Taking Over the Asylum: Empowerment and Mental Health

By Marian Barnes and Ric Bowl.

Palgrave

£14.99

ISBN 0 333 74091 2

The title of this book greatly exaggerates the progress made by
people who use mental health services in their struggle for civil
rights, or even the right to respectful treatment within the
NHS.

The writers start with a discussion of the term “empowerment”
and related concepts, and from the first this shows itself to be an
outsider account.

In the description of the development of the mental health
system survivor movement, important early leadership roles such as
those of Peter Campbell of Survivors Speak Out and Jan Wallcraft of
Mindlink are ignored.

The major developments of self-help and self-management
techniques are barely represented. Important internal discussions,
such as those about the relationship of the survivor movement with
the mainstream disabled people’s movement, are missing.

That said, there is much interesting description and analysis in
the book.

The authors cover policy and practice, noting the sometimes
cynical use of the ‘user card’ by managers and the government.
Discussion of women’s issues also has an outsider flavour, missing
some vibrant strands of women’s action, especially in the sphere of
anti-ECT campaigning. Barnes and Bowl accurately point out that, in
common with the early days of the women’s liberation movement,
ethnic minority mental health service users are not sufficiently
included, either within most service user or survivor groups or in
‘consultations’ by service planners and providers. The book also
has a welcome non-London perspective.

The authors question the rationale of the attempt to graft “user
involvement” onto existing institutions based on the paternalist
medical model. The book concludes that there is little partnership
working between service planners and providers and service users
that has led to real change in mental health organisations in the
UK.

This book relies heavily on academic literature – largely
ignoring the vast literature within the mental health service user
and survivor movement. In a discussion of whether these groups
constitute a new social movement, this is more than an oversight.
Once again, mental health service users are treated as passive
objects. While an outsider account that assesses all the available
evidence would be welcome, this is not it.

Vivien Lindow is an independent consultant and
researcher, and a survivor of the mental health
system.