Empowerment and the psychiatric consumer/ex-patient movement in the United States: contradictions, crisis and change

Abstract

A political movement in the United States by consumers and ex-patients of psychiatry has challenged the assumptions and negative consequences of traditional mental health practice and its control by professionals. In recent years, the movement has succeeded in gaining support to produce alternative programs based on a philosophy of 'consumer empowerment' and run entirely by consumers and ex-patients. In this article, I present results from an ethnographic study of one such alternative and I attempt to explain the discrepancy between the center's philosophy of empowerment and its actual practices. Utilizing this data, the consumer literature, and interviews with consumer leaders nationwide, I explain this situation in terms of conceptual problems with the terms 'empowerment' and 'consumer empowerment', local structural conditions under which the center operated, and the larger situation of the psychiatric consumer/ex-patient movement in the United States today. The case study represents a crisis in the consumer movement today, in which rapid growth of alternatives has been accompanied by a social amnesia of the emancipatory vision that originally spawned the movement.