Putting the parity into service-user

participation: An integrated model of

social justice
Davies K., Gray M., Webb S.A. Putting the parity into service-
user participation: An integrated model of social justice
Models of service-user participation have derived from citi-
zenship or consumerist agendas, neither of which has
achieved the structural reforms important for the most mar-
ginalised social work clients. This article proposes Frasers
model of parity of participation as an appropriately multi-
faceted frame for capturing the social justice aspirations of
service-user participation. A qualitative case study compared
the experiences and expectations of people who had used
Australian mental health services with a sample who had used
Australian homelessness services to examine their expecta-
tions of participation at individual and representative levels.
The ndings reinforce concerns from Frasers research about
the tendency for identity-based consumerist notions of par-
ticipation to reify group identity. This leads to tokenistic
service-user involvement strategies that have little impact on
participation at a structural level. Frasers parity of participa-
tion is shown to have untested potential to reshape service-
user participation to meet the social justice aspirations of
social work clients.
Key Practitioner Message: Innovative, service-user driven
strategies for collaboration will be those which challenge
existing power structures; Service users want their contri-
butions to decision making to generate identiable change in
the system of social services; The success of service-user
participation strategies might be the extent to which political,
economic and cultural opportunities are enhanced.
Kate Davies
1
, Mel Gray
2
, Stephen A. Webb
1,3
1
Research Institute for Social Inclusion and Wellbeing,
University of Newcastle, New South Wales, Australia
2
School of Humanities and Social Science, University of
Newcastle, New South Wales, Australia
3
Social Work, Glasgow Caledonian University, Scotland, UK
Key words: homelessness, mental health, parity of participa-
tion, service users, social justice
Kate Davies, Research Institute for Social Inclusion and Well-
being, University of Newcastle, Callaghan, NSW 2308, Australia
E-mail: kate.davies@uon.edu.au
Accepted for publication 20 May 2013
The divide between service-user participation and
social justice has grown in the wake of neoliberal
agendas of participation as consumer choice. At the
same time, rights-based and identity-framed notions of
participation have failed to adequately challenge the
power inequalities that marginalise many social service
clients. This article examines the potential for Frasers
(2008a) model of parity of participation to mobilise an
integrated model of social justice and social service
delivery that recognises the complex nature of eco-
nomic (distribution), cultural (recognition/identity) and
political (representation) factors. This analysis is illus-
trated by a recent empirical study which took the form
of two in-depth case studies regarding service-user per-
spectives on evidence and participation in the Austral-
ian homelessness and mental health sectors. Both the
homelessness and the mental health case studies
entailed an analysis of key Australian government
documents pertaining to evidence and participation, 11
interviews with service users, ve interviews with
service providers, and focus groups with service users
to present and critique preliminary ndings. For the
purposes of the study, participation was conceived of at
the individual and representative levels. At the indi-
vidual level, participatory practice entails a collabora-
tive or client-driven approach to decisions about the
persons choice of service, choice of treatment and
mode of treatment. Following initial interviews with
service users, this notion was extended to include indi-
vidual levels of advocacy, where clients considered
that their personal interactions constituted a type of
participation where they challenged stigma and dis-
crimination. The representative level of service-user
participation entails the involvement of either self-
nominated or appointed service users as representatives
of their peers (in these case studies they represented
other people who had experienced homelessness or
mental illness) in policy or organisation-level decisions
DOI: 10.1111/ijsw.12049
Int J Soc Welfare 2013: :
I NTERNATI ONAL
J OURNAL OF
SOCIAL WELFARE
ISSN 1369-6866
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2013 The Author(s). International Journal of Social Welfare 2013 John Wiley & Sons Ltd and the International Journal of Social Welfare 1
regarding the strategic or operational aspects of social
service delivery. The case studies exemplify the incom-
patibility of contemporary participatory practices, at
individual and representative levels, with social justice
aspirations, namely participatory parity. We propose
that the service-user participation movements failure
to attain real structural change stems from differing
perceptions of participation on the part of policy
makers, service providers, practitioners and service
users. For most marginalised service users, participa-
tion is not just about being involved or exercising
choice, but about seeking representation and justice.
