This article contextualizes some of the more specifically focused articles in this Special Issue of ‘Women and Mental Health’ by reviewing general historical and political currents structuring contemporary discussions around questions of models, treatment and provision for women within British mental health services. We highlight some particularities of the current British context (in relation to other national scenes) in terms of the forms and expressions of feminist activity around mental or emotional distress. While not absolute mirrors of each other, resonances (...) between general trends in feminist debates and organizational forms within feminist mental health work give rise to a wide spectrum of sites of intervention. We discuss some of the conditions that gave rise to these forms of (visible) feminist intervention within mental health service provision, focusing particularly on women's counselling and therapy services, and we offer an analysis of the range and conceptual tensions within which such interventions may be situated, including contested perspectives on power and empowerment. We also consider ways in which women's political activity around mental health issues is likely not to be noticed as such, given women's prototypical positions as patients and practitioners. We end by identifying what we see as current challenges for feminist activism around distress and its links with the conditions of women's lives and oppression more generally, not only as instances of more general tensions and challenges within contemporary feminisms, but also as offering an arena of opportunity for broader alliance and coalition-building. (shrink)