‘I am also doing research’: Engaging mental illness and precarity in Ouagadougou

Narratives about mental health in Africa often present people with mental illness in situations of extreme precarity, such as in chains or on the street. In this article, the author argues that such representations should not become the only story regarding mental illness in Africa. The article focuses on the story of Joseph, a man who is an outpatient of a psychiatric ward in Ouagadougou, Burkina Faso, and reflects upon his experience of mental illness in relation to the ongoing story of his life. His confident statement ‘I am also doing research’ provides an entry point for understanding his engagements with life and mental illness as acts of experimentation that are not necessarily rooted in precarity. His story shows how precarity and possibility can evolve alongside each other. It also shows the role that psychiatry already plays in (some of) the lives of people with mental illness in an African context, interacting with other narratives of mental troubles and healing.     

From ‘Invisible Problem’ to Global Priority: The Inclusion of Mental Health in the Sustainable Development Goals

Perceptions regarding the importance of mental health are shifting at a global level. Once described as an ‘invisible problem’ in international development, mental health is now being framed as one of the most pressing development issues of our time. Concern over the historical absence of mental health from the development agenda — despite its being regarded as a major obstacle to development — has led to its recent inclusion in the UN Sustainable Development Goals (SDGs). This article critically examines three intersecting axes key to its inclusion in the SDGs: 1) the conceptualization and calculation of the contribution of mental disorder to the global burden of disease; 2) the quantification of mental disorder as an economic burden; and 3) the relationship between mental distress and poverty. The article highlights the urgent need to foster a more nuanced understanding of the interplay between mental health and development, and shows how, at times, interventions in the two fields work together in producing reductionist, economistic, individualized and psychologized responses to poverty.     

The Meaning of Normality: the controversy about the mental health campaign in Sweden 1969

At the height of the Swedish welfare society, a campaign with the aim of promoting mental health issues within the Swedish labour market was launched. The title and purpose of the campaign, ‘Mental health – an action of increased understanding and solidarity at work’, was to illuminate mental health issues at work. Surprisingly to the organizers, the mental health campaign stirred up major opposition, especially from the political left. The idea of mental hygiene in an industrial and workplace setting, a cross-breed between the values of the Human Relations School and psychiatric science, was received with deep mistrust. The campaign caused an agitated debate in the media about power relations between employers and employees. The political disagreements were exposed in a number of articles in the daily newspapers and in the evening papers during the summer of that year. This article undertakes an investigation of the campaign literature and the media debate. The interpretation of the debate highlights different opinions about the meaning of normal mental health. Four different views of normality and mental health which demonstrate the complexity of the issue are presented. Mental health could mean adjustment and harmony, it could be a medical weapon to suppress the working class, it could even mean a neutral state of absence of mental problems, or lastly it could be a claim for the right to live a normal life.     

Rural mental health and social geographies of caring

This paper contributes to an emerging geographical literature on the social geographies of caring. Drawing on recently undertaken empirical work in the Scottish Highlands, personal accounts about the provision of both formal and informal care for people with mental health problems are evaluated. The notion of ‘community care’ is critiqued, as too are claims about how rural and remote rural locations engender particular configurations of caring roles, practices and relations. It is shown that geographical distance, social proximity, stoic cultures and rural gossip networks all have a part to play in how caring occurs in such places. The paper concludes by suggesting areas of future research.     

Interaction during mental health floating support home visits: managing host–guest and professional–client identities in home-spaces

Mental health work has been transformed by ‘shifting geographies of care’ from institutions to care in communities, in particular by the emergence of support located within home-spaces. This article studies a floating support service targeted at people with mental health problems and contributes to research on post-institution and home care geographies. The data contain 17 audio-recorded home visits conducted by professional care workers. An ethnomethodological analysis informed by geographies of care in home-spaces shows how the home as a material space has consequences for conversations and the relations between the service users and workers. The parties orient to two relational and shifting identity pairs in their ‘home-space talk’: a host–guest pair (social call talk) and a professional–client pair (targeted intervention talk). Professional–client pair dominates, and in this sense floating support produces institutionalization of home-spaces. However, social call talk that enables service users to act as hosts governing their home-spaces has important functions. Orientations to hosts and guests create symmetry and trust among the parties that encourages recovery promoting interaction. The article also demonstrates the applicability of the methods developed in the geographies of mental health and home in the ethnomethodological interaction analysis, and the other way round.     

