Akiko works as the Interim Director of Liberty, an advocacy group and membership organisation which challenges unjust laws, protects civil liberties, and promotes human rights. She was previously CEO of the National Survivor User Network (NSUN), a mental health charity led by and for people with lived experience. 

Akiko's previous roles include Director of NGO Mental Health Europe, as well as leading a service at Mind in Camden for people who hear voices, working in the community, youth services, forensic settings, and Immigration Removal Centres. Akiko is a Professor in Practice at the Institute of Medical Humanities at the University of Durham, and has been a trustee on a number of charity boards, most recently National Voices and ISPS UK.