October 2004

I am a family leader involved with our recently formed governance structure for our new system of care project, and I am struggling with feelings of oppression and insignificance. I have also been asked to become the co-chair of this group. Are these feelings common for family members involved in system of care governance structures? How can our community's governance structure support equal and valued participation of family members?

First, let me say I am sorry you are feeling this way; it is not a comfortable position in which to be. The feelings you are experiencing are not uncommon among family members participating in governance structures that are being developed and implemented in system of care projects. Unfortunately there are still many family members who feel their right to speak and be heard is being hindered. It is important for any individual taking on a leadership role to understand the role of a governance structure to a system of care, as well as how to facilitate a process for equal and valued participation of everyone involved, especially families and youth who are service recipients of the system of care.

A system of care governance structure is involved with the decision-making and oversight of a system of care at the policy level. The governance structure should reflect not only system of care principles and values, but should also ensure an inclusive process for decision-making. There should be an emphasis on family members and youth sharing their own unique experiences and perspectives. Goal Two of the President's New Freedom Commission Report states that “mental health will be family and consumer driven.” In order for mental health to become family and consumer driven, our governance structures need to value and appreciate the voices of families and youth. It will be important for everyone to discuss what “family and consumer driven” means to their community.

Consensus is a process for group decision-making. Webster's dictionary defines consensus as “a way to develop a collective opinion or come to agreement.” A fundamental right of the consensus process is that everyone involved should be able to express themselves in their own words and in their own ways. Even in a good consensus planning process, an individual in the group may not totally agree with the final decision, but good consensus planning does mean that everyone feels that his or her position is heard, respected, and taken into account when final decisions are made. There are a variety of tools and training available for leaders using a consensus model in their governance structures.

Many families involved in a consensus process fear that their voices will not be respected and heard or that they will not have final input into decisions being made. This can create feelings of oppression among family members. Some families have engaged in what they thought was a consensus process, but final decisions were still made covertly by another group or by an individual who dominated everyone else. Sometimes there has even been an individual who employs “the block” as described by Starhawk, which also results in feelings of oppression. When these actions occur, the governance structure is not using a real consensus model.

Consensus is a process for individuals who want to work honestly and in good faith to find good solutions for the group. It cannot be used by people who do not, cannot, or will not cooperate. Consensus should not be attempted in a group with people who want to maintain their power or maintain control over others. A true consensus process gives all group members the power to make decisions and also demands that they take responsibility for those decisions. If the governance structure in your system of care community is not ready for consensus, then they will need to implement a voting process. There are tools such as Roberts Rules of Order that can support a voting model. However, even under the best circumstances, voting necessarily means that those in the minority will not get what they want. If the same group continues to be in the minority, they may eventually develop negative feelings and decide to leave the group or retaliate.

In taking on the leadership role as co-chair of your governance structure, you will have to facilitate the process chosen by you and the other members of your governance structure. Sometimes this is discussed in advance by the group, and sometimes the co-chair needs to exert his or her leadership skills to move the group toward a process. There are many tools and trainings that provide strategies for becoming a good facilitator and for implementing effective meetings.

By no means are these all the answers in getting your governance structure to equal and valued family participation. In order to get to this point, your group may even need outside facilitation or mediation. An environment also needs to be created within the governance structure that supports families and youth, and this includes providing appropriate orientation, meeting times, food, childcare, transportation and/or stipends. I wish you and all families out there the best in working toward positive change for children/youth with SED and their families.