Exercising the Right to Speak Out 

In 23 years of being treated for mental illness, I have learned that it is common for some treatment providers to assume flawlessness. Although a practitioner may have training, practice, and experience on their side, It is questionable how much this experience should override someone’s right to think independently. Putting out a statement in treatment that questions the validity of a claim should be respected for its originality, not delegitimized.

The interrogation of my ‘Lived Experience’ has been commonplace with many psychiatrists, therapists, or peer specialists. Çommunication can become rocky when a person with a diagnosis expresses their rights in treatment. In treatment, it is the right of a patient to say their preference for the exercise and provision of care.

It has been my experience that practitioners can get hung up on how they do things, clinically speaking. Even more problematic, clinically speaking, everyone is quite different, and treatment should be person-centered. However, it seems as if theoretical example person ‘A’ may be getting too similar a treatment to person ‘B’ for very different disorders and presentation.

Clinicians must respect our rights; this should go without saying in mental health treatment. Expressing our needs may become a life or death situation for patients. When patients question the quality and provision of their care, it can create volatility.

When people feel that treatment is not going well and the therapist does not agree to change mental health treatment, this should be a red flag. It has been my experience that therapists can distort the severity of someone’s symptoms in their care when their motive is to retain their job as a therapist. I have seen this happen firsthand.

I think this is common due to the origins of mental health treatment. In psychoanalysis, the responsibility is given to the therapist to have an absolute understanding of the workings of a patient’s mind. In my opinion, this power differential helped give birth to the hegemony within the psychiatric profession. Finally, in the 1960s, mental health advocates began to question this hierarchy. Soon, the advent of patient rights came into being. I have learned that practitioners who call themselves peer specialists often betray their practice. They also often fall victim to a paradigm of teaching ‘learned’ helplessness.

Peer specialists especially should have respect for the position of a consumer. Taking on a superior attitude due to being a peer specialist runs contrary to standards of being a peer in the first place. Yet being with somebody, and thinking on their level, is essential in peer practice. However, before peer certification became the norm in New York State in 2015, empathic communication was more commonplace in peer agencies.

The hiring of peers may have to do with funding streams or simply because agencies get grants when they hire peers and get opportunities for other ‘reimbursable allowances’ having to do with money. Peers don’t require as much money as social workers when it comes to salary.

So I see the practice of hiring peers as being cheapened, and the real value is disappearing. Peers are overworked and don’t love their jobs anymore. While it is excellent that peers are more valued now than before, I see some themes remain the same between therapist practice and peer practice.

When it comes to peer practice in the future, it is essential to deeply examine the dynamics and the absolute authority present with therapists. Having volunteered at multiple peer agencies spanning my treatment, I feel this is critical as we move forward.

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