Globalization, global mental health and politics: Advocating for Mental Health For All!

President Trump's mental health status has been put forward throughout his presidential mandate

 

The Culture of mental health is steadily growing and the globalization of mental health becoming more obvious. In fact, mental health culture is becoming a new trend in the modern society. Thus mental health is becoming as well an important political theme. The question no matter where you are reading this article is: does your mental health matter? Keep the question in mind as you read this story of how mental health is becoming a global theme of political importance. Even though this article is not about politics, the author puts forward the important role of politics in shaping mental health development. The paradoxes and perhaps controversies surrounding the evolution of global mental health (1) could indicate the difficulty acknowledging the place mental health should have in human well being and development.

The history of global mental health that is the international perspective to different aspects of mental health, is recent. There is reason to believe that the idea of global mental health was born in 1992 with the first World Mental Health Day celebration organized by the World Federation for Mental Health. The World Federation for Mental Health (WFMH) is the only international multidisciplinary, grassroots advocacy and education organization concerned with all aspects of mental health. It was founded in 1948 to advance, among all people and nations, the prevention of mental and emotional disorders, the proper treatment and care of those with such disorders, and the promotion of mental health (2). However, some prominent authors in the field of global mental health date it back as to 1990 (1). The term ‘global mental health’ was conceptualized and used for the first in 2007 with the Lancet (3). The internationalization of mental health since then has not ceased to increase as the world has been sharing the same stories Moreover,  the world is now also into the fullest grasp of the digital revolution, characterized by rapid exposure to and access of information of a variety of forms. Naturally, one of such information which was known to the world was the election in 2017 of the 45^th president of the United States of America: President Donald John Trump. Rapidly, observations of the mental health status of the political figure president Trump was then made. Several ideas and evidences generated surrounding the mental health status of Donald Trump are been made (5, 7). The mental health status of Trump has contributed to internationalize mental health in a certain way. However, more focus been given to the political figure rather to the human being suffering from a mental health condition. Perhaps this explains the violence that is perceptible in the mass media when talking about Trump’s mental health status.

All this is happening in a context where in the history of global mental health, mental health has never gained so much attention as it is having now. The true relevance and meaning of mental health in the global agenda should not be shaded by the present world politics tainted by the new political history of the US and its former president. There is also more reason to think that the globalization of mental health or mental health seen as a global issue started with the 2030 Agenda and Sustainable Development Goals (SDGs) by 2015. The World Economic Forum (WEF) which started in 1971 has been an important space where political and other leaders of society come to shape global agenda.  Mental health as an idea has not been concretely discussed in the WEF until very recently. In 2015, in an issue briefing brain research and in 2019 whole discussion sessions were made on mental health. During WEF 2019 important political figures like Prince William were panelist. Interestingly, not only he shared his political vision for mental health but he talked of his lived experience of mental health issues. Is it a coincidence that since then mental health has taken a greater place in WEF discussions. Or is the political will and power to make mental health a priority the true drive in mental health development across the globe? So mental health as a global issue of relevance, is very recent. A gradual ideological yet very concrete paradigm shift from the slogans time to act to time to invest has then become very rapidly manifest.

Again, with the UN Policy brief on Covid19 and mental health published in 2020, the call for action to world leaders was more direct.  Therefore, 27years later the World Mental Health Days has not had the impetus on global mental health as the few Davos meetings and the rise of the covid19 pandemic. Therefore, it is clear, from this analysis that the role of political will and power in mental health development is crucially indispensable. Mental health has been struggling to get to this degree of international spotlight because humanity prior to now has somehow been blind to the need to invest in mental health. However, there is also a lot to know from this struggle. 1) Is mental health understood as it should by policy and decision makers? 2) Mental illness is invisible. It is ignored most of the time and mental health seems to be utopic.

Despite this extraordinary progress in global mental health, recently there is also such a very open, yet subtle violent relationship between mental health and politics that could threaten global mental health. Even if this state of things is not new as Judith Herman suggested (4) when she writes “the systematic study of psychological trauma therefore depends on the support of a political movement. Indeed, whether such study can be pursued or discussed in public is itself a political question”. This is ironical but clearly depicted in the way mass labelled President Donald Trump.  The question of if Mental health has been a political question can also  be seen clearly in the history of  psychology and psychiatry with the fate of those with a mental health issue and with the history of women, with the phenomenon of the witch hunts. In either cases, deciding on who had a mental illness has always been used as a political weapon. Today, it is the way with which mass media has normalized the violence between mental health and politics which is of interest and how this mediatized violent relationship can jeopardize paths to true promises of mental health for all. What is the nature of the violent relationship between mental health and politics?

