The current "system of care" in the treatment of the mentally ill is sorely hurting. The system lacks a necessary transitional phase from holding the status of a patient to the desired role of being a working member in the community.

I am in favor of the notion that the experience of fulfilling such a role despite my condition is possible. Indeed, I have had the opportunity to live on both sides of the fence. First, I am mentally ill; second, I am an advocate; third, I am, by profession, an art therapist with a diverse and varied work history and a resume that reveals work in fair housing, public access, and exposure as an artist in the city of Brattleboro.

Work has provided me with much more than a paycheck. It has been gratifying for many reasons with the most important being the rewards of seeing myself, and having other people see me, as a necessary member of society. The work place has proven to be a setting in which I developed important relationships and contributed to the community.

What I am finding now, within this largely progressive and compassionate city, is that there is a continued movement to deinstitutionalize (a very old word) the mentally ill into the work place without significant support and respect for the process. That transitional phase from being incarcerated to being "set free" currently does not exist for many patients as I have discovered. It is enough to realign oneself with the notion that we literally have our own keys with which to enter the world of the living. Add to that unstructured time, little accountability, or obligation to show up, and you are in for realizing the theory of chaos.

What is called for are out-patient programs that value individual and group settings where patients may test the waters of what it means to be liberated from the confines of the often times constricted lifestyle of the psychiatric institution. Interesting and educational groups with specific themes like critiquing the written word (book clubs), discussion around film and theater, current events, music appreciation, art and movement therapy, meditation, and finally, practical groups such as medication management, budgeting, how to conduct food shopping and cooking, designing a personal exercise regime, and how to contend with symptoms in social situations, will help to acclimate the mentally ill individual into the community in a healthy and welcoming way. All of the above mentioned are referred to as "therapeutic activities" and do not exist at this time to the extent that they should both in the inpatient and outpatient treatment milieu.

Moving too quickly through this system can be detrimental to both the individual that suffers and the efforts of the community to establish a place for productivity. That is why it is important to provide therapeutic dialogue both in groups and individually consistently and steadily for the duration of the transitional phase. The need and obligation for sessions and group interaction has never been more neglected. The quick fix as we know it is not useful anymore. The revolving door syndrome, for many, continues to spin out of control. It is crucial that consideration be given to assessing the current system of care. Preserving and enhancing the existence of outpatient treatment will ensure health and sanity for the mentally ill and for all in the community.

Kelley Murray receives services from Health Care and Rehabilitation Services in Brattleboro. She is an unemployed art therapist with a master's degree in art therapy from Norwich University.