Call for papers: Globalising Mental Health or Pathologising the Global South?

Call for Papers

 Disability and the Global South:

An International Journal

www.dgsjournal.org

 Globalising Mental Health or Pathologising the Global South?

Mapping the Ethics, Theory and Practice of Global Mental Health

 Guest Editors: China Mills and Suman Fernando

Currently, the World Health Organization (WHO) and the Movement for Global Mental Health, are calling to ‘scale up’ psychiatric treatments, often specifically access to psychiatric drugs, globally, and particularly within the global South. Amid these calls, others can be heard, from those who have received psychiatric treatments in the global North and South, and from some critical and transcultural psychiatrists, to abolish psychiatric diagnostic systems and to acknowledge the harm caused by some medications. Furthermore, voices have also been raised advocating the need to address social suffering, personal distress and community trauma in the global South in a context of poverty, political violence and natural disasters; and calling for people given psychiatric diagnoses to have their human rights protected by disability legislation.

The Movement for Global Mental Health frames distress as an illness like any other, calling for global equality in access to psychiatric medication. However there is a growing body of research from the global North that documents the harmful effects of long-term use of psychiatric medication and questions the usefulness of psychiatric models (see Angell, 2011; and Whitaker, 2010). This raises concerns; about the ‘evidence base’ of Global Mental Health; about increasing access to psychiatric drugs globally; about the promotion of psychiatric diagnoses such as ‘depression’ as an illness; and changes the terms of debate around equality between the global South and North. What are the ethics of ‘scaling up’ treatments within the global South whose efficacy are still hotly debated within the global North?

There are other concerns about Global Mental Health; that it exports Western ways of being a person and concepts of distress that are alien to many cultures, and imposed from the ‘top down’, potentially repeating colonial and imperial relations (Summerfield, 2008), and that psychiatry discredits and replaces alternative forms of healing that are local, religious or indigenous (Watters, 2010). Alongside this, many users and survivors of the psychiatric system argue for the right to access non-medical and non-Western healing spaces, and to frame their experience as distress and not to depoliticise it as ‘illness’ (PANUSP, 2012). Yet for the pharmaceutical industry – there is a huge financial incentive in both expanding the boundaries of what counts as illness, and expanding across geographical borders into the often ‘untapped’ markets of the global South. This marks a process of psychiatrization, where increasing numbers of people across the globe come to be seen, and to see themselves, as ‘mentally ill’ (Rose, 2006).

This is the context in which this special issue is situated. We would like to invite contributions that are inter-disciplinary and that ground rich conceptual work in ‘on the ground’ practice. We really welcome papers that try to grapple with the complexity and the messiness of debates around Global Mental Health. We hope to explore a range of issues and address some difficult questions, including (but not exclusively);

•  Issues over access to healthcare and the right to treatment in the global South, and how these debates may be different for mental distress compared to physical illness and disability

• Critical analysis of the evidence base of Global Mental Health and the ‘treatment gap’ in mental health care between the global South and North
• Global mental health as a disabling practice
• Examples of mental health activism and lobbying within the global South as well as resistance
• Dilemmas and accounts of ‘doing’ mental health work in the global South, notably in contexts of poverty
• The globalisation of psychiatry; accounts of how psychiatry travels, and of whether counter-approaches to mental health (alternative or indigenous frameworks) may travel too
• Accounts of alternative ways of understanding health, distress and healing – counter-epistemologies and plural approaches from the global South and North.
• Issues around colonialism, imperialism and psychiatry, and of possibilities for decolonising psychiatric practises
• The role of the pharmaceutical industry and its connections with psychiatry – the global production, distribution and marketing of drugs – how drugs travel globally.
• An exploration of the ethical dimensions of Global Mental Health, and who has the power to set the Global Mental Health agenda.
• Should wellbeing and distress be addressed by health policy and medical funding, or be understood outside of a medical framework?
• What are Global Mental Health interventions claiming to ‘treat’?
• Is there a role for psychiatry within Global Mental Health?
• Critical approaches to the Movement for Global Mental Health; can and should mental health be global?

