National Association for Rights Protection and Advocacy

Make or Break Opportunities:
Providing alternatives during a first major crisis

Peter Stastny, M.D.

When a person experiences altered states for the first time, they are usually at risk of involuntary hospitalization, forced treatment, and excessive use of psychotropic drugs. These risks can be minimized by the introduction of alternative, non-coercive interventions, such as the Scandinavian models of Open Dialogue and the Parachute Project, as well as Soteria Houses and similar crisis residences. Even though there is a growing research base substantiating the success of these models, American psychiatry has consistently eschewed and attacked them, mainly due to their flexible use of medications. Instead, the psychiatric community has favored prevention and early intervention programs that attempt to identify youngsters at risk for serious crises, often diagnosing them as pre-psychotic, and treating them with medications and intensive psychosocial programs. This workshop describes these alternatives in detail and presents strategies for promoting their greater availability.