Interview with Augustus Osborne

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

What is the article “Embracing Pluralism: Rethinking Western Psychiatric Models for Equitable Global Mental Health” about?

This article is fundamentally a challenge to one of global health’s most comfortable assumptions: that what works in Boston or London will work in Freetown or Kampala, provided we translate it carefully enough. The global mental health movement has done genuinely important work in drawing attention to the enormous burden of mental illness in low- and middle-income countries up to 85% of people with mental health conditions in these settings receive no treatment at all. But in its urgency to close that treatment gap, the movement has largely exported Western psychiatric frameworks wholesale: the DSM diagnostic categories, pharmaceutical-centred treatment protocols, and individual psychotherapy as the gold standard of care.

My article argues that this approach carries real risks that are too often ignored. It can produce cultural mismatch where diagnostic tools built on Euro-American concepts of depression and anxiety fail to capture how distress is experienced and expressed in other societies. It can medicalise what is fundamentally social suffering, framing poverty, displacement, and structural injustice as individual disorders amenable to a prescription. And it can marginalise or displace indigenous healing systems traditional practitioners, religious leaders, community elders that communities trust and turn to.

The paper is not an argument against biomedical psychiatry. It is an argument for pluralism: a framework that values multiple healing traditions as equally legitimate, prioritises cultural adaptation and local leadership, and insists that equity not just coverage must be the measure of success. I draw on evidence from Zimbabwe’s Friendship Bench, community-based programmes in India and Pakistan, and hybrid models from Nepal and Uganda to show that locally grounded approaches are not second-best alternatives they are often more effective, more sustainable, and more meaningful to the people they serve.

Tell us a little bit about yourself and your research interests.

I am a public health researcher based in Freetown, Sierra Leone, where I was born and trained. I hold an MSc in Public Health and a BSc in Biological Sciences from Njala University, and I have spent the past decade trying to understand and generate evidence about the structural forces that shape health and illness in Sierra Leone and across sub-Saharan Africa.

My research spans a wide range of topics: maternal and child health, health systems strengthening, infectious disease, health equity, and increasingly, the intersection of digital health and social determinants of wellbeing. I have authored and co-authored over 140 peer-reviewed publications, and I used to teach Epidemiology and Biostatistics at Njala

University, where I tried to pass on not just statistical methods but a way of thinking about evidence who produces it, who it serves, and whose experiences it tends to miss.

What connects all of my work is a preoccupation with equity with understanding why health outcomes are so unequally distributed, and with generating the kind of evidence that can actually move policy in the right direction. I use a range of tools ArcGIS for spatial analysis, machine learning for predictive modelling, NVivo and MAXQDA for qualitative work but the driving question is always the same: who is being left behind, and why?

Mental health sits at a particularly important intersection of these concerns. In Sierra Leone, the legacy of a decade-long civil war, the Ebola epidemic, and chronic poverty has created an enormous burden of psychological distress yet mental health services remain desperately under-resourced, and the frameworks imported to address the gap do not always fit the realities of the people they are meant to serve.

What drew you to this project?

Honestly, it was the gap between what I observed in practice and what the global mental health literature was telling me should work.

Working in Sierra Leone first as a surveillance officer during the Ebola outbreak, then in health systems research I repeatedly encountered situations where people in psychological distress were navigating between multiple systems of care simultaneously: visiting a biomedical clinic, consulting a traditional healer, seeking counsel from a religious leader. This was not confusion or ignorance. It was a rational response to a plural reality, where different systems offered different things and no single framework captured the full picture of suffering or healing.

Yet the global mental health literature I was reading largely treated this pluralism as a problem to be overcome, a sign of inadequate access to proper care rather than as a resource to be understood and built upon. I found that framing both empirically questionable and, frankly, troubling in its assumptions about whose knowledge counts.

I was also struck by the growing body of evidence from programmes like Zimbabwe’s Friendship Bench, which showed that community-embedded, culturally resonant interventions could achieve outcomes comparable to or better than imported Western protocols. That evidence deserved a more prominent place in the conversation about how global mental health should be organized and funded. Writing this paper was my attempt to make that argument systematically drawing together the critique, the evidence, and a concrete set of recommendations in a way that might be useful to researchers, practitioners, and policymakers working in this space.

