4.6 Article

Epistemic injustice and mental health research: A pragmatic approach to working with lived experience expertise

期刊

FRONTIERS IN PSYCHIATRY
卷 14, 期 -, 页码 -

出版社

FRONTIERS MEDIA SA
DOI: 10.3389/fpsyt.2023.1114725

关键词

lived experience; epistemic injustice; elite capture; epistemic exploitation; mental health

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Epistemic injustice refers to the denial of knowledge creation and meaning derivation opportunities for marginalized groups, particularly impacting racialized communities in mental health research and service delivery systems. Lived experience involvement and leadership are suggested for combating epistemic injustice, but challenges such as elite capture and epistemic exploitation exist. This paper proposes a pragmatic approach to address these issues and suggests three considerations: reflecting on purpose and impact, embedding lived experience roles with appropriate support and remuneration, and working alongside existing systems while developing new spaces for alternative knowledge.
Epistemic injustice refers to how people from marginalized groups are denied opportunities to create knowledge and derive meaning from their experiences. In the mental health field, epistemic injustice occurs in both research and service delivery systems and particularly impacts people from racialized communities. Lived experience involvement and leadership are often proposed as methods of combatting epistemic injustice, a tool for ensuring the views of people at the center of an issue are heard and can inform decision-making. However, this approach is not without challenges. In this paper, we draw on our work as intermediary organizations that center lived experience perspectives to challenge epistemic injustice. We highlight two problems we have identified in working in the mental health research field: elite capture and epistemic exploitation. We believe that these problems are barriers to the radical and structural change required for epistemic justice to occur. We propose a pragmatic approach to addressing these issues. Based on our work we suggest three considerations for researchers and our own organizations to consider when involving people with lived experience. These include reflecting on the purpose of creating knowledge, with a focus on impact. Embedding lived experience roles, with appropriate employment, support and remuneration, and acknowledging that it may be necessary to work alongside existing systems as a critical friend while developing new spaces and structures for alternative forms of knowledge. Finally, the mental health research system needs to change. We believe these three considerations will help us better move toward epistemic justice in mental health research.

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