efficient. the amount of time spent in the programs, and how proactive the members are in them, has also been correlated with increased benefits. decreased hospitalization and shorter durations of hospitalization indicate that self-help groups result in financial savings for the health care system, as hospitalization is one of the most expensive mental health services. similarly, reduced utilization of other mental health services may translate into additional savings for the system. while self-help groups for mental health increase self-esteem, reduce stigma, accelerate rehabilitation, improve decision-making, decrease tendency to decompensate under stress, and improve social functioning, they are not always shown to reduce psychiatric symptomatology. the therapeutic effects are attributed to the increased social support, sense of community, education and personal empowerment. members of self-help groups for mental health rated their perception of the group's effectiveness on average at 4.3 on a 5-point likert scale. social support, in general, can lead to added benefits in managing stress, a factor that can exacerbate mental illness. list emotions anonymous emotions anonymous (ea) is a derivative program of neurotics anonymous and open to anyone who wants to achieve emotional well-being. following the twelve traditions, ea groups cannot accept outside contributions. a similar 12-step program is known as "emotional health anonymous". grow grow was founded in sydney, australia, in 1957 by a roman catholic priest, father cornelius keogh, and people who had sought help with their mental illness at alcoholics anonymous (aa) meetings. after its inception, grow members learned of recovery, inc. (the organization now known as recovery international) and integrated its processes into their program. grow's original literature includes the twelve stages of decline, which state that emotional illness begins with self-centeredness, and the twelve steps of recovery and personal growth, a blend of aa's twelve steps and will-training methods from recovery international. grow groups are open to anyone who would like to join, though they specifically recruit people who have been in psychiatric hospitals or are socioeconomically disadvantaged. grow does not operate with funding restrictions and have received state and outside funding in the past. neurotics anonymous neurotics anonymous is a twelve-step program open to anyone with a desire to become emotionally well. according to the twelve traditions followed in the program, neurotics anonymous is unable to accept outside contributions. the term "neurotics" or "neuroses" has since fallen out of favor with mental health professionals, with the movement away from the psychoanalytic principles of a dsm-ii. branches of neurotics anonymous have since changed their name to emotions anonymous, which is currently the name in favor with the minnesota groups. groups in mexico, however, called neuróticos anónimos, still are referred to by the same name, due to the term "neuroticos" having a less pejorative connotation in spanish. this branch continues to flourish in mexico city as well as largely spanish-speaking cities in the united states, such as los angeles. recovery international recovery, inc. was founded in chicago, illinois, in 1937 by psychiatrist abraham low using principles in contrast to those popularized by psychoanalysis. during the organization's annual meeting in june 2007 it was announced that recovery, inc. would thereafter be known as recovery international. recovery international is open to anyone identifying as "nervous" (a compromise between the loaded term neurotic and the colloquial phrase "nervous breakdown"); strictly encourages members to follow their physician's, social worker's, psychologist's or psychiatrist's orders; and does not operate with funding restrictions. fundamentally, low believes "adult life is not driven by instincts but guided by will," using a definition of will opposite of arthur schopenhauer's. low's program is based on increasing determination to act, self-control, and self-confidence. edward sagarin compared it to a modern, reasonable, and rational implementation of émile coué's psychotherapy. recovery international is "twelve-step friendly." members of any twelve-step group are encouraged to attend recovery international meetings in addition to their twelve-step group participation. criticism there are several limitations of self-help groups for mental health, including but not limited to their inability to keep detailed records, lack of formal procedures to follow up with members, absence of formal screening procedures for new members, lack formal leadership training, and likely inability of members to recognize a "newcomer" presenting with a serious illness requiring immediate treatment. additionally, there is a lack of professional or legal regulatory constraints determining how such groups can operate, there is a danger that members may disregard the advice of mental health professionals, and there can be an anti-therapeutic suppression of ambivalence and hostility. researchers have also elaborated specific criticisms regarding self-help groups' formulaic approach, attrition rates, over-generalization, and "panacea complex". formulaic approach researchers have questioned whether formulaic approaches to self-help group therapy, like the twelve steps, could stifle creativity or if adherence to them may prevent the group from making useful or necessary changes. similarly others have criticized self-help group structure as being too rigid. high attrition rates there is not a universal appeal of self-help groups; as few as 17% of people invited to attend a self-help group will do so. of those, only one third will stay for longer than four months. those who continue are people who value the meetings and the self-help group experience. overgeneralization since these groups are not specifically diagnosis-related, but rather for anyone seeking mental and emotional health, they may not provide the necessary sense of community to evoke feelings of oneness required for recovery in self-help groups. referent power is only one factor contributing to group effectiveness. a study of schizophrenics anonymous found expert power to be more influential in measurements of perceived group helpfulness. panacea complex there is a risk that self-help group members may come to believe that group participation is a panacea—that the group's processes can remedy any problem. sexual predation and opportunism often membership of non-associated self-help groups is run by volunteers. monitoring of relationships and standards of conduct are seldom formalized within a group and are done on a self-regulating basis. this can mean undesirable and unethical initiation of sexual and intimate encounters are facilitated in these settings. predatory and opportunistic behavior in these environments which by association involve divulging volatile mental states, medication changes and life circumstances mean opportunities by those willing to leverage information that is often normally guarded and deeply personal, is a risk more-so than in other social meetup settings or professionally governed bodies.