A philosophical exploration of experience-based expertise in mental health care

The idea that (former) patients are experts who could contribute to mental health care practices is gaining traction. Experts-by-Experience are increasingly employed by institutions to contribute to various levels of care, organization and policy-making. However, the success of this movement is hindered by conceptual and epistemological ambiguities. Our goal in this paper is to turn to the rich philosophical literature to start addressing such ambiguities. We first summarize the advantages of and challenges for Experience-based Expertise movement in mental health care. Next, we explicate the theoretical assumptions of this movement by outlining its salient tenets, with a focus on the Dutch mental care system. We point out three challenges of the movement that could be addressed using the insights by recent work in philosophy of mind and philosophy of science, i.e., (i) conceptual problems, (ii) worries about the subjectivity of the contributions of Experts-by-Experience, and (iii) addressing of the conflicts between the Experts-by-Experience and other experts. We conclude by proposing an enactive affordance-based framework as a candidate for clarifying the goals of the Experience-based Expertise movement in a way that avoids the current conceptual and epistemological problems and opens up venues for its growth.