Beyond Binary Narratives of Mental Health Advocacy: Latent Profiles of Mental Health Activists and Advocates With Lived Experience

Psychiatr Serv. 2023 Feb 1;74(2):112-118. doi: 10.1176/appi.ps.20220078. Epub 2022 Jul 14.

Abstract

Objective: In this article, the authors used data from a national survey of mental health activists and advocates (MHAAs) with lived experience of psychiatric disabilities to investigate attitudes toward psychiatric care.

Methods: The authors distributed a survey, developed by a team led by researchers who were also service users, to both mainstream and more critical advocacy groups and networks (N=547 participants), and they analyzed the data by using latent class analysis (LCA). Four survey variables regarding beliefs about involuntary hospitalization, assisted outpatient treatment, medication, and diagnosis were used to generate latent subgroups. The authors explored associations between key survey variables and latent classes with chi-square tests and analysis of variance.

Results: LCA indicated an optimal six-class solution. The classes existed on a spectrum of positions, ranging from highly favorable views of traditional psychiatric practices to highly critical views, with classes in the middle representing distinct profiles of attitudes toward treatment and diagnosis. Significant between-group differences were found for participants' psychiatric treatment histories, motivations to engage in activism and advocacy, and views about mental health care and advocacy priorities.

Conclusions: Findings reveal considerable heterogeneity among MHAAs and challenge binary narratives of mental health advocacy.

Keywords: Attitudes toward involuntary treatment; Attitudes toward mental illness; Attitudes toward psychiatric medications; Participatory research; Patient advocacy; Sociopolitical issues.

MeSH terms

  • Attitude
  • Humans
  • Mental Disorders* / diagnosis
  • Mental Disorders* / therapy
  • Mental Health*
  • Surveys and Questionnaires