Misunderstood and underappreciated: a critical review of mental health advocacy and activism in low- and middle-income countries

Abstract

Mental health advocacy and activism have been highlighted as important in the effort towards creating environments for better mental health. However, relevant research in low- and middle-income (LMIC) settings remains limited and lacks critical exploration. We seek to contribute to filling this gap by exploring driving factors behind mental health advocacy and activism efforts in LMIC settings. This review uses a critically informed thematic analysis using conceptual frameworks of productive power to analyse peer-reviewed articles on mental health advocacy or activism over the last twenty years. We suggest that the current body of research is marred by superficial explorations of activism and advocacy, partly due to a lack of cohesion around definitions. Based on our findings, we suggest a conceptual framework to guide deeper explorations of mental health advocacy and activism. This framework identifies Legitimacy, Context, and Timing as the main dimensions to consider in understanding activism and advocacy efforts. The fact that they remain misunderstood and underappreciated creates missed opportunities for meaningful inclusion of lived experience in policy decisions and limits our understanding of how communities envision and enact change.