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- Convenors:
-
Nigel Cox
(Manchester Metropolitan University)
Lucy Webb (Manchester Metropolitan University)
- Location:
- FUL-104
- Start time:
- 11 September, 2015 at
Time zone: Europe/London
- Session slots:
- 2
Short Abstract:
With a Global Mental Health focus, this panel explores ideas, ideologies and methodologies spread by Western psychiatry/psychology. Through exposition and argument, the panel will discuss the export of psychiatric/psychological expertise to non-Western contexts, proffering solutions for practice
Long Abstract:
This panel will debate Global Mental Health, and will explore the ideas, moralities, ideologies and methodologies propagated by Western psychology and psychiatry. Over two decades of enquiry, Nikolas Rose and others have shown that, in the West, psychological self-sufficiency is accorded considerable privilege. The means by which a person can become known (and knowable) are ascribed by psychiatric and psychological knowledge and their schemata: for instance, one can be known (or know oneself) as depressed, 'emotionally intelligent', or versed in 'mindfulness'. Such discourses partly establish and sustain ways in which mental well-being is understood in the West. It is from this position that the export of psychiatric and psychological expertise to non-Western contexts may problematized. Can researchers and practitioners reconcile Western and non-Western mental health knowledge, beliefs and practices? What is the nature of this reconciliation? Would such a reconciliation aid or hinder recovery from mental 'illness'? Moreover, in attempting to 'do good', do researchers and practitioners risk misunderstanding, obscuring or misappropriating local practices in ways that are (epistemically) injurious? This panel will debate all of these points.
Accepted papers:
Session 1Paper short abstract:
The World Health Organisation currently exports Western psychiatric expertise to low/middle income countries. Our paper explores concepts for mental health in the Global North/South, and the epistemic injustices that may be inflicted without a paradigmatic shift in ideas of evidence for practice.
Paper long abstract:
The World Health Organization's Mental Health Action Plan 2013-2020 (MH-GAP) identifies actions for all member states to alleviate the global burden of mental ill health, including an obligation for mental healthcare to be delivered in a 'culturally appropriate' manner.
We argue that such a requirement is problematic, not least because such pronouncements remain framed by the normative prepositions of Western medical and psychological practice and their associated ethical, legal and institutional standpoints.
Western ideology of selfhood and individuality has been found to clash with local notions of the person-hood and community in many low and middle income countries (McGruder 1999; Mohatt et al 2008; Kirmayer et al 2011; Fernando 2012). As such, the export of evidence based Western mental health expertise will require different paradigms of evidence to deliver locally meaningful interventions for mental health.
Our paper presents concerns regarding methodologies for future research practice relating to representation and exclusion in the guise of epistemic injury, presumptive methodologies arising from the Western focus on the individual, and related ethical issues.
References
Fernando, G. (2012b) Bloodied but unbowed: resilience examined in a South Asian community, American Journal of Orthopsychiatry, 82, 3, 367-75.
Kirmayer, L. et al (2011) Rethinking resilience from indigenous perspectives, Canadian Journal of Psychiatry, 56, 2, 84-91.
McGruder, J. (1999) Madness in Zanzibar: 'schizophrenia' in three families in the 'developing' world. Ph.D. dissertation, University of Washington.
Mohatt, G. V. et al (2008) Risk, resilience, and natural recovery: a model of recovery from alcohol abuse for Alaska Natives, Addiction, 103, 2, 205-15.
Paper short abstract:
Our research draws from qualitative data collected during three months of fieldwork studying a local, small-scale, psychosocial and person-oriented alternative approach to responding to mental distress in Kathmandu. We put forward suggestions for policy makers and development practitioners.
Paper long abstract:
The magnitude of mental health issues in developing countries is nothing new. However, only recently has it been designated a 'global emergency' by a Movement for Global Mental Health (MGMH) - a movement that has its roots in the global North and assumes a model of care that emphasizes the need for psychiatric medication. Critics towards the MGMH are concerned about the psychiatrization of distress and the silencing of alternative ways of healing. We present qualitative data from three months of fieldwork studying a local, small-scale, psychosocial and person-oriented alternative approach to responding to mental distress in Kathmandu. Bringing the voices of the sufferers to the forefront and using a human rights framework, we found this local approach to be highly effective. We suggest ways in which learning from local responses to contextualized mental distress could inform policy and improve practice.
Paper short abstract:
This paper examines yoga-inspired therapies for treatment of mental health problems. By emphasising patients’ focus on self-knowledge, these novel forms of therapy promise a transformation of biomedical understandings of mental illness.
Paper long abstract:
Although the mainstream association with yoga in the western world is that with super-flexible bodies, the discipline’s foundational text, Patañjali’s Yoga Sutras, purports the principal focus of the practice to be stilling the modifications of the mind. Yoga, alongside other Vedic scriptures such as Samkhya and Dharma, sees individuals as being caught up in webs of behavioural and thought patterns created through attachments to sensory experiences and the material world. These citta vritti or mind complexes, however, can be alleviated through exercise in attention to one’s thoughts, bodily movements, breath and, generally speaking, self-study and self-knowledge. Traditional yoga texts inspire new treatment models developed in clinical psychiatric settings of the National Institute for Mental Health and Neuroscience (NIMHANS) in Bangalore, South India. In this paper I discuss the limitations and possibilities entailed by such attempts to combine yogic and biomedical concerns, knowledge and practice. Yoga-based therapy, I suggest, could be seen as contributing to the anticipated transformation from evidence-based medicine to individualised treatment. This is taking place through the emphasis on patients’ awareness and self-knowledge as well as on the necessarily temporal and processual nature of wellbeing that yoga promotes. With regards to the above, and following Ingold’s approach to landscape and dwelling, I explore how modern therapeutic applications of yoga invite us to reconsider mental health as a fundamentally environmental concern.
Paper short abstract:
Schizophrenia is a mental disorder, whose treatment in the West is based mostly on medication, while most people feel unable to get access to psychological treatment. This paper aims at shedding light on the role of culture and personality in understanding this disorder in depth.
Paper long abstract:
Schizophrenia refers to a severe mental disorder that affects the way a person perceives the world. It is a challenging disorder characterized by lots of misconceptions whose causes are still largely unknown. Despite the evolution of the West Sciences, medication still keeps the primary therapy for psychosis in the West overlooking vital issues, such as how people make sense of what has happened to them.
According to the British Psychological Society's report most people are unable to get access to psychological treatment. The most significant finding of this report is the need to concentrate on helping each person to make sense of their experience, emphasizing the role of culture in understanding this disorder in depth.
Luhrman (2014) drawing from her research, argues that people who suffer from schizophrenia, may hear "voices" differently depending on cultural context, giving as example that the voices are harsher in the United States and more benign in Africa and India.
Therefore, a fuller understanding of schizophrenia and the human psychological and social behavior through a cross-cultural perspective, will open a window for substituting the Western paternal treatment with a more empowering treatment, that focuses on the way we as a society think about and contribute to 'psychosis' and 'schizophrenia.
References
Cooke, A. 2014,Understanding Psychosis and Schizophrenia. Division of Clinical Psychology
Luhrmann, T. M. & Padmavati, R. & Tharoor, H. & Osei A, 2014 Differences in voice-hearing experiences of people with psychosis in the USA, India and Ghana: interview-based study. The Royal College of Psychiatrists