This seminar, as part of the European W.F.M.H. programme examines relevant mental health issues by multi-international and multidisciplinary working groups. The report focuses on the working relationships of voluntary and statutory mental health services in Europe, within the broader context provided by the USA and Canada. The seminar covers the topics of advocacy, volunteer services and self-help groups and the basic conflict of who is to have the knowledge, power, right and responsibility for delivering care is central to all discussion.