Critical perspectives on the NIMH initiative “Grand Challenges to Global Mental Health”

Shukla, Abhay; Philip, Anand; Zachariah, Anand; Phadke, Anant; Suneetha, A; Davar, Bhargavi V.; Cehat,; Srinivasan, Chinu; Mankad, Dhruv; Qadeer, Imrana; Kalathil, Jayasree; Lalita, K; Sajaya, K; Jacob, K. S.; Balimahabal, Kamayani; Gupte, Manisha; Rao, M. Govinda; Salie, Moosa; Prakash, Padma; Chatterjee, P.; Baru, Rama; Melkote, Rama; Shukla, Rajan; Gaitonde, Rakhal; Bisht, Ramila; Duggal, Ravi; Khanna, Renu; Priya, Ritu; Srivatsan, Rangaprasad Arun; Timimi, Sami; Sarojini, N; Sathyamala, C.; Ashtekar, Shyam V; Fernando, Suman; Tharu, Susie; Shatrugna, Veena

doi:10.20529/ijme.2012.102

Cited by 7 publications

(6 citation statements)

References 1 publication

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“…The models of mental health that are currently being mainstreamed within the development agenda may be problematic (for reasons too numerous to list in detail here). Among the many criticisms that have been levelled at these models are: that they are the products of specific social, cultural, economic and historical trajectories that reduce social complexity to diagnoses of illness (Fernando, ; Shukla et al., ); that they are alien to many cultures (Summerfield, ); and that they are sometimes exported in a ‘top down’ manner that reasserts colonial assumptions about Western expertise and superiority (Mills, ; Titchkosky and Aubrecht, ). Since there are currently no biological diagnostic tests for most mental disorders, diagnosis remains highly subjective (Timimi and Radcliffe, ).…”

Section: Mental Health In the Sdgs: Success And Resistancementioning

confidence: 99%

From ‘Invisible Problem’ to Global Priority: The Inclusion of Mental Health in the Sustainable Development Goals

Mills¹

2018

Development and Change

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Perceptions 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.

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Section: Mental Health In the Sdgs: Success And Resistancementioning

confidence: 99%

From ‘Invisible Problem’ to Global Priority: The Inclusion of Mental Health in the Sustainable Development Goals

Mills¹

2018

Development and Change

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“…For example, Vikram Patel, one of the leaders of the MGMH, has attacked such critiques as reminiscent of ‘the most virulent brand of cultural relativism, which smacks not only of ignorance of a vast body of scientific evidence but more disturbingly of the racist ideologies that led one-time colonial administrators to deny mental health care to the ‘natives’ because they were either perceived to be psychologically immature or had supernatural treatments to deal with their conditions’ (Patel, 2014). Such astonishing comments ignore the fact that the growing counter-discourse (Shukla et al 2012; Clark, 2014; Fernando, 2014; Mills, 2014; White & Sashidharan, 2014) is serious, evidence-based and contains many ‘native’ voices. In this paper we will argue that there is, in fact, a far stronger moral case for caution when it comes to the transfer of Western psychiatric theories, categories and interventions to non-Western settings, with their diverse histories, cultural traditions, definitions of the person, economic imperatives and modes of help-seeking.…”

Section: Introductionmentioning

confidence: 99%

Primum non nocere. The case for a critical approach to global mental health

Bracken

Giller

Summerfield

2016

Epidemiol Psychiatr Sci

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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.

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“…LMICs have a variety of different ways of naming, understanding and responding to similar affective phenomena and often actively resist the implementation of western models of mental health [45]. Thus, many have questioned the assumptions embedded in models that claim to be global, in particular that they promote simplistic biomedical frameworks disconnected from lived experience, and overlook indigenous forms of healing, social support networks and rights-based organizing [36]. …”

Section: Discussionmentioning

confidence: 99%

The (Mis)appropriation of HIV/AIDS advocacy strategies in Global Mental Health: towards a more nuanced approach

2017

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BackgroundMental health is increasingly finding a place on global health and international development agendas. Advocates for Global Mental Health (GMH), and international organizations such as the World Health Organization (WHO) and the World Bank, argue that treatments available in high-income countries should also be made available in low- and middle-income countries. Such arguments are often made by comparing mental health to infectious diseases, including the relative disease and economic burdens they impose, and pointing to the applicability of the right to access treatment for mental health, not only infectious diseases. HIV/AIDS advocacy in particular has been held up by GMH advocates as offering an appropriate strategy for generating global commitment.DiscussionThere is a need to assess how health issues are framed not only in relation to social goods outside of health (such as human rights, security or development), but also in relation to other health or disease models, and how health policy and practice is shaped as a result. The article debates the merits and consequences of likening mental health to HIV/AIDS, and identifies four major problems with the model for GMH advocacy being developed through these analogies: 1. An inappropriately universalizing global approach to context-specific problems; 2. A conception of human rights that focuses on the right to access treatment at the expense of the right to refuse it; 3. A tendency to treat poverty as a psychiatric issue, rather than recognizing that mental distress can be the result of poverty and other forms of inequality; 4. The prioritization of destigmatization of disease over social justice models.ConclusionThere are significant problems with the wholesale adoption of an (often simplified) version of HIV/AIDS advocacy as a model for GMH. Yet critical engagement with the important and nuanced differences between HIV/AIDS and mental health may nevertheless point to some possibilities for productive engagement and cross-fertilisation between advocates, activists and scholars in both fields.

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Critical perspectives on the NIMH initiative “Grand Challenges to Global Mental Health”

Cited by 7 publications

References 1 publication

From ‘Invisible Problem’ to Global Priority: The Inclusion of Mental Health in the Sustainable Development Goals

From ‘Invisible Problem’ to Global Priority: The Inclusion of Mental Health in the Sustainable Development Goals

Primum non nocere. The case for a critical approach to global mental health

The (Mis)appropriation of HIV/AIDS advocacy strategies in Global Mental Health: towards a more nuanced approach

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