Mental health consumer-run organizations are alternatives to mainstream mental health services, and they have the dual focus of supporting members and creating systems change. The existing literature suggests that these organizations have beneficial impacts on social support, community integration, personal empowerment, subjective quality of life, symptom distress, utilization of hospitals, and employment/education. However, much of this research is cross-sectional or retrospective and has not used comparison groups, thus limiting conclusions about the effectiveness of these organizations in improving the lives of members. Although many consumer-run organizations also have a focus on social systems change, there has been little research documenting either the nature of these activities or the system changes that result from such activities. We provide an overview of a longitudinal study of four mental health Consumer/Survivor Initiatives. The study examines both individual-level and systems-level activities and impacts by using both quantitative and qualitative methods with a participatory action research framework. © 2006 Wiley Periodicals, Inc.