A framework for remuneration of lived experience expertise
From Recognition to Realisation: Equal Pay for Work of Equal Value - Lived Experience Expertise in Global Mental HealthCollaborating with Health Economic experts and people with lived experience (PWLE), the Global Mental Health Peer Network (GMHPN) has co-produced a framework aimed at accelerating progress in the equitable and ethical remuneration of lived experience (LE) expertise in global mental health, with funding support generously provided by Kokoro and Vitol Foundation.
To achieve this objective, an inclusive, mixed-methods approach has been employed with the aim to develop a fair, appropriate, and evidence-based framework to guide global remuneration practices for LE expertise across various stakeholders and sectors involved in mental health. The concept of the project aims to consider the diversity of contexts, complexities, and expertise required for the authentic engagement of experts by experience (EbE) in mental health advocacy, policy, legislation, services and research. |
Remuneration framework vs remuneration costing model
Our initial objective was to develop a remuneration costing model specifically for LE expertise, whereby a set formula would have been developed to provide remuneration rates based on level of expertise, role specifications and location/ context by aligning rates with similar roles in the open labour market. However, as the project progressed, we encountered challenges in creating a fair and evidence-based model that could equitably align LE roles with comparable roles in terms of workload and output, ensuring consistent pay scales. The main obstacles have been a lack of transparency in sharing information about payment structures and significant disparities in remuneration across roles, organizations, and demographic locations.
We concluded that developing a remuneration framework was a more practical approach, as our goal is to uphold the principle of "Equal Pay for Work of Equal Value" for LE roles—a principle firmly supported by laws, guidelines, strategies, and collective advocacy efforts worldwide. Aligning with the above, we focused on what exist, what are the gaps and propose a payment scale that is fair for LE expertise who contribute towards work of equal value as our professional and stakeholder counterparts.
Our initial objective was to develop a remuneration costing model specifically for LE expertise, whereby a set formula would have been developed to provide remuneration rates based on level of expertise, role specifications and location/ context by aligning rates with similar roles in the open labour market. However, as the project progressed, we encountered challenges in creating a fair and evidence-based model that could equitably align LE roles with comparable roles in terms of workload and output, ensuring consistent pay scales. The main obstacles have been a lack of transparency in sharing information about payment structures and significant disparities in remuneration across roles, organizations, and demographic locations.
We concluded that developing a remuneration framework was a more practical approach, as our goal is to uphold the principle of "Equal Pay for Work of Equal Value" for LE roles—a principle firmly supported by laws, guidelines, strategies, and collective advocacy efforts worldwide. Aligning with the above, we focused on what exist, what are the gaps and propose a payment scale that is fair for LE expertise who contribute towards work of equal value as our professional and stakeholder counterparts.
Context
Today, the value of LE expertise in driving policy, practice and procedural change in global mental health is accepted without contention. Grounded in a well-established evidence base, international human rights instruments, and global frameworks and commitments in health and development, there is a clear imperative to ensure the meaningful and authentic involvement of PWLE of mental health conditions and psychosocial disabilities. Their participation is essential in the design, implementation, and evaluation of health interventions and programmes, as well as in research, health systems design, decision-making, and policy development. Furthermore, this position has resonated across multilateral and bilateral agencies, research bodies and funding agencies, academic institutions, the private-sector and philanthropy. This recognition and the growing inclusion of LE expertise in mental health advocacy, policy, legislation, services and research has encouraged the momentum for fair and transparent remuneration, reflecting the time and expertise that people living with mental health conditions and psychosocial disabilities offer across the domains of global health and development - Equal Pay for Work of Equal Value. Providing remuneration, not only ensures active, equitable, meaningful and authentic peer engagement but further shows that individuals’ contributions and expertise are valued and acknowledged. |
Problem
Global acknowledgement for the experiential value of PWLE has been established, however the problem remains to translate this experiential value into fair and transparent remuneration that is commensurate with the level of effort, goals, objectives and cultural, economic, and legal contexts of involvement and participation.
