Can the state empower communities through localism? An evaluation of recent approaches to neighbourhood governance in England

‘Empowerment’ is a term much used by policy-makers with an interest in improving service delivery and promoting different forms of neighbourhood governance. But the term is ambiguous and has no generally accepted definition. Indeed, there is a growing paradox between the rhetoric of community empowerment and an apparent shift towards increased centralisation of power away from the neighbourhood in developed economies. This article explores the literature relating to empowerment and identifies two broad conceptions which reflect different emphases on neo-liberalism. It goes on to discuss two models illustrating different levels of state intervention at the neighbourhood level and sets out evidence from two neighbourhood councils in Milton Keynes in central England. In conclusion, it is argued that those initiatives which are top-down, state-led policy initiatives tend to result in the least empowerment (as defined by government), whereas the bottom-up, self-help projects, which may be partly state-enabled, at least provide an opportunity to create the spaces where there is some potential for varying degrees of transformation. Further empirical research is needed to test how far localist responses can challenge constraints on empowerment imposed by neo-liberalism

Does strategic involvement of mental health service users and carers in the planning, design and commissioning of mental health services lead to better outcomes?

There is an assumption, explicit in the current government policy, that involvement of mental health service users and carers in the planning, design and commissioning of mental health services will lead to better outcomes. The aim of this study was to examine evidence from board-level participation of service users and carers that might support this assumption. A thematic analysis of documents generated by a strategic Lancashire Mental Health and Social Care Partnership during 2007 was undertaken. Themes for the analysis were generated from priorities identified from a postal survey of mental health services users from across Lancashire. The findings indicate that whilst service user and carer involvement is a high priority, the Lancashire Partnership spent most of its time discussing process and actions. Where service user involvement resulted in better outcomes, these improved outcomes were limited to the individual service users involved, rather than better outcomes for all service users. Whilst the membership of mental health service users and carers on the Lancashire Partnership Board presents a visible commitment from senior officers and may confer greater legitimacy to the decisions made by the Lancashire Partnership, service users and carers do not appear to play the desired instrumental role. Rather, their presence may be largely symbolic. This sends out the message across the health and social care system that partnership with service users and carers and their empowerment is important and has the potential to evolve further