Who are the experts? A study of the everyday enactment of expertise in mental health care

Public welfare increasingly integrates ‘ordinary citizens’ as experts in the provision of services. While scholars argue that the advent of citizen expertise represents a new openness in knowledge production, little attention has been given to how this new premise for calling someone an expert changes the everyday enactment of expertise. This article examines expertise as an interactional accomplishment, analysing how participants negotiate epistemic access, primacy and accountability in knowledge production. Drawing on ethnographic field notes and interviews collected in Danish mental health care, the analysis clarifies the conditions under which expertise is either validated or contested. Findings show that participants must downplay their access to formal ratification of expertise, deflect validity challenges to their epistemic primacy in lay knowledge and take responsibility for ‘tinkering’ with knowledge in their everyday life. While confirming greater openness in knowledge production, the study reveals a rising uncertainty about who reliable and accountable experts are in mental health care.