Unusual Experiences and Beliefs

For Mental Health Awareness Week 2025, project EPIC organised a webinar focusing on the harms caused by negative stereotypes associated with people who have unusual experiences and beliefs. Panelists included Martino Belvederi Murri and Fiona Malpass. The event was supported by The Royal Institute of Philosophy and the Voice Collective.

Poster of the webinar

Martino is Associate Professor at the Institute of Psychiatry and Director of the School of Specialization in Psychiatry, working as a clinical psychiatrist in the Acute Psychiatric Inpatient Unit. His research integrates clinical psychiatry with advanced statistical modelling and computational psychiatry, focusing on late-life depression, early psychosis, and psychosomatics. He has a specific interest in depression phenotyping, demoralization, psychosis outcomes, physical activity interventions, cognitive factors, cannabis use.

First slide of Martino's presentation

Fiona works at Mind in Camden as the Project Development and Innovation Lead, which includes managing the Hearing Voices Projects, working with young people, prisons, forensic settings and immigration removal centres, and the London Hearing Voices network. They have a background in psychology and philosophy of mental health, as well as having personal experience of many forms of distress, including hearing voices. They use this in their work to build connections, as well as to challenge the status quo and provide provocations to ways of thinking and working.

What good support looks like
from Fiona's presentation

Both Martino and Fiona discussed whether the notion of epistemic injustice can be usefully applied to the situation of people who experience non-consensual reality, and reflected on the challenges that practices in healthcare and everyday prejudices in friends, family, teachers, and doctors may present for young people who hear voices.

The problem, according to Martino, emerges because we tend to think that if a person is suffering from a psychotic disorder or is experiencing a psychotic episode, then they are not able to judge any aspect of reality. That's a that is an unnecessary and wrong generalization. We see all the time that even when a person has a persecutory experience, they often are able to judge many, many situations. 

The job of the psychiatrist is not to assign a label of normality to people, but to help them by not increasing their suffering, relieving the harms, and reducing the risks. The most difficult challenge is to support a person in a moment of crisis, which might require depriving them for a certain time of their liberty, without negatively affecting their self-perception and their sense of dignity. Even in an involuntary admission, if possible, the person must be involved in decisions concerning their care. A humane care ultimately means respect and mutual understanding.

Forms of testimonial injustice in psychosis
from Martino's presentation

Martino concluded his presentation by discussing the existence of a paradox: although there is increasing attention to ethical and philosophical issues, there are reduced resources. Whereas healthcare professionals aim to do better, they have fewer resources at their disposal to improve care. 

Fiona talked about kind of work they do at the Voice Collective, which is based at London, Camden, but also about the collaboration with the EPIC project, thinking about agency and epistemic injustice, as it relates to young people who hear voices, or have other unusual perceptions or beliefs.

The Voice Collective works across London and the UK more broadly but has also an international reach. The bulk of the work is to support people under the age of 26, and their families, carers and supporters, with an emphasis on young people who have highly stigmatized and potentially overwhelming and distressing experiences. These experiences can be hearing voices, seeing things, tasting things, smelling things, having felt presences, having multiple senses of self, forms of dissociation, paranoia, the list goes on. 

The Voice Collective is established to provide more community grassroots care, coming from a non-clinical, non-pathologizing community perspective and adopting a pluralistic approach where many factors may be considered as relevant to people's experiences.

Factors contributing to distressing experiences 
from Fiona's presentation

They establish peer support groups for young people who have these experiences: one online group for 11 to 15 year olds; and a peer support group for an older age group, 16 to 25 year olds. Young people chat to each other, ask each other questions, and just offer solidarity and friendship to each other. Another activity is to set up advisory groups for research projects or steering groups for service development, because a big part of the Voice Collective approach is trying to help young people be heard and be listened to and have input into things to push back against the epistemic injustice that they face. The aim is to create spaces where young people's knowledge is valued.

Young people are often seen as incapable. There's often an emphasis on young people who hear voices being powerless. Their experiences are often framed as a deficit and part of a severe mental health issue. For some people voices can be massively distressing and overwhelming, but there are times where voices are helpful. Some people have very positive experiences of their voices, and neutral ones, too. So it is difficult for young people who have these less stereotyped versions of voices to talk about them for fear of their voices being seen as something inherently wrong, and an issue with them, and with how they experience the world. The healthcare system can be a very oppressive system to be part of where young people often experience a lot of coercion going along with whatever treatment pathway is recommended to them.

If you want to listen to the full presentations by Martino and Fiona, and follow the question and answer session that followed, watch the recording of the webinar below and let us know what you think.