Aftermath to Lattermath and the Iconomy of Psychiatry: Shifting from hospital-centric towards community-centric mental health-care ecosystems

Drawing on Professor Emeritus Terry Smith’s work on Aftermath Architecture, we reflect on how the world’s purportedly ‘eternal’ architectural icons can be transformed in the public consciousness, by terrorism and political intrigue, into impermanent ‘soft targets’. In parallel we explore the grandiose ‘Iconomy’ of Psychiatry, and the decay of its grandiose institutional icons into stigmatizing stereotypes of dysfunctional mental health services. Professor Smith also invoked a related concept: the ‘Lattermath’, a late 15th century term for the new shoots of grass growing after harvest, to make the case that a renewal of hope is possible for architecture, prioritizing domestic and communal living. To achieve an enduring ‘Lattermath’ in psychiatry requires us to shift the centre of gravity of mental health services from being so hospital-centric towards community living. It also entails rebuilding mental health-care eco-systems which integrate clinical, lived experience, and carer expertise, while optimizing mental health and wellbeing outcomes., It also entails heeding First Nations caring for nature and community, their climate change activism and their resilience, and operationalizing human rights and an ‘invisible village’ or a co-designed local community of ongoing mental health care and support for individuals and families while ever they need it.