Psychological theory and its impact on mental health
practice and policy
By Graham Little PhD AFNZIM
The nature of scientific knowledge
The nature of cause
Model of scientific knowledge
The theory of psychology
Multiplicity of structure
Importance of attention
‘I’ and self
Thought and thinking
Our spirit and spirituality
The mental health questions
What is mental health?
Education policy and curricula
Issues of focus and effectiveness
The question addressed can be put: if we have complete and full causal understanding of human conduct and social systems, would that understanding impact social policy? And what would that impact be?
This paper argues ‘yes’, such understanding would need to be bought to account in shaping and revising mental health practice and policy. Today, there is no agreed theory nor any commonly accepted insight into the causality of social systems, people in particular. As a consequence, social policy surrounding such things as mental health has arisen in the absence of any clear orientating conceptual framework, it has arisen piecemeal, from occasional fragmented theory, some of which is thoroughly discredited, and from practical experience and research on what does and does not work. Therefore if an orientating framework is developed, as undoubtedly it will be then it can only forge a sharper and more effective insight into the social systems and into policy and practice surrounding mental health leading to more clear and more effective policy based on better understood principles.
The papers at this site are a systematic attempt to build a full understanding of the causality of social systems; it is as yet the only comprehensive system of thinking to succeed in such an endeavor. While all the details may or may not be correct, the system yet to be seriously reviewed and tested, the overall framework of the thought can only be correct, it is impossible to see an idea as anything other than a class of events, and the systematization of ideas in science must embrace this immediate distinction between a variable and its value. The distinction between variables and their values can only lead to a structure of any theory of human affairs quite different from that commonly encountered and one not necessarily related to the immediacy of a person. The nature of the theory arising within this system of thinking is a conceptual description of the person, it does not necessarily look or feel or within the immediacy of the theory carry with it the sense of a person. The full understandings of the theories at this site arise as intellectual processes, application of the theories being a conceptual process and not an intuitive process.
This paper reviews core understandings developed at this site and proceeds from them to explore their implications for and impact on social policy and practice of mental health.
The nature of scientific knowledge
The core issue in the understanding of knowledge is the separation of a variable from its value, this separation itself based on the understanding of an idea as a class of events, the properties of the idea being a summarized and abstracted system of descriptions of aspects of the events, with no actual event necessarily embracing any or all of those properties. This looseness is easily coped with in daily, common life, so we can easily use a table as a chair, or vice versa. For science this looseness in notions of variable is not acceptable, which forces definitions of Variables and systems of variables as crucial tools in building scientific understanding of the regularities of the universe.
Once the definition of a Variable is accepted, then various consequences must follow, for example the coherence of the Variable means by definition that below this level of conceptual understanding the very nature of that being described changes. In more simple terms this means that science exists in domains, each domain being defined and determined by the coherent system of variables (the Variables, with capital denoting the coherence). Below this level the nature of the scientific understanding changes.
Underlying each domain of science is a domain that describes the mechanisms whereby the higher domain of science is in fact manifest. But this does not mean that the higher domain is reducible to the lower, it merely means they exist in a certain relationship, described in the immediate and ultimate effect structure. For example, Thought emerges in the theory of psychology as a Variable, with Thought being defined as that available to consciousness, the values of the Variable Thought being the ideas we have. Thought being a Variable means it is not reducible to underlying Variables, the underlying Variables are descriptions of neural processes and mechanisms, and ideas are not reducible to those mechanisms, even though they encode the idea. So examining some system of neural operations will not tell the researcher of the psychology, not unless the researcher knows and understands the exact relationship between neural functioning and the psychological events a consequence of that neural functioning. Even existence of such detailed understanding of which neuron resulted in which psychological event, there is much evidence that the system is flexible and malleable, so correlations understood now, do not mean they will be precisely the same next time. Psychology is not reducible to neural physical events, and psychology is a unique domain of science that must be studied in its own right.The nature of cause
There are developed in the papers at this site the two crucial aspects of cause. First, the structure of the immediate and ultimate effect relations paralleling the definition of cause (the relation between classes of relation between classes of event) creating models of the mechanisms of the universe. For example, we can create quite precise models of the mechanism of the solar system and its immediate environment; as a result of those models we are very confident the sun will rise tomorrow (we can even precisely predict the time).
