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Understanding epistemic injustice among individuals with psychotic experiences: a scoping review protocol

Oct 2026 · BMJ Open · Vol 16 · 0 citations · 53 references
Medicine

Abstract

Abstract Introduction Epistemic injustice—namely testimonial and hermeneutical injustice—has increasingly been recognised as a critical concern within mental health research and practice, including in relation to psychosis. Despite the growing theoretical interest in this area, empirical evidence remains sparse, conceptually fragmented and methodologically heterogeneous. To date, no scoping or systematic review has examined how epistemic injustice is experienced by individuals with psychosis or psychotic-like experiences, or how it is addressed in the existing literature, thereby signalling a clear and currently unmet need for evidence synthesis. Methods and analysis The present protocol outlines the methodology for a scoping review designed to systematically map the breadth, depth and characteristics of the available evidence concerning epistemic injustice in people with psychotic experiences. The review aims to: identify how epistemic injustice is conceptualised and described in relation to psychosis or psychotic-like experiences; summarise the findings regarding the experience of epistemic injustice in people with psychotic experiences; explore how the literature addresses complex issues such as impaired insight, alterations in intersubjective experience of reality, involuntary treatment and social and political marginalisations; examine the implications for clinical practice, training, service organisation and policy while identifying gaps warranting further empirical investigation. The protocol was developed following the Joanna Briggs Institute (JBI) methodology for scoping review protocols and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Protocols (PRISMA-P) checklist. The review will be conducted in accordance with JBI methodology for scoping reviews and reported in line with the PRISMA extension for Scoping Reviews (PRISMA-ScR). A comprehensive search strategy will be implemented across major electronic databases, complemented by reference list screening. Two reviewers will independently screen, select and extract data, with disagreements resolved through discussion and when required, consultation with additional reviewers. Data will be charted using an iterative approach and synthesised through descriptive, narrative or thematic techniques. Eligible sources will include quantitative and qualitative empirical studies, case reports and case series and contributions including first-person accounts of epistemic injustice among individuals with psychotic experiences. Following protocol registration, the search strategy was finalised on 26 June 2026 and title/abstract screening has since commenced. No results are reported at this stage; these will be presented in full in the completed scoping review. Ethics and dissemination Findings will provide the first comprehensive mapping of this emerging field and inform future empirical research, mental-health education and policy development grounded in epistemic justice. Results will be disseminated through peer-reviewed publication, presentations at departmental seminars and scientific conferences, and a policy brief for policymakers, healthcare providers and other stakeholders, outlining actionable recommendations to address the challenges identified. This protocol was registered on the Open Science Framework on 18 June 2026 (OSF; DOI: https://doi.org/10.17605/OSF.IO/XSD58).

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