What was one of the most interesting findings?

The finding that most stayed with me and that I think has the broadest implications is the evidence around stigma. The dominant narrative in global mental health has long been that the biomedical model reduces stigma by framing mental illness as a brain disease rather than a moral failing or spiritual affliction. The logic is intuitive: if depression is a chemical imbalance, not a character flaw, people should be less blamed for it.

But the evidence I reviewed tells a more complicated story. In several settings, the introduction of Western psychiatric labels increased stigma because these diagnoses were experienced as foreign, permanent, and frightening in ways that local idioms of distress were not. In rural China, medicalizing depression led to greater social distancing, not less. In Sri Lanka, Western diagnostic terms for schizophrenia were associated with new forms of social exclusion. The assumption that biomedical framing is universally destigmatizing turns out to be empirically unfounded and it is an assumption that has shaped enormous amounts of global mental health investment.

This matters because it illustrates a broader point: the risks of exporting Western models are not just theoretical. They play out in real people’s lives, in communities where the introduction of a foreign framework can disrupt existing social networks, undermine indigenous coping strategies, and create new forms of harm even while trying to help. That is a finding that should give the global mental health movement serious pause.

What are you reading, listening to, and/or watching right now?

I am currently reading The Wretched of the Earth by Frantz Fanon which feels more relevant than ever to the questions this paper raises about knowledge, power, and whose frameworks get to count as universal. Fanon’s analysis of colonial psychiatry is remarkably prescient, and I find myself returning to it as a grounding text for thinking about decolonial approaches to global health.

In terms of listening, I have been following the Global Health with Greg Martin podcast, which does a good job of bringing together researchers and practitioners from the Global South in conversations that do not always make it into mainstream journals. There is something valuable about hearing researchers from Sierra Leone, Uganda, and Nepal speak in their own voices about the challenges and opportunities in their contexts.

And I have been watching with great interest and some anxiety about the ongoing debates about artificial intelligence in healthcare. My own research has moved increasingly into machine learning applications for public health, and the questions about bias, equity, and whose data trains the models feel very continuous with the questions I am raising in this paper about whose knowledge shapes global mental health frameworks.

If there was one takeaway or action point you hope people will get from your work, what would it be?

The one thing I most want readers to take away is this: pluralism is not a compromise it is a superior framework.

I am aware that pluralism can sound like a polite way of saying “let’s include everyone and not make hard choices.” That is not what I mean. I mean something more specific and more demanding: that the most effective, most equitable, and most sustainable approaches to global mental health are those that genuinely value multiple healing traditions as legitimate on their own terms not as supplements to biomedical care, not as cultural window-dressing on Western protocols, but as systems of knowledge and practice that have evolved to address human suffering in specific social and historical contexts.

The practical implication is that funders, policymakers, and researchers need to stop treating the question “how do we scale up Western psychiatric models in low-income countries?” as the primary question of global mental health. The primary question should be: “How do we build mental health systems that are meaningful, accessible, and effective for the specific communities they serve?” Sometimes the answer will involve biomedical psychiatry. Often it will involve traditional healers, community volunteers, religious leaders, and social interventions that address the structural roots of distress. Almost always it will require local leadership, genuine community co-design, and the humility to recognize that the Global North does not have a monopoly on wisdom about how human beings heal.

That shift from export to partnership, from uniformity to pluralism is the action point I hope this paper contributes to.

Interview With Shai Satran

Posted by michellezernick

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Shai Satran is a Postdoc at MIT in the program of Science, Technology, and Society. His research lies at the intersection of Anthropology, Psychology and Technology. His dissertation, Couch to Keyboard: Patients, Labor and Data in the Age of Psychotherapy Automation, is an ethnography of computerized therapy, its development and its dissemination in Israel’s public mental health system. He is also trained as a psychotherapist.