The second aspect of cause is ‘why this event at this place, at his time?’ This second aspect of cause relates to the actual values of the variables, the question able to be rephrased: we understand the mechanisms, so we know that if the system is in state A, it will go to state B: it went to state B, so why did we have state A, at this time at this place?
Imagine the system as follows.
The mechanism is ACB, what is observed is AB. So the first aspect of cause is obeyed, we know the mechanism. So now we ask: why did AB occur at time T? This is the second aspect of cause. It reduces to the question ‘why did AC?’ because once AC then B follows.
Now imagine we come to understand the mechanism of ACB as below. That is, we learn that AC is in fact ADC, and similarly we learn that CB is in fact CEB. So the question of ‘why AC?’ becomes ‘why AD, because once AD, C follows, and similarly CEB.
This line of argument is an infinite regress, at each step asking ‘what are the antecedents for this value of this variable?’ This line of argument results in us saying: ‘I know enough, I am satisfied with the depth of the explanation, and pursuing further explanation will not add sufficient to my understanding to justify the effort’.
What emerges from this model of cause is that cause in fact is a collision of circumstance. So the circumstances of ADC collide with the circumstances of CEB. Each can be tracked back to earlier antecedents, which in turn can be tracked back to yet earlier, etc. The model of the mechanisms merely tells us that if and when the circumstances of ADC and CEB ever do collide, then AB will occur. So if I leave my garage at some exact time, and travel at some precise speed to the traffic light and if I do not stop in time, and if some other person left their home at some exact time, and if they traveled at some exact speed and if they were not fully watching the lights, then we would crash. It may seem trivial, but the model of cause above exactly describes such collision of circumstances.
Model of scientific knowledge
With this backdrop, and with epistemology more concerned with the relationship between knowledge and that to which the knowledge relates, there emerges the question ‘can knowledge itself be modeled and what would be the nature of such a model?’ In the paper Model of knowledge and tools for theory creation, this issue is fully explored, and it is concluded with the view that knowledge can be modeled, and that the immediate and ultimate effects of W. Ross Ashby, coupled with definitions and concepts developed in the paper, do in fact represent just such a model of knowledge. The tools of Ashby, and the other concepts to support and elaborate those tools are themselves knowledge, and being a model of scientific knowledge they can then be applied in a transparent manner to create models and theory within any branch of science.
The theory of psychology
Applying the tools for theory creation to the situation of a person in their environment produces the general theory of psychology as described in the paper Why we do what we do: the outline of a general theory of psychology. The details on development of the theory will not be reproduced here and I will merely summarize key aspects of the theory as important in relation to the issue of the policy and practice surrounding mental health, and what the theory can and cannot offer in supporting better mental health policy and practice.
Multiplicity of structure
This is a crucial aspect of the theory, it proposes that our psychology consists of ‘units’ I have called mental sets. A mental set is itself not a single fixed entity, it can be in several forms and it can itself evolve, for example it can develop or lose cognitive aspects so that it can become an emotional element, or can become an emotional and cognitive unit.
The cognitive or aspects of our psychology contained in the variable Thought is our worldview. With a multiple structure we may have more than one worldview, and we may or may not realize it.
The emergent manner of our being in the world I call our novel, it is part writ, part emerging, part being created and part determined by our history. Our novel embraces all aspects of our mental sets, and is effectively the summary of those as expressed by us in our history, our likely immediate future and the range of alternative futures implicit within our mental sets, some of which may be latent and unknown to us.
Personality lies in the content, structure and style of our novel. For example, the content is part the nature of our world view, structure the relating of elements within our world view and situations encountered in our life along with the emotions engendered and allowed, finally the style of our novel in the manner we express the mental sets.
A crucial aspect of personality is also the extent of integration, a unified worldview and consistency of emotion in relation to ideas and situations.
Cause of all that is us lies in the multiplicity of structure presented by the model, the mechanism, with cause of this precise reaction/behavior/feelings at his time being a function of the mechanistic structure presented by the model along with understanding of the why each of the contributing variables had that value at that time, cause as the collision of circumstance, with us only ever having sufficient causal understanding which for people is bounded by two factors, first the cost of gaining the relevant data versus the increased insight accruing (common to all issue of cause), and second the extent of the interactive complexity of the system which describes a person which limits the ability to track back to find the causal sequence which resulted in this variable having this value at this time..
