This chapter describes the different areas of user involvement (relevant interventions, type and quality of provided services, professionals and user training, research direction and criticism, supporting legal framework empowerment and implementation), the data on the extent of this involvement on European and national level and the institutional, clinical and ideological framework that determines user involvement in the issues that concern this group. The necessity of extending the debate between the involved parties (users, professionals, relatives, decision-makers at health policy level, etc.) and the terms and conditions that will make this debate equal, essential and productive are the points this chapter is focused on.