More responsibility, less control: psychiatric survivors and Welfare State restructuring

Abstract

This paper is concerned with the implications of recent Welfare State restructuring for psychiatric survivors' citizenship status. Using the Province of Ontario as a case study, the paper examines the extent to which recent change in mental health care and social assistance programs has worked to facilitate or constrain survivors' ability to exercise control over their lives. Despite recognition of the importance of survivors' participation in the mental health care system in the late 1980s, recent years have seen a return to a more traditional treatment paradigm characterized by professional control. Concurrently, restructuring of social assistance programs has led to a decline in the real value of income supports and growing pressure on informal support networks. As a result, psychiatric survivors are increasingly held responsible for their own material well‐being and public conduct, but are less able to exercise control within everyday life.

Notes

∗ School of Geography & Geology, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M1, Canada. Email: [email protected]

ACT teams are multidisciplinary teams of professionals that are intended to provide support to people living in the community on a 24‐hour, as needed, basis. Nelson et al. (2001) note that reactions to ACT teams are mixed. On one hand, evidence suggests that they help to reduce hospitalization rates, and that they may be preferable to other intervention approaches. On the other hand, there are concerns that teams are overly concerned with social control, focus primarily on drug use to control symptoms.

Based on key informant interviews with counselors at a non‐profit employment service for people with disabilities in Hamilton.

This figure is based on calculations using Statistics Canada's Consumer Price Index (CPI). The CPI for March 2002 was 119.5 where the 1992 CPI value is set at 100.

Available at: http://www.cfcs.gov.on.ca/CFCS/en/programs/IES/OntarioDisabilitySupportProgram/Publications/odspisdir.htm (accessed 9 September, 2003).

Additional information

Notes on contributors

Robert D. Wilton ∗

∗ School of Geography & Geology, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M1, Canada. Email: [email protected]