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This survey portrays mental health services' practice in relation to Government policy. However, adherence to guidelines cannot be taken as a guarantee of service quality or efficiency.

This evidence can be used in allocating resources such respite care, family therapy and CBT to carers. These findings have implications for how mental health services might improve their provision for carers, for instance, involvement in care planning may help carers to cope.

This article draws on insights gained from three projects described as participatory action research (PAR) and undertaken in separate contexts within the UK. What binds them together alongside the commitment to PAR is that each project coordinator raised the issue of the under-representation of opportunities for disruption as a trajectory to knowledge democracy. PAR places a relational process at the centre of the research practice. It brings together people with varied knowledges, perspectives and experiences and aspires to be a nonhierarchical, relational, collaborative endeavour. This challenge and disrupts the traditional hierarchical hegemony of the external expert in research situations. Bringing people together does not, however, equate to shared agency, authentic participation and knowledge democracy. For different knowledges to be created previous knoweldges need to be disrupted. The argument raised in this paper is that a neglected element of PAR has been the deliberate intent to nurture disruption within communicative spaces in relationally based engagements. It is posited that disruption within the PAR process itself, the disruption of beliefs and assumptions that underpin local actions, is an important enabler of other voices and knowledges being recognised and acted upon. Forged by a range of actors the disruption of hitherto accepted knowledge creates a space for new ways of seeing and doing. The three projects described in this paper reveal how and why the recognition of the centrality of disruption, and harnessing its power, contributes to creating a functional knowledge democracy for more radical change.

Accessible summary• People with learning difficulties have been involved in research that asked them to tell their stories about how they support (help) each other. • There were many times when people had helped each other in lots of different ways. • People talked about times when they had listened to each other and helped each other when things were hard. They also spoke about working as a team and helping each other to learn. • Supporting each other can make life better for people with learning difficulties and help to break down the barriers. SummaryMutual Support, a model of peer support by and for people with learning difficulties, was constructed through a participatory research process. The research focussed on individual narratives from people with learning difficulties. These narratives were then brought together to form a collective model of support. This paper outlines the detailed research process and positions the collective model of support within the self-advocacy and involvement movements. Direct quotes from people with learning difficulties illustrate the different aspects of the multifaceted model. The positive effects of Mutual Support, which form the basis of the implications for wider policy, theory and practice, are also outlined. These include people being able to participate more fully; ambitions being fulfilled; people who have been mentored becoming mentors themselves; and dignity and respect being reclaimed. The overall argument is that, as an example of empowerment through participation, peer support by and for people with learning difficulties has emancipatory potential.Keywords Empowerment through participation, experience-based narrative research, inclusive research, peer support by and for people with learning difficulties