The core tension the essay identifies lies in the mismatch between how psychiatrists are trained and how psychiatric practice is governed. Psychiatry is unusual among medical specialties in that its practitioners are explicitly taught to evaluate biological, psychological, and social dimensions of illness simultaneously. A clinician assessing a patient may consider neurochemistry, family history, and housing status in the same encounter. Yet, the authors argue, the dominant frameworks that structure psychiatric work remain oriented toward individual symptom management. Treatment protocols, reimbursement systems, and professional incentives are largely built around the episodic care of discrete patients rather than the population-level conditions, such as poverty, war, and social exclusion, that generate much of the distress clinicians see every day. The result, they suggest, is a discipline whose diagnostic sophistication routinely outpaces its engagement with causes.

The scale of the problem is well documented in the global mental health literature. Treatment gaps for common mental disorders remain enormous in many low- and middle-income countries, where the majority of people with conditions such as depression, anxiety, and psychosis receive no formal care at all. The essay emphasizes that this burden is not distributed evenly. Conflict and forced displacement have disproportionate impacts on psychological wellbeing, and structural inequity, understood as the systematic arrangement of resources and opportunities along lines of wealth, geography, and identity, shapes who becomes ill, who gets treated, and who recovers. In such contexts, the authors contend, a purely clinical response risks treating the symptoms of arrangements that will simply generate new patients tomorrow. Addressing mental health at scale therefore requires attention to the machinery that produces distress, not only the individuals who present with it.

Pragmatic solidarity, as the essay deploys the concept, is the practice of standing with communities rather than merely serving them. Farmer’s formulation, developed through decades of work delivering health care in settings of extreme poverty, insisted that effective medicine in such contexts requires accompanying people in their struggle against the conditions that sicken them, including through advocacy for material change. Applied to psychiatry, this means that the discipline’s obligation does not end at the prescription pad. Psychiatrists, the authors argue, are positioned to engage in structural advocacy, to support community-led models of care, and to demand institutional accountability from the hospitals, universities, funders, and governments that shape mental health systems. The framing is deliberately practical: solidarity is presented not as sentiment but as a set of enactable practices with measurable consequences for health.

A central pillar of the argument concerns how global mental health work is conducted across borders and cultures. The authors contend that effective collaboration requires horizontal partnerships, in which expertise and decision-making authority are genuinely shared rather than flowing in one direction from high-income institutions to lower-income settings. Closely related is the demand for epistemic justice, the recognition that communities experiencing mental distress hold valid knowledge about their own needs and priorities, and that this knowledge should carry weight in the design of programs and research. The essay argues for the centering of community-defined priorities over externally imposed frameworks, a critique aimed at models in which diagnostic categories, intervention packages, and research agendas are developed elsewhere and delivered without meaningful local input. In such models, the authors suggest, even well-intentioned programs can reproduce the very inequities they claim to address.

The essay then moves from principle to practice, illustrating what pragmatic solidarity looks like at three distinct levels: the individual, the institutional, and the policy arena. At the individual level, clinicians can begin by interrogating their own practice, asking how the social circumstances of their patients connect to their symptoms and where their professional voice might be used in support of change. At the institutional level, the authors point to material redistribution as a concrete mechanism, directing resources, training opportunities, and infrastructure toward the communities and institutions that have historically been excluded from them. Institutional accountability also features here, with the implication that organizations engaged in global mental health should be answerable to the populations they serve rather than only to their funders.

Participatory research emerges as another key entry point. Rather than extracting data from communities for analysis and publication elsewhere, participatory approaches involve community members as partners in framing research questions, collecting and interpreting evidence, and determining how findings are used. For psychiatry, a field whose evidence base has been criticized for underrepresenting the populations that bear the greatest global burden of mental illness, this represents both an ethical correction and a scientific opportunity. Research that genuinely reflects community priorities is more likely to produce interventions that people will actually use, and more likely to identify the structural variables, from housing insecurity to exposure to violence, that conventional study designs often treat as background noise rather than objects of inquiry.

Policy engagement completes the picture. The authors argue that psychiatrists have both the standing and the evidence base to advocate for policies that address the social determinants of mental health, and that this advocacy is a legitimate and necessary extension of professional practice rather than a departure from it. Because psychiatric training integrates biological, psychological, and social perspectives, psychiatrists are unusually well placed to translate population-level evidence into policy arguments that policymakers can act upon. The essay’s call to action insists that the discipline move from recognition of structural drivers, which it describes as well documented, to active participation in dismantling them, a shift that requires clinicians and institutions to see advocacy, partnership, and redistribution as core professional activities rather than optional extras.

What gives the essay its urgency is the insistence that pragmatic solidarity is not merely a theoretical framework but a tangible, enactable way of improving global mental health. The authors are careful to ground their argument in the realities of psychiatric work: clinicians face time pressure, resource constraints, and institutional demands that can make engagement beyond the clinic seem impractical. Yet their response is that the alternative, a psychiatry confined to symptom management while the conditions producing those symptoms remain untouched, is itself a form of practical failure, one that guarantees that the global treatment gap will persist. By identifying specific mechanisms, from community partnership and participatory research to material redistribution and policy engagement, the essay aims to lower the barrier between recognition and action, offering psychiatrists a concrete repertoire rather than an abstract ideal.

The broader significance of the argument extends beyond psychiatry to global health more generally. The essay joins a growing body of scholarship that questions whether technical interventions, however sophisticated, can succeed in contexts where the fundamental drivers of ill health are structural. For mental health in particular, where conditions such as depression and trauma are so tightly entangled with conflict, displacement, poverty, and exclusion, the stakes of this debate are especially high. The authors’ contribution is to argue that the profession’s own training, with its integrated attention to biological, psychological, and social dimensions, already contains the intellectual resources needed for a solidarity-oriented practice. What remains, they contend, is the ethical and institutional commitment to act on that training, standing alongside the communities most affected by mental distress and working with them to change the conditions that produce it.

Subject of Research: The role of psychiatrists in practicing pragmatic solidarity to address structural drivers of global mental distress

Article Title: Beyond the clinic: The role of the psychiatrist in practicing pragmatic solidarity

Article References: Berhe, A., Bala, A., Okopie, T., Agwagom, J., Khan, M., & Song, S. J. (2026). Beyond the clinic: The role of the psychiatrist in practicing pragmatic solidarity. PLOS Mental Health, 3(8), e0000705. https://doi.org/10.1371/journal.pmen.0000705

Image Credits: AI Generated

DOI: 10.1371/journal.pmen.0000705

Keywords: psychiatry, global mental health, pragmatic solidarity, Paul Farmer, structural inequity, treatment gap, epistemic justice, community-led care, participatory research, health policy, conflict and displacement, social determinants

The research team, led by Glenn Hunt and including collaborators from Myanmar and Europe, set out to document what they call the lived multifunctionality of these upland landscapes. Rather than measuring land-use performance solely through external metrics such as yields per hectare or carbon stocks, the researchers asked the people who inhabit and manage these landscapes how they perceive and value them. This methodological choice matters, because the gap between technocratic assessments and local understandings of sustainability has real consequences. In Myanmar, land that is managed under customary jhum cycles is frequently classified by the state as vacant, fallow, or degraded, a bureaucratic label that opens the door to appropriation, concession allocation, and forced conversion to other uses.

The fieldwork combined three complementary approaches. Participatory mapping sessions allowed villagers to draw and annotate the land-use mosaic of their territories, identifying jhum fields, forests, home gardens, terraced paddy fields, and other elements. Livelihood product inventories then catalogued the enormous range of goods that each land-use type contributes to household economies, from staple crops and wild vegetables to medicinal plants, fibers, fuelwood, and timber. Finally, community-based scoring exercises asked villagers to rate each land-use type against a set of locally defined functions, producing a quantitative picture of perceived multifunctionality that could be compared across villages and land-use categories.

The results were striking in their consistency. Jhum fields, the very land-use type most often maligned in policy discourse, emerged as the most multifunctional of all. They provided the widest range of livelihood products of any land use in the mosaic and contributed reliably to food security, the supply of medicines, the availability of construction materials, and the reproduction of cultural practices. This is not an accident of design but the product of a sophisticated management system. In jhum cultivation, plots are cleared, cultivated for a limited period, and then left to regenerate under fallow, a rotational cycle that maintains a dynamic patchwork of vegetation at different successional stages across the landscape. That patchwork, the study shows, is precisely what generates the breadth of products and services that communities depend upon.

