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Working Well Together:

Working Well Together:. Training Individuals Who Identify as Consumers and Family Members for Employment in Public Mental Health .

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Working Well Together:

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  1. Working Well Together: Training Individuals Who Identify as Consumers and Family Members for Employment in Public Mental Health This curriculum was written and produced by Inspired at Work for Working Well Together and was funded by the Mental Health Services Act (MHSA) in partnership with the California Department of Mental Health.

  2. Sally Zinman History of the Consumer/Survivor Movement

  3. Learning Objectives • Define the key principles that underlie the consumer movement. • Identify the core tenets of the family movement. • Analyze the points of commonality and difference between the two movements.

  4. Background • Psychiatric care in the United States was based upon the beliefs and existing tools of the medical model. • Belief that individuals with a psychiatric diagnosis could not make good decisions about their care. • Goal was to alleviate symptoms and ensure people behaved in socially acceptable ways.

  5. Background • Fear and Stigma allowed society and providers to treat people as less than fully human.

  6. Background • Beliefs and existing medical options led to: • Forced commitment to psychiatric hospitals • Forced medication, electric shock therapy, lobotomies, restraints • Long term stays in locked units “Fearful of Diagnosis” Sybil Nobel

  7. Exercise Your Health Care Experiences

  8. The Early Consumer/Survivor Movement – 1970’s • Influenced by other civil rights movements in society. • Fiscally, states were willing to spend less on expensive hospital care. • Many patient/survivors moved into communities.

  9. The Early Consumer/Survivor Movement – 1970’s • Militant stage of the movement • Autonomous groups; belief in local control • No money from mental health system • Separatist • No major outreach Howie the Harp

  10. Activities • Developed avenues for expressing outrage • Annual Conference on Human Rights and Against Psychiatric Oppression held at campgrounds and college campuses, unfunded. • Madness Network News, news vehicle for communication.

  11. Activities • Small groups—mostly on two coasts: • Network Against Psychiatric Assault • Insane Liberation Front • Mental Patient Liberation Front

  12. Activities • Most common self-description was “psychiatric inmate” • Self and group information and education • Support, consciousness raising groups • Landmark book published in 1978: On Our Own: Patient Controlled Alternatives to the Mental Health System by Judi Chamberlin

  13. Principles • Against forced treatment • Against inhumane treatment—medications, lobotomy, seclusion and restraints, and ECT • Anti-medical model, usually described as anti-psychiatry • Involvement in every aspect of mental health system • Emerging concept of consumer/survivor-run alternatives to mental health system

  14. 1980’s • The movement becomes more mainstream • Monies from Mental Health System • Early goals achieved • Time of re-engagement with the system Second Step Players (formed in 1985) is a theater troupe

  15. Activities • Department of Mental Health funded self-help/peer support programs. • Federal Government began to fund consumer/survivor-run programs. • Beginning of statewide consumer-run organizations—1983, California Network of Mental Health Clients. • Many mental health system-funded trainings and conferences; first national Alternatives Conference in 1985.

  16. Activities • Growth of rights protection organizations—Protection and Advocacy, Inc. • Social change from the inside as well as the outside. • More consumers/survivors sitting on decision-making bodies. • Gains made in rights protection for consumers.

  17. Principles • The same principles as the earlier days are expressed in positive rather than negative ways: • Self determination and choice • Stigma and discrimination reduction • Rights protections • Self determination and choice

  18. Principles • Rights protections • Holistic services • Self-help/peer-support • Program Involvement in every aspect of mental health system— “Nothing About Us Without Us” • Concept of recovery Jean Campbell

  19. 1990’s • Employment in mental health system including management level jobs • Offices of Consumer Affairs • Increased self-help programs • Growth in self-help/peer-support programs with system funding • Federal recognition of the importance of the consumer/survivor movement demonstrated through the funding of two consumer/survivor-run technical assistance centers

  20. 1990s • Multiple training and learning opportunities • Noticeable consumer/survivor involvement at most levels of mental health system • Consumer/survivor participation and partnership with other constituency mental health groups • Beginning of client-run research, research on self-help/consumer-run programs, and consumer researchers

  21. 1990s • Work with policy makers to legislate and otherwise influence policy • Ongoing advocacy gains • Described as “decade of recovery” (Bill Anthony, 1993)

  22. 2000s • Incorporation of self-help/peer-support into system • Development of mental health services that recognize the significance of trauma and spirituality • More diverse and inclusive consumer/survivor movement • Creation of National Coalition of Mental Health Consumer/Survivor Organizations

  23. Concerns • Successful inclusion in the mental health system threatens the loss of our consumer/survivor values. • Some advocacy losses with the push to increase involuntary treatments such as outpatient commitment and other forms of coercive treatment.

  24. System Culture Change • Evidence of system culture change as a result of consumer/survivor involvement. • Passage of Mental Health Services Act • Voluntary promotion of self-help/peer-support • Involvement of consumers/survivors at all levels of mental health system • Promotion of recovery as a goal

  25. System Culture Change SAMHSA’s National Consensus Statement on Mental Health Recovery reflects basic consumer/survivor principles. “We envision a future when everyone with a mental illness will recover.” The President’s New Freedom Commission on Mental Health, July 2003

  26. http://www.promoteacceptance.samhsa.gov/ Sally Zinman 510-639-1335 510-644-1916 (home office) szinman@acbhcs.org Su Budd 913-205-7554 subudd@freeshell.org Gayle Bluebird 352-525-3195 (home office) 352-219-1095 (cell) gaylebluebird@aol.com

  27. Exercise Client/consumer Bill of Rights

  28. History of the Family Movement

  29. Background • Two types of family groups • Families/parents with adult children with psychiatric disorders. • Families/parents/caregivers of minor children with emotional, behavioral and mental health challenges.

  30. Background • Parents of Adult Children Movement inspired by: • Blaming of parents for their children’s mental health issues. • Schizophrenic Mother • Lack of access/influence to professionals making decisions about care. • Confidentiality rules that kept parents out of information loop. • De-institutionalization

  31. Background • Parents/Caregivers of Minor Children Movement inspired by: • Lack of control over care • Blaming of parents • Need for family support • Inappropriate care provided by the system

  32. Background • Lack of focus on family unification • Fragmented and uncoordinated services

  33. Three Major Family Groups • National Federation of Families for Children’s Mental Health • National Alliance of the Mentally Ill. • National Mental Health Association (now Mental Health America)

  34. Similarities Across All Groups • Advocacy • Family Support • Research • Public Awareness/anti-stigma

  35. National Federation of Families • Focus on family advocacy • Have been successful in incorporating family decision-making into treatment decisions • Provide self-help • Encourage family providers in the system

  36. National Alliance of the Mentally Ill • Began in 1979 • Emphasis on most severely affected individuals is unique among the three groups • Have been successful in advocating for research to support a brain-based etiology. • This has caused some friction with the consumer movement

  37. National Alliance of the Mentally Ill • Public awareness campaign/anti-stigma • Gained federal and private support for improved community based services • Has campaigned for parity

  38. Mental Health America • Pioneer in mental health advocacy • Effective in strengthening the child mental health movement in the 1980’s and 1990’s • Focus on all age ranges and degree of disability

  39. Mental Health America • Seeks wellness for a healthy nation • Views issues as essentially related to social justice

  40. System Culture Change • Evidence of change as a result of the family movement: • Families are partners in decision-making • Focus on family-driven, child-centered care • Parity in insurance coverage • Emergence of culturally relevant care • Statewide members on boards, committees and legislative groups

  41. Exercise Family and Child Bill of Rights

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