The consumer/survivor/service-user protest movements of the 1970s-1990s led to policy changes and government funding of mental health consumer-run or self-help organizations (SHOs). A cross-national study in the United States and United Kingdom-England of SHOs incorporated nonprofit organizations run by and for people with problems in common, considers the tightrope of accepting government funding which brings stability and legitimacy but also potentially conflicts with self-help/mutual aid ethos and practices. Case studies of two SHOs in England and three SHOs in the United States show that the self-help/mutual aid ethos is embedded in the organizations' practices. Complex and nuanced relationships between SHOs and sympathetic professionals facilitate these developments.