In the United States, the number of mental health mutual support groups (MSG), self-help organizations (SHO) (run by and for mental health consumers and/or family members) and consumer-operated services (COS) was estimated in 2002 to be 7,467. In Canada, CSI's (Consumer Survivor Initiatives) are the preferred term. "In 1991 Ontario led the world in its formal recognition of CSI's as part of the core services offered within the mental health sector when it began to formally fund CSI's across the province. Consumer Survivor Initiatives in Ontario Building an Equitable Future' (2009) pg 7.