BOOK REVIEW An Overlooked Consequence of Globalization: Exporting American Notions of Mental Illness and Mental Health (original) (raw)
Related papers
Driving Us Crazy: The Globalization of Mental Health and the Historicity of Emotions
There is now a solid body of research to suggest that mental illnesses are not, as sometimes assumed, spread evenly around the globe and across history. In a talk based on his recent book, Watters will review the body of work by cross-cultural psychiatrists that has shown that mental illnesses appear in different cultures and periods in history in endlessly complex and unique forms. Because the troubled mind has been perceived in terms of diverse religious, scientific, and social beliefs of discrete cultures, the forms of madness from one place and time in history often look remarkably different from the forms of madness in another. But with the increasing speed of globalization, things are changing quickly. The remarkable diversity once seen among different cultures’ conceptions of madness is now disappearing. A few mental illnesses identified and popularized in the United States, depression, post-traumatic stress disorder, and anorexia among them—now appear to be spreading across cultural boundaries and around the world with the speed of contagious diseases. Indigenous forms of mental illness and healing are being replaced by disease categories and treatments made in the USA. To lay bare these international trends, Watters will explore four case studies: The rise of anorexia in Hong Kong in the 1990s; the spread of Post-Traumatic Stress Disorder and western trauma therapy to Sri Lanka after the Boxing Day tsunami; the changing notions of schizophrenia in Zanzibar; and the selling of depression to Japan after that market was opened to SSRIs.
Culture, Medicine, and Psychiatry
The author suggests to consider some important hidden connections in Global Mental Health (GMH) discourse and interventions, above all the political meaning of suffering and symptoms, the power of psychiatric diagnostic categories (both Western and traditional) to name and to occult at once other conflicts, and the implicit criticism expressed by so-called local healing knowledge and its epistemologies. These issues, by emphasizing the importance to explore other ontologies, help to understand the perplexity and resistance that GMH and its agenda meet among many scholars and professionals, who denounce the risks of reproducing and globalizing Western hegemonic values concerning health, illness, and healing. Keywords ''Palimpsest nature'' of psychiatric disorders Á Hegemonic dimensions of psychiatric diagnostic apparatus Á Crypto-racism Á Indocile suffering Á ''Minor'' and ''subjugated'' (healing) knowledge
Embodied in the very concept of Global Mental Health (an area that is emerging as both a field of study and a global movement), mental health is conceptualised as being 'global'; mental disorders are constructed as having 'a physical basis in the brain….they can affect everyone, everywhere' and are understood to be 'truly universal' (WHO, 2001a:x, 22). The construction of 'mental disorder' as universal is used to draw attention to inequalities in access to mental health care and treatment globally-the 'treatment gap'-and to push to scale up mental health services in low and middle-income countries (LMICs) based on those in high-income countries (HICs). This push arises from two separate, yet interrelated, arenas; the World Health Organization (WHO), and the Movement for Global Mental Health (MGMH) (www.globalmentalhealth.org). Such a view-reducing complex matters of living, behaving and thinking to 'mental' health and disorder developed in a particular socio-cultural context-is strongly contested by groups of service users and survivors of psychiatry, or those who identify as psychosocially disabled, in the global North and South; by academics and professionals in the field of transcultural psychiatry; and by members of the Critical Psychiatry Network (CPN) (http://www.criticalpsychiatry.net/) (see Fernando, 2014; and Mills, 2014). Even more importantly, this drive to export mental health systems from HICs to LMICs is occurring at a time when serious questions are being asked about the utility and validity of psychiatric diagnoses. More specifically, there is a) concern that such psychiatrization constructs human experience (for example, emotional distress, problems of living, conflicts in relationships and social suffering) as 'mental disorder' treatable by drugs (e.g.