Framing models of participation
The history of service-user participation can be traced
to theories of citizenship and democracy. For Hegel
(1942), the self-realisation of political subjects was not
possible without the opportunity to participate in the
state. Non-participation was considered close to dehu-
manising. T. H. Marshall (1963) claimed that citizen-
ship was a status bestowed on full members of a
community and all who possessed this status were
equal with respect to the rights and duties with which
the status was endowed. As such, citizenship repre-
sented obligations and privileges that constituted mem-
bership in a society. Recognising the inherent tensions
between citizenship, welfare and capitalism, he also
claimed that individual economic participation made it
possible for governments to relinquish their social
protection and redistribution obligations to offset the
worst effects of an unregulated market (Turner, 2009).
Marshall suggested that social services, as a means to
provide access to a decent quality of life, were impor-
tant for their role in equalising status, more so than for
equalising income.
Arnsteins (1969) inuential ladder of citizen par-
ticipation (p. 216) showed a linear progression from
forms of non-participation, such as manipulation, to
tokenistic participation, such as consultation, to citizen
control through effective representation as the highest
rung of citizen power. Hers was a model in which true
participation, following Hegel (1942), gave citizens the
freedom to exercise their rights; only through full citi-
zenship could democracy be realised. At the other
extreme, however, participation could be a means to
manipulate, placate and, ultimately, suppress citizen
rights, thus the need for lobby groups to represent citi-
zens whose rights were being ignored or compromised,
or intervention programmes and other such initiatives
to get the citizen to act as his or her own master
(Cruikshank, 1999, p. 102).
For the service-user participation movement, par-
ticipation was problematic where it failed to alter the
structure of power relations. Service providers and
social service practitioners, however, saw service-user
participation not only as an instrument of social justice
but also as a process of empowering service users to
assume their full rights of citizenship and be fully
represented in structures of decision making directly
affecting them (Beresford, 2007; Beresford & Croft,
1993, 2004).
In recent years, service-user participation has gained
mainstream legitimacy, particularly through the collec-
tive efforts of people with disability and people with
experience of mental illness. In the United Kingdom
and in Australia, the highly political process of self-
organisation, which manifested in lobby groups and
self-help groups, now operates alongside, against or
within government-sanctioned service-user forums,
such as advisory groups. For Barnes (1999, 2008), the
dangers of incorporating participatory practice into
formal systems of governance may be outweighed by
opportunities for transformation through collaboration
between user groups and government. The ongoing
question, however, is the extent to which power is dis-
tributed between partners in this process and users are
able to exert real inuence on outcomes.
For policy makers and managers caught in neoliberal
politics, participation was the means through which
service users as consumers exercised choice. It was the
job of service providers to provide them with the widest
range of services from which to choose, while compe-
tition between service providers engendered the best
quality services. Hence the emergence of neoliberalism
in Western welfare systems led to a strong emphasis on
service-user choice as a form of user empowerment.
This marketisation of services led to person-centred
care with care packages tailored to service-users
wants within a mixed economy of welfare, wherein
provision was shared by public and private providers.
The service user as consumer was seen to have an
active role in shaping service delivery through their
decisions about the services they chose. In reality,
however, neoliberal welfare increased inequality and
favoured people who were better resourced, informed
and able to access quality services at the expense of the
most vulnerable (Barnes & Prior, 1995; Newman,
Glendinning, & Hughes, 2008).
Importantly, what these differing assumptions about
participation overlooked was the empirical question of
whether participatory practices actually achieved what
they set out to achieve. Carr (2004, 2007) noted that
while service-user participation in the UK had become
a legislative requirement, its impact had not been moni-
tored or evaluated effectively. The normative impera-
tive of participation had not been backed by empirical
evidence of its effectiveness and, rather than real par-
ticipation, tokenism had led to service users having a
seat at the table without actually having any real oppor-
tunity to inuence decisions and affect lasting change
(Arnstein, 1969; Cornwall, 2008). The aspirations for
Davies et al.
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service-user participation have become unclear, as have
the outcomes. This study sought to clarify the motiva-
tions and aspirations for service users themselves to
participate at individual and representative levels and,
further, to examine the extent to which the outcomes of
service-user participation contribute to broader societal
and economic participation.
