Tuesday, January 14, 2020

Developing global mental health services

I've discussed before (eg. see previous post) how we tend to have an understanding of illness as implying physical abnormality. An article by Suman Fernando highlights how much this perspective is a 'Western' understanding. Even within Western cultures this interpretation of illness is only really since the nineteenth century (eg. see previous post). 

Suman highlights the plurality of mental health systems in place in the global south: "Western systems, traditional indigenous systems, new, innovative systems, and those that attempt to adapt Western systems to make them ‘culturally sensitive’ to local norms". I  don't think we should underestimate the plurality of health care systems in the West with much uptake of 'alternative' and complementary health care besides standard health care.

This blog has been critical of biomedical approaches in psychiatry. I therefore agree with Suman than mental health development should not be colonised by biomedical psychiatry (eg. see previous post). Nor should we medicalise difficult social problems, like poverty and lack of social support, that require political and economic solutions (see previous post). As Suman concludes:- 
the aim of all agencies seeking to develop mental health services must be to enable local people to develop services that are ethical, that is for the benefit of the people concerned as subjects rather than objects of development, and sustainable without dependence on rich countries in the West. 

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