1 An Introduction to the Consumer Movement Self-Help

2 What is the mental health consumer movement? Effort by people with mental illness to: – Establish control over psychiatric treatment – Combat stigma – Acknowledge diversity among people with psychiatric illnesses – Develop systems of care that reflect diverse needs and wishes of mental health consumers

3 From mental patient to mental health consumer In psychiatric hospitals, referred to as “mental patients” Antipsychiatry position taken by some discharged patients: “psychiatric survivors” In community mental health centers: “clients” In consumer movement (beginning in 1980’s: “mental health consumer”

4 Mental health consumers: Acknowledge existence of mental illness Claim right to choose the types of services they want to use

5 Resources for consumer-run organizations “Conscience constituencies” (individuals or groups sympathetic with plight of mentally ill individuals) supported development of resources for mental health consumer groups Financial resources came from federal, state, and local authorities

6 Activities of mental health consumer groups Conferences Workshops Letter writing campaigns Social support services (e.g., drop-in centers, support groups)

7 Examples of consumer groups National Mental Health Consumer Self-Help Clearinghouse (technical assistance for developing consumer groups and projects)—funded by federal Community Support Program National Alliance for the Mentally Ill (NAMI)— families of the mentally ill

8 Social psychology of consumer movement Many people with mental illnesses may be reluctant to acknowledge this status publicly. The consumer movement allows people with mental illnesses to reinterpret their experience of illness in terms of external causes, rather than personal problem. This allows them to focus on changing society, rather than on resolving personal problems. This results in a feeling of empowerment.

9 Mental health service providers’ viewpoints In psychiatric hospitals, psychiatrists hold ultimate authority over patients. Decisions tend to be related to medical diagnosis. In community settings, less social distance between providers and clients. Staff is more focused on client’s ability to function in community. This leads to more common ground between mental health staff and consumer movement in designing treatment alternatives.

10 What consumers want Psychosocial rehabilitation Social support programs Reduced stigmatization of people with mental illness Confidentiality of psychiatric records Personal choice in treatment Enhanced quality of life

11 Problems with mental health consumer movement Lack of agreement on what choices should be offered in treatment, how best to improve quality of life Competition for scarce funding resources Managed care replacing public mental health service provision has made it more difficult for mental health consumers to influence policies governing allocation of resources for treatment

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