The 'consumer-as-provider' initiative

The National Institute of Mental Health has provided funding in Region I (New England) to several technical assistance centers: the Center for Community Change through Housing and Supports (Vt.); the Human Resource Association of the Northeast (Mass.); and the recently funded National Empowerment Center (Mass.). These federally funded projects are focused on guiding the mental health field toward a more consumer-driven system. The authors have been involved with these organizations and also provide consultation along with Northern Rhode Island Community Mental Health Center (NRICMHC) staff and consumers to other counties and states on improving services for adults and children with longer-term psychiatric problems. The consulting team for NRICMHC has encountered some communities where the hiring of current or former consumers appeared to present a "quick fix" for system problems rather than a reflection of more fundamental changes in attitudes and programs. Based on the authors' personal and family experiences, as well as their work experiences, they have reexamined some of the conventional wisdoms in the rapidly evolving area of "consumers as providers."