An Introduction to the Consumer Movement

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 http://www.mhselfhelp.org/ • National Alliance for the Mentally Ill (NAMI)—families of the mentally ill http://web.nami.org/

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