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Consumer-driven services are service programs that include a significant contribution from mental health consumers in design, administration, executive leadership, and/or service provision. These programs vary widely in focus, size and the degree to which consumers are involved in day-to-day programming and development. The essential characteristics of CDS are universal however—any CDS program must feature active participation of consumers as a regular part of its planning process, and input from consumers must be of foremost importance in decision-making.
A wide variety of organizational settings may lend themselves to CDS programs, from large mental health service agencies to unique grassroots efforts run on a volunteer basis. Some, but not all, of these organizations have consumer involvement as a part of their charter or mission statement, as for instance a requirement for a majority of consumers on their Boards of Directors or staff. Many CDS are completely independent incorporated organizations. Others may operate under a charity umbrella framework, within a traditional provider agency, or even as part of an inpatient hospital program.
The mental health consumer movement began in the late 1940s to raise awareness about the maltreatment of people who were hospitalized for mental illness. As the movement slowly succeeded against the entrenched effects of disempowerment, coercive treatment practices and human warehousing, consumers began to create their own alternatives to psychiatric hospitals. Self-help and peer support groups emerged to empower people be proactively engaged in their own mental health, and to advocate for change within the mental health system as a whole.
Most of the original programs were established and run entirely by people with psychiatric histories for mutual support and advocacy purposes and operated almost entirely, if not entirely, on a volunteer basis. Many of these organizations went on to play leading roles in the development of the consumer movement, paving the way for consumers to be accepted as valued service providers and participants in mental health policy and treatment planning.
Today mental health consumers are involved in a wide range of positions in the mental health system, including in traditional service structures like case management and respite care. Some mental health agencies have significant consumer representation on their boards and in executive positions, and some of the first consumer programs have expanded to large corporations with multi-million-dollar budgets.
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