This work traces and anticipates past present and future changes in mental health services to assess the impact both of developments in care and of the implications of new organisational change. It includes contributions and perspectives of those involved in services at all levels including service users to draw upon their experience to give a fuller picture of today and help sketch in tomorrow. It balances academic scrutiny with personal involvement to reflect both national trends and local initiatives. Overall this work is in two volumes each of which can stand alone: this Part 1 focuses on the realities of offering and receiving care at a practical and local level; it concentrates on personal experiences within mental health services as user carer provider and professional. The companion book Part 2 reviews policy and practice from national and international perspectives. Together these books provide essential information and views on mental health services for professionals throughout health and social care managers policy planners and policy shapers including those in the third sector and patient groups academics and the media.