Legislating for user involvement in the United Kingdom: Mental health services and the NHS and Community Care Act 1990

Recent legislation in the U.K., particularly the NHS and Community Care Act 1990, has encouraged the direct participation of service users in the planning and management of care services. This paper explores evidence of how the interests of service users experiencing mental distress are represented within community care services in the U.K. and the extent to which this leads to a devolution of power to those service users. The evidence is drawn from a survey of principal officers in social services departments responsible for mental health services and interviews with 135 service users. This reveals considerable confusion about the meaning and purpose of user involvement and about how service users can best be represented; little evidence, despite users' interest in it, of power-sharing; and limited commitment of resources to make further participation possible. The conclusion considers how, in the light of this evidence, Central and Local Government might further develop user involvement.