Sociopolitical Trends in Mental Health Care: The Consumer/Survivor Movement and Multiculturalism

Abstract

Since the 1990s, two sociopolitical developments have left a substantial mark on mental health care: the “consumer/survivor” movement and multiculturalism. Consumer/survivors claim that psychiatrists make them sick, and their advocacy, funded in part by the federal government and state mental health agencies, has resulted in legal an policy initiatives that restrict the work of psychiatrists and care for the seriously mentally ill, including laws restricting involuntary treatment and electro-convulsive therapy (ECT). While consumer/survivors see themselves as the “last minority,” women, sexual minorities, and ethnic minorities are the focus of multicultural therapy, which makes identity politics the central theme of therapy. The goal of these therapies is to foster the patient’s understanding of how his or her psychological distress is due to oppression and social injustice. This chapter provides an overview of these two influential developments in mental health care and illustrates the practical implications of these developments for psychiatric care and the mental health care system generally.

Keywords: consumer/survivor movement, multiculturalism, multicultural therapy, identity politics, mental health care trends, mental health law, minorities