The mental health arena has not traditionally been associated with choice.  Typically, those with mental illness were treated, confined, hospitalized, marginalized - basically, we were treated as passive (or sometimes not so passive) objects of services.  There was no real hope of our lot in life changing.  We would be sponges on society for the rest of our "poor, miserable" lives.

This same view was put on those with cancer, or diabetes, or amputations.  They received services, yes, but they had the power to help make decisions on their treatments.  Does the cancer patient want chemo, radiation, both, or none?  Does the diabetic want to try diet and exercise, an oral medication, or insulin injections?  Does the amputee want to have a prosthesis or would they be happier without?  The doctors and other medical authorities certainly made their recommendations, but the patient had the final say in which facility they chose, which treatments they would accept, and how and when they would proceed.  Certainly, their insurance coverage or lack thereof probably guided some of those decisions, as did the recommendations of their caregivers (professional and other), but the decision still rested with them.

The tide has begun to change in Virginia.  Those who have been diagnosed with mental illness are now being seen as a partner in their own treatment.  They are asking questions about their diagnoses and the treatments available.  They are having frank discussions with their doctors and caregivers and those doctors and caregivers are listening.  Even our state government is listening - and asking - to and for our opinions on how we would like to see our treatments change.  That is the basis of transformation in this commonwealth.

Those with mental illness SHOULD be integral in the choice of their treatments.  Ultimately, we know ourselves and our bodies better than someone who sees us for 15 minutes once a month.  We know if a side effect is worth tolerating or whether it is not worth the improvement we see in our condition.  We SHOULD be integral in the choice of which facilities we use.  We SHOULD be integral in the choice of the programs at the facilities we use.  We are the customers. 

With the help and input of those with mental illness in Virginia, Virginia's mental health system can become one of the most highly sought-after systems in the country.  While the commonwealth did not rate highly in NAMI's 2006 Report Card of State Mental Health Programs, that doesn't mean we should give up.  Now we know where to focus our effort.  Let us walk together into that bright new day where mental illness is just like any other illness and those with mental illness are treated with the same respect and courtesy as any other person.