What is your article “From Craft to Labor: How Automation is Transforming the Practice of Psychotherapy“ about?

My article is about a novel form of therapist-assisted computerized therapy and how it is changing the ways in which therapists do psychotherapy. I argue that computerized therapy introduces what is a major change to how psychotherapy is conducted, namely, that it constitutes a shift in psychotherapy’s status as a profession, from craft to labor. I use these terms in the Marxist sense, but basically what I mean to say is that therapists today usually still retain a very high level of control over the content and form of their therapeutic work, and that this is now changing in significant ways. I detail how computerized psychotherapy’s ‘division of labor’ is minimizing the control and influence of the therapists conducting therapy, while introducing a new and powerful level of management, and potentially degrading therapists’ status – but, and this is important, that it is also potentially of real value for patients.

Tell us a little bit about yourself and your research interests.

I was trained as a psychotherapist in Israel, and as a trainee I began practicing therapy. At a certain point I understood that I might find therapy more interesting to think about than to actually do, and decided to pursue a PhD through which I would be able to think deeply about issues related to psychotherapy. I think psychotherapy is fascinating and in my eyes still mysterious; how does it work? What is actually happening there? Beyond psychotherapy I have an interest in technology and its seemingly ever-growing role in our everyday life, dreams and fears.

What drew you to this project?

In one of the monthly seminars in the public clinic in which I was practicing, a psychology professor came to introduce a digital ‘gamified’ therapeutic app he developed as a supplement to face-to-face therapy. He presented the app, and a plethora of accompanying empirical evidence of its efficacy. After the lecture was over and the professor left, the head psychologist asked who would like to use the app with their patients. Over thirty therapists in the room, and not one raised their hand. I remember thinking “well, that’s interesting!”

What was one of the most interesting findings?

One thing that I found interesting, and this really came from ‘the field’ and not at all something that I expected to encounter, was the disparity in the experiences of computerized therapy between patients and therapists. While patients’ reactions were mixed of course, many of them describe the course of online therapy as a very positive, and beneficial, experience. Therapists, on the other hand, recognized the utility of this therapy but invariably described the experience as unfulfilling, and emphasized how they do not want to continue working as online therapists. I have come to realize that this gap between the experience of ‘service providers’ and ‘customers’ has become exceedingly common (e.g. Amaozn), and is in itself indicative of neoliberal trends and the professional shift I describe in the article.

What are you reading, listening to, and/or watching right now?

Unfortunately, I barely read for fun anymore! My next research project is a history of computer scientist Joseph Weizenbaum and his ELIZA computer program (1966) which famously impersonated a Rogerian (Carl Rogers’ client centered therapy) psychotherapist. So, I am reading through some of the seminal early texts of artificial intelligence; the things I imagine Weizenbaum must have been reading back then…

If there was one takeaway or action point you hope people will get from your work, what would it be?

That it would be a mistake to blindly vilify technology while romanticizing face to face interactions. I can understand, and even relate to, a certain disdain for the very idea of automating psychotherapy, but I think its worth remembering two things: First, there are real world constraints to providing quality care at scale and that different things work for different people. While many people may need a human relationship and a face to face encounter to experience positive change, others might actually do well with less than that. Second, not all in-person therapy is good therapy. Some of the patients I met during my research actually arrived at computerized therapy in order to avoid a face to face encounter with a therapist. It is painful but important to acknowledge that the very worst things that happen in therapy (malpractice, emotional abuse or sexual assault), even if they are rare, happen in face to face therapy.

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2025 Early Career Development Award Winner

Posted by michellezernick

Congratulations to our 2025 Early Career Development Award winner, Harry Whittle, for his piece, Ronaldo on the Clapham Omnibus: Complex Recoveries in Complex Psychosis.

Harry is a psychiatrist and anthropologist in training. He is currently a doctoral researcher in the Department of Anthropology and Sociology at SOAS University of London, where he is part of the Centre for Anthropology and Mental Health Research in Action (CAMHRA). Harry’s research focuses on ideas of recovery, rehabilitation, and community in mental health and mental health services, particularly in relation to people living with more complex, severe, and enduring forms of psychosis.