Forests and home gardens play equally important, but complementary, roles. Forests supply wild foods, medicinal plants, and materials that jhum fields alone cannot provide, while home gardens close to the homestead support dietary diversity and generate income through the sale of vegetables, fruits, and small livestock. Terraced paddy fields, where they exist, contribute staple grain but occupy a narrower functional niche. The study emphasizes that none of these land-use types functions in isolation. Together they form an interdependent landscape mosaic in which households deliberately spread their livelihood activities across multiple land uses, reducing risk and buffering against crop failure, price shocks, and seasonal scarcity. This diversification strategy, refined over generations, is a hallmark of resilient upland livelihood systems across Southeast Asia.

The technical core of the study lies in its systematic comparison of perceived multifunctionality across land-use types. By aggregating community scores and product inventories, the researchers could demonstrate that the functional profile of jhum is not merely broad but also consistent: it contributes to nearly every valued function, even where other land uses outperform it on any single measure. Forests, for example, may supply more timber, and paddy fields more rice, but jhum fields deliver a balanced portfolio of contributions that underpins everyday subsistence. The authors argue that this portfolio logic is invisible to conventional land assessments, which typically evaluate each land-use type against a narrow set of agronomic or forestry indicators and therefore systematically undervalue rotational systems.

The policy implications are profound. In Myanmar, as in many other countries with significant upland Indigenous populations, state land classifications determine which areas can be titled, leased, or conserved. When jhum fallows are mapped as vacant or degraded land, the rotational cycle that sustains both livelihoods and regenerating vegetation is broken, and communities can lose access to the very landscapes that feed them. The study documents how this misrecognition is not simply a technical error but a clash between epistemologies: between a governance framework that reads landscapes through static land-cover categories, and an Indigenous understanding that reads them through lived relationships, seasonal cycles, and customary institutions. The authors frame this as a matter of epistemic justice, arguing that sustainability transformations cannot be inclusive if the knowledge systems of the people who manage the land are excluded from the categories used to govern it.

The findings also speak to a broader global debate. Shifting cultivation supports millions of people across the tropical uplands of Asia, Africa, and Latin America, and it has been the subject of contested narratives for more than a century. Colonial administrators condemned it, development programs have sought to replace it with sedentary agriculture, and some conservation initiatives have blamed it for deforestation. Yet a growing body of research suggests that, at appropriate fallow lengths and population densities, rotational systems can maintain biodiversity, soil fertility, and carbon stocks while sustaining livelihoods without external inputs. The Naga Hills study adds a crucial dimension to this literature by grounding the argument in the detailed perceptions of the communities themselves, showing that what outside observers see as degraded fallow is locally understood as a productive landscape in a necessary phase of renewal.

For the Naga communities of Layshi Township, the stakes are immediate. Their territories lie in a remote border region that has experienced conflict, restricted access, and limited state investment, making self-provisioned livelihoods all the more essential. The interdependence of jhum fields, forests, and gardens means that interventions targeting any single land-use type ripple through the whole system. Converting fallows to plantations, restricting forest access, or pushing paddy expansion onto sloping land each erodes a different strand of the livelihood web. The study’s participatory methods, by making local valuations explicit and comparable, offer a practical template for land-use planning that begins with recognition rather than replacement, and that treats villagers as experts on their own landscapes rather than as obstacles to development.

Ultimately, the research makes a case that extends well beyond the Naga Hills. If sustainability transformations are to succeed in the world’s upland regions, they must be built on an accurate understanding of how multifunctional landscapes actually work and on respect for the people who sustain them. Recognizing customary land-use systems such as jhum, the authors conclude, is critical not only for ecological sustainability but for more equitable development policy. The alternative, continuing to classify living, working landscapes as empty and degraded, risks destroying precisely the diversity and resilience that both local communities and the global community now urgently need to protect.

Subject of Research: Indigenous perceptions of the multifunctionality of shifting cultivation landscapes in the Naga Hills of Myanmar

Article Title: Lived multifunctionality: Indigenous perceptions of shifting cultivation landscapes in the Naga Hills of Myanmar

Article References: Hunt, G., Makury, A., Fogerite, J., von der Mühlen, M., Htet, A. S., Bastide, J., Heinimann, A., & Rueff, H. (2026). Lived multifunctionality: Indigenous perceptions of shifting cultivation landscapes in the Naga Hills of Myanmar. PLOS Sustainability and Transformation, 5(10), e0000288. https://doi.org/10.1371/journal.pstr.0000288

Image Credits: AI Generated

DOI: 10.1371/journal.pstr.0000288

Keywords: shifting cultivation, jhum, Naga Hills, Myanmar, indigenous knowledge, multifunctional landscapes, land governance, food security, epistemic justice, sustainability transformation, participatory mapping, upland livelihoods

The commentary is the culmination of a series of articles that began unexpectedly, when a private letter to a clinician-researcher was encouraged into a peer-reviewed publication. Asaria writes from a position rarely represented in academic literature: that of someone with longstanding illness who has been labelled ‘treatment-resistant’ and has experienced the fear generated by newer terminology such as ‘terminal anorexia nervosa’. Notably, the lead author of the 2022 proposal that introduced the concept of ‘terminal anorexia nervosa’ has since expressly disavowed the phrase, a development Asaria highlights as evidence that the conceptual spectrum running from ‘treatment resistance’ to ‘terminality’ deserves urgent scrutiny.

At the heart of the argument is a challenge to the assumption embedded in the term ‘treatment resistance’: that non-response to therapy reflects a limitation within the patient rather than limitations in the care provided. Asaria asks a series of pointed questions. Should someone be called treatment-resistant if the treatment they received addressed physical risk only, without appropriate psychological care? What if the treatment was poorly delivered, of insufficient duration, or mismatched to their needs? Should expressions of pain, trauma, or iatrogenic harm be recast as ‘resistance’? The answer offered to each question is an emphatic no. A related critique targets the term ‘ego-syntonic’, which implies that an eating disorder is experienced as harmonious with the person’s entire personality and that their resistance to treatment is therefore voluntary. Asaria argues this functions as a form of volitional stigma, denying the tangled internal identity conflicts that many people experience and that are extremely difficult to articulate, particularly during acute phases of illness when thinking is clouded and alexithymia, the difficulty identifying and expressing emotions, may be pronounced.

The terminology debate matters because it shapes real clinical pathways. When patients are perceived as wilfully resistant, clinicians face what bioethicists have framed as a dilemma: whether to persist with recovery-focused treatment or shift to harm reduction and palliative care approaches. Asaria’s concern is that this creates a perceived binary choice between recovery-focused and non-recovery-focused pathways, especially within under-resourced health systems where highly tailored care may not be realistic. In an open letter to the Chief Executive of NHS England, Asaria argued that recovery and harm reduction are not mutually exclusive, and that a recovery pathway should unconditionally involve harm-reduction strategies when necessary, alongside professionals who hold hope for their patients even when patients struggle to carry it themselves.

The commentary raises specific technical concerns about applying harm reduction, originally developed for substance use disorders, to eating disorders. There are no consensus guidelines governing its use in this context, and the two categories of illness remain distinct in both the DSM-5 and ICD-11 classification systems. The physiological risks of nutritional compromise are substantial and unevenly distributed: a calorie intake and body mass index tolerable for one person whose body has adapted to prolonged starvation may be imminently life-threatening for another. Neuroimaging evidence sharpens the stakes. The ENIGMA Eating Disorders Working Group identified grey matter deficits in underweight and partially weight-restored individuals with anorexia nervosa, including cortical thinning exceeding that seen in any other psychiatric disorder studied, and a meta-analysis found a persistent 1.98% reduction in grey matter volume even among people recovered for more than 18 months. Bone health is similarly vulnerable, with osteoporosis that may be reversible in adolescence becoming extremely difficult to reverse after skeletal development stops. Asaria also warns that harm reduction, without professional oversight and clear boundaries, can drift into an ambiguous middle ground between pro-recovery and pro-illness positions, a concern reinforced by research on TikTok recovery content containing mixed signals.

Palliative care raises parallel difficulties. Unlike cancer, which is widely recognised as capable of becoming incurable, active eating disorder treatments are typically provided with the expectation of recovery within a limited timeframe, making genuine clinical agnosticism about prognosis difficult to achieve. Asaria distinguishes between compassionate end-of-life palliative care, which constitutes an ethical duty owed to anyone dying from malnutrition secondary to any illness, and broader palliative ‘models’ applied across populations of people who are not dying. The practicalities compound the concern: palliative care services globally are severely under-resourced, with the World Health Organization estimating that only 14% of people who need end-of-life palliative care currently receive it. There is also a hazardous conceptual overlap, since harm reduction and palliative care components can be blended, leaving unclear at what point one approach becomes the other.

