AbstractIn Hong Kong as elsewhere, there have been calls for an active and inclusive notion of citizenship to empower people affected by mental illness service users (hereinafter users) in addition to conventional altruistic or non-discrimination principles in policy initiatives. In this paper we take a somewhat different perspective to consider how the users may contribute individually and collectively to empower themselves, and how political participation might help to re-assert the status and practice of citizenship. It shows that participation matters in the formation of citizenship for the users. We further assume that political participation is attributable to individual resources, motivations for getting involved and the presence of advocacy agencies to facilitate participation. We then proceed to analyse the level of political participation by the users and the general public based on data from two comparable surveys. We argue that voter empowerment is the most essential factor in bringing about a stronger sense of citizenship among the users. The findings will be discussed in the light of the practice of citizenship and the implications for public policy development.