Saturday, November 21, 2015
Defining Global Mental Health
Global Mental Health & Psychiatry Newsletter
Global Mental Health Forum
Prof. Vincenzo Di Nicola, MPhil, MD, PhD, FAPA
Université de Montréal
Defining Global Mental Health & Psychiatry
Issue: What is Global Mental Health & Psychiatry?
Forum Question: Is there an emerging consensus for re-visioning mental health and psychiatry in a global way that includes social concerns, recognizes cultural diversity, and embraces the mission of public health, comparing mental illness across cultures and around the world?
A metaphor for health: If we imagine health as a river winding around the world, there are tributaries which feed into the larger river, which flows into the sea.
The river of health and its tributaries:
* Medicine and well-being is the river
--“Global Health & Medicine” is its name
* Psychiatry is a tributary, with many rivulets:
--Transcultural or simply Cultural Psychiatry (Lim, 2006)
--HBM Murphy (1982) of McGill defined this field as Comparative Psychiatry, “the international and intercultural distribution of mental illness”
* Public Health and Epidemiology are tributaries
In this view, Global Mental Health & Psychiatry is the emerging term for the tributary that collects all the rivulets (e.g., Social Psychiatry, Cultural Psychiatry, and Public Health) merging into the river of Global Health & Medicine (Cf. Okpaku, 2014; Sorel, 2012).
These rivulets and tributaries represent broader envelopes or contexts for psychiatry than more narrowly-defined disease-specific (e.g., mood disorders, eating disorders), age-specific (e.g., child, geriatric psychiatry), or intervention-specific (e.g., by therapeutic approach – psychodynamic psychiatry; or by activity – consultation-liaison psychiatry, integrated care) approaches.
Challenges for GMH:
1. Re: “Global”
Why does global mean?
(Cf. Okpaku, 2014; Sorel, 2012)
A global – i.e., “general” – approach?
A globally “embracing” approach, collecting and integrating approaches, schools, and traditions?
Global as in “worldwide” – in a democratic way or an imperialistic way?
(Cf. Ethan Watters, Crazy Like Us, 2011)
2. Re: “Mental Health” vs. Psychiatry
Why mental health instead of psychiatry?
Marketing (health is more appealing than illness or “disorder”)
vs. identity (as physicians)
3. Who is invited/feels welcome under this new umbrella?
Psychiatrists? Psychologists? The therapeutic communities of practice?
Public Health and Epidemiology?
Lim, Russell F. (2006). Clinical Manual of Cultural Psychiatry. Washington, DC: American Psychiatric Publishing, Inc.
Murphy, H.B.M. (1982). Comparative Psychiatry: The International and Intercultural Distribution of Mental Illness. Berlin: Springer-Verlag.
Okpaku, Samuel, Ed. (2014). Essentials of Global Mental Health. Cambridge, UK: Cambridge University Press.
Sorel, Eliot, Ed. (2012). 21st Century Global Mental Health. Burlington, MA: Jones & Bartlett.
Watters, Ethan (2011). Crazy Like Us: The Globalization of the American Psyche. New York: Free Press.