Against this backdrop, the proposed recovery-fostering care framework offers five principles: holding hope for meaningful recovery and enabling opportunities for it; building therapeutic alliances; formulation-based and epistemically just care; unconditional safeguarding; and supporting caregivers. RFC is explicitly not a scientific model with the specification demanded of academic frameworks. It is a creative, flexible, person-led approach that prioritises lived experience over strict adherence to manuals and values humanity-based care alongside evidence-based care. Recovery within RFC is defined by the individual, may be understood as an evolving, non-linear journey of healing without time limits, and does not require the complete absence of symptoms to be meaningful.

The practical expression of RFC is strikingly concrete. Supported meaningful activities might involve accompanying a patient to cafés, museums, parks, or volunteering organisations; mindful walking that attends to sensory experience; or creative pursuits ranging from painting and photography to poetry and music, many of which cost relatively little compared with other areas of eating disorder expenditure. These activities can carry an exposure-like effect, helping people re-engage with situations long avoided, and they create contexts for relational care that may be more therapeutic than the activity itself. Walking side by side, Asaria notes, can be easier for people who struggle with eye contact than sitting opposite a clinician in an appointment room. The framework’s relational core is distilled into the acronym CHEAP: Compassion, Hope, Empathy, Appreciation, and Patience. These values require no specialist resources or training, only humanity, which Asaria calls the most accessible and affordable resource in eating disorder care, recalling a friend of a person who died with an eating disorder who felt some professionals seemed to ‘hide behind a lack of funding’.

Formulation-based care operationalises epistemic justice: the recognition that diagnostic manuals know less about the patient than the patient knows about themselves. Collaborative case formulations, potentially structured around the ‘Five Ps’ model of presenting, predisposing, precipitating, perpetuating, and protective factors, become a lived experience-based guide prioritised over treatment manuals derived from populations that may not represent the individual patient. Care plans and safety plans are explicitly combined into ‘care/safety plans’ to signal that safeguarding is unconditional, and harm reduction is repositioned as a clinician-supervised safeguarding intervention within a broader recovery-fostering approach rather than an overall model of care. Caregivers, meanwhile, are recognised as people with direct lived experience deserving care in their own right, with dedicated caregiver support plans and tailored resources for sibling and partner caregivers whose contributions are often overlooked.

The commentary closes with cross-cutting standards: nutritional counselling rather than mere education, health monitoring that includes quality of life and social functioning, weighing practices that never make access to care contingent on body mass index, and clinical training that addresses the needs of underserved groups in developmentally appropriate, identity-affirming, neurodiversity-affirming, and trauma-informed ways. Asaria acknowledges the structural obstacles that rigid healthcare systems pose to such flexibility, but argues that inflexibility should be treated as a problem to be solved through creative thinking rather than a permanent barrier. Whether the field embraces recovery-fostering care or continues down pathways that quietly abandon the possibility of recovery may depend on accepting the paper’s central claim: that delivering care with compassion, hope, empathy, appreciation, and patience should never be considered unaffordable.

Subject of Research: Lived experience perspectives on care approaches and recovery-fostering care for people with longstanding eating disorders

Article Title: Care approaches for people with longstanding eating disorders: a lived experience perspective on the need for recovery-fostering care

Article References: Asaria, A. (2026). Care approaches for people with longstanding eating disorders: a lived experience perspective on the need for recovery-fostering care. Journal of Eating Disorders, 14(1), Article 237. https://doi.org/10.1186/s40337-026-01786-5

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01786-5

Keywords: eating disorders, anorexia nervosa, treatment resistance, recovery-fostering care, harm reduction, palliative care, lived experience, therapeutic alliance, epistemic justice, safeguarding, caregivers, mental health

Psychological formulation is the process of applying psychological theory to build a collaborative understanding of a person’s difficulties, which then informs their plan of care. Unlike diagnosis, which asks what category a person fits into, formulation asks what has happened in a person’s life, what meanings they have drawn from those events, and how those meanings shape their current distress. It has long been recognised as a core competency by psychiatrists and clinical psychologists, and it aligns closely with the recovery model of mental health, which shifts the emphasis from narrow clinical outcomes to goals that are personally meaningful to service users. Yet despite years of government endorsement of recovery-oriented practice in the United Kingdom, routine activities such as acute care-planning vary substantially in how far they actually embody recovery principles, and service user involvement remains inconsistently integrated.

The problem the researchers set out to address was a striking one: almost no existing formulation frameworks had involved service users at the development stage. Drawing on principles of epistemic justice and the disability rights movement’s slogan of ‘nothing about us without us’, the team built the Personal Narrative Model collaboratively with clinicians, academics and a Service User Advisory Group. Two core advisory group members attended approximately twenty meetings during development, shaping the model’s framing, assumptions and language. The resulting framework is trantheoretical, strengths-focused and deliberately accessible, integrating political, social and biopsychosocial influences on distress. It incorporates the Power Threat Meaning Framework, which famously reframes the diagnostic question from ‘What is wrong with you?’ to ‘What has happened to you?’, alongside Hagan and Smail’s power-mapping model, strengths-based approaches, the Comprehend, Cope and Connect model and established team formulation guidelines.

Structurally, the Personal Narrative Model offers prompts for reflection rather than a fixed protocol, organised under headings such as ‘Strengths and Resources’, ‘Past Experiences’, ‘Meaning’, ‘Threat’, ‘Threat Responses’ and ‘Next Steps’. It is designed to be used one-to-one with service users or within multidisciplinary team formulations. The advisory group insisted the model be grounded in the realities of ward life, that its language remain accessible, and that strengths-based practice be prioritised. Three iterative versions were produced before testing. The model was piloted on a UK specialist inpatient ward of roughly ten beds for people diagnosed with a personality disorder, where staff received four ninety-minute training sessions covering the model’s development, formulation practice and the practicalities of implementation, including a role-play exercise simulating how the model might be introduced to a service user.

The evaluation used a two-phase exploratory sequential design guided by a critical realist framework. Phase 1, running from April to November 2019, involved a focus group with seven inpatient staff, including nurses, a clinical nurse specialist, a healthcare assistant and an occupational therapist, held one month after training. Phase 2, adapted to online delivery because of the COVID-19 pandemic, took place between May and November 2020 and comprised an open-ended survey with twenty-six participants from across the UK, including practitioners, practitioners with lived experience and people with lived experience of services, plus follow-up interviews with eight participants. All data were analysed using reflexive thematic analysis following Braun and Clarke’s six stages, with selected transcripts double-coded by two team members and NVivo 12 supporting data organisation. Ethical approval was obtained from the North West Liverpool Central Research Ethics Committee and the Anglia Ruskin University Faculty Research Ethics Panel, and all participants gave written informed consent.

The findings split into three overarching themes: the value of collaborative formulation, ‘selling’ and embedding change, and implementation barriers. On the first theme, reactions were strongly positive. One participant with lived experience called the model ‘incredibly useful and needed’, while a practitioner said she would be ‘so happy to use it’. Participants valued the way the model explored how people feel about their current treatment, something rarely discussed in therapy sessions, and appreciated that it encouraged thinking about a person’s own constructs in ways other models do not. One lived-experience participant described it as ‘almost like a little life tool’ for structuring thoughts. Others highlighted the whole-person approach: one practitioner contrasted it favourably with a medical model ‘based on numbers on a paper resulting from laboratory tests’, and both groups praised the balance of difficult past meanings with more positive interpretations, such as reframing the experience of bullying from ‘I am a failure’ to ‘it made me stronger to fight bullies and protect others’.

Yet the study also surfaced important caveats within that enthusiasm. Some participants warned that a strengths focus could feel invalidating for people who struggle to identify anything positive about themselves, particularly some clients with personality disorder diagnoses; as one practitioner with lived experience put it, for some clients the suggestion of any strength meets the response of ‘how dare you say that I’ve got strengths’. Participants also noted that engaging service users to explore strengths could be a hard, possibly distressing and lengthy process given long-held beliefs about self-worth, even if it remains essential for long-term recovery. These nuances matter because they show that even a collaboratively designed, recovery-oriented tool cannot simply be dropped into practice without attending to timing, support and the individual’s readiness to engage.

The second and third themes explain why a well-received model nonetheless failed to take root. Ward staff described care-planning as a demoralising tick-box exercise, with one saying she found forwarding care plans to other organisations ’embarrassing’ and another suggesting formulation could actually replace care-planning altogether. Participants proposed strategies for ‘selling’ the change: positioning the model as building on existing practices rather than replacing them, emphasising its value in improving confidence with risk, and making sure junior staff felt included. But the barriers were formidable. The medical model remains deeply embedded in inpatient settings, where, as one practitioner observed, staff are ‘busy putting out fires’ and ‘don’t have time to look for the source’, and where the prevailing attitude can be that patients ‘just need to check with the meds and they’ll be fine’. Nurses worried formulation was ‘another thing to do’ that psychologists should handle, and some participants described a culture in which pushing unpopular change could carry real professional costs, with one interviewee bluntly stating that sometimes ‘you need to shut up’ to keep your job.

