Words like service-user empowerment and co-production imply an aspiration to symmetry in the relationship between clinicians and service-users in UK mental health policy. Why has this aspiration amounted to little in practice? Drawing on the work of feminist philosophers examining how features of real-life contexts, e.g., power relations, can impair or enhance the production of shared meanings and knowledge, I am theorizing the difference between symmetric and asymmetric conditions for the production of meaning and knowledge between clinicians and service-users. The aim is to assess the scope and limits of the aspiration to relational symmetry in the delivery of mental health services.