This study uses focus groups of users, carers, and structured staff interviews to explore the physical health needs of mental health services users and the barriers that make it hard for them to seek or gain access to services. Results found that despite the inextricable link between physical well-being and mental health, professionals in both primary and secondary care fail to view users holistically. Professional role ambiguity and poor communications result in access difficulties for users and add to the burden felt by carers. A focus on reactive interventions to ill-health rather than on health promotion and physical well-being took place in context of paternalism, strict, adherence to the medical paradigm and failure to take users' physical health concerns seriously. Implementation of the National Service Framework (NSF) standards are discussed in the light of these findings.