How Iceland's rethinking mental health: are we getting it all wrong?

The Icelandic organization Hugarafl rejects the "brain disease" model, emphasizing a recovery and empowerment model instead. What can we learn?

Ninna Katrínardóttir started to feel depressed when she was 12, 13 years old. “I was bullied a lot when I was a kid. I had a difficult relationship with the man who made me with my mother — I don’t call him my father,” she says. The psychiatrist immediately prescribed her some pills. “‘Take one a day, and they’ll help you.’ But they didn’t tell me what else to do,” Ninna continues. “I was flat for many, many years.”

At age 17, she took all the pills at once, trying to end her life, but the doctors pumped out her stomach. Two days later, they sent her home with a new prescription — and nothing else. The following ten years were a blur — a cycle of feeling flat, going off the pills, emotions spiraling out-of-control, not knowing how to react, and taking the pills again. Ninna was stuck in the revolving door of Iceland’s mental health care system, rotating between the psych ward and home. Maybe the doctors would refer her to this four-week seminar or that six-week support group. But Ninna always had the same question, “And then what?”

In Fall 2020, after spending months alone due to pandemic lockdowns, Ninna went to her doctor and said she was giving up. Her doctor asked if she had heard about Hugarafl, a community center down the street for people with mental health conditions. She started going regularly, marveling at how the staff and service users at Hugarafl were indistinguishable, at how there was no limit to how long she could stay, and at how it was all for free. Suddenly, she had a community of people who’d been through the same thing she had — and thus some hope that things could get better.

“I was finishing myself,” Ninna says. “If I hadn’t found Hugarafl at that moment, I don’t know if I would be alive today.”

Ninna Katrínardóttir, project manager at Hugarafl