The Cultural Politics of Mental Illness: Toward a Rights-Based Approach to Global Mental Health

A call to action: Re-activating the latent human factor for achieving the UN SDGs-cultivating courageous partnerships and compassionate human systems

The raison d'être for psychotherapy1 is to address individual suffering and distress. The sustainable development goals address suffering and distress on a global scale in the context of threats to the survival of our communities and planet.

OBJECTIVE

We propose scaling up therapeutic principles for collective impact and nurturing therapist commitment beyond the therapy room, to activate and sustain compassion-in-action at the community system level.

DESIGN

The SDGs represent the strength of collective human concern and action coming together. At the half-way point, we are falling dangerously short of our targets, requiring an urgent response. The tenet of this paper is that the weakest link in our journey is not technical capability or finances, or even the impact of multiple intersecting crises, but our ability to collaborate for sustained action-it is the human factor-hence, we need a psychologically informed response.

METHOD

Notably, least 'visible' is SDG17, the umbrella goal designated means of implementation, through partnership. Partnership has been treated as a transactional element of SDG projects, rather than the vital heartbeat connecting daily actions to the 2030 vision. Partnership is about investing in relationships and a commitment to working together with a common purpose-the bailiwick of psychological therapists.

RESULTS

We propose an architecture to support the development of courageous partnerships and compassionate systems.

CONCLUSION

Compassion uniquely potentiates global action on wicked problems.

Mad activisms in mental health: a integrative review

The following text presents the results of a integrative review whose purpose was to identify and analyze the production of academic literature on mad activism in the field of mental health and its link with the notions of disability and neurodiversity. From searches conducted in May 2023 in the Web of Science, Scopus, and PubMed databases, 52 articles were selected, and thematic content analysis strategies were applied. The results account for various articulations between the concepts addressed, establishing a critical look at the biomedical model in mental health. In the forms of mad activism, the human rights approach, the fight against stigma and its influence on the reform processes of the mental health system become relevant. On the other hand, a framework of social justice, identity policies and practices of mutual support from the community are established. As a whole, they emphasize methodological innovations and an intersectional perspective on the production of knowledge. It is concluded that it is possible to situate madness as a field of constitution of a political actor and epistemic subject. Based on this, possible lines of research on mad activisms in Latin America are formulated.

Negotiating human rights narratives in Global Mental Health: Autism and ADHD controversies in Brazil

Promoting evidence-based treatments and the human rights of people living with mental illness are the two pillars of Global Mental Health (GMH). Critics counter that human rights narratives must also include social justice frameworks. We draw on the cases of autism and ADHD in Brazil to discuss the role of human rights in mental health in the context of GMH. A human rights perspective involves citizenship rights for individuals living with mental distress and provides a framework to problematise the logic of GMH centred on individual rights and rights to treatment. We begin with an overview on human rights discussions in GMH and examine the introduction of human rights discourses in the Brazilian psychiatric reform. We then explore how autism and ADHD became priorities of GMH interventions as well as the constitution of two styles of activism and mobilisation of human rights around these conditions. One follows the universal public health logic and promotes health as a social right. The other follows the logic of parents' associations that redefined those conditions as forms of disability to advocate for specialised services and interventions. Finally, we discuss these forms of human rights mobilisation and their implications for Brazilian mental health and GMH.

Moving Toward a Human Rights Approach to Mental Health

The University of Florida Counseling and Wellness Center (UFCWC) has implemented peer support and professional training programs to address human rights identified within advocacy groups comprised of individuals who have, themselves, been diagnosed with mental illness. These programs are moving the UFCWC toward fulfilling a 2017 United Nations report emphasizing rights-based professional training, provision of genuine informed consent, and availability of non-compromised peer support alternatives. Collaborating with student peers, four UFCWC faculty members have facilitated forms of peer support developed within service-user movements, while openly identifying experiences of reclaiming their own lives from the impacts of adversity, intense mental distress, and traumatizing responses of others to their distress. In the wake of the current pervasive health, economic, and social justice crises, professionals have a collective opportunity to recognize the human experience and rights of those suffering mental distress. These UFCWC programs offer one example of steps taken toward that goal.

Recovery From Severe Mental Health Problems: A Systematic Review of Service User and Informal Caregiver Perspectives

Introduction: The recovery approach aims to have users' perspectives at the heart of service development and research; it is a holistic perspective that considers social needs, personal growth and inclusion. In the last decade recovery-oriented research and practice has increased greatly, however, a comprehensive model of recovery considering exclusively the perspectives of people with lived experience has not been devised. Aims: This review aimed to develop a framework and contextualize service users' and informal caregivers' understanding of recovery from severe mental health problems. Methods: We systematically searched 6 databases including key terms related to knowledge, experience and narratives AND mental health AND personal recovery. The search was supplemented with reference sourcing through gray literature, reference tracking and expert consultation. Data analysis consisted of a qualitative meta-synthesis using constant comparative methods. Results: Sixty-two studies were analyzed. A pattern emerged regarding the recovery paradigms that the studies used to frame their findings. The resulting recovery framework included the domains Social recovery; Prosperity (Legal, political, and economic recovery); Individual Recovery; and Clinical Recovery Experience (SPICE). Service users' definitions of recovery tended to prioritize social aspects, particularly being accepted and connecting with others, while caregivers focused instead on clinical definitions of recovery such as symptom remission. Both groups emphasized individual aspects such as becoming self-sufficient and achieving personal goals, which was strongly linked with having economic means for independence. Conclusions: The recovery model provided by this review offers a template for further research in the field and a guide for policy and practice. Predominant definitions of recovery currently reflect understandings of mental health which focus on an individual perspective, while this review found an important emphasis on socio-political aspects. At the same time, only a small number of studies took place in low-income countries, focused on minoritized populations, or included caregivers' perspectives. These are important gaps in the literature that require further attention. Systematic Review Registration: The review protocol was registered on PROSPERO (CRD42017076450); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=76450.