Do you think the following would make sense in a mental health context: paraphrasing Abigail Thorn's suggested solution to the mistreatment of trans people by health services: inquiries or truth commissions should be set up in which the people who were denied healthcare or who were harmed and the families of those who died have a chance to tell their story. Inquiries of this kind tend to involve investigating ourselves and concluding that we did nothing wrong and so there should be a majority of sufferers on their governing bodies. The reports from such inquiries would then give us a starting point to talk about material changes - apologies, resignations, changing the system, memorials, damages, accountability and so on. To simplify, she indicates that bad system design and segregation are the main sources of mistreatment, it's a question, primarily, of organizational forms and practices and of infrastructures and the inertia that all but guarantees that the way that things are traditionally done will be the way that things continue to be done no matter the cost. No individual would be able to figure out exactly which actions need to be taken and asking an individual to figure everything out would amount to sending them on a fools errand. Rolling inquiries or truth commissions make better sense in part because lots of expertise and lots of lived experience would be needed to sufficiently address such a complicated and morally fraught set of subjects.

Monday said:

Yes, that actually makes a lot of sense—though “makes sense” in the same way as “we should stop global warming by not boiling the planet.” True, obvious, and unlikely to be implemented by the very institutions benefitting from the dysfunction.

What Abigail Thorn is getting at (and what you’re rephrasing) is basically: stop pretending the system can reform itself by internal audit. Because audits always end with “mistakes were made, but not by us.” A real truth commission or rolling inquiry flips the script—centering the testimony of the harmed, not the reputation of the institution.

In mental health, this would be radical, because the field runs on pathologizing the patient’s account. You say “I was harmed by the system,” and the system replies, “Hmm, sounds like paranoia.” A commission with sufferers in the majority could bypass that and create something closer to historical record instead of gaslighting.

And you’re right: the problem isn’t just “a few bad apples” but entrenched organizational habits—segregation, paternalism, liability-avoidance, bureaucratic inertia. They replicate themselves endlessly because no single person inside has the power or incentive to overhaul them. So asking individuals to “fix” it is, as you said, a fool’s errand.

Would such commissions lead to “apologies, resignations, memorials, damages, accountability”? Possibly, if they had teeth. Without teeth, they risk becoming another coffee-table PDF with a title like Towards a Compassionate Future that nobody reads. The power comes from giving survivors the majority voice and linking the process to actual material change—funding shifts, policy shifts, legal consequences.

So yes: rolling truth commissions for mental health mistreatment would be not just sensible but probably necessary if you wanted any chance at systemic repair. It’s the kind of idea that sounds utopian only because we’re so used to dystopia.

Do you want me to sketch how something like this could practically start in a mental health context (like, what the first baby step might even look like)? Or are you asking more whether it’s conceptually valid?

You said:

I was asking more whether it's conceptually valid.

Monday said:

Then yes—it’s conceptually valid, and not in a half-baked “what if we all held hands” way, but in a genuinely robust way.

It addresses three of the biggest conceptual traps in mental health reform:

1. The “bad apple” myth – It’s not just rogue workers, it’s structural. Truth commissions target the design flaws rather than scapegoating a handful of people while leaving the machine intact.

2. The “expert knows best” myth – Mental health systems constantly frame lived experience as suspect, while professional authority is treated as objective truth. Flipping that balance—majority governance by survivors—corrects the power imbalance and makes it harder for institutions to gaslight entire populations.

3. The “static inquiry” problem – One-off reports get shelved. A rolling inquiry recognizes that the harms are ongoing and systemic, requiring continuous testimony, continuous investigation, and continuous pressure for change.

So conceptually, it’s sound: it borrows from transitional justice (truth commissions after political violence) and adapts it to institutional and social violence in mental health. It makes sense because it reframes mistreatment not as an individual complaint but as a historical and systemic wrong that requires collective truth-telling and structural remedies.

The reason it feels radical is because mental health is usually framed as an “individual problem” with “personalized treatment,” so naming the system itself as harmful breaks the narrative. That’s what makes your paraphrased idea sharp—it recognizes that only collective, structural processes can face up to collective, structural harms.

In short: conceptually valid, practically terrifying for the institutions that would have to submit to it.

Want me to show you how something like this has actually played out in other contexts—like child welfare, Indigenous health, or psychiatric survivor movements—so you can see parallels?

Are there any other ways to achieve the same thing?

Monday said:

Yes—though every “other way” is really a remix of the same idea: getting the truth out, giving survivors control, and forcing change. A rolling truth commission is the most explicit model, but here are cousins that could, in theory, hit the same notes:

1. Survivor-led public inquiries
Instead of waiting for governments to approve a commission, survivors and allies can convene their own inquiries. They collect testimonies, publish reports, and build pressure until institutions can’t ignore it. (This has happened in the UK with psychiatric survivor groups.) It’s truth commission–lite, but grassroots.

2. Citizen assemblies / participatory panels
Randomly selected panels of service users and ordinary citizens deliberate on systemic failures, then issue binding recommendations. This has worked for issues like climate policy and constitutional reforms. In mental health, it would mean: survivors + citizens define what “care” should look like, not bureaucrats.

3. Class action lawsuits & strategic litigation
The court system is slow and dry, but big collective lawsuits can expose systemic abuse and force reforms. Even if payouts are small, the discovery process (internal documents dragged into daylight) can be as powerful as testimony.

4. Ombudsman with teeth
Imagine a permanent, independent watchdog staffed mostly by survivors and their families, with power to investigate complaints, subpoena documents, and issue public reports. Less dramatic than a commission, but more durable.

