In the United States, people psychiatrically labeled have the highest rates of unemployment, are most likely to be killed by police, and die 20 to 25 years prematurely. Yet, most advocacy and scholarship focuses almost exclusively on the mental health system and critiques of psychiatry.

Against the backdrop of a psychiatric medical malpractice trial, this chapter employs philosopher Miranda Fricker’s concept of epistemic injustice to illustrate how the failure to focus Mad scholarship and advocacy beyond the mental health system facilitates the denial of basic human and civil rights. This chapter argues that until Mad activists and scholars expand their gaze beyond psychiatry and the mental health system, the movement will fail in its liberation efforts because the oppression of people psychiatrically labeled is largely rooted in epistemic injustice. Until epistemic justice is achieved – that is, until society considers those psychiatrically labeled credible witnesses to their own experiences and until they are able to render intelligible to themselves and others their experiences of oppression – the discrimination and oppression will endure. True Mad liberation demands a counter, Master Narrative that elevates difference over sameness, humanity over sanity, and the inherent value of people over the transactional value of money.