'Union Recognition':
rethinking the way of organizing the clients
If we are to reform the
mental health system, how do we deal with
its way of behaving unreasonably in helping people? If the
system is entirely impervious to reason, then there is little else
to do but to wage a determined defense of ‘patients rights’. For
anything to be possible beyond this narrow stategy, it would
have to be that some ‘reasonable’ and productive conversations with
some providers and allied non-clients can happen. And moreover
that this dialogue strategy, about the way to change/humanize
mental health service delivery, might eventually take center stage,
becoming itself the engine of change.
The fundamental difference in perspectives between managers and
clients leads to the metaphor of the clients movement being
described as a ‘labor union’. Of course it is not literally
that, but clients are expected by the system to be compliant,
in a way analogous to how workers are expected to take orders. If
they (clients/workers) network, then they can hope to defy the
system/bosses. Moreover, there is a step beyond this, where there
comes to be mutual acceptance
of the principle of independent
organizing — ‘union recognition’, in the metaphor.
When the ‘union recognition’ principle is applied to the madness
question, we are talking about making changes in the way managers
and clients relate. Rather than clients being ‘inherently
irrational’ we now have a sphere of discussion/‘rationality’ that
is mutually agreed upon. Today’s ‘dialogue’ model does not take
enough into account the difference in standing of the parties, and
needs to challenge much more the topics, needs to go much deeper
into the ‘good sense’ of the ‘treatment’ process itself. As we
move from the defensive stance of ‘patients rights’ to taking up
core humanist issues like ‘trauma of treatment’, we will start to
take on the very way that society views ‘rationality’.
To overcome the present tendency towards exclusionary management
of the clients movement we need to reach meaningfully to and thus
involve many more clients in the reform process. But the current
shift in the system, towards so-called ‘recovery’, as presently
constituted, still begs the question of ‘trauma of treatment’. To
involve a lot of people in the clients perspective, we need to
build a tradition of accountability to people’s concerns about
treatment/abuse issues, prior to their becoming matters of
litigation. The independent client organizing, the ‘union’, can
win the right to, and then pursue negotiation over the boundaries
of decent and humane treatment, of fulfilment of our visionary
potential as human beings.
Tom Harkins, Eureka
Gerald Minsk, Los Angeles
Andrew Phelps, Berkeley
Phil Winn, Sunnyvale
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