Abstract
This study examines the views of patients of adult in-patient psychiatric services in a large, rural county in England. The views were obtained over a 4-year period using a semi-structured interview schedule and were then subject to qualitative analysis. The emergent themes extracted from the comments made by the patients reflect what appear to be the most important issues for in-patient service users. The 13 themes identified are presented with illustrative comments, and discussed in relation to the methodology used and the issues of the intransigence and power of psychiatric institutional systems. Finally, the challenge of pursuing more humane and caring practices within psychiatric institutions is considered and means of achieving and monitoring this are discussed.