Mental Health activists of the civil rights times recognized, as did many other groups seeking self-definition, that such labels are metaphors that reflect how identities are perceived and constructed (McDonald 206).
In particular, in the mental health field they shape the nature of the relationship between the giver and receiver of psychiatric services, be it one with an emphasis on reciprocity or hierarchy (McLaughlin 2007).
In Australia, informal support groups of people who had recovered from episodes of mental ill health were formed during the first wave of moving patients out of psychiatric hospitals into the community in the 1960s.
The term also implied assumptions of rationality and ability to make choices in one's own best interests rather than be a passive incapacitated recipient of "expert" attention (McDonald 2006).
Other terms sometimes used by members of this community for empowerment through positive self-identification include "peers," "people with mental health disabilities," "psychiatric survivors," "users," individuals with "lived experience" and "ex-patients."