Abstract

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. This is accomplished through the examination of several epistemic and ethical features of psychiatry that underlie the importance of engaging in participatory research in the field, unpacking their connection to participatory research, and offering suggestions related to their implications for research methodologies. The epistemic features include: the irreducible value of patient experience, the extent of disagreement and uncertainty in the field, and the value-laden nature of knowledge in psychiatry. The ethical features include: the preponderance of harm, denials of agency and epistemic injustice, and the constant struggle for power. These features offer useful touchpoints for thinking through why participation matters in mental health research.