# Difference and subordination – the epistemic struggles of collaborative knowledge production in the field of mental health

## TL;DR

This paper explores how power dynamics affect knowledge production in collaborative mental health research involving people with lived experience.

## Contribution

It reveals how researchers without lived experience often dominate collaborative knowledge-making processes.

## Key findings

- Researchers with and without lived experience produced distinct knowledge systems.
- Integration of these systems favored the perspectives of those without lived experience.
- Power imbalances and divergent interests shape collaborative mental health research outcomes.

## Abstract

Collaborative or co-productive approaches in the field of mental health care research are often legitimized by the argument that researchers with lived experience of mental health crisis and disability (= LE) produce different knowledge as compared to those without these experiences At the same time, there is a lack of studies that report on the underlying collaborative processes and on how these processes affect the knowledge that is being produced. This manuscript describes a collaborative research process and how this process impacted the knowledge produced.

The collaborative research process entailed a multi-step coding process, using a variant of thematic analysis. To facilitate comparison, two code systems were produced, one by researchers with and the other by researchers without LE of mental health crisis and disability. Subsequently, the code systems of these two sub-teams were integrated into a single code system. To evaluate the potential differences between the code formations of the two sub-teams as well as the effects of their integration, three focus groups suceeded, composed of 1) psychology students as well as researchers 2) with and 3) without LE, whose results are at the core of this manuscript.

The focus group participants described extensive differences between the code formation of the researchers with and without LE – first in form, but also more substantially in the contents of both systems – corresponding to two distinct logics for understanding the implementation of PSW: an “institutional” and “interactional” logic. The integration process of both code systems was described as invasive, resulting in a final code system that more closely resembled the primary code system of the researchers without LE.

The distinct logic of the two code systems can be thought of as distinct but complementary positions on the topic of PSW implementation. Such an explanation, however, falls short, as it silences the power relations and diverging interests and positions of the researchers involved. This is supported by what resulted from the integration of both code systems, resulting in the continuation of the logic of the researchers without LE. It is concluded that epistemic struggles and their knowledge politics require greater attention in the context of collaborative mental health research.

The online version contains supplementary material available at 10.1186/s40900-025-00720-4.

Collaborative or co-productive mental health research is often justified with the argument that researchers with lived experience produce different knowledge as compared to those without these experiences. This paper engages two research questions: 1) do researchers with and without lived experiences of mental health crisis and disability produce different types of knowledge in qualitative research? and 2) do these knowledges change through their collaboration? The paper reports on the processes of a collaborative research project on the implementation of peer support work in mental health care. We show that the perspectives and positions of researchers both with and without lived experience differed substantially, resulting in two distinct bodies of knowledge. When bringing these bodies together, we discovered that the perspectives of the researchers with lived experiences were dominated by those without. We conclude that power relations and divergent interests within collaborative research teams need greater attention in the context of co-productive mental health research.

The online version contains supplementary material available at 10.1186/s40900-025-00720-4.