title: Service user led organisations in mental health today.
abstract: BACKGROUND
  Since 1990, health policy in England has stressed the importance of user involvement in shaping and delivering services.
  
  
  OBJECTIVE
  To explore mental health service user-led organisations (ULOs) in England, as they interact with decision-makers to bring about change desired by them with a focus on institutional norms behaviour and specialised knowledge impacting service users' relationships with services.
  
  
  METHODS
  An ethnography of five ULOs in two provider organisations (NHS Trusts) including observing their meetings and interactions with decision-makers, conducting in-depth interviews and collecting reflective diaries kept by two members of each group.
  
  
  RESULTS
  During the study, one group ceased to operate. This was a group which refused to adopt the institutional rules and norms of managerial discourse. The other four groups survived by navigating the changing environment which existed at the time of the study, although often at some cost. Themes of autonomy and leadership were also identified.
  
  
  CONCLUSIONS
  The current environment is one of the organisational complexity and change and the place of ULOs is an ambiguous one as they strive to maintain autonomy whilst at the same time being an acceptable voice to managers.
authors.affiliation: a Service User Research Enterprise (SURE), Institute of Psychiatry, Psychology & Neuroscience, King's College London , de Crespigny Park , London , UK .
authors.forename: Diana
authors.initials: D
authors.lastname: Rose
authors.affiliation: b School of Applied Social Science, University of Brighton , Mayfield House, Falmer, East Sussex , UK , and.
authors.forename: Dee
authors.initials: D
authors.lastname: MacDonald
authors.affiliation: a Service User Research Enterprise (SURE), Institute of Psychiatry, Psychology & Neuroscience, King's College London , de Crespigny Park , London , UK .
authors.forename: Aaron
authors.initials: A
authors.lastname: Wilson
authors.affiliation: c Centre for Mental Health, Imperial College London , Claybrook Centre , London , UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Crawford
authors.affiliation: b School of Applied Social Science, University of Brighton , Mayfield House, Falmer, East Sussex , UK , and.
authors.forename: Marian
authors.initials: M
authors.lastname: Barnes
authors.affiliation: a Service User Research Enterprise (SURE), Institute of Psychiatry, Psychology & Neuroscience, King's College London , de Crespigny Park , London , UK .
authors.forename: Edward
authors.initials: E
authors.lastname: Omeni
mesh_terms: D003657:Decision Making; D004739:England; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D010358:Patient Participation
keywords: Service user led organisations; patient and public involvement; service user involvement; user led organisations