‘They shut them out the road’: Migration,mental health and the Scottish highlands

There is a small literature tackling migration and mental health, but less is said about the migration of people with mental health problems (incipient or diagnosed). The present paper considers what might be claimed about such migration, particularly when entailing movement into rural and remote areas where lack of anonymity, high social visibility and certain differences in how ‘locals’ and ‘incomers’ are treated may have serious consequences for those displaying psychological and behavioural differences. Drawing upon qualitative evidence from in‐depth interviewing of in‐migrants with mental health problems living in the Scottish Highlands, light is thrown on the connections between their problems and the decision to relocate to this predominantly rural region. Attention also focuses on dissonances between expectations regarding their new situation and their actual experiences of it in terms of both natural landscapes and, more importantly here, social milieux. There are further implications for changing regional attitudes towards mental health, suggesting certain impacts that arise not just from the in‐migration of people themselves who have mental health problems, but also from the ideas and practices that they often carry with them.     

Farmwomen's emotional geographies of care: a view from rural Ontario

This article contributes to geographies of rural women's health by investigating farmwomen's perceptions of their caring roles and responsibilities, which are crucial to the wellbeing and sustainability of rural people and their communities. Featuring a thematic analysis of interviews and a focus group with farmwomen from Ontario, Canada, the research examines farms and farming as unique places and spaces of care. Informed by the literature on emotional geographies, the article examines how care is situated and performed through farmwomen's negotiation of multiple, overlapping identities and how these are embodied and affective in emotional work. The findings not only confirm the paramount role of women in rural care, they demonstrate the interdependence of family, community and work as central to the challenges of rural women's health. The article argues that the link between health and productivity on the farm is crucial to understanding farmwomen's caring, and highlights the paradox that their emotional work is as much about opportunities for power and resistance as it is about obligation and subordination.     

Hygiene,health, and bodily knowledge, 1880-1940: a New Zealand case study

One of the key aims of the Dunedin Southern Suburbs project has been to examine the factors that structured opportunity in a period of rapid modernization in New Zealand, 1880-1940. This article argues that health was a key determinant of opportunity and examines how people thought about their bodies and sought to maintain health. It argues that older, humoral theories about health were maintained alongside new understandings wrought by the germ theory and that both placed a high value on regimen. Mothers were regarded as the household experts on health but lacked a vocabulary to communicate with their daughters about menstruation. While bodily health was an ideal to be striven for, there was little communication about bodily pleasure, a situation subject to change with the adoption of family limitation.     

Bishop Bickersteth’s Visitation Returns for the Archdeaconry of Craven,Diocese of Ripon, 1858

Abstract

In 1868, an article in the Yorkshire Post about the West Riding Pauper Lunatic Asylum drew attention to Yorkshire's pivotal role in the history of mental health care. It was because of this history, it was claimed, that Yorkshiremen had a special interest in the treatment of the insane. The purpose of this paper is to explore critically this assumption in light of the recent work on the Poor Law's relationship with the asylum. The growth and development of two asylums in the neighbouring North and West Ridings of Yorkshire will be compared and contrasted. The first part of the paper offers a brief explanation of Yorkshire's pivotal role in the history of the institutional approach to the problems of mental health and the growth of institutions in the counties. Central to the paper will be an examination of how each county responded to the differing demands on its resources and how this impacted on the nature of care at each institution. Ultimately, this paper aims to show how Poor Law finances contributed significantly to the development of each institution.     

