“Toward a new architecture for global mental health”


McGill University’s Laurence J. Kirmayer and Duncan Pedersen examine the core controversies that dog the “global mental health” agenda in a freely available editorial for Transcultural Psychiatry.

“Despite the efforts to build a solid scientific foundation for [Global Mental Health],” the authors write, “there continues to be controversy and debate about the knowledge base, as well as the appropriate methods for establishing priorities, research themes and approaches, and modes of developing and/or adapting interventions in global mental health.”

The authors begin by outlining some of the key critiques such as, “the priorities of global mental health have been largely framed by mental health professionals and their institutional partners mostly located in wealthy countries, which therefore reflects the dominant interests of psychiatry and may give insufficient attention to locally defined priorities” and “global mental health tends to emphasize professional mental health interventions and may marginalize indigenous forms of helping, healing, and social integration that can contribute to positive outcomes and recovery.”

The authors later trace some of the negative impacts of the dominant approaches of the global mental health agenda, such as “diagnostic systems that are not appropriate for local cultural contexts, resulting in misdiagnosis” and “failing to recognize relevant personal and social problems that demand solutions other than mental health treatment.”

At the level of health systems, the authors also identify problems such as, “displacing attention from social structural and political economic determinants of mental health to the immediate and proximal biological causes of poor mental health outcomes in individuals” and “adopting the economic agendas of multinational pharmaceutical corporations or other vested interests that may ultimately conflict with public health goals.”

(Abstract) (Full text) Toward a new architecture for global mental health (Kirmayer, Laurence J. and Pedersen, Duncan. Transcultural Psychiatry. Published online before print October 30, 2014. Doi: 10.1177/1363461514557202)