Abstract
The movement for global mental health (MGMH) has raised awareness about the paucity of mental health services, particularly in low- and middle-income countries. In response, policies and programs have been developed by the World Health Organization and by the Lancet Commission on global mental health, among other organizations. These policy initiatives and programs, while recognizing the importance of being responsive to local needs and culture, are based on Western biomedical conceptualizations of emotional distress. In the paper, we discuss how a rights-based approach can promote the voice and participation of people with lived experience into the MGMH. We argue that a human rights framework can be enhanced by incorporating the conceptual approaches of critical inquiry and community mental health. We also discuss how rights-based approaches and service-user activism can productively reconfigure Western psychiatric conceptualizations of distress and provide both a moral and empirical justification for a paradigm shift within the MGMH.
This is a preview of subscription content, log in via an institution to check access.
Notes
Survivors and users of psychiatry, and mental health care more generally, and those who self-identify as psychosocial disability advocates, represent a heterogeneous group and have made a wide range of critiques of the MGMH.
References
Aftab, A. (n.d.). Conversations in critical psychiatry. Interview series by Awais Aftab, MD. Retrieved September 22, 2020, from https://www.psychiatrictimes.com/series/critical-conversations-in-psychiatry.
Aftab, A., & Waterman, G. S. (2020). Conceptual competence in psychiatry: Recommendations for education and training. Academic Psychiatry. https://doi.org/10.1007/s40596-020-01183-3.
Berlant, L. (2007). Slow death (sovereignty, obesity, lateral agency). Critical Inquiry, 33(4), 754–780. https://doi.org/10.1086/521568.
Boyle, M. (2020). Power in the power threat meaning framework. Journal of Constructivist Psychology. https://doi.org/10.1080/10720537.2020.1773357.
Brhlikova, P., Pollock, A. M., & Manners, R. (2011). Global burden of disease estimates of depression–how reliable is the epidemiological evidence? Journal of the Royal Society of Medicine, 104(1), 25–34. https://doi.org/10.1258/jrsm.2010.100080.
Burns, J. K. (2009). Mental health and inequity: a human rights approach to inequality, discrimination, and mental disability. Health and Human Rights, 11, 19–31. https://www.jstor.org/stable/25653100.
Caplan, G., & Caplan, R. (2000). Principles of community psychiatry. Community Mental Health Journal, 36(1), 7–24. https://doi.org/10.1023/a:1001894709715.
Chapman, A. R. (2010). The social determinants of health, health equity, and human rights. Health and Human Rights, 12(2), 17–30. https://www.jstor.org/stable/healhumarigh.12.2.17.
Chapman, A. R. (2016). Global health, human rights, and the challenge of neoliberal policies. Cambridge: Cambridge University Press.
Charlton, J. I. (1998). Nothing about us without us without us: Disability, oppression and empowerment. Berkeley, CA: University of California Press.
Cheng, R., Church, K., Costa, L., Harris, D., Moffatt, K., & Mohammed, S. (2008). Mental health recovery: Users and refusers. Final report on “Nothing about us without us:” What do psychiatric survivors in Toronto think about mental health “Recovery”.
Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P., et al. (2016). Scaling-up treatment of depression and anxiety: A global return on investment analysis. The Lancet Psychiatry, 3(5), 415–424. https://doi.org/10.1016/S2215-0366(16)30024-4.
Christopher, J. C., Wendt, D. C., Marecek, J., & Goodman, D. M. (2014). Critical cultural awareness: Contributions to a globalizing psychology. American Psychologist, 69(7), 645. https://doi.org/10.1037/a0036851.
Cohen, C. I. (1993). The biomedicalization of psychiatry: A critical overview. Community Mental Health Journal, 29(6), 509–521.
Cohen, C. I., & Timimi, S. (2008). Liberatory psychiatry: Philosophy, politics and mental health. Cambridge: Cambridge University Press.
Compton, M. T., Bakeman, R., Capulong, L., Pauselli, L., Alolayan, Y., Crisafio, A., et al. (2020). Associations between two domains of social adversity and recovery among persons with serious mental illnesses being treated in community mental health centers. Community Mental Health Journal, 56(1), 22–31. https://doi.org/10.1007/s10597-019-00462-0.
Cosgrove, L., Mills, C., Karter, J. M., Mehta, A., & Kalathil, J. (2019). A critical review of the Lancet Commission on global mental health and sustainable development: Time for a paradigm change. Critical Public Health. https://doi.org/10.1080/09581596.2019.1667488.
