Public policy in Australia recommends that the relationship between consumers and mental health professionals should be one of equals and that consumers be encouraged to have input into service delivery at every level. This approach requires a significant change in attitude for mental health professionals and within services. Although consumer input into mental health service delivery has improved, there is still a long way to go. Unfortunately, consumers consider many of the efforts by mental health services to be tokenistic. This paper considers some of the issues regarding consumer participation, including the changing community attitudes towards people with a mental illness, the concept of recovery, challenges for health professionals and the impediments to consumer participation.