When asked about his article, Harry said:

In the article, I think critically about recovery in psychosis. I ask how it complicates our understanding of recovery if we consider the experiences of people with the most complex forms of psychosis, who have inadvertently been excluded from much debate on this topic. Drawing on six months of ethnography on an inpatient psychiatric rehabilitation unit, the article centres around a man I call Shepherd, whose journey to becoming a more confident, calmer, happier person was characterised by caution, masking, social withdrawal, and scepticism towards hope. These are embodied practices that seem incompatible with many portraits of recovery in the literature. Yet, here, they enabled—or even constituted—Shepherd’s recovery. The social complexities and ambivalences in his story reflect not only how complex recovery can be, but also how complex people’s relationships with mental health services can be. During his lengthy psychiatric admission, the coercive structures of the hospital were difficult to separate from the time, space, and relative safety they afforded Shepherd, which allowed him to figure out his recovery for himself. If we oversimplify recovery by missing people like Shepherd, we risk structurally undermining the interventions—like inpatient rehabilitation here—that may best support them to live well.

Congratulations, well earned!

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Interview With Nora S. West

Posted by michellezernick

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Assistant Professor, University of California, San Francisco

I am a social scientist who uses qualitative and mixed methods within infectious disease screening, diagnostics, and therapeutics. My research interests focus on understanding mental health trajectories during diagnosis and treatment, the influence of mental health on engagement with infectious disease care cascades, and implementation science approaches for integrating mental health services into infectious disease care.

What is your article “Okweraliikirira and Okwenyamira: Idioms of Psychological Distress Among People Living with HIV in Rakai, Uganda” about?

This study explored how people living with HIV in rural Uganda understand and express psychological distress. Interviews were conducted with 42 people, including those living with HIV, healthcare workers, and community members. Two main local terms were used to describe mental distress: okweraliikirira (worry/apprehension) and okwenyamira (deep thoughts/many thoughts). These expressions of distress were specifically linked to HIV-related challenges like fear of death, stigma from family and community, disclosure concerns, and financial stress from managing HIV care. Both types of distress were said to worsen HIV medication adherence and could progress to more severe mental health problems if left unaddressed. Participants identified counseling and social support as key treatments. The study suggests that understanding culturally specific ways of expressing distress is important for healthcare provision. Using local terms rather than Western psychiatric labels like “depression” may help identify people who need psychosocial support and make screening culturally appropriate and effective.

Tell us a little bit about yourself and your research interests.

My research focuses on understanding the dynamics of mental health across care and treatment cascades for infectious diseases, primarily, TB and HIV.

What drew you to this project?

I worked on several studies that used mental health screeners among people living with infectious diseases, and from that work, I realized that the interpretation of the screeners and expressions of mental distress did not always map onto commonly used screeners.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I have been reading Barbarian Days: A Surfing Life by William Finnegan and recently watched Downfall: The Case Against Boeing.

If there was one takeaway or action point you hope people will get from your work, what would it be?

Healthcare providers, mental health programs, and researchers should consider the relevance of incorporating culturally specific idioms of distress—like “okweraliikirira” (worry/apprehension) and “okwenyamira” (deep/many thoughts)—into their screening and treatment approaches rather than relying solely on Western diagnostic frameworks.

Other places to connect:

Website

Interview With Nathalia Costa

Posted by michellezernick

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

*Senior Research Fellow, University of Queensland*

Nathalia Costa is passionate about deepening the understanding of healthcare issues through qualitative methods and methodologies, with a focus on theoretically grounded, critical, reflexive and collaborative approaches. She advocates for pluralist inquiries to achieve the intersubjective understandings needed for impactful collective action.

What is your article “Non-clinical Psychosocial Mental Health Support Programmes for People with Diverse Language and Cultural Backgrounds: A Critical Rapid Review” about?