Risk aversion emerged as a particularly consequential barrier. Staff feared that conversations about past experiences might destabilise service users or open up distress they felt unequipped to manage, and several suggested careful attention to timing and available support before introducing the model. This finding resonates with broader evidence: a systematic review by Read and colleagues found that only zero to twenty-two per cent of service users reported being asked about childhood adversity by adult mental health services, despite widespread recognition that many have experienced trauma. The authors also note that no participants in the focus group had actually adopted the model in practice by the time of the discussion, apart from one who intended to try it with new service users, an implementation gap the researchers interpret as the study’s most important finding.

The study has limitations that the authors acknowledge candidly: a single researcher conducted the qualitative analysis, samples were small and drawn from one inpatient site, and some survey wording, such as asking how likely the model was to ‘make improvements’, may have nudged participants towards positive responses. Even so, the Personal Narrative Model stands among the first formulation frameworks co-designed with service users from the outset, and its promising acceptability signals genuine appetite for more contextualised, less medicalised ways of understanding distress. The practical recommendations that emerge, including integrating formulation into existing care processes rather than adding it as an extra task, securing leadership support, tailoring training to staff’s existing knowledge, and planning carefully for risk conversations, offer a roadmap for researchers and practitioners hoping to embed psychological interventions in acute settings where change is hardest and, arguably, most needed.

Subject of Research: Acceptability and implementation of a service-user co-designed psychological formulation model in acute mental health inpatient care

Article Title: An exploration of acceptability of a collaboratively developed model of formulation

Article References: Pringle, A., Totman, J., Van Bortel, T., & Kaminskiy, E. (2026). An exploration of acceptability of a collaboratively developed model of formulation. PLOS Mental Health, 3(9), e0000718. https://doi.org/10.1371/journal.pmen.0000718

Image Credits: AI Generated

DOI: 10.1371/journal.pmen.0000718

Keywords: psychological formulation, mental health, co-production, service user involvement, recovery model, acute inpatient care, medical model, Power Threat Meaning Framework, implementation barriers, epistemic justice, PLOS Mental Health, qualitative research

Across mental health research, involvement of people with lived experience has expanded considerably over the past two decades. A substantial body of literature suggests that meaningful involvement can broaden research agendas, surface neglected priorities, challenge deficit-based framings, and produce knowledge more closely attuned to the realities of care and recovery. Co-produced approaches have been associated with improvements in the relevance, ethical quality, and social legitimacy of research, and they challenge long-standing hierarchies between professional and experiential forms of knowledge. Peer Researchers sit at the sharp end of this movement: rather than serving only as participants or external advisors, they help shape research questions, study design, recruitment, data generation, analysis, interpretation, dissemination, and leadership. In principle, this functions as a structural intervention within research systems, redistributing authority over who is considered capable of producing knowledge.

Yet the co-production literature also documents serious risks when involvement is poorly resourced or weakly embedded within institutions. Tokenism, stigmatisation, unequal power relations, emotional labour, exploitation, and involvement that remains procedural rather than substantive are all recurrent concerns. A recent scoping review of lived experience co-design in eating disorder research identified 76 studies but found substantial variation in how lived experience was incorporated, ranging from opportunistic consultation to full integration across the project lifecycle. Methodological reporting was often limited and inconsistent, with many studies stating that lived experience had been included while providing little detail on roles, processes, or actual influence on research decisions. The mere presence of lived experience within a project, the authors argue, reveals little about the authority afforded to contributors or whether their knowledge altered the research at all.

The commentary identifies five connected domains in which challenges commonly arise: recruitment and representation; trauma, stigma, and welfare; power-sharing and decision-making; training and career development; and structural resourcing. These areas overlap in practice—recruitment is shaped by who can afford to participate, welfare by how workloads are organised, power-sharing by when Peer Researchers enter a project, and career progression by whether institutions invest in sustained rather than episodic involvement. In each domain, the authors pair a description of the problem with practical suggestions for more ethical and meaningful participation.

Recruitment emerges as an early site at which inclusion and legitimacy are actively shaped. Opportunities often favour individuals who meet conventional definitions of recovery, are already connected to research networks, or hold formal diagnoses. Self-selection processes may privilege those with stable health, financial security, and confidence in professional environments, excluding people whose insights are valuable but who are distant from services, mistrust healthcare systems because of previous trauma, or fall outside dominant stereotypes of who develops an eating disorder. This compounds existing inequities: racialised communities, LGBTQ+ people, men, disabled and neurodivergent people, people in larger bodies, and older people may all be excluded when their experiences do not align with the field’s narrow historical image. The authors also highlight the representational burden placed on a sole Peer Researcher expected to speak for an entire community, when experiential expertise is inherently situated and plural. Suggested remedies include recruiting beyond specialist services, involving lived experience collaborators in designing recruitment materials and selection criteria, and funding multiple contributors or community partnerships where diverse insight is sought.

Trauma, stigma, and welfare present a second cluster of difficulties. Lived experience accounts consistently document services experienced as stigmatising or disbelieving, with people described as manipulative, attention-seeking, or insufficiently motivated—dynamics that constitute forms of epistemic injustice, shaping whose accounts are treated as credible. For Peer Researchers, the perspectives for which they are invited into research may remain subtly mistrusted, reframed as pathology, or contained within it. Emotional labour is central rather than incidental to this work, which can involve engaging with accounts of illness, treatment, and recovery that resonate with or unsettle one’s own history. Eating disorders are often marked by fluctuation, relapse, and long-term management rather than a simple transition from illness to wellness, yet research environments may assume contributors are either fully recovered or too unwell to participate. The authors advocate trauma-informed participatory frameworks organised around anticipation, flexibility, reflection, safety, and relational trust: discussing risks in advance, allowing people to opt in or out of particular tasks, adapting meeting schedules, and making explicit that stepping back from a task will not be interpreted as failure. Crucially, they stress that risk should be assessed in relation to specific tasks rather than attached to lived experience as a general category, and that protective exclusion—however well-intentioned—can reproduce the very judgements about competence that Peer Research is meant to challenge.

Power-sharing is perhaps the most consequential domain. Lived experience may be welcomed mainly in forms that fit established project structures, such as personal reflection or validation of decisions made elsewhere, while Peer Researchers are kept out of the parts of the process where concepts are defined, assumptions challenged, and interpretations negotiated. Concerns about vulnerability or readiness may steer them away from work deemed too sensitive or technical, narrowing their roles and preserving existing distributions of authority. The authors argue that clearer differentiation between forms of expertise can strengthen collaboration: statistical modelling, trial design, data governance, qualitative interpretation, experiential understanding, and ethical judgement each involve distinct competences, and technical skill in one domain does not confer exclusive authority over the framing, interpretation, or lived relevance of research. Practical steps include agreeing decision-making processes at the outset, creating routes for disagreement, documenting how lived experience input influenced the project, and being transparent when a decision cannot be shared for legal or governance reasons. The clearest marker of genuine collaboration, they suggest, is whether lived experience input can change the work itself.

Training and career development compound these problems. Many Peer Researchers remain employed on fixed-term or consultancy arrangements tied to individual studies, limiting opportunities to develop sustained expertise or academic careers. Training within projects may focus narrowly on enabling contributors to support pre-existing designs, while researchers without lived experience receive little preparation in the relational and ethical demands of co-production. The authors call for reciprocal but not symmetrical development: Peer Researchers gaining access to methodological and institutional knowledge, and established researchers developing skills in accessibility, power-sharing, and epistemic reflexivity. Sustainable roles require clear employment structures, fair compensation, appropriate authorship, and progression routes into substantive posts, fellowships, and leadership—while recognising that some Peer Researchers may prefer portfolio or community-based forms of work.

Underlying all of this is the structural context: eating disorder research is a comparatively small and under-resourced field, with investment disproportionately low relative to disease burden and mortality. Short project cycles and competitive grant processes mean Peer Researchers are often involved only after funding is secured and key decisions have been made, creating a genuine ethical dilemma for researchers who would otherwise involve them earlier. The authors propose structural solutions including pre-award involvement funds, institutional seed funding, and funding mechanisms that allow project designs to evolve throughout the lifecycle. They also examine how ethics and governance frameworks, developed primarily for research participants, may be misapplied to Peer Researchers in ways that overemphasise vulnerability, and how payment delays, benefit restrictions, and insecure contracts directly shape who can afford to contribute. Responsibility for change, they conclude, is shared across research teams, institutions, funders, ethics bodies, and the wider field—not individuals alone.

