The need to delegate certain responsibilities to others and a correspondingreliance upon these others is a basic feature of the social, economic andpolitical worlds. Whether we are depending upon a close friend, tradingbased on certain expectations or casting a vote for a particular candidate,notions of trust are vital in facilitating this process of delegation andthe peace of mind we have in doing so. Lately, both academics and the massmedia have been concerned with the apparent difficulty in trusting withinlate-modern society and the implications of this threatened or‘declining’ trust for social capital, economic trade andpolitical authority. At the centre of these concerns is the suggestion thattrust is something both vital and endangered.

The complex manifestations of trust within political systems, or financialmarkets, are well beyond the scope of this study; instead, this book seeksto shed light on trust within the social context of healthcare. Nonetheless,while trust relations are in some senses very much context-specific, anexamination of trust within one case of delegation can surely be instructivefor understandings of how trust functions in other settings. In particular,we hope that by examining trust where it is particularly vital, andparticularly endangered, the analysis expressed in this volume may saysomething about trust that is pertinent beyond the delegation of care forpeople experiencing serious mental health problems. Of course, we also seekto make a contribution to comprehension of the nature of trust, the factorsbehind it and the ramifications of its presence or absence in this importanthealthcare and social policy setting.

People experiencing psychosis do not necessarily choose to have their caredelegated to mental health professionals themselves, and yet in many sensesthey may trust (or distrust, or mistrust) nevertheless. This issue of trustand its relation to (free) choice, as developed in Chapter Four, isimportant within a number of different environments (social, economic andpolitical).