Involving consumers in the discharge process.

Abstract

It is clear to those involved in psychosocial rehabilitation that consumers inherently have the ability to effectively communicate with each other and to be supportive of those who have experienced life in psychiatric hospitals. This article will describe an innovative model for consumers providing into-hospital reach-out and will discuss why participants in self-help clubhouse programs are ideally suited for involvement in the hospital discharge process.This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 20 Psychosocial Rehabilitation Journal disrupting problem, and bringing about desired social and/or personal change. (Gartner & Reissman, 1982)The Virginia Alliance for the Mentally Ill (the support and advocacy organization for Virginia's relatives of the mentally ill, affiliated with the National Alliance for the Mentally Ill) and the Commonwealth Clubhouse Association (consisting of mental health service consumers) are good examples of mental health self-help organizations in Virginia. Elsewhere, the Community Network Development Project at the Florida Mental Health Institute demonstrates the efficacy of a mutual aid network within a state hospital (Gartner & Reissman, 1982).Support for the premise of using self-help as a method of reducing hospital recidivism is also mentioned by Fraser, Fraser, and Delewski (1985) is a study on how club members in Salt Lake City had expanded social networks and greater community support as a result of their participation in the clubhouse program. The study further suggested that the role of the clubhouse staff had a direct relationship to reduced rehospitalization. The authors felt that "staff and clients developed qualitatively different ties in clubhouse program. . .these ties appear to be more informal and normative than those established in clinical outpatient programs. In comparison to the kind of ties developed in clinical settings, such ties may actually be more influential in affecting client behavior and may account for the marked success of clubhouse treatment programs" (p. 41).The attitudes that clubhouse staff have are fundamental to the success and expansion of this model. Their willingness to engage with and view the strengths rather than the pathology of the club members cannot be overemphasized. "Most critical to client involvement is the practitioners' commitment to the goal of client involvement and their belief that rehabilitation is done with clients and not to clients" (Anthony, Cohen, & Farkas, 1982, p.87). Another example in Florida of a self-help group, which also focuses on staff and client collaboration, is Project Return (PR).

Beyond the service paradigm: The impact and implications of consumer/survivor initiatives.

“…The approach to service provi sion in these models focuses on explor ing an individual's abilities as they relate to dealing with a particular illness and to living and working in the com munity. Ideally, the support offered by staff members contributes to recovery, a complex process through which con sumer/survivors gain mastery over their illness (Anthony, 1993;Deegan, 1988 Shelton & Rissmeyer, 1989). In the United States a review by the Human Resource Association of the Northeast found increasing activity in this area, with a majority of states indicating that funding would be in creased in coming years (Specht, 1988).…”

“…Broadly speaking, these can be grouped into two closely related areas: attempts to improve elements of basic social support such as housing and income, and new approaches to providing mental health services (of which the various components of psychosocial rehabilitation are the most prominent) (Kaufmann, 1995; Wollert, 1986). Perhaps the most striking feature of these new service models is their recognition of the capacities of individual consumer/survivors (Carling, 1993; Chamberlin, Rogers & Ellison, 1996; Macnaughton, 1992; Rapp, Shera & Kisthardt, 1993; Segal, Silverman & Temkin, 1993; Shelton & Rissmeyer, 1989). The approach to service provision in these models focuses on exploring an individual's abilities as they relate to dealing with a particular illness and to living and working in the community.…”

“…In addition to there being developments in the service system, state and provincial governments in the United States and Canada are showing interest in a new strategy which recognizes the capacities of consumer/survivors. The emphasis in this approach is to provide resources directly to organizations of consumer/survivors for advocacy, community economic development, and self-help, independent of professional staff or agencies (McLean, 1995; Mowbray, Chamberlin, Jennings & Reed, 1988; Rapp et al, 1993; Segal et al, 1993; Segal, Silverman & Temkin, 1995; Shelton & Rissmeyer, 1989). In the United States a review by the Human Resource Association of the Northeast found increasing activity in this area, with a majority of states indicating that funding would be increased in coming years (Specht, 1988).…”

“…The expatients’ movement, described by Chamberlin (1990), can be traced back to the late 1960s and early 1970s, with historical aspects that go back much farther. Many of the early groups in this movement were advocacy oriented and sharply critical of mental health and psychiatric practice (Chamberlin 1990; McLean, 1995; Shelton & Rissmeyer, 1989). The other historical root that contributes to the current situation is the self-help movement reflected in such groups as Recovery Incorporated and Grow, which date from the 1930s and 1950s respectively (Galantei, 1988; Lee, 1995; Omark, 1979; Powell, 1975).…”

Creating job opportunities for people with psychiatric disabilities at a university-based research center.

“…The last decade has seen an increase in opportunities for people with psychiatric disabilities to become service providers. In mental health agencies across the country, people with psychiatric disabilities have been hired as case managers (Manning & Suire, 1996; Sherman & Porter, 1991; Solomon & Draine, 1995), vocational support specialists (Mowbray, Moxley, & Collins, 1998), consumer advocates (Dixon, Krauss, & Lehman, 1994), and outreach workers (Fisk, Rowe, Brooks, & Gildersleeve, 2000; Shelton & Rissmeyer, 1989). In addition, in recent years there has been an increase in the number of consumer-run services (Mowbray & Tan, 1993; Torrey, Mead, & Ross, 1998; Van Tosh & del Vecchio, 2000).…”