Victoria, Australia has experienced significant changes in the structure and delivery of mental health services over the past three decades. As a result of these changes, there is now an expectation that consumers of services and their carers have increased opportunities to participate in the design and delivery of services. There currently exists a paucity of research that examines the degree to which this goal has been realized in practice. This article presents findings from a qualitative research study investigating the perceptions of consumers and carers regarding the degree to which the contemporary service system allows for their increased participation. Data were collected through in-depth interviews with consumers and carers. The findings suggest that consumers have identified an increased scope for their participation, although this varies considerably from service to service. Carers on the other hand described very little opportunity for participation at any level. The responses of carers suggest there may be some inherent difficulty in facilitating increased participation for both groups. Strategies to support carer participation are urgently required if the goals of state and national mental health policy in Australia are to be realized.