 I'm going to start off by showing three photos that all are within the same setting and after I show the three photos I'm going to ask for some audience participation in some responses in what you think you're seeing here. So here's the first photo, this is the second, and this is the third. And like I said, they all take place within the same setting. So does anybody have any ideas of what they think they're seeing within these photos? Go ahead, shout out some answers. School, community center, tidy areas, housing complex, counseling center, alright so I heard a bunch of responses that all said things along the line. If a community center, a place for growth, learning, engagement with others, maybe rejuvenation, relaxation and enjoyment. Perhaps unsurprisingly, I didn't hear any guesses of this being a mental health institution. This isn't incredibly surprising given that I'm giving this talk to a predominantly American audience because in America we tend to distinguish mental health care from anything resembling rejuvenation or enjoyment or fun. In fact, I experience this phenomenon on a very micro level quite regularly when I tell people that I'm a clinical social worker. Usually people's responses are something along lines of exasperated or pitting responses. And those responses become even more startled when I tell them that I find this work enjoyable and energizing and yes, even fun. Just like it's hard to envision that these photos could be a mental health institution, I found that it's hard for us to conceptualize mental health care different than what we have come to normalize in this country. These photos were in fact of the public psychiatric care center in a town called Giel, Belgium. Here are some photos from my trip to Giel just to give you a visual representation of what the town is like. With the rich 750-year history dating back to the 6th century legend of St. Dymphna, Giel has what's called a de-institutionalized mental health care system in which people throughout Belgium who are experiencing mental illness can be placed with a foster host family who takes them in and cares for them like a new member of their family. The approach in Giel is one of de-pathologizing mental illness. And this approach to de-pathology is seen even in the root level of the term that is referred to people with mental illness. Not calling them patients, but rather borders or guests is a way that humanizes people with mental illness in Giel. These families that take in borders usually come from long lineages and many generations of families that have taken in borders. And their approach is not to cure these symptoms or get rid of them, but rather to accept and welcome borders as they are. Care not cure is the motto that the psychiatric care center utilizes, seeing these unique mental differences as benefits rather than burdens. This level of understanding of mental illness is something that I was taught in my master of social work degree, that there's actually some beneficial value to that with which we pathologize of mental illness. Body, for example, has been evolutionarily useful at keeping us all safe from dangerous situations. It's what alerts each of us to slam on our brakes when we think we're about to hit the car in front of us. And in the past year, I have completed my social work field placement at the Women's Center of Southeastern Michigan, employing this same tactic of finding the beneficial value in mental illness within the 10 clients that I got to counsel. I help them on a range of presenting issues from expanding their social support networks to looking for a job to rebuilding confidence and self-esteem after toxic relationships. And universally what I found is that showing people that there's some beneficial value to this thing that's pathologized in the rest of society has tangible healing benefits to it. So I want to point to some contrast between what I experienced in my time here at the Women's Center and what I found in Giel. I applaud the Women's Center and really commend the work that it does as a center in depathologizing mental health care. But upon my arrival back to the U.S. from Giel, I've been disappointed and saddened to think about my clients here only receiving one hour of therapeutic care in which they felt embraced and accepted fully as they are in comparison to the entire lifetime of community, social, and family support that Borders and Giel receive. That's one hour a week compared to a lifetime of support, which is a really stark difference. Another big difference is in the shame that I felt that my clients feel in asking for help in seeking therapy and even coming to the Women's Center, which I think is a very welcoming and inviting space, especially when I compared this to the community protection that Borders experience in Giel. I got to observe this first hand during a European festival that was taking place in Giel during my visit. This is a picture of the festival. This festival brought in vendors from a variety of European countries to sell their goods and food to people in the town. While there, one of the vendors was making fun of how a border walked because he walked differently than how people normally do. And people in the community who weren't part of this border's family and didn't know him very well approached the vendor and asked him why he was making fun of someone, especially since this border wasn't doing anything to harm him. And I think about this in contrast to the shame that my clients feel here versus this community protection that this border experienced. It wasn't something that he had to take on alone, it was something that he felt embraced by and didn't even have to approach himself, but rather was taken care of. Another stark contrast between what I've experienced in regards to mental health care here and in Giel is in the noticeable and observable affect and mood in the population. The community in Giel is integrated with borders and community members living side by side. And visitors to the town frequently comment on the happiness and contentment that you can see within the population. This sits in stark contrast to the high levels of life dissatisfaction and nearly 70% rate of disengagement with work evident in American culture. So at this point you must be wondering why don't we bring a model like Giel to the U.S.? And actually that's been tried several times before. Nearly 50 years ago an American woman named Ellen Baxter traveled to Giel to learn more about this model of care. Her story was personal, looking for an alternative to the lack of care that her mother received in this country and which her mother could have benefited from as she was suffering from mental illness. Baxter proposed instituting a model of family foster care in the U.S. in her grad school applications. And she was rejected by every school, all with everyone claiming that this proposal was not going to be viable in the U.S. A psychologist at Harvard told her that there wouldn't be enough families here that would host borders. A sociologist at UCSD said that the very notion of accepting mental illness goes against the American ideal of wanting to fix things that are broken. But Baxter didn't let this stifle her. Instead, she rejected those rejections and created a co-housing community in New York City where people with mental illness live side-by-side New York City residents and there's a noticeable impact in the reduction of symptom severity in those living there. Many of you may know the one and four statistic that 25% of people will have a mental illness at some point in their life but as a social worker I've been trained to be critical of us versus them or helper versus helped language. While we may not all meet the criteria for a mental health diagnosis, I believe that everyone in this auditorium has at some point experienced a situation in which they felt excluded due to something that made them different or due to something that was different about them. As a social worker, I don't believe that we can change the culture without acts of subversion or going against the grain. And I think part of doing that is in digging into that part of ourselves that knows what exclusion is like and in being a member of the community in which we wish we had had in those situations. I've been inspired by Mary Pfeiffer's quote on cultural change because she calls for subversion or going against the grain and creating this change. She says social change is a million acts of kindness. But cultural change is a million subversive acts of resistance. Cultural change is built in small moments and is built incrementally. It is built over time. It is built every time we have the courage to approach a vendor who is making fun of how someone in our community is walking. It is built every time we pause and let someone finish speaking when we want to interject and share our own thoughts. It is built every time we stop and have a conversation with someone that we would normally avoid eye contact with on the street. And when these small moments are built up over time and are done at a constant critical mass, they become the norm, rather than the exception. They create cultural change. They create a cultural ideal. And like Ellen Baxter, they show that a culture that is accepting of difference does not need to be at odds with American values, but can be part of this country's value system when we have the courage to practice acting subversively. Thank you.