Embedding Lived Experience Safely in Mental Health Service Delivery
Many mental health providers now involve people with lived experience directly in service delivery, quality improvement and workforce development. When done well, this strengthens engagement, trust and relevance. When done poorly, it creates safeguarding risks, role confusion and governance gaps. This article examines how lived experience can be embedded safely and ethically in day-to-day delivery, aligned with co-production, lived experience and personalisation and integrated coherently within existing service models and care pathways.
Why lived experience roles require structure
Commissioners increasingly expect lived experience input to go beyond advisory panels, but they are equally clear that such roles must sit within robust governance frameworks. Lived experience does not replace professional training, clinical accountability or safeguarding responsibilities.
Clear role design protects both the individual and the service.
Operational example 1: Peer support roles with defined scope
Context: A community mental health service introduced peer support workers to improve engagement.
Support approach: Peer roles focused on engagement, navigation and emotional support, with explicit exclusions around clinical advice and crisis intervention.
Day-to-day delivery: Peers worked alongside clinicians, with regular supervision and escalation pathways.
Evidence of effectiveness: Improved attendance and reduced drop-out without increased incidents.
Safeguarding and boundary management
Lived experience roles can blur boundaries if not managed carefully. Commissioners and inspectors expect providers to demonstrate how they identify, manage and review safeguarding risks associated with peer and lived experience involvement.
Operational example 2: Boundary breaches addressed through supervision
Context: A service identified concerns about informal contact outside agreed settings.
Support approach: Supervision frameworks were strengthened and boundaries clarified.
Day-to-day delivery: Clear guidance was reinforced during team meetings.
Evidence of effectiveness: No recurrence and improved staff confidence.
Commissioner expectation: safe, scalable lived experience models
Commissioner expectation: Commissioners expect lived experience roles to be clearly defined, supervised and scalable. They look for workforce plans, training and role descriptions that show lived experience is embedded intentionally, not informally.
Regulator expectation: consistency and protection
Regulator expectation (CQC): Inspectors assess whether lived experience involvement is safe for everyone involved and whether people understand the limits of those roles.
Operational example 3: Lived experience input into staff training
Context: A provider wanted to improve trauma-informed practice.
Support approach: People with lived experience co-designed training sessions alongside clinicians.
Day-to-day delivery: Sessions were structured, facilitated and evaluated.
Evidence of effectiveness: Improved staff confidence and inspection feedback.
Governance mechanisms that underpin safe delivery
Strong governance includes role clarity, supervision, safeguarding escalation and regular review. Without these, lived experience involvement risks becoming unsafe or tokenistic.
Providers that embed lived experience within governance frameworks demonstrate maturity, accountability and quality.