Courtesy American Association for the Advancement of Science , Science 11 Dec 2020

 

The nature of this violent relationship is twofold, on the one hand the omission to use political power and political will to prioritize mental health in political and development agendas, and on the other hand the use of political will and power to increase stigma around mental health. The idea of omission might lead to several interpretations. One might put forward ignorance and misunderstanding about mental health and mental illness, their true essence and value. Also one could see this omission as a denial mechanism. In this case the use of power to create more stigma around persons with a mental health condition is of particular interest. The use of the mass media by politics in this manner of creating stigma has been very prevalent in the way mass media associated Trump with mental illness.  Now with the paradox and controversies it might lead to, president Trump’s poor mental health status would seem very evident with all the labels (5, 6, and 7). Yes stigma and the violation of rights of persons suffering from a mental health condition have clearly been done in the aforementioned situation with Trump since it is accepted from the presented evidence that he has a mental health condition. It should be noted that on the one hand, Trump is a historical political figure, and on the other hand he is also a modern political figure considered as a psychopathological and psychiatric case, (5, 6, and 7).  However, from evidences we now know that mental illness is more than just an aggregate of idiosyncratic syndromes (10). We also know the social determinants of mental health. We know the links between poverty and mental health. We also know the effect of parenting styles on child and adolescent development. Therefore the use of the mass media to deform the true face of mental health and ‘mental illnesses’ should be a big concern in our modern society. Since mass media threaten the rights of persons with a mental disability and exposes them to more stigma. These two elements are threats to their well being and effective recovery. The fact is this mental health is not given the consideration deserves. Mind your language! Yes, the mass media uses a stigmatizing language to address mental health issues and talk about people with a mental health problem (12). Politics uses mental health labels for power (13, 14).  This can be seen concretely in the way Trump a political figure was called and labelled throughout his presidential mandate (5). The violent relationship between politics and mental health is mediated by the use of an uneducated mass media on the true nature of mental illness and mental health.

The use of political will and power to make mental health an important element of governance and development was manifest in Davos 2019. The use of this political will and power to paint a better picture of mental health is politically correct because without political will mental health will not Move. The mounting evidence is that mental health problems have no preference, no gender, no color, and even if evidence is turned to a greater mental health treatment gap in Low Middle Income Countries (LMICs) like Cameroon (yet with a mental health policy, programme and plan since 2016) it is because these LMICs have issues of poverty which affect well being (8). Mental health development is imperative for global development and attainment of the Sustainable Development Goals (SDGs) (1, 15).

In Cameroon, the growing collaborative efforts of mental health advocates, local NGOs, passionate and dedicated mental health professionals and the mental health department of the ministry of public health has led to a more concrete political will to make mental health an important element for development. For example, with the National Development Strategy document (NDS30).  “…Emphasis will also be laid on intensification of the provision of specialized care services, with special attention on the management of disability and mental health, developmental disorders, burn victims, and palliative and end-of-life care…” (NDS30 p.75). The need to invest in mental health is becoming our common responsibility. And do you know why? This is because mental health is everyone’s business. This is also because mental health issues are psychosocial issues (10) intimately tied to the fact of being human. The rights of persons with a mental disability needs to be respected. This is the only guarantee our efforts to reduce the mental health treatment gap increasing globally will be protected. Additionally, in our life time we have a 1 out of 4 probability at any given time to have a mental health condition. We have enough evidence to take mental health seriously!

Everywhere in the world mental health treatment gaps are increasing and there are increased inequalities in access to mental health care. We know the Covid19 has worsen the situation of mental healthcare. Nevertheless, we have evidence political will and power can change the way mental health is considered. This political will and political power ought urgently to be put at the service of mental health development, global mental health. It is strategic and cost effective to invest in the mental health of populations. Interestingly last month, mental took a leading role at the 148^th session of the World Health Organization’s Executive Board (11). There is hope…this is what mental health should be, for You, for me, for everyone everywhere!

Reference

Demassosso., D. (2021). Globalization, global mental health and politics: Advocating for mental health for all! (ongoing work) Mental Health Leadership and Advocacy  Programme (mhLAP) Alumnus.