Global mental health and its discontents: an inquiry into the making of global and local scale.

Global Mental Health's (GMH) proposition to scale up evidence-based mental health care worldwide has sparked a heated debate among transcultural psychiatrists, anthropologists, and GMH proponents; a debate characterized by the polarization of global and local approaches to the treatment of mental health problems. This article highlights the institutional infrastructures and underlying conceptual assumptions that are invested in the production of the global and the local as distinct, and seemingly incommensurable, scales. It traces how the conception of mental health as a global problem became possible through the emergence of Global Health, the population health metric DALY, and the rise of evidence-based medicine. GMH also advanced a moral argument to act globally emphasizing the notion of humanity grounded in a shared biology and the universality of human rights. However, despite the frequent criticism of GMH promoting the bio-medical model, we argue that novel logics have emerged which may be more important for establishing global applicability than arguments made in the name of nature: the procedural standardization of evidence and the simplification of psychiatric expertise. Critical scholars, on the other hand, argue against GMH in the name of the local; a trope that underlines specificity, alterity, and resistance against global claims. These critics draw on the notions of culture, colonialism, the social, and community to argue that mental health knowledge is locally contingent. Yet, paying attention to the divergent ways in which both sides conceptualize the social and community may point to productive spaces for an analysis of GMH beyond the global/local divide.