiency gains may well outweigh the risk of harm to patients, although they probably won’t. But they might. Even though that’s very unlikely. But we can’t be certain without conducting a trial, can we?

We also can’t rule out the possibility, the very small possibility, the extraordinarily minute possibility, that turning secure mental health facilities into petting zoos, thus allowing small children to stare at, photograph, and even touch the inmates, would improve outcomes for patients, and wouldn’t in fact result in terrible harm being inflicted on both patients and innocent children. While the idea may sound depraved and disgusting, there may well be a market for this sort of thing, and the money earned through door sales could help fund other mental health services.

In my opinion these ideas are all terrible ones. But that’s just my opinion, and it’s not based on any clinical evidence. In a debate where facts are needed, opinions are worthless. So, for example, in my view it would be the height of stupidity to encourage sufferers of extreme paranoid delusions or anxiety disorders to pilot passenger aircraft. And yet no airline has ever actively done this, so shouldn’t we at least encourage them to give it a go before passing judgment? It may turn out that putting the lives of hundreds of passengers in their hands is the very best medicine. It probably won’t, and an awful lot of people may well end up being killed. But at least we would have hard data at the end of the trial.

In all probability these will prove to be appallingly bad ideas, every one of them. But we can’t be sure, so let’s roll a few of them out, spin the wheel, and see what happens. What harm can come from conducting experiments on the mentally ill?

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