Bibliotherapy schemes aim to improve mental health and well-being. Schemes focus on engagement with either imaginative literature or self-help texts and are now commonplace in U.K. public libraries. Impetus for bibliotherapy schemes was influenced by health policy and a drive toward partnership working. There is a recognized need for in-depth evaluation of bibliotherapy services; the lack of evaluation is problematic, as the schemes are designed without reference to service user perspectives. There is a need to identify and analyze usage to assess effectiveness of the schemes. Drawing on data from interviews and focus groups with library and health professionals and service users, this article explores the service provider and service user perspective on bibliotherapy schemes. It concludes that—for service providers—there is a lack of clarity and understanding about how bibliotherapy works, and this impacts on the experience of service users. While service providers and service users share a common goal of improving mental health and well-being, their understandings of bibliotherapy differ, meaning there is a potential gap between service provision and service user needs. The article concludes that in-depth research influenced by user-centered design principles, may help to improve services in practice.