This critical rapid review examined non-clinical psychosocial support services for culturally and linguistically diverse (CALD) populations delivered by lay health workers. Drawing on a critical realist framework and Brossard and Chandler’s taxonomy on culture and mental health, the review analysed 38 studies (10 quantitative, 7 mixed-methods, and 21 qualitative), mostly conducted in North America and Europe. While many interventions focused on specific populations (e.g., refugees, Latinx immigrants) and targeted outcomes like depression and trauma, fewer studies used multimodal approaches or focused on broad populations. Despite short intervention durations, most reported positive psychosocial outcomes. Qualitative findings underscored barriers such as inadequate resources and limited cultural alignment. The review found most studies operated within split-relativist paradigms, aiming to help participants navigate Eurocentric systems. Culturally responsive and context-sensitive models, prioritisation of social determinants of health and community engagement are likely to be critical to ensure best practice in non-clinical psychosocial support.

Tell us a little bit about yourself and your research interests.

I am a Brazilian scholar living and working in Australia, and committed to shaping, enhancing and transforming quantitative evidence through qualitative methods and methodologies to make research, practice and education more inclusive and nuanced. With postdoctoral studies in policy and at the interface of clinical science and sociology, I draw from these disciplines to explore healthcare challenges and generate insights that drive meaningful change.

What drew you to this project?

I was drawn to this project through my longstanding collaboration with A/Prof Rebecca Olson and Dr Jenny Setchell, with whom I share a commitment to social justice and critical approaches to health research. An opportunity to evaluate a service providing non-clinical psychosocial support for people from multicultural backgrounds came up, and we thought it was important to ground our evaluation in a rigorous and critical understanding of best practice in this area. Rebecca invited me to co-lead the rapid review with her, and I enthusiastically accepted, seeing it as a valuable opportunity to contribute to work that aligns with my values and interests in diversity and policy-informed research.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I have been reading The view from Nowhere, by the philosopher Thomas Nigel. It is a book about subjectivity and objectivity – he argues that pure objectivity is impossible because we are embodied, situated beings. As far as I can tell from what I read so far, the book calls for a balance between subjectivity and (inherently limited) objectivity.

If there was one takeaway or action point you hope people will get from your work, what would it be?

It would be great if researchers and practitioners working in non-clinical psychosocial support for people from multicultural backgrounds to move beyond eurocentrism and individualistic understandings and approaches to mental ill-health, and instead adopt approaches that are grounded in an understanding of social, cultural, structural, historical and political contexts.

Other places to connect:

Website

Interview With Domonkos Sik

Posted by michellezernick

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Associate Professor, Eötvös Loránd University, Budapest

My research deals with various topics in critical theory including political culture and mental disorders in late modernity. My work has appeared in such venues as The Sociological Review, Theory, Culture & Society, European Journal of Social Theory, Thesis Eleven, Journal of Mental Health. Most recent books: Empty suffering (Routledge 2021) Salvaging modernity (Brill 2025).

What is your article “Between Depression and Alienation: Burnout as a Translator Category for Critical Theories“ about?

The article explores the psychopathological and sociological discourses surrounding the contested notion of burnout, with the aim of reintroducing it as a ‘translator category’. Such concepts, which can translate between everyday language, medical language and critical language, are particularly important in cases which originate from both individual and social causes. Without these translator categories, biomedical and psychopathological interpretations veil the social components of suffering – therefore, inevitably mistreat it as an exclusively individual problem. Furthermore, attempts at social critique also remain inaccessible because they rely on their own set of diagnostic concepts (such as alienation), while lay actors interpret their suffering as an illness or mental disorder (such as depression). To avoid these dead ends, the article discusses how burnout as a translator category can link the discourses of alienation (as a cause of burnout) and depression (as a consequence of burnout) while remaining accessible as a lay category.

Tell us a little bit about yourself and your research interests.

I was trained as a sociologist and philosopher in post-socialist Hungary. Initially, my research focused on democratic transition, particularly its phenomenological features. Since 2010, however, my attention has shifted from the criteria of democratic culture to the personal consequences of failed democratization. This led me to explore the links between social suffering and mental health issues, a topic which has become my main area of expertise over the last decade.

