There is a growing buzz around lived experience, service-user voice, and co-production in mental health. And rightly so; these are liberatory frameworks rooted in the survivor and mad liberation movements: the idea that people with direct experience of distress should not merely be consulted, but should help shape mental health systems from the ground up. But as I navigate my role as a lived experience advisor, I’ve come to see how these radical ideas are being absorbed and quietly transformed by a capitalist, bureaucratic mental health system into a form of participation that looks collaborative on paper, but often feels extractive in practice.
Co-production as cheap labour
Co-production is supposed to mean shared power. But too often, institutions want our stories, insights, and emotional labour without real decision-making authority, fair pay, or sustainable support. The demand for “authentic voices” becomes a way to legitimate services, secure funding, or meet equality targets. Lived experience roles proliferate, but paradoxically, they can also reproduce the very hierarchies they claim to challenge.
In my work, I’ve seen how lived experience contributions are solicited for their “value,” a value that is rarely shared in a way that redistributes control. Rather than shaping policy, we’re tapped for panels, consultations, or feedback sessions, frequently with tight deadlines, minimal compensation, or unclear influence on outcomes. Our presence is leveraged to demonstrate inclusion, without a structural commitment to shifting power.
The structural cost of “inclusion”
This dynamic is intimately tied to capitalism. In a system where productivity is prized above all else, mental health becomes a matter of cost efficiency and risk management. Just as CBT (in its neoliberal incarnation) individualises distress so that people can return to work, so too does co-production within institutional structures risk becoming a tool for market legitimacy rather than systemic transformation. Mainstream services often prioritise treating symptoms rather than addressing the root causes of distress: precarity, inequality, exploitation.
From this perspective, co-production can be recast as a way to manage dissent: inviting service users into consultative spaces, but not ceding real power or control over decisions. Instead of redistributing resources, institutions ask for emotional labour. Instead of shifting systems, they collect data (our stories) to validate the very systems that need changing.
Resistance from below: reclaiming co-production
But this isn’t just a story of extraction. There are vibrant, radical examples of co-production being reimagined on the ground in grassroots, peer-led, user-led, and survivor-led spaces. In these contexts, co-production is less about token involvement and more about mutual aid, shared accountability, and collective care.
Some collectives are choosing not to sit on advisory boards but to build parallel structures: peer-run networks, community-led mutual support groups, and political spaces where lived experience is not a resource to be mined, but a starting point for collective organising. These groups centre decision making in the hands of those most impacted, not just in consultation but in ownership: defining priorities, setting agendas, and holding power to account.
In doing so, they challenge the commodification of lived experience. Rather than serving as proof of inclusion, our stories become building blocks of a different mental health paradigm – one rooted in solidarity, not service delivery.
Emotional labour, burnout, and boundaries
This reclaiming is not easy. The emotional labour of sharing personal, often painful experience to help others is draining, particularly when not matched with real agency or resources. I have felt, at times, that the very act of being invited in to “co-produce” working groups or policy discussions can be a burden: a repeated performance of vulnerability that doesn’t lead to change.
Without structures that support us with fair pay, accessible processes, and decision-making authority, co-production risks becoming another form of precarity. We are often asked to give more than we receive. We tell our stories, critique systems and build momentum, but we don’t always see meaningful transformation. The emotional toll builds up: burnout, alienation, and disillusionment.
Reimagining participation: towards redistribution, not consultation
So how do we reclaim co-production in a way that is truly liberatory?
- Redistribution of power: true co-production must include real decision-making authority. Lived experience should not just feed into boards or steering groups — it should define them. Institutions must be willing to cede control, not just to listen.
- Fair remuneration and resources: emotional labour needs to be compensated fairly. But more than that: lived experience roles need sustainable funding, not just short-term or one-off consultancy payments.
- Collective structures over tokenism: support the growth of user-led, peer-led, and survivor-led organisations. These groups can challenge existing systems not by being incorporated into them, but by constructing something new.
- Boundary setting and self-care: we need to build frameworks that acknowledge the emotional cost of co-production. That means providing support, mentorship, debriefing spaces, and protecting people from exploitation.
- Structural vision, not individual fixes: co-production should not simply accommodate us within existing systems. It should be a tool for imagining something different: care systems rooted in mutual aid, community accountability; solidarity, not productivity.
Conclusion: reclaiming our power
The radical potential of lived experience is not in simply being invited into existing structures, it’s in refusing those structures when they demand too much labour and too little change. True co-production is not a checkbox. It is political, transformative, and deeply uncomfortable. It requires more than listening. It requires redistributing power, sharing resources, and building systems from below.
If we are to reclaim our collective agency, we must insist that co-production becomes more than a symbolic inclusion. We must make it a tool for liberation.