Integrating evidence-based practices and the recovery model.

Consumer advocacy has emerged as an important factor in mental health policy during the past few decades. Winning consumer support for evidence-based practices requires recognition that consumers' desires and needs for various types of treatments and services differ significantly. The authors suggest that the degree of support for evidence-based practices by consumer advocates depends largely on the degree of disability of the persons for whom they are advocating. Advocates such as members of the National Alliance for the Mentally Ill, who focus on the needs of the most seriously disabled consumers, are most likely to be highly supportive of research that is grounded in evidence-based practices. On the other hand, advocates who focus more on the needs of consumers who are further along their road to recovery are more likely to be attracted to the recovery model. Garnering the support of this latter group entails ensuring that consumers, as they recover, are given increasing autonomy and greater input about the types of treatments and services they receive. The authors suggest ways to integrate evidence-based practices with the recovery model and then suggest a hybrid theory that maximizes the virtues and minimizes the weaknesses of each model.

Getting ready for recovery: reconciling mandatory treatment with the recovery vision.

Considering treatment of serious mental illnesses, it might appear that the recovery model would be incompatible with any form of mandatory treatment. The authors suggest that this is not so. With individuals whose psychotic illness substantially impairs decision making, mandatory treatment may offer the best hope of getting well enough for recovery to be possible. It is essential, however, that any program involving involuntary community treatment involves recovering individuals who have themselves experienced a serious mental illness. The authors propose the use of a consumer-run guardianship program and a capacity review panel as two possible ways to achieve such participation.

Psychology practitioners and schizophrenia: a view from both sides.

In recent years some few psychologists, psychiatrists, and other mental health professionals have begun to reveal their own experiences as persons who have been diagnosed with various forms of serious mental illnesses. This article gives a brief background of one such person, a practicing psychologist who was diagnosed early in his adult life with schizophrenia. Despite numerous breakdowns and hospitalizations he was able to establish a career as a practitioner and as an advocate. The article also offers a number of recommendations for professionals in this field based on the author's experiences as both a recipient and a provider of psychological services to persons with schizophrenia and other serious mental illnesses.

Advocacy, recovery, and the challenges of consumerism for schizophrenia.

Advocacy organizations such as the National Alliance for the Mentally Ill (NAMI) and patient consumer groups are playing an ever-increasing role in public health policy and patient care in schizophrenia. The recovery philosophy which recognizes the unique contributions of those who have experienced mental illness is now a part of treatment approaches in many states. Several states have extended these consumer initiatives to incorporate advance directives, an approach that has generated much debate. The NAMI destigmatization campaign, grounded in the neurobiology of major mental illness, is an unprecedented, concerted effort to change public opinion and to achieve parity at all levels for persons with severe and persistent mental illness. This article describes and chronicles these initiatives and explores their implications for the management of schizophrenia into the next millenium.

The mental health service consumer's perspective on mandatory treatment.

The nature of serious mental illness is such that patients are not always willing to accept the treatments providers deem appropriate for them. At times such treatment is mandated against the expressed wishes of the client. This chapter provides an overview of consumer perspectives on this process.