A new article in Psychosis contends that the mental health field has learned to speak the language of lived-experience participation while leaving psychiatric and academic authority essentially unchanged.
Lars Veldmeijer of NHL Stenden University of Applied Sciences and Jim van Os of Utrecht University Medical Center introduce a concept they call “participatory assimilation” to describe what happens when people with lived experience are invited into design and research, only to see their perspectives absorbed into preexisting expert frames.
“Participatory assimilation is the practice of involving individuals with lived experience in design and research processes, often because it is mandated by policy or funding, insofar as their perspectives and contributions can be integrated into or are supportive of researchers’ preconceived, theory-driven problem definitions and solution strategies,” the authors write, adding:
“What once started as a strategic and meaningful attempt to include the voices of minority and marginalized groups, such as service user and survivor accounts, has now transformed into a rhetoric where participatory buzzwords are commonly used in research and innovation publications, but have lost their original meaning.”
Participation is now widely required by funders and policymakers. Yet the authors suggest that the field often “talks the talk” without “walking the walk,” leaving lived-experience contributors treated as data points, rather than co-owners of knowledge or decision-making.
“Therefore, instead of being engaged as legitimate epistemic agents, people with lived experience are enlisted as useful data points that validate the researchers’ goals.”
In communication with Mad in America, the first author, Lars Veldmeijer explained the significance of their work this way:
“Participation without power is performance. We introduced participatory assimilation to describe how lived-experience voices are welcomed initially and then absorbed into the dominant frame, an all-too-common outcome. Our aim was practical: move from box-ticking co-design to genuine power-sharing where lived-experience colleagues are decision-makers and power is mapped throughout. That’s how innovation in mental health care, our ultimate goal, becomes accountable – and humane.”
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