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Book Review   |    
Kraig J. Knudsen
Psychiatric Services 2007; doi:
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by Donald M. Linhorst; New York, Oxford University Press, 2005, 368 pages, $39.95

Dr. Knudsen is a mental health services researcher with the Office of Program Evaluation and Research, Ohio Department of Mental Health, Columbus.

Since the advent of the consumer movement in mental health, empowerment has been a popular term used to symbolize one component of consumer-driven care. Today, when recovery from mental illness is a reality for many people, mental health professionals still do not have an understanding of recovery and the tools necessary to assist persons with mental illness in this journey. Much of the available literature on empowerment is conceptual and does not provide useful information that can be translated into practice with persons with severe mental illness. Donald Linhorst's book is different. Empowering People With Severe Mental Illness is the first book to provide a step-by-step approach to empowering mental health consumers. Clinicians, policy makers, planners, mental health administrators, and students will find practical and evidence-based strategies to transform their services from traditional patriarchal mental health care to a collaborative, consumer-driven model.

Dr. Linhorst, an associate professor of social work at St. Louis University with 13 years of practice experience, defines the process of empowerment as "that which prepares people to participate more effectively in an activity that increases their power, control, or influence." The book's first four chapters provide the background and conceptualization for the rest of the book. They summarize the basic elements of empowerment, provide an understanding of the history of powerlessness among persons with mental illness, and carefully present a framework of conditions necessary for empowerment. The remaining chapters focus on applying this framework to treatment planning, housing, organizational decision making, planning and policy making, employment, research, and consumer-driven service provision. Each of these chapters provides a comprehensive overview of the topic and uses research evidence when appropriate. Throughout these chapters, Dr. Linhorst, like a good educator, provides concrete examples of empowerment through his own work in community and hospital settings.

The only deterrent is the author's use of a similar format in chapters 5 through 11. At times, it appears redundant, leaving readers with a feeling that they have read similar material in the previous chapter. Even so, these chapters provide unique, valuable information, as well as practical suggestions, to enhance the empowerment of persons with mental illness.

A particular strength of this book is its attention to empowering persons with severe mental illness who have been subjected to legal forms of coercion, such as involuntary inpatient or outpatient commitment. Empowerment is not a word often associated with involuntary commitment. However, Dr. Linhorst's book brings to light a number of realistic methods to increase a person's sense of empowerment and dignity during times of crisis.

Empowering People With Severe Mental Illness is a good introduction to the empowerment of people with severe mental illness. It analyzes and applies a cogent framework to empowerment in several treatment domains. As a mental health professional, I gained fresh, useful ideas for my own work from this book. I believe that to be the mark of a good text. I would recommend this book as required reading for any student or practitioner in mental health services.

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