In 1998 Diane McDiarmid, then the director of training at the University of Kansas School of Social Welfare, heard Daniel Fisher, M.D., co-director of the National Empowerment Center, speak about the importance of promoting hope and recovery for consumers. "My colleagues and I were so inspired, we decided we had to put those ideas into practice," she said.

They formed a group that spent the following year methodically exploring ways to empower mental health care consumers through the provision of educational opportunities. There were only a few models to guide them in developing the idea they came up with—to offer training for employment in the human services field (Psychiatric News, October 5).

So the group turned to findings about supportive employment programs to help them with their effort at supportive education. The program that resulted, Consumers as Providers (CAP), is structured to "build hardiness," as well as help consumers develop the knowledge and skills they need to be effective service providers, according to McDiarmid.

Requirements for the program increase gradually, and participants always have a great deal of help, both formal and informal, from CAP program staff as they complete those requirements.

During the first month of the 15-week program, participants spend three hours in class and three hours in a group-supervision format each week. During the second month, the total number of hours rises to eight. Case managers meet on a one-to-one basis with each participant at least twice a month.

Even the selection process proceeds at a deliberative pace. Potential enrollees are invited to an informational meeting where applications are circulated. But staff insist that consumers think about their decision for at least a month, complete applications, write an essay about the reasons why they want to be in the program, and participate in an interview.

Eligibility requires at least a GED, a diagnosis of severe and persistent mental illness, and history of participation in state-funded community support services.

McDiarmid said, "When the students first come to class, they are so compliant. But within two to three weeks, they’ve got their hands on their hips and are challenging what we have to say. It’s terrific to see their transformations. After all, that kind of questioning is part of the educational process."

Anna E. Collins, an instructor in the program, attributes many of the changes to the fact that the participants begin to regard themselves as students rather than as consumers. They start to dress differently and to think of themselves as future professionals. The first group of classes took place at the University of Kansas, and the program has expanded to nine other sites.

After five or six weeks of classes, each participant begins an internship at a social service agency, initially for eight hours a week and later for 16 hours. That aspect of the program posed its own challenges. McDiarmid knew that many professionals would be reluctant to hire consumers as mental health practitioners or even to allow them to serve as interns.

She convened a two-day meeting of consumers and various other stakeholders in the program. "Staff at the mental health agencies were worried about role confusion for the consumers and about dual relationships if a consumer worked in an agency where she or he was also a client," she said. "The staff were even concerned about losing their professional licenses issued by the Kansas Behavioral Science and Regulatory Board (BSRB)."

McDiarmid responded to the legal concerns by getting a formal ruling from the BSRB that students could intern or work in mental health agencies as long as their rights as consumers were protected. Education and experience with CAP interns have been her most effective tools in persuading staff of mental health agencies that consumers can contribute to service delivery.

"The internships have started to change the organizational culture," McDiarmid said. "Consumers are part of team meetings at agencies. They can offer excellent ideas about the resources consumers need. And staff become more aware of their language and assumptions about consumers."

Jan Hanson, who graduated from CAP last December, has found herself becoming a role model for other consumers. As peer-support coordinator at Johnson County Mental Health Agency in Kansas, she supervises 10 peer-support providers. "Consumers come up to me and say, ‘I’m glad you’re doing such a great job. That’s what I want to do,’ " she said. For herself, she said, the job gives her a "reason to get up out of bed in the morning."

No job guarantees are offered by the staff, but graduates frequently end up with paid employment in attendant care, according to McDiarmid. That term refers to state-funded positions in which the attendant works one to one with a consumer to help implement goals that have been developed with the help of a case manager.

As of May, 124 consumers had applied to the program. One hundred and three of them were interviewed, and 95 of those were selected. Sixty-seven students graduated. Thirty-four students found paid employment following the class, and seven students enrolled in postsecondary education.

More information on Consumers as Providers is available by calling (877) 458-6804. ▪