"Mirroring" the World Versus "World-Making": The Crisis of Ethics in Indian Mental Health Systems.

In the context of neoliberalism and increasing globalization, technocratization, and scientification of mental health care, people suffering from socio-politico-economic problems ranging from poverty to structural violence are often transmogrified into "patients" with mental health problems to be "treated" with psychopharmaceuticals and individualized psychological therapies. Drawing from three socio-political issues India witnessed in the past 3 years, concerning three marginalized sections, namely, farmers, LGBTQIA+ people, and migrant workers, I illustrate the silence of mainstream mental health disciplines in India on sheer instances of structural violence and social suffering. Deflection of attention from human rights violations by mainstream mental health systems raises critical questions about the ethics and politics of mental health disciplines. The social, political, and material contexts that are central to lived experiences are almost always unaccounted in mental health academia, research, and practice. Engaging people with lived experiences advances equity by breaking down power dynamics, establishing collaborative decision-making, and improving equitable outcomes. Thus, knowledge production in mental health becomes irrelevant to political action and transformative policies that are crucial for positive mental health outcomes. By ignoring and thus implicitly sanctioning discriminatory, exploitive neoliberal architecture, mental health systems maintain the very upstream factors that cultivate and sustain mental distress. In this way, mainstream mental health practice in India fails to undertake world-making , raising deeper questions in public mental health ethics. [ABSTRACT FROM AUTHOR]