Recovery From Schizophrenia: Psychiatry And Political Economy

TREATMENT 289consumers and professionals that has established a consumer-run drop-in centerand a full-scale psychiatric clinic for the treatment of severely ill people. Theclinic is directly accountable to an elected consumer board and to a second boardcomprised of professionals and other interested people. All matters of clinic policyrequire the consent of the consumer board. CHARG also provides consumeradvocates for patients at the local state hospital, in boarding homes and in otherlocations. The advocates visit the hospital wards, attend treatment-planningmeetings and accompany clients to court hearings; among other services, theyhelp clients find apartments, apply for public assistance, appeal adverse SocialSecurity rulings and contest involuntary treatment certifications. 50An innovative program in Denver, Colorado, at the Regional Assessment andTraining Center (RATC), has trained mental health consumers with long-termmental illness to work as aides to case managers within the state mental healthsystem, as residential counselors and as vocational rehabilitation staff. 51 Traineeswith well-controlled major mental illness receive 21 credit hours of collegeeducation during six weeks of classroom training and a 14-week field placement.Classroom courses include mathematics, writing, interviewing techniques, casemanagement skills, crisis intervention and professional ethics. Following thesupervised internship in a community mental health program, trainees earn acertificate from the local community college and are guaranteed employmentwith a community mental health program. As case manager aides, the programgraduates help mentally ill clients with budgeting, applying for welfareentitlements and finding housing, and they counsel their clients on treatment,work and other issues. By 2002, after 16 years of the program’s operation, wellover a hundred consumer mental health workers had been placed in employmentthroughout the service system, providing models for patients and staff alike ofsuccessful recovery from mental illness. Two-thirds of the trainees continue to besuccessfully employed in the mental health system two years after graduation fromthe training program. Building on the initial success, RATC now trainsconsumers for other mental health staff positions, such as residential care workersand job coaches for clients in supported employment.This program has been replicated in other states of the union. In Houston,Texas, a similar program has trained and placed over 50 consumer casemanagers, and other replication projects have been established in Washingtonstate, Utah and Oregon. 52 The consumer aides are paid a standard wage but arestill relatively cheap; they perform tasks (for example, apartment hunting) thatprofessionals are happy to see others take on and they achieve some things thatprofessionals cannot. In particular, they serve as role models for clients who arestruggling to manage their lives better and they effectively reduce the antagonismthat many clients show towards treatment. The consumer staff also raise the staffand patient level of optimism about outcome from illness.It does not require a special program for a mental health agency to involveconsumers in delivering treatment. At the Mental Health Center of BoulderCounty, in Colorado, people with serious mental illness are part of the governing