The theme for World Mental Health Day 2026 — “Lived experiences heard: Real voices. Real change” — resonates deeply with me. At the heart of my advocacy is a conviction that has grown stronger over the past six years: people living with mental illness should not simply be spoken about, spoken for or brought in once the agenda is set.
Our voices need to help steer the debate.
This is personal for me.
Six years ago, my public mental health advocacy was born out of one of the most traumatic and vulnerable experiences of my life.
I lived through a public bipolar episode with psychosis and the stigma and humiliation that follow when the vulnerability is exposed. The experience became the catalyst for my public mental health advocacy.
In the aftermath, I received care in a state mental healthcare facility. There, I came to understand just how vulnerable people living with mental illness can become in systems designed to care for them.
I encountered a paternalistic approach that troubled me: decisions being made about people rather than with them. The irony was not lost on me. I had lived with mental illness since adolescence, long before I became a medical doctor.
Years later, having worked within mental healthcare services, I found myself experiencing the system from the other side once again — this time carrying both perspectives.
Although I understood mental illness through a professional lens, my experience as a mental healthcare user exposed the limits of that lens. It revealed how much professional knowledge can miss without the insight that only lived experience provides.
I was left with a choice. I could remain angry and resentful or I could use what I had lived through to become an agent and catalyst for change.
I chose to become an agent and catalyst for change. That does not mean sanitising the trauma or pretending it did not wound me. But I decided not to let it silence me. In a sense, I became my own statement against stigma.
Mental illness does not belong only to the faceless patient in a waiting room. It can also be the doctor, the colleague, the parent, the author, the accomplished professional or the person sitting next to you.
We need a paradigm shift in how we perceive people living with mental illness — away from the deficit and towards possibility, dignity and agency.
Over time, I learnt that I could not wait for someone else to hand me permission to speak. I had to amplify my own voice rather than wait for platforms to allow me in. As that voice grew, so too did my ability to advocate for something larger than myself: for people living with mental illness to be seen, heard and recognised as active participants in shaping the systems and conversations that affect their lives.
That is why this year’s theme feels so significant. People with lived experience are often welcomed as storytellers, panellists and keynote speakers. Storytelling matters. It humanises and dismantles stigma.
But if our stories are valuable enough to inspire an audience, are they not valuable enough to inform the policies, programmes and services that shape our lives?
We should not be passengers on a route somebody else has mapped. We should be co-pilots. We should be co-architects.
Lived experience should be present not only on the stage but in the rooms where decisions are made — contributing to policy development, programme design, service delivery and the evaluation of whether interventions intended for us meet our needs.
It is important to say clearly that this is not about dismissing or antagonising clinical expertise. I know its value because I have practised in it. I am also a beneficiary of clinical expertise through a multidisciplinary team. I rely on it and I respect it. Clinical and professional knowledge matter.
But acknowledging their importance cannot mean undermining lived experience. Lived experience is not an optional extra. It is critical.
Clinical expertise and lived experience are not rivals. My medical background has equipped me with knowledge and tools that continue to inform my work.
My lived experience has given me insights that no textbook or professional training could have taught me.
Holding both perspectives has reinforced my conviction that mental healthcare is strengthened, rather than threatened, when the people who live its realities are meaningfully included.
I often challenge the default language around mental illness. We frequently hear that someone is “suffering from” a mental illness. Suffering can indeed be part of illness, both for the individual and for those around them and I would never minimise that reality.
But suffering need not be the totality of the story. With appropriate treatment, support and interventions, people living with mental illness can build meaningful, productive and thriving lives.
That is why I say: I am not suffering from mental illness; I am thriving despite it. This is not optimism for effect. It is a rejection of the assumption that diagnosis cancels possibility.
Perhaps this is the paradigm shift that “real voices, real change” asks of us: to move beyond merely hearing stories and begin recognising the expertise within them.
To create spaces where people living with mental illness are present not only when stories are being told but when decisions are being made. Not as symbolic participants but as partners — as co-pilots and co-architects.
When people most familiar with the terrain help draw the map, the route is far more likely to reflect reality. We need to embrace the real voices of lived experience in order to achieve real change.
Dr Samke Ngcobo is a medical doctor, mental health advocate, author and founder of Vocal Mentality, using professional expertise and lived experience to challenge mental health stigma.