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.
The sanitation ladder is a useful tool that is being used to monitor progress towards the sanitation target of the MDGs. This tool could be even more useful if it can be refined to be based on the functions of sanitation systems rather than on a hierarchy of predefined sanitation technologies. This paper presents a seven-rung function-based sanitation ladder where the functions can be broadly divided into health functions and environmental functions. The proposed ladder is intended as an inspiration for nations, and the JMP, to move towards a function-based rather than technology-based monitoring of sanitation progress. A functional approach to monitoring of e.g. the sanitation target of the MDGs would require some major shifts in the monitoring methods used but it is argued that such an approach would: (i) actually monitor the public good, which is desired from a sanitation system; (ii) stimulate donors, governments and municipalities to think beyond the provision of certain sanitation technologies; (iii) allow for local solutions to the sanitation problem to be developed; and (iv) spur innovation within the sector.
The ideas of critical psychiatry are influencing a growing number of psychiatrists in Britain and elsewhere. In this article we examine the origins and development of critical psychiatry over the past 25 years, through the work of philosophers such as Foucault and of critical social theorists such as Ingleby, Miller and Rose. We outline the important differences between critical psychiatry and antipsychiatry. Finally, we examine the current status of critical psychiatry, and what is called postpsychiatry. We regard both as an attempt by practising psychiatrists to engage with service users' concerns about psychiatry, with government policies that stress democracy, citizenship and the importance of social and cultural contexts in health care, and with what might broadly be described as postmodernism.
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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