全球南方的抑郁症与全球心理健康:对政策和言论的批判性分析》。

0 HEALTH CARE SCIENCES & SERVICES International journal of social determinants of health and health services Pub Date : 2024-04-01 Epub Date: 2023-12-17 DOI:10.1177/27551938231220230
Gojjam Limenih, Arlene MacDougall, Marnie Wedlake, Elysee Nouvet
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引用次数: 0

摘要

过去二十年来,抑郁症已成为一个突出的全球公共卫生问题,尤其是在中低收入国家(LMICs)。世界卫生组织(WHO)和全球心理健康运动制定了国际指南,以改善全球的心理健康服务,并将低收入和中等收入国家作为优先考虑的对象。这些努力为推进低收入与中等收入国家的抑郁症和其他精神、神经和药物滥用疾病的护理和治疗带来了希望。干预指南,如世界卫生组织的 mhGAP-干预指南,是以证据为基础的工具和指南,有助于检测、诊断和管理最常见的精神障碍。本文以全球南部为实证地点,利用福柯批判性话语和文件分析方法,探讨这些国际干预指南如何作为知识-权力过程的一部分,以某些形式而非其他形式在世界上体现和具体化。文章提出,这些国际指南通过对生物政治假设和影响、政府性和 "可能性条件 "的(再)生产,塑造了有关抑郁症的全球话语。文章利用实证数据展示了二元思维有时占主导地位的细微差别、复杂性和多维性,并将支持和反对全球心理健康的论点联系起来。文章最后指出了几种抵制性论述,并建议重新认识常见精神障碍的治疗差距。
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Depression and Global Mental Health in the Global South: A Critical Analysis of Policy and Discourse.

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.

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