title: Service user governors in mental health foundation trusts: accountability or business as usual?
abstract: BACKGROUND
  National Health Foundation Trusts present opportunities for individual mental health service users to be active in the governance of trusts. This is one of a range of mechanisms for patient and public involvement and one which promotes an individual rather than collective approach to involvement.
  
  
  OBJECTIVE
  Within the context of a broader study of the impact of service user involvement in mental health services, the objective of this article was to explore the experience of service user governors in foundation trusts and their capacity to hold boards to account.
  
  
  METHODS
  The Council of Governors in three foundation trusts were observed for a year. Focus groups with service user governors were undertaken in each trust.
  
  
  RESULTS
  Service users had different expectations and understandings of the role and approached it in different ways. Key themes that emerged concerned: the role of a governor, conduct and content of meetings, agenda setting, relationships and representation.
  
  
  CONCLUSIONS
  The experiences of mental health service user governors need to be understood within the complex environment of patient and public involvement in general and of mental health service user involvement in particular. The dislocation of the service user governor role from other forms of service user activity and involvement result in confusion about how notions of holding a trust to account and representation of other service users can be addressed within a boundaried institutional environment.
authors.affiliation: University of Brighton, Brighton, UK.
authors.forename: Dee
authors.initials: D
authors.lastname: MacDonald
authors.affiliation: University of Brighton, Brighton, UK.
authors.forename: Marian
authors.initials: M
authors.lastname: Barnes
authors.affiliation: Imperial College London, London, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Crawford
authors.affiliation: King's College London, London, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Omeni
authors.affiliation: King's College London, London, UK.
authors.forename: Aaron
authors.initials: A
authors.lastname: Wilson
authors.affiliation: King's College London, London, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Rose
mesh_terms: D005582:Foundations / Q000458:organization & administration*; D006075:Governing Board / Q000458:organization & administration*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D010361:Patients; D012941:Social Responsibility; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom
keywords: foundation trust governors; governance; institutional theory; mental health service user involvement