Since the 1980s, consumer-run drop-in centers have popped up in nearly every metropolitan area in the United States. Today, the Center for Mental Health Services (CMHS) estimates that the country's 2,100 consumer-run organizations- organizations in which more than 50 percent of the decision-makers are mental health consumers-serve more than 500,000 people each year.
Supported by grants from mental health or other local organizations, the goal of these drop-in centers is to help people with mental illnesses reintegrate into their communities, says Ronald Bassman, PhD, who was treated for schizophrenia at the age of 22 before becoming a clinical psychologist.
Bassman says that when consumers are in charge, they empower themselves and others toward recovery, and reinvent attitudes on how to best treat serious mental illnesses along with it.
"It's based on the concept of self-determination," says Bassman, a former member of APA's Task Force on Serious Mental Illness. "When people make choices and follow through on their own choices, they consistently do better."
Home away from home
Many drop-in centers, including the newly developed Brevard Drop-in Center, in Melbourne, Fla., serve needs outside of the traditional mental health care system. Instead of clinical support, they simply offer safe environments for people to socialize, communicate and participate in activities that support recovery, says Jean McPhaden, executive director of the Brevard center and a mental health consumer.
At the Brevard center, the most popular activities include the peer-run support groups, member-led arts-and-crafts projects, and free phone service. But most importantly, says McPhaden, members enjoy the center's comfortable, unstructured atmosphere, and the chance to interact with people who understand where they're coming from.
"There are no hassles; no one telling you that you must do this or that to recover," she says. "It is a supportive, recovery-promoting environment."
The only requirement, notes McPhaden, is proof of a mental illness diagnosis, often in the form of an empty pill bottle for a psychiatric drug prescription.
Other drop-in centers' activities vary from place to place and month to month, based on consumers' needs and interests, says Bassman. In addition to offering support sessions and social events, some centers sponsor excursions to museums or sporting events or offer consumer-led computer and Internet training.
Some consumers find that their development and recovery is enhanced by their mental health advocacy efforts through their drop-in center. By helping other members obtain housing, transportation and other government services, or by educating the public about mental health issues, consumers recognize that they are also helping themselves.
But it's by participating in local events or hosting community gatherings that patients truly begin to realign themselves as community members, says Bassman. For example, the Second Opinion Society, a consumer-run drop-in center in Whitehorse, Yukon, attempts to integrate people into the larger community by inviting the entire community to events. Consumers and non-consumers alike attend yoga classes together at the center. This breaks down stigmas and helps the community understand that people with serious mental illnesses are capable of a full recovery, says Bassman.
"Here we see that people are people, and even if one has a mental illness, the community remains open to that person's participation and contribution," he says.
Taking back control
Interestingly, these centers' goal of empowering consumers can be a tough sell to some psychologists, says Mary Beth Kenkel, PhD, dean and professor of the College of Psychology and Liberal Arts at the Florida Institute of Technology, and vice chair of the Brevard center's board of directors. That's because members determine the center's activities, services and codes of conduct, which sometimes differ from tried-and-true tactics of the mental health profession, she says. For example, when the center first opened, she says she questioned the need for on-site laundry facilities. Today, this is one of the center's most popular services.
"Often, when a question comes up about what activities to offer, the professionals want to jump in with the answers, when really the answer should be, 'Well, what do the members want?'" Kenkel says.
But psychologists' concerns about some drop-in centers are valid, cautions Bassman. He says some centers may be run by consumers in name only, receiving direction from non-consumers or even the center's funding organization, directly conflicting with the concept of being consumer-run. It can also be tough for a drop-in center to become more than a place for people with a mental illness to stop in for a bite to eat, he says.
"It's very dependent on the climate that's established by the people who are doing the most to get it going," he says.
But with capable consumers in place, backed by the support of mental health professionals, consumer empowerment even has its place in more traditional community health centers-those not run by consumers-says former APA President Pat DeLeon, PhD, JD. Working with clients, rather than always trying to be "the doctor," enables psychologists to better help clients learn to care for themselves, he believes.
"The future for psychology is getting involved in what most psychologists aren't being trained to think about: helping [clients] really control their own destiny," notes DeLeon.
So far, Brevard is on the right track in that regard, says Kenkel, noting that the center nearly doubled its daily member attendance after opening its permanent location in February. And according to McPhaden, more than one member says the center has helped them avoid additional hospitalization for their disorders, by enhancing their self-worth and giving them tools for managing their mental illness.
A mental illness diagnosis, says Kenkel, "is not a death note, but something that needs to be coped with just like any other chronic medical disease. Even though you may have some symptoms of illness, you can still have a good quality of life."
- Bassman, R. (2007). A Fight To Be: A Psychologist's Experience from Both Sides of the Locked Door. Albany, NY: Tantamount Press.