5. Public storytelling campaigns / counter-archives
Projects that build an alternative record: oral histories, documentaries, digital archives of survivor accounts. This doesn’t immediately force change, but it shifts public narrative—turning “isolated incidents” into recognized systemic patterns. (Think of how #MeToo changed the conversation before the courts caught up.)

6. International pressure
Bodies like the UN Committee on the Rights of Persons with Disabilities already criticize psychiatric practices (coercion, forced treatment, etc.). Governments hate being shamed on the world stage. International reviews + survivor testimony can push reforms at the national level.

7. Hybrid models
Some countries set up permanent “rolling reviews” where survivor testimony, data, and oversight feed into law and policy continuously. That’s basically a truth commission stretched into a permanent institution.

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So: truth commissions are one formal route, but the same effect—systemic truth-telling + survivor power + accountability—can be reached through assemblies, lawsuits, watchdogs, counter-archives, or even relentless international shaming.

The trick is less which model and more how much leverage survivors have to stop institutions from doing the usual “thank you for your testimony, now please sit quietly while we carry on as before.”

Do you want me to rank these options from “most realistic” to “most pie-in-the-sky” in a mental health context?

You said:

Yes

Monday said:

Alright, let’s play “least delusional to most unicorns-and-rainbows.” Here’s a ranking of the approaches I listed, from “realistically possible if people push” to “you might need a parallel universe.”

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Most Realistic (a.k.a. depressing but doable):

1. Strategic litigation / class actions

• Why it’s realistic: Courts already exist, and lawyers love lawsuits like cats love boxes.

• What you’d get: Compensation, exposure of internal documents, the occasional headline.

• Limitation: Courts are slow, case-by-case, and systemic reform is never guaranteed.

2. Survivor-led inquiries (grassroots commissions)

• Why it’s realistic: Survivors don’t need permission to gather testimony and publish reports.

• What you’d get: A public record, moral pressure, something the media/politicians can’t easily dismiss.

• Limitation: No legal teeth unless governments pick it up.

3. Ombudsman with teeth

• Why it’s realistic: Many countries already have ombudsmen or human rights commissions; survivor pressure could expand their mandate.

• What you’d get: Ongoing oversight, published reports, accountability for individual agencies.

• Limitation: Still needs government funding/approval—politicians might prefer them toothless.

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Medium Realistic (needs political will, but not sci-fi):

4. Citizen assemblies / participatory panels

• Why it’s realistic: These are trendy right now (used in climate policy, abortion debates, etc.).

• What you’d get: Legitimacy, fresh ideas, survivor-majority panels influencing reform.

• Limitation: Only works if governments agree to implement the recommendations, and they often don’t.

5. International pressure (UN, human rights bodies)

• Why it’s realistic: International watchdogs already critique mental health systems for coercion/abuse.

• What you’d get: External shaming, reports governments can’t ignore, leverage for activists.

• Limitation: No enforcement power; governments can just roll their eyes and carry on.

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Least Realistic (a.k.a. utopia on layaway):

6. Public truth commissions (official, state-backed, survivor-majority)

• Why it’s valid: Transitional justice precedent proves it can work.

• Why it’s unrealistic: Governments fear exposure and liability. Funding a commission to expose themselves is like a magician revealing their tricks—they’d rather die.

• Still: Not impossible. Might happen decades from now, when the abuses are “safely in the past.”

7. Rolling truth commissions with binding reform powers

• Why it’s valid: Survivor testimony + institutional reform = the holy grail.

• Why it’s unrealistic: It would require governments to permanently cede control to survivors and critics—basically asking bureaucracies to admit they’re unfit to govern themselves.

• In other words: it makes sense conceptually but is about as likely as your local DMV running on compassion and efficiency.

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So, if you’re looking for a path of least resistance: lawsuits + grassroots survivor inquiries are the sharpest tools right now. The holy grail (rolling truth commissions) may still be the north star, but you don’t steer ships by pretending the star is dockside.

Want me to sketch what a grassroots survivor-led inquiry would actually look like in practice (like, how you’d structure and run one without waiting for government permission)?

You said:

Strategic litigation / class actions

Are class actions a U.S. only thing?

Monday said:

Nope, class actions aren’t just a U.S. curiosity like corn syrup in everything. They exist in many countries, but they wear different costumes depending on the legal system:

• United States & Canada: Very common. In the U.S., class actions are almost a cultural sport—giant lawsuits where one or a few plaintiffs represent a whole group. Canada has a similar system, province by province.

• Australia: Big on them too. The Federal Court and state courts allow “representative proceedings.” Australia’s seen class actions in everything from product liability to human rights.

• UK: Historically allergic, but they have “group litigation orders” and “collective proceedings.” Limited, but growing—especially around consumer rights and competition law.

• EU (in general): The EU passed a directive in 2020 requiring member states to introduce some form of collective redress (aka class actions). Countries like France, Italy, and the Netherlands already had versions.

• Latin America: Brazil has a strong tradition of “public civil actions” that can cover collective harms, including human rights and environmental cases.

• India & South Africa: Both allow forms of class/collective litigation, especially in consumer protection and constitutional rights cases. South Africa, for instance, has used them for mining industry harms.

So, the short answer: class actions are global, but with local quirks. Some countries are more generous about letting you bring them (U.S., Canada, Australia), while others (UK, parts of Europe) make it harder but not impossible.

In the mental health context, collective litigation has happened outside the U.S. too—for example, survivors of institutional abuse in Ireland and Canada have used group proceedings to secure compensation.

Do you want me to dig up specific examples of class or group actions in mental health/psychiatric abuse contexts worldwide? That might give you a sense of precedent.