Immediately below is my understanding of the new SAMHSA approach to medications for people with serious mental illness.
What they proposing is using the “Eastern Finnish Dialogue “ treatment protocol, outlined by Roger Whiticker in his book, Anatomy of an Epidemic. The anti-psychiatry movement appears to be accepting this as a compromise, and the polarization of the recovery and civil rights movements is largely a thing of the past.
Treating people with the Eastern Finnish Dialogue method is just that, a dialogue. When a person arrives psychotic or suicidal, the first question is “What Happened” . Then the person is left alone in a natural setting and offered tea etc. If they want to talk, the idea is to obtain their story. By no later than the next day, if they remain so agitated or depressed that they are not safe, they are calmed down with a benzodiazepine. If they are suffering depression leading to suicidal thoughts, they might receive something else, besides a benzodiazepine. Hopefully they will sleep.. Once they awake, they may be alright, but, if not, a course of antipsychotics or whatever is appropriate is tried until it has a chance to work. If the person returns to a normal range of emotions and feelings, it is not assumed that they need continued medication to retain this, but instead the medications are slowly drawn down. If the person continues to be OK, then they continue in treatment without medication until the need for it might become clear. If after the first trial of medications has been tried and failed, the sequence is repeated at least 3 times as necessary. After that, if the person needs the meds, they are resumed as a continued but temporary remedy. Indeed, some people will need them for their lifetime.