I first saw a list of stakeholders in a CMHS publication in the 90's. I counted 103 names, three consumer groups. I knew something was wrong with the picture and have felt silenced and invisible but not sure just why. At this meeting, I realized this supposed collaboration isn’t the model! Consumers aren’t one of many, now at the table, but perceived as only a piece of the many interests.

I think that’s not the framework. I think the model is the natural social tension between individual autonomy and group good. Various systems value the one over the other, from anarchy to dictatorship.

What’s wrong with how mental health issues are presented is that the individual wishes are folded into the group issues, one stakeholder among many. The proper model is of only two major stakeholders, the individual and the group, so that at any meeting there will be as many speaking for the individual (this will be consumers; depending on the culture, families; and, for, a few, advocates) and for the group (this will included the myriad of social stakeholders, professional guilds, education, corrections, payers, ... ).

That’s a better fit, a transformative fit.