The medical model of mental illness is the basis for virtually all publicly funded mental h alth care in the United States. The limitations and harm induced by a system oriented in this way has been well established. As an alternative to the medical model, a framework referred to as the Three Legs of the Stool has been articulated by a county mental health board and promotes a system of care that is centered on the premise that services should “do no harm”. The three legs are the principles and values associated with (1) trauma-informed care, (2) recovery/resiliency, and (3) medication optimization.
It is one community’s attempt to fit the round peg of person-directed, recovery-oriented care into the square hole of the medical model which is directed by professionals and seeks to manage symptoms of an "illness". While this is admittedly a difficult fit, it is helping to mitigate the harm caused by a system that tends to objectify the people it is intended to help and embraces harmful practices such as diagnosing human suffering, promotes the use of coercion and force and relies on drugs as the primary and often exclusive method of relieving suffering or addressing emotional and psychological challenges. In contrast to this, the Three Legs approach focuses on relational and narrative approaches to relieving suffering and promotes non-medical, natural activities and supports to help people improve their quality of life. This approach acknowledges the lack of science behind psychiatric diagnoses and the harm that frequently results from their use. A wide range of valuable approaches that can be offered that don’t require a psychiatric diagnosis will be reviewed. This includes a continuum of services and supports that are currently available in a county public mental health system.