Why Democratize Psychiatric Research? A Call for Participatory Approaches

Phoebe Friesen outlines six critical reasons why participatory research in psychiatry is essential for ethical and epistemic progress.


Phoebe Friesen’s latest article in Philosophy, Psychiatry & Psychology underscores the urgent need for participatory research in psychiatry. By focusing on the lived experiences of service users, Friesen aims to shift the conversation towards a more inclusive and ethical approach to mental health research.

She writes:

“I hope to shift the discussion away from an exclusive focus on the impact of participatory mental health research, and toward a broad array of justifications that underscore the importance of including those impacted by research in the process itself. Building on decades of rich discussions of why ‘nothing about us without us’ matters in the field of psychiatry, this paper aims to illuminate the justifications underlying participatory research in psychiatry and how these justifications might shape participatory methodologies.”

Friesen argues that the integration of experiential expertise in psychiatric research addresses significant gaps and biases inherent in the field. She identifies six key features—three epistemic and three ethical—that support the necessity of participatory research. These include the irreducible value of patient experience, the extent of disagreement and uncertainty in psychiatry, and the value-laden nature of psychiatric knowledge. Ethically, she highlights the preponderance of harm in psychiatric history, denials of agency, and the constant struggle for power. Friesen’s work aligns with the growing global call for rights-based and holistic approaches to mental health care, emphasizing the transformative potential of inclusive research practices.

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  1. You make some excellent points; I would like us to develop the Serious probability that florid psychosis develops in context of: 1) loss of freedom, 2) coercion with toxic drugs, 3) sparse analysis of how these toxic drugs impact all neural pathways and result in behavioral manifestations which result in blaming “the illlness”, and 4) desperate efforts of the trapped adolescent to imagine a more tolerable reality. The mechanistic, allopathic paradigm is truly an iron-toothed ratchet and hideously cruel. No wonder my daughter told me she wanted to be an eagle and to fly very high.

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  2. “Is power truly distributed?” No, forced and coerced psychiatric and psychological drugging of innocent humans needs to end.

    “Is the community involved the appropriate one?” Should this actually state ‘has the community involved the appropriate One?’ And, as one who was coerced and forced psychiatrically drugged, for belief in God and the Holy Spirit, and it is God whom I believe is “the appropriate One,” to judge all. I’d say most definitely not.

    “Are those involved diverse or merely an agreeable subset of patients? Are there opportunities to ask questions and identify assumptions or biases in the methodology or other aspects of the research?”

    For goodness sakes, “mental health professionals” – who now claim they know nothing about the common adverse and withdrawal symptoms of your drugs. Let God do the judging, instead of you scientific fraudsters. And I do still have hope He is, and will.

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