The commentary’s synthesising argument is that meaningful Peer Research depends not simply on the presence of people with lived experience within research teams, but on the conditions under which their expertise enters, influences, and is sustained within research. Differences in training and formal responsibility will remain, but ethical collaboration requires that these differences do not become a general hierarchy through which experiential knowledge is routinely subordinated. The possibility of distress or fluctuating health, the authors insist, should prompt responsive support and flexibility rather than exclusion as the default response. If the field can deliver broader recruitment, paid involvement during project development, reciprocal training, sustainable career pathways, proportionate governance, and transparent reporting of how lived experience has changed the work, Peer Researchers could move from being rhetorically welcomed to genuinely consequential contributors—with corresponding gains in the quality, relevance, and ethical integrity of eating disorder research itself.

Subject of Research: The role and integration of Peer Researchers with lived experience in eating disorder research

Article Title: Reflections on the role of Peer Researchers in eating disorders: identifying challenges, best practices, and future directions

Article References: Downs, J., Maloney, E., Carnegie, A., Thomas, K. S., & Chapman, L. (2026). Reflections on the role of Peer Researchers in eating disorders: identifying challenges, best practices, and future directions. Journal of Eating Disorders, 14(1), Article 238. https://doi.org/10.1186/s40337-026-01757-w

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01757-w

Keywords: eating disorders, peer research, lived experience, co-production, epistemic justice, participatory research, research ethics, trauma-informed practice, power-sharing, mental health research, research funding, stigma

The research team conducted a rapid review of global case studies, a method designed to synthesize a broad and scattered evidence base within a structured analytical frame. Rather than cataloguing individual examples of unfairness, the authors interrogated the accumulated evidence to identify where and how climate action is engaging with the core pillars of justice that political philosophers and environmental justice scholars have developed over decades. Their conclusion is both encouraging and cautionary. The three classical dimensions of justice—distributive, procedural, and recognitional—are indeed being engaged with in urban climate initiatives worldwide, but the depth and simultaneity of that engagement determines whether an intervention becomes genuinely transformative or merely cosmetic.

Distributive justice, the first pillar, concerns who receives the benefits and burdens of climate policy. In practical terms, it asks whether a new flood barrier protects wealthy waterfront districts while informal settlements remain exposed, or whether urban tree-planting programs cool already leafy neighborhoods while heat-vulnerable districts stay bare. The review finds that cities increasingly deploy joint mitigation and adaptation interventions—projects that reduce emissions while building resilience—and that the distributional question is now explicitly on the agenda in many of them. Yet distribution alone is a blunt instrument. A solar subsidy program can be perfectly equal in formal terms and still be inaccessible to renters, low-income households, or residents without legal tenure, which is why the authors insist that distributional analysis must be paired with the other pillars.

Procedural justice addresses the second dimension: who participates in deciding. It examines whether affected communities have genuine voice in the design, implementation, and evaluation of climate interventions, or whether participation is reduced to token consultation after the key decisions have been made. The synthesized case studies show that exclusionary governance remains one of the most persistent barriers to equitable urban climate action. When planning processes are technically opaque, conducted in dominant languages only, or scheduled in ways that exclude working residents, the resulting policies tend to reproduce the very vulnerabilities they claim to address. The review identifies procedural reforms—co-production of plans with communities, transparent decision criteria, and accountability mechanisms—as a recurring feature of the more successful pathways.

Recognitional justice, the third classical pillar, goes deeper still. It asks whether the identities, histories, and knowledge systems of marginalized groups are respected within climate governance. Recognition failures can be subtle: Indigenous worldviews dismissed as irrelevant to technical flood modeling, gendered patterns of climate vulnerability ignored in mobility planning, or the specific exposures of migrants and ethnic minorities rendered invisible in aggregate city statistics. The authors find that recognition is increasingly invoked in climate action, but that it is often the thinnest of the three pillars in practice, acknowledged in policy language without changing who holds power or whose knowledge counts.

This is where the paper’s conceptual contribution becomes significant. The team extends the standard triad by integrating two additional dimensions: epistemic justice and restorative justice. Epistemic justice concerns the credibility afforded to different kinds of knowledge. In urban climate contexts, this means treating residents’ lived experience of flooding or heat as legitimate evidence alongside satellite data and hydrological models, and creating institutional channels through which local and Indigenous knowledge can genuinely inform technical decisions. Restorative justice, meanwhile, addresses deeply rooted systemic exclusions by confronting historical wrongs—colonial dispossession, discriminatory housing policy, and the extraction that built urban wealth in some places at the expense of others. A city cannot simply plan forward from an unjust baseline, the framework suggests; it must also account for how that baseline was produced.

The central analytical claim of the review is that climate initiatives are more likely to become transformative when they address multiple dimensions of justice simultaneously. This is a testable proposition with real design implications. A cooling center program that distributes resources fairly (distributive), is sited through community deliberation (procedural), respects the needs of elderly residents and informal workers (recognitional), incorporates their knowledge of neighborhood microclimates (epistemic), and acknowledges past disinvestment in their districts (restorative) is structurally different from a program that scores well on only one axis. The authors argue that single-pillar interventions tend to stall or backslide, because unresolved injustices in other dimensions eventually undermine them—participation without recognition becomes tokenism, and recognition without redistribution becomes symbolism.

From the synthesized evidence, the researchers distill key principles for enabling just and equitable action. While the review is careful not to prescribe a single template—urban contexts vary enormously between, say, a rapidly growing South Asian megacity and a shrinking post-industrial city in Europe—the principles converge on a common logic. Justice must be embedded from the earliest stages of intervention design rather than retrofitted after opposition emerges. Power must be genuinely shared with the communities who bear climate risks. Knowledge hierarchies that privilege formal expertise must be opened to plural ways of knowing. And institutions must be built to sustain these practices over time, because justice is not a one-time consultation but an ongoing condition of governance.

The practical payoff of the framework is a shift in what the field asks of research. As the authors put it in their abstract, the work is intended to move researchers and practitioners beyond identifying climate injustices toward an actionable roadmap for co-producing equitable climate solutions. Co-production is the operative term: the pathways the review maps are not top-down blueprints delivered to passive beneficiaries, but collaborative processes in which residents, municipal agencies, researchers, and civil society organizations jointly define problems and solutions. This framing reflects a broader movement in sustainability science over the past decade, but the review gives it sharper normative teeth by insisting that the quality of co-production be judged against all five justice dimensions.

The timing of this synthesis matters. Urban populations continue to grow fastest precisely in regions with the highest climate exposure and the weakest adaptive capacity, and national governments remain slow to deliver the finance and institutional support cities need. In that gap, municipal governments, community organizations, and hybrid actors are improvising climate action on their own—and the review’s evidence suggests that those improvisations succeed most often when justice is treated as constitutive of effectiveness rather than as a constraint on it. The authors declare no competing financial interests, and the paper is published open access, making the framework available to the practitioners it is meant to serve. What the study ultimately offers is a vocabulary and a checklist for a question that every city will face this century: not simply whether climate action happens, but who it is for, who decides, and whose past it repairs.

Subject of Research: Urban climate justice frameworks for equitable mitigation and adaptation in cities

Article Title: Overcoming urban climate injustice: synthesising global pathways and principles

Article References: Prakash, A., Bulkeley, H. A., Singh, C., McGregor, D., & George, R. (2026). Overcoming urban climate injustice: synthesising global pathways and principles. npj Urban Sustainability. https://doi.org/10.1038/s42949-026-00477-z

Image Credits: AI Generated

DOI: 10.1038/s42949-026-00477-z

Keywords: urban climate justice, climate adaptation, climate mitigation, distributive justice, procedural justice, recognitional justice, epistemic justice, restorative justice, co-production, urban sustainability, climate governance, rapid review

The review’s central conceptual move is to distinguish two kinds of assistance. Instrumental or representational assistance helps learners generate options, translate, format, retrieve, summarise or re-express material. Judgement-bearing assistance goes further: it evaluates correctness, relevance, quality, persuasiveness, ethical acceptability or evidential sufficiency. The two categories can overlap, since even a summary selects what matters, but judgement-bearing assistance is normatively far more demanding because it delegates not only the production of work but the standards by which that work is assessed. A learner may use AI repeatedly yet remain epistemically agentic if the interaction prompts questioning, comparison and revision; another may use it once but treat its answer as decisive in a high-stakes task. The analytic boundary, the authors insist, is not use versus non-use but the relation between assistance and judgement.

