Author:Doerte Bemme (McGill University)
Paper short abstract:
The presentation attends to the ways a participatory framework called “Theory of Change” (ToC) operationalizes (and perhaps challenges) the paradox between universality and contingency within a multi-country research consortium in Global Mental Health.
Paper long abstract:
The movement for Global Mental Health (GMH) is a multi-disciplinary assemblage striving to treat 'mental health' on a global scale through evidence-based interventions. While relying heavily on standardized epidemiology to advocate for mental health in the policy arena, GMH's treatment models and clinical trials often employ flexible and iterative research designs that square the demands of a globally comparable data production with the contingencies of situated knowledge and health systems. Drawing on empirical fieldwork within a multi-country mental health research consortium, this presentation attends to the ways a participatory framework called "Theory of Change" (ToC) operationalizes (and perhaps reformulates) the paradox between universality and contingency in practice. "Theory of change" workshops reverse-engineer a desirable outcome by inviting a number of stakeholders to collectively define the process and steps required to achieve it. The resulting "ToC maps" can vary greatly from country to country, yet they create the language, conceptual skeleton and, importantly, new spaces of indeterminacy, through which knowledge emerges, flows, and temporarily hardens for the sake of global comparison. By paying attention to ToC as a space and practice that is neither "global" nor "local" I seek to trouble the common narrative of how universal categories, metrics and modes of accounting come up against "local" realities "on the ground".
Movement of medical knowledge & practice: crossing borders and constructing boundaries in a global world