Importance of attention
Within the model is taken as a functional system, with no effort being made to describe how that functional system works, so attention is a ‘black box’ across which certain functions occur. If this hypothesis proves false, the model would need to be revisited and reassessed.
Attention can be focused or spread.
‘I’ and self
The self is created; it is an object in our worldview with a particularly important function of positioning ourselves within that worldview. As a consequence the emotions that surround ‘I’ tend to become implicated in almost all aspects of our novel. In short, the emotions that surround ‘I/self’ become a significant aspect of the style of our novel; to the point they can verge on the overall theme or the novel.
Consciousness is built from three fundamental components, first ‘I’, and I know it is I conscious. Attention, which focuses me, what I am doing, what I perceive, what I will do, can do and cannot do. The third component is the multiplicity, enabling one part of the system to be the input and/or environment to any other part of the system. This enables what I call the ‘scratch pad’ view of consciousness, we are able to use multiplicity and attention to ‘sketch out ideas’ in one part of the system, and then action those ideas via other parts of the system, all the while ‘I’ know ‘I’ am doing this, and I am able to locate the ideas within my world view and so in relation to me.
Thought and thinking
Our thoughts carry our historical intent in that they represent how we assessed and viewed some object or situation or idea. To allow the thought today is to assume that all aspects of that object or idea or situation, are as they were.
The activity of thinking, the input of effort to ‘see’ now, to relate to and locate the object of our attention anew in our worldview carries current intent. It is the effort of thinking and the lack of assumption and hence the injection of the subtleties and nuances and developments since we last thought of the object that makes the struggle to think the only way of ensuring current intent.
The second aspect of Thought is that there is no necessary hierarchy, so that beliefs, values, ideas, concepts, and attitudes all have the same weight, same potential impact as values of the variable Thought. All Thoughts can be integrated into our worldview in various ways, can have associated emotions, can relate is some way to ‘I’, the self-object within our worldview and the object that tends to root our worldview. We can choose some set of definitions for some aspect so that we can deem attitudes to hold a certain relation to habit and behavior, to contain certain emotive elements, and to hold certain relation to the ‘I’ of our world view, but such a definition is completely arbitrary and merely a convenient way of discussing certain types of Thought.
The final aspect of Thought is that there are no necessary or special objects of Thought. So ‘I’ emerges, as does ideas on mother, father, and God; but the person and their upbringing determine the ranking of these. There is nothing in the theory that structures these objects or even suggests that they should or must exist. I would seem logical that ‘I’ would emerge as a central construct within most if not all worldviews, since the world outside is related to ‘I’, as is the world inside; by extension, extension it would also appear likely that ‘relevant others’, those other people most closely linked to ‘I’ would also emerge as important objects in the world view. But these items and issues are emergent aspects of developmental psychology, and because the theory offers no advance structure, all developmental psychology must relate to the culture and circumstances within which the person developed, because the structuring of the individual world view and the elements must be derived from the culture and upbringing since it was not ordained by the theory from the start. The structure of the worldview and objects in it are the content of our novel, derived from the content within which evolve, and meshed with our style which can result is us extending as individuals beyond the limits set by our upbringing.
There are very few truly uncontrollable reactions, the reaction to an unexpected bang close to one’s ear would likely result in an uncontrollable reaction. Short of rather trivial, reactive situations, all else can be contained and subjected to one’s will and intent.
To bring current intent into thoughts demands sufficient wrestle and intensity of thinking to integrate one’s current views on the topic, unless this is done, then there is only historical intent in Thought. The act of thinking is an act of exercising freewill, at all times freewill is opposed by habit, by the systematization within our neural structures of what we thought and felt yesterday and the demanding tendency to process current input from the environment via the same neural sequences.
To truly exercise free will is to wrestle with our self, our dispositions and habits, including our history as coded in our genes and our upbringing.
Habit as already been described in its opposition to freewill. Habit is the flow of energy through the developed neural system and pathways in our brain and nervous system such that the thoughts and behavior and feelings arise a consequence of the flow and not as a consequence of what we might choose for our self in the circumstances.
The operation of our brain and neural systems occurs without our knowledge and in manner ‘unconscious’, but this is not what is typically meant by the term. By "unconscious" is meant aspects of our psychology which influences us in a way such we are not aware of that influence, and most likely we are not aware of the very existence of these structures in our psychology.
