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A Fragile Revolution

Consumers and Psychiatric Survivors Confront the Power of the Mental Health System

By Barbara Everett
Subjects Psychology, Political Science, Medical
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Paperback : 9780889203426, 263 pages, January 2006

Table of contents

Table of Contents for
A Fragile Revolution: Consumers and Psychiatric Survivors Confront the Power of the Mental Health System by Barbara Everett



The research questions

A word about methodology

Some caveats

1. Nothing changes and no one gets better

Becoming a professional helper

What is mental illness?

Help for the patients

Nothing changes and no one gets better

Control battles

Who’s in charge of the staff?

Helpless and hopeless

In conclusion

2. From insanity to mental illness to psychiatric disability


Mental illness

Anti-psychiatric thought and feminist criticism

The therapeutic community


Psychiatric disability

In conclusion

3. Power and protest

Power inequity and oppression


For your own good

Power as protest


Power as a contractual relationship

New social movements

Personal empowerment and social action

When things go wrong

In conclusion

4. A new power contract?


Another group of partners

The making of policy

The forgotten partners

In conclusion

5. A special bond

Telling stories

Four stories

Sadly mistaken

A special bond

The personal becomes political

In conclusion

6. Them


They hate emotion

It’s just a job

They are abusive

But they’re more like us than they think

The system

In conclusion

7. Us

Getting involved

Is this a social movement

Consumer? Survivor? Consumer\survivor? Or just a person?

When some of “us” joined “them”

The Ontario Psychiatric Survivors Alliance

In conclusion

8. Partnership

The threat and the promise of partnership

The problems with partnership

The personal costs

Feeling used

If it’s not partnership, what is it?

Will mental health reform work?

In conclusion

9. What do consumers and survivors believe in?

It’s a chicken or egg thing

What needs to change?

What are consumers and survivors going to do about it?

Disability rights

In conclusion

10. Final thoughts and understandings

So, what’s it all about?

A legacy of violence

The power of powerless people

The powerlessness of powerful people

Things change and people get better

A political identity in search of a future

In conclusion


Appendix I. Research methodology

Sample selection

A global view of the respondents

Data collection techniques and sources

Data analysis




Despite two centuries and three major reform movements, mental patients have remained on the outside of the mainstream of society, often living in poverty and violence. Today we are undergoing yet another period of reform and, in a historical first, ex-mental patients, now calling themselves consumers and psychiatric survivors, have been recruited in record numbers by the Ontario government to participate in the change process.

A Fragile Revolution investigates the complex relationship between ex-mental patients, the government, the mental health system, and mental health professionals. It also explores how the recent changes in policy have affected that relationship, creating new tensions and new opportunities.

Using qualitative interviews with prominent consumer and survivor activists, Everett examines how consumers and survivors define themselves, how they define mental illness, and how their personal experience has been translated into political action.

While it is clear that consumers and survivors have affected the rhetoric of reform, they know that words do not equal action. As they struggle to develop their own separate advocacy agenda, they acknowledge that theirs is a fragile revolution, but one that is here to stay.


Everett is a professional. She has worked in institutional and agency settings and has a valid take on the nature of power and powerlessness, control and being controlled. ... Quotations from consumer/survivors make the book come alive. ... Everett has done a good service to professionals and clients alike.

- Pat Capponi, The Journal of Addiction and Mental Health, Vol. 4 #4, July/August 2001

[As] a worker in the mental health field. ..[it] was gratifying to see my lived experience described in a cohesive way within a theoretical framework that helped me understand my professional experiences at a deeper level. ... The author's ability to integrate the historical context of mental health reform with the experiences of consumers/survivors, the viewpoints of family members, and the perspectives of professionals is both exceptional and sensitively done. I highly recommend this book for anyone coming in contact with the mental health system--consumers/survivors, family members, mental health professionals, and students who are plannng to enter the field of mental health.

- Ru Tauro, Canadian Journal of Community Mental Health, Vol. 21 #1, Spring 2002

The initial section on the history of the consumer movement is excellent. ... Everett's discussions about `partnership,' about the different meaning behind the terms `consumer' and `survivor,' and about possible retaliation against consumer activists are all excellent and important. Her description of the failure of well-funded consumer groups is illuminating. ... The discussion about whether consumer-survivors can participate without being co-opted is worth the price of the entire book. ... I finished the book wanting to phone the author and continue the discussion, to argue with her and to agree with her.

- Ronald J. Diamond, Psychiatric Services, Vol. 52, #39, September 2001

The major sources of information for Everett's study were consumers and psychiatric survivors and those involved in providing services to this group. In-depth interviews yielded striking stories of pain and heroism as people sought help from a system with limited help to give. ... Everett['s]., a powerful examination of the mental health system from the inside, presents a strong case for continued reform in the system.

- Robert B. MacIntyre, Canadian Book Review Annual, 2000

A Fragile Revolution demonstrates quite unequivocally, a first-rate strategic thinker, competent analyst, and elegant literary stylist. ... This is the book you give to non-academic Psych Industry Workers for their `own short course in what the antipsychiatry movement is all about. ... A major contribution and a must-read for anyone concerned with Canadian mental health policy making and development.

- Byron Fraser, In a Nutshell, Winter/Spring 2002