How to avoid epistemic injustice in healthcare: the case of youth mental health emergency services in the UK


  • Lisa Bortolotti University of Birmingham



mental health, emergency service, epistemic agency, therapeutic relationship


In this article I propose some principles that safeguard the patient’s agency and allow healthcare professionals to lay the foundations for a constructive dialogue in the clinical encounter. The purpose of the encounter is to share knowledge and arrive at informed decisions that are the product of genuine collaboration. In our project we studied interactions between healthcare practitioners and young people accessing a mental health emergency service in the UK. The attitude of the healthcare professional that seems to promote effective communication and contribute to a trusting therapeutic relationship consists of treating the young person as an epistemic agent. The practitioner legitimizes the patient’s need for support and views the patient not just as a problem to be solved or a disease to be diagnosed, but as a person with complex needs and interests. This stance enables the patient to actively participate in decisions concerning their treatment.