Self-Determination Among Mental Health Consumers/Survivors

It is well known that people with psychiatric disabilities lack self-determination in their lives. A number of studies have demonstrated the high rates of poverty experienced by many of these individuals, leading them to confront a variety of barriers to a higher quality of life. Moreover, concepts of self-determination and client control have not yet proliferated in the public mental health system. In spite of this, consumers/survivors have organized to demand their civil rights and full inclusion in making decisions regarding their own treatment. This article traces the history of self-determination for citizens with psychiatric disabilities, describes major barriers to self-determination, presents several theories of self-determination with potential relevance for mental health consumers/survivors, and offers ways in which self-determination and consumer control might be achieved both within and outside of service systems.