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Globalization and Health
Published in: Globalization and Health 1/2017

Open Access 01-12-2017 | Debate

The (Mis)appropriation of HIV/AIDS advocacy strategies in Global Mental Health: towards a more nuanced approach

Authors: Alison Howell, China Mills, Simon Rushton

Published in: Globalization and Health | Issue 1/2017

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Abstract

Background

Mental health is increasingly finding a place on global health and international development agendas. Advocates for Global Mental Health (GMH), and international organizations such as the World Health Organization (WHO) and the World Bank, argue that treatments available in high-income countries should also be made available in low- and middle-income countries. Such arguments are often made by comparing mental health to infectious diseases, including the relative disease and economic burdens they impose, and pointing to the applicability of the right to access treatment for mental health, not only infectious diseases. HIV/AIDS advocacy in particular has been held up by GMH advocates as offering an appropriate strategy for generating global commitment.

Discussion

There is a need to assess how health issues are framed not only in relation to social goods outside of health (such as human rights, security or development), but also in relation to other health or disease models, and how health policy and practice is shaped as a result. The article debates the merits and consequences of likening mental health to HIV/AIDS, and identifies four major problems with the model for GMH advocacy being developed through these analogies: 1. An inappropriately universalizing global approach to context-specific problems; 2. A conception of human rights that focuses on the right to access treatment at the expense of the right to refuse it; 3. A tendency to treat poverty as a psychiatric issue, rather than recognizing that mental distress can be the result of poverty and other forms of inequality; 4. The prioritization of destigmatization of disease over social justice models.

Conclusion

There are significant problems with the wholesale adoption of an (often simplified) version of HIV/AIDS advocacy as a model for GMH. Yet critical engagement with the important and nuanced differences between HIV/AIDS and mental health may nevertheless point to some possibilities for productive engagement and cross-fertilisation between advocates, activists and scholars in both fields.
Footnotes
1
45% of HIV programme spending went on treatment, as compared to 22% on prevention (17% went on
‘programme coordination’ and 16% on ‘other’)
 
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Metadata
Title
The (Mis)appropriation of HIV/AIDS advocacy strategies in Global Mental Health: towards a more nuanced approach
Authors
Alison Howell
China Mills
Simon Rushton
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2017
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-017-0263-3

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