Mission informed discursive tactics of British mental health service-user survivor movement (BSUSM) resistance to formalization pressures accompanying contractual relationships with purchasing authorities

Background: Deinstitutionalization public services consumerism coincided with the growth of user survivor-led voice groups from 23 (1987) to 896 (over 77% public funded 2001). Whether these opportunities are an unqualified plus for the movement was recently explored (Armes, 2006). Aims: Exploring contradictory potential of community care policy in formal relationships between purchasing authorities and user survivor-led groups: Methods: Semi-structured one-to-one interviews with BUSM pioneers (n = 8). Three discussion groups with a range of BUSM activists (n=13). Discourse analysis focussing on Foucauldian relationship between power and resistance within user survivor standpoint. Results: Four discursive resistance tactics for coping with pressures to formalize BUSM activities (reformism, rationalization, professionalization, pride) identified from pioneers who discussed how tactics relate to each other. Discussion group evidence of pioneer tactics existing in wider movement led to an amended model indicating overarching influence of hope and pride in BUSM mission. Conclusions: User survivors engaged in voice activities challenge power relations. Formal relationships between user survivors and purchasing authorities do not necessarily reproduce discrimination. User survivor activists keeping 1980s movement's informal empathic values alive.