Top down policy development will be a thing of the past, with grassroots cooperation and communities becoming the lifeblood of society. It is going to be important to prioritise our recovery from white mindedness, undoing the harms of centuries of scientific racism that enabled colonisation and became embedded in our culture and institutions.

Alongside that, recovery from structural misogyny and restrictive gender binaries is going to be central to developing a healthy and equitable society with drastic reductions in violence against women and girls. The move is towards a system that values care work, and has a drastically remodelled conception of the everyday relations between people, with care and cooperation valued over control and competition. A new focus on balance and interdependence in governance will be spearheaded by scholars in Queer Studies and Mad Studies. Aiming to help us reconfigure the social rules that we live within to be safer and healthier for everyone.

In the old United Kingdom, the devolved nations will be joined by the new devolved regions of what was once called England, with direct democracy replacing the borders of traditional nation states. Doughnut Economics and Community Wealth Building become the cornerstones of an emerging economic system. Addressing climate justice becomes achievable as industry is held to account for the use of natural resources. Air, earth, water and future generations have representation in the political system, with all decisions keeping in mind the impact on seven generations in the future and the likely perspective of seven generations past. Education will be recognised as a political act, with neutrality seen as a delusion of the past.

At the centre of everything will be the question - what can we do about human suffering? What financial sacrifices can be made to achieve social justice? What new identities and cultures will come to be in this new world? What will happen in a system where the major causes of adversity and suffering are dismantled? Will we find more balance in our diverging needs for both safety and freedom? Will there be a need to prevent those with more power from meeting their needs in ways that damage others, or will power relations be transformed into an unrecognisable landscape that could not have been imagined before?

Those with power shape the scripts that are given to us, even the language and facts we have to make sense of our own experience.

Coming back to the real world and the tasks at hand, the PTMF argues that it is not possible to carry out credible research to understand severe emotional distress while we continue to use concepts of illness and disorder that have serious scientific problems. Psychiatric concepts like ‘bipolar disorder’ and psychological concepts like ‘emotionally unstable personality’ fail to recognise people as humans with needs who are impacted by the world around them. In our culture we see biology as the deepest truth and individuals as separate from communities and their social world. The PTMF argues that we need to centre meaning making. Both in how we conceptualise and research the problems of severe emotional suffering and troubled or troubling behaviour, and in how we respond. The PTMF has taken on the mammoth task of challenging the psychiatric establishment. It lays out how we can build systems around an understanding that distress is most often a response to social inequality and power abuses. The route to doing this is by centring narrative and meaning making, and acknowledging disparities in power.

Those with power shape the scripts that are given to us, even the language and facts we have to make sense of our own experience. When we sense they do not tell the real story, we meet together as activists to uncover the truths that have been obscured. For any readers who doubt that the most severe forms of emotional distress are linked to social adversity and believe them to be biologically based, I invite you to explore the links between the distress we have been taught to call ‘schizophrenia’ and poverty, abuse and neglect.

The PTMF has been made freely available online, and you can search these terms and have a look. For those who do not enjoy academic texts, there is a website with videos and talks and examples of how the PTMF can be used by everyone from peer support groups, to policy makers, therapists and community activists.