disorganised and used illicit drugs. 13 Yet it might be argued that there are potential benefits of LAIs over oral formulations in promoting recovery. So, is the job of mental health professionals (and of nurses, perhaps, in particular) to enable and respect individual patient choice, or to try to `enforce' adherence? When asked, many patients complain that they are not involved in treatment choices, often perceiving that choices are made for them by doctors or nurses. 14 In a national patient survey in England in 2007 only 43% of patients stated that they had had a say in decisions about the medication they take. In some mental health services only half of patients were told the purpose of new medication before it was started, and fewer than 40% reported that they had been told about potential side-effects. 1 Ensuring that patients are involved in treatment choices has become an important quality indicator by which mental health services in England are judged. Involving patients in treatment decisions is no longer a `nice to do', it has become a `must do'. 1 Choice is not a one-off event at the start of treatment. Patients make choices each time they take a pill or accept an injection. As mental health professionals we are at risk of being in denial about the complex and sophisticated ways in which patients express choice by self-managing medication in combination with a range of other `coping' techniques to enable them to achieve their personal goals. 3 For example,