We particularly welcome contributions from those who have lived experience of a psychiatric diagnosis, or of distress, and those who work in the global South, or in contents of poverty, on mental health issues. Short reports and stories, are equally encouraged alongside longer theoretical papers. Papers should be no more than 8000 words, with an abstract of 150-200 words.

Those wishing to submit an article or express an interest in contributing, please email China Mills china.t.mills@gmail.com. Manuscripts will be sent anonymously for peer review, and comments and recommendations relayed to authors through the editors. Instructions on formatting for the journal can be found here: http://dgsjournal.org/information-for-authors/

All contributions should be submitted no later than: 21^st July 2013

New issue of Review of Disability Studies (8:2) is now available

The new issue, Volume 8 Issue 2, of the Review of Disability Studies is now posted online at www.rds.hawaii.edu.

Articles include:

• Teacher Educators’ Varied Definitions of Learning Disabilities – Rachael Gabriel (University of Connecticut, USA) and Jessica Lester (Washington State University, USA)
• Parental Chronic Illness: Current Limitations and Considerations for Future Research  - J.W. (Bill) Anderson (Illinois State University, USA), Caitlin A. Huth (Eastern Illinois University, USA), Susan A. Garcia (Western Governors University, USA) and Jennifer Swezey (Advocate Lutheran Children’s Hospital, USA)
• Disability Studies and the Language of Mental Illness – Katie Aubrecht (University of Toronto, Canada)
• Education of Children with Disabilities as Constructed within a Russian Newspaper for Teachers – Maria Oreshkina (University of Scranton, USA), Jessica Lester (Washington State University, USA) and Sharon Judge (Old Dominion University, USA)
• Conceptualizing the “Dis” of Our Abilities: A Heuristic Phenomenology – Jamie Buffington-Adams (Indiana University, USA)

The new issue also includes Book and Media Reviews (of The Stress of Combat, the Combat of Stress: Changing Strategies towards Ex-Service Men and Women and Historicizing Fat in Anglo-American Culture) as well as Disability Studies Dissertation Abstracts.

CFP: ‘Living With Social Categories: Ethnicity, Mental Health, and Learning Disability in An Age Of Austerity’ Conference (June, UK)

Title: Living With Social Categories: Ethnicity, Mental Health, and Learning Disability in An Age Of Austerity

Date: 18th June 2012

Place: The Open University, Milton Keynes

Key Note Speaker: Professor James Nazroo (University of Manchester, UK)

Chair: Professor Richard Jenkins (University of Sheffield, UK)

Brief Description: This one day interdisciplinary conference seeks to re-ignite debates about the lived consequences of the category of Black and Minority Ethnic (BME) in statutory services. Using mental health (MH) and Learning Disability (LD) as reference points the conference will explore fresh understandings and theorisations for how BME plays out within the care/control function of the state. Conference organisers acknowledge that ‘Learning Disability’ is contested by advocacy groups; however it is employed here to reflect its use in statutory services. 

The conference is hosted by the Faculty of Health and Social Care (The Open University) and the Race and Ethnicity Study Group (British Sociological Association).

Background: Notwithstanding recent advancements, there remains a disjuncture between theory and praxis in the sociology literature on ethnicity. While it is now accepted that ethnicity is an ontologically unstable category (Alexander 2006), writers arguably over-emphasise ethnicity qua ethnicity at the expense of material and psychic consequences of ethnic categorisations (Carter and Fenton, 2011). However there is long-standing evidence that the category BME has consequences for lived experience in statutory services where the state’s care/control function is thrown into sharp focus. Consequently although less likely to receive welfare services, BMEs are over-represented in the coercive aspects of ‘caring’ services. In MH and LD for instance, some BME groups are less likely to access preventative services but more likely to be detained for involuntary treatment (Mir et al, 2001; Care Quality Commission and National Mental Health Development Unit, 2011). Thus ‘[p]aradoxically, they receive the MH services they don’t want, but not the ones they do or might want’ (Keating and Robertson, 2004, p446). While the applied literature has helpfully evidenced these inequalities, it struggles to satisfactorily operationalise ethnicity to reflect current substantive understandings of fluidity (Nazroo, 2011; Salway et al 2009, 2011). The present age of austerity is likely to exacerbate longstanding inequalities, hence the timely need to refocus on the sociological processes which lead to embodiment of social categories such as BME, MH, and LD.      

