Consumer-Survivors are Vital Contributors to Behavioral Healthcare’s Success

We rapidly are approaching the much beloved winter holidays. At this time of year, it is quite important to step back and reflect on our accomplishments in the behavioral healthcare field. Although we discuss and debate our problems and crises very frequently, we rarely, if ever, mention any successes. We all know that this imbalance is quite unhealthy.

This year, my thoughts are prompted by the very recent release of historian Phyllis Vine’s new book, Fighting for Recovery (Beacon Press, Boston). This powerful text details the 50-year effort by consumer-survivors to transform behavioral healthcare. I would like to reflect on some key accomplishments that have been achieved through the growth and efforts of this important national movement. These developments are quite remarkable.

Undoubtedly most profound is the role that consumer-survivors played in establishing that recovery can and does occur for those with behavioral health conditions. With the possibility of recovery, one can have hope. Without it, one can have no hope. Recovery is a personal process of regenerating one’s voice and rebuilding one’s life. This remarkable gift of recovery has come to us through the first-person experiences of consumer-survivors as they live their lives. It has not come through research or service development.

One only can regain his or her voice and life if others listen to what one has to say. Hence, recovery essentially is a social process that leads to friendships and community support. For most people, it is a lifelong process of transformation toward wellness.

This concept of recovery has had very profound effects upon our behavioral health community. We now have recovery-oriented services, recovery-oriented systems of care (ROSCs), and wellness recovery action plans (WRAPs). And the Substance Abuse and Mental Health Services Administration (SAMHSA) has just introduced a new and much-needed Office of Recovery.

Of almost equal importance is the introduction of peer support services. It is intuitively obvious that those who have the lived experience of a behavioral health condition are best equipped for outreach, engagement, and support of others who have these conditions.

These peers have become a key resource in the behavioral healthcare field. One can find peers working at the doors of emergency rooms and jails, in community outpatient programs, and even in residential and inpatient settings. The peer workforce is a wonderful gift, especially now as we confront an unprecedented major human resource shortage in our field.

Peers not only provide traditional support services, but now also operate peer service programs. These can range all the way from recovery-centric community outpatient programs to warm lines, hot lines, and crisis response services. More recently, peer-operated community respite programs also have been initiated.

Another essential accomplishment has been the rapid introduction of the principle of person-centered care via the Affordable Care Act. This principle requires a focus on the whole person and that individual’s needs, guided by a person-first approach to care. Consumer-survivor advocacy played a leading role in the introduction of this principle.

Within less than a decade, the principle of person-centered care has led to self-directed care, another very important innovation and gift. In self-directed care, the client plays a foundational role in determining care goals, as well as the actual care received. This innovation now is beginning to sweep through the field. Self-direction is key to recovery and wellbeing.

Finally, a large number of consumer-survivors now are undertaking and receiving advanced degrees in the social and behavioral sciences. These credentials permit them to seek and obtain federal and foundation grants to evaluate and improve behavioral health services. This work is another very important gift to our field.

I simply cannot overstate the importance of the success peers have had in reducing the social isolation and fear that accompany behavioral health conditions and in giving people the hope that is essential for recovery from these illnesses. The consumer-survivor movement opened our field to these possibilities during the past half century. Now, peers are leading us into the future with peer-operated services and self-directed care. We do have much to be grateful for at the end of 2022.

Ron Manderscheid, PhD, is the former president and CEO of NACBHDD and NARMH, as well as an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and the USC School of Social Work.

The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.