Introduction

The study reported here concerns the constitution and activity of what we refer to as ‘user groups’ in the fields of state provision of services for people with mental health problems and with physical disabilities. Although one purpose is to report in some detail on one example of a group operating in each of these fields (in Chapters 3 and 4 respectively), our conclusions also draw on evidence from our research into four other groups (Barnes et al, 1996), and a second purpose is to offer a more general analysis of the relationship of this kind of group to present and future policy options. In this chapter, we outline the context for the report. This can conveniently be divided into two elements, each the subject of a section below: the larger macro-social context forpolicy and the narrower context provided by policy itself, though it is not suggested that these are theoretically or causally unrelated. A third section of this chapter introduces the elements of the ‘user movement’.

The context for policy

Much of the thrust of our analysis hinges upon some concept of citizenship, a concept which is far from static. Historically, it has been conceived as carrying a complex cluster of meanings: defined legal or social status; means of signifying political identity; a focus of loyalty; a requirement to perform duties; expectations of rights; and a yardstick of good social behaviour (Heater, 1990, p 163). At different historical moments particular elements of this cluster have been emphasised. Thus, for much of the present century until, say, 1980, citizenship has been predominantly discussed from a liberal perspective, that is as a set of rights that enables the individual to “function relatively equally in private life or in exchange in civil society” (Meehan, 1993, p 177). T. H. Marshall’s (1950) influential analysis of the development over time of, respectively, civil, political and social rights, all counterposed against social class, is the classic text of this genre, which remains at the heart of recent, more sophisticated, sociological accounts such as those of Twine (1994) and Roche (1992).

Over the last two decades, however, the emphasis of discussion has changed in several ways, not all of which are consistent with each other.