The relationship between self-help and providers in mental health is sometimes ambiguous. In this paper, the authors describe a selfhelp initiative developed through collaboration among consumers and providers. The five-stage model describes how consumers and providers change together in developing a permanent and effective self help community. The model has been implemented in a state psychiatric hospital, a social rehabilitation day program, and a transitional residential facility. We describe the implementation process in these three settings and examine its strengths and limitations.The relationship between providers and consumers1 in the self-help movement is a topic of concern in the mental health system. Providers see self-help as a cost effective way to provide social support for individuals who have long-term disabling conditions. However, many professionals remain concerned that the consumer self-help movement will undermine professional care by encouraging rebellion, noncompliance, and deterioration among an already severely debilitated group of persons. Among consumers of mental health services, there is skepticism about the abilities of 1 Writers in the self-help movement in mental health have yet to develop a consensus as to terminology. In this paper, we use the word "consumer" to designate all individuals who regard themselves or are regarded by others as "patients", "clients", or survivors of the system of professional mental health care. The term "member" refers to people who participate in self-help activities. For the most part, these individuals have undergone some period of hospitalization in a psychiatric facility. Many have ongoing, if intermittent, contact with providers in outpatient mental health agencies. The term "consumer" is preferred because it implies freedom of choice in the use of professional services, despite the reality that many mental health consumers are force-fed.

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This study presents the perceptions of a sample of homeless people, living on the streets, in Allegheny County, Pennsylvania. Questions were asked that elicited their opinions about drug addiction, housing and treatment needs. Two-thirds of the 225 persons interviewed in 2000 and 2001 reported that they were not eligible for treatment or housing. Forty-two percent of those who received treatment for substance use disorders reported that their treatment was ineffective because aftercare and residential supports were not available to them. The major findings of this study were: That service eligibility requirements were a barrier to adequate care; and that more homeless persons would consider treatment if housing placement was part of the continuum of services.