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Patient activation, defined as one’s attitudes and confidence toward managing illness, has been not been thoroughly studied in consumers with schizophrenia. The current study sought to understand the relationship between patient activation and symptoms, medication adherence, recovery attitudes, and hope in a sample of 119 adults with schizophrenia. The participants were enrolled in an 18-month randomized controlled study of the Illness Management and Recovery program. Data were collected at baseline; correlations and stepwise multiple regressions were used to examine the relationships and determine the unique contribution of variables. Higher patient activation was most strongly associated with positive recovery attitudes, higher levels of hope, and fewer emotional discomfort symptoms. Patient activation was significantly related to a broad measure of illness self-management, providing evidence for the construct validity of the patient activation measure. Our findings emphasize the importance of recovery-based mental health services that recognize level of patient activation as a potential factor in consumer outcomes.