Social and Spiritual Capital: Building ‘Emotional Resilience’ In Communities and Individuals

Abstract

The article examines the relationship between mental health, mental health promotion, religious communities and general issues of public health. It begins with an exploration of what is meant by mental health drawing a distinction between it, mental illness and mental health promotion, and argues that mental health can have a profound impact on physical health. The relationship between religious communities and the mentally ill is analysed next. Despite the attitudes of many in mental health provision, religious communities can offer a supportive environment for the mentally ill. The article avoids a ‘faith communities—good’, ‘mental health services—bad’ dichotomy, recognizing that religious communities can be excluding and discriminatory. The ambiguity of some experiences is recognized: are they forms of religious experience or symptoms of psychosis? The article highlights the inceasing advocacy of the user/survivor movement. In the final section, the relationship between mental health and public health is explored. It is suggested that religious communities can be places for the promotion of mental health. Mental health promotion is understood as aiming to strengthen both individuals and communities; its value is explored in relation to public health issues. It is suggested that those who are socially excluded are at a greater risk of some form of mental illness and that this may well impact on their physical health. Related to this are the beneficial effects of opportunities for participation in decision making, be it in the workplace or the local community. The article ends by arguing that service providers and service users need to be involved in decisions and planning. Further, some elements of mental health promotion will need to involve those outside the statutory sector.     

The psychologization of humanitarian aid: skimming the battlefield and the disaster zone

Humanitarian aid's psycho-therapeutic turn in the 1990s was mirrored by the increasing emotionalization and subjectivation of fund-raising campaigns. In order to grasp the depth of this interconnectedness, this article argues that in both cases what we see is the post-Fordist production paradigm at work; namely, as Hardt and Negri put it, the direct production of subjectivity and social relations. To explore this, the therapeutic and mental health approach in humanitarian aid is juxtaposed with the more general phenomenon of psychologization. This allows us to see that the psychologized production of subjectivity has a problematic waste-product as it reduces the human to 'Homo sacer', to use Giorgi Agamben's term. Drawing out a double matrix of a de-psychologizing psychologization connected to a politicizing de-politicization, it will further become possible to understand psycho-therapeutic humanitarianism as a case of how, in these times of globalization, psychology, subjectivity and money are all interrelated.     

Witchcraft,Social Cohesion and Participation in a South African Village

The past thirty years have seen development agencies, non‐governmental organizations and their funders embrace ‘participatory’ development strategies. These strategies require the poor to take part in decision‐making about, and the implementation of, development projects and programmes. Underlying enthusiasm for participation is the recognition that centralized, top‐down systems and methods have not delivered development, and the assumption that the poor are eager and able to ‘participate’. Using ethnographic research on witch beliefs and their impact on social relations in a South African village, this article argues that such assumptions are not always justified. It shows that witch beliefs and related conflicts have long‐term negative consequences for intra‐community relations and examines what this implies for development policy and practice.     

中国古村镇保护利用中的悖论现象及其原因

中国的古村镇保护利用工作经过了30多年的发展取得了积极的进步,但是也出现了因保护而破坏的严重问题。本文尝试从对古村镇定义的修订切入,将古村镇作为一种文化综合体和文化生态系统进行分析,强调古村镇是由器物、行为、制度、精神四个层面构成的文化综合体,是具有自组织性的文化生态系统,对系统中任意环节的破坏都会造成保护利用的悖论现象。在此基础上,本文总结出保护环境与破坏环境、重现建筑特色与消解建筑特色等四重"中国式悖论",并进一步从社会文化环境、理念认知、管理机制以及开发模式等层面分析了中国式悖论产生的原因。     

国外健康地理学研究进展

传统医学地理学研究从自然生态学角度出发,着重探讨自然环境对人类身体健康的影响。随着社会经济的发展,自然环境对人类健康的作用逐渐减小,社会文化环境成为影响人类健康,特别是城市居民身体健康的主要因素。本文回顾了20世纪70年代社会文化转型以来,医学地理学研究的重点转向以社会文化视角探究社会文化环境对人们身体健康,特别是心理健康的影响,以及医学地理学向一门新的健康地理学转变的过程,并梳理了新的健康地理学理论和研究内容的变化,总结了当前学科存在的一些问题,最后对新时期我国健康地理学的发展提出了展望。     

Understanding Public Support for Time Limits and Other Welfare Reforms

This article presents results of a reanalysis of data from a survey of New York residents regarding that state's welfare system and proposed welfare reform. The data danger from most previous studies of public opinion about welfare because questions were asked about a range of specific welfare reform options, such as various time limits, eligibility restrictions, and work requirements, that are key features of the new federal welfare law. Specifically, the analysis explores the extent to which public support for these reforms can be explained by self interest factors, political qualification, and beliefs regarding the poor, social rights, and the welfare system. White these variables have been found to be important in prior research, they provide a somewhat less consistent explanation of support for specific features of the new welfare system in the United States.     

