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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?

Cox, N and Webb, L (2016) 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? Sociology of Health and Illness: a journal of medical sociology, 37 (5). pp. 683-697. ISSN 1467-9566

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Abstract

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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