What drew you to this project?

After exploring several clinical categories (e.g. depression, anxiety, addiction) from a critical theoretical-phenomenological perspective (see my book Empty Suffering) I became interested in a phenomenon located at the intersection of biomedical and lay discourses. This is how I found the topic of burnout, which is contested within the biomedical discourses, while being widely applied by the lay actors at the same time.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I enjoy reading novels, viewing them not just as an excellent way to relax, but also as a constant source of inspiration for my social scientific work. As well as the better-known classics by authors such as Balzac and Dostoevsky, and contemporaries such as Ali Smith and Kazuo Ishiguro, I also enjoy the vivid Central European literary scene (authors such as Péter Nádas and Mircea Cărtărescu).

If there was one takeaway or action point you hope people will get from your work, what would it be?

Most mental health conditions are inextricably linked to social dysfunction and structural distortion. If we do not address the ‘social pathologies of contemporary civilization’ (that is also the name of a research network I am currently involved in: https://socialpath.org/), there is little hope of stopping the ‘epidemics’ of depression and burnout.

Other places to connect:

Website

Interview With Florin Cristea

Posted by michellezernick

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Florin Cristea is a PhD candidate in psychological and medical anthropology at the Freie Universität Berlin. His research focuses on understanding the moral world of people diagnosed with severe psychiatric disorders. In his work, he engaged with the social and clinical life worlds of people with a lived experience of psychiatric encounters in Romania, Tanzania, and Indonesia.

What is your article “Navigating the Unknown: Mental Pain, Uncertainty, and Self-Isolation in Bali and Java“ about?

Suffering has long been a central theme in anthropology. Yet, despite growing interest in psychology and psychiatry, anthropological engagement with mental or emotional pain (as stand-alone concepts) has remained limited. In my article, based on fieldwork in Indonesia on severe psychiatric disorders, I tried to understand the impact of mental pain on the person experiencing it and their immediate environment. I first outlined the salient attributes of mental pain as they emerged during my conversations with patients and observations of their everyday lives. I then suggested that these attributes contributed to the uncertainties individuals faced as part of their experiences with severe psychiatric disorders. Finally, my main argument was that the interplay between mental pain and uncertainties informed certain illness behaviors, particularly tendencies toward self-isolation.

Tell us a little bit about yourself and your research interests.

I am interested in the anthropology of mental health and illness, as well as in Global Health and Global Mental Health. I am fascinated by how different knowledge worlds come together and influence people’s understanding of what it means to be healthy, sick, and ultimately human. While my work has been strongly influenced by critical medical and psychological anthropology, I try to maintain an open engagement with the psy and biomedical sciences and seek venues of mutual understanding and collaboration.

What drew you to this project?

I initially was drawn to alternative understandings of the mind in Indonesia. However, mapping out these understandings proved far more complex than I had anticipated. Addressing mental pain was my way of making sense of the muddle that became my data.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

A friend recently recommended “Lightseekers” by Femi Kayode, and I am looking forward to reading it on my upcoming vacation. I am grateful to have time to enjoy something completely unrelated to work.

If there was one takeaway or action point you hope people will get from your work, what would it be?

Isolation of people diagnosed with a severe psychiatric disorder is a fairly common problem, irrespective of where it occurs. It is important to note or to reiterate that isolation is not only the result of social attitudes toward mental illnesses, nor is it an individual issue. It is part and parcel of the intersubjective nature of the encounter between the social and the individual. We need to do better in understanding this relationship.

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Interview With Ángela Cifuentes Astete

Posted by matthewbmartinelli

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Professor, Department of Humanistic Studies, Universidad Técnica Federico Santa María, Santiago, Chile. Associate researcher, Transdisciplinary Laboratory on Social Practices and Subjectivity (LaPSoS), Faculty of Social Sciences, Universidad de Chile. External member, Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, España

Ángela Cifuentes is a transdisciplinary researcher, clinical psychologist and psychoanalyst, holding PhDs in Social Sciences and in Medical Anthropology and Global Health. In recent years, she has focused on exploring experiences of anxiety, forms of affectation, and mental health care practices in contemporary Chilean universities shaped by neoliberal logic.

