Shifting the Paradigm in Community Mental Health: Towards Empowerment and Community

• Published in: Canadian psychology = Psychologie canadienne 2001, Vol.42 (4), p.315
• Main Author: Beal, Georgiana
• Format: Review
• Language: English
• Subjects: Community mental health care; Mental health care
• ISSN: 0708-5591; 1878-7304
• DOI: 10.1037/h0088126

Although the literature has emphasized the importance of consumer involvement and partnership in mental health care for many years, the achievement of this objective remains elusive. This book, as it combines theory, practice, and research (a case study) about the processes of empowerment and integration of consumers of mental health care in a Canadian setting, delineates strategies and approaches that can be factors in fulfilling this important aim. The varying levels that need to be involved are discussed and this contributes to an understanding of the conditions that facilitate and inhibit this process. The course of empowerment is described on three levels: policy and planning, organizational, and individual. The body of the text, a study of the community of Kitchener-Waterloo, tracks the changes that occurred during the paradigm shift from the institutional-medical approach to an empowerment-integration approach in community mental health. The research, which includes the voices of consumers, yielded rich information about the change processes and outcomes at these levels, and concludes by offering an examination of why there was a less-than-complete shift to the ideals of community mental health. The explanation grows out of the assumptions and values underlying the varying levels. A key chapter is on the themes and lessons learned. Again, we are reminded that values and principles must be embraced by all levels of mental health care - policy, institutional and individual - in order to create coherence and a culture. It is this coherence that makes change happen. The authors also point out that one of the weakest areas in terms of enabling empowerment lies in the proper allocation of resources, and they argue that it will be necessary to invoke the ideals of community integration and social justice. They provide a framework for the key dimensions of the empowerment-community integration paradigm and they argue that this must be linked to ideals of public good and equality for this objective to be realized. Shifting the Paradigm in Community Mental Health is a welcome contribution to the literature on the implementation of consumer empowerment and involvement in mental health treatment and care. The authors offer an approach enabling the reader to see the dimensions for empowerment and community integration termed the empowerment-community integration paradigm. The book will be useful for a wide audience, including consumers, professionals, stakeholde