We agree that consumers' perspectives have had a limited impact on major policy shifts but note that they have resulted in important changes in the role of patients and families in all aspects of mental health treatment. In addition, we take issue with the use of "consumer" and "survivor" as one combined term because of the words' very different connotations. The field of psychiatry and the consumer movement may still differ in their views on the need for involuntary treatment but are now generally allied around the need for more effective and better-funded psychiatric services.