Mental health and lived experience: The value of lived experience expertise in global mental health.

There is no disputing the current established global consensus that people with lived experience of a mental health condition ("people with lived experience") play an integral role in influencing policy and processes in global mental health. Specifically, the role they hold as agents of change through which they can lead and co-lead projects on mental health, alongside a multidisciplinary team, as recommended in the findings of the report of Lancet Commission on ending stigma and discrimination (Thornicroft et al. [2022], "The Lancet Commission on ending stigma and discrimination in mental health", Lancet, 400, 1438-1480). Immense value is associated with their unique expertise not learned through theoretical concept but based on real-life experience. Appreciating their involvement in processes is a human right, supported by international human rights instruments such as the United Nations Convention on the Rights of Persons with Psychosocial Disabilities (2006). However, there remains an expectation that people with lived experience are expected to be involved in processes and service delivery without receiving remuneration for their expertise. This article will provide the basis for which processes must follow the principle of equity; that lived experience expertise ought to be equally compensated for based on equal pay for equal work. In closing, it will provide a recommendation for stakeholders on how to improve upon effective engagement with people with lived experience, leading to meaningful and authentic contributions.

Agents of Change for Mental Health: A Survey of Young People's Aspirations for Participation Across Five Low- and Middle-Income Countries.

PURPOSE: Effective intervention, policy, and research in mental health and well-being (MHWB) require young people to be understood not only as beneficiaries, but also as active agents in codesigning and implementing initiatives. To identify pathways for young people's participation in promoting MHWB in low- and middle-income countries (LMICs), this study surveyed young people's aspirations for engagement, their spheres of influence, capacity building needs, and key barriers to participation. METHODS: Using U-Report, United Nations Children's Emergency Fund's social messaging tool and data collection platform, we distributed a short quantitative survey to a nonrepresentative, but large sample of young people aged 15-29 across five LMICs: Nigeria, Brazil, Jamaica, South Africa, and Burundi. RESULTS: A total of 42,689 young people responded, with representation from most or all provinces within each country. Participants' average age was 23.8 years (SD = 3.77). Young people's core aspirations were to join a mental health awareness project and to support their peers. Participants considered schools and community settings to be the most important spheres for engagement. Lack of information about mental health was the main perceived barrier to participation, and mental health classes the main training need. DISCUSSION: In many countries, MHWB is not taught or discussed in schools and youth-led mental health interventions are rare. Findings from this study reveal clear aspirations for participatory engagement to promote MHWB among young people in LMICs. To support meaningful participation, policymakers and youth service providers must ensure that young people have access to mental health literacy training and opportunities to raise awareness in schools or community settings.

Perspectives: involving persons with lived experience of mental health conditions in service delivery, development and leadership.

Globally, there has been an emphasis on the importance and value of involving people with lived experience of mental health conditions in service delivery, development and leadership. Such individuals have taken on various roles, from peer support specialists and other specialised professions to leadership in mainstream industries. There are, however, still obstacles to overcome before it is possible to fully include people with lived experience at all levels in the mental health and related sectors. This article discusses the benefits, both to the individual and to the public, of involving persons with lived experience in service delivery, development and leadership.