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ABSTRACT: Developing consumer-oriented programs for rural areas presents a major challenge for practitioners and policy makers. The mental health consumer movement, a successful urban creation, has yet to fully impact rural practice and be of benefit to individuals with severe and persistent mental illness. Rural mental health professionals face unique challenges and opportunities in utilizing rural strengths to foster consumer participation in the design and implementation of service delivery. The authors address the unique barriers facing rural communities and propose a selfhelp model as a service delivery alternative.
INTRODUCTION
A significant portion of individuals with severe and persistent mental illnesses live in rural areas (Sullivan, Jackson & Spritzer, 1996) yet programs to serve this population historically have neglected inclusion of consumers in the design and implementation of mental health services. While urban-based service delivery systems have embraced mental health consumer organizations in both policy design and practice, rural service delivery appears to be lagging behind in seriously including such organizations in designing consumer-oriented programs (Wagenfeld, et al., 1994). Despite the growing political influence of nationally recognized consumer groups, rural mental health service delivery has yet to be impacted. Due to the unique characteristics of rural areas, most human service programs do not rely upon organized consumer groups for input which complicates efforts for full inclusion of consumers at the micro and macro levels. But given the great strides made at the local, state and national levels by mental health advocacy groups and the fact people with severe and persistent mental illness do live in rural areas, greater attention must be focused on the rural dimension of this movement's potential.
The organized consumer movement started and flourished in urban areas yet it has not made an impact on or upon the delivery of rural mental health services due in part, to the unique problems faced by practitioners and the people with whom they work. Unique barriers exist in developing consumer-based programs and a gap in the literature exists directly studying the rural component to this influential movement. The dearth of research studying the rural consumer movement presents challenges and opportunities for rural practitioners, policy makers and advocates. This paper examines the consumer movement and the unique problems faced by rural communities in enhancing services to...