The myth of representation: The case for consumer leadership

Abstract Australian government policy now embodies a clear expectation that consumers should be participants in all aspects of mental health services. A number of barriers have been identified as inhibiting the realisation of this goal, with the negative attitudes of professional staff being recognised as a major factor. A more pervasive barrier with the potential to minimise the positive developments in consumer participation is the issue of representation. It has been claimed that consumers who are actively involved in participatory roles are not necessarily representative of the broader population of mental health consumers. The paucity of literature makes this argument difficult to either defend or refute, although there is limited research evidence to suggest that the views of active consumers may indeed be similar to those who do not choose to have involvement. The aim of this paper is to consider the implications of engaging in debate about the extent to which consumer advocates might represent a broader group. In particular the potential consequences of this argument include: silencing activism; questioning the legitimacy of consumer roles; and, discriminatory expectations of consumers. These issues are discussed with the aim of establishing the need to use the term consumer leadership to describe participation which is aimed at the systemic level.