Reinstating social justice
The ethical underpinnings of social justice are complex
and contentious. Nancy Frasers (2005) work in theo-
retical sociology has been signicant in this eld. Her
notion of parity of participation, which requires
social arrangements that permit all to participate as
peers in social life (Fraser, 2005, p. 73) was key to her
framework of social justice. Fraser (2008ab) divided
the concept of social justice into three constitutive
domains: economic, cultural and political, and posited
three crucial reparative mechanisms to achieve parity
of participation: redistribution, recognition and repre-
sentation. Her framework responded to a tendency to
emphasise the importance of identity struggles and pri-
oritise the recognition of identity as fundamental to
achieving social justice. She did not underestimate the
importance of recognition, but saw real dangers in
group identity struggles that failed to recognise the
heterogeneity of individuals. Fraser (2001) proposed
instead, a status model (p. 24) focused on the ways in
which the status of people was subordinated. The cul-
tural value was constructed, not according to a group
identity, but in relation to the structural ways in which
certain people were prevented from full participation in
society. Furthermore, her framework suggested that
redistributive measures were just as important as struc-
tural change to compensate for status subordination.
Redistribution referred not only to the sharing of wealth
but also to the sharing of economic power. Recognition
and redistribution were the foci of Frasers earlier
works, but her more recent social justice framework
explicitly included representation, noting that measures
to redress political subordination and incapacity were
crucial (Bozalek, 2012; Fraser, 2008b, 2009).
Swanson (2005) criticised Frasers separation of the
economic, cultural and political for falsely implying
that these domains operated independently of one
another. For Butler (1998), the domain of identity was
central and de-emphasising culture equated to a resist-
ance to unity (p. 44). Honneth (2001, 2004), perhaps
Frasers most vigorous and challenging critic, asserted
that Fraser had reduced recognition to a cultural value
in identity politics and had failed to fully grasp its
complexities. In many respects, Honneth and Fraser
were arguing for the same side. Both acknowledged
that recognition and rights-based approaches to
social justice were essential and the just allocation of
resources was crucial. Honneth, however, asserted that
the struggle for redistribution stemmed from a founda-
tional ontological struggle for recognition. He saw
maldistribution as indicative of the sociocultural values
attributed to certain activities and roles. As such,
redistribution would apparently ow from struggles for
recognition. Fraser agreed that recognition and rights-
based approaches were essential, but claimed that
identity-focused approaches to social justice had the
propensity to diminish the importance of its structural
economic aspects. The danger in emphasising the
recognition aspect of this struggle was that divisive
group identities and stereotypes would be reinforced.
Injustice could be perpetuated through individualiz-
ing, victim-blaming discourses, while structural per-
spectives are absent or marginalized (Fraser, 2012,
p. 45). In Frasers terms, as the axis of recognition is
elevated, the axis of distribution is stalled.
Service-user participation, as distinct from this
broader notion of participatory parity, has been posited
as the empowerment of subordinated groups or indi-
viduals, recognising their fundamental human right to
be represented and have a say in the decisions that
affect them, or as the empowerment of individuals
through increased opportunity to choose services
within a market-based system. The present study con-
sidered that analysis of service-user participation
requires a framework that actually reects the multi-
faceted and systemic challenges intrinsic to social
justice, and it is apparent that the type of dualism (later
threefold with the inclusion of representation) inherent
in Frasers model of participatory parity affords a
useful tool for analysing the impact of social service
interventions on equality and opportunity. The study
examined the extent to which service users considered
that they participated in social service decisions, at
the individual and representative levels, the type of
activities which they considered to be participatory
and whether service-user participation did, or could,
contribute to participatory parity and social justice.
Service-user perspectives: homelessness and
mental health case studies
To examine the applicability of Frasers social justice
framework to notions of participation within social ser-
vices, two case studies drew on the direct perspectives
of people who had experienced the extreme end of
subordination and inequality. The case studies were
purposefully selected to contrast the experiences of
mental health service users who, in Australia, had a
long history of consumer participation, with those of
homelessness service users who were just beginning to
have recognised roles in this area. After analysing
policy documents pertaining to mental health and
homelessness in Australia, key consumer advisory
Putting the parity into service-user participation
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groups and agencies were approached to support the
recruitment of service users to the study. The study was
advertised through these consumer groups and agen-
cies, via presentations at service-user meetings, e-mail
bulletins and mail-out newsletters. Participants then
self-nominated directly to the researcher and were pro-
vided detailed information about the research and pro-
cesses for maintaining condentiality. Ethics approval
was granted by the university Human Research Ethics
Committee. Because service-user and consumer groups
were used as intermediaries for recruiting participants,
most of the studys respondents identied as service-
user representatives or consumer advocates, although to
varying degrees. In each case study, 11 service users
(total of 22 service users in all) took part in individual,
semi-structured interviews to discuss their understand-
ing of participation and aspirations for engaging with
social services. A small sample of service providers
was also interviewed ve for the homelessness case
study and six for the mental health study. Relevant
service providers were identied through policy analy-
sis and the interviews with service users. Service pro-
viders were invited to participate through a direct
written invitation. The intention was to test for consist-
encies and/or tensions between service users and pro-
viders understandings. All interviews were transcribed
and identifying features including names were changed
to protect anonymity. They were then coded to group
experiences of participation, motivations for participa-
tion, and challenges and opportunities for participation.
