The Division of Social and Transcultural Psychiatry is a network of scholars and clinicians within the Department of Psychiatry, Faculty of Medicine, McGill University, devoted to promoting research, training and consultation in social and cultural psychiatry. The Division has produced an excellent series entitled Global Mental Health: Bridging the Perspectives of Cultural Psychiatry and Public Health. Here are some of the series.

Vikram Patel - Why Mental Health Matters to Global Health (ASI 2012)

 

"Global health is the new avatar for what we once called "international health" and, going back further in time, "tropical medicine". Global health stands out from its predecessors in three key respects: first, its priorities are determined by the science of the burden of disease; second, its driving philosophy is equity, i.e. justice and fairness in the distribution of health in society; and third, its scope is global, i.e. it concerns actions which can benefit the health of people globally.

This presentation will present evidence to make the case that mental health is not only relevant to global health in all these respects, but in fact lies at its very heart. The presentation will then address some key road-blocks to global efforts to improve access to care for people with mental disorders, in particular the grave shortage and iniquitous distribution of mental health specialist resources. New evidence from low resource settings is showing how task-sharing of mental health care with lay and community health workers is an effective model for delivery of evidence-based treatments for mental disorders. Armed with the knowledge that one can unpack complex mental health treatments, and train and support non-professionals to deliver them, perhaps the promise of mental health for all is realizable. In particular, we will need to empower those who are affected by mental disorders to assure their right to receive care that enables recovery and live a life of dignity. We can attain the lofty goal of "mental health for all" only if we involve all in the process."

Gilles Bibeau - Halt to the Abuse of Globalization in the field of Mental Health (ASI 2012)

The notion of culture has been under attack in anthropology during the last decades. People have particularly denounced what appears as a double process of objectification: internally, when cultures are presented as coherent and homogeneous entities; externally, when societies and cultures are presented as well-bounded and clearly separated from one another. These critiques
have been formulated against a double horizon: (i) a historical one where colonization is analyzed as having produced a certain vision of the Otherness of the alien cultures: a vision built on processes of exoticization that facilitated the colonizer’s domination and the play of power relationships; and (ii) a transversal horizon with the current awareness of the power of
globalization forces including the importance of large-scale movements of populations, the circulation of images and products through trade and the media, and individuals’ concrete and imaginary travels throughout societies and cultures where they can live and imagine themselves as participating in multiple worlds. It is striking to see that at the very same moment when
anthropology was criticizing the notion of Culture, mental health clinicians and researchers seemed to have discovered Culture. However, most of them seem unaware of the traps that this notion entails. Cultures are generally heterogeneous, plural and paradoxical; they are infused and modulated by power relationships at the global and local levels. Individuals circulate between
various cultural worlds and often belong simultaneously to several of them. This paper will discuss the implications of a critical medical anthropology for global mental health.

The “folie à trois” between global mental health, anthropology and psychiatry

Joop de Jong, Free University Amsterdam

Mitigating the global mental health gap is complicated by controversies around the need to address psychiatric versus psychosocial problems, the professional disciplines and societal sectors being involved, the collaboration between community, (non-) governmental and international actors, the applicability of “talking therapy”, the emphasis on vulnerability versus resilience, the way to deal with complex health systems and with culturally-diverse groups, or the question whether day-to-day care is different in times of disaster or political violence. This presentation will first argue that a public mental health paradigm may help to transcend many of these contradictions that often seem to be more relevant for professionals and scholars than for people coming to terms with their plight. Secondly, this presentation will elaborate the complementarity of a universalistic view of mental health versus local perceptions and expressions such as idioms of distress. The choice between these perspectives is highly relevant for the type of practitioners that is likely being involved in solving socio-psychological or more serious afflictions. This implicates a need for research into the efficacy of local healing methods and into the healers’ contribution to bridge the mental health gap. Thirdly, the perennial debate between universalism and relativism may be solved with cultural neuro-scientific and neuro-anthropological research. The paradigm of cultural neuroscience may help us refine our global psychiatric diagnostic classification system and assist in bridging the worlds of global mental health, anthropology, psychiatry and epidemiology.

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