Poles apart: does the export of mental health expertise from the Global North to the Global South represent a neutral relocation of knowledge and practice?
Open accessAbstract
The World Health Organization's Mental Health Action Plan 2013-2020 identifies actions for all member states to alleviate the global burden of mental ill health, including an obligation for mental healthcare to be delivered in a 'culturally appropriate' manner. In this article we argue that such a requirement is problematic, not least because such pronouncements remain framed by the normative prepositions of Western medical and psychological practice and their associated ethical, legal and institutional standpoints. As such, when striving to export Western mental health expertise, different paradigms for evidence will be necessary to deliver locally meaningful interventions to low and middle income countries. Our discussion highlights a number of philosophical concerns regarding methodologies for future research practice, including those relating to representation and exclusion in the guise of epistemic injury, presumptive methodologies arising from Western notions of selfhood, and related ethical issues.
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Mental health programmes in the Global South have often perpetrated epistemic violence or injustice by validating one knowledge system over another, replicating colonial dynamics and obscuring real needs.
“mental health programmes, particularly when implemented in the Global South, have often been noted to perpetrate forms of 'epistemic violence' or 'injustice' (Watters 2017;Cox and Webb 2015;Burgess 2022), instances in which one system of knowledge is validated over another, thus replicating colonial dynamics of knowledge production and imposition, frequently resulting in real needs being obscured.”
From Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda (2023) · cites this paper as Cox and Webb 2015
Resistance to psychoactive medication ranges from grassroots user/survivor movements that denounce human rights violations to therapeutics oriented toward non-pharmacological recovery-based frameworks.
“Resistance against psychoactive medication ranges from grassroot networks such as “user” and “survivor” movements, denouncing the ways in which psychopharmaceuticals can be used to violate human rights, to the rise of therapeutics explicitly oriented towards non-pharmacological, 'recovery'-based frameworks (Cox and Webb 2015;Giordano 2014).”
From Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda (2023) · cites this paper as Cox and Webb 2015
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Torre, C. (2023) · London School of Economics and Political Science (LSE) · doi:10.21953/lse.00004557
- Authors
- Cox, N., & Webb, L.
- Affiliations
- Manchester Metropolitan University (GB)
- Corresponding author
- Cox, Nigel
- ORCID
- Venue
- Sociology of Health & Illness
- Publisher
- Wiley
- Published
- 2015-02-13
- Volume
- 37
- Issue
- 5
- Pages
- 683-697
- ISSN
- 0141-9889 (ISSN-L)
- 1467-9566
- OpenAlex
- W1981220424
- Cited by
- 45
- References
- 9
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 8 · 2023: 1 · 2022: 1 · 2021: 11 · 2020: 7 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 4
- FWCI
- 4.91
- Type
- journal article
- Language
- en
- Open access
- green
- e-space.mmu.ac.uk
- Licence
- Locations
- Sociology of Health & Illness (publishedVersion)
- PubMed (publishedVersion)
- e-space (Manchester Metropolitan University) (acceptedVersion)
- e-space (Manchester Metropolitan University) (acceptedVersion, other-oa)
- e-space (Manchester Metropolitan University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Keywords
- cultural appropriateness, Western epistemology, selfhood, research ethics, low- and middle-income countries, global mental health, epistemic injustice
- MeSH terms
- Mental Disorders, Developing Countries, Health Status, Humans, Human Rights, Medicine, Traditional, Mental Health, Mental Health Services, Residence Characteristics, Self Concept, Sociology, Medical, Global Health, World Health Organization, Developed Countries, Cultural Competency
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