User involvement in mental health nursing practice: rhetoric or reality?

Following the review of mental health nursing, nurses need to address the dilemma for providing empowering care in a climate of increasing control and stigma. This paper discusses the background to, and significance for nursing, of the 'user movement' in the UK. A current 'explosion' of user groups does not imply that these form a homogeneous group, nor that they share similar perspectives. Consultation and involvement mean little if unmatched with action. This may be constrained by the 'market' in which the 'true power' is held by the budget holder, and by stigmatizing policy imperatives claimed to be in the public interest. Self-advocacy may be legitimized by the desire to prevent providers 'speaking out'. These difficulties may, however, provide convenient excuses for inaction. A new professional identity may be found in forging political alliances with users, in which a reappraisal of traditional boundaries may go some way towards reducing the stigma surrounding mental health problems.