We welcome papers from postgraduate and early career researchers that address the following themes:

• What sociological theories are useful in explaining/could explain the disproportionate representation of BME in MH and LD services?
• What are the possibilities, limitations and challenges of using ethnic categorisations to describe and explain inequalities in the provision of statutory services? Is an integrative (or intersectional) approach more useful?
• Interrogating the category of BME: Although widely used in applied studies, BME is rarely explored critically. What is the history of the category; whose interests does it serve?
• Spaces of care/control: ‘Space’ could be geographical, virtual, material, and mental – how is care/control operationalised; what are the mechanisms?
• How can the gap between theory and practice be reduced? Is it an issue of dissemination? If so, how can this be bridged?

Deadline for abstract submission: 1st May 2012

BSA members and non-members, please contact Godfred Boahen (g.f.boahen@open.ac.uk) to reserve a place at the conference

Second Keynote’s Title and Abstract Announced for Theorising Normalcy and the Mundane: 3rd International Conference (Chester, UK: June 2012)

If you need any further encouragement to attend the Theorising Normalcy and the Mundane: 3rd International Conference at the University of Chester (June 26th-27th 2012), here are details of our second keynote speaker: China Mills, who will be discussing…

Spoof: Faking Normal, Faking Disorder

 Abstract:

“[T]he most potent weapon in the hands of the oppressor is the mind of the oppressed” (Steve Biko, 1978: 92).

How do spoof, ‘fake’ psycho-pharmaceutical adverts work to queer the ‘real’ adverts, and the disorders they market the drugs for? How do they crip conceptions of normality and sanity?

These spoof ads point to a creeping psychiatrization of our everyday lives, a psychiatrization globalised through ‘mental health literacy’ campaigns and psycho-education in low-income countries of the global South. This paper will explore how this psychiatrization interlaces with colonial subject formation. For while pharmaceutical adverts and psychiatry interpellate, hail, ‘make up’, and elicit particular subjects – as pharmaceutical citizens, neurochemical selves; there is also a force at work in ‘making up’ these subjects, through the power of the gaze, that for Frantz Fanon; objectifies, seals, crushes and abrades. But how does medication broker subjectivity? How does it, as the ads claim, restore us to ourselves, make us whole again?

This paper will attend to the visual, to mechanisms of looking, to psychiatric fields of visibility. In India, many mental health Non-Governmental Organisations (NGOs), go to rural areas to ‘identify’ people with ‘mental illness’, making them visible through diagnostic systems developed in the global North, and medicating them. They say these people are ‘invisible people’. So how do medication and psychiatry make people visible? What ways of ‘seeing’ do they make possible? For Homi Bhabha (1994) invisibility does not signify lack; instead it works to disrupt identification and interpellation through refusing presence. Thus how might these ‘invisible people’, those who refuse to ‘reproduce hegemonic appearances’ (Scott, 1990), work to disrupt the gaze of psychiatry? Might invisibility; the doubling, dissembling image of being in two places at once (Bhabha, 1994), work as both a ‘symptom’ of oppression, and a means of subversion?

To read psychiatrization as a colonial discourse opens up possibilities to explore how the secret arts, the hidden transcripts, of resistance of the colonised might be read in people’s resistance to psychiatry – from the slyness of mimicking normality, to the mockery of ‘spoof’ drug adverts. How the ‘disembodied eyes’ of the subaltern that see but are not seen, might disrupt and subvert both the presumed ‘I’ of the unitary ‘whole’ subject, and the surveillant, penetrative ‘eye’ of psychiatry.

How medication might work to make people visible is more troubling if we read invisibility as camouflage and potential subversion. It suggests that medication might make people more vulnerable in their submission to sociality, in their domestication. But with what conceptual tools can we establish whether being invisible is an act of resistance through camouflage, a strategy solely for survival, or a mark of adaptation and assimilation? Perhaps certain forms of psychiatric ‘looking’ allow us not to ‘see’; enable us to encounter difference and yet defer it, domesticate it– to recuperate the hegemonic, the status quo, in the final look.

