The current system clearly isn’t working, so where do we go from here?

The humane asylum.

Today, people with SPMI can be at risk of aggressive, potentially harmful overtreatment early in their involvement with the mental health system. Later – after suboptimal or negligible responses to available therapies, and in the face of persistent psychological suffering and associated disability – they are at risk of therapeutic neglect, coloured in part by burnout and therapeutic nihilism among caregivers, and in part by a dearth of suitable models and care settings.