A critical review of the Lancet Commission on global mental health and sustainable development: time for a paradigm change

Abstract

In October 2018, the UK government, positioning itself as a global leader in mental health, hosted a Global Ministerial Mental Health Summit. The event was scheduled to coincide with the publication of the Lancet Commission on Global Mental Health and Sustainable Development. Despite claiming a public health and social determinants approach, the report focused on the importance of ‘closing the treatment gap’ through the use of Western diagnostic tools and interventions. In response, coalitions of mental health activists and service-users organized open letters detailing their concerns with the summit and report. Among these concerns were the ways in which recent UK government policies, particularly welfare reform, violated the rights of persons with disabilities; the lack of stakeholder representation and involvement in the report; and the continuation of the colonial legacy in which the ‘North drives the South.’ Expanding on the concerns raised by this coalition of activists and service-users, we argue that a focus on societal (structural) determinants and political economy could open new possibilities for global mental health beyond narrow individualized interventions. Additionally, we suggest that a politically informed societal determinants of health framework is needed in order to move the Global Mental Health Movement in a more emancipatory direction.