LAUSR

Purpose This paper is an author’s reply to the article by Cresswell (2017) critiquing the original piece by Spandler and McKeown (2017) on truth and reconciliation (T&R) in psychiatry. The paper aims to discuss this issue. Design/methodology/approach It continues the dialogue about the nature of reconciliation in mental health services and reflects on distinctions between the nature of historical abuses within the asylum system and the need to understand and prevent further harm within contemporary services. Findings Whilst the authors acknowledge the tension between reconciliation and democratic debate they suggest that the process does not have to mean agreement or acquiescence. They reaffirm their optimistic belief that better mental health services are possible and appreciate that true reconciliation is a process that will require both debate and the building of constructive alliances. Originality/value A grassroots T&R process might be a form of transitional justice which does not negate the need for wider social and policy changes, but may actually help achieve it.