PT - JOURNAL ARTICLE AU - Alex James Miller Tate TI - Contributory injustice in psychiatry AID - 10.1136/medethics-2018-104761 DP - 2019 Feb 01 TA - Journal of Medical Ethics PG - 97--100 VI - 45 IP - 2 4099 - http://jme.bmj.com/content/45/2/97.short 4100 - http://jme.bmj.com/content/45/2/97.full SO - J Med Ethics2019 Feb 01; 45 AB - I explain the notion of contributory injustice, a kind of epistemic injustice, and argue that it occurs within psychiatric services, affecting (at least) those who hear voices. I argue that individual effort on the part of clinicians to avoid perpetrating this injustice is an insufficient response to the problem; mitigating the injustice will require open and meaningful dialogue between clinicians and service user organisations, as well as individuals. I suggest that clinicians must become familiar with and take seriously concepts and frameworks for understanding mental distress developed in service user communities, such as Hearing Voices Network, and by individual service users. This is especially necessary when these concepts and frameworks explicitly conflict with medical or technical understandings of users’ experiences. I defend this proposal against three objections.