Fostering Self-Determination as a Means to Recovery

Purpose: This study explored how a group of service users and providers from a community mental health center in Illinois, developed a shared understanding of disability from a civil and human rights perspective as a way to foster self-determination. Method: The study used an emancipatory approach called collaborative inquiry (CI), a participatory research method that uses cycles of action and reflection to introduce new ideas and concepts and then reflect on what was learned. 12 participants including eight service users and four professional and peer providers completed initial baseline interviews. Service users and providers then participated together in 5 cycles of CI. Participants learned about disability studies concepts and disability rights during the action groups. During reflection groups, they considered how the concepts applied to their work and daily lives as well as how the concepts changed their perspective of psychiatric disability. Results: Analysis resulted in seven overarching themes that suggest the participant’s thinking evolved over time. Themes include belief that disability is in the person, barriers to community participation, power relationships, stigma around psychiatric disability, rethinking disability, humanity within disability and looking toward the future. Participants found that the disability concepts changed their perception of psychiatric disability and left them with a sense of greater empowerment related to community engagement and decreasing stigma. Implications: Introducing disability studies concepts to a combined group of service users and providers, using an approach like CI, can potentially shift the power in the mental health system, afford a greater sense of autonomy and allow service users to feel more self-determined. The results suggest that proponents of stigma reduction must reconsider their reliance on the use of overcoming illness stories. A disability rights curriculum for people with psychiatric disabilities would be most effective if it includes modules on invisible disability and rewriting narrative stories to reflect art, culture and shared disability history. Recovery Model interventions may be more effective at affording self-determination if they include education around disability concepts as well as action elements around social and civil rights approaches to disability.