Mental sets with no or limited cognitive component form the core of our unconscious, with no or limited Thought associated, they are not obviously accessible to attention, to our awareness, but can result in feelings and reactions exhibited in the present that may or may not be appropriate or relevant: our past, unconscious shaping our today.
Hope is used as an example of how our novel, the living dynamic of our expression of our self and our past projected forward to forge our future acquires and has themes, qualities of emotion described as positive, negative, hopeful or depressed.
The central dynamic of our novel is ‘I’ or self, the ‘mover’ of all aspects of me. As a result of this central position, and as has been mentioned previously, the emotions surrounding self tend to imbue the whole of the novel giving it themes, patterns or qualities of feeling that permeate the whole, often not immediately apparent, more sensed that said, perhaps only evident in the slight variation of tone of voice or selection of word. So the whole is imbued with hope or despair, flowing from the core, the ‘I’. The themes of our novel, the hope or hopelessness, are described as qualities of our spirit, which is why elsewhere I describe depression as an affliction of the spirit.
Our spirit and spirituality
The theory offered and still yet emerging is a complete description of all that is human, but it includes no ‘soul’ as an entity, as an object, as a ‘thing’ having existence beyond the mechanisms and structures as postulated by the theory. Science cannot disprove the existence of a soul, and those who believe in a soul cannot prove its existence, so the issue is not whether it does or does not exist, rather the issue is, given that we begun with clear rules for the conceptualization of any theory, and given we followed those rules and that we have created a theory that does offer full and reasonable explanation, then we do not need the concept.
So what is left of our spirit, our spirituality and is humankind more than a collection of physical bits and pieces?
There has been and remains elements in science that saw cause as a ‘reductionist’ process, hence humans were reducible to atoms, photons molecules and the like. This notion is completely rebuffed by the papers at this site, shown as naïve conceptualization of the issues, resulting in quite inadequate conceptions of cause and of crucial human issues such as spirituality, hope and faith.
The very core of our spirit is ‘I’, the self. Likely the most significant object in our world view, definitely the central object in our world view since all other elements of our world view are located in relation to self.
The ‘I’ is not an object, it is a psychological structure embedded within the mental sets of our overall psychology. The emotions and attitudes surrounding self are among the most potent in our psychology, from these flows the themes to our novel. If our novel is our way of being in the world, then from the self flows much of the essence of how we are in the world. Sensed, not said, experienced not thought, subtle not immediate but crucial elements to which people gravitate or withdraw, are uplifted or pulled down, such elements describe our spirituality, derived from our spirit, they describe the crucial aspects of us that in no manner can be reduced to anything smaller than ‘me as a person’. The theory at this site merely describes the parts and relations between those parts that result in me as a person, but my spirituality relates to the whole and is not reducible to the parts from which the whole comes to be.
The variable Thought is a central element in the theory, and it is the understanding of the levels of thinking available that separates humankind from other animals, and also draws attention to important aspects of the skills that need to be developed in order to ensure ongoing, stable mental health across all society.
There are three levels of conceptualization.
The importances of conceptualization for mental health lies largely in the second order processes whereby effective self-management tools (nouskills) result in improved relations between a person and their social and physical environment.
The mental health questions
Sound mental health provides the platform for greater length of life, and greater enjoyment of life. Unfortunately there has not until now been an integrated general theory of psychology, and as a result mental health issues have tended to be fragmented and piecemeal. It is not the intention here to survey current understanding or views on the issues, simply to present from within the theory outlined the implications that do arise and are deductible from the theory. Should the theory fall, then these conclusions must then be questioned.
The issue of mental health is approached from the point of view of several questions, as follows.
The theory developed does provide apt and accurate description of the causation within human affairs, and offers good descriptive explanation of the issues important in folk psychology, such as hope faith and spirit; as well as placing in perspective key academic issues such as causation, mechanisms and integration of academic schools of thought on psychology. Because of the broad integrative nature of the theory it does not result in outcomes widely different from the pragmatic activities already known; this is as it should be, with the current weight of empirical evidence being well interpreted from within the theory.
For policy and practice, there may be little new, but certainly a shift in emphasis and focus, with currently practical experience given weight and authority by being given strong theoretical rationale.
What is mental health?
