CLINICAL HANDBOOK OF SCHIZOPHRENIA

302 IV. PSYCHOSOCIAL TREATMENTbeen relegated to a position as second-class citizens living under a system of laws that allowedinvoluntary commitment laws to deny them their liberty. They see the psychiatricsystem as one that disempowers those it is claiming to help. They oppose any form offorced, coerced, or assisted treatment. They deny that there is any scientific basis for thebrain disease model of mental illness. They see themselves as following in the footsteps ofearlier liberation movements, particularly blacks pursuing civil rights and the women’smovement for equality (Chamberlin, 1978).Given their focus being on rights, it is not surprising that the survivors frequently workcooperatively with civil rights lawyers and legal rights groups. They tend to be very activewith the National Association for Rights Protection and Advocacy (NARPA), the BazelonCenter for Mental Health Law (formerly the Mental Health Law Project), and the Protectionand Advocacy entities funded by Center for Mental Health Services (CMHS), a divisionof the Substance Abuse and Mental Health Services Administration (SAMHSA).Today the initiatives set in motion by these early activists are embodied by groupswith names such as Mind Freedom and the Support Coalition International.The other group of self-helpers that arose from the organizational split in 1985 generallyrefers to its members as “consumers.” Originally the consumers established arather large organization, the National Mental Health Consumers’ Association (NMHCA),but this group has not been active since the late 1990s. Despite the recent inactivity ofNMHCA, consumers, like those individuals identifying themselves as survivors, continueto fight stigma and discrimination, but they are additionally much more comfortable seeingthemselves as persons in recovery and in need of treatment. The consumers tend to beperceived as less radical or “antiestablishment” than the survivors and, as a result, canfrequently be seen working in partnership with organized psychiatry and other traditionalmental health provider groups.Whereas the uniting mantra of the survivor groups tends to be “No forced treatment,”the shibboleths of consumer groups are more likely to include slogans such as“Nothing about us without us” and “Advocacy is the best therapy.”COMBINED FAMILY–CONSUMER EFFORTSA self-help group that has arisen during the past three decades, which many view as beingthe most effective of all the mental health advocacy groups, is the NAMI organization. Theacronym NAMI originally stood for the National Alliance for the Mentally Ill, but in 2005,the organization changed its official name to the National Alliance on Mental Illness.Originally founded by a group of mental health activists who came together inMadison, Wisconsin, in 1979, NAMI was comprised primarily of family members ofadults with serious mental illnesses such as schizophrenia and bipolar disorder. NAMIgrew very rapidly, to the point that it recently claimed to have over 210,000 members andover 1,100 affiliates. Unlike some of the consumer- or survivor-only advocacy groups,NAMI calls for improved treatments and services, in addition to its fight against discriminationand stigma. In this effort, like DBSA, NAMI works closely with professional providergroups, particularly with research-oriented and community-based psychiatrists.NAMI’s activities in the past few years have increasingly focused on the problems ofthe mentally ill in the criminal justice system. NAMI has become an integral part of crisisintervention team (CIT) training for police officers, which generally comprises 40 hoursof classroom and experiential training delivered by consumers, family members, mentalhealth professionals, and experienced police personnel. Upon completion of the training,CIT graduates tend to be the officers who will respond to police calls involving persons