More responsibility, less control: psychiatric survivors and Welfare State restructuring

This paper is concerned with the implications of recent Welfare State restructuring for psychiatric survivors' citizenship status. Using the Province of Ontario as a case study, the paper examines the extent to which recent change in mental health care and social assistance programs has worked to facilitate or constrain survivors' ability to exercise control over their lives. Despite recognition of the importance of survivors' participation in the mental health care system in the late 1980s, recent years have seen a return to a more traditional treatment paradigm characterized by professional control. Concurrently, restructuring of social assistance programs has led to a decline in the real value of income supports and growing pressure on informal support networks. As a result, psychiatric survivors are increasingly held responsible for their own material well-being and public conduct, but are less able to exercise control within everyday life.