Global Mental Health and systems of diagnostic classification: clinical and cultural perspectives

Abstract

Historical and conceptual aspects of Global Health and Global Mental Health are examined and topics such as resources, professional and social attitudes toward mental disorders, the multidimensional experience of getting ill and the presence of world systems of psychiatric diagnosis and classification, are reviewed. The application of these areas of knowledge in medical practice require the integrated use of clinical and socio-cultural perspectives whose precise alignment is an essential component of accurate diagnoses, successful treatments and a consistent improvement of mental health as a component of public health. The latter includes preventive measures applicable to general populations, communities and health care proper. Management of socio-cultural aspects of diagnosis and treatment is imperative as is that of the growing relationship between mental health and neurosciences. The operationalization of this series of interactive processes must be part of legislations which, in turn, can make training, research and dissemination of the resulting data, possible.

Understanding global mental health: a conceptual review

“…Within the context of those promoting the growth of mental health infrastructure globally, GMH is characterised by a global–local debate, where there is the generalisable evidence-based biomedical approach to services versus the more empathetic locally embedded service approach. 30 32 45 48 53 60 The global approach has been described as the propagation of Western psychiatry, which is at risk of stifling cultural alternatives to mental healthcare. 30 52 54 60 In contrast, the local approach calls for a bottom-up approach to mental healthcare and prioritises local knowledge and stakeholders engaged in designing and delivering care.…”

“… 30 32 45 48 53 60 The global approach has been described as the propagation of Western psychiatry, which is at risk of stifling cultural alternatives to mental healthcare. 30 52 54 60 In contrast, the local approach calls for a bottom-up approach to mental healthcare and prioritises local knowledge and stakeholders engaged in designing and delivering care. 30 32 69 …”

“… 30 52 54 60 In contrast, the local approach calls for a bottom-up approach to mental healthcare and prioritises local knowledge and stakeholders engaged in designing and delivering care. 30 32 69 …”

“… 37 Training and education programmes are developing culturally competent curriculums, encompassing approaches to care for marginalised populations, such as asylum seekers and migrant communities. 30 41 75 81–83 GMH has noted a shift in focus in mental healthcare, from targeting the determinants of mental disorders through treatment to reorienting care towards more promotion and prevention. 51 64 Priebe et al 64 demonstrate how resource-oriented interventions can tap into ‘existing resources and social structure in LMICs’ as a way to promote mental health within communities.…”