Although recent years have witnessed the development of various repositories of best practices, principles and paid participation policies across numerous sectors, there remains little consensus on appropriate models for global remuneration, particularly evident in relation to fair remuneration for the involvement and participation of PWLE living in Low-and Middle-Income Country contexts.
In these settings, it is of critical importance to pursue equitable remuneration for LE contributions to the field. Fair and equitable remuneration promotes greater participation and engagement of LE stakeholders, leading to more inclusive and representative policy, research, and development initiatives.
Additionally, fair remuneration addresses inequalities in settings where mental health is a low priority, and those with LE face additional barriers to accessing support and opportunities.
Providing remuneration can also ensure that LE stakeholders are able to sustain their involvement in mental health initiatives, allowing for ongoing contributions.
Numerous global stakeholders deserve due acknowledgement for their active commitment to recognizing the specialized knowledge of EbE, and remunerating their contributions despite the challenges imposed by policies and procedures that are yet to comprehensively recognize and integrate this distinct form of expertise into formalized structures. Equally, if the experiential value is not met with adoption of equitable remuneration practices, the recognition of the core value of participation is arguably no value at all.
Through our investigations, no guidance exists that provides an evidence-based standardised structure for the remuneration of the impact and value of LE expertise in mental health policy, research and services.
This means that global stakeholders have little guidance as to how to incorporate the involvement of LE engagement and consultation that is fairly remunerated into their initiatives and projects.
Global acknowledgement for the experiential value of PWLE has been established, however the problem remains to translate this experiential value into fair and transparent remuneration that is commensurate with the level of effort, goals, objectives and cultural, economic, and legal contexts of involvement and participation.
Although recent years have witnessed the development of various repositories of best practices, principles and paid participation policies across numerous sectors, there remains little consensus on appropriate models for global remuneration, particularly evident in relation to fair remuneration for the involvement and participation of PWLE living in Low-and Middle-Income Country contexts.
In these settings, it is of critical importance to pursue equitable remuneration for LE contributions to the field. Fair and equitable remuneration promotes greater participation and engagement of LE stakeholders, leading to more inclusive and representative policy, research, and development initiatives.
Additionally, fair remuneration addresses inequalities in settings where mental health is a low priority, and those with LE face additional barriers to accessing support and opportunities.
Providing remuneration can also ensure that LE stakeholders are able to sustain their involvement in mental health initiatives, allowing for ongoing contributions.
Numerous global stakeholders deserve due acknowledgement for their active commitment to recognizing the specialized knowledge of EbE, and remunerating their contributions despite the challenges imposed by policies and procedures that are yet to comprehensively recognize and integrate this distinct form of expertise into formalized structures. Equally, if the experiential value is not met with adoption of equitable remuneration practices, the recognition of the core value of participation is arguably no value at all.
Through our investigations, no guidance exists that provides an evidence-based standardised structure for the remuneration of the impact and value of LE expertise in mental health policy, research and services.
This means that global stakeholders have little guidance as to how to incorporate the involvement of LE engagement and consultation that is fairly remunerated into their initiatives and projects.
Our Approach
We took a stepped approach, led by PWLE, to draw from existing resources and best practices, engaging PWLE and GMHPN members who had been involved in various roles, gained perspectives from stakeholders, and utilizing our experiences in GMHPN’s EbE Consultancy Services Unit.
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Challenges and Gaps
Ideally, and with our initial approach, we aimed at developing a fair and equitable remuneration model, however, it became apparent that there is little transparency related to disclosure of salaries or fees in the open job market.
While we were trying to understand the reason behind this lack of transparency, we came across various resources discussing exactly why.