The preliminary ndings from these interviews were
presented back to service users through focus groups to
test the rigour and accuracy of the ndings, with three
service users participating in the homelessness focus
group and four participating in the mental health
focus group.
Qualitative data generated from the case studies
reinforced ndings from the literature that suggested
participatory practices in social services had increased,
but had done so in inconsistent and tokenistic ways
(Beresford & Croft, 2004; Carr, 2007; Cruikshank,
1999). Service users participated in decision making
regarding social services through a number of means,
which varied greatly across the two sectors of mental
health and homelessness. At a representative level,
service-user participation was a fairly new concept in
the homelessness sector. The rst consumer advisory
groups had been formed only in the last 5 years and
there was increasing demand for service users to be
represented in government advisory panels or to be
consulted on policy developments through service-user
forums. However, there were also noticeable absences,
such as the lack of service-user representation in
national advisory boards. There were few citizen-
controlled means of group participation, although
some respondents chose to operate independently,
outside formal groups in order to retain their level of
control. In the mental health sector, service-user rep-
resentative roles were often far more structured, paid
positions. Many service users had participated in main-
stream health and social service agencies, even as
employees of these agencies in consumer-designated
roles. Respondents described taking part in a diverse
list of long-established and new consumer groups,
some funded and/or supported by government agen-
cies, others driven directly by service users. Again,
some participants chose to operate as individual advo-
cates rather than within agency or user-controlled
groups. At an individual level of service-user partici-
pation, there were more similarities than differences
across the case studies. Mental health and homeless-
ness service users revealed that collaborative decision-
making processes had been undermined by the sheer
fact that there were no options from which to choose.
Rather than being empowered by increased opportuni-
ties to choose services and exercise market power,
service users felt that there was little diversity in the
options for social services, the standard of services was
often poor and the more desperate they were for a
service the less likely they were to make an active
choice. Weakened by severe crisis and unable to take
control of her situation, Jane (homelessness service
user) explained that:
. . . people are angry, people get discriminated
against. Not just from society as a whole, but from
the very services that are there to, set up to, help
protect them and help them on their way and help
them exit the cycle of homelessness.
This signalled what Fraser (2005) called institution-
alised value patterns of exclusion. Service-user partici-
pation did not adequately capture the types of inclusion
or exclusion important to service users. Respondents in
both case studies described disparities in participation
which manifested in difculties to attain or sustain
employment, compromised access to legal protection,
nancial poverty, poor physical health, limited control
over where to set up home and a general sense of
feeling different from others in mainstream society. The
aspiration to maintain stable, secure housing or main-
tain good mental health is seen as a mark of full citi-
zenship in Australian society.
Frasers (2001) notion that participation was not just
an issue of social acceptance, but also required signi-
cant attention to the economic and political domains of
distribution, held true for these respondents. With
regard to the political domain, service users accounts
consistently showed that their experience reected their
structural position in a distributed eld of power rela-
tions. Nevertheless, identity was at times over-riding
for these respondents, who bore the brunt of stigmati-
sation, labelling, marginalisation and misrecognition.
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Recognition was thus crucial to enhancing parity of
participation. This was most evident in the mental
health case study, where the experiences of participa-
tion in formal mechanisms, such as advocacy and advi-
sory groups, were more strongly established, but it was
also expressed by respondents in the homelessness case
study. Those who participated in representative and
advocacy work did so largely because of a sense that
their unique experience of local services could contrib-
ute to an improved experience for others in similar
positions in the future. They also believed that the expe-
rience of service-user participation had provided them
with expert skills and condence that supported their
own recovery, whether personal or professional.
