This article investigates whether and how the stigma experiences of mental health service users relate to trust in the professionals caring for them and how both stigma and trust relate to service user satisfaction. The study uses survey data gathered from mental health service users (N 650 service users from 36 organizations) and applies multilevel regression analyses. The results show that service users with more stigma experi- ences report less trust and are, partially for that reason, less satisfied with the services. Furthermore, service users with more severe symptoms and those with a psychotic disorder seem the most vulnerable ones for the processes occurring 2011 Elsevier Inc. All rights reserved.