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2. Depression and Global Mental Health in the Global South: A Critical Analysis of Policy and Discourse.

Author

Limenih, Gojjam, MacDougall, Arlene, Wedlake, Marnie, and Nouvet, Elysee

Subjects
SUBSTANCE abuse treatment, MENTAL illness treatment, MIDDLE-income countries, MEDICAL protocols, AUDITING, MENTAL health, SELF-management (Psychology), HEALTH policy, DESCRIPTIVE statistics, WORLD health, DISCOURSE analysis, THEMATIC analysis, EVIDENCE-based medicine, MEDICAL screening, MEDICAL needs assessment, MENTAL depression, LOW-income countries, SUFFERING
Abstract

Over the past two decades, depression has become a prominent global public health concern, especially in low- and middle-income countries (LMICs). The World Health Organization (WHO) and the Movement for Global Mental Health have developed international guidelines to improve mental health services globally, prioritizing LMICs. These efforts hold promise for advancing care and treatment for depression and other mental, neurological, and substance abuse disorders in LMICs. The intervention guides, such as the WHO's mhGAP-Intervention Guides, are evidence-based tools and guidelines to help detect, diagnose, and manage the most common mental disorders. Using the Global South as an empirical site, this article draws on Foucauldian critical discourse and document analysis methods to explore how these international intervention guides operate as part of knowledge-power processes that inscribe and materialize in the world in some forms rather than others. It is proposed that these international guidelines shape the global discourse about depression through their (re)production of biopolitical assumptions and impacts, governmentality, and "conditions of possibility." The article uses empirical data to show nuance, complexity, and multi-dimensionality where binary thinking sometimes dominates, and to make links across arguments for and against global mental health. The article concludes by identifying several resistive discourses and suggesting reconceptualizing the treatment gap for common mental disorders. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Action to protect the independence and integrity of global health research

Author

Storeng, Katerini T., Abimbola, Seye, Balabanova, Dina, Mccoy, David, Ridde, Valery, Filippi, Veronique, Roalkvam, Sidsel, Akello, Grace, Parker, Melissa, Palmer, Jennifer, Abejirinde, Ibukun, Adebiyi, Babatope, Affun-Adegbulu, Clara, Ahlgren, Jhon Alvarez, Ahmad, Ayesha, Al-Awlaqi, Sameh, Aloys, Zongo, Amul, Gianna Gayle, Arthur, Joshua, Asaduzzaman, Muhammad, Asgedom, Akeza Awealom, Assarag, Bouchra, Atchessi, Nicole, Atkins, Salla, Badejo, Okikiolu, Baeroe, Kristine, Molleh, Bailah, Bazzano, Alessandra, Behague, Dominique P., Beisel, Uli, Belaid, Loubna, Bernays, Sarah, Bhuiyan, Shafi, Biermann, Olivia, Birungi, Harriet, Blanchet, Karl, Blystad, Astrid, Bodson, Oriane, Bonnet, Emmanuel, Bose, Shibaji, Bozorgmehr, Kayvan, Brear, Michelle, Burgess, Rochelle, Byskov, Jens, Carillon, Severine, Cavallaro, Francesca L., Chabeda, Sophie, Chandler, Clare, Chapman, Rachel, Chikuse, Francis F., Chinwe, Juliana Iwu, Cislaghi, Beniamino, Closser, Svea, Colvin, Christopher J., Cresswell, Jenny, da Cunha Saddi, Fabiana, Daire, Judith, Dalglish, Sarah, de Brouwere, Vincent, de Sardan, Jean-Pierre Olivier, Delvaux, Therese, Desgrees du Lou, Annabel, Diallo, Brahima A., Diarra, Aissa, Dixon, Justin, Doherty, Tanya, Dumont, Alexandre, Eboreime, Ejemai, Engelbrecht, Beth, Erikson, Susan, Faye, Adama, Fischer, Sara, Fournet, Florence, Fox, Ashley M., Francis, Joel Msafiri, Gautier, Lara, George, Asha, Gilson, Lucy, Gimbel, Sarah, Glenn, Jeff, Gopinathan, Unni, Gordeev, Vladimir S., Gradmann, Christoph, Graham, Janice E., Gram, Lu, Greco, Giulia, Grepin, Karen, Guichard, Anne, Gupta, Pragya Tiwari, Guzman, Viveka, Haaland, Marte E. S., Haggblom, Anna, Hagopian, Amy, Hammarberg, Karin, Handschumacher, Pascal, Hann, Katrina, Hasselberg, Marie, Hawkes, Sarah, Howard, Natasha, Hurtig, Anna-Karin, Hussain, Sameera, Hutchinson, Eleanor, Idoteyin, Ezirim, Infanti, Jennifer J., Irwin, Rachel, Islam, Shariful, Joarder, Taufique, John, Preethi, Johnson, Ermel, Johri, Mira, Justice, Judith, Kabore, Charles, Kadio, Kadidiatou, Kamwa, Matthieu, Kelly, Ann H., Kenworthy, Nora, Kittelsen, Sonja, Kloster, Maren Olene, Kocsis, Emily, Koon, Adam, Kumar, Pratap, Lal, Arush, Lange, Isabelle, Lanthorn, Heather, Lees, Shelley, Lexchin, Joel, Lie, Ann Louise, Limenih, Gojjam, Litwin-Davies, Isabel, Lodda, Charles Clarke, Lonnroth, Knut, Manton, John, Manzi, Anatole, Manzoor, Mehr, Marchal, Bruno, Marten, Robert, Matsui, Mitsuaki, Mbewe, Allan, Mc Sween-Cadieux, Esther, McGoey, Linsey, McNeill, Desmond, Mendenhall, Emily, Mendez, Claudio A., Mirzoev, Tolib, Mohammed, Shafiu, Moland, Karen Marie, Molyneux, Sassy, Mumtaz, Zubia, Murray, Susan Fairley, Nambiar, Devaki, Nelson, Erica, Nieto-Sanchez, Claudia, Norheim, Ole Frithjof, Nouvet, Elysee, Obare, Francis, Okungu, Vincent, Onarheim, Kristine Husoy, Ostebo, Marit Tolo, Ouattara, Fatoumata, Ozawa, Sachiko, Pai, Madhukar, Paina, Ligia, Parashar, Rakesh, Paul, Elisabeth, Peeters, Koen, Pennetier, Cedric, Penn-Kekana, Loveday, Peters, David, Pfeiffer, James, Pot, Hanneke, Prashanth, N. S., Preston, Robyn, Puyvallee, Antoine de Bengy, Rahmalia, Annisa, Reid-Henry, Simon, Rodriguez, Daniela C., Ronse, Maya, Sacks, Emma, Samb, Oumar Malle, Sanders, David, Sarkar, Nandini, Sarriot, Eric, Scheel, Inger Brummenaes, Schwarz, Thomas, Scott, Kerry, Seeley, Janet, Seward, Nadine, Shannon, Geordan, Shearer, Jessica, Shelley, Katharine, Sherr, Kenneth, Shiffman, Jeremey, Simard, Frederic, Singh, Neha S., Soors, Werner, Springer, Rusla Anne, Strong, Adrienne, Sundby, Johanne, Taylor, Stephen, Tetui, Moses, Topp, Stephanie M., Tsofa, Benjamin, Turcotte-Tremblay, Anne-Marie, Undie, Chi-Chi, Van Belle, Sara, Van Heteren, Godelieve, van Rensburg, Andre Janse, Sriram, Veena, Venkatapuram, Sridhar, Wagenaar, Bradley H., Wallace, Lauren, Walugembe, David R., Wariri, Oghenebrume, Whiteside, Alan O. B. E., Yakob, Bereket, Zakayo, Scholastica, Zitti, Tony, Zwi, Anthony, Centre population et développement (CEPED - UMR_D 196), Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5), and Signatories

