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In this paper I problematize knowledge on reducing the ‘gap’ in treatment produced by 14 national mental health policies in Africa. To contextualize this analysis, I begin with a historic-political account of the emergence of the notion of primary health care and its entanglement within decolonization forces of the 1960s. I unpack how and why this concept was subsequently atrophied, being stripped of its more revolutionary sentiments from the 1980s. Against this backdrop, I show how, although the 14 national mental health policies are saturated with the rhetoric of primary health care and associated concepts of community participation and ownership, in practice they tend to marginalize local meaning-systems and endorse a top-down framework heavily informed by colonial medicine. The policies thus end up reproducing many of the very Eurocentric assumptions that the original primary health care notion sought to transcend. More specifically, the paradigms of evidence-based research/practice and individualised human rights become the gatekeepers of knowledge. These two paradigms, which are deeply embedded within contemporary global mental health discourse, are legislating what are legitimate forms of knowing, and by extension, valid forms of care. I argue that a greater appreciation of the primary health care concept, in its earliest formulation, offers a potentially fruitful terrain of engagement for developing more contextually-embedded and epistemologically appropriate mental health policies in Africa. This in turn might help reduce the current ‘gap’ in mental health care treatment so many countries on the continent face.

Disability and the Global South (DGS), 2015, Vol. 2 No. 3

This in-depth, illustrated report on the abuses of female patients with psychosocial or intellectual disabilities at institutions in India found that patients experience widespread neglect and abuses of their rights, including denial of legal capacity, a lack of community-based support and services, verbal and physical violence as well as involuntary treatment and admission. It recommends that “India undertake urgent reforms to guarantee the legal capacity of people with psychosocial or intellectual disabilities and take steps to shift from institutional to community-based care and services for people with disabilities”, with specific recommendations for central and state government level, national and state commissions and international donors

Note: Easy-to-read version, summary and video also available

This short video highlights the situation of female patients with psychosocial or intellectual disabilities at institutions in India. In conjunction with the report by Human Rights Watch, it calls for the better treatment of women and girls in institutions and increased de-institutionalization

Note: Full report, summary and easy-to-read version also available

This resource presents guidance on child-focused victim assistance. The first section contains the acknowledgements, foreword, acronyms and chapters one through four outlining victim assistance introductory information, stakeholders, international standards, principles, coordination and cross-cutting issues.  Another six stand-alone documents are available for the six technical components comprise data collection and analysis, emergency and continuing medical care, rehabilitation, psychological and psychosocial support, social and economic inclusion, and laws and policies. The final chapter contains resources and references that users may find helpful

Life expectancy and the situation of persons living with Spinal Cord Injury (SCI) in low income settings was explored. Mortality rates from injuries and challenges in daily lives of people with injuries from poorer economic backgrounds are were investigated and are compared with those with higher incomes. Literature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals.

There are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges.

Conclusion: The study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.

This resource is a collection of articles focused upon the treatment of people with psycho-social disabilities in health-care settings, particularly with regard to torture, abuse and ill-treatment, and reflecting on the Special Rapporteur on Torture’s 2013 thematic report.

It brings together contributions by more than thirty international experts in response to the United Nations Special Rapporteur on Torture Juan E. Méndez’s thematic report, providing insights into essential topics and highlighting issues at the forefront of the intersecting medical, legal, and policy fields. It supports a commitment to tackling the challenges that continue to arise in promoting and protecting the human rights of persons in diverse healthcare settings globally

This discussion paper addresses the problematic nature of legal capacity as it affects people with psychosocial disabilities and others, focusing in particular on issues of vulnerability and responsibility. It concludes with a project concept tailored to explore universal legal capacity in practice

This leaflet presents information for disabled or Deaf women, or women who have an impairment or long-term health condition who have been a victim or survivor of violence. It presents information about rights and services in the UK that can help. It highlights barriers to accessing services or information, makes recommendations and presents what works based upon project results.

A central claim in publicity for the Movement for Global Mental Health is that the movement is both ‘rights-based’ and ‘evidence-based’. In this article we focus on the second claim, critically examining the evidence on which the movement’s programme is based. The concepts and methodology of the movement are those of mainstream Western psychiatry, so we first review briefly the inadequacies and inconsistencies of this framework, in particular the problems of identifying, measuring, explaining and treating ‘mental illnesses’. We conclude that the scientific knowledge base of contemporary psychiatry has been gravely distorted by its dependence on financing from the pharmaceutical industry, which has led to exaggerated attention on biomedical theories and treatments with a corresponding neglect of social factors and prevention. Second, we examine the problems of transferring this framework to low and middle-income countries. Adopting a biomedical view enables the movement to evade awkward questions regarding the cultural embeddedness of the issues it deals with and their relation to social, economic and political conditions in these countries. Confident claims are made by the movement about the nature and prevalence of ‘mental illnesses’ across the world, the burden they represent, and the benefits to be expected from tackling them by ‘scaling-up’ mental health services based on Western knowledge. However, cross-cultural psychiatric epidemiology is not sufficiently developed to be able to support any of these claims and the considerable quantities of data that are produced as ‘evidence’ turn out to be largely based on guesswork. The article concludes that Western psychiatry can certainly provide low- and middle income countries with instructive examples – but they are mainly examples of what not to do.

Disability and the Global South, 2014, Vol. 1 No. 2