On Our Own, Together: Peer Programs for People with Mental Illness

Chapter 2: The Historical and Philosophical Development of Peer-Run Support Programs

17 2 The Historical and Philosophical Development of Peer-Run Support Programs Jean Campbell The general public thinks of people with mental illness as the quintessential “Other”—persons who represent the subterranean depths of humanity and whose differentness makes us not really human at all. It is common practice to call us by our diagnoses rather than our names. Usually we are simply referred to as “the mentally ill.” Mental health professionals subsume our identity with a global sentence of illness and disability. It is often presumed that we do not know what is in our own best interests. Our feelings of anger and joy are scrutinized for signs of pathology and violence. Our needs and desires are imputed for us, as if we were mute. We are routinely consigned to everyday lives emptied of quality, vitality, and dignity. When you look closer, however, to the margins of society, you find us speaking for ourselves. By forming peer relationships, we have created a dynamic way of life that embraces cooperation, connection, and community . Our social relations are complex. We build networks of support and service, produce culture and research, and dream of a liberated future. Collectively we choose to call ourselves persons diagnosed with a mental illness, people with psychiatric disabilities, persons who have experienced madness, mental health consumers, psychiatric survivors, or mental health clients. But most important, each person has a name; each person has a story. As mental health systems have matured, professionals have begun to change their views about the abilities of people with mental illness. They have started to include consumer/survivors as partners in the design, delivery, and evaluation of services (Campbell 1996, 1997). Progressive forces in the mental health community recognize that differences in perOnOurOwnFinalPages .indd฀฀฀17 4/16/05฀฀฀6:09:51฀PM 18 On Our Own Together: Introduction and Background spective between mental health professionals and persons who have been institutionalized are “valuable, worthwhile, and important” (McCade and Unzicker 1995, 61). In describing a framework for the role of consumers as providers of psychiatric rehabilitation, Mowbray and Moxley (1997, 39) suggest that one rationale for peer-run support programs is that “consumers have the ability to form creative, nontraditional, and more beneficial alternatives or adjuncts to formal mental health services. . . . Since the consumer-controlled program is developed and delivered by consumers, it has the potential of contributing something that is very different in rehabilitation and community support than what individuals with professional training can do within existing structures.” The delivery of mental health care in the United States today is being challenged. On one hand, professionals and policymakers acknowledge that mental health services have failed to help people get the level of care that research has shown to be effective. Financial resources are limited and traditional mental health programs are both fragmented and strained by growing demands for services. On the other hand, the recovery model of service delivery suggests that “adjuncts and alternatives to formal treatment , involvement in self-help groups, and social opportunities at local drop-in centers foster empowerment and provide opportunities for a more meaningful life” (Forquer and Knight 2001, 25). Further, many peerrun programs serve persons who will not accept, or who do not choose to participate in, traditional services (Segal, Silverman, and Temkin 1995). Therefore, when peer support services are included within the continuum of community care, the mental health system expands quantitatively, by reaching more people, and qualitatively, by helping people become more independent and interdependent (Gartner and Reissman 1982). As a result, mental health administrators are increasingly open to shifting resources to a recovery-based model of community services (President’s New Freedom Commission for Mental Health 2002). Such a shift presents a compelling case for dialogue between traditional mental health providers and mental health consumer/survivors about what promotes and deters recovery, and the inclusion of persons with mental illness as partners in collaborative systems of service and support. By responding to the experiences of people with mental illness, peerrun programs provide the needed support for people in their struggles to live with dignity and hope. Consumer/survivors have discovered that recovery is not a state that impinges on everyday life from the outside. Rather,theinherentdynamicsofrecoveryaregroundedinaperson’smind OnOurOwnFinalPages.indd฀฀฀18 4/16/05฀฀฀6:09:52฀PM Development of Peer-Run Support Programs 19 and body—in his or her hopes, needs, preferences, and choices. Most...