Systems Can Trap or Liberate—Why Institutions, Not Just Individuals, Shape Recovery

When mental illness enters a family, the search for solutions rarely stops at personal effort or well-intended advice. The Galvins, for example, struggled through a patchwork mental health care system—sometimes encountering supportive doctors, but more often facing rigid or stigmatizing institutions. Public hospitals, insurance rules, and social services created invisible barriers, sometimes making urgent care too costly, too inflexible, or too shaming to pursue.

Contrast this with well-resourced families or communities, where systems offer options—private counseling, teacher support, family leave, or wellness programs—that relieve pressure. In one telling moment, the Gary family provides a refuge for Margaret, not by fixing her inner struggles, but simply by changing her external environment—attending a different school, changing routines, and surrounding her with new cultural cues. The difference comes not just from individuals' resilience, but from altering whole systems of support.

Modern behavioral science championed the concept of 'person-in-environment,' arguing that you can only understand and change individual outcomes by redesigning the context in which decisions and coping take place. When a system changes, even slightly, individuals gain new room to breathe.

Sketch out all the formal and informal systems that affect your most difficult problems: your family's expectations, your school's policies, health resources, or peer groups. Notice which ones help and which hinder your progress. Then look for a micro-opportunity where you have some leverage to nudge things toward support: a small suggestion, a request, or just flagging a barrier you face. Changing your environment, even incrementally, increases your chance of sustained growth or healing, especially when personal willpower is stretched thin.