The evolution of the disability rights movement¹

 

Historically, the disability rights movement has consisted primarily of people with physical disabilities. Traditionally, people with psychiatric disorders stood apart from the larger disability rights community. Because of the disability rights movement's profound current impact on public policy and social awareness of all disabilities, mental health advocacy must be examined in the context of its evolution.

The disability rights movement in the U.S. developed slowly over the twentieth century. While some groups organized around a shared occupation related illness (e.g. miners with black lung disease), specific disability (e.g. The National Federation of the Blind) or other common ties (e.g. war veterans), the social isolation of many individuals with disabilities and their frequently low socioeconomic status hindered them from organizing.

Social changes which began in the 1960s inspired the vigorous growth of the disability rights movement. The movement embraced the values of equal opportunity and social integration advocated by people of color and women and appropriated the political activism of the civil rights, women's, and consumer movements. The concepts of self-determination and freedom of choice nurtured the idea of independent living. This model of coping with disability, in contrast to the medical dependence paradigm, provided a new framework for living with long-term disabilities.

Changes in the populations of people with disabilities in the U.S. also fostered the disability rights movement. Many adolescents and young adults joined the ranks of people with disabilities after the polio epidemic in the early 1950s and the Vietnam war in the 1960s and 1970s. More recently, an aging population and the relative increase in chronic medical illness have added to the number of people with disabilities. Medical and technological advances have lengthened life span and resulted in the survival of people with previously fatal diseases or congenital conditions. Discrimination, as opposed to physical impairment or personal attitude, has become an increasingly important issue in the lives of people with disabilities.

The recognition of discrimination as a key problem for people with disabilities fostered a sense of common identity which, in turn, furthered work in the public policy arena. Advocates documented discrimination and developed an arsenal of information which fueled their advocacy efforts. (See Figure 1, page 2)² The growing coalitions of people with psychiatric disabilities and their families share features with the broader disability rights movement, including social influences, an evolving sense of shared identity, and increasing involvement in public policy. Medical advances, such as deinstitutionalization and improved pharmacological treatment, have contributed to social and public policy trends. The civil rights and consumer movements of the 1960s and 1970s motivated some individuals with psychiatric disabilities, just as they motivated the larger disability rights movement, culminating in the passage of the Americans with Disabilities Act (ADA) in 1990. Beginning in the early 1970s, small groups of former patients fought against institutionalization and mental hospital