Webinaires Global Mental Health Webinar : Contingent universality and the making of global guidelines for mental health
Differently from debating whether or not mental health is global, this presentation explores the conditions of possibility that produce and legitimate mental health as global, adding empirical depth to understanding global mental health’s contingent universality. Specifically, the presentation foregrounds the perspectives of those involved in the design of the World Health Organization’s (WHO) mhGAP-Intervention Guide (mhGAP-IG) – evidence-based guidelines designed to be a key tool for scaling up mental health globally.
Findings centre on the strategies used within the development of the mhGAP-IG to achieve contingent universality, including: framing universality as equivalent to action and cultural relativism as equivalent to nihilism; acknowledgement of, but delaying of, complexity in favour of pragmatism; prioritization of systematic reviews and randomized research design in decisions about what counts as evidence; narration of tensions through technical issues rather than around the epistemic infrastructure and epistemology of mental health’s universality; ascribing messiness to local contexts of primary healthcare, and not to the messy process of designing and constructing guidelines, nor to the messy work of standardisation; and problematisation of the contexts and means of implementation rather than problematisation of design. The presentation uses empirical data to show nuance, complexity and multi-dimensionality where binary thinking often dominates, and to make links across and between arguments ‘for’ and ‘against’ global mental health.
China Mills is a Senior Lecturer of Public Health, in the School of Health Sciences, at City, University of London. She researches the policies and practices of global mental health, and the politics of suicides linked to welfare reform, border imperialism, and corporate practices.
Mónica Ruiz-Casares, PhD, MSc, MA, LLB Associate Professor, Division of Social and Transcultural Psychiatry, McGill University