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The H.O.P.E Approach

First Do No Harm is developing the H.O.P.E Approach, a system for understanding and managing mental ill-health based on the experiences of young people who have previously been hospitalised for mental illness. Our approach is inspired by a trauma-informed perspective and understands that, at present, so-called 'treatment' for mental ill health is impersonal, inadequate, and relies excessively on categorising and understanding mental illness within the boundaries of rigid diagnostic criteria.

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What is the H.O.P.E approach?

The H.O.P.E approach is designed by people with lived-experience. From overall care and approaches, to day-to-day interactions and everything in between, the approach is inspired by people, communities and understanding that have cultivated a sense of hope, compassion and unwavering courage for people dealing with mental-ill health and distress.

In time, we want the approach to be adaptable to both community and residential settings, with its principles and strategy embedded within the procedural frameworks utilised by care providers and professionals, at both local and organisational level. We hope the approach can be continually developed, amended, and used in conjunction with professionals and providers seeking to reform current understandings of mental-ill health so that long-lasting, meaningful change can be made. Lived and professional experience alike, if you're interested in working with us to refine the approach, we would love to hear from you.

Have you had valuable experiences that have helped you, big or small? Share it with us.

The H.O.P.E approach is both an acronym and a deliberate reference to the word ‘hope’. An integral part of human survival, hope is a potent weapon against adversity and life-threatening distress.

Often, however, for the person who needs hope the most, it is missing. This notion is intrinsic to the H.O.P.E approach; anyone has an inherent capability to ‘hold the hope’ for a person in distress, and it is often exactly the weapon they need.


The H.O.P.E approach is centred upon four fundamental principles that inform all aspects of care within the approach.


A person’s behaviour makes sense within the context that it emerges.

We seek to enable a person to make meaningful change by fully understanding their own responses and patterns that drive seemingly ‘ill’ behaviour.


There is no singular cause of mental-ill health, but there is one person.

We acknowledge the complex interplay between genetic, socio-environmental, and developmental factors that influence a person’s risk of mental-ill health. We want to utilise research to inform how we understand and help an individual person, not a conglomerate of ‘patients’. Similarly, a cause should only benefit the person, not professionals, to inform their own understanding their own life, journey, and ‘recovery’. 


Diagnoses alienate, people unify.

We want to move away from pathologising distress, which serves to alienate a person through diagnostic terms, labels, and the medicalisation of human suffering. For a person to ‘recover’, they need other people.


We sit with and alongside a person in distress, not above.

We recognise that hierarchical structures within care practice mirrors harmful, and further retraumatising, power dynamics. These dynamics both inadvertently, and at times deliberately, serve to disempower and reduce an individual to be regarded as, by themselves and others, a ‘subject’ unworthy of autonomy, respect and capacity to know themselves. We as ‘professionals’ are human beings willing to sit alongside a person who is suffering, without suppositions of ‘right’ and ‘wrong’, but with the ability to hold an unwavering hope and knowledge that the person always has the potential to feel and express their distress differently.

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