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Paper short abstract:

This paper is an ethnographic study of the relationship between Global Mental Health interventions in a refugee settlement in Uganda and the country’s self-reliance policy. It argues that these interventions are used to deresponsibilise institutions, medicalising refugees' socio-economic distress.

Paper long abstract:

This paper offers ethnographic reflections on the introduction of Global Mental Health interventions in a refugee settlement in Uganda, and on their relationship to the country’s self-reliance refugee policy. Under Uganda’s self-reliance policy, often misleadingly depicted as a “humanitarian success story”, refugees are encouraged to become economically independent actors - a task that proves challenging for many due to insufficient basic humanitarian assistance. Since 2018, small Health Centres in Ugandan refugee settlements also include a Mental Health ward. The influence of Global Mental Health thinking and policy is evident in this recent addition, as the field is notably very reliant on psychotropic treatment and has in recent years been advocating for the expansion of mental health services and their integration in primary care ones, in an attempt to "bridge the treatment gap". Drawing on 13 months of in-depth ethnographic fieldwork in the refugee settlement of Palabek, northern Uganda, this paper argues that such programmes are anything but neutral actors in the Ugandan refugee response, directly supporting the “self-reliance agenda” by establishing an explicit connection between mental health and economic self-sufficiency. Consequently, refugees who struggle to navigate uncertain economic landscapes and to rebuild their lives in a displacement setting where assistance is constantly reduced are often diagnosed with psychiatric conditions and prescribed psychotropic treatment. This paper warns that the introduction of global mental health interventions in emergency settings risks medicalising socio-economic distress, de-responsibilizing governmental and humanitarian institutions and allowing them to disengage from issues of chronic poverty and profound inequality.