Self-Determination for people with psychiatric disabilities requires one key ingredient: RECOVERY.

Recovery is the experience of balance after having been involved with symptoms of a psychiatric disability. It is not the elimination of a disorder, but a heightened awareness, ability and desire to participate in life.

The five principles of self-determination* are: freedom, authority, support, responsibility and confirmation.

For people living with psychiatric disabilities, self-determination means the freedom to decide how one wants to live his or her life without negative outside influence. This includes choices such as where to live and with whom to associate. A person-centered plan is step one toward freedom.

Self-determination also means freedom from control measures such as coercive treatment, non-consumer-directed services, restricted involvement in society, discriminative law enforcement and stigma. Through many of these, self-determination is not possible.  

Authority means control over one’s life, including goals and finances. Authority means the opportunity for self-sufficiency via income generation, whether by employment or business ownership – to supplement public funding. Where state or local funding is concerned, such as that for psychiatric services, one chooses providers and has medication options. Disclosure and advanced directives are other examples of authority.

Support is the organization of resources in ways that are life-enhancing and meaningful to the individual. Peer-to-peer support and consumer-directed services are proven avenues for support. Planning teams may also be formed to support goals being met. Enhancement of self-esteem and self-efficacy are by-products of such support.

Responsibility in recovery requires self-management, leadership training, and crisis planning. Responsibility also includes the recognition of the contribution people with disabilities can make in their communities through activities such as volunteerism.

Confirmation is the important role that the self-advocate must play in a system that promotes self-determination for people with psychiatric disabilities. This may include advocacy, political activism or other expressions. It is very much about improving choice for self and others.

The Center for Self-Determination, Tom Nerney and Patricia Carver, 2004

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