Abstract
A growing number of mental health service recipients in the English-speaking world are choosing to describe themselves as “survivors”. This is partly because we survive in societies which devalue and discount our personal experiences and perceptions. But it is chiefly because we have survived an ostensibly helping system which places major obstacles across our path to self-determination. The recent emphasis upon consumerism, choice and advocacy is to be welcomed even though we must ask whether the psychiatric service can be sufficiently flexible to embrace and respond to evidence from service users and carers.

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