In this chapter, we move on to consider the practicalities of survivor involvement. Beginning with a brief discussion of power issues in this context, we then consider consultation as part of official, legislative and policy requirements, and the need for sound and concrete policies, whatever type of participation is being considered. We then discuss some of the difficult issues that need to be part of any strategy for user involvement. These include safety, representativeness, diversity issues, and the need for resources and support. The chapter ends by opening up a discussion of what works and what does not, with a particular focus on the limited strategy of inviting individual survivors to attend policy meetings and forums on behalf of other woman, a strategy which we found in our study to be often inappropriate, upsetting and ineffective.
In general, it is of little point engaging in consultation and participation policies, as we have indicated in previous chapters, if nothing changes as a result and if the exercise remains cosmetic rather than an integrated part of policy and service delivery. However, many studies of consultative strategies with service users have found that such a tokenistic outcome is common. Consultation is carried out but there is no link between this and actual progress (Lindow and Morris, 1995). A clear issue here is who has power (see also Chapter 3), how it is operated and how much it is shared.
Where agencies retain all the power and the service users being consulted have very little, it is clear that the most likely outcome is that nothing much will change if users voice their issues and concerns. Thus, there has to be a shift if effective user participation is to be possible. This can be hard to bring about, however. In general, service user involvement is widely viewed as difficult to achieve and as hampered by social exclusion and by inadequate understandings of the operation of power, as discussed in earlier