Notions of participation as a highly political means
of empowerment by which service users exercised their
right to be active in decisions affecting them, but
which also served as an end in itself by building skills
and condence for the service user (Beresford, 2007;
Beresford & Croft, 1993), held true to an extent for
these service users. In the homelessness case study, the
newly developing service-user advocacy groups in
Australia were often supported by public interest and
legal services, on the premise of participation as a
human right. Certainly, a number of respondents noted
that their experience of participation was one that had
had signicant personal benet and many, in both case
studies, described feelings of increased condence,
worth and purpose. Advocacy, even when practised at a
personal level rather than at a formal representative
level, was an act that allowed people to challenge the
system. Some respondents saw potential for their par-
ticipation as a professional development tool enabling
them to act as skilled human service sector workers in
the future, particularly in the mental health case study
where paid consumer roles were common.
Importantly, respondents perceived that participa-
tion could not be constrained to notions of service-user
involvement and representative and formal practices,
such as advisory groups, committees and consulta-
tions. For the service users in this study, service-user
participation was indistinguishable from the type of
participation envisaged in social justice frameworks
and also involved a plethora of ways in which people
sought an equitable balance of power, respect, nancial
security and recognition. Table 1 summarises some of
the responses that service users themselves identied as
participatory mechanisms, demonstrating that their
conception of participation was much more rich,
dynamic and heterogeneous than that conceptualised in
the participation literature.
Many service users had disengaged from formal rep-
resentative participation activities because they felt
they did not have the skills to take part or because they
believed their unique status would not be respected. In
this sense, the notion of parity of participation is a
fruitful device because it considers participation as the
way in which society (in this case, the social services)
supports individuals opportunities to reshape the
structure of society. In order to achieve such enhanced
opportunities for marginalised service users, a one-
size-ts-all approach to participation is insufcient.
Service-user participation is not only about the ways in
which people access, use and engage with services, but
also about the ways in which they access broader
opportunities within a society as a result of a social or
therapeutic intervention.
The notion of participation as consumerism was
strongly challenged in the literature for its failure to
account for the needs of the most vulnerable members
of society (Barnes & Prior, 1995; Newman et al.,
2008). Most of the service-user respondents in this
study are considered to be among the most vulnerable
members of Australian society, yet respondents spoke
of participation in consumer advisory groups, of
working as consumer advocates and taking on roles
as consumer representatives. While they identied as
consumers of social services, they contradicted this
notion of consumerism in describing their failure to
be afforded choice in accessing services. Neoliberal
models of individualised, informed choice were funda-
mentally problematic to the service users because, in
Table 1. Diverse modes of participation.
Economic Cultural Political
Use income to purchase private services.
Gain formal education to access different
job opportunities.
Learn about the social benets system in
order to access maximum payable benet.
Work as a paid consumer consultant.
Challenge stereotypes by presenting in public
and personal exchanges as intelligent, kind
and normal.
Gain education.
Access those services where one felt
respected.
Build positive relationships with workers.
Be a whole person (not just about
illness/issue) build relationships, work,
have diverse social and recreational interests.
Take part in formal advisory groups and
committees.
Speak publicly about experiences, as
a representative.
Set up service-user run groups,
activities and research projects.
Take part in letter-writing campaigns.
Advocate as part of a formal group
or as an individual to friends, peers
and family.
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reality, there were limited, or no, options from which to
choose. The majority of service users in both case
studies felt subjected to the whims of social service
providers pressuring them to simply take what was
on offer.
They expressed cynicism about the gap between
those who could afford to pay for mental health ser-
vices true consumers making active decisions about
their treatment and those who could not afford to pay.
Service users without the means to access the private
system had to accept the limited range of public or
community services available or refuse services and
nd their own means of recovery. A consumerist
approach exacerbated the disparity in participation
because often times preferred services were rendered
unattainable to those without the means to pay, or had
serious nancial consequences for those determined to
access preferred fee-for-service treatments that spent
disproportionate amounts of their income (often a dis-
ability pension) on services.
While users of homelessness-related services
described themselves as consumers in relation to par-
ticipation activities, their descriptions of using social
services indicated that they were not, in fact, consum-
ers at all. Most of the respondents had achieved some
stability in their housing and income (although this was
often a pension, casual employment or unemployment
income) and were now at a point where they felt they
had made some choice about where they lived and
which services they accessed to support their needs.