To operationalise that boundary, the review proposes six diagnostic criteria separating productive reliance from harmful dependence: contestability, recoverability, transfer, traceability, distributed responsibility and epistemic plurality. Dependence becomes problematic when the relation is difficult to contest, obscures its evidential basis, weakens the learner’s capacity to reconstruct or transfer judgement, or allocates responsibility to people who lack meaningful control. Conversely, frequent AI use can remain productive when it provokes comparison, makes uncertainty visible and leaves the learner more capable of independent and collaborative judgement. The criteria are offered as diagnostic questions for research, design and pedagogy rather than a psychometric scale, and no single criterion is decisive in every context; the pattern matters, as does the importance of the delegated judgement.

The heart of the paper is an analysis of four sociotechnical pathways through which AI affordances and institutional conditions can slide into harmful dependence. The first is fluent authority. Large language models produce grammatically polished, coherent and often confident responses, and fluency is epistemically persuasive because users can mistake ease of processing for reliability. Anthropomorphism, social presence and personalisation can amplify this effect: conversational systems occupy roles associated with human epistemic others, such as respondent, tutor, editor and evaluator, and a supportive tone with apparent memory may encourage the transfer of interpersonal trust to a system that lacks human understanding, responsibility or commitment to the learner. The risk is not error alone but the alignment of error, confidence and immediacy, especially for learners with limited domain knowledge.

The second pathway is frictionless delegation. Generative AI compresses searching, reading, comparing, synthesising and drafting into a single request-response cycle. Cognitive offloading can be adaptive when it frees limited resources for planning, reflection or complex problem solving, but adjacent research on internet search suggests that persistent access to external information can alter memory, confidence and future search behaviour. When intermediate epistemic actions disappear from the workflow, learners may complete tasks without practising the very actions the tasks were intended to develop. Assessment incentives intensify the problem: if institutions reward polished products while leaving process and justification invisible, delegating epistemic work becomes rational, and AI shifts from scaffold to substitute, particularly in feedback and evaluation.

The third pathway is opaque synthesis. Conversational AI often presents an integrated answer without making its source selection, weighting, exclusions or uncertainty inspectable. Traditional search was never transparent or neutral, but it commonly exposed multiple documents, authors and domains, even if learners evaluated them poorly. Conversational synthesis can hide that plurality behind one voice, transforming the learner’s task from selecting among visible sources to recovering the evidential structure of an answer that appears already complete. This can weaken verification while improving the surface quality of the product, making epistemic deficits harder for teachers to detect. It also threatens disciplinary reasoning, since a generic synthesis may flatten the distinct standards by which historical, scientific and philosophical claims are warranted.

The fourth pathway is institutionalised dependence. Universities and schools shape reliance through procurement, platform integration, assessment design, timetabling, policy and professional development, while commercial systems encode objectives concerning engagement, speed, cost and data capture. Once AI is built into learning management systems, writing environments and feedback workflows, it may become the default route into academic work rather than a discrete tool chosen by the learner. Institutionalisation also redistributes authority and responsibility: a student may be held accountable for claims generated through an institutionally licensed but opaque system, a teacher may be expected to police use without access to system logs, and a university may depend on vendor assurances that cannot be independently audited. The review argues that responsibility should track control, knowledge and benefit across learners, educators, institutions and providers, rather than being dumped on the end user.

This institutional dimension brings epistemic justice to the centre of the analysis. Generative systems draw on unequal knowledge infrastructures and may reproduce dominant languages, classifications and perspectives while marginalising local, minoritised or experiential knowledge. Drawing on Miranda Fricker’s account of epistemic injustice and on recent work on formative epistemic injustice, the authors argue that learning arrangements can wrong students by restricting the knowledge, practice and accurate self-assessment through which they develop as knowers. Repeated reliance may also reshape learner identity, fostering a self-conception of being unable to write, understand or judge without AI. Productive reliance should expand participation and capability over time; harmful dependence makes learners and institutions more fragile when the system is absent, changes its terms or fails particular communities.

Against these risks, the review proposes relational epistemic agency as the normative aim: the capacity to question, verify, compare, justify and take responsibility for knowledge claims within human, technological and institutional relations. This is not independence from the machine, and it is not an anti-dependence position. Education has always involved dependence on teachers, peers, texts, instruments and institutions, and ideals of self-sufficient knowing are both unrealistic and exclusionary. The relevant test is functional and developmental: does the human-technology relation enlarge the learner’s capacity to participate in epistemic practice, or merely deliver a product? A calculator supports mathematical agency when the learner understands when and why its operations are appropriate; a generative model supports inquiry when it expands hypotheses, reveals alternatives and prompts verification. The same tools bypass agency when they become non-contestable authorities.

The practical implications are concrete. Designers should provide claim-level provenance where feasible, distinguish retrieved evidence from model-generated synthesis, represent uncertainty through alternatives and explicit unknowns, preserve user control over prompts and outputs, and surface disagreement and culturally diverse sources. Pedagogy should move from policing AI use to teaching AI-mediated judgement, with routines for lateral reading, source triangulation and claim verification, and assignments that require learners to annotate AI responses, identify unsupported assumptions and document why they accepted or rejected particular suggestions. Assessment should make process, judgement and transfer visible through staged drafts, oral defence, source maps and reflective decision logs, without becoming surveillance-heavy. Institutions, meanwhile, should evaluate procurement for provenance, bias, auditability and data governance, and specify which learning outcomes must remain demonstrably human. The empirical agenda that follows is equally clear: researchers must track which epistemic actions are preserved, transformed or displaced, using process evidence such as interaction traces and think-aloud protocols, and must examine organisations and markets, not only learners. The future of knowing, this review suggests, depends less on how often students use AI than on whether the systems and institutions around them are configured so that judgement survives the delegation.

Subject of Research: Epistemic dependence and learner agency in AI-mediated education

Article Title: Epistemic dependence in AI-mediated learning

Article References: Du, Y., & Yuan, Y. (2026). Epistemic dependence in AI-mediated learning. AI & SOCIETY. https://doi.org/10.1007/s00146-026-03294-1

Image Credits: AI Generated

DOI: 10.1007/s00146-026-03294-1

Keywords: generative AI, epistemic dependence, epistemic agency, AI in education, cognitive offloading, epistemic justice, evaluative judgement, large language models, human-AI interaction, assessment, educational governance, AI & Society

The study, published on 30 September 2026, is not an empirical survey of thousands of doctoral candidates but something arguably more unusual: a critically oriented interpretive synthesis built on a targeted documentary review of peer-reviewed research and published accounts from doctoral students and supervisors. Rather than treating documents as passive evidence, the author mobilizes a deliberately plural theoretical framework, drawing on field theory, governmentality studies, decolonial thought and phronetic social science. The paper is candid about the tensions among these traditions, which rest on different epistemological assumptions, and does not attempt to reconcile them fully. Instead, it uses them analytically, as complementary lenses, to expose governance effects that any single framework might miss.

The central conceptual move is the definition of depoliticization as a governance effect. When universities describe doctoral training in the language of outputs, throughput, rankings and excellence, they present choices as technical necessities rather than as decisions that could have been made differently. The study argues that this displacement is precisely the point: once scholarly worth is converted into countable outputs and reputational signals, the underlying questions about what knowledge is for, who it serves, and whose standards define legitimacy disappear from view. Metrics, in this account, do not merely measure the academy; they reorganize it, rewarding behavior that fits the indicators and rendering everything else invisible.

From the synthesis, the study identifies four interconnected mechanisms through which this depoliticization operates. The first is metric governance itself, the conversion of scholarly worth into publications, citations and reputational markers. The second is managerialism and audit culture, which reorganize doctoral temporality and supervision through monitoring and throughput pressures. The third is the persistence of epistemic hierarchies, in which Eurocentric standards of legitimacy are universalized and may enable extractive relations with scholars and knowledge traditions in the Global South. The fourth is the structurally produced human cost, including distress and burnout among doctoral researchers, which institutions often individualize even though, the paper argues, it is institutionally induced.

Each mechanism reinforces the others in ways the paper traces carefully. Metric governance creates the demand for auditable performance; managerialism supplies the administrative machinery that monitors it; epistemic hierarchies determine which kinds of work can be counted as excellent in the first place; and the human costs are then read as personal failings rather than systemic outcomes. The analysis draws on a rich sociological tradition, including Robert Merton’s classic account of the Matthew effect, in which accumulated advantage compounds for already-privileged scholars, and on anthropological work on audit cultures that describes how rituals of verification reshape institutional life. The reference list also engages the metric tide review of research assessment, a landmark critique of indicator-driven evaluation.

