Seeking a New Way Forward

Can we change the broken mental health care system?

by Joy Howard

Patients seeking mental health care often encounter stigma, provider shortages, and other stumbling blocks. (Illustration by John Holcroft)

Hope has two beautiful daughters. Their names are anger and courage; anger at the way things are, and courage to see that they do not remain the way they are.

As we worked on this issue of Brigham Health magazine focused on mental health, I often thought of the quotation above, most frequently attributed to St. Augustine of Hippo, the 4th-century theologian and philosopher.

The deeper we probed this topic, the more we, too, grew angry with how routinely people with mental illness are stigmatized, marginalized, discriminated against, and, especially in this country, incarcerated. And yet, the more people we interviewed, the more we encountered astonishing courage and hope.

In her brilliant book, Hope in the Dark, Rebecca Solnit gives a 21st-century spin on St. Augustine’s definition: “Hope is not a lottery ticket you can sit on the sofa and clutch, feeling lucky. It is an ax you break down doors with in an emergency….To hope is to give yourself to the future—and that commitment to the future is what makes the present inhabitable.”

From the people we met throughout the Brigham Health system, we learned about axes of hope breaking down doors that stand in the way of people needing and seeking mental health care.

What are your stories of hope, anger, and courage related to mental illness? How are you wielding your ax of hope? Tell us at

Joy Howard
Managing Editor