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While shared decision making (SDM) in general health has proven effectiveness, it has received far less attention within mental health practice with a disconnection between policy and ideals. The purpose of this paper to review existing developments, contemporary challenges, and evidence regarding SDM in mental health with a particular focus on the perspectives of service users.

This is a review of international papers analysed using narrative synthesis of relevant data bases.

The review shows significant barriers to the utilisation of SDM including ethical and legal frameworks, accountability and risk. The medical model of psychiatry and diagnostic stigma also contributes to a lack of professional acknowledgement of service user expertise. Service users experience an imbalance of power and feel they lack choices, being “done to” rather than “worked with”.

The paper also presents perspectives about how barriers can be overcome, and service users enabled to take back power and acknowledge their own expertise.

This review is the first with a particular focus on the perspectives of service users and SDM.

This review paper will look at internationally existing publications in the English language on mental health shared decision making (SDM) implementation of a variety of interventions, including different methodologies and research methods, age groups and countries. The purpose of this paper is to provide an overview of: process, degree and outcomes of implementation; barriers and facilitators; perspectives on implementation by different stakeholders; analysis of the process of implementation in mental health services through the lenses of the normalisation process theory (NPT).

Following a targeted literature search the data were analysed in order to provide an overview of methodologies and methods applied in the articles, as well as of the variables listed above. Three different types of information were included: a content analysis of key issues, reflective understanding coming out of participating in implementation of an SDM project in the form of two narratives written by two key participants in an SDM pilot project and an NPT analysis of the process of implementation.

Only a minority of mental health SDM research focuses on implementation in everyday practice. It is possible and often desirable to achieve SDM in mental health services; it requires a low level of technology, it can save time once routinized, and it is based on enhancing therapeutic alliance, as well as service users’ motivation. Implementation requires an explicit policy decision, a clear procedure, and regular adherence to the aims and methods of implementation by all participants. These necessary and sufficient conditions are rarely met, due to the different levels of commitment to SDM and its process by the different key stakeholders, as well as due to competing providers’ objectives and the time allocated to achieving them.

The review indicates both the need to take into account the complexity of SDM, as well as future strategies for enhancing its implementation in everyday mental health practice. Perhaps because applying SDM reflects a major cultural change in mental health practice, current value attached to SDM among clinicians and service managers would need to be more positive, prominent and enduring to enable a greater degree of implementation.

This paper presents the findings of an investigation into a mental health promotion initiative in young offender institutions across England. The study involved a survey of staff attitudes towards mental health promotion, and surveyed practice run by these staff. Analysis of staff descriptions of mental health promotion revealed a degree of confusion and a lack of clarity over the definition of mental health and mental health promotion. The concept of a mental health promotion initiative which aimed to improve the well‐being of the general inmate and staff population was not a shared vision and not part of the core work of either health care staff or prison officers. It is recommended that any future campaigns on mental health or health promotion should have a central lead, with some flexibility to allow for the development of local initiatives, fostering local relationships and partnerships.

On 1 April 1978, the Israeli peace movement burst into world consciousness when an estimated 25,000 Israelis demonstrated in Tel Aviv to urge the administration of Prime Minister Menachem Begin to continue peace negotiations with Egypt. A grassroots group called Peace Now is credited with organizing and leading that demonstration. Today, the “peace camp” refers to left‐wing political parties and organizations that hold dovish positions on the Arab‐Israeli conflict and the Palestinian issue. While some figures in the Labor Party view themselves as the peace movement's natural leader, political parties further to the left like the Citizens Rights Movement (CRM) and Mapam are more dovish. In the last 10 years, many grassroots peace organizations have, like Peace Now, formed outside the political party system, with the goal of influencing public opinion and eventually having an impact on policy makers. Peace Now is still the largest, most visible and influential of those organizations.