In this paper I will explore how spoof adverts may mimic ‘real’ ads in a similar way to how some people mimic normality, slyly; a ‘resemblance and menace’ that mocks the power of the ‘real’ and the ‘sane’, their very power to be a model (Bhabha, 1994:86). Will you be able to tell the difference between the ‘real’ and the ‘fakes’?

 

China Mills is in the final stages of writing up her PhD thesis, which employs a colonial discourse analysis of Global mental Health’s ‘scale-up’ of psychiatry, and the psychiatrization of India. She is funded by the Education and Social Research Institute, at Manchester Metropolitan University, UK. China has worked within, and been allied to, the UK and Indian psychiatric user/survivor movement for some years, and is a member of the editorial collective of Asylum magazine for democratic psychiatry (www.asylumonline.net).

For more information on the conference click here.

Details of Next DRF Seminar: 8th February 2012 (1pm-3pm)

DRF Seminar Series: Seminar #4

Date/Time: 8th February 2012 (Weds) 1pm-3pm

Venue: Room 10111 in the Arundel Building, City Campus, Sheffield Hallam University (More information on the venue can be found here.)

• China Mills (Education and Social Research Institute, Manchester Metropolitan University): Globalising Disorder; Crossing Borders through Disorders

Abstract: In an increasingly globalised psycho-pharmacological world, access to psychiatric medication, ‘scaling-up’ of psychiatric services, and closing the ‘treatment gap’ between low and high income countries, are equated with social justice and equality. In this space, mental illness is framed as akin to physical illness; and the argument is made that just as AIDS medications should be available to those in low-income countries, so should psychiatric medications. The incitement of mental health into a discourse of global emergency and crisis suggests an abnormal deviation from a normal order, yet mental illness may also be read as a ‘normal’ reaction to that (dis)order – as a ‘healthy’ response to the ‘unhealthy’ globalisation of Neoliberalism. Yet making the claim that mental health problems, such as Depression, are a ‘normal’ response to inequitable market relations in the global South, may also be normative, as it glosses over a simultaneous globalisation; that of bio-psychiatric explanations of distress. Just as psychiatric diagnostic systems, such as the Diagnostic and Statistical Manual (DSM) blur the borders of normality and abnormality, enabling increasing experiences to be conceptualised in psychiatric terms; they also enable psychiatric disorders to cross geographical borders, enabling the psychiatrisation of new populations, and new ‘emergent markets’ for the pharmaceutical industry. For example,in India, in response to a spate of farmer suicides that occurred due to neoliberal agricultural reforms, the Indian Government launched a study to find a genetic cause for suicide, and campaigners called for anti-depressants to be more widely available to farmers. But what does it mean to frame the distress caused by economic reforms as ‘mental illness’, and provide interventions that work at the level of individual brain chemistry and genes, and that are part of the same neoliberal rationale that led to distress in the first place? This paper will explore what the framing of mental illness as akin to physical illness and disability, makes possible within the field of Global Mental Health, with a specific focus on India. 

• John Quinn (Department of Politics, University of Sheffield): New Labour and Disability Politics

Abstract: When the ‘New’ Labour government came into power in 1997, it was seen by many previously marginalised groups as an opportunity to have more say in the way the country was run. One of these was a ‘new social movement’ calling for disability rights – which arguably only came into existence in Britain during the mid-1970s and had continued developing during 18 years of Conservative rule. However there had been little unity between different strands of this movement, due not only to the wide range of disabilities represented, but also because of disputes over both ends and means. After a Labour government lasting 13 years this research aims to use a variety of methods to see whether it proved lucky or unlucky for disabled people in Britain, seeing to what extent lives have changed and how much of this is due to the way the government and social movement have impacted on and affected each other.

Next Seminar: 15th March 2012 (Thurs) 1.30pm-3.30pm

Slot 9: Sarah Thompson (Department of Education, Childhood and Inclusion, Sheffield Hallam University): Title TBC

Slot 10: Tom Andrews (Department of Education, Childhood and Inclusion, Sheffield Hallam University): Exploring the impact of sexuality on the lifeworld of adolescents with autism