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knowledge and professional interaction with consumers.

Simon Davis.  Vancouver Community Mental Health Services, and Social Work and Family Studies, University of British Columbia

The “Recovery” Vision and Risk-Aversion in Psychiatric Service Delivery: Thoughts on the Reconciliation of Competing Perspectives

Currently in North America reference is being made to a “recovery” vision in the delivery of mental health services. This is a model that would emphasize holistic care and collaboration; autonomy, empowerment and risk-taking among service recipients; and a hopeful attitude among service providers. There are a number of barriers to implementation of this vision, including a tradition of medical paternalism, and a corporate culture that is “risk-averse.” This presentation (i) gives a history and explication of the “recovery” concept, (ii) reports on data from a study of system “recovery fidelity,” and (iii) speaks to a possible reconciliation of risk aversion and empowerment in service delivery.

Ana Stefancic. Sociomedical Sciences, Mailman School of Public Health, Columbia University

The Role of Non-Profit Social Service Agencies in Enhancing Citizenship for Persons with Psychiatric Disabilities

Persons with severe mental illness, particularly those who experience homelessness, encounter multiple obstacles to enhancing their citizenship, with citizenship understood both as membership status and participatory process. Within public mental health, service agencies are increasingly expected to help advance consumers’ goals of social integration and citizenship. This presentation suggests how agencies and services may be restructured so that “program citizenship” can serve as a path to full citizenship as opposed to a marginalized alternative. Agencies can assist consumers to achieve participatory parity (Fraser, 2003) by facilitating access to resources, developing individual capacities, connecting consumers to venues in which those abilities can be exercised, and engaging in advocacy and community development. As such, participation and citizenship can be enhanced in four domains: 1) individual services; 2) agency operations; 3) the mental health treatment system; and 4) social, civic and political realms. Janoski’s (1998) model of citizenship and a Capabilities approach to disability (Mitra, 2006; Hopper, 2007) will inform the presentation. A Housing First program that provides independent housing and consumer-driven services without treatment prerequisites will be used to provide concrete examples of such efforts and potential barriers.

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