However, all respondents indicated that while homeless
and experiencing signicant crisis, they were forced
to take what was on offer through community-sector
emergency and short-term accommodation facilities
or public housing, and often their only choice was
between the bed on offer or sleeping rough. Sometimes
the bed on offer was in an unsuitable, crime-ridden
location, away from essential social supports, in facili-
ties governed by regulations with which they did not
concur. Sometimes they did not meet the criteria to
receive public housing, despite clearly signalling they
had reached the end of the line and run out of accom-
modation options; nor did they have the means a
good rental history, references, money and secure
employment to participate in the private housing
sector. The failure of both the public and private
housing market to meet their needs and their inability
to function as consumers with choice were central to
their homelessness status.
Service-user participation was seen as important
because, without it, the system of social services could
not adequately meet the needs of its service users.
Across both case studies, there was a strong belief that
the social services need a real big shaking up (Sue,
homelessness service user). This was often an altruis-
tic notion, whereby service users were adamant that
others should not have to endure the same negative
experiences they had themselves endured. Melanie
(homelessness service user), in describing her chal-
lenges for nding appropriate housing and how it had
motivated her to become an advocate for others, said
its uncomfortable [for me] getting up those stairs,
but more to the point is, how many other people are
really not happy and cant say anything about it? In
both case studies, there was a common perception that
those who had managed to successfully navigate the
complex and often-challenging system of social ser-
vices felt a responsibility to use their knowledge to
improve the situation for future service users or to
speak up on behalf of others who lacked the con-
dence, opportunities or skills to do so. Mental health
service user Tara stated, I have empathy with the
people who use the system and who dont know what I
know. And I know that what I have learnt is useful and
I want to share that.
Service-user participation as an investment in
system improvement was a form of distributive justice.
Those who participated as advocates believed that their
insight gleaned from the experience of homelessness or
mental illness could contribute to important policy-
level changes in the funding and delivery of services.
They did not see that policy makers and service pro-
viders could make the necessary changes to the system
without service-user expertise. Homelessness service
user Paul stated:
The homeless people themselves are the experts. And
I know a lot of people will say, But youre part of the
problem, how can you be part of the solution? Well
no-one understands the problems better than a
homeless person.
Those whose participation was more personal also
believed their experience could be transformative and
change stereotypical assumptions on homelessness
and mental illness. They rmly believed their active
involvement would result in better outcomes in indi-
vidual clientpractitioner interactions. The act of
participation was not both the end and the means
(Beresford & Croft, 1993, p. 6), it was the means to
creating change through distributive expertise and
experience. It was not just a static human right, but an
active dynamic process aimed at achieving a common
good. Strategies that treated participation as an end in
itself were criticised for being tokenistic: When people
had been asked to give input but felt their contribution
had not inuenced decision making, when they had
been given positions on committees but not been asked
their opinion, when they had been employed as an
advocate but not treated as a professional, when they
had been told their input was valuable but had not been
paid, then participation was seen to have failed. Token-
istic participation did not sufce.
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From service-user participation to integrative
social justice
Frasers (2001) model of parity of participation chal-
lenges undue emphasis on identity-focused approaches
to participation, whereby the result is often to impose
a single, drastically simplied group identity, which
denies the complexity of peoples lives, the multiplic-
ity of their identications and the cross-pulls of their
various afliations (p. 24). In this study, mental health
service users in particular expressed signicant con-
cerns about the pressures for them to conform to an
identity associated with mental illness, overlooking
their diverse roles as parents, spouses, siblings,
workers, friends and successful members of society.
Stigma and discrimination were all too easily attached
to simplied identities: the mentally ill or home-
less. Service users were strongly motivated to partici-
pate in representative groups and advocacy activities
precisely to challenge stigmatisation and discrimina-
tion and correct misperceptions. However, even the
forums in which they participated as activists tended
to homogenise service users, leading some to avoid
group or representative modes of participation. Mental
health service user Greta said, Thats why I walked
away from peer groups, because Im . . . doing it in a
different way. Others soldiered on, believing the
benets outweighed the challenges. Identity, then, was
important to service users, most of whom felt mis-
recognised, even within the representative forums in
which they participated.
To mitigate such problems, Fraser (2001) proposed
a status model where the purpose was to de-
institutionalize patterns of cultural value that impede
parity of participation and to replace them with pat-
terns that foster it (p. 25, original emphasis). Rather
than focus on shared group identity, in this case home-
lessness or mental illness, a status model highlights the
ways in which people are prevented from taking part in
the full spectrum of opportunities available to members
within mainstream society. In Frasers (2001) status
model, participation involves more than representative
activities and is extended to issues of access to eco-
nomic, social, cultural and political opportunities.
