Professor Chambers is entirely correct to say that widespread public education and awareness of mental health, is needed to aid early diagnosis and interventions; often the longer a mental health difficulty goes unrecognised and untreated, then the problems are more ingrained and more intractable and difficult to overcome.

As an independent mental health service user initiative we have found, as people who have primary experience of mental health difficulties, that self-help techniques with support, often in conjunction with pharmaceutical products is the most efficacious way of managing and overcoming mental health difficulties.

Northern Ireland has been held in a kind of stasis, whilst the conflict has been on-going, during this period of relative calm, new light has been shed on overlooked issues, like mental heath care provision and the models of treatment currently provided.

In criticising Professor Mary Chambers, Mr O'Donnel and Ms Breslin, cite a number of bodies who should respond to the article, but dismiss service users in a derisory couple of paragraphs. It is indicative of the general attitude toward mental health service users that has existed and been nurtured within the mental health environment. Their claims that there has been genuine and meaningful user involvement in mental health services is certainly not what the true picture is in our experience. This is based upon the knowledge of our staff and volunteers who have primary and secondary experiences of mental health difficulties. This experience has been gained by engaging the current mental health system and those who deliver it to the service user. Peter Beresford has done some groundbreaking work with the University of Middlesex in this regard in England, but here in Northern Ireland, there is widespread obstruction and obfuscation, when it comes to including mental health service users in the involvement of training of health care professionals, service design, planning and monitoring of services. This obstruction has been identified in several research articles. We believe that there is a need and an argument for a completely new approach to mental health from the NHS and that it is required at every level not only training as cited by Mary Chambers.

Mr O Donnel and Ms Breslin are concerned about the 'integrity' of the 'preparation programs and we agree that this needs to be maintained with a genuine and meaningful input from independent service users or groups. They go on to point to lack of resources and indeed that is an issue, one that we are also very concerned about. However, the resource argument does not account for the obsessive need for the comfort-blanket of the medical model, that mental health care professional still cling to. It does not account for the rigid, 'them and us' attitude which dominates many psychiatric environment, it does not account for the 'hear no evil, see no evil, speak no evil' ethos which also pervades every psychiatric environment.

There are other partnership approaches to the care and treatment of mental ill health in some of our EU Members states that should be seen as the way forward for mental health services in n. Ireland. These mental health services have service users at the core of the service planning.

There are a number of many excellent, dedicated and caring mental health professionals that require the appropriate levels of support. If the training institutions were to include the expertise of people with primary and secondary experience of mental health in a meaningful and genuine approach, then this would bring about a sea-change in the mental health environment and would lead to improved services, improved care and a better relationship between service-users and people who are on the front-line, delivering those services.