This question is more difficult than it appears. For example, a person who is a hired killer for some drug czar, they may be fully at peace with what they do, may been of seriously sound mind, and fully enjoy their work, gaining great satisfaction from their self-perceived artistry. They may have full and enjoyable relations with a range of people, many of who may have no idea of what they really do. Is such a person mentally healthy; and how is mental health to be defined such that this question is addressed and answered without invoking moral and ethical standards?
Mental health is in part defined by the absence of dysfunction; this is an appropriate but unsatisfying definition. Elsewhere I have described and defined mental illness and insanity, with mental illness being the dysfunction of the mechanism of our psychology, namely neural functioning, and insanity being adoption and living out of ideas that locate the person beyond the bounds of the society to which they ostensibly belong (these ideas and social bounds being defined by the values given the variables of the theory).
The first aspect of an improved definition of mental health can now be stated as the person who is mentally healthy is not mentally ill, that is they have neural structures free of disease or illness, and so the mechanisms of their psychology function in a manner ‘normal’.
An interesting general question follows: can a person defined as ‘insane’ be mentally healthy? This question invokes no contradictions, since the definition of insanity relates not to perceived mental health, but to the acceptability of the conduct within the society to which the person belongs. Within some other society the person may be normal, and hence the apparent conflict in the question would never arise since the question would never be asked of the person. The question of the mental health of the hired killer now comes into focus, the thinking and attitudes are beyond the bounds of our society, but these in this instance are moral and ethical issues, judgments on our part, even an abhorrence of the very existence of such a person, but do such concerns have any place in judging the mental health or otherwise of such a person? And if we cannot or should not apply ethical and moral issues here, then where does that leave issues surrounding the mental health of a person deemed insane, when insanity itself is a normative judgment? The issues surrounding insanity can be made more difficulty, for example a person with normal neural functioning may believe it appropriate to kill children if money gets tight, and shows no remorse or guilt when they do kill several children and gets caught, in fact does not try to hide the crime. All the aspects of insane behavior are evident, yet the views and behavior have a consistency, a permanency, and the person is at peace with their own conduct, all of which suggests they are indeed mentally healthy, but completely at odds with our society.
There has only been brief sketching of the conceptual landscape surrounding the relationship between mental health and insanity, it is a most difficult landscape, and I will pursue it no further here.
Morality and ethics have to do with the values of the variables of the theory, and there is clearly great complexity of the issues surrounding defining of mental health in terms of the values of the variables. The point emerging is that there is however some merit and some legitimacy in defining mental health in terms of the stability, consistency, permanency, and degree of integration of the values of the variables describing the person’s psychology. So, for example, the hired killer would be mentally healthy, the child killer mentally healthy (although insane).
What is being attempted is a prescriptive concept of mental health, this perhaps one of the first, and certainly the only one derived from a full causal description of human conduct. This effort is far from complete, and here I merely hope to chart the direction of such a prescription.
The adoption of this what I call ‘process’ approach, does lead on to significant issues for education policy and curricula, for example the development of nouskills and the training of people in the application of those nouskills could lead to improvements in how people manage themselves, and so lead to more people exhibiting the type of balance above, that is to an increase in mental health. The issue of what attitudes, what emotions, and the nature of significant situations are all ethical and moral issues for which we hope the person makes appropriate choices, but if they do not they can be defined insane, or criminal depending on circumstances.
There is within the theory and summarized above, a definite distinction between mental illness and insanity. Mental illness is illness; insanity is a moral and ethical judgment deeming the person to be ‘beyond the bounds of acceptable conduct in the society’. Within the context of mental health now presented, there are two choices: insanity can be defined before or as before plus the person is mentally not healthy, that is they exhibit instability and significant variation even across similar situations. This has the merit of making definitions of insanity somewhat less normative.
A second aspect of the theory and the emerging definitions and understanding is the question of ‘who is accountable for the ideas allowed to be enacted by the person?’ Some of these issues I have considered elsewhere, see Definitions of insanity, mental illness and the impossibility of temporary insanity. The theory proposes freewill, that we can surmount our inherent tendencies, that we also allow or collude with some of our tendencies when at times we should not; it is not we could not; we accepted them and allowed them to be enacted. This theory places the accountability of the ideas we allow and not allow on the person, this part of the view that freewill is an aspect of our struggle to find balance and reason, and that if we forego that struggle we forego our responsibilities. No history excuses us of the struggle; with the legal criteria being circumstances beyond that a reasonable person can or should be expected to endure. Such issues become important in forging and refining notions of natural justice the root of all legal systems.
