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"Mills, China"
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Decolonizing global mental health : the psychiatrization of the majority world
\"Decolonizing Global Mental Health offers a critical postcolonial reading of this newly emerging arena, with a particular focus on psychology's and psychiatry's encounters with, and responses to, distress or 'mental illness' in low-income countries. The World Health Organisation and the Movement for Global Mental Health currently push for the 'scale-up' of psychiatric and psychological interventions on to low-income countries, modelled on those from high-income countries. However critiques of psychiatric and psychological services from service users, the survivor movement and professionals, often remain invisible within 'Global Mental Health' literature. This book argues that it is imperative to explore how this alternative 'evidence base' might be mobilized to fruitfully interrogate calls to 'scale up' psychiatric and psychological services in the majority world. The book seeks to de-familiarize current 'Western' conceptions of psychology and psychiatry using postcolonial theory, and seeks to bring into focus a series of questions and problematizations. As such it is ideal reading for undergraduate and postgraduate students, as well as researchers in the fields of critical psychology and psychiatry, social and health psychology, cultural studies, public health and social work\"-- Provided by publisher.
Book
Measures of Social Isolation
Social isolation is a deprivation of social connectedness. It is a crucial aspect that continues to be named by people as a core impediment for achieving well-being and as a relevant factor for understanding poverty. However it is not routinely included in surveys that provide data on multidimensional poverty measurement. Although the challenge of measuring social connectedness is daunting, this paper argues that existing research in several fields provides solid ground for the construction of basic internationally comparable indicators that measure specific aspects of social isolation. In particular, this paper synthesises the relevant literature on the measurement of social isolation and related phenomena, and on the basis of this synthetic review, proposes a module of indicators to measure social connectedness that could be feasibly incorporated into an internationally comparable multi-topic household survey.
Journal Article
The (Mis)appropriation of HIV/AIDS advocacy strategies in Global Mental Health: towards a more nuanced approach
Background
Mental 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.
Discussion
There 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.
Conclusion
There 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.
Journal Article
Burden and benefits-related suicides: “misperception” or state crafted reality?
Purpose
This article aims to focus on deaths by suicide in relation to UK welfare reform as a case study to question one of suicidology’s most dominant theories – the Interpersonal Theory of Suicide (Joiner, 2005) and its influential ideas on “perceived burdensomeness” – as well as wider ideologies on suicide and mental health reflected in this approach.
Design/methodology/approach
This article draws on evidence from disabled people’s campaigning groups (primary sources) and research literature (secondary sources), which shows the negative psychological impact of burden discourse and how this shows up in people’s accounts of feeling suicidal, in suicide notes and in family accounts of those who have died by suicide. It uses this evidence to problematise the Interpersonal Theory of Suicide (Joiner, 2005), specifically its ideas about “burden” as an individual misperception, and the assumption that suicide is always the outcome of mental health problems.
Findings
The findings highlight the systemic, intersectional and cumulative production of suicidality by governmental “welfare reform” in the UK, through positioning welfare claimants as “burdens” on society. They show that by locating the problem of burdensomeness in individual “misperceptions”, the Interpersonal Theory allows the government’s role in crafting stigmatisation and conditions of suicidality to be overlooked and to be reproduced.
Originality/value
The article raises urgent ethical questions about the application of approaches, such as the Interpersonal Theory of Suicide, to benefits-related suicides and calls for approaches to benefits-related harm and suicide to be rooted in social and disability justice.
