Researchers' agency and the boundaries of global mental health: perspectives from and about Latin America.

Abstract

The decolonise global health movement has critically reassessed the field's historical and political underpinnings, urging researchers to recognise biases and power imbalances through reflexivity and action. Genuine change is seen as the outcome of the researcher's self-awareness, often leaving the underlying structures of global health-and global mental health (GMH)-in the background. Here, we problematise how expectations around agency and change have been mobilised in discussions around decolonisation, highlighting the gradual and contingent nature of international collaboration in GMH.We present three international research initiatives based in or focused on South America: RedeAmericas, the Platform for Social Research on Mental Health in Latin America and the HEalthcaRe wOrkErS project. Instead of comparing the three initiatives directly we identify and discuss common elements among them that challenge and redefine the boundaries of GMH by leveraging local leadership, creating hybrid expert profiles and implementing principles of equity and epistemic justice. Particular attention is given to the fragmentary translation of these principles into the project's concrete activities.The interplay of agency and the structural confines of GMH is examined in each initiative, expanding the notion of 'boundaries' in the field beyond geographical or institutional demarcations. Using the notion of milieu, we call for a more nuanced understanding of the field as simultaneously shaping and being shaped by the tentative collaborative infrastructures developed by researchers. We advocate for a reconceptualisation of GMH that is as diverse and complex as the issues it seeks to address.