The precise definitions of insanity and mental illness offer the opportunity to precisely define legal distinctions between psychologist and psychiatrist. A psychologist is trained in psychology, and a clinical psychologist in the treatment of people with personality problems and those deemed insane. A psychiatrist is a person fully trained as a psychologist, but also one trained in neural functioning and the effect of drugs on neural functioning and psychology, and so is able to treat mental illness, as well as psychological problems, and is able to prescribe drugs for any of the conditions.
The legal distinction between psychologist and psychiatrist means that the psychiatrist is trained to distinguish between insanity and mental illness; this is a most difficult distinction and as yet there is limited technology to make such a determination, especially when the psychology of the person can and will affect their physical neural state and vice versa.
Within the theory there is no real distinction as to counseling processes adopted by either group; and given the nature of the theory and its multiplicity and its ‘process and no-normative’ structure, the counseling training of either psychologists or psychiatrists must entail great detail and specific type of circumstance. In short, counseling support lies in the detail of the Thoughts, Emotions and behavior linked to situations, and the requires detailed training to equip a person to deal with corrective tactics and strategies, a ‘one type of process’ does not and will not deal with the range of variation that is encountered.
There are three levels of counseling arising from within the theory as follows.
Education policy and curricula
The prescriptive approach to mental health outlined in this paper leads immediately to a number of questions bearing directly to what is offered in schools, and what public education systems should reasonably seek to achieve in the mental health field. The questions are as follows.
The concepts of nouskills and the development of these skills in young people, in a manner that is supported by better understanding of how people do in fact work, can only lead to more adults with more balance and more success in handling the behavioral and emotional problems life inevitably presents. These issues arise from the theory, which is a non-cultural construction with culture being merely one possible set of values for the variables within the theory. Few if any curricula yet have systematically tackled these issues.
Issues of focus and effectiveness
With Thought as a central variable of the theory, there is the significant issue of self-fulfilling prophecies and their role in human affairs. We do have considerable potential to become what we think most of the time.
In economics there is the paradox of composition that is what is good for one person may not be good if everyone does it in the society. This social science of mental health has yet to wrestle adequately with such considerations. Being sympathetic is simply not good enough, and the conceptualization of effective strategies is much, much harder than generally understood by those who currently drive efforts in this area of social science. For example, in my own country New Zealand, there has been a quite extensive advertising campaign promoting the notion that ‘mental illness’ (not defined as to what was meant) is okay, that it is part of life, and that we as members of society should enable people to talk about it and to accept them. A significant part of the focus appeared to be on depression, but that was not made clear. Now the promoters obviously believe they are doing the right thing, but there is little or no evidence they have seriously wrestled with the messages and nuances inherent in the ads.
The good intentions of those promoting this ad campaign are very evident, but good intentions can in fact make matters worse. The inherent message across this campaign was sympathy, which is what not to do, better is objectivity. There is an enormous gap of focus between helping a person, doing a lot for one individual, and helping society that is doing a little for millions of people. In helping a society, one person may be adversely impacted by the message, but that is offset by the overall gain in the greater community. These are most complex questions demanding much, much more effective thought than yet exhibited by those conducting the mental health budget in my country.
A more effective program for example, would be to establish centers where nouskills relative to dealing with one’s own depression were offered either for a small fee or free. Then in the ad campaign, which could have been much more simple, encouraged people that they could help themselves to better mental health, and said where for them to go.
Mental health is a complex question that is assisted by good psychological theory, this paper is an opening of the process of bringing a comprehensive theory to bear on the questions and begins to offer a prescriptive, objective, value-free and culture free definition of mental health. For twenty years I have been involved in business training and personal development, since almost the beginning I have offered to people the skills of self-management as the very basis of effective effort in relation to a goal. The nouskills involved are understood and work; they do lead and result in more balanced and more effective conduct and greater satisfaction with self and with life. I did not call it emotional intelligence, but certainly wish I had thought of the term!
The definition of mental health is based on the processes and integration inherent in our psychology (as distinct from the processes of our neurology), and from this perspective emerges the proposition that the most fundamental, most useful focus for mental health policy is to build in all people the tools and understanding and willingness to manage self, and in so doing to increase the lot of their own self assurance, self respect, dignity and enjoyment of the life they choose.