This chapter offers a perspective of mental health service users’ experiences of research from one who is not a mental health service user. Some 20 years as a consultant psychiatrist in the UK NHS have provided their own rich and intimate familiarity with mental health services and the experiences of those who use them. I am convinced that much can be gained for all concerned by respecting those experiences in much more detail. I know that I am not alone in this. However, this collection and related publications are testimony to widespread frustration that it is not happening quickly enough. Continuing failure to incorporate non-medical approaches into mental health services’ policy, practice and research are experienced as oppressive and harmful. The value of a social perspective on ‘mental health difficulties’, the services available to provide for them and the research upon which they are purported to be based is compelling. Of particular interest to a social scientist is the need to understand the nature and background of this resistance to change.

One approach to this is to consider the causes and implications of locating ‘mental health difficulties’ in a ‘medical illness’ framework. From a historical perspective, this is a relatively recent development, but it has become virtually universal, and defines participants’ roles and power relations in ways that influence their expectations of research. The ‘medical illness’ framework imposes a distinction between ‘service user’ and ‘service provider’, generating distinct communities of discourse. Experiences within these distinct communities of discourse generate distinct forms of knowledge, and it is, of course, the relative contributions of these to even wider discourse that determines the power relation between them. Thus, to what extent, from this point of view, are service users’ perspectives truly distinct, or are they better understood as a reflection of the arbitrary (though long-standing) distinction between ‘users’ and ‘providers’? Are both communities better understood as component parts of a larger whole? To what extent is it an epistemological fallacy to talk in terms of service users’ experiences when service users and service providers are both entwined in a dance where both play their parts, albeit with different experiences of power and privilege?