Subjects
Project commissioning, media_common.quotation_subject, environmental health, Commission, Public administration, 03 medical and health sciences, Politics, 0302 clinical medicine, Political science, Agency (sociology), Global health, 030212 general & internal medicine, media_common, 030503 health policy & services, Health Policy, Public Health, Environmental and Occupational Health, Censorship, 16. Peace & justice, 3. Good health, Negotiation, Editorial, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Human medicine, 0305 other medical science, International development
Abstract

In a recent Viewpoint in the Lancet , some of us shared our experience of censorship in donor-funded evaluation research and warned about a potential trend in which donors and their implementing partners use ethical and methodological arguments to undermine research.1 Reactions to the Viewpoint—and lively debate at the 2018 Global Symposium on Health Systems Research —suggest that similar experiences are common in implementation and policy research commissioned by international donors to study and evaluate large-scale, donor-funded health interventions and programmes, which are primarily implemented in low resource settings. ‘We all have the same stories’, was one of the first comments on the Viewpoint, followed by many private messages divulging instances of personal and institutional pressure, intimidation and censorship following attempts to disseminate unwanted findings. Such pressure comes from major donors and from international non-governmental organisations (NGOs) obliged to have an external assessment but who then maintain a high degree of confidentiality and control. That such experiences are widespread reflects the deeply political nature of the field of ‘global health’ and the interconnections between priority setting, policy making and project implementation, which sit within a broader set of deeply entrenched power structures.2 3 Researchers in this field routinely find themselves working within—and studying—complex power relations and so experience challenges in negotiating their own position between interests of commissioning agencies and funders, implementers and country governments, as well as those of their own research institutions and their partnerships with other researchers spanning high-income, middle-income and low-income countries.4–7 They often receive research funding from major donor agencies like the UK Department of International Development (DFID), the US Agency for International Development (USAID), the Agence Francaise de Developpement (AFD), UNITAID and the Bill and Melinda Gates Foundation,8 who commission evaluations for their own funded projects, even though they have …

Published
2018

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