To illuminate recurring structural patterns while acknowledging contextual variation, the study uses international references from Latin America and Sub-Saharan Africa as secondary, literature-based vignettes. These are not presented as case studies in a conventional comparative design but as illustrations of how the same governance logics manifest under very different conditions. Work on doctoral education in South Africa and Uganda, on managerialism and academic resistance in Chilean higher education, and on decolonial pedagogies in the Abya Yala region feeds into the analysis. The paper is explicit that these vignettes are literature-based and secondary, a methodological honesty that distinguishes the study from claims of direct ethnographic authority over the contexts it discusses.

The human costs receive particular attention, and here the study incorporates quantitative findings in a carefully bounded way. Statistical research on the social predictors of doctoral student mental health and well-being, including a differentiated two-profile solution and odds ratios linking mentoring quality, publication output and well-being, is used as contextual documentary evidence rather than as independent inferential support. The paper notes that these findings show how doctoral well-being is shaped by relational and institutional conditions rather than by productivity alone. In other words, the distress that pervades doctoral education is not an unfortunate side effect of rigorous training but, on this account, a predictable product of governance regimes that restructure time, supervision and worth around countable outputs.

Supervision emerges as a critical site in this transformation. The synthesis draws on scholarship that retheorizes doctoral supervision as professional work and on studies of how supervisory roles are being redefined across different cultural contexts. Under audit regimes, the supervisory relationship risks being reorganized around monitoring and throughput: the supervisor becomes a manager of completion times and publication pipelines rather than an intellectual mentor. The study also engages feminist scholarship on care and leadership in the academy, including work on chairing and caring, and the pedagogical tradition of teaching as the practice of freedom, to imagine what supervision might look like if it were organized around relational and intellectual flourishing rather than auditable progress markers.

The decolonial dimension of the argument is among its most provocative claims. By universalizing Eurocentric standards of legitimacy, the paper argues, metric regimes do not simply rank knowledge; they decide in advance which knowledge traditions can appear as knowledge at all. Drawing on epistemologies of the South, decolonizing methodologies, and critiques of epistemic injustice, the study suggests that extractive relations with scholars in the Global South are not accidental byproducts of internationalization but structural features of a system in which legitimacy flows from a small set of institutions, languages and publication venues. The vignettes from Africa and Latin America show scholars navigating, resisting and reworking these hierarchies, even as the global architecture of evaluation remains largely unchanged.

The study does not conclude that accountability itself is the enemy. Its discussion argues for a plural and responsible approach to evaluation that preserves legitimate demands for accountability while broadening what counts as rigor and public relevance. The final move is constructive: the paper proposes principles for repoliticizing doctoral education through care-centered pedagogy and socially engaged scholarship. That means reopening questions that metrics have closed, treating doctoral students as whole people rather than output generators, valuing community-engaged and publicly relevant research alongside publication counts, and building evaluation systems that acknowledge rather than conceal the value judgments embedded within them. Whether universities can loosen the grip of the indicators they have come to depend on remains an open question, but the study makes a compelling case that the current arrangement is not a technical inevitability. It is a choice, and choices can be remade.

Subject of Research: Depoliticization of knowledge in doctoral education through metric governance, audit culture and epistemic hierarchies

Article Title: Depoliticizing knowledge in doctoral education

Article References: Muaquesse, A. (2026). Depoliticizing knowledge in doctoral education. Higher Education. https://doi.org/10.1007/s10734-026-01764-5

Image Credits: AI Generated

DOI: 10.1007/s10734-026-01764-5

Keywords: doctoral education, metric governance, audit culture, managerialism, epistemic justice, decolonial thought, research evaluation, supervision, mental health, academia, higher education policy, Global South

The argument rests on a significant tension at the heart of modern doctoral education. Public and patient involvement in research, often abbreviated to PPI, is now embedded in health and care legislation, professional education and the requirements of major research funders in the United Kingdom, the United States, Canada and Australia. In the UK, bodies such as the National Institute for Health and Care Research treat public involvement as a fundamental component of good research practice, while in the United States the Patient-Centred Outcomes Research Institute actively encourages engagement in funded studies. Yet, despite this policy shift, the structures of the PhD, conceived as an individual pursuit culminating in a solo-authored thesis and an oral defence, have largely failed to adapt, leaving doctoral candidates who want to work collaboratively facing regulatory, financial and cultural obstacles.

The network itself emerged from a single social media post in April 2023, in which one author asked when the rules of PhDs would change to recognise collective endeavour in knowledge production. The question struck a chord. More than fifty people from the UK and beyond joined the first online meeting in July 2023, and the group has since grown into a structured network with subgroups dedicated to issues ranging from ethics and funding to examination practice. Its members span the full spectrum of doctoral life, from aspiring students to supervisors, examiners and people who contribute their lived experience to doctoral research, and the new paper draws on the personal reflections of eight members who have carried out participatory PhDs themselves.

Technically, the authors draw careful distinctions between related but distinct traditions. Participatory research, rooted in critical and emancipatory scholarship, aims to redistribute power across the research process, with people from marginalised groups acting as co-researchers and decision-makers at every stage. Patient and public involvement, by contrast, refers to structured involvement of lay contributors, most commonly in health and social care, and does not necessarily entail shared epistemic authority or co-production of knowledge. Co-production overlaps with both but is applied more broadly across research, service design and evaluation. The authors stress that these approaches operate along a spectrum rather than fitting into binary categories, shaped by the capacities, interests and institutional circumstances of everyone involved, and they argue against a one-size-fits-all definition of what participation should look like.

The practical barriers the network identifies are considerable. Doctoral regulations in the UK and many other countries require students to demonstrate an independent and original contribution to knowledge, a criterion that sits awkwardly with genuinely collaborative inquiry. At one Scottish university, the authors found no specific guidelines for working with members of the public on research, beyond rules for commercial or professional collaboration that require formal letters of engagement and named partners on the thesis. Ethical approval processes present further difficulties, since they often assume an extractive, researcher-led model and can blur the distinction between a research participant, a co-researcher and a member of a reference group, even though UK Health Research Authority guidance states that ethics approval is not required when involving people in the planning or design stage of research.

Examination practices compound the problem. The viva voce, the oral examination in which candidates defend their thesis, focuses on the final written product rather than the process, which is problematic for participatory projects whose collaborative dimension may not be visible in a solo-authored document. It remains unclear whether co-researchers can co-author parts of a thesis or attend the viva, and one network member reported being told that including a public contributor at their examination might be impossible because of academic regulations and questions about the contributor’s qualifications. The authors describe the language of defending a thesis as itself reflecting the exclusive nature of the traditional PhD, and they note that adapting collaborative chapters into a single-voiced academic format can erase the very contributions that made the research meaningful, even when the collaborative writing process is, as one recent candidate described it, a radical act of epistemic justice.

Funding and training gaps are equally pressing. Doctoral students frequently operate on limited budgets, and the additional costs of participatory work, such as reimbursing contributors for their time, can be unattainable without dedicated support. At one English university, a facilitating research fund has been used successfully to pay co-researchers, but only by classifying them as consultants within a PPI framework rather than as researchers in a participatory project, illustrating how payment systems themselves can reinforce hierarchies. Training resources for public involvement tend to target early career researchers and beyond, with few specific programmes for doctoral students, although examples of good practice exist, including a co-designed Master’s unit in Public Involvement in Research at Bournemouth University and participatory action research training for education doctoral students reported in the United States.

The paper situates these demands within a changing policy landscape. The UK’s Research and Evaluation Framework, which assesses university research quality and informs public funding, is shifting toward openness and collaboration: the upcoming REF2029 renames research environment as People, Culture and Environment and raises its weighting from fifteen to twenty-five per cent, while impact becomes Engagement and Impact, broadening the evidence base accepted for case studies. Legislative frameworks add further momentum, with the Care Act 2014 in England and the Social Services and Well-being Act 2014 in Wales both positioning co-production as a central principle of public services. To help visualise what is possible, the network co-created a logic model mapping participatory activities onto every stage of the doctoral journey, from question formulation and literature reviewing to data analysis, dissemination and co-authorship, while also flagging principles to consider and current limitations that remain impossible to overcome.

Underlying the practical proposals is a deeper epistemological argument. The authors contend that participatory methods require a shift in ontological and epistemological paradigms, connecting their case to decolonial critiques that seek to share power, recognise knowledge systems erased by European colonialism and rehumanise research. They confront the standard criticism that participatory approaches compromise scientific rigour, countering that societies are not homogenous and that positivist methods focused on large trends often miss crucial nuance. Citing work on the three Rs of rigour, relevance and reach, they point to evidence that community-based participatory research can strengthen all three, producing findings that matter to local people, attract wider attention and benefit from community scrutiny. They also note that traditional academia is not free of bias, citing cases of retraction and misconduct, and arguing that explicit positionality and reflexivity can increase transparency rather than diminish it.

