In this timely analysis, Rich Moth assesses mental health services in a period of major change. Based on extended fieldwork in community mental health services, he explores the many impacts of policy reform, marketisation and austerity on NHS mental health provision, and positions developments in the contexts of neoliberalism and an increased emphasis on individual responsibility. Firmly rooted in the lived experiences of people using mental health services and the everyday practices of social workers, nurses and psychiatrists, he develops a stimulating perspective on how mental distress is understood and responded to within these settings.