Abstract
The participation of patients and the public in the development of clinical treatment guidelines is increasingly valued in international guideline programmes. This paper extends the findings of Harding et al. (2010) exploration of the views of service users of mental health resources who participated in NICE guideline development groups developing UK clinical treatment guidelines for mental health related disorders. In this research, service users reported not unduly obstructed by some of the concerns raised about their involvement as lay members, influencing the relevance of recommendations to the individual consumer of the service, and grappling with the opaque nature of decision-making processes and asymmetries in power. We argue that these insights, combined with observations from research in guideline development and advances in the recovery movement and in the shared decision-making clinical model leads to progress in the guideline development topics of translation of evidence to recommendations, optimising the acceptability of treatment recommendations to service users, participants in the treatment decision being different but equal and reconciling different types of knowledge.