Sunday, June 18, 2017

Developing the Relational Infra-Structure for Human Rights in Mental Health: Introducing Intentional Peer Support

Yeah, yeah, human rights are great in theory.  The rhetoric is wonderful.  We’re all members of a human family.  We’re all endowed with reason and conscience. Everyone is equal in dignity and rights.  The elimination of fear and want is the highest aspiration of humankind.  Yada yada.

But how does anyone really live this? Especially in an arena like mental health where people are, yanno, crazy. 

I can only speak for myself,  but the best approach I’ve come across so far is Intentional Peer Support,

What makes Intentional Peer Support (IPS) so special…?  IPS offers a principled, practical theory for putting human rights principles into actual practice.  It fosters mutually-engaging, sustainable relationships that honor diversity, grow understanding, and generate win-wins for all concerned.

When I first came across IPS, I had a foot in both worlds.  I was the director of a peer-run wellness and recovery center – but I was also a licensed mental health counselor.  IPS convinced me not only that force and coercion are harmful – but that it is possible to create meaningful, mutually-responsible communication across vast divides in human consciousness.  It also showed me the power and importance of human relationships in generating the energy and opportunities required for personal and social change.

Better yet, the power of IPS comes largely from creating relationships that actually work in the real world.  Thus:

  • With IPS, I can include my own needs while also supporting those of others.  
  • With IPS, I can live my own truth and my own values while also honoring beliefs and values of others that are often very different.  
  • With IPS, I can have my own experiences and my own reality and still communicate meaningfully with someone who is seeing, hearing or experiencing life from a totally different realm.  
  • With IPS, I can negotiate conflicting priorities and paradigms in inclusive ways that add value for all concerned.

This is very different from traditional mental health relationships, where the ground rules often are:

  • Different for providers and clients 
  • Decided unilaterally by the provider
  • The same for all clients and decided in advance
  • Take it or leave it (or even imposed involuntarily)
  • One-way in terms of who gets help and who gives it
  • One-way in terms of who risks sharing personal matters and who doesn’t
  • Applicable only to the world that mental health professionals like to operate in  

That is not a model for human rights relationships!  It also is not a model for how people in the real world mostly treat each other.  Imagine starting out on a friendship with someone who actually treated you this way.  Few of us would stick around for very long.  A family that operated in this way probably wouldn’t be seen as very healthy either.

Just as important – what would we learn about how to treat other people if we did?   Basically, the model for conventional therapy relationships communicates that the people who get paid get power. They get to set the ground rules and tell others what is acceptable.  They get to decide when the relationship starts and when it ends.  They also get to decide who talks and when - what is important to talk about and what isn’t.

This unilateral way of interacting is a recipe for hard feelings, resentments and human rights abuses. Instead of teaching respect and regard for different needs, outlooks and ways of being, it says that compliance with powerful others is required – and that's just how it is.

It’s hardly surprising, then, that many of us do not benefit from mental health relationships as much as some might hope.  It's also not surprising that many of us leave mental health relationships with some complicated feelings about power and control.  We may end up actively looking for ways to restore our sense of self-worth and individuality.

This may lead to exactly the things that conventional mental health says it wants to prevent.  We may take power and impose ourselves on others in the domineering, unilateral ways we learned. Or we may put our right to individuality in other people’s faces.

Conversely, we may play it safe and give up power to domineering others.  We may let ourselves be pushed around.  Or we my rely excessively on others rather than developing our own unique needs and gifts.

In contrast, the learnings from IPS relationships actually promote mutual regard and respect for human rights.  Unlike conventional mental health, IPS relationships:

  • Go both ways
  • Seek to create genuine, meaningful human connections
  • Recognize that everyone has needs and limits
  • Value the interests and viewpoints of all concerned
  • Don’t prioritize one person’s knowing over others
  • Seek to negotiate differences openly and honestly
  • Try to do what is good for relationships, versus elevating some individuals over others
  • Make clear that relationships need to work for everyone who is involved
  • Encourage self-awareness, co-learning and ongoing co-reflection by all participants. 
  • Define the success of relationships in terms of whether they create mutually transformative individual and social change.

Better yet, the learning and gains from IPS practice are are entirely transferable.  The principles of IPS work just as well at home as they do in clinical or peer support settings.  They work in all kinds of contexts, for all kinds of issues and for people from all walks of life.  Thus, IPS can be used to support meaningful conversations between Republicans and Democrats and capitalists and socialists. The same is true for Christians, Muslims, agnostics and atheists - and for people of all incomes, classes, races, genders and national origins.

This is good for several reasons.  IPS supports conversations that are respectful of human rights to occur. It also prevents the misunderstanding and escalations that lead to 911, police or crisis squads being called in.  This is not just true for mental health settings, but potentially everywhere.

Thus, IPS practice resources ordinary people to have conversations that resolve conflicts, if not avoid them altogether.  It supports people to connect with each other and value each other across human differences. When people like each other and feel comfortable, authorities don't get called in.

This too is good news.  If authorities are not needed - and therefore not called - no one gets profiled, confronted, shackled, tazed or shot.  No one gets dragged in, locked up, restrained or force drugged.  No one gets removed from their life, their home, their job, their family - and potentially loses all of this.  No one gets diagnosed, labeled or further set back by another recurrence.  People simply go on with their lives and have another uneventful day as neighbors, family or friends.

This experience is not theoretical.  I have lived it, experienced it and seen it happen again and again. It leads me to believe that IPS is a promising practice – not only for reconciling human rights and mental health practices – but also a variety of pressing social justice concerns.  It offers a way of thinking about relationships that honors diversity and creates added value for all concerned.

Over the next few weeks, this blog will go into the practice of Intentional Peer Support more deeply. It will seek to explain, in clear concise terms, the core theory of IPS and how it works in action.  It will try to demonstrate how IPS can be used in mental heath and other social justice contexts to create the human rights-informed relationships that many of us are seeking.


  1. And you attempted the first ever forced intervention based on IPS. You are indeed a ground-breaker.

    1. OMG, Sharon! Welcome! Good to hear from you.

    2. Wow.Powerful writing! I've taken the IPS training and it is phenomenal for crisis work. Thank you!

  2. Thank you :)
    I see Intentional Peer Support as both heart-work, and a practice that as with any practice, requires practice... Every day for me there are connections and disconnections, misunderstandings of worldview, sparkling moments, regrets and much to learn from.
    IPS as much as anything provides me with a framework to be able to see, understand, reflect and try again...

  3. This is beautiful, Chris. I am going to share this with our AZ Human Rights Committees at our statewide mtg this Saturday! Thank you!!


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