From Ex-Patient Alternatives to Consumer Options: Consequences of Consumerism for Psychiatric Consumers and the Ex-Patient Movement

Abstract

The psychiatric consumer movement in the United States evolved out of the political activism of a small group of antipsychiatry "ex-patients" (former patients) early in the 1970s. The shift in the movement from radical opposition to the medical model to viewing the latter as a possible choice in treatment occurred gradually under a series of social and political changes (e.g., deinstitutionalization), responses to those changes (e.g., the Community Support Program of the National Institute of Mental Health), and the involvement of new actors on the scene (e.g., the National Alliance for the Mentally Ill, a family consumer movement). This article traces the evolution of the psychiatric consumer movement up to the early 1990s in the light of these larger social, political, and economic developments. The author then considers the consequences of that evolution for both consumers and the ex-patient movement in the context of the unique nature of consumerism in the United States and the more recent restructuring of mental health services under managed care.

How settings change people: Applying behavior setting theory to consumer‐run organizations

“…Consumer/survivor initiatives have taken many different forms including businesses, case management programs, drop-in centers, and advocacy organizations (McLean, 2000;Mowbray, Chamberlin, Jennings, & Reed, 1988). Consumer-run organizations are a specific kind of consumer/survivor initiative that provides warm, encouraging, and accepting environments where members can socialize and develop supportive relationships.…”

Goal Achievement and the Accountability of Consumer-Run Organizations

“…[1][2][3] These initiatives have become increasingly widespread over the years, and today, mental health self-help initiatives outnumber traditional mental health organizations in the United States. 4 While these initiatives vary widely, they are typically based in a self-help/mutual aid philosophy, which values (1) the promotion of inner strengths, (2) a reliance on helping each other, (3) a rejection of hierarchy, (4) a sense of community, (5) empowerment and participation, and (6) self-acceptance and openness.…”

Recovery in the USA: From politics to peer support

“…The Mental Patients’ Liberation Movement (who called themselves ‘ex-patients’ ) were very much influenced by the anti-psychiatry movement that began in the 1960s by professionals that held the belief that psychiatry was making people worse, not better (McLean, 2000). The first efforts to restructure the mental health system were led by professionals including Thomas Szasz, R.D.…”

“…In the mental health liberation movement there was a bifurcation between two groups: those who identified themselves as ‘consumers’ were somewhat more accepting of the traditional ‘medical model’ of treatment and tried to influence the established mainstream system. In contrast, the survivor movement was dedicated to developing alternatives to the traditional mental health system (McLean, 2000). Despite those fundamental differences, both groups rejected the politics of psychiatric control over people with mental illnesses; the consumer movement rejected it in favour of a more collaborative approach with mental health professionals (Van Tosh, 2006).…”

“…They rejected the support of professionals and even government funding at first because of a wariness about co-optation (McLean, 2000). The degree to which mental health professionals and non-consumers, particularly family members, should be involved in consumer efforts is one issue that has at times divided survivors and consumers (Tomes, 2006).…”