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The Movement for Global Mental Health (MGMH) argues that there is a moral imperative that psychiatric treatments should be made available to all communities across the world. But psychiatric theories, categories and interventions emerged in the Western world are based on a set of assumptions about the nature of the self and society, nature and the supernatural, health and healing that are not universally accepted. In this paper we argue that there is a stronger moral case for caution with regard to the export of psychiatric thinking. Without a critical interrogation of such thinking the MGMH is at risk of doing a great deal of harm to the diverse, and sometimes fragile, systems of care that already exist across the world.

Of late there has been a proliferation of centres and programmes providing mental health care for refugees and victims of violence. This proliferation has mainly occurred in Western countries, but an increasing number of projects have been delivered to Third World war zones in the name of the treatment of 'war trauma'. Western psychology and psychiatry provide the theoretical and therapeutic tools which are used by most of these projects. This paper argues that because these tools are not value neutral, there are profound ethical problems associated with this work. The insights developed by a number of postmodern theorists are used to provide a framework for discussing these problems.

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There is growing international concern that large numbers of children are being recruited to military forces in situations of conflict around the globe, despite the fact that there are principles established in international law specifically directed against the use of children as soldiers. It has been assumed that military experience will have negative psychological effects on children, and several projects aimed at the rehabilitation of such children have been developed. We have had opportunities to examine the situation of child soldiers in Uganda, Liberia and Sierra Leone. In this article we draw attention to some of the conceptual and practical problems involved in this rehabilitative work.

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