Davar, B. (2008). From mental illness to psychosocial disability: Choices of identity for women users and survivors of psychiatry. Indian Journal of Women’s Studies. https://doi.org/10.1177/097152150801500204.
Davar, B. (2016). A local critique of global mental health. Disability in the global south (pp. 437–451). Cham: Springer.
Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291(21), 2581–2590. https://doi.org/10.1001/jama.291.21.2581.
Dirth, T. P., & Adams, G. A. (2019). Decolonial theory and disability studies: On the modernity/coloniality of ability. Journal of Social and Political Psychology, 7(1), 260–289. https://doi.org/10.5964/jspp.v7i1.762.
Farmer, P. (2004). Pathologies of power: Health, human rights, and the new war on the poor (Vol. 4). Berkeley, CA: University of California Press.
Fine, M. (2012). Resuscitating critical psychology for “revolting” times. Journal of Social Issues, 68(2), 416–438. https://doi.org/10.1111/j.1540-4560.2012.01756.x.
Fine, M. (2018). Just research in contentious times: Widening the methodological imagination. New York, NY: Teachers College Press.
Gajaria, A., Izenberg, J. M., Nguyen, V., Rimal, P., Acharya, B., & Hansen, H. (2019). Moving the global mental health debate forward: How a structural competency framework can apply to global mental health training. Academic Psychiatry. https://doi.org/10.1007/s40596-019-01073-3.
Gardner, C., & Kleinman, A. (2019). Medicine and the mind-the consequences of psychiatry's identity crisis. The New England journal of medicine, 381(18), 1697.
Hoffman, S. J., Sritharan, L., & Tejpar, A. (2016). Is the UN convention on the rights of persons with disabilities impacting mental health laws and policies in high-income countries? A case study of implementation in Canada. BMC International Health and Human Rights, 16(1), 28. https://doi.org/10.1056/NEJMp1910603.
Hopper, K. (2007). Rethinking social recovery in schizophrenia: What a capabilities approach might offer. Social Science & Medicine, 65(5), 868–879. https://doi.org/10.1016/j.socscimed.2007.04.012.
Jenkins, J. H. (2013). Palpable insecurity and Sen’s comparative view of justice: Anthropological considerations. Critical Review of International Social and Political Philosophy, 16(2), 266–283. https://doi.org/10.1080/13698230.2012.757917.
Karter, J. M., & Kamens, S. R. (2019). Toward conceptual competence in psychiatric diagnosis: An ecological model for critiques of the DSM. Critical psychiatry (pp. 17–69). Cham: Springer.
Kattari, S. K. (2020). Ableist microaggressions and the mental health of disabled adults. Community Mental Health Journal. https://doi.org/10.1007/s10597-020-00615-6.
Kirmayer, L. J., & Pedersen, D. (2014). Toward a new architecture for global mental health. Transcultural Psychiatry, 51(6), 759–776. https://doi.org/10.1177/0959353512467963.
Kleinman, A. (2007). What really matters: Living a moral life amidst uncertainty and danger. Oxford: Oxford University Press.
Le Noury, J., Nardo, J. M., Healy, D., Jureidini, J., Raven, M., Tufanaru, C., et al. (2015). Restoring Study 329: Efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence. BMJ, 351, h4320.
MacNaughton, G., & Frey, D. F. (Eds.). (2018). Economic and social rights in a neoliberal world. Cambridge: Cambridge University Press.
McCabe, A., & Davis, A. (2012). Community development as mental health promotion: Principles, practice and outcomes. Community Development Journal, 47(4), 506–521. https://doi.org/10.1093/cdj/bss026.
Metzl, J. M., & Hansen, H. (2018). Structural competency and psychiatry. JAMA Psychiatry, 75(2), 115–116.
Moncrieff, J. (2018). Capitalism and psychiatry: Applying Marxist critical theory to the mental health industry. Social Theory & Health. https://doi.org/10.1057/s41285-017-0060-3.
Moncrieff, J., & Steingard, S. (2019). What is critical psychiatry? Critical psychiatry (pp. 1–15). Cham: Springer.
Mosher, L. R., & Burti, L. (1989). Community mental health: Principles and practice (pp. 323–346). New York: Norton.
Murray, C. J. (1994). Quantifying the burden of disease: The technical basis for disability-adjusted life years. Bulletin of the World Health Organization, 72(3), 429.
National Survivor User Network. (2018). Open letter to the organisers, partners and deleates of the Global Ministerial Mental Health Summit. Retrieved September 22, 2020, from https://www.nsun.org.uk/news/global-ministerial-mental-health-summit-open-letter.
