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Accepted Paper:
Paper 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.
Different ways to become known and knowable as a person: ideas, ideology and epistemic injustices in Global Mental Health
Session 1