Journal Article
The Routledge International Handbook of Global Therapeutic Cultures
The Routledge International Handbook of Global Therapeutic Cultures explores central lines of enquiry and seminal scholarship on therapeutic cultures, popular psychology, and the happiness industry. Bringing together studies of therapeutic cultures from sociology, anthropology, psychology, education, politics, law, history, social work, cultural studies, development studies, and American Indian studies, it adopts a consciously global focus, combining studies of the psychologisation of social life from across the world. Thematically organised, it offers historical accounts of the growing prominence of therapeutic discourses and practices in everyday life, before moving to consider the construction of self-identity in the context of the diffusion of therapeutic discourses in connection with the global spread of capitalism. With attention to the ways in which emotional language has brought new problematisations of the dichotomy between the normal and the pathological, as well as significant transformations of key institutions, such as work, family, education and religion, it examines emergent trends in therapeutic culture and explores the manner in which the advent of new therapeutic technologies, the political interest in happiness, and the radical privatisation and financialisation of social life converge to remake self-identities and modes of everyday experience. Finally, the book features the work of scholars who have foregrounded the historical and contemporary implication of psychotherapeutic practices in processes of globalisation and colonial and postcolonial modes of social organisation. Presenting agenda-setting research to encourage interdisciplinary and international dialogue and foster the development of a distinctive new field of social research, The Routledge International Handbook of Global Therapeutic Cultures will appeal to scholars across the social sciences with interests in the advance of therapeutic discourses and practices in an increasingly psychologised society.
eBook
Psy-expertise, therapeutic culture and the politics of the personal in development
Expertise stemming from the psy disciplines is increasingly and explicitly shaping international development policy and practice. Whilst some policy makers see the use of psy expertise as a new way to reduce poverty, increase economic efficiency, and promote wellbeing, others raise concerns that psychocentric development promotes individual over structural change, pathologises poverty, and depoliticises development. This paper specifically analyses four aspects of psy knowledge used in contemporary development policy: child development/developmental psychology, behavioural economics, positive psychology, and global mental health. This analysis illuminates the co-constitutive intellectual and colonial histories of development and psy-expertise: a connection that complicates claims that development has been psychologized; the uses and coloniality of both within a neoliberal project; and the potential for psychopolitics to inform development.
Journal Article
Reflections on doing training for the World Health Organization's mental health gap action program intervention guide (mhGAP-IG)
The World Health Organization's (WHO) mhGAP-Intervention Guide (mhGAP-IG), is a tool designed for non-specialists to detect, diagnose and manage common mental disorders. In this paper we specifically focus on how the mhGAP-IG is understood and used in the training of non-specialists - as part of a task-sharing strategy key to scaling up mental health in LMICs. Specifically, this paper is interested in how mhGAP training enacts pedagogic modes of address that invite, enact and circulate particular ways of knowing and doing mental health. Despite being highly scripted, we cannot know from the mhGAP training manuals how training actually takes place in practice, or about whether local contextual epistemologies of distress are able to interrupt or resist universal tools. This is important because while the IG and its training may be designed for expansion and global use, this doesn't tell us much about how they are actually used, enacted, appropriated, or resisted around the world. The research detailed here draws upon interviews with people involved in designing the mhGAP-IG and/or delivering training, and focuses on moments when training takes off or diverts from the script. The data detailed here shows instances when people's own philosophies of life and understandings of distress shape the training they deliver. Instead of assuming that universal tools such as mhGAP enact top-down medicalization, we attend to the complex practices engendered by mhGAP and the nuances of local adaptation.
Journal Article
The politics of the global governance of mental health
This chapter focuses on governance in global mental health policy-making, taking as its starting point that current dominant conceptions of mental health have always been global, have always been about governance, and have always been tied to racialization. Focusing on the connections between governance of madness, racialized and colonial governance, and global governance, it shows how the seemingly new governance of global mental health is linked to long established global governance of madness through the psy-disciplines. Global health governance is usually understood as complex and multifaceted, and involving multiple 'factors, forces, and actors'. Typologies of governing (national, international and global) are seen as intertwined, with global governance seen as distinct because it involves (or talks to) non-state actors, such as non-governmental organizations and multinational corporations. Metrics are key tools in constructing and making visible the global scale of mental health, and thus in justifying the need for the global governance of mental health.
Book Chapter