What is your article “The University Lives Anxiety and De-pression”: Diagnostic Uses and Affective Negotiations in Mental Health Care Services for University Students in Chile” about?

In this article, I explore how mental health problems are experienced and named in Chilean universities, especially in contexts marked by competition, performance, and inequality. Based on interviews I conducted with students and mental health professionals across three types of institutions, I analyze the everyday uses of diagnoses like “anxiety” and “depression.” I show that, both for students and for professionals, these diagnoses do not necessarily reflect clinical illnesses but often serve as ways of naming forms of distress tied to the demands of academic life. In many cases, they allow students to access institutional support or justify difficult decisions, such as taking a break or changing degrees. I argue that these diagnostic uses are also affective negotiations in response to pressures of academic performance and social adjustment, and they open space for imagining alternatives in the face of failure. Mental health in the university thus emerges as a complex, contested, and constantly shifting field.

Tell us a little bit about yourself and your research interests.

My experience as a clinical psychologist and psychoanalyst in various public and private mental health institutions has shaped a critical lens on experiences of suffering, affects, and the modes of management and care within institutions, leading me to focus on their political, cultural, and socio-historical dimensions. I am interested in generating knowledge that enables a deeper understanding of complex phenomena and contributes to social transformation. Currently, I am particularly interested in continuing research on university mental health, especially how global mental health discourses are locally reconfigured in Chilean universities in the post-pandemic context, exploring the affects, interdependencies, and technical mediations that shape students’ everyday care practices.

What drew you to this project?

The article is based on part of the findings from my doctoral research. Initially, the project aimed to study so-called ‘anxiety disorders’ in the context of public health in Chile. However, during the course of my doctoral studies, various expressions of distress erupted in Chilean universities: first, in May 2018, feminist protests against abuse and gender-based violence within universities; and then, in April 2019 (just a few months before the ‘chilean social uprising’), protests demanding greater access to mental health treatment services in universities. In those protests, student banners—echoed in the title of my article—declared that ‘at university we live anxiety and de-pression.’ This shifted my attention toward the use of mental health language in expressions of discontent, the institutional management of anxious affects, and its relationship to performance demands in universities.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

This year, I’ve immersed myself in the work of Ursula K. Le Guin, fascinated by her ability to imagine alternative forms of life, relationships, and vital persistence. Her literature has become a source of inspiration for rethinking research as a political gesture. After reading several of her science fiction novels, I’ve now begun reading the fantasy saga “The Earthsea Cycle” with my daughter. Musically, I tend to move between very different registers — from dense, dark sounds to fusions that open up to something more hopeful. Lately, while working, I’ve been listening a lot to Tigran Hamasyan, an Armenian jazz pianist whose music helps me stay grounded and focused. On screen, I’m watching the final season of “The Handmaid’s Tale”.

If there was one takeaway or action point you hope people will get from your work, what would it be?

The main conclusion I aim to convey through my work is that mental health in university settings cannot be understood or addressed solely through reductionist and biomedical perspectives—nor can it be fully captured by interpretations that frame it exclusively as a form of inescapable social control. My research shows that while diagnoses and expressions of distress often involve individualized uses, they also function as affective languages and negotiation strategies in response to the demands of neoliberal academia. The key takeaway I propose is to rethink university mental health as a situated, collective, and political issue that reflects structural forms of exclusion, precarity, and inequality. It is urgent that public policies and institutional interventions acknowledge this pragmatic-political dimension of diagnoses, and move toward co-constructed strategies that do not reduce the complexity of student suffering to the private or clinical realm, but instead open up spaces for listening, recognition, and transformation of the structural conditions that produce it.

Other places to connect:

Website

Interview With Christopher Chapman

Posted by matthewbmartinelli

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Assistant Professor, Nanyang Technological University; Postdoctoral Affiliate, University
of Oxford

I am a medical anthropologist and sociologist. My work explores the intricacies of health and medicine in the Asia-Pacific, focusing on how people care for each other and how these practices intersect with medical and social service systems.

