Skip to main content
Log in

Beneficence vs. Obligation: Challenges of the Americans with Disabilities Act for Consumer Employment in Mental Health Services

  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Involvement of mental health service consumers in the provision of mental health services is a growing model in community mental health. It is, however, a complicated issue, made ever more so by the passage of the Americans with Disabilities Act. In this ethnographic case study, we seek to explore the changes one social services agency has made to adjust to the requirements of the ADA and the impact of these changes on their consumer employees. Our results indicate potential for positive progress as a result of the ADA, but also unexpected pitfalls as organizational cultures change as well.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Abramovitz, Mimi. (1996). Regulating the Lives of Women: Social Welfare Policy from Colonial Times to the Present. Boston: South End Press.

    Google Scholar 

  • Americans with Disabilities Act of 1990, P.L. 101–336.

  • Colson P., El-Sadr W., Hirsch-Moverman Y., Thomas G., Gee V. The Role of Peer Workers in Enhancing Adherence to LTBI Treatment.International Union Against TB and Lung Disease— North American Region, Vancouver, CA. February 2000.

  • Colson P., Francis L., Mizzi P. Beneficence Versus Empowerment: Challenges for Consumer Employment in Mental Health Services. American Sociological Association Annual Meeting, Chicago IL. August 1999.

  • Cook, Judith A., Jonikas, Jessica A., and Razzano, Lisa A. (1995). Randomized Evaluation of Consumer Versus Non-consumer Training of State Mental Health Service Providers. Community Mental Health Journal, 31(3): 230.

    Google Scholar 

  • Dixon L., Krauss, N., and Lehman, A. (1994) Consumers as Service Providers: The Promise and the Challenge. Community Mental Health Journal, 30(6): 615–625.

    Google Scholar 

  • Estroff, S. E. (1981). Making It Crazy: An Ethnography of Psychiatric Clients in an American Community. Berkeley: University of California Press.

    Google Scholar 

  • Francis, L. E. (2000). Conflicting Bureaucracies, Conflicted Work: Dilemmas in Case Management for Homeless People with Severe Mental Illness. Journal of Sociology and Social Welfare, XXVII(2): 97–112.

    Google Scholar 

  • Francis L., Colson P., Mizzi P. Persons with Severe Mental Illness as Employees in a Community Mental Health Agency: an Exploratory Study. Society for Social Work and Research, Charleston, SC. January 2000.

  • Granger, B. (2000). The Role of Psychiatric Rehabilitation Practitioners in Assisting People in Understanding How to Best Assert Their ADA Rights and Arrange Job Accommodations. Psychiatric Rehabilitation Journal, 23(3):215–222.

    Google Scholar 

  • Interagency Council on the Homeless (1992). Outcasts on Main Street: Report of the Federal Task Force on Homelessness and Severe Mental Illness. National Institute of Mental Health/Alcohol, Drug Abuse and Mental Health Administration, Department of Health and Human Services. Washington, D.C.: U.S. Government Printing Office.

    Google Scholar 

  • Lehman, A. F. (1993). Introduction. Pp. i–xi in Working for a Change: Employment of Consumers/ Survivors in the Design and Provision of Services for Persons Who are Homeless and Mentally Disabled. Center for Mental Health Services, DHHS: Baltimore, MD.

    Google Scholar 

  • Manning, S. and Suire, B. (1996). Consumers as Employees in Mental Health: Bridges and Roadblocks. Psychiatric Services, 47(9): 939–941.

    Google Scholar 

  • McCabe, S. and Unzicker, R. (1995). Changing Roles of Consumer/Survivors in Mature Mental Health Systems. Pp. 67–75 in New Directions for Mental Health Services, No. 66, Summer. San Francisco: Jossey-Bass.

    Google Scholar 

  • Mowbray, C. (1997). Benefits and Issues Created by Consumer Role Innovation in Psychiatric Rehabilitation. In Mowbray, C., Moxley, D., Jasper, C., and Howell, L. (Eds.), Consumers as Providers in Psychiatric Rehabilitation (pp. 45–63). Columbia, MD: International Association of Psychosocial Rehabilitation Services.

    Google Scholar 

  • Mowbray, C. and Moxley, D. (1997). A Framework for Organizing Consumer Roles as Providers of Psychiatric Rehabilitation. In Mowbray, C., Moxley, D., Jasper, C., and Howell, L.(Eds.), Consumers as Providers in Psychiatric Rehabilitation (pp. 35–44). Columbia, MD: International Association of Psychosocial Rehabilitation Services.

    Google Scholar 

  • Mowbray, C., Moxley, D., Thrasher, S., Bybee, D, McCrohan, N., Harris, S., and Clover, G. (1996). Consumers as Community Support Providers: Issues Created by Role Innovation. Community Mental Health Journal, Vol. 32: 47–67.

    Google Scholar 

  • ResearchWare, Inc. (2000). HyperRESEARCH, Version 2.0. Randolph, Massachusetts. Online at http://www.researchware.com.

  • Riffer, N. W. (2000). Working Responsibly with Employees with a Psychiatric Disability. Psychiatric Rehabilitation Journal, 23(3):281–284.

    Google Scholar 

  • Rogers, E.S., Chamberlin, J., Ellison, M., and Crean, T. (1997). A Consumer-Constructed Scale to Measure Empowerment Among Users of Mental Health Services. Psychiatric Services, 48(8): pp. 1046–1054.

    Google Scholar 

  • Salzer, M. (1997). Consumer Empowerment in Mental Health Organizations: Concept, Benefits, and Impediments. Administration and Policy in Mental Health. 24(5), May: 427–428.

    Google Scholar 

  • Segal, S., Silverman, C., and Temkin, T. (1993). Empowerment and Self-help Agency Practice for People with Mental Disabilities. Social Work, 38(6): 705–715.

    Google Scholar 

  • Stephens, C. L., Belisle, K. C. (1993). The ‘Consumer-as-Provider’ Initiative. Journal of Mental Health Administration, 20(4) 233–240.

    Google Scholar 

  • Trochim W., Dumont, J. and Campbell, J. (1993). Mapping Mental Health Outcomes from the Perspective of Consumer/Survivors. National Association of State Mental Health Program Directors Research Institute, Inc., Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Baltimore, MD.

    Google Scholar 

  • Van Tosh, L. (1993). Working for a Change: Employment of Consumers/ Survivors in the Design and Provision of Services for Persons Who are Homeless and Mentally Disabled. Center for Mental Health Services, DHHS: Baltimore, MD, pp. 10–12.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Francis, L.E., Colson, P.W. & Mizzi, P. Beneficence vs. Obligation: Challenges of the Americans with Disabilities Act for Consumer Employment in Mental Health Services. Community Ment Health J 38, 95–110 (2002). https://doi.org/10.1023/A:1014559519492

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1014559519492

Navigation