PERSPECTIVE - A seat at the table: Trend or illusion?

Responding to Nancy Tomes's conclusion that mental health consumers are beneficiaries but not primary causes of a new attentiveness to consumers' concerns, this review finds various historical and contemporary reasons for the mental health consumer movement to remain vigilant: the system's shallow acceptance of consumer self-determination; continued reliance on expedient coercive tactics rather than therapeutic engagement; the currently narrow reach of initiatives in self-direction; and the fragmentation of authority in the delivery of public services and supports needed by mental health consumers.