What do we need from our leaders?
This is an important question to consider, for all of us, but especially for those seeking to take up a leadership role. When providing guidance to others and making decisions, we need a strong knowledge base as well as considerable determination. To provide good guidance and leadership we also need considerable empathy, and at least some understanding of the broader context. In good leaders, this can often involve having relevant lived experience. In the context of mental health care and wellbeing, for example, it can be extremely beneficial for those in leadership positions who are making important decisions about how things are structured and organised to have been in treatment or recovery themselves, or to have sought out mental health support and care generally.
There has been a major push for leaders who have lived experience in recent years, and with good reason. Empathy is a key tool in compassionate and useful decision making, and having been in the position of those you are making decisions on behalf of is a great way to ensure your empathy for them. Yet, lived experience alone is not enough to make a good leader.
What Is Lived Experience Leadership?
The push toward considering lived experience in mental health care comes from a general understanding that, when individuals who do not understand what’s at stake make decisions, they can end up making bad ones. Critical histories of mental health care have unveiled how assumptions made by authority figures such as doctors and politicians resulted very often in the oppression and even harm of individuals who needed support and care. A lack of empathy for the situation of those they were treating led to some of the stigmas around mental health that we still struggle with today. [1] A good example of this is the historical diagnoses of hysteria that many women were given by male doctors who could not (or maybe didn’t want to) understand the unique mental and physical challenges they were facing. [2]
Research has shown that individuals with lived experience are particularly valuable in care settings. A study conducted in 2024, for example, documented how healthcare professionals with lived experience needing or receiving care were highly motivated to improve the care they provided for others. [3] Laurie Edmundson has also documented how her own lived experience with receiving a borderline personality disorder diagnosis went on to shape her healthcare career and allowed her to lead by example. [4]
Why Lived Experience Alone Isn’t Enough
While this move has been a good one in some respects – helping to reduce stigma, for example, and close the gap between those who have the authority to make decisions concerning mental health care and those who are receiving mental health care – there is also a risk associated with prioritising lived experience. Specifically, when we afford lived experience a higher position of importance relative to the other necessary features of good leadership, we can end up tokenising those who have diagnoses or are in mental health care. As Chris Frederick has pointed out, at best this becomes a box-ticking exercise for mental health providers and governmental organisations who want to look inclusive without doing any of the research or work. At worst, it becomes exploitative of people’s lived experience with mental health care and treatment. [5] While lived experience can be a benefit to mental health care leaders, it is not the same thing as having strong knowledge and robust practice in the field.
So what are the other features that make a good leader, and why are they so important in mental health care in particular?
Professional Qualifications
This is where qualifications and professional experience come into consideration. For good mental health practitioners, many years of study and accreditation go into equipping individuals to provide care and treatment to others. Studying mental health care in its various forms, as well as getting guidance in practicing diagnoses and treatment, is critical to being able to provide leadership for others. And this study shouldn’t stop when a practitioner is given their formal qualification! Good leadership involves staying on top of contemporary research and findings in the field, as well as continuously reviewing new practices against old ones to ensure that the decisions being made are the best possible ones given all the information.
Systems Knowledge
What’s more, good mental health leadership involves a strong knowledge of the system in which you are working and leading others. Each individual context is different, and each governmental context takes a different approach to mental health provision. Mental health support at work, for example, can look very different from mental health support at home or school. And treatment for mental health conditions looks very different in different countries or even states! A good leader will have a strong working knowledge not only of their own context, but of the general differences among contexts that are relevant to their work.
Experience-In-Practice
Finally, and perhaps most importantly, a different type of experience is needed for good leaders in mental health care: that is experience of practice. Going through treatment or seeking out mental health support in other ways can doubtless inform an empathetic understanding for leaders who are making decisions on behalf of others. But this empathetic understanding is not much help to those who need to make difficult choices and lead others by example: for that, one needs experience as a mental health care practitioner. They say that practice makes perfect, and this is certainly the case for those who need to make informed and thoughtful decisions about mental health provision for others – while having been on the receiving end of care is useful, what is most important is understanding the stakes from the perspective of a leader, and having the professional experience to know how decisions will impact others and account for those impacts before making them.
[1] Roberts-Pedersen, E. (2024). Making Mental Health: A Critical History. Routledge.
[2] Tasca, C., Rapetti, M., Carta, M. G., & Fadda, B. (2012). Women and hysteria in the history of mental health. Clinical practice and epidemiology in mental health : CP & EMH, 8, 110–119. https://doi.org/10.2174/1745017901208010110
[3] Miller, R., Ehrenberg, N., Jackson, C., Stein, V., Van der Vlegel-Brouwer, W., & Wojtak, A. (2024). Just a story? Leadership, lived experience and integrated care. Health expectations : an international journal of public participation in health care and health policy, 27(3), e14084. https://doi.org/10.1111/hex.14084
[4] Edmundson L. Lived experience as a leadership asset. (2026). Healthcare Management Forum. 39(1):6-9. doi:10.1177/08404704251347532
[5] Frederick, C. Lived experience is not enough: the illusion of inclusion in mental health spaces. (2025). National Survivor User Network. https://www.nsun.org.uk/lived-experience-is-not-enough-the-illusion-of-inclusion-in-mental-health-spaces/.
