Abstract
This article explores how 'wicked problems' such as climate change might force psychiatry to rethink some of its fundamental ideas and ways of working, including clinical boundaries, understandings of psychopathology and ways of organising. We use ethnographic evidence to explore how mental health service 'survivor' activists are already rethinking some of these issues by therapeutically orienting themselves towards social problems and collective understandings of well-being, rejecting 'treatment as usual' approaches to distress. In this way we provide an example of the potential of activists to help psychiatry negotiate the climate crisis.