Questions, Concerns and Speaking Up

Many times in the course of receiving mental health care, an individual may feel like things are not going well, or that they are not receiving the treatment that is most beneficial. However, those same individuals may feel like they are unable to question the mental health professionals who are treating them. Additionally, a person may not have the energy or desire to take steps to demand better care and will go along with whatever treatment that they are receiving. This is especially true in the beginning stages of diagnosis and recovery. However, no one knows themselves better than the patient and research has shown that while some providers may be resistant to listening to patient concerns this does not mean that those individuals should not continue to attempt to have their voices heard.

Self Advocacy

Rogers, Chamberlain, Ellison, and Crean (1997) define self-advocacy as empowerment and note that this is often seen in a negative light as a “buzz-word” in the field but state that this should not discourage caregivers and treatment providers from encouraging it in patients. They give some definitions of what empowerment can look like for the individual. It can include making choices and decisions regarding treatment, having access to mental health education, understanding their rights and feeling a part of a supportive group. Sometimes, treatment can feel like something being imposed instead of a collaborative effort between provider and patient. This is not uncommon as providers may convey the attitude that they know best and that the patient should follow treatment recommendations without questions.

Outside Advocates and Family Members

Some mental health care consumers are better equipped to advocate for themselves in the treatment process. This may be due to cognitive ability, severity of mental health diagnosis, and generally personality. Many people are not aware that it is okay to speak up when they know that something is wrong or not working. In the case that an individual cannot or will not advocate for themselves, there are other resources available in mental health advocacy. This may include community advocates, or family members who can be involved in the process. Beal (2001), points out that it is important to rethink what empowerment means and that sometimes it needs to happen at the policy level. Consumers can have a voice at this level as well. Mental health advocacy groups are often very interested in having people with mental health concerns participate in action in these groups. A simple search on the Internet can often give a list of groups such as these.

When participating in an advocacy or policy change action, a receiver of mental health treatment will often be more involved in their own treatment, and may receive education about further steps that they can take to better care. Evans, and McGaha (1998) review one way in which patients and their families have engaged in this opportunity. This was done by participating in a survey process to help researchers better understand how to encourage advocacy. They received information that indicated that it is valuable to the field of mental health treatment for consumers and caretakers to have their voices heard regarding what they might need and how services can be improved.

Not Every Professional is a Good Fit.

The nature of mental health issues is that many times professionals rely on self-report in order to provide treatment options. If a patient is uncomfortable with a provider, the first step is to find someone else to provide services with whom they are comfortable having a dialogue with. Consumers should have some idea of what outcomes they are looking for and to make those clear at the beginning. There may be a need to negotiate those expectations as they may not be realistic, but in all cases, the patient should feel that they are being heard. If a medication is causing too many difficult side effects, they should report that, if a therapist is not seen as being helpful in providing counseling, a different counselor may be needed. It is important that recipients of mental health services are aware that nothing is owed to a provider, and that seeking out someone else is okay.  Many times, patients have to pay considerable amounts of money for the treatment that they receive and receiving the best treatment should be an expectation. Not every professional is a good fit.

Finding Your Voice

Patients should feel encouraged to research a treatment provider before using their services whenever possible. Word of mouth is often the best course of action, but online information is also available with reviews of providers and descriptions of their approaches to treatment. Even if a provider is chosen, at any time during treatment, it is perfectly normal for a patient to feel that things are not going well, and to switch to someone else. In any case, if a patient is receiving care that is not meeting their needs, giving up on treatment should not be part of the consideration. Continuity of care is important in recovery, and while frustration can be common, there is usually a provider available to meet the specific need of that patient. Care should be considered a partnership.

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Beal, G. (2001). Shifting the paradigm in community mental health: Towards empowerment and community. Canadian Psychology, 42(4), 315-316.

Evans, C. J., & McGaha, A. C. (1998). A survey of mental health consumers' and family members' involvement in advocacy. Community Mental Health Journal, 34(6), 615-23.

Rogers, S., Chamberlin, J., Ellison, M., Crean, T. (1997). A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatric Services, 48(8), 1042-1047.

About the Author

Cathy England, MA

Cathy holds a Master’s degree in Psychology and has 13 years of work experience in counseling and social work. Cathy is an advocate for mental health awareness and enjoys educating people about mental health and the ways that it impacts people and communities. Most of her experience has been in work with court dependent or delinquent adolescents and their families. Cathy has also worked as a volunteer as a Court Appointed Special Advocate (CASA) for children under court supervision.

Professional Website: crawfordcasa.org