Background: Australian mental health policy requires that mental health services facilitate meaningful and genuine consumer participation in all aspects of mental health services. Roles for practitioners who work from their own experience of significant mental health challenges and mental health service use have been implemented in many services to promote participation and the development of more consumer focused services. Aims: To enhance understanding of perspectives of individuals working in lived experience roles to more closely understand their experiences and opinions about these roles. Method: A grounded theory study interviews were conducted with 13 lived experience practitioners. Results: The medical model was a core category arising from this work. Participants described the medical model as a prevailing culture within mental health services from their personal and professional experiences. This culture imposed a major limitation on the implementation, effectiveness and development of lived experience roles and themselves as individuals. It was also seen as a major limitation to the progress of Recovery orientated reform. Conclusions: The development of Recovery oriented services requires a strong lived experience practitioner workforce, with appropriate resourcing and support available. The current medical model approach requires critique to facilitate reform and avoid tokenism.