Competing Realities: The Contested Terrain of Mental Health Advocacy

208 Pages·1990·11.07 MB·English

by  Susan Meyers Chandler

Competing
Realities
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COMPETING
REALITIES
The Contested Terrain
of Mental Health Advocacy
SUSAN MEYERS CHANDLER
PRAEGER
NewYork
Westport, Connecticut
London
Library of Congress Cataloging-in-Publication Data
Chandler, Susan Meyers.
Competing realities : the contested terrain of mental health
advocacy / Susan Meyers Chandler,
p. cm.
Includes bibliographical references.
ISBN: 0-275-93356-3 (alk. paper)
1. Mental health services—United States. 2. Mental health
policy—United States. I. Title.
RA790.6.C398 1990
362.2*0973—dc20 89-22815
Copyright © 1990 by Susan Meyers Chandler
All rights reserved. No portion of this book may
be reproduced, by any process or technique, without
the express written consent of the publisher.
Library of Congress Catalog Card Number: 89-22815
ISBN: 0-275-93356-3
First published in 1990
Praeger Publishers, One Madison Avenue, New York, NY 10010
A division of Greenwood Press, Inc.
Printed in the United States of America
The paper used in this book complies with the Permanent Paper Standard issued
by the National Information Standards Organization (Z39.48-1984).
10 9 8 7 6 5 4 32 1
This book is dedicated to all persons coping with
mental illnesses.
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Contents
Acknowledgments ix
1 The Persistent Problems of People with Mental Illnesses 1
2 Recurring Themes: Progress and Retreat 11
3 Deinstitutionalization and the Impact of Laws on
Mental Health Policy 39
4 Dollars Following Clients? The Influence of Financing
Methods on Mental Health Care 53
5 Changing Models of Advocacy 69
6 Privatizing the Public Mandates 83
7 The Advocacy Organizations 97
8 The Positions (and Needs) of Mental Health Advocates 113
9 Finding the Zones of Agreement 131
10 The Joyce Brown Story 155
11 Managing Solutions 171
Bibliography 181
Name Index 189
Subject Index 193
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Acknowledgments
While I was working on this book, I was frequently asked, "Why are
you interested in writing about people with mental illnesses?" People
asked me why I continue to go to state legislatures again and again to
make the point that mental health services are inadequate, that fund
ing is insufficient and planning nonexistent. People frequently ask me
if I have a "sick person" in my family, as if that would explain my
interest and commitment.
In reality, my concern for people with mental illnesses comes from
the knowledge that this problem can strike anywhere, to anyone, at
any time. And this is coupled with the fact that wherever it occurs,
help is usually poorly provided and effective services are few and far
between. Most people just don't seem to care about this social
problem or the millions of people it afflicts. That is why I have
written this book.
This book is based on my work over the last five years with the
Mental Health Association in Hawaii. However, my earliest interest
in the field of mental illness was shaped by Drs. Thomas Scheff, Steve
Segal, and Troy Duster at the University of California. Later, I was
continuously prodded and inspired by the intelligence, analytical
skill, dedication, and compassion of Dr. Sheila Forman at the Mental
Health Association in Hawaii.
I wrote a significant portion of the book while at the National Center
for Social Policy and Practice, National Association of Social Workers.
Dr. Karen Orloff-Kaplan provided a supportive environment (along
with an office and a computer) that sped the book along to completion.
My colleagues at the School of Social Work at the University of
Hawaii helped in a variety of ways. Ms. Hisae Tachi, in particular, is
one of those people who always knows where things are and easily
and graciously lends a helping hand.
I would like to thank my parents, Helen and Saul Meyers (who both
actually proofread the book!). Their clear vision for a better society
and commitment to all disadvantaged people has been a beacon for
my professional work. To my husband, David, whose good cooking