"Self determination refers to the right of individuals to have full power over their lives, encompassing concepts that are central to existence in a democratic society, including freedom of choice, civil rights, independence, and self direction" (Cook &  Jonikas, 2000).  What this means is that if you lack self determination, it is not a fault in yourself.  You have the right to make your own choices and no one has the right to deny that from you.  We empower you to make those decisions, have opinions, and direct your own life.

So, what is the first step? 

First, you have to accept that you are indeed capable of making those choices for yourself.  It doesn't mean you have to do so alone, you do have a support system that will help you make your choices, but the choice is yours.  Now, doesn't that give you a sense of relief? 

Next, once a decision is made, you need to find a way to make incremental steps toward that goal.  And indeed, goal is a great way to look at this.  Everyone has his or her "own place".  "Virtually all persons can work in meaningful employment and/or produce income through the development of microenterprises." (Nerney, 2005.)  No one's goal is to be non-productive; it is finding a place that allows us to fulfill our goal to be productive that is sometimes so difficult.  Sometimes it may seem that our illness is an insurmountable obstacle to ever holding down a job, much less finding a career.

Perhaps you have always wanted to be monetarily self-sufficient.  In order to do that, you need an income.  Let's re-read that sentence...."you need an income."  Somehow, that isn't quite the same as having a job, is it?  We aren't expecting you to go out and become the CEO of some huge corporation right away, if ever.  Maybe your goal should be a bit smaller, after all, this may be new territory.

What if the issue is with your mental health provider?

Remember that you hired them.  They work for you.  You have the right to manage your own life.  They are there as an advisor.  The should be working WITH you toward recovery. not pREACHing to you.  Here are some suggestions from the "Self-Determination Series" (Peterson, Jonikas, Cook and Priester, 2003.)

When you are ready to have a difficult conversation with a provider, you should try to do the following things:

• Have the discussion during a scheduled meeting
• Speak in respectful, calm and neutral tones
• Focus on how you feel, not on what you think the provider feels
• Spend 10% of your time on the problem, and 90% on the solution
• Realize that it may take several meetings to come to an agreement
• Have your final agreement put into your treatment plan or in writing
• Ask a family member, friend, or advocate to attend the meeting(s) with you, if that will give you more confidence

Resources:

1. Cook, J.A. & Jonikas, J. A (2002).  Self-determination among mental health peers/survivors: Using lessons from the past to guide the future.  Journal of Disability Policy Studies, 13(2), 87-95.
2. Nerney, T. (2005). "Communicating Self-Determination: Freedom, Authority, Support and Responsibility", http://www.self-determination.com/publications/toolsprint.html, (May, 2005), paragraph 5.
3. Peterson, Cook, Jonikas, & Priester (2003.) Self-Determination Series, University of Illinois at Chicago, p.3.