Decolonizing Global Mental Health is a book that maps a strange irony. The World Health Organization (WHO) and the Movement for Global Mental Health are calling to 'scale up' access to psychological and psychiatric treatments globally, particularly within the global South. Simultaneously, in the global North, psychiatry and its often chemical treatments are coming under increased criticism (from both those who take the medication and those in the position to prescribe it). The book argues that it is imperative to explore what counts as evidence within Global Mental Health, and seeks to de-fami
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Based on interviews with members of the Guideline Development Group (GDG) of the World Health Organization's (WHO) Mental Health Gap Action Programme (mhGAP) Guidelines for Mental, Neurological and Substance Use Disorders, this article adds empirical depth to understanding the contingent and strategic nature of universality in relation to mental health. Differently from debating whether or not mental health is global, the article outlines the people, ideas, and processes involved in making it global. Thematic analysis of interviews carried out with nine (out of 21) members of the original mhGAP GDG identified six intersecting strategies that enable the construction of universality in global mental health (GMH): 1) processes and practices of assembling expertise; 2) decisions on what counts as evidence; 3) framing cultural relativism as nihilistic; 4) the delaying of complexity to prioritize action; 5) the narration of tensions as technical rather than epistemological; and 6) the ascription of messiness to local contexts rather than to processes of standardization. Interviews showed that differently from the public-facing consensus often presented in GMH, GDG members hold contrasting and contingent understandings of the nature of universality in relation to mental health diagnoses and interventions. Thus, the universality of mental health achieved through the mhGAP Guidelines is partial and temporary, requiring continuous (re)iteration. The article uses empirical data to show nuance, complexity, and multi-dimensionality where binary thinking sometimes dominates, and to make links across arguments 'for' and 'against' global mental health.
ABSTRACTPerceptions regarding the importance of mental health are shifting at a global level. Once described as an 'invisible problem' in international development, mental health is now being framed as one of the most pressing development issues of our time. Concern over the historical absence of mental health from the development agenda — despite its being regarded as a major obstacle to development — has led to its recent inclusion in the UN Sustainable Development Goals (SDGs). This article critically examines three intersecting axes key to its inclusion in the SDGs: 1) the conceptualization and calculation of the contribution of mental disorder to the global burden of disease; 2) the quantification of mental disorder as an economic burden; and 3) the relationship between mental distress and poverty. The article highlights the urgent need to foster a more nuanced understanding of the interplay between mental health and development, and shows how, at times, interventions in the two fields work together in producing reductionist, economistic, individualized and psychologized responses to poverty.
One of the symptoms of post financial crisis austerity in the UK has been an increase in the numbers of suicides, especially by people who have experienced welfare reform. This article develops and utilises an analytic framework of psychopolitical autopsy to explore media coverage of 'austerity suicide' and to take seriously the psychic life of austerity (internalisation, shame, anxiety), embedding it in a context of social dis-ease. Drawing on three distinct yet interrelated areas of literature (the politics of affect and psychosocial dynamics of welfare, post and anti-colonial psychopolitics, and critical suicidology), the article aims to better understand how austerity 'kills'. Key findings include understanding austerity suicides as embedded within an affective economy of the anxiety caused by punitive welfare retrenchment, the stigmatisation of being a recipient of benefits, and the internalisation of market logic that assigns value through 'productivity' and conceptualises welfare entitlement as economic 'burden'. The significance of this approach lies in its ability to widen analytic framing of suicide from an individual and psychocentric focus, to illuminate culpability of government reforms while still retaining the complexity of suicide, and thus to provide relevant policy insights about welfare reform.
While the World Health Organization calls to 'scale up' access to psychotropic drugs for children in the global South, research from the global North has found that long‐term use of psychotropic drugs may be at best ineffective, or at worst harmful. Questioning what counts as evidence within the Movement for Global Mental Health, this article maps the physical, psychological and sociopolitical effects of increasingly global psychotropic interventions into children's lives. This psychiatrisation will be read alongside colonisation, leading to the uncomfortable question of whether every child should have the right to a psychotropic childhood.
In 2014, a long continuing battle began to find out more about Government record-keeping on the deaths of disabled people claiming benefits. Drawing on a timeline of evidence co-produced with disabled people, we analyse how deaths related to the benefits system are an outcome of slow violence, where both the delay between policies and their harmful effects, as well as the more active use of delay tactics, are central to how the Department for Work and Pensions (DWP) weaponise time as a strategy to avoid accountability and deny justice. DWP reviews into deaths are an under-researched yet significant focus because they are (supposedly) tools through which the DWP investigates the harms of its own policies, and yet, they are designed and carried out in a way that systemically invisibilise state accountability.