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The purpose of this paper is to review some of the key mental health education and training developments of the last decade of immense change to the service system in England. This change was part and parcel of the Labour Government's mental health modernisation agenda.

This paper aims to explore the extensive roots of peer support in mental health, and to identify the values and principles that the authors wish to hold onto as choices are made as to how and whether to engage with formal peer support within the National Health Service (NHS).

The authors attempt to cover the ground of three types of peer support, but with an emphasis on informal peer support and participation in consumer or peer‐run groups as providing the roots for the third more formal type, which is often known as intentional peer support (IPS).

Professionalisation of peer support may endanger the equality that lies at the root of peer support relationships. Independence may also be compromised if peer support becomes just another part of mainstream services. Whilst an individual/personalised approach to providing services has many strengths, one must be careful not to remove all opportunity for service users to meet together, support one another, plan and campaign.

The findings suggest that commissioners of services should aim for a plurality of peer support and be careful to ensure that informal peer support is flourishing as an essential basis for more formal peer support.

The paper shows that, with an increased interest in providing peer support as part of mainstream services, it is important to stress the basic values and principles that underpin informal service‐user led peer support.

This paper outlines the concept of service user leadership and both describes and reflects on an accredited training programme that enables mental health service users to take a leadership role.

The authors argue for a service user leadership approach and the training programme is reviewed by previous participants

Service users can take on a leadership role if they are given suitable and relevant training and development opportunities. Service user led training can be transformational.

Commissioners of mental health services should consider how to support service user leadership programmes, which can reach places and achieve outcomes that traditional mental health services are unable to attain.

The concept of service user leadership is relatively new and the training programme described in this paper is both original and highly valued by participants with many significant outcomes.