*Working in what is considered a “consumer” role, most people would assume that I identify as a “consumer”. But I don’t. Put simply, I just can’t identify with that term, and to be honest I feel the same way when it comes to alternatives such as “service-user”.
I choose instead to identify as a person.
I’ve had experiences in my life that have lead me to work in the mental health and addictions sector. These experiences probably enable me to work in this sector more effectively, because I bring personal knowledge as well as professional knowledge to my work. I don’t feel that I should need to share those life experiences to prove my validity as a humanitarian and as an asset to the community sector. I’m a person – a person with a strong sense of social justice and who believes that all human beings should be free from harm and treated with fairness and respect.
The History of the term “Consumer”
The term “consumer” came out of the psychiatric survivor’s movement in the 1970’s. At the time it was seen as a term of empowerment. It asserted that those accessing mental health services could have a say in what services they wanted to use.
This is all very well, except that I feel like the choices that people have in the mental health system are still really limited and focus predominantly on a bio-medical, Pakeha approach. And that the “treatment” paths offered to people still fall short of choice outside of choice around what medication you would like prescribed to you.
So have we truly reached full “consumer” status yet? I would argue that we haven’t. But is this is a good goal anyway? Sometimes I feel more excited about moving towards the goal of genuine partnership, rather than focusing on the particular labels we use.
I would also argue that the labels we often employ to describe people who have accessed mental health and addictions services can be irrelevant for many people, including those that use the services. That isn’t to say that these labels aren’t helpful for some people, but that we should have opportunity to self-identify rather than have labels imposed upon us.
What is wrong with using the term consumer?
Consumerism: The word consumer makes me think about shopping. Shopping and consumerism. Things that might make us feel instantly happy, but that can have a negative effect on our pockets. Shopping and consumerism can also be bad for our health, our families, and our sense of self.
Drugs: Before I started working in the sector I didn’t know that the word “consumer” existed in this particular context. And when I did find out that it existed, it confused me. Service-user also confused me. User makes me think of drugs. Users and consumers of drugs, (whether prescription or illicit) – are these really the terms we want to be using when we are trying to work within a framework of social inclusion and empowerment?
Social Exclusion: “Consumer” is a term that, in this context, is only used in the mental health and addictions sector and I feel that this use of insular terminology may be preventing us from reaching goals that we strive toward: social inclusion, acceptance, understanding, autonomy, and aroha.
Labels: “Consumer” is a label imposed by others. Those new to mental health and addictions services may now have this label placed on them, (albeit a label that is supposed to be of empowerment, but a label nonetheless). Labels are often used to other certain groups of people. This labelling and othering leads to discrimination and an idea that some are less human than others. I for one believe we are all human and should be treated thus.
Protectionism and competition: I can’t help but feel that the protection and policing of these labels within the sector can actually work to our disadvantage. Some may have a pretty narrow view of what a “consumer” is. Some people seem to believe that you need to have accessed a particular level of services in order to be a “true and authentic consumer”. For example, you need to have been in an inpatient unit, or been under the Mental Health Act in order to be considered a real “consumer”. But what about all of those people that have either not been able to access services because there are no services available to them? And what about all of those people who have simply been too frightened to access services and have managed to get through without clinical support? Are their experiences of trauma and stress less valid than others? I don’t believe their experiences are less valid. I just wish there were more services that were better funded and that were less scary to access so that people felt ok about getting support when they needed it.
Reinforcing hierarchies: Labels such as the ones mentioned mean that those people in positions of power, e.g. psychiatrists, maintain their position of power and are allowed to remain the authority on things as personal to us as our health and well being. It is my belief that we are each authorities on our own wellness and that we should be in a position of partnership with clinicians and other service providers.
But what about our identity?
Of course there are positive aspects to having a term that we can all identify with. It gives people a sense of community. It can provide one with a sense of identity within our communities. It brings people together to advocate toward common goals. It generally makes it easier so that we can fit into a box or a category in order to explain who we are and what we are about.
I’m not advocating for loss of identity. I’m advocating for a stronger sense of self and of the multi-faceted human beings that we are. We can’t simply squeeze a whole group of people into a box anyway and say that we are all the same. We’re not. Even if we can tick the “consumer” box we are all still so different. So does this box therefore become irrelevant, perhaps?
What is the perfect term to use?
There is no perfect term and there never will be as far as I am concerned. The important thing to keep in mind here, I believe, is self-identification. Until we allow people the space to be able to self-identify, rather than have a term applied to us on our behalf, we will not be working to our fullest potential, collectively or individually. Labeling people, and policing those labels, works against the movement of rights and empowerment that we are all hopefully working within.
What can we do?
I look to other movements and can’t help but feel that we have things to learn from them. Take, for example, the queer movement. I read a couple of weeks ago, that some advocates were pushing for a more inclusive term to describe communities, GSD (Gender and Sexual Diversities), to replace LGBT as the common umbrella term. I personally think this is great. However, I’m sure that some individuals in GSD communities probably disagree, as there is never going to be one blanket term that everyone is going to be happy with, but, at least there is widespread discussion happening and this pushes people to be self-reflective and to continue to grow and change the movement.
I believe we need more conversations and more flexibility in the terms we use about ourselves and other people. We need to respect self-identification. We need to be respectful of the histories of these terms, and seek to move forward by bringing more people alongside us. We need to work towards genuine partnership between client and clinician. We need to recognise that we are all human and that we all have mental health that needs to be nourished and protected by systems and by our family, whanau, friends, and peers.
I’d like to see more conversations happening in the “consumer”/”service-user”/”tangata whaiora” movement. The more conversations we can have on these matters the more we are able to tease out our commonalities as well as our differences as survivors, as tangata whaiora, as consumers, as users, as humans.
*What is the C Word? This is a blog about social (in)justice and mental (ill)health. The writers will scrutinize a range of c-words, with the aim of exploring connections between socio-political issues and a wider concept of health. We hope to move away from a binary of mind versus body, to show that there is not simply “mental health” and “physical health,” and that our health (collectively and individually) cannot be isolated from the environmental, spiritual, historical, and socio-political contexts in which we live.
The C Word is written by a group of diverse individuals who wish to comment and express their views of the wider concepts of health and socio-political issues they see as relevant to health, human rights, and diversity.
The opinions and contents of the C-Word blog do not necessarily represent the views and opinions of Changing Minds, or anyone associated with the organisation.