Whither Mental Health Policy-Where Does It Come from and Does It Go Anywhere Useful?; Comment on “Cross-National Diffusion of Mental Health Policy” (original) (raw)

Cross-National Diffusion of Mental Health Policy

2014

Background Following the tenets of world polity and innovation diffusion theories, I focus on the coercive and mimetic forces that influence the diffusion of mental health policy across nations. International organizations’ mandates influence government behavior. Dependency on external resources, namely foreign aid, also affects governments’ formulation of national policy. And finally, mounting adoption in a region alters the risk, benefits, and information associated with a given policy. Methods I use post-war, discrete time data spanning 1950 to 2011 and describing 193 nations’ mental health systems to test these diffusion mechanisms. Results I find that the adoption of mental health policy is highly clustered temporally and spatially. Results provide support that membership in the World Health Organization (WHO), interdependence with neighbors and peers in regional blocs, national income status, and migrant sub-population are responsible for isomorphism. Aid, however, is an insufficient determinant of mental health policy adoption. Conclusion This study examines the extent to which mental, neurological, and substance use disorder are addressed in national and international contexts through the lens of policy diffusion theory. It also adds to policy dialogues about non-communicable diseases as nascent items on the global health agenda.

Evaluting the WHO Assessment Instrument for Mental Health Systems by comparing mental health policies in four countries

Bulletin of The World Health Organization, 2008

Mental health is a low priority in most countries around the world. Minimal research and resources have been invested in mental health at the national level. As a result, WHO has developed the Assessment Instrument for Mental Health Systems (WHO-AIMS) to encourage countries to gather data and to re-evaluate their national mental health policy. This paper demonstrates the utility and limitations of WHO-AIMS by applying the model to four countries with different cultures, political histories and public health policies: Iraq, Japan, the Philippines and The former Yugoslav Republic of Macedonia.

Diffusion of Innovation in Mental Health Policy Adoption: What Should We Ask about the Quality of Policy and the Role of Stakeholders in this Process?; Comment on “Cross-National Diffusion of Mental Health Policy”

2015

In his recent study, Gordon Shen analyses a pertinent question facing the global mental health research and practice community today; that of how and why mental health policy is or is not adopted by national governments. This study identifies becoming a World Health Organization (WHO) member nation, and being in regional proximity to countries which have adopted a mental health policy as supportive of mental health policy adoption, but no support for its hypothesis that country recipients of higher levels of aid would have adopted a mental health policy due to conditionalities imposed on aid recipients by donors. Asking further questions of each may help to understand more not only about how and why mental health policies may be adopted, but also about the relevance and quality of implementation of these policies and the role of specific actors in achieving adoption and implementation of high quality mental health policies.

Evaluating the WHO Assessment Instrument for Mental Health Systems by comparing mental health policies in four countries

Bulletin of the World Health Organization, 2008

Mental health is a low priority in most countries around the world. Minimal research and resources have been invested in mental health at the national level. As a result, WHO has developed the Assessment Instrument for Mental Health Systems (WHO-AIMS) to encourage countries to gather data and to re-evaluate their national mental health policy. This paper demonstrates the utility and limitations of WHO-AIMS by applying the model to four countries with different cultures, political histories and public health policies: Iraq, Japan, the Philippines and The former Yugoslav Republic of Macedonia. WHO-AIMS provides a useful model for analysing six domains: policy and legislative framework; mental health services; mental health in primary care; human resources; education of the public at large; and monitoring and research. This is especially important since most countries do not have experts in mental health policy or resources to design their own evaluation tools for mental health systems...

Evaluating the WHO Assessment Instrument for Mental Health Systems by Comparing Mental Health Policies in Four Countries/ Evaluation De L'instrument D'evaluation Des Systemes De Sante Mentale De l'OMS Par Comparaison Des Politiques De Sante Mentale De Quatre pays/Analisis del Instrumento OMS De E...

Bulletin of The World Health Organization, 2008

Mental health is a low priority in most countries around the world. Minimal research and resources have been invested in mental health at the national level. As a result, WHO has developed the Assessment Instrument for Mental Health Systems (WHO-AIMS) to encourage countries to gather data and to re-evaluate their national mental health policy. This paper demonstrates the utility and limitations of WHO-AIMS by applying the model to four countries with different cultures, political histories and public health policies: Iraq, Japan, the Philippines and The former Yugoslav Republic of Macedonia. WHO-AIMS provides a useful model for analysing six domains: policy and legislative framework; mental health services; mental health in primary care; human resources; education of the public at large; and monitoring and research. This is especially important since most countries do not have experts in mental health policy or resources to design their own evaluation tools for mental health systems. Furthermore, WHO-AIMS provides a standardized database for crosscountry comparisons. However, limitations of the instrument include the neglect of the politics of mental health policy development, underestimation of the role of culture in mental health care utilization, and questionable measurement validity.

The “World Mental Health” Framework: Dominant Discourses in Mental Health and International Development

Canadian journal of community mental health, 2004

This paper draws on experiences and research in mental health and international development to explore a dominant "World Mental Health" discourse. This kind of analysis provides a starting place to examine the critiques and ongoing theorizing of a global mental health ideology. Seeing the field as it is socially organized (Smith, 1987, 1990a, 1999) necessitates an understanding of how an ideological "World Mental Health" is discursively arranged as part of a global undertaking to decrease poverty and increase capitalist productivity and trade. Through this exploration of the discourses in use internationally, I argue that rediscovering local truth is possible as researchers pursue and share knowledge that has as its starting place a way of knowing outside these dominant discourses. We need a new sociology of knowledge that can pick apart a wide body of commentary and scholarship: complex international law; the claims and disclaimers of officialdom; postmodern relativist readings of suffering; clinical and epidemiologic studies of the long term effects of, say, torture and racism (Farmer, 2003, p. 241). The emphasis on global understandings and solutions for mental health problems provides a convenient distraction from our understanding of economic globalization's impact on mental health problems. In this paper I introduce some important ideas, "claims and disclaimers of officialdom" (Farmer, 2003, p. 241), and discourses that are used in understanding and managing mental health work globally, in developing countries and beyond. The mental health discourse is vast. My interest here is in offering background on how mental health work is becoming conceptualized as part of a global undertaking to decrease poverty and increase capitalist productivity and trade. I explain how mental health is part of the mandate of the World Health Organization (WHO), the pre-eminent body in developing a global understanding and policy for health programs, as well as other key organizations influencing the directions of health care internationally. The World Bank and the International Monetary Fund (IMF) are important players in developing discourse on the relation between mental health and improved productivity or "development." As I explore in this paper, these discourses are not entirely separate even though they originate in different organizations with distinct goals for economic and social development. Together these "mental health" _____________________________________________________________________________ The author would like to acknowledge Dr. Marie Campbell's assistance with the initial thesis on which this work is based. Dr. Cheryl Crocker was also instrumental in the revision of this manuscript and the author would like to thank her and the anonymous reviewers whose recommendations have greatly enhanced the final paper.