Decolonising global mental health: the role of Mad Studies
Global mental health, 2023
In recent years, there has been a growing and high-profile movement for 'global mental health'. This has been framed in 'psych system' terms and had a particular focus on what has come to be called the 'Global South' or 'low and middle-income countries'. However, an emerging 'Mad Studies' new social movement has also developed as a key challenge to such globalising pressures. This development, however, has itself both being impeded by some of the disempowering foundations of a global mental health approach, as well as coming in for criticism for itself perpetuating some of the same problems as the latter. At the same time, we are also beginning to see it and related concepts like the UNCRPD being given new life and meaning by Global South activists as well as Global North activists. Given such contradictions and complexities, the aim of this paper is to offer an analysis and explore ways forward consistent with decolonizing global mental health and addressing madness and distress more helpfully globally, through a Mad Studies lens. Impact statement We have written this paper in the hope of provoking debate in the general field known as global mental health. The paper puts users/survivors/people with psychosocial disabilities front and centre of thinking about how we should be treated in the Global North and the Global South. Should the first export its ministrations to the second? Many say 'no' but do so from the standpoint of professionals. By drawing on the emerging terrain of Mad Studies we propose a way for the voices of experience to be heard and listened to. But this intervention is not just at the level of debate; Mad Studies is also a praxis and we hope to spark a dialogue about action in the field of 'mental health' in the very diverse and unequal worlds we inhabit. Mental health globalisation: Solution or problem The current move to globalise mental health can be understood as both a trend and a selfconscious development. Whilst colonial countries have psychiatrised their colonies for two centuries, this has mainly been in the replication of institutions. The current move to global mental health is more widespread and coordinated. It has been understood to mean the rapid expansion of psychiatric interpretations and responses to human mental distress and difficulty. These have generally been framed in medicalised, individualistic terms, primarily seeing the problem or pathology in the individual, their family or, less often, the wider community. The first major modern exporting of western psychiatry followed the collapse of the Soviet Union. This tended to be wholesale and undifferentiated between eastern bloc nations, centred on US-dominated big pharma. This resulted in a system which was still heavily institutionalised, generally of poor quality and underfunded (Petrea and Haggenburg, 2014). The researcher China Mills has offered a definitive critique of the much broader Western 'movement for global mental health' which followed, highlighting the overdue need for its decolonization. The call of the World Health Organization (WHO) and the Movement for Global Mental Health was to 'scale up' access to psychological and psychiatric treatments globally, particularly within the Global South (Mills, 2014). While this has been offered as a positive, Mills has raised three fundamental and enduring questions in relation to the 'globalisation of mental health'. These are first, whether the call for equality in global access to psychiatry is a helpful one. Second, whether everyone should have the 'right' to a 'psychotropic citizenship' and third, whether mental health can, or should, be global and appropriately conceived of as a concept with global application. She raises major doubts in all three cases and calls for the decolonisation of mental health. Mills relies heavily on Fanon and his theory of 'colonising the mind' (Fanon, 1967). However, we cannot approach these questions solely through the work of those from Western societies, however, grounded their claims to follow Southern writers. Importantly, writers have approached decolonialising mental health from within the Global South itself calling for the resurgence of African or South
Globalizing Mental Health: Exporting Controversy
GLOBALIZING MENTAL HEALTH: EXPORTING CONTROVERSY, 2018
The World Health Organization has called for concern regarding the global burden of mental health, which was found to be underestimated. A plan for the upscaling of mental health services was published to provide guidelines for the implementation of increased access to mental health services globally. Concurrently the plan was critiqued by psychiatry's opposing forces with accusations ranging from obscured pharmaceutical interests to contemporary colonization. This paper takes the reader through the history, several conceptualizations, and ultimately the global significance of mental health and its medical field of psychiatry by means of a narrative literature review. A theoretical framework on technology transfer was constructed, and used as a measure to judge the viability of Western mental healthcare as a basis to expand upon globally through the exportation of its concepts. The basis on which mental healthcare might be exported was found to be dichotomous. While its conceptualization as a product facilitates expansion quite effortlessly, its lacking scientific validity as a medical field may prove to be a potentially destructive basis to expand upon. With adverse global consequences as a potential prospect, the World Health Organization is found to have underestimated its role as a vector in the spread of mental illness.
Genealogies and Anthropologies of Global Mental Health
Culture, Medicine and Psychiatry, 2019
Within the proliferation of studies identified with global mental health, anthropologists rarely take global mental health itself as their object of inquiry. The papers in this special issue were selected specifically to problematize global mental health. To contextualize them, this introduction critically weighs three possible genealogies through which the emergence of global health can be explored: (1) as a divergent thread in the qualitative turn of global health away from earlier international health and development; (2) as the product of networks and social movements; and (3) as a diagnostically- and metrics-driven psychiatric imperialism, reinforced by pharmaceutical markets. Each paper tackles a different component of the assemblage of global mental health: knowledge production and circulation, global mental health principles enacted in situ, and subaltern modalities of healing through which global mental health can be questioned. Pluralizing anthropology, the articles include research sites in meeting rooms, universities, research laboratories, clinics, healers and health screening camps, households, and the public spaces of everyday life, in India, Ghana, Brazil, Senegal, South Africa, Kosovo and Palestine, as well as in US and European institutions that constitute nodes in the global network through which scientific knowledge and certain models of mental health circulate.
Culture, mental health and psychiatry - Spring 2024
While mental illness has recently been framed in largely neurobiological terms as brain disease, there has also been an increasing awareness of the contingency of psychiatric diagnoses. In this course, we will draw upon readings from medical and psychological anthropology, cultural psychiatry, and science studies to examine this paradox and to examine mental health and illness as a set of subjective experiences, social processes and objects of knowledge and intervention. On a conceptual level, the course invites students to think through the complex relationships between categories of knowledge and clinical technologies (in this case, mainly psychiatric ones) and the subjectivities of persons living with mental illness. Put in slightly different terms, we will look at the multiple links between psychiatrists’ professional accounts of mental illness and patients' experiences of it. Questions explored include: Does mental illness vary across social and cultural settings? How are experiences of people suffering from mental illness shaped by psychiatry’s knowledge of their afflictions?
Culture bound syndromes-contextualising and historically locating mental illness
I still remember the day we went through the ICD-10 in the clinical psychology class. Our professor, a practicing and competent clinical psychologist, talked us through the various symptoms that constituted a mental illness. Mental illnesses such as PTSD(Post Traumatic Stress Disorder) schizophrenia and depression were assumed to be universal. Extensive studies have been conducted around the world documenting these illnesses. We finally got to the section on culture bound syndromes. Presented as mental illnesses of the global south, most conditions seemed like glorified superstition, the workings of an uneducated mind.