The Cycle of Equitable Codesign' Using Restorative Practice Principles to Address Epistemic Injustice and Advance...

Area of Science:

• Mental Health Research
• Participatory Design
• Social Justice in Healthcare

Background:

• Co-design is increasingly used in mental health but often suffers from tokenism and limited influence.
• These limitations stem from systemic epistemic and relational inequities within mental health systems.
• Lived experience knowledge is frequently devalued, hindering genuine co-design efforts.

Purpose of the Study:

• To analyze co-design challenges in mental health through the lens of epistemic injustice.
• To propose a restorative justice-informed framework for equitable co-design.
• To introduce a staged model for ethically grounded and relationally just participation.

Main Methods:

• Commentary informed by literature on co-design and lived experience in mental health.
• Reflection on reported experiences of individuals with lived experience of mental health challenges.
• Informal consultations with individuals with lived experience and co-design participation.

Main Results:

• Co-design challenges are rooted in epistemic injustice, devaluing lived experience.
• Restorative justice principles offer a pathway to address power imbalances and relational harms.
• The Cycle of Equitable Codesign framework (acknowledgement, restoration, co-design) is proposed.

Conclusions:

• Reframing co-design within a restorative justice approach moves beyond procedural inclusion to ethical, relationally just practice.
• Addressing epistemic injustice is crucial for co-design to realize its transformative potential in mental health.
• Equitable co-design requires attention to timing, power dynamics, and relational conditions.