Background: Few studies have investigated user involvement initiatives in whole organizations. The aim was to explore the experiences of professionals and user representatives taking part in the implementation of a user involvement plan.

Materials: A qualitative study in a mental health hospital included interviews and observational data.

Discussion: Three different stories emerged. The first described the implementation as a success. The second described the implementation as a success, but after overcoming several obstacles. The third described that the development plan had limited impact.

Conclusions: Close attention should be made to decision-making and resource allocation when implementing user involvement.