It has been interesting and exhilarating to read the responses to my initial essay. And also saddening when we hear the gallows humour of the mental health social workers cited by Rich Moth and Andy Brammer, and Colette Bremang's confusion when, as a newly qualified social worker, she is left unprepared and unsupported in the face of mothers struggling with mental health problems. And there is ‘the despair, helplessness, hopelessness’ of the service user, as expressed by June Sadd, survivor activist and social work educator. All the more important, then, that this concluding section should both serve as a summary of the debate so far and attempt to move us on: after all, as Marx put it, the point is ‘not to interpret the world but to change it’.

In the responses, we see some important developments of the original arguments. Helen Spandler explores the deeper perspective that comes from listening to those ‘experts by experience’ and the importance, before rushing in with risk assessments and quick-fix treatments, of ‘letting madness breathe’. Rich Moth and Andy Brammer detail the corrosive impact of markets, targets and medicalisation; and Jerry Tew provides a wider policy analysis. June Sadd explores how racism impacts at both individual and institutional levels and likens this to a colonialism that traps both service user and worker.

What stays with me is the need to watch the jargon. There are the obvious danger phrases such as ‘“reorganisation”, “reconfiguration” or “re-engineering”’ (Andy Brammer). Others are more seductive: ‘clustering’ presented as improving the assessment and therefore the treatment of people's needs but actually reinforcing the ‘commodification’ of welfare. Rich Moth further argues that ‘evidencebased’ can be no more than evidence of how big pharma can manage and manipulate the market. Jerry Tew notes the slippage between ‘social work’ and ‘social care’, where the latter's assumption of deficit models undermines the ethical and theoretical underpinning of social work. Most dangerous of all is when the words that come from our own experiences as service users and workers, such as ‘empowerment’, ‘personalisation’, ‘social inclusion’ and ‘recovery’, are taken up by managers and policymakers and flung back at us.