While consumer advisory groups offer an opportunity
for service-user involvement, they do not necessarily
align with full participation in the sense in which Fraser
(2001) used the term to refer to achievement of full
citizenship status within participatory democracies.
This study afrmed the ideal-typical construction
of redistribution, recognition and representation, indi-
cating that actual practice fell short of such a model of
social justice. It also supported some of Honneths
(2004) criticisms in that service users in this study
repeatedly linked the disparity in the opportunities
afforded to them to issues of identity, such as stigma
and discrimination. They saw that economic and politi-
cal disparities stemmed from the more general issues
associated with misunderstanding them, their skills,
capacities, interests and preferences, while considered
under the simplied identity of mental health or home-
lessness service user.
However, in realising such weaknesses within this
social justice framework, the concept of parity of par-
ticipation was necessary to counter normative notions
of service-user involvement and representative modes
of participation that dominated the service-user partici-
pation discourse. Participation was not just a tool for
recognising their right to involvement. Their goal was
structural change. Service-user participation, though
awed, offered opportunities to take part in society and
was therefore a starting point. However, the end to
which service users aspired was social justice.
The dynamic nature of peoples capacities and inter-
ests signicantly impacted on the way in which they
engaged in formal participation structures. Both case
studies demonstrated that people were more likely to
take part in formal advocacy and participation activi-
ties when their circumstances were relatively stable.
However, it was not just about the individuals capacity
or willingness to participate, but also the way in which
participation had been construed as particular sets of
activities, such as taking part in committees, that were
really only accessible to those with resources and
capacity (including stability) to take part. Cruikshanks
(1999) assertion that participation and empowerment
were, paradoxically, tools to enact compliance and
make people govern themselves through the capacity
of citizens to act upon themselves, guided by the exper-
tise of the social sciences and social service profes-
sionals (p. 89) was a concern reected in the research
ndings. The tools of participation tended to be con-
trolled by the authorities government and service
providers and sometimes even consumer groups
rather than service users themselves and were overly
simplistic, homogenous responses to highly complex
and dynamic circumstances. The exceptions were the
groups, largely within the mental health case study,
that were operated independently by service users,
such as peer groups, creative art groups and lobby
groups. For some respondents, such as Tara, these
groups were an important means of retaining power
and citizen control, although continually faced with a
lack of resources and funds. For others, such as Sarah
and Greta, these groups continued to offer problematic
forums for group, shared identity. Respondents were
cynical about whether participatory practices were
deliberately exclusionary because policy makers and
practitioners were seen to be ill-prepared to confront
and accommodate service users in the midst of crisis.
This was in stark contrast to Frasers (2000) emphasis
on the structural nature of participation, in which the
Putting the parity into service-user participation
Int J Soc Welfare 2013: :
2013 The Author(s). International Journal of Social Welfare 2013 John Wiley & Sons Ltd and the International Journal of Social Welfare 7
opposite would hold true. Rather than attribute peo-
ples unfavourable circumstances to their own failings
(Fraser, 2012, p. 51), social justice would be realised
where the most subordinated members of the society
had opportunities to participate in economic, political
and cultural activities.
Within the mental health case study, many of the
service users noted that what it means to be well is a
state that continues to change over time. Within the
homelessness case study, notions of successful out-
comes also evolve, as peoples circumstances alter and
as they move between periods of crisis and stability.
There is, therefore, a problem in individualising social
service use to the point at which service users must be
able to articulate outcomes in order to have a successful
intervention, or in placing too much responsibility on
the service user for the success or otherwise of an
intervention. Where participation in service use is nar-
rowly dened as the individual service user contribut-
ing to, or determining, preferences for outcomes, there
is insufcient breadth to incorporate participatory prin-
ciples in situations where an individuals capacity is
limited. In this case, participation becomes a privilege
that is only earned when the point of stability is attained
and which is withdrawn when that stability falters.
However, where participation is considered in relation
to the structural enablers and inhibitors that allow a
person to access the full range of opportunities within a
society, the complex and dynamic nature of peoples
capacity can be accommodated. Participation then
becomes the guiding principle by which interactions
with service users can be measured and practitioners
test their work by the extent to which it either enables or
inhibits participation, based on the service users
current circumstances.