The boundaries of eros— Sex crime and sexuality in Renaissance Venice

Throughout Western history there have been two sharply differentiated beliefs about the character of creativity. However, one of these beliefs—Judaeo-Christian and neo-Platonic—has occupied such a dominant position that the very existence of the other has been obscured and ignored. Yet the evidence for this second belief is no less extensive or vivid. It has never been formulated in the same way as the first and so has never constituted a tradition as such; yet it has existed over as long a period of time and can therefore be called a tradition. Moreover, this second belief seems to bear a closer relation to the character of creativity displayed by people regarded as ‘creative’, as well as to what we have learnt about creativity in this century from psychologists. Attitudes to creativity in the modern period have generally been based on the first tradition, but the activities of creative people have borne out the validity of the second tradition. The attitudes, in other words, have been based on false expectations. To recover the lost tradition, therefore, may enable us to see more accurately what we may or may not achieve by being creative.     

Challenges in ‘Translating’ Human Rights: Perceptions and Practices of Civil Society Actors in Western India

Rights‐based approaches have become prevalent in development rhetoric and programmes in countries such as India, yet little is known about their impact on development practice on the ground. There is limited understanding of how rights work is carried out in India, a country that has a long history of indigenous rights discourse and a strong tradition of civil society activism on rights issues. In this article, we examine the multiple ways in which members of civil society organizations (CSOs) working on rights issues in the state of Rajasthan understand and operationalize rights in their development programmes. As a result of diverse ‘translations’ of rights, local development actors are required to bridge the gaps between the rhetoric of policy and the reality of access to healthcare on the ground. This article illustrates that drawing on community‐near traditions of activism and mobilization, such ‘translation work’ is most effective when it responds to local exigencies and needs in ways that the universal language of human rights and state development discourse leave unmet and unacknowledged. In the process, civil society actors use rights‐based development frameworks instrumentally as well as normatively to deepen community awareness and participation on the one hand, and to fix the state in its role as duty bearer of health rights, on the other hand. In their engagement with rights, CSO members work to reinforce but also challenge neoliberal modes of health governance.     

Is There a National Policy For Children and Youth With Serious Emotional Disturbance?

This article examines the status of a national mental health policy for children in need of mental health services. The need for systems planning and services integration involving multiple agencies is presented. The different programs of the major governmental agencies involved in the delivery of services to children are reviewed, as are the range of services provided. This article demonstrates the fragmentation and duplication that is endemic in all aspects of mental health, and that consequently makes policy implementation exceedingly difficult.     

Folk beliefs,special deposits,and engagement with the environment in early modern northern Finland

It is widely recognized that folk beliefs flourished in early modern Finland which had formally been Christianized for centuries. These folk beliefs seem to propose, in the modern view, that people in the past believed in the existence of non-human beings, such as trolls and spirits, and considered a variety of material things from artefacts to landscape elements to have special properties, such as agency, consciousness, and personality. Folk beliefs, however, may have been misrepresented due to the assumption that they originate in religious-like thinking. This paper reconsiders the nature of folk beliefs, their relationship with religion, and their significance to archaeological interpretation both theoretically and through a case study. It is argued that folk beliefs in early modern northern Finland – and in other similar contexts – can be understood in terms of local perception and engagement with the material world. Folk beliefs, in this view, were embedded in the dynamics of everyday life, and they are, at least in the specific case discussed in this paper, indicative of two-way relatedness between people and various constituents of the material world. The archaeological implications of this view are discussed in the context of the 17th-century town of Tornio on the northern Gulf of Bothnia.     

A Model for Mental Health Needs and Resourcing in Small Geographic Areas: A Multivariate Spatial Perspective

This paper considers how small area variations in a set of psychiatric referral outcomes in a London health authority of 750,000 people may inform health need assessment and health resourcing for mental illness based on true need. As well as adopting a multivariate perspective, the spatial interdependence of the outcomes is included in the modelling approach outlined. By contrast, existing studies on mental health need tend to focus on single outcomes, and may not include spatial dependence. The analysis relates to three hospital referral outcomes for psychiatric conditions, and to total community mental health referrals across sixty‐seven electoral wards in East London.