There are a variety of definitions and terms for those who use mental health services, including ‘service user’, ‘consumer’, ‘patient’, ‘client’, ‘survivor’, ‘expert by experience’ Each of these terms connote types of roles and relationships within mental health systems.Historically, the voice of the service user has rarely been heard. However this has, to some extent, changed in recent years. Service users and service user movements have been more active in challenging discrimination, stigma and the power of professionals.In the UK in particular a number of policies associated with personalisation have been introduced. These are designed to devolve power and resources from the State to service users and carers. There is disagreement about how successful personalisation has been, with contrasts between collectivist and consumerist approaches.Recovery approaches are increasingly being used to plan and inform mental health systems. They imply that the views of service users are more prominent. As a result professional power is challenged and new forms of care and treatment are sought by service users.These changes to policy and practice with, and for, mental health service users imply a change in professional attitudes and behaviour. This chapter concludes with an argument for more holistic, inclusive practices that engage more fully with service user views.
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