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This paper aims to demonstrate the confluence of thinking across several areas, in their critique of modernity, with potential solutions in the mental health field.

The paper uses case and organisational examples related to relevant theory and clinical practice to demonstrate relevant contradictions and paradoxes in “modernised” mental health care. This is based on the author's experience as a public sector psychiatrist specialising in “personality disorder” to lead a government programme of new service developments in the field.

Modern methods of management, focusing on measurement, prediction and control – in the service of efficiency and economy – are not sufficient to meet the needs of a population with high incidence of “personality disorder”. A major change of attitude is required, to an authentic biopsychosocial approach, including spiritual and other non‐verbal considerations.

Hitherto, research has not combined these elements in a way that has made it easy to capture and analyse them. New methodologies and paradigms may be called for.

Mental health care should not be considered an entirely rational process that can be measured and manualised; considerations of how to better manage complexity and uncertainty are urgently needed.

Destigmatisation and normalisation of mental distress and “illness” should occur.

The paper introduces two new terms to mental health discourse: “greencare” and “biopsychosocialism”.

This paper aims to describe a method of training for practitioners in democratic Therapeutic Communities (TCs) which has been used in several settings across the world over the past 25 years: the “Living-Learning Experience” (LLE) workshop. It goes on to consider the cross-cultural implications of the work.

Drawing on the experience of running exactly the same programme in different countries and cultures, the paper examines the cross-cultural adaptability and describes necessary adaptations for local circumstances. It also contains original ethnographic research in UK and Italy; further study is planned for other countries.

The workshops are readily transferable to different cultures and are appreciated for their democratic and relational way of working.

The ethnographic study examines the workshops in some depth, in UK and Italy, and could usefully be replicated in other countries. No quantitative, outcome or follow-up studies have yet been done, and this paper could contribute to the design of useful quantitative studies.

The paper demonstrates that the LLE is a useful experiential learning tool in widely different settings. It could be developed in different ways, such as for developing relational practice or establishing therapeutic environments in different settings.

The workshops' acceptance in widely different cultures indicates that the open and non-didactic format addresses essential and fundamental qualities required for therapeutic engagement and human relatedness.

This is the first description of the principles of democratic TCs being applied across different international settings. Its value extends beyond the TC field, to the use of democratic and relational principles' applicability in therapeutic pedagogy and training.

The purpose of this paper is to describe the role of the expert by experience, and its benefits and challenges.

Review of the relevant literature and a case study has been performed.

The role of the expert by experience is fluid and complex. Staff need to understand the ambiguities of the role.

Experts by experience (XBXs) play an important role in TC practice. They need support and supervision. Staff need to learn about the complexities and fluidity of the role, and to be aware of its transitional position between service user and staff member.

XBXs challenge the binary notion of staff and service user. The role calls for a different relational rather than procedural conceptualisation.

This is the first description of the lived experience of an expert by experience, working in a therapeutic community setting, with the analysis of the helpful and unhelpful aspects of the role.

The purpose of this paper is to provide an overview of the application of therapeutic community (TC) method in non-TC environments.

Milieu treatment is defined and differentiated from TC “proper”. Literature is reviewed covering attempts to use TC methods in inpatient wards, across hospitals, and more recently in the criminal justice system and more widely through the enabling environments initiative.

It is unclear whether TC milieu treatments proved helpful in acute ward environments in their heyday in the 1950s, 1960s and 1970s, in particular those involving people suffering from acute psychosis, and the changing landscape of psychiatric provision may make further investigation difficult. The reasons for this, and for the difficulties reaching a firm conclusion, are outlined. In contrast, TC milieu interventions appear to be demonstrating usefulness more recently in less mixed populations without the implementation of full TC “proper”.

Much of the research is old and the methodology poor, which limits the conclusions that can be drawn.

Recent innovations pick up in a more accessible way principles of therapeutic communities that can inform and improve care in a variety of contexts. They are sufficiently well defined to lend themselves to research, which should now be a priority.

After a gap in developments in the field, recent innovations are reintroducing elements of TC functioning to new contexts including criminal justice settings, inpatient wards, homeless shelters and city communities.

The purpose of this paper is to present a model of democratic therapeutic community (DTC) for people with a diagnosis of schizophrenia and psychotic disorder, namely the Group-Apartment (GA). The authors will describe it in more detail, discussing the ideas which lie behind it, considering the relative cost of treating people in larger residential DTCs and in GAs, outlining findings from the first data gathered on a GA and looking at the usefulness of this model in post-modern societies, with particular reference to Sicily.

In brief a GA is a flat, located in an urban apartment building, inhabited by a small group of people. In this paper the authors consider an apartment inhabited by a group of three or four patients with the presence of clinical social workers who work in shifts for several hours a day on all or most days of the week (Barone et al., 2009, 2010). GA is also inspired by the pioneering work of Pullen (1999, 2003), in the UK tradition of the apartment post TC for psychosis.

GAs in Italy have become one of the main methods of support housing in recovery-oriented treatment, because it allows the empowerment of the users and fights against the stigma of mental illness (Barone et al., 2014; Bruschetta et al., 2014). The main therapeutic activities provided in the GA depend on the type of recovery route being supported, on the level of autonomy being developed and on the level of participation in the democratic life of the local community.

GAs appear better, cheaper and a more appropriate treatment for mental problems in the current financial and social climate than larger institutions. Where they have been tried out, they have been found to be effective, by users and by stakeholders. They exemplify the advantages of the DTC for encouraging recovery, but cost less to run. In accordance with DTC principles, the social democratic process is used not only to evaluate the clinical effectiveness of GAs, but also to build a network to support the development of innovative mental health services and new enabling environments (Haigh et al., 2012).

The purpose of this paper is to introduce prolonged therapeutic community action research and compare research on new social movements in both Latin America and throughout the Australasia Southeast Asia Oceania Region where the later region’s new social movements emerged in large part from Therapeutic Community Outreach.

The qualitative method used combined prolonged depth interviews, action research, gathering warm data (N Bateson) and archival research and triangulated the findings. In writing this paper, a connoisseur derived narrative method is used consistent the socio-cultural contexts involved.

The characteristics and significant implications and values of these new social movements are outlined. These new social movements are not taking familiar forms with political power as an identifier – rather, a core feature is their transformatory potential in re-forming socio-cultural and socio-psychic patterns of everyday social relating penetrating the micro-structures of society. New forms of social movement are lively in unexpected public places within everyday socio-cultural life.

The research implications extend to providing processes used in pioneering TCs in Australia in the 1960s.

Co-action outlined may be a resource for therapeutic communities under threat in parts of the world.

The transformatory potential within new social movements is not political, but socio-cultural and any focus on power relations would miss this shift.

The action research overviewed in this paper is perhaps a unique example of prolonged engagement in integrated action research on TC processes over more than 60 years.

The purpose of this paper is to apply current understanding of service user involvement (SUI) to forensic practice with reference to the benefits and drawbacks. Specifically, it discusses models of SUI and their application to a psychologically informed planned environment (PIPE) located in a Category C male prison.

Drawing upon residents’ experiences, the evaluation reflects on the contribution of cultural, environmental and political factors to the success or failure of SUI within the PIPE service.

The evaluation will review current systems and explore ways of improving and strengthening strategies by referring to the “whole systems approach” to SUI (Wright, 2006).

The evaluation makes recommendations for local and national SUI within PIPE services.