This chapter explores the development of service user led action in Uganda from the perspective of an activist with psychosocial disabilities. This activism has developed under the auspices of the UN CRPD and wider UN provisions for the achievement of people’s human and civil rights. It is based on an integrated holistic rather than narrowly medicalized response to madness and distress although it does not highlight a particular different paradigm of experience. Given the limited resources of government in low income countries and competing priorities, it places an emphasis on mobilizing communities to support people with psychosocial disabilities and challenge traditional stigmatizing understandings of them, which still apply in psychiatrized responses to the local situation imported from Global North. At the same time a local role is still seen for conventional mental health services in hybrid association with such new peer-led thinking, which differs from concepts of user/survivor movement in Global North and highlights the role of the family.