P515 When the Patient Must Build the Record: Psychiatric Credibility, Institutional Reframing, and the Visibility Infrastructure of Self-Documentation

This paper examines what happens when a psychiatric patient must construct an independent evidentiary record in order to preserve the visibility of a disputed care experience. Using a named first-person case, it develops the concept of visibility infrastructure: records, chronology, source distinctions, version controls, comparison surfaces, and correction practices that keep an event independently examinable when institutional documentation possesses greater downstream authority than patient recollection. The analysis distinguishes evidence retention from visibility infrastructure, nominal from meaningful continuity, administrative characterization from reconciliation with primary evidence, and documentary inconsistency from falsification. It also preserves favorable and unfavorable facts, later mitigation, unresolved questions, and the distinction between patient interpretation and adjudicated findings. The paper argues that patient-built documentation can function not as a substitute for institutional records or formal adjudication, but as a structured comparison surface capable of preserving chronology, attribution, contradiction, provenance, and uncertainty for later independent examination.