A local council has issued a vote of no confidence in the NHS trust which runs mental health services in its area.
The vote by St Helens Council follows concern over modernisation plans drawn up by the Five Boroughs NHS Trust.
Councillors fear it could lead to a cut in services in St Helens and accused the trust of failing to consult them.
A trust spokesman expressed "surprise" and "disappointment" at the council and said it always talked to its partners about future strategy.
Consultants are currently working with St Helens, Halton, Knowsley and Warrington councils, Primary Care Trusts and the Five Borough's Trust to look at ways of improving mental health services in the region.
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We are not making any cuts to service but are looking to modernise
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But Councillor Andy Bowden said the authority needed to be convinced it was working in a partnership that ensured proposals affecting St Helens were properly consulted on before decisions were taken.
He said there were concerns that a mental health ward could close under the trust's plans.
"We would condemn this happening in St Helens where there are low levels of investment in mental health and there is evidence of over capacity in neighbouring Warrington," said Mr Bowden.
The Five Borough's Trust said it had been a partner in the local authority and primary care trust initiative to develop a future strategy for mental health services.
A spokesman said: "We are not making any cuts to service but are looking to modernise.
"We will consult on any new proposals and fully consider our stakeholders contribution before any change is considered.
"Our intention is to improve service delivery first and foremost, but like many other trusts we are actively managing our financial position and have continued to reduce our projected overspend without resorting to closure - but through redesign and refocusing our management arrangements."