The mental health service as conspirator

Abstract

Mental health cannot offer substantial help to persons trapped by poverty and discrimination without working for change in the system that has trapped them. Traditionally mental health has considered the hurts of its clients to be private, shielded by confidentiality. However, mental health is part of the establishment. “Confidentiality” seems to the client to mean the worker will do nothing about the rest of the establishment that the poor person sees as the real source of his troubles: teachers, welfare workers, police and housing authorities. Too often this is true. Helping poor people with their most crippling problems means using mental health insights to help other agencies be more humane, effective, and compassionate.