Introduction

In this chapter, I want to explore a particular aspect of the Movement for Global Mental Health that is relevant to the concerns of this book: how it situates what it calls ‘mental disorders’ within a wider global discourse of illness and disability. The Movement for Global Mental Health is an increasingly influential international network of individuals and organisations that, alongside the World Health Organization (WHO), aims ‘to scale up the coverage of services for mental disorders in all countries, but especially in low-income and middle-income countries’ (Lancet Global Mental Health Group, 2007, 87). While what is meant by services here includes some mention of psychosocial and community interventions, in general, recommendations for first-line treatment in low- and middle-income countries seem to rest – for resource reasons (WHO, 2001b) – on psychiatric medications.

In an attempt to raise awareness of mental health internationally, the Movement for Global Mental Health points out the lack of resources dedicated to mental health in comparison to those for physical illnesses, such as for heart disease. To make this claim, it frames mental distress as ‘illness’ that is akin to physical illness, and all of these illnesses as disabilities. It calculates the high ‘burden’ of these different types of disability and then points out that many governments pay insufficient attention to mental health. Following this logic, a call is made for increased global equality both in terms of attention to, and funding of, healthcare for physical illness and mental illness, and in terms of access to treatments.

In some ways, this seems like an admirable attempt to raise awareness of the importance of mental health. However, I want to use this chapter to explore how the claim that mental distress is akin to physical illness is problematic in a number of ways. In an attempt to navigate some of these issues, this chapter will first explore the Movement for Global Mental Health's assumption that mental distress is caused by a biochemical imbalance that is chronic and disabling. It will explore how this may be problematic because it goes against much user/survivor advocacy that emphasises distress not ‘illness’ and calls attention to how experiences of distress are embedded within social contexts.