This Perspective article addresses the issue of recovery in mental health research, policy and practice from a service user/survivor perspective. In doing so, it brings to bear a fundamentally different viewpoint to that which has dominated psychiatric history, one based on lived experience rather than the ideological allegiances of its founders. The article addresses the modern history of Western mental health provision, its over dependence on medicalised individual understandings of wellbeing, the limitations this has imposed and the challenges it has been subjected to. The issue of recovery is examined in its historical context, exploring its strengths and weaknesses. The latter weaknesses have been magnified by the association of recovery by different governments, nationally and internationally, with pressing mental health service users and others experiencing distress into employment; this is often poor quality and unsupported employment. The article puts this in the broader context of a number of values and principles underpinning both the developing psychiatric system survivor movement and the emerging international interest in Mad Studies. In doing so, the article offers a basis for the radical reform of both understandings of madness and mental distress, recognition of their holistic relations and more helpful routes to offering support and engaging with the lived experience and experiential knowledge of mental health service users.