We have described in earlier chapters the gradual acceptance of the validity of the users of mental health services exercising more autonomy, either outside or inside mainstream services. We have also stressed important differences between autonomous action, initiated and controlled by people who identify themselves as users or survivors and action taken from within service systems to consult or more actively involve users in decision-making processes. In the latter context, we have described how ‘benefits’, whether to service users themselves or to the services, are imputed rather than always carefully thought out. In particular, confusion may arise between seeing user involvement as a therapeutic goal and creating opportunities for service users to significantly influence the nature of support provided for them.
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