Patel, V., Araya, R., Chatterjee, S., Chisholm, D., Cohen, A., De Silva, M., et al. (2007). Treatment and prevention of mental disorders in low-income and middle-income countries. The Lancet, 370(9591), 991–1005. https://doi.org/10.1016/S0140-6736(07)61240-9.
Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., et al. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553–1598. https://doi.org/10.1016/S0140-6736(18)31612-X.
Pan African Network of People with Psychosocial Disabilities (PANUSP). (2011). Cape town declaration of 16 October 2011. Retrieved September 22, 2020, from https://disabilityglobalsouth.files.wordpress.com/2012/06/dgs-01-02-10.pdf.
Pahwa, R., Smith, M. E., Patankar, K. U., & Ghosh, S. (2020). Social networks, community integration and recovery for individuals with severe mental illnesses in India and the US: A comparative study. Community Mental Health Journal. https://doi.org/10.1007/s10597-019-00546-x.
Porsdam Mann, S., Savulescu, J., & Sahakian, B. J. (2016). Facilitating the ethical use of health data for the benefit of society: Electronic health records, consent and the duty of easy rescue. Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences, 374(2083), 20160130. https://doi.org/10.1098/rsta.2016.0130.
Povinelli, E. (2011). Economies of abandonment. Durham, NC: Duke University Press.
Price, M. (2013). Defining mental disability. Disabil Stud Reader, 4, 292–299.
Pūras, D. (2017). Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (Report A/HRC/35/21). United Nations. Retrieved September 22, 2020, from https://documents-dds-ny.un.org/doc/UNDOC/GEN/G17/076/04/PDF/G1707604.pdf?OpenElement.
Pūras, D. (2019). Right of everyone to the enjoyment of the highest attainable standard of physical and mental health—report of the special rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health (Report A/HRC/41/34). United Nations. Retrieved September 22, 2020, from https://documents-dds-ny.un.org/doc/UNDOC/GEN/G19/105/97/PDF/G1910597.pdf?OpenElement.
Raven, M. (2015). Analysis of mortality in mental disorders. JAMA Psychiatry, 72(11), 1150–1150. https://doi.org/10.1001/jamapsychiatry.2015.1362.
Rose, N. (2018). Our psychiatric future. Hoboken: Wiley.
Russo, J., & Wooley, S. (2020). The implementation of the convention on the rights of persons with disabilities: More than just another reform of psychiatry. Health & Human Rights: An International Journal, 22(1), 151–161.
Shukla, A., Philip, A., Zachariah, A., Phadke, A., Suneetha, A., Davar, B., et al. (2012). Critical perspectives on the NIMH initiative" Grand Challenges to Global Mental Health". Indian Journal Of Medical Ethics, 9(4), 292. https://doi.org/10.20529/IJME.2012.102.
Steingard, S. (2019). Critical psychiatry: Controversies and clinical implications. Cham: Springer.
Summerfield, D. (2013). “Global mental health” is an oxymoron and medical imperialism. BMJ, 346, f3509. https://doi.org/10.1136/bmj.f3509.
Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94(4), 651–656.
Turner, E. H. (2013). Publication bias, with a focus on psychiatry: Causes and solutions. CNS Drugs, 27(6), 457–468.
WHO Commission on Social Determinants of Health, & World Health Organization. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. Geneva: World Health Organization.
World Health Organization. (2016). Out of the shadow: Making mental health a global development priority. Retrieved September 22, 2020, from https://www10.who.int/mental_health/advocacy/WB_event_2016/en/.
World Health Organization. (2017a). A human rights-based approach to health. World Health Organization. Retrieved September 22, 2020, from https://www.who.int/hhr/news/hrba_to_health2.pdf.
World Health Organization. (2017b). Depression and other common mental disorders: Global health estimates (No. WHO/MSD/MER/2017.2). World Health Organization. Retrieved September 22, 2020, from https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf;jsessionid=B52A884D53D55C274FAE92269CE10B89?sequence=1.
Yeung, W. S., Hancock, N., Honey, A., Wells, K., & Scanlan, J. N. (2020). Igniting and maintaining hope: The voices of people living with mental illness. Community Mental Health Journal. https://doi.org/10.1007/s10597-020-00557-z.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Cosgrove, L., Morrill, Z., Karter, J.M. et al. The Cultural Politics of Mental Illness: Toward a Rights-Based Approach to Global Mental Health. Community Ment Health J 57, 3–9 (2021). https://doi.org/10.1007/s10597-020-00720-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-020-00720-6