The purpose of this article is to report on the system-level findings of a longitudinal study of four mental health consumerñrun self-help organizations. Quantitative and qualitative data revealed that staff and members of the four Consumer/Survivor Initiatives (CSIs) participated actively in system-level activities, including community planning, public education, advocacy, and action research. The qualitative data revealed a number of perceived system-level outcomes related to these activities: (1) changes in perceptions (changed perceptions of the public and mental health professionals about mental health or mental illness, the lived experience of consumer/survivors, the legitimacy of their opinions, and the perceived value of CSIs) and (2) concrete changes (tangible changes in service delivery practice, service planning, public policy, or funding allocations). These findings are discussed in the context of previous work on system-level activities and impacts of consumer/survivor organizations. © 2006 Wiley Periodicals, Inc.