Your report about the rising demand on mental health services and the revolving door syndrome (news focus, 25 October) mentions alternatives to hospital admission, in particular the increasing use of assertive outreach teams. It is important to offer mental health service users a range of appropriate support and care in community settings. We manage many such services ourselves. The wider the choice, the less likely that people will end up in hospital.

But one question was not posed: what do service users themselves want? There is a danger we end up funding services that we 'experts' think are required, and fail to listen properly to service users who may want something quite different. Many of our service users, for example, tell us they want more 24-hour access services to combat the social isolation they feel. But we have enormous problems securing funding to establish these.

Health secretary Alan Milburn recently talked of offering patients more choice and giving them more power. It is time to involve mental health service users meaningfully - not just in a token fashion - in planning and commissioning services.

Gil Hitchon Chief executive Mental Aftercare Association (MACA)