Views & Reviews Personal View

“Global mental health” is an oxymoron and medical imperialism

BMJ 2013; 346 doi: (Published 31 May 2013) Cite this as: BMJ 2013;346:f3509
  1. Derek Summerfield, honorary senior lecturer, Institute of Psychiatry, King’s College, and consultant psychiatrist, South London and Maudsley NHS Foundation Trust
  1. derek.summerfield{at}

Why do we assume that Western notions of psychiatry translate to other settings, asks Derek Summerfield

A remarkable thing about psychiatry is that its primary object—what is referred to as mental disorder—remains undefined. Bar organic categories, mental disorders are not facts of nature but cobbled together syndromes, with psychiatrists as the cobblers. Given that mental disorders are also grounded in Western culture, how do they translate to non-Western settings?1

Do the methods that identify depression in Spain identify the same thing in Sudan? The World Health Organization has been describing depression as carrying the greatest global burden of all diseases,2 which is a bizarre claim and testament to the dangers of viewing a psychiatric category as if it were a disease like any other disease. Is depression really more burdensome than AIDS (currently 34 million cases, with 1.8 million deaths in 2010), tuberculosis (8.7 million new cases in 2010, with 1.4 million deaths), or malaria (216 million cases in 2010, with 665 000 deaths)?

An emergent discipline entitled “global mental health,” backed by WHO, the US National Institute of Mental Health, and the …

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