The Bigger Picture

The human focused approach

This is an introduction to the ideas and thoughts that inspire our work at Starfish. We have been involved in a search to make sense of the landscape that we find ourselves working in and asking why, what and how can we best support the people who find themselves in difficulty that we serve.

These questions surround all aspects of what it is to be human, from hope to despair, from order and puzzlement to making meaning. Therefore the approach we are developing – and continue to develop after many years – is a multi-disciplinary approach that reflects the many ways of exploring the unique experiences of humans, drawing from psychology, sociology, anthropology and philosophy.

The current mental health paradigm – used to explain the distress people find themselves experiencing and on which their interventions are based – is predominately bio-medical and reductionist. Unfortunately, such a model inhibits, or at worst excludes, the important role that people who experience mental distress are able to contribute. 

The current paradigm is often experienced as a series of monologues dictated by professionals – who build their knowledge on only certain types of evidence-based research such as random controlled trials (RCT’s) – which represent only certain types of evidence collected within tightly defined “bio-medical” parameters.  When taken out of context this evidence can be inadequate and misleading.

We are not against this evidence as such; rather we believe that the definition and scope of “evidence” for identifying pathways to progress must be broader, including practice-based evidence, i.e. the continuous process of investigating what works for whom. Practice-based evidence is a research technique steeped in personal experience and rooted in personal and social context.

Although the bio-medical paradigm is dominant we are not alone in our thinking and many other individuals and groups are also questioning and challenging current thinking and practice in relation to mental health and human distress.

We would like to propose an alternative paradigm to the current framework of understanding: One based not on monologue but a dialogue between individuals and professionals and between different communities. Further foundations of the new paradigm are localism and an acceptance of uncertainty with respect to what will constitute recovery for any particular individual. Localism acknowledges the wider context of people’s lives and the variation of opportunities for marshalling resources for recovery. Acceptance of uncertainty follows from the centrality of solutions emerging from dialogue and shared power in decision making.