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In the United Kingdom and elsewhere, the move from government to governance has been well documented (Stoker, 1998; Rhodes, 1996, 1997). In the global North, governance is understood as a response to complexity and a recognition that many problems cannot be solved by government alone, whereas in democracies across the North and South, there is a concern to address the democratic deficit and [re]legitimize the state. In both contexts, new governance spaces and opportunities have emerged for non-governmental actors to engage in the process. Interest in community or “third sector” participation has spread around the globe, albeit with very different expressions in different contexts, and in many cases at the insistence of international financial institutions. Deacon (2007, p. 15) describes such global trends as “the contested terrain of emerging global governance” in which he includes both international non-governmental organizations and transnational social movements. Although this shift represents new opportunities, the extent to which the spaces for participation offer a new vision of the public domain is contested (Fung & Wright, 2003; Cornwall & Coelho, 2007).

Reform is coming too slowly to institutions for adults with intellectual and mental health disabilities in Bulgaria, Romania and Serbia, where chronic neglect, filthy conditions, and the use of physical restraints and high‐dosage drugs to control behaviour remain routine.