User Empowerment — A Decade of Experience
| Pages | 5-13 |
| DOI | https://doi.org/10.1108/13619322199600036 |
| Date | 01 December 1996 |
| Published date | 01 December 1996 |
| Author | Ingrid Barker,Edward Peck |
| Subject Matter | Health & social care |
The Mental Health Review 1:4 ©Pavilion Publishing (Brighton) 1996 5
Ingrid Barker
ASSOCIATE CONSULTANT,CMHSD
EdwardPeck
DIRECTOR,CMHSD
Introduction
Over the past eleven years, British users of mental
health services have been working hard to ensure
that they have a greater voice in the development
and running of services. It was in 1985 that patients’
councils and advocacy projects began to develop in
Britain, and Survivors Speak Out was formed. This
period of early development was described in Power
in Strange Places.1There has been a very significant
growth in the user movement over the last ten years,
and a recognition in most quarters that users have a
legitimate role on three distinct levels in the system:
in the planning of their own support; in the design
and running of statutory and independent services
provided for users; and in the establishment of user-
run or user-led services.
Recently, users, managers and clinicians have
been reflecting on the progress made over the last
decade and one focal point for this was the
conference: User Empowerment: Ten Years On,held
in Nottingham, which CMHSD helped to organise.
Drawing on the discussions from that conference,
this article aims to put the growth of the user
movement in context, describe some of the main
developments, draw attention to key documents
and pose some questions for the future.
Aculture for change
Of course, the user movement in Britain did exist
prior to 1985. These groups, and many of the
individuals who became involved in the user move-
ment in the mid-1980s, had views that were rooted
in the culture of the 1970s.
Drawing on perspectives from the civil rights
movement in the US, anti-psychiatry, de-institution-
alisation, labelling theory and normalisation2people
started to use consciousness-raising methods
established by women’s and black groups in relation
to mental health.3This approach brought those
many personal stories of mental health users’
experiences into a wider political context. The
personal became political and people wanted to
use collective action to bring about change.
This broadly left-of-centreapproach arose
simultaneously with the emergence of the ‘new
conservatism’ of 1980s Britain. Actual or quasi-
markets were being introduced into public services
in the UK, in which the consumer of services was
to be given increased influence. Such approaches
were intended to lead to greater choice, more
responsiveness to complaints and service develop-
ments based on consumers’ wishes.
At the same time, the government reflected,
in their reforms of the health service, a decreasing
deference to doctors. Health authorities were to
establish a ‘champion of the people’ role, their
decisions should reflect what people want.4Alan
Langlands, soon to become Chief Executive of the
NHS, told the Health Select Committee of Inquiry
into mental health services, ‘We are listening to
carers an d users, the people whom we think know
best about services’.5
In this context, the aspirations of the emerging
user movement could be embraced by left and right.
Nonetheless, thereis clearly a potential tension
between campaigning based on consciousness-raising
and consumerism based on choice; a tension reflected
in the mid-1980s by one of the founders of the
Campaign Against Psychiatric Oppression when
User Empowerment –
A Decade of Experience
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