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This qualitative study assessed clients' participation in organizational decision making in a public long-term psychiatric hospital. Numerous examples were found in which clients meaningfully participated in the decision-making process and achieved favorable policy changes. Three means of involving clients were found to be especially useful: (1) using a consumer council, (2) involving clients in the formal policy review process, and (3) including clients in the hospital's performance improvement system. The authors offer guidelines for mental health organizations wishing to promote client participation in organizational decision making. Implications for social work are discussed.

Study reviews documents and conducts focus groups with clients and staff of a public psychiatric hospital to identify barriers to empowerment and the conditions that must be present for client empowerment to occur through treatment planning. For empowerment to occur, clients need psychiatric stability and decision-making skills. (Contains 40 references.) (GCP)