A selective look at self-help groups in the United States

Government health policies in the United States have emphasized private business and professional solutions, benignly neglecting self-help mutual 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-help 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 occurred in tandem with the civil rights and women's movements especially during and after the 1970s; both challenged bureaucracies and traditional authority. Self-help groups are often criticized for focusing on emotional support. However, major changes occurred stemming from separate self-help advocacy movements for persons with cancer, AIDS, mental illness, disabilities, alcohol problems and women's conditions. Currently, self-help resource centres which provide information and referral, among other services, are viewed as important linking organizations. The social demographic composition of self-help group members has been estimated to be disproportionately white middle class females. An active interdisciplinary network of over 200 researchers, most from academia, studies self-help mutual aid. The future of resource centres is less certain than for groups since centres have Little legitimacy while requiring substantial resources. The impact of current changes in health care (e.g. managed care) on self-help mutual aid is unknown.