Surveys of consumer satisfaction with psychiatric services are frequently included in program evaluations, ostensibly providing the patient's perspective. However, the consistently high levels of satisfaction reported, despite a wide variety of measures, suggest that these surveys may be of questionable validity. Recognizing that most surveys ask patients to rate aspects of care that professionals feel are important, the authors used a focus-group method to generate attributes of ideal care from the patient's viewpoint. A pool of 50 patient-generated items were rated for importance by a second group of inpatients on locked units of a provincial psychiatric hospital. A factor analysis and mean importance ratings identified interpersonal relations with staff as a key factor of patient satisfaction. The authors designed a seven-item measure of satisfaction based on this key factor.