The authors are candid about the limits of their own perspective, acknowledging that the voices of people drawing on care and support services, unpaid carers, people with learning disabilities, abuse survivors, working-class and homeless people remain under-represented both in their network and in research more broadly. Their recommendations are correspondingly ambitious: universities and funders should create environments conducive to participatory work, reduce unnecessary bureaucracy, ring-fence funding, adapt milestones and policies, and embed participatory principles in research methods education from undergraduate level onward. The paper sets out principles for a participatory PhD, including supported students, experienced supervisors, agreed power-sharing with public contributors, flexible funding and adaptability to changing circumstances. The Participatory PhD Network intends to continue developing this emerging field, and its members argue that only by recognising diverse forms of knowledge, including experiential expertise grounded in equalised relations of power, can doctoral education remain relevant, rigorous and aligned with a more democratic vision of knowledge production.

Subject of Research: Reforming doctoral education to support participatory and collaborative PhD research with public and lived-experience involvement

Article Title: Supporting participatory PhDs: a call to action

Article References: Supporting participatory PhDs: a call to action. (n.d.). https://doi.org/10.1007/s10734-026-01776-1

Image Credits: AI Generated

DOI: 10.1007/s10734-026-01776-1

Keywords: participatory PhD, doctoral education, patient and public involvement, co-production, research methods, Higher Education, viva examination, research funding, epistemic justice, decolonial research, Participatory PhD Network, research ethics

At the heart of Yang’s book is a systematic comparison of how Chinese and Anglo-American societies conceive the public good of higher education. Using a method the review describes as trans-positional analysis, Yang moves between the two traditions across five key themes, refusing to treat either as a universal benchmark against which the other must be measured. In the Anglo-American tradition, the public good of universities has been framed largely through liberal individualism, market accountability and the state’s retreat from direct provision. In the Chinese tradition, by contrast, education has long been entwined with the moral cultivation of persons, the responsibilities of family and collectivity, and the state’s role as guarantor of social harmony and meritocratic mobility. Yang’s argument is that these are not merely different policy preferences but structurally different ways of generating public value.

The reviewers sharpen this point by distinguishing three levels at which the structural differences operate. At the normative level, the two traditions answer differently what a university is for: individual enrichment and economic productivity in the Anglo-American frame, versus self-perfection and collective flourishing in the Confucian frame. At the institutional level, they differ in how funding, governance and evaluation distribute responsibility between state, market and society, with Chinese higher education embedding the state more deeply in defining educational purpose, as seen in debates over the gaokao entrance examination and its double constraints. At the subjective level, students and academics internalise these divergent logics, shaping how individuals imagine their own agency, obligation and belonging within the university.

What makes the review—and the book it examines—technically significant for the field is the concept of epistemic justice, borrowed from Miranda Fricker’s 2007 work on power and the ethics of knowing. Applied to higher education research, epistemic injustice means that knowledge produced in non-Western traditions is systematically discounted, translated into Western categories or treated as exotic raw material rather than as theory in its own right. Tao and Li argue that Yang’s comparison directly challenges this Western-centrism. By drawing on Chinese philosophical resources with the same seriousness conventionally reserved for liberal political theory, the book performs what the reviewers call an advance in epistemic justice: it insists that the Chinese tradition can generate concepts, not merely case studies.

The most conceptually charged of these resources is tianxia, often translated as all-under-heaven, an classical Chinese vision of world order in which political and moral community extends across the entire known world rather than being bounded by nation-states. In recent years, philosopher Zhao Tingyang has revived tianxia as an ontological argument for a new world order, and Yang and her collaborators—including Simon Marginson and Xin Xu—have developed it as a heuristic for higher education, proposing a world-centred rather than nation-centred imaginary for global academia. Their 2024 article in Globalisation, Societies and Education, titled Thinking through the world, and their 2025 Higher Education paper on the global aspirations of Chinese universities both treat tianxia as a lens for imagining universities as contributors to a shared human world rather than competitors in a zero-sum rankings game.

Yet the review is refreshingly candid about the disputes this agenda has provoked, and it engages critics rather than dismissing them. Four risks receive sustained attention: reductionism, essentialism, re-orientalism and the co-optation of tianxia. Reductionism is the danger of flattening vast, internally diverse civilisations into single explanatory formulas. Essentialism treats Chinese and Western cultures as fixed, homogenous essences rather than dynamic, hybridising formations—a concern echoed by W.W. Lo and Rui Yang’s work on hybridisation and recombination in Chinese societies, and by Zhu, Shen and Yang’s 2025 Higher Education study showing how Chinese humanities and social science scholars actively transform traditions into academic resources rather than merely inheriting them.

Re-orientalism poses a subtler trap. Building on Edward Said’s 1977 critique of Orientalism and subsequent debates in Chinese scholarship by scholars such as Wang Ning and Zhou Ning, the reviewers note that even well-intentioned efforts to celebrate Chinese traditions can reproduce the same East-West binary that Orientalism created, positioning China as a mystical civilisational Other. Mulvey’s 2026 article in Comparative Education goes further, asking whether the essentialisation of China within so-called critical internationalisation studies constitutes a new Orientalism. The tianxia concept attracts the sharpest critique of all: Fei Yan’s 2026 article, The darker side of Tianxia, warns that the framework carries imperial histories and could be co-opted to serve state power, while Moreno García and Pines’s comparative historical work on Maat and Tianxia reminds readers that ancient world-order ideologies, Egyptian and Chinese alike, were instruments of rule as much as philosophies of harmony. Berlin debates between Zhao and Western philosophers, documented in World Philosophy, show that these objections are not merely external attacks but live controversies within the tianxia literature itself.

The reviewers’ response to these disputes is arguably the review’s most important analytical move. Rather than concluding that tradition-based research is too dangerous or too essentialist to pursue, they argue that the risks are internal to any serious cross-cultural scholarship and must be managed through methodological reflexivity, attention to hybridity and genuine two-way dialogue. They situate Yang’s book within a broader movement documented across the field: Xu’s work on epistemic diversity in comparative research and on a Chinese definition of internationalisation; Bamberger, Mulvey and Yan’s 2026 call for internationalisation scholarship beyond the Western horizon; Jackson and Kwak’s probing question of whether philosophy of education is Western at all; and parallel non-Western resources such as Dladla’s Ubuntu philosophy of liberation and Mun and Min’s account of the Korean public good as jeong. Seen together, these works suggest a discipline in the midst of an epistemic diversification whose trajectory Yang’s book may well consolidate.

The practical stakes extend well beyond theory. For policymakers, the three-level framework—normative, institutional, subjective—offers a diagnostic tool for understanding why policy transplants so often fail: a governance model detached from its civilisational soil produces different, and sometimes perverse, effects when grafted onto another tradition. For university leaders navigating international partnerships, the review implies that cooperation grounded in mutual conceptual translation will be more durable than arrangements that quietly assume Anglo-American categories are universal. For students, particularly the growing cohort of globally mobile learners whose identity negotiations are documented in Xiaoshi Li’s own research on Chinese master’s students in Hong Kong, the debate determines whether their educational traditions are treated as liabilities to be overcome or as resources to be drawn upon.

Tao and Li close with a forward-looking assessment: Yang’s book, they conclude, will prompt more equal and meaningful cross-cultural dialogues in the field, making it invaluable to researchers, policymakers, students and anyone interested in what they call civilisational dialogues. The phrase is telling. What began as a book review has become a statement about the future epistemology of higher education research itself—a field long dominated by centres in the United States, the United Kingdom and Western Europe, and increasingly challenged by scholarship from East Asia and the Global South. Whether tianxia, Confucian self-cultivation and kindred concepts can enrich a genuinely global conversation without hardening into new orthodoxies remains an open question. But the review makes clear that the question can no longer be avoided, and that the answer will shape how universities everywhere understand their public purpose.

Subject of Research: Traditions as civilisational resources for cross-cultural dialogues in global higher education research

Article Title: Traditions as civilisational resources for cross-cultural dialogues in global higher education research: disputes and prospects

Article References: Traditions as civilisational resources for cross-cultural dialogues in global higher education research: disputes and prospects. (n.d.). https://doi.org/10.1007/s10734-026-01759-2

Image Credits: AI Generated

DOI: 10.1007/s10734-026-01759-2

Keywords: higher education, public good, cross-cultural dialogue, tianxia, epistemic justice, comparative education, Chinese tradition, Anglo-American higher education, Western-centrism, civilisational dialogue, Lili Yang, internationalisation