A SELECTIVE LOOK AT SELF-HELP GROUPS IN THE UNITED-STATES

Government health policies in the United States have emphasized privat e business and professional solutions, benignly neglecting self-help m utual aid. This paper presents a selective overview of the development and current situation of self-help groups (SHGs) and resource centres in the United States based on a literature review, recent interviews and the author's observations. The development of contemporary self-he lp groups is linked with the 1935 founding of Alcoholics Anonymous (AA ). AA is a model for 100 or more other SHGs which are non-hierarchical direct democracies that avoid advocacy. The major growth of groups oc curred in tandem with the civil rights and women's movements especiall y during and after the 1970s; both challenged bureaucracies and tradit ional authority. Self-help groups are often criticized for focusing on emotional support. However, major changes occurred stemming from sepa rate self-help advocacy movements for persons with cancer, AIDS, menta l illness, disabilities, alcohol problems and women's conditions. Curr ently, self-help resource centres which provide information and referr al, among other services, are viewed as important linking organization s. The social demographic composition of self-help group members has b een estimated to be disproportionately white middle class females. An active interdisciplinary network of over 200 researchers, most from ac ademia, studies self-help mutual aid. The future of resource centres i s less certain than for groups since centres have Little legitimacy wh ile requiring substantial resources. The impact of current changes in health care (e.g. managed care) on self-help mutual aid is unknown.