Breaking the vicious cycle: mental illness and poverty in global mental health
Doerte Bemme (McGill University)
Paper short abstract:
This paper explores the ways in which the movement for Global Mental Health engages and intertwines the discourses on mental health and poverty reduction.
Paper long abstract:
The movement for Global Mental Health has recently reinvigorated discussions regarding the causal relationship between poverty and mental illness. Beginning in the 1980s, mental illness and poverty were described as being caught up in a "vicious cycle", yet the direction of causality still remains unresolved: proponents of "social causation" claim that poverty causes mental illness, while others argue that mental illness gradually leads into poverty through social drift. These two theoretical positions also suggest very different interventions focusing either on financial and structural aid, or on mental health treatments. New discussions in Global Mental Health have attempted to settle this controversy through conducting a systematic review that applies the principles of evidence based medicine (EBM) - including the privileging of randomized clinical trials (RCTs) - to the body of academic literature in order to reexamine the link between poverty and mental health. This paper investigates the ways in which Global Mental Health shapes the causality debate in new ways. I will particularly focus on the construction of "evidence" and on the novel ways in which health and economic indicators intersect within the GMH discourse. Against this backdrop, this paper explores whether the endpoint of mental health interventions is shifting from a concern with health towards the improvement of productivity and economic well-being, and how such intersectional evidence base aligns mental health with "development" agendas.
Economic wealth and mental health: questioning the paradoxes