Magazine article Behavioral Healthcare Executive

Peer Providers: Token Employees or Vanguards of Change? Mental Health Systems Engages Public, Raises Funds, by Deciding to Tell Its Story

Magazine article Behavioral Healthcare Executive

Peer Providers: Token Employees or Vanguards of Change? Mental Health Systems Engages Public, Raises Funds, by Deciding to Tell Its Story

Article excerpt

In the business world, workforce development requires not only a clear vision of where you want the enterprise to go and how you propose to get there, but also who the best people are to get you to the destination.

As we wring our hands about the lack of funding to provide high-quality behavioral healthcare for all Americans and the chronic shortage of qualified professionals to deliver needed services, we seem reluctant to pursue either innovation or adequate investment in transforming the service delivery system.

Yet, even amid these struggles, people in recovery from serious mental illness in the evolving role of consumer-providers are not just playing bit parts in this transformation, but are emerging as producers, directors and stars of the "show."

Many of us in recovery feel that consumer-run organizations (CROs) are treated by mental health care and advocacy leaders as recipients of their benevolence, instead of workers and individuals who deserve more than token roles in developing and delivering community mental health services. I challenge public agencies and advocates to do three things:

1. walk the talk when it comes to recovery-based practices,

2. invest in consumer-run organizations with large infusions of cash from all sectors of the economy to reduce our chronic dependence on the uncertain resources and unwieldy restrictions inherent in public funding, and,

3. re-examine current models of advocacy that have not had a measurable impact on the reduction of prejudice and discrimination that continues to fester in many parts of society.

As to the first challenge, developing a mental health workforce that is truly recovery-oriented will require more than evidence-based studies and journal articles or small focus groups. It will require that community mental health service providers open their doors and their minds to the true experts in the field of recovery ... the end users (patients, consumers, and clients).


Are the leaders and line staff of mental health and allied service systems able to undergo the scrutiny of the end-users and then make changes that my peers and I can see, touch, and feel? I hope so because the alternative is to keep talking evidence-based, "recovery-oriented" services even while those striving to move their lives from system-bred helplessness to strength and personal power are met with indifference and tokenism in many agencies.

Investing money in new or unconventional social service start-ups takes courage, driven by the hunger for change and discontent with the status quo. And, just as shrewd entrepreneurs are risk-takers, people moving toward recovery are also risk-takers. We leave the house and drive to the store to buy a few items instead of living in fear and social isolation inside our homes. We find the courage to say to a physician or other health care provider that available 'treatment options' do not work or their side-effects are unacceptable, regardless of what the DSM or Physicians Desk Reference says. We also have the courage to risk rejection when we offer unorthodox solutions to intractable workforce problems.

In the last 30 years, despite public advocacy and education to reduce the stigma that families and consumers experience due to mental illness, the stigma seems as strong as ever. Despite some battles won against stigma, we may be losing the war. There are ominous signs on the horizon that social attitudes against those who suffer from 'storms in our brains' may be hardening; that the door to the Cuckoos' Nest may swing open once again, ready to warehouse those who do not fit American social norms or those seen as dangerous or inconvenient. …

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