Participatory Concepts in Mental Health Care: Will they be a driving force behind a reform movement supported by unified advocacy? PART I
BY Maria Mangicaro
SUBJECT: The author, a mental health e-Patient and legal blogger with an interest in psychotic disorders, discusses various reasons that influence the perspectives of mainstream advocates, as opposed to those of the Psychiatric Survivors’ movement.
The article considers: Will the Participatory Medicine movement, evolving in a culture of postmodernist interpretations of psychiatry, foster a new model of mental health care that is much more connected to the concerns of patients and supported by unified advocacy?
Divided Advocacy in Mental Health Care: Addressing the elephant in the room.
As well as aiding the effort to reduce the stigma and discrimination associated with mental illness, advocacy has been critical in promoting the rights of persons affected with mental health disorders.
Advocacy movements have substantially influenced mental health policy and legislation in some countries, and are believed to be a major force behind improving services in others.
Although many organized advocacy groups exist, the diverse perspectives and conflicting opinions create attitudinal barriers that make a successful reform movement seem virtually impossible.
A critical issue in mental health care is the human rights issue of depriving patients of their right to refuse unwanted and potentially harmful medical treatment – forced psychiatry. Compulsory psychiatric treatment results in certain consumers being deprived empowerment strategies and is contrary to a participatory agenda.
Mental health providers and advocates of opposing views are realizing the value of various
concepts and philosophies such as; peer specialist certification, Shared Decision Making (SDM), Psychiatric Advance Directives (PADs) and Postmodern Psychiatry (postpsychiatry) that capture the quintessential properties of participatory medicine.  
In effect, the fixed perspectives of organized advocacy are akin to the story of the seven blind men and the elephant. The ancient Indian fable involves a group of blind men touching an elephant to learn what it is like. As each man describes a different part of the animal, their varied perspectives create opposing views and a conflict erupts. Resolution is achieved through the advice of a wise sage who suggests the group unifies using a shared perspective in order to gain a complete understanding.
The emerging Participatory Medicine movement, along with the application of postpsychiatry interpretations, may provide a foundation for advocacy groups to understand diverse perspectives, work towards common goals and act as a unified front for effective reform.