HOME > WHO > O'Hagan, Mary >


O'Hagan, Mary 200912 "Leadership for Empowerment and Equality: A proposed model for mental health user/survivor leadership," International Journal of Leadership in Public Services 13p.

last update:20150803


A user/ survivor is a person who has used services, often specialist mental health services, to assist them resolve their mental health problems.


A high proportion of people who use services are young, indigenous, or from ethnic minorities. All these groups have their own experiences of marginalization and all to some extent have formed social movements based on the same principle of self-determination as the user/survivor movement. People from these groups may be doubly disempowered in the service context. The user/survivor movement in many countries is predominately white and middle aged.


Their〔publicly funded mental health systems〕dual and somewhat conflicting purpose is the facilitation of recovery, as well as the control of people diagnosed with mental illness who are deemed a danger to themselves or others. In response to professional beliefs, community expectations and political pressure to ensure control, leadership in large mental health services tends to be preoccupied with risk management at the expense of more responsive or innovative goals that private sector companies are often more able to pursue.


[…] the user/survivor movement was founded on the principle of self-determination; it has non-negotiable values on equalising the distribution of power and on ‘empowerment’ for users and survivors at an individual and group level.


There is no universal or ‘correct’ reality. Users and survivors do encourage each other to reframe their stories, but the purpose is to increase wellbeing rather than to ‘correct’ their stories.


It’s interesting that the critiques on conventional leadership also resonate with the user/survivor movement’s critique of biological psychiatry. This includes the movement’s observations that psychiatry believes in its own moral good when the profession has also done harm, psychiatry tends to take responsibility away from the patient, it is reductionist and lacks inquiry into the context of people’s lives, and it believes that medicine has a monopoly on evidence and solutions.


User/survivor specific competencies
・Personal development through the experience of mental distress. […]
Of course, mental health workers without lived experience could do with many of these user/survivor specific competencies as well.


Firstly, there needs to be a philosophical shift in the way people view madness, from the deficits-based pathology view, to the view that madness is a crisis of being that value and meaning can be derived from (Mental Health Advocacy Coalition, 2008). This is essential because the root of all forms of discrimination is the denial that madness is a legitimate human experience; the deficits-based view perpetuates inequality and disempowerment, despite its benign intent.
Mental Health Advocacy Coalition 2008 “Destination: Recovery: Te ?nga ki Uta: Te Oranga”, Mental Health Foundation of New Zealand


Secondly, there needs to be a psychological shift within users and survivors themselves, from a marginalised disempowered identity to empowered identity.

翻訳:伊東 香純

*作成:伊東 香純
UP: 20150803 REV:
O'Hagan, Mary  ◇精神障害/精神医療
TOP HOME (http://www.arsvi.com)