— Discussion and Analysis

This paper offers Mad Studies as an alternative entry point for engaging with madness in higher education, arguing that centring madness in pedagogical praxis has the potential to interrupt hegemonic ways of knowing, being, and learning. We illustrate how this disruption is facilitated by examining particular aspects of pedagogical praxis mobilized in Mad Studies, including building curriculum alongside mad community, centring madness in course design and student assessment, and the practice of mad positivity. Ultimately, this approach provides a metacurriculum of unlearning, challenging students to consider how their engagement with madness in the classroom, and beyond, has the potential to disrupt sanist systems of oppression and the normalcy they reconstitute.

Participants were consumers (n ¼ 6) working with public or private mental health organizations in Australia, and colleagues (n ¼ 3) or managers (n ¼ 5) of these consumers. Discursive psychological principles informed the analytic process, to explore contexts in which ‘representativeness’ was used to empower and disempower consumers. The findings suggest there is a lack of clarity about what is meant by representation in the mental health sector. Expecting individual consumer leaders to be representative of consumer views more broadly disempowered them in their roles. Some participants instead discussed ways that organizations should be responsible for seeking representation from more consumer leaders, thus empowering consumers working in the sector. Using the term ‘representative’ to refer to consumers working in mental health does not reflect the value of the consumer perspective and is not well understood within the sector. Comprehensive training should be provided so that mental health service providers are clear regarding the expectations of people in these roles.

The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services.

This report shines a light through the prism of this new leadership framework by drawing on findings from 30 in-depth interviews and surveys completed by Lived Experience Leaders (LEx leaders). It maps, identifies, and explores the complex landscape, reach and presence of Lived Experience Leadership flourishing across UK society. However, this report also illuminates significant structural, systemic and cultural barriers that hinder, block or inadequately support LEx leaders capacity to thrive.