As a community psychiatrist, I believe that mental health is not solely determined by intrapsychic mechanisms. In addition to infantile traumas, our sense of well-being in the world is determined by outside influences like poverty, racism, and powerlessness, as well as positive influences like teachers and mentors.
Rather than just identifying patients’ internal conflicts and prescribing medications, community psychiatrists focus on getting families, schools, churches, and service agencies to come together to support their most vulnerable members. Building a collaborative model where talents are pooled helps to identify, intervene and help people before they become desperately symptomatic. This is a preventative model rather than an interventional approach.
For 14 years, I was the only psychiatrist for my area of the Indian Health Service. Since we had so few resources, it was critical to mobilize and help tribes identify their strengths. I worked with teachers to help them identify and intervene early with children, brought traditional healers into hospitals, and trained community health representatives, doctors and nurses. But I had never worked with non-Indian communities in this way until recently. My friend, the CEO of a hospital in a small city in Minnesota, asked me to help him design a community healing ceremony. As a 10th anniversary gift of its presence in the community, he wanted to sponsor an event that would promote the idea that living together in community promotes health.
It didn’t take much to persuade me to go to Red Wing Minnesota, for what he called my “Discovery Tour.” He wanted me to meet and talk to people, walk the streets, meet with its support structure, and then make some recommendations.
Red Wing is a lush, verdant, Mississippi River Valley town of 16,000 that has eagles nesting on its riverbanks. Driving into town is like entering a Dutch master’s painting. Ninety-five percent of its inhabitants are descended from Scandinavian and German Protestants who arrived in the mid-1800s. Upon arrival of the new settlers, Chief Red Wing of the Mdewakanton Dakota (Sioux) welcomed them. This Dakota community is still here (quite affluent now because of its profitable casino) and represents 3% of the population. The other 2% are by and large Hispanic (mostly Mexican) and African-American, and they are a growing presence in the schools and social service agency utilization.
Red Wing is community that shares a common ethic of mutual support. They build art centers, concert halls, support their local baseball team, fill the new hockey arena, hang fresh flowers from downtown lampposts, and are environmentally conscious. My discovery tour included time with the mayor, civic leaders, philanthropists, artists, fishermen, waitresses and bartenders. I spoke with children, teenagers, retirees, and visited the Anderson Center which is the largest artist community in Minnesota.
On my last night, I met with the Hospital Board for dinner. We dined outside on a bluff overlooking the Mississippi River as the sun set. I told them what I’d seen and that Red Wing was already a living example of a collaborative model of health; they all understood the importance of mobilizing their strengths, and moving proactively into the future while staying connected to the principles that have sustained the city’s remarkably healthy soul.
The sun was setting when our hostess spoke; she said she had lived in her home for nine years and, for the first time, had found an eagle feather on her lawn that morning. She wanted to give it to me . . . it sent shivers down my spine. I took the feather and talked about its traditional significance, its serendipitous arrival at this moment in time, and how the healing ceremony we were contemplating had already begun with this blessing.
Then I walked alone to the embers of the charcoal cooking fire and waved the curling smoke skyward carrying my words to touch the ear of the Great Spirit. I gave this blessing, “Thank you for all the gifts that have sustained us in community, bless this community as it moves into the future. In the language of the Mdewakanton Dakota, I say this for all my relations, Mi Takuye Oyacin.”