Mental Health Programs

About CMHS

Draft Principles of Consumer-Driven Care

These principles are stated in the affirmative to set forth an ideal to which systems should strive rather than being indicative of steps to be taken toward a positive direction.

Consumer-Driven Definition

Consumer-driven ¹ means consumers have the primary decision-making role regarding the mental health and related care that is offered and the care received. In addition, the consumer voice is paramount in determining all aspects of care for consumers in the community, state, and nation. The consumer voice must be present and fully represented both collectively and individually with regard to all aspects of service delivery from planning to implementation to evaluation to research to defining and determining outcomes. This includes, but is not limited to the policies and procedures governing systems of care, choosing supports, services, and providers; setting goals; designing and implementing programs; monitoring outcomes; and determining the effectiveness of all efforts to promote mental health and wellness.

¹ The term “consumer” as used in this document is used for the sake of brevity and should be understood to mean those people who are receiving or have received mental health services either voluntarily or involuntarily and in that context, “consumer” is intended to include those who refer to themselves as survivors, ex-patients, ex-inmates, clients, users or other similar terms. Mental health services includes those services, including vocational rehabilitation, employment services, housing services, social security and other services that are designed to be supportive of a person living their life to the fullest in the community of their choice.

Guiding Principles

When communities, states, or the federal government design policies affecting the mental health care for consumers, the following principles must be honored:

Consumers are the primary authors and decision-makers in developing policies affecting local, state, and national mental health service delivery. All meetings and preliminary discussions about the scope of policy design efforts involve consumers. Consumers outnumber government staff, contractors and secondary stakeholders (non-recipients of mental health services) and are the first and primary stakeholder.
As primary authors and decision-makers, consumers are compensated with comparable wages paid to other staff and service providers. Public entities lead the way in hiring consumers thereby setting an example for private business.
Input from consumers is meaningful beyond mere tokenism. Internal meetings including only government employees and providers or their contractors, and excluding representative consumers are discrimination and contrary to the ideals that define consumer-driven.

Consumers are given accurate, understandable, and complete information necessary to make informed, consensual choices regarding services and/or supports. Information will be provided in a language and method/format the consumer is able to understand.
Consumers are organized to collectively use their knowledge and skills as an engine for systems transformation.
People who provide services and/or supports embrace the concept of sharing information, decision-making authority and responsibility for outcomes with consumers. Community organizations, states, and the federal government ensure that providers are trained by consumers on culturally competent shared decision-making, and consumer culture.
Providers take the initiative to change practices from provider-driven to consumer-driven care and support the new role of consumer-provider partnership. Community organizations, states, and the federal government ensure that providers are trained by consumers on the meaning and benefits of consumer-driven care.
Administrators allocate resources, staff, training, and support resources to make consumer-driven practices work at the point where services and supports are delivered to consumers.
Consumers and consumer-run organizations engage in culturally competent peer support activities to reduce isolation and strengthen the consumer voice, with targeted outreach to include the voice of consumers in diverse ethnic and special population communities.
Consumers are treated with dignity and respect and within the full contexts of their lives, including awareness and sensitivity to culture and cultural worldviews, language, sexual orientation, housing and employment preferences, social and economic status, religious preferences, political opinions and other life choices.
Commitment to cultural competence is evident in all consumer-driven strategic planning, policy and program development.
Services are culturally and linguistically appropriate, with sensitivity to historical, cultural and religious experiences of diverse populations.
Programs eliminate disparities for cultural, racial and ethnic consumer populations.
Services to cultural, racial and ethnic consumer groups include and value the concept of inter-relational approaches that may embrace participation of extended family, tribes and other natural self-determined definitions of community inclusiveness.
Consumer driven approaches recognize the diversity of beliefs and values held by different racial/ethnic and cultural communities. Recognizing different world views of the concepts of interdependence vs. independence, self-sufficient, self-determined vs. person in their community, and embrace the diversity of values in definition of consumer-driven and self-determination.
Prejudice, racism, discrimination, and stigma are not accepted at any level.
Consumers are entitled to the full enumeration of rights as listed in the Universal Declaration of Human Rights.
Consumers lead, control, exercise choice over, and determine their own path of recovery by maximizing autonomy, self-agency, and independence.

Characteristics of Consumer-Driven Care

1. Consumers’ experiences, their visions and goals, their perceptions of strengths and needs, and their guidance about what makes them comfortable, steers decision making about all aspects of service and system design, operation, research and evaluation.
2. Meetings and service provision occur in culturally and linguistically competent environments. Consumers’ voices are heard and valued, everyone is respected and trusted, and it is safe for everyone to speak honestly.
3. Administrators and staff actively demonstrate their partnerships with all consumers by sharing power, resources, authority, and control with them.
4. Consumers have full access to useful, understandable information and data in their primary language, as well as sound professional expertise so they have good information to make decisions.