Global mental health policies fail: How neoliberal governance silences structural solutions over lived expertise
Original framing: “[Editorial] Rethinking lived experience” — The Lancet
The 2020 *Black Feminist Therapy* collective in the US documented how Black women’s mental health is disproportionately affected by medical gaslighting (e.g., their pain being dismissed as 'hysteria'), yet these voices are absent from 'lived experience' policy tables. Disabled activists like *Patty Berne* (Sins Invalid) argue that 'accessibility' is a mental health issue, but their frameworks are excluded from global health agendas. The framing also ignores how LGBTQ+ communities of colour face intersectional erasure—e.g., the 2019 *Trans Day of Remembrance* report found that 80% of trans murder victims had untreated mental health conditions due to systemic exclusion.
The 'lived experience' narrative functions as a neoliberal smokescreen, individualising systemic failures while obscuring the historical and structural mechanisms that create mental health crises.
Indigenous sovereignty models (e.g., *whānau ora*), decolonial precedents (e.g., *Basaglia Law*), and marginalised voices (e.g., *Black Feminist Therapy*) all demonstrate that mental health equity requires dismantling extractive systems—not just 'hearing' voices within them. The trickster reveals the absurdity of celebrating 'voice inclusion' while corporate actors (pharma, tech) capture the discourse, proving that the real disruption lies in reimagining governance itself. Solutions must centre universal basic services, artistic-spiritual reparations, and divestment campaigns, as these address the root causes (poverty, racism, colonialism) that 'lived experience' framing conveniently ignores.