Employers are reluctant to share salary or fee amounts for roles, including that of general consultants, for several reasons. Revealing salary information could give competitors insights into their pay structure, making it easier for them to undercut or offer more attractive packages to top talent. Employers may prefer to keep salary information confidential to maintain a competitive edge in attracting candidates. Companies may also avoid disclosing salaries to prevent internal dissatisfaction. If current employees learn that new hires are being paid more for similar work, it could create resentment and impact morale. This is particularly true in firms with pay structures based on negotiation or experience. Employers want to maintain flexibility in salary negotiations and disclosing a salary range upfront might limit their ability to negotiate based on an individual candidate’s experience, skills, or specific contributions. Some companies have policies around salary transparency, especially in larger organizations or those with complex pay scales. These policies may be designed to avoid potential misunderstandings or disputes. In some cases, sharing salary data may be legally sensitive, especially in regions where salary transparency laws are evolving. For example, some jurisdictions have enacted laws that restrict how companies disclose or discuss pay rates to prevent discrimination. Furthermore, by not listing salary information, employers may get a wider range of applicants who are open to negotiating, potentially bringing in candidates with higher expectations who might be willing to accept a lower offer than initially anticipated. Salaries for roles like general consultants can vary based on experience, skill level, location, and other factors, and employers may prefer to assess each candidate on an individual basis, rather than limiting themselves to a fixed salary range.
While these factors explain the reluctance, there's also an increasing push for transparency in salary discussions, particularly driven by movements to reduce pay inequality and promote fairness. Some employers are beginning to recognise the value of openly sharing salary information to attract candidates who value transparency.
Based on these challenges, we needed to change direction and build on the experiences of the GMHPN and its EbE Consultancy Services, and create a framework that is practical and commits to a way forward to continue elaborating on this work.
Ideally, and with our initial approach, we aimed at developing a fair and equitable remuneration model, however, it became apparent that there is little transparency related to disclosure of salaries or fees in the open job market.
While we were trying to understand the reason behind this lack of transparency, we came across various resources discussing exactly why.
Employers are reluctant to share salary or fee amounts for roles, including that of general consultants, for several reasons. Revealing salary information could give competitors insights into their pay structure, making it easier for them to undercut or offer more attractive packages to top talent. Employers may prefer to keep salary information confidential to maintain a competitive edge in attracting candidates. Companies may also avoid disclosing salaries to prevent internal dissatisfaction. If current employees learn that new hires are being paid more for similar work, it could create resentment and impact morale. This is particularly true in firms with pay structures based on negotiation or experience. Employers want to maintain flexibility in salary negotiations and disclosing a salary range upfront might limit their ability to negotiate based on an individual candidate’s experience, skills, or specific contributions. Some companies have policies around salary transparency, especially in larger organizations or those with complex pay scales. These policies may be designed to avoid potential misunderstandings or disputes. In some cases, sharing salary data may be legally sensitive, especially in regions where salary transparency laws are evolving. For example, some jurisdictions have enacted laws that restrict how companies disclose or discuss pay rates to prevent discrimination. Furthermore, by not listing salary information, employers may get a wider range of applicants who are open to negotiating, potentially bringing in candidates with higher expectations who might be willing to accept a lower offer than initially anticipated. Salaries for roles like general consultants can vary based on experience, skill level, location, and other factors, and employers may prefer to assess each candidate on an individual basis, rather than limiting themselves to a fixed salary range.
While these factors explain the reluctance, there's also an increasing push for transparency in salary discussions, particularly driven by movements to reduce pay inequality and promote fairness. Some employers are beginning to recognise the value of openly sharing salary information to attract candidates who value transparency.
Based on these challenges, we needed to change direction and build on the experiences of the GMHPN and its EbE Consultancy Services, and create a framework that is practical and commits to a way forward to continue elaborating on this work.
Our remuneration framework is developed by incorporating multiple components, including: (i) comprehensive desktop research, (ii) a review of relevant literature, (iii) survey feedback from PWLE and stakeholders collaborating with them, and (iv) insights gained over five years of managing GMHPN’s dedicated “Experts By Experience Consultancy Services” unit. The LE Expertise Self-Assessment Tool has been tested with a GMHPN team and revised accordingly.
View the booklet
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