Introduction

Since the publication of the call for Global Mental Health in The Lancet in 2007, followed by the renewed call in 2011, there has been a significant jump in research and publication in this field, with attendant funding. While the Movement for Global Mental Health (hereafter MGMH) movement purports to utilise a public health approach, it is one that is heavily influenced by individual health and clinical medicine. Our understanding of public health depends upon a population-based approach that engages with supra-individual determinants, considers public health greater than just the sum of individuals’ health, and considers health itself as context-dependent. For this, we employ the Social Determinants of Health approach to mental health, to critically evaluate Global Mental Health. We also problematise the so-called “treatment gap” which is purported to be a spectacular 90 per cent in the Low and Middle Income Countries (LMICs), thus creating a significant economic burden as calculated by the Disability Adjusted Life Years (DALY) metric. The proposed, purportedly “cost-effective” solution of task shifting supported by trials is essentially clinical, which, along with the attendant plan to “scale up” such services, effectively decontextualises population health.

In the following sections, we first present a case study of an Indian mental health programme that involved ideas similar to those of the MGMH but predated it by over two decades.