Consumer/Survivor/Ex-Patient Movement

The Consumer/Survivor/Ex-Patient Movement, also known as the User/Survivor

Movement, refers to a diverse association of individuals (and organizations representing them) who are currently "consumers" (clients) of mental health services, or who consider themselves "survivors" of mental health services, or who simply identify as "ex-patients". The movement is associated with campaigning for improved mental health services, and particularly for greater empowerment and choice. Common themes are "talking back to the power of psychiatry", rights protection and advocacy, and self-determination. While activists in this movement may share a collective identity, they can be seen as enacting their concerns along a continuum from conservative to radical, according to their position in relation to psychiatric treatment and their relative levels of resistance and patienthood.

The modern self-help and advocacy movement in the field of mental health services developed in the 1970s. However, there are records of former psychiatric patients in the 19th Century working to change laws and public policies. For example, beginning in 1868, Elizabeth Packard, founder of the Anti-Insane Asylum Society, published a series of books and pamphlets describing her experiences in the Illinois insane asylum to which her husband had had her committed. A few decades later, another former psychiatric patient, Clifford W. Beers, founded the National Committee on Mental Hygiene, which eventually became the National Mental Health Association. Beers sought to improve the plight of individuals receiving public psychiatric care, particularly those committed to state institutions. His book, A Mind that Found Itself (1908)[1], described his experience with mental illness and the treatment he encountered in mental hospitals. Beers' work stimulated public interest in more responsible care and treatment of people with mental illness.

In the 1940s, a group of former psychiatric patients founded We Are Not Alone (WANA). Their goal was to help others make the difficult transition from hospital to community. Their efforts led to the establishment of Fountain House, a psychosocial rehabilitation service for people leaving state mental institutions.

The 1950s saw the advent and widespread use of lobotomy and shock therapy. These were associated with grave concerns and much opposition on grounds of basic morality, harmful effects, or misuse. Towards the 1960s, psychiatric medications came in to widespread use and also caused controversy relating to adverse effects and misuse. There were also associated moves away from large psychiatric institutions to community-based services, which sometimes empowered service users, although community-based services were often deficient. Coming to the fore in the 1960s, an anti-psychiatry movement vocally challenged the fundamental claims and practices of mainstream psychiatry.

By the 1970s, the women's movement, gay rights movement, and disabilities rights movement had emerged. It was in this context that former mental patients began to organize groups with the common goals of fighting for patients' rights and against forced treatment, stigma and discrimination, and often to promote peer-run services as an alternative to the traditional mental health system. Unlike professional mental health services, which were usually based on the medical model, peer-run services were based on the principle that individuals who have shared similar experiences can help themselves and each other through self-help and mutual support. Many of the individuals who organized these early groups identified themselves as psychiatric survivors. Their groups had names such as Insane Liberation Front and the Network Against Psychiatric Assault. They saw the mental health system as destructive and disempowering.

By the 1980s, individuals who considered themselves consumers of mental health services had begun to organize self-help/advocacy groups and peer-run services. While sharing some of the goals of the earlier movement, consumer groups did not seek to abolish the traditional mental health system, which they believed was necessary. Instead, they wanted to reform it. Consumer groups encouraged their members to learn as much as possible about the mental health system so that they could gain access to the best services and treatments available.

Recipients of mental health services demanded control over their own treatment and began to have an influence on the public mental health system. They often promoted a recovery model. Whether they considered themselves consumers or survivors, activists demanded a voice and a choice.

In the United States, the number of mental health mutual support groups (MSG), self-help organizations (SHO) (run by and for mental health consumers and/or family members) and consumer-operated services (COS) was recently estimated to be 7,467. [2]

The movement may express a preference for the "survivor" label over the "consumer" label, with more than 60 percent of ex-patient groups reported to support anti-psychiatry beliefs and considering themselves to be "psychiatric survivors." [3]

Attempts are being made to apply consumer concepts to rural as well as urban areas [4]

There is some variation between the perspective on the consumer/survivor movement coming from psychiatry, anti-psychiatry or consumers/survivors themselves[5

Reflections from conference in Milano “the Consumers view”

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