Lived experience leadership is essential for reforming the mental health sector. However, deep-rooted barriers, such as entrenched mindsets and existing power structures, block the potential for lived experience perspectives to be leveraged for change. The aim of this paper is to critically examine the dominance of hierarchies that continue to marginalise lived experience roles and impede the advancement and authority of these roles in leadership and lived experience-led approaches. It emphasises the need to challenge systemic clinical authority and disrupt the prevailing dominance of the medical model in order to fully harness lived expertise, driving reforms and the creation of non-clinical alternatives.
Larsen et al. (2025) studied this question.