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The Power of the Prosumer

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I will always remember this short exchange between myself and a big wig. This big wig was what I call a clinician-craft in the system of care. The clinician craft worked for a local mental health agency assigned to my case.

‘You’re not easy to serve,’ the director of care management said. ‘What? What does that even mean?’ I asked the director at the agency, one of the big five mental health agencies in the county.

‘You’re different. You’re high functioning…’ My mental health worker said inappropriately, but unabashedly. 

The worker wrote me off!

I am a prosumer. Thinking back, it has been a long, long road. I’ve experienced mood disorder, depression, and anxiety since I was a teenager. I’ve had half a dozen experiences attempting suicide. Since then, I’ve graduated to full bloom psychosis, schizophrenia, and hospitalisation after hospitalisation – state, local, and everything. I’ve experienced recovery in my terms, more education, licensure, and practice within the same system that treated me throughout my years in the order.

Many activists in mental health reform have changed the system for the better through their years of advocacy, hard work, blood, and tears. Their lives were at risk, and the fruits have been born. The story of my mental health disorder, and the tenure of my recovery, weren’t depicted in the film One Flew Over the Cuckoo’s Nest.

First diagnosed with a significant mental health disorder as a teenager, I wrote a little synopsis of my life. Re-named Randal McMurphy, seeing myself as some character similar to Kubrick’s depiction of the mental health system in the Cuckoo’s nest film. But I was young, naive, a teenager. I had no idea so many people worked so hard, so that wasn’t my experience in the system. My uncle, my aunt, their reality was different. They were inwards, so deplorable Heraldo would have loved to do an exposé. My ward in the state hospital. Well, let me tell you something.

Big screen television, computer room, we had the works! The state hospital I was in had some high technology, not to mention a first-class lounging area to relax. 

I wasn’t chained to a twin bed on a metal frame in a warehouse. Today, I have a job. I am happy, and I am a good advocate. I am also an enemy of the mental health system; the people around me fear me. I am not talking about the system’s operants or the powers that be in the operation of care.

Let me tell you who I am talking about so roundaboutly. The people I am describing serve the same folks I do as a therapist and as a peer. We even have the same goals, I hope, the end.

My knowledge and professional license couldn’t be more of a threat to the powers that be in the mental health movement. Reformers will say that I have ‘signed off’ on the system of repression.

Well, my interests or careerism are not in question. I have witnessed from both personal experience and professional, what works, what doesn’t, and have been a victim of a system of oppression.

This dual position also means I have bold ideas. Bright Ideas of what needs to happen, and what isn’t happening in the mental health system. What that looks like for people like me and those I serve in the mental health system.

My ‘arrogance’ is my knowledge. I am passionate about my ideas and their importance because I have seen what happens when putting into play and given air time. People thrive, diagnoses are understood as what they are, and the system shifts for the better that much further.

That director I quoted earlier has since been fired. My decision to air out the meeting’s transcript on social media helped with that, I am sure. This ‘crat’ director may have categorized me, stigmatised me, ‘othered’ me. Still, I also knew what she was doing from the moment the meeting left the station. After all, I knew her type.

I knew what she was doing in both clinical and non-clinical terms. I also knew, given my personal and professional experiences, how to disable and stop her bullshit in its tracks. In doing so, exacting not just catharsis but positive change. I knew how to make meaning where meaning was at odds with the very forces that sought to destroy its potential.

This potential is what I think is in crisis. The potential we prosumers have to change the system. I have talked a lot about the disjointed mental health movement. I have talked a lot about what I see needs to change and how to go about it. I have also seen what this can mean for people in real terms.

People with a covert plan have tried to use me in the same way so many peers and people with lived experience have been co-opted into the system of care. I will no longer let these folks derail and pollute my vision or the purposeful steps I take to bring people lightening speed knowledge. To truly change the system, we must pass through some trauma, so it does not accumulate and harm others.

My promise moving forward is to be my authentic self. I realise the risk to the mental health discourse when authenticity becomes an endangered species in the system – question why someone’s plan is at odds with mine. I will always bring the disparity to the public’s attention to decide.

The one thing I learned from the movement is learning the importance of choice, perspective, and doing what’s right and being allowed to do so without restriction. What makes us human? How can we bring humanity to the system and personal perspective of your situation and interests? 

What drives and defines my future work are identifying and eliminating people who continue to throw roadblocks in my recovery within the system. I am suggesting now, in very bold terms, that we look out for those that seek to eliminate our choices and restrict our freedoms doing so.

My voice matters! Our voices matter. I will no longer let the infighting, the camps, and the polarities of this movement hinder me and derail progress in their tracks. 

The mental health movement is too valuable, and its potential to do real justice in spaces of supreme injustice, and make what is so wrong, right. People like this director or ‘clinician crat’ are now more disabling than ever.

I promise to make you crat’s increasingly visible as time unfolds. Your cheap, dangerous facade will be the next step for reformers to dismantle as the real crisis in mental health.


This article was originally published in Mental Health Affairs.


Image credit: Freepik

Max E. Guttman, LCSW  is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.


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