Academic journal article Ethical Human Psychology and Psychiatry

Breaking out of the Mainstream: The Evolution of Peer Support Alternatives to the Mental Health System

Academic journal article Ethical Human Psychology and Psychiatry

Breaking out of the Mainstream: The Evolution of Peer Support Alternatives to the Mental Health System

Article excerpt

The consumer/survivor/ex-patient (c/s/x) movement has been instrumental in the development of a variety of peer-support alternatives to traditional mental health services in both the United States in Canada. This article explores the role of the c/s/x movement in the creation of such alternatives and discusses the various ways peer support is defi ned and has been put into practice. We also discuss the potential for future alliances and dialogues between progressive mental health professionals and the c/s/x movement as both groups seek ways to reconceptualize mental illness and recovery outside of the medical model paradigm.

Keywords: consumer/survivor/ex-patient movement; peer support; alternatives; empowerment; recovery

While it is easy to challenge and critique ideologies that one fi nds objectionable, the greater diffi culty lies in creating viable alternatives to the dominant practices of our society (Leitner & Phillips, 2003; Lyons, 2001). The largely grassroots political and advocacy movements of consumers, psychiatric survivors, and ex-patients (c/s/x) have been instrumental in creating and sustaining peer support alternatives that often operate outside of the confi nes of the mental health system. In this article, we will discuss various modes of peer support approaches to the treatment of severe psychological disturbances that serve as alternatives to traditional, medically based forms of psychiatric treatment in the mental health system. We explain the role of the c/s/x movement in the creation of alternatives to mental health professionals who may not know about the purpose and activities of the movement. In doing so, we hope to create more opportunities for dialogues and alliances between progressive mental health professionals and the c/s/x movement.

As clinical psychologists and allies of the psychiatric survivor movement, we are interested in exploring how to facilitate mutually enriching dialogues between these two groups without co-opting alternative discourses into mainstream practice. This article is one such attempt to begin dialogues about alternatives to the traditional mental health system. We believe that psychologists need to have a greater understanding and awareness of such alternatives so that appropriate referrals may be made to such services. We also strongly support the development of alternative discourses around the experiences of severe psychological distress and recognize that the c/s/x movement is at the forefront of creating such alternatives.

MAINSTREAM CONTROVERSIES

Many researchers and psychologists (e.g., Boyle, 2002b; Breggin, 1991; Fisher, 2003; Gosden, 2001; Karon, 1992; Read, 2004; Warner, 2004) have challenged the claim that serious psychological disturbances (e.g., schizophrenia, bipolar disorder) are biologically based illnesses and have written about the ways in which this dominant narrative is perpetuated in public and professional discourses. Currently, the main areas of clinical research tend to center on genetic and neuroanatomical abnormalities as well as neurochemical imbalances. Most mental health professionals operate under the framework of the medical model, and thus their interventions typically address biological and cognitive processes that are deemed sick, dysfunctional, and delusional. However, the medical model underemphasizes issues such as social conditions, political oppression, family systems, interpersonal relationships, spiritual crises, and the trauma of physical and sexual abuse that are experienced by many people seeking help.

Boyle (2002a) discusses the various ways that alternatives to the medical model are silenced and highlights the roles of fi nancial power, medical authority, and biologically reductionistic discourses that largely determine who gets to defi ne the nature of psychopathology. There is a considerable fi nancial investment for the pharmaceutical companies as well as the fi eld of psychiatry to promote these beliefs (Fisher, 2003; Gosden, 2001). …

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