Conclusion
The case study ndings afrm concerns identied in
the literature review about the inadequacy of par-
ticipation as a rights-based or consumerist approach,
revealing important considerations for the future devel-
opment of the concept. Table 2 summarises the key
strengths and challenges for notions of participation as
rights-based and consumerist, as derived from this
study. It also outlines key challenges and opportunities
afforded by the concept of parity of participation.
At their most vulnerable, service users did not have
the means to actively consume, but, as their condence
grew and their circumstances stabilised, some found
that mechanisms, such as private service provision,
expanded their opportunities and independence. Agen-
cies engaged with service users in recognition of their
right to participate, and service users at least those
with the condence and resources to do so took up the
opportunity to exercise that right. However, the service
users in this study revealed that the rights-based
approach had not engaged them sufciently in actual
decision-making processes and the outcomes of their
participation were often unclear. They wanted a more
tangible role in the problem-solving process. Further,
this approach tended to result in representative modes
of participation, whereas consumerism resulted in
individualised modes.
In measuring the effectiveness of participation, the
key question is not whether service users were given the
opportunity to participate, but whether there were posi-
tive effects on economic, identity/cultural and political
opportunities for service users as a result of the policy
or intervention. While service-user involvement at rep-
resentative levels may prove to be important (although
Table 2. Implications for participation frameworks.
Participation as right Participation as consumerism Participation as social justice/parity of
participation
Representative participation Individual participation Capacity for individual and representative
notions of participation
Results in legislated and formal mechanisms for
service-user input
Provides power and independence for those
with necessary capacity and resources
Encompasses aspects of rights-based and
consumerist approaches
Treats the act of participation as the end goal
(having a seat at the table is sufcient
acknowledgement of the right to participate)
Requires capacity and resources for independent
decision making that service users,
particularly in crisis, may not have
Recognises that single issue of
homelessness or mental illness does not
reect full extent of exclusion
Service-user involvement instead of meaningful
participation
Exacerbates economic inequalities because
those who can afford to pay for private
services have greater choice
Emphasises responsibility of authorities to
change, rather than of service users to
adapt
Service users given the right to participate, but
not necessarily the means (such as skills,
technology, condence, appropriate settings)
Implies availability of diverse options for
treatment and services, when in fact there are
few choices to be made in regard to services
Underestimates centrality of identity to
service-user perceptions of disparity
Power retained with authorities as they control
opportunities for participation
Implies active decision to consume services,
when in fact people are often forced into
service use through poverty or poor health
Supports examination of complexities and
interconnections between aspects such as
poverty and participation
Leads to tokenistic practices Leads to further marginalisation of vulnerable
people
Needs further development to translate to
meaningful/operational actions
Davies et al.
8
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2013 The Author(s). International Journal of Social Welfare 2013 John Wiley & Sons Ltd and the International Journal of Social Welfare
further testing is required) in enhancing the relevance
and applicability of policy and practice, what is most
important is that the outcomes of policy and practice
enhance opportunities to participate more fully in
society. More service-user involvement does not neces-
sarily lead to more participation and it is the actual
impact on opportunities and capacities to participate in
society that is most important. Service-user advocacy
and advisory groups similarly need to refocus their
strategies to consider less emphasis on involvement and
move towards advocating for actual structural change.
In Australia, as in countries such as the UK and the
USA, service-user participation has tended towards
rights-based or consumerist choice approaches. The
homelessness and mental health service-user case
studies demonstrate the ineffectiveness of these
approaches in capturing the aspirations and needs of
highly marginalised service users. Given this failure,
parity of participation has proved useful as a tool for
testing the cogency of claims of participation in
framing the discussion of social justice and examin-
ing the differences between economic and political
forms of (re)distribution. However, further research is
required to determine the extent to which parity of
participation might actually change outcomes for
service users in empirical terms. Whether parity of
participation can be operationalised as a device to
shape and measure policy and practice approaches, or
whether it is simply a useful heuristic device, remains
to be tested. The promise of parity of participation
revealed in this study is its usefulness in examining the
complex and interconnected aspects of participation
that have tended to be oversimplied in existing
service-user involvement strategies. However, a rigor-
ous testing of the domains of recognition, redistribution
and representation as tools for developing and assess-
ing human service policy and shaping the ways in
which services engage with service users is needed.
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