Successful Finnish mental health system is focus of four-day series


Published: Wednesday, September 11, 2013 at 4:36 p.m.
Last Modified: Wednesday, September 11, 2013 at 4:36 p.m.

There is a place in the world where people with mental health conditions are not labeled, locked up, or even given medications.

That far-away place is Western Lapland, and a series of panel discussions and documentary film screenings in Gainesville this weekend will feature its mental health system.

New York City-based Daniel Mackler, a psychotherapist turned documentary filmmaker, is coming to Gainesville to show his films and talk about the Finnish system, which is featured in one of his films called “Open Dialogue.” The events surrounding the documentary run from Friday to Monday at various locations in Gainesville.

The film's name refers to the system itself, which is based on open-ended talk therapy involving the patient and his or her social network (family members or friends), doctors, nurses and social workers.

“I kept asking where the main (psychiatric) system was,” said Mackler, who with a grant was able to travel to Western Finland to make his film. “But this (open dialogue) was the main program. To the people in this area, this was psychiatry.”

Mackler had been a practicing psychotherapist for a decade in New York, where he heard “consistently horrible stories” about treatment in a psychiatric system that started to seem “draconian,” he said.

So he went in search of alternative systems where results were better.

And in Western Lapland, results of the open dialogue system -- which evolved over a couple of decades and was started by a group of young, idealistic therapists -- have been stunningly positive.

Eighty-five percent of patients have recovered after five years, and only one-third have ever taken antipsychotic drugs. The patients also had higher employment rates than the general population.

As Mackler points out in the film, this was not a wealthy community, and their health care system provides a solution that is not costly. But it works, and patients are happy with it.

“It's about letting people talk and not telling them what to do,” Mackler said. “They have the answers within them.”

Getting to those answers involves more than a typical 45-minute weekly therapy session, though, Mackler continued.

In Finland, the team of therapists might meet with patients -- in their homes -- for two hours a day for a month.

“But then the person is done. It ends up being much cheaper,” Mackler said, adding that it's a more empowering experience for patients.

“They don't get labeled (with psychiatric illness), and they are stronger because they've worked through a crisis.”

Mackler said that he thinks the system is transferable, even though it goes against a lot of psychiatric training in the U.S.

Patients here, however, are eager for an approach that works, and wary of the effects of medications and to some extent, the whole mental health-care system, Mackler said.

That means that they often wait to use it, or try to avoid it, whereas in Finland, “People end up trusting the mental health system, so the lag time is weeks and not months or years” between symptoms and being seen, he added.

Dave Byrd, a Gainesville resident who has been treated for manic depression since 1981, will be speaking on a panel with Mackler and other local experts on Monday afternoon following a screening of “Open Dialogue.”

“The most impressive thing about the film is the teamwork involved,” Byrd said. “That was never done to me.”

Byrd said that he voluntarily went to the hospital with encouragement from his parents. At the hospital, “they put me in a room and gave me a shot without telling me what it was,” he continued.

“My biggest problem was that nothing was really explained; I was treated like an animal. Just because I have mental illness doesn't mean I can't understand something.”

Byrd said that although he has continued to use medications, he has been able to taper them with alternative therapies such as yoga, tai chi, acupuncture and energy massages.

He also credits his social network with aiding his recovery.

“Friends and family have been a very strong part of my recovery …as important as the meds,” he said.

Mackler also will be speaking to a group of veterans during his visit. According Vianne Marchese, chair of community care services at the North Florida/South Georgia Veterans Health System, the open dialogue principles are “very much in line with what we are aspiring to do at the VA and are doing,” by putting the patient at the center of the recovery team.

“My hope is just to open up dialogue. It's an opportunity for veterans to hear empowering stories about how people have achieved their recovery,” Marchese said.

Following is the schedule of events that are free and open to the public:

-- Friday, 7 p.m.: meet and greet with filmmaker Daniel Mackler followed by 7:30 p.m. screening of Mackler's movie “Take These Broken Wings” and a Q&A with Mackler. At United Church of Gainesville, 1624 NW 5th Ave.

-- Saturday, 8 p.m.: screening of Mackler's “Coming Off Psych Drugs” followed by 10 p.m. musical performance. At Civic Media Center, 433 S. Main St.

-- Sunday, 11 a.m.-noon: seminar with Daniel Mackler on “Open Dialogue.” At United Church of Gainesville.

-- Sunday, 6:30-8:30 p.m.: screening of Mackler's “Healing Homes” followed by Q&A with Mackler. At Trinity United Methodist Church, 4000 NW 53rd Ave.

-- Monday, 1-5 p.m.: screening of “Open Dialogue: An Alternative Finnish Approach to Healing Psychosis,” followed by Q&A with Mackler and panel discussion with local psychiatrists, lawyers, psychiatric patients and survivors. At United Church of Gainesville.

Contact Kristine Crane at 338-3119, or kristine.crane@gvillesun.com.

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