ABSTRACT
The mental health world pullulates with pressure groups and one consistent feature of government review of public service provision has been to establish the ‘users’ as an integral part of each service, citing such devices as: giving users a choice/personalisation; funding following users’ choices (individual budgets); and engaging users through voice and co-production (representation in decision-making). When the issue of ‘choice’ in mental health provision is properly addressed, there will be considerable readjustment called for. Major decisions about service changes and reconfigurations may be the subject of public consultation but are customarily cast in a form which has only two alternatives – the status quo or the given worked-out proposal. In parallel, on a personal level, choice is an elusive commodity with virtually all the power in the providers’ hands. Individual personalised care budgets are in their infancy and regarded with suspicion.
