A Fragile Revolution: Consumers and Psychiatric Survivors Confront the Power of the Mental Health System

Despite two centuries and three major reform movements, mental patients have remained on the outside of the mainstream of society, often living in poverty and violence. Today we are undergoing yet another period of reform and, in a historical first, ex-mental patients, now calling themselves consumers and psychiatric survivors, have been recruited in record numbers by the Ontario government to participate in the change process. A Fragile Revolution investigates the complex relationship between ex-mental patients, the government, the mental health system, and mental health professionals. It also explores how the recent changes in policy have affected that relationship, creating new tensions and new opportunities. Using qualitative interviews with prominent consumer and survivor activists, Everett examines how consumers and survivors define themselves, how they define mental illness, and how their personal experience has been translated into political action. While it is clear that consumers and survivors have affected the rhetoric of reform, they know that words do not equal action. As they struggle to develop their own separate advocacy agenda, they acknowledge that theirs is a fragile revolution, but one that is here to stay.

Table of Contents:
A Fragile Revolution: Consumers and Psychiatric Survivors Confront the Power of the Mental Health System by Barbara Everett Acknowledgements Introduction The research questions A word about methodology Some caveats 1. Nothing changes and no one gets better Becoming a professional helper What is mental illness? Help for the patients Nothing changes and no one gets better Control battles Who's in charge of the staff? Helpless and hopeless In conclusion 2. From insanity to mental illness to psychiatric disability Insanity Mental illness Anti-psychiatric thought and feminist criticism The therapeutic community Deinstitutionalization Psychiatric disability In conclusion 3. Power and protest Power inequity and oppression Dominance For your own good Power as protest Agency Power as a contractual relationship New social movements Personal empowerment and social action When things go wrong In conclusion 4. A new power contract? Partnership Another group of partners The making of policy The forgotten partners In conclusion 5. A special bond Telling stories Four stories Sadly mistaken A special bond The personal becomes political In conclusion 6. Them Invisibility They hate emotion It's just a job They are abusive But they're more like us than they think The system In conclusion 7. Us Getting involved Is this a social movement Consumer? Survivor? Consumer\survivor? Or just a person? When some of ""us"" joined ""them"" The Ontario Psychiatric Survivors Alliance In conclusion 8. Partnership The threat and the promise of partnership The problems with partnership The personal costs Feeling used If it's not partnership, what is it? Will mental health reform work? In conclusion 9. What do consumers and survivors believe in? It's a chicken or egg thing What needs to change? What are consumers and survivors going to do about it? Disability rights In conclusion 10. Final thoughts and understandings So, what's it all about? A legacy of violence The power of powerless people The powerlessness of powerful people Things change and people get better A political identity in search of a future In conclusion Postscript Appendix I. Research methodology Sample selection A global view of the respondents Data collection techniques and sources Data analysis References Index

About the Author :
Barbara Everett has worked as a psychotherapist for people with histories of severe childhood trauma. She currently works as a consultant to the Ministry of Health and is co-authoring a textbook for trauma therapists.

Review :
``Everett is a professional. She has worked in institutional and agency settings and has a valid take on the nature of power and powerlessness, control and being controlled.... Quotations from consumer/survivors make the book come alive.... Everett has done a good service to professionals and clients alike.'' -- Pat Capponi -- The Journal of Addiction and Mental Health, Vol. 4 #4, July/August 2001 ``The major sources of information for Everett's study were consumers and psychiatric survivors and those involved in providing services to this group. In-depth interviews yielded striking stories of pain and heroism as people sought help from a system with limited help to give.... Everett['s]...book, a powerful examination of the mental health system from the inside, presents a strong case for continued reform in the system.'' -- Robert B. MacIntyre -- Canadian Book Review Annual, 2000 ``[As] a worker in the mental health field...[it] was gratifying to see my lived experience described in a cohesive way within a theoretical framework that helped me understand my professional experiences at a deeper level.... The author's ability to integrate the historical context of mental health reform with the experiences of consumers/survivors, the viewpoints of family members, and the perspectives of professionals is both exceptional and sensitively done. I highly recommend this book for anyone coming in contact with the mental health system--consumers/survivors, family members, mental health professionals, and students who are plannng to enter the field of mental health.'' -- Ru Tauro -- Canadian Journal of Community Mental Health, Vol. 21 #1, Spring 2002 ``A Fragile Revolution demonstrates quite unequivocally, a first-rate strategic thinker, competent analyst, and elegant literary stylist.... This is the book you give to non-academic Psych Industry Workers for their `own short course in what the antipsychiatry movement is all about.... A major contribution and a must-read for anyone concerned with Canadian mental health policy making and development.'' -- Byron Fraser -- In a Nutshell, Winter/Spring 2002 ``The initial section on the history of the consumer movement is excellent.... Everett's discussions about `partnership,' about the different meaning behind the terms `consumer' and `survivor,' and about possible retaliation against consumer activists are all excellent and important. Her description of the failure of well-funded consumer groups is illuminating.... The discussion about whether consumer-survivors can participate without being co-opted is worth the price of the entire book.... I finished the book wanting to phone the author and continue the discussion, to argue with her and to agree with her.'' -- Ronald J. Diamond -- Psychiatric Services, Vol. 52, #39, September 2001