Provided by David Satcher, M.D., Ph.D.
Surgeon General of the United States of America
Chapter 2
Overview of Consumer and Family Movements
Since the late 1970s, mental health services continue to be transformed by the
growing influence of consumer and family organizations (Lefley, 1996). Through
strong advocacy, consumer and family organizations have gained a voice in
legislation and policy for mental health service delivery. Organizations
representing consumers and family members, though divergent in their historical
origins and philosophy, have developed some important, overlapping goals:
overcoming stigma and preventing discrimination, promoting self-help groups, and
promoting recovery from mental illness (Frese, 1998).
This section covers the history, goals, and impact of consumer and family
organizations, whereas the next section covers the process of recovery from
mental illness. With literally hundreds of grassroots consumer organizations
across the United States, no single organization speaks for all consumers or all
families. In fact, even the term “consumer” is not uniformly accepted. Despite
the heterogeneity, these organizations typically offer some combination of
advocacy and self-help groups (Lefley, 1996).
Many users of mental health services refer to themselves as “consumers.” The
lexicon is complicated by objections to the term “consumer.” To some, being a
consumer erroneously signifies that service users have the power to choose
services most suitable to their needs. Those who object contend that consumers
have neither choices, leverage, nor power to select services. Instead, some
consumers refer to themselves as “survivors” or “ex-patients” to denote that
they have survived what they experienced as oppression by the mental health
system (Chamberlin & Rogers, 1990). This distinction can best be understood in
its historical context.
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