What is your article “Yuri’s Story: Memory, Relational Healing, and the Reflexive Logics of Art Therapy in Japanese Clinical Psychology” about?

Child protection systems around the world utilize mental health professionals to conduct assessments and provide children with therapeutic care. Japan is no exception. But thinking about child welfare and mental health cross-culturally helps us appreciate the
social side of practices that are commonly seen as (or hoped to be) objective, technical, and universal. My article details how clinical psychologist Yuri learned how to use art therapy to improve her professional work with abused or neglected children. Yuri’s story inadvertently dug up her own painful memories. Her return to childhood through art therapy unsettled her worldview: was her clinical work actually for the children, or was it just for herself? Yet, Yuri renewed her sense of clinical will. Cathartic resolutions of distress may help care practitioners develop empathy and become better carers. This is how Yuri thought art therapy was innovative for mental health care.

Tell us a little bit about yourself and your research interests.

While I am originally from a small, rural town in the Northwestern U.S., my research training has taken me across the world, from Hawai‘i and Japan to the U.K. and Thailand. My experiences in these places shape my interests in how people think about and enact care—and the lived realities of how caregiving plays out.

What drew you to this project?

I always find myself drawn to the ‘in-between’ things, especially in medicine and culture. Child protection does not immediately bring things like clinics and hospitals to mind, but it is a critically important arena where decisions and actions have dire consequences for one’s health and well-being. Japan’s child protection system has been undergoing significant reform throughout the past decade, providing an even more complicated space to think about care and culture.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

While I am reading (and re-reading) chapters from my in-progress book, I also recently started re-reading the Expanse series by James S. A. Corey. It is a fun hobby, but for my work, it is also helpful in seeing how writers in other genres craft an argument, describe social life, and present information to the reader.

If there was one takeaway or action point you hope people will get from your work, what would it be?

I cannot stress enough the value of strong and long-term relationships in ethnographic work. Yuri’s story was not a single moment, but conversations at the office, meetings in the therapy room, and chats in coffee shops over a year. I learned some of the most moving parts of her life quite late into my fieldwork. It can take time to appreciate another person’s life, but taking small steps toward making a person feel wanted can go a long way in building a rewarding connection (like inviting someone to a cup of
coffee/tea).

Interview With Henry J. Whittle

Posted by matthewbmartinelli

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Doctoral researcher, Department of Anthropology and Sociology & Centre for Anthropology and Mental Health Research in Action (CAMHRA), SOAS University of London

Dr Henry Whittle is a psychiatrist and anthropologist in training. He began his research career using mixed methods to study food insecurity, before pivoting towards mental health rehabilitation after specialising in psychiatry. Following further training in medical anthropology, he is currently working towards a PhD at SOAS University of London.

What is your article “Ronaldo on the Clapham Omnibus: Complex Recoveries in Complex Psychosis“ about?

In the article, I think about what we mean by recovery in psychosis. I ask how it complicates our current understanding of recovery if we consider the experiences of people with the most complex forms of psychosis. These people are inadvertently excluded from much debate on this topic. Ethnography is one of the few ways that their experiences can be incorporated meaningfully. Drawing on six months of ethnography on an inpatient psychiatric rehabilitation unit, the article centres around a man I call Shepherd, whose journey to becoming a more confident, calmer, happier person looked very different to most portraits of recovery in the existing literature. This is important because our understanding of recovery shapes mental health policy in material ways. If we oversimplify recovery by missing people like Shepherd, we risk structurally undermining the interventions—including inpatient rehabilitation—that may be most effective in supporting them to live well.

Tell us a little bit about yourself and your research interests.

I am a psychiatrist and anthropologist, still working through my training in both disciplines. I currently work in an Early Intervention in Psychosis service in London and I will be part of the new Centre for Anthropology and Mental Health Research in Action (CAMHRA) at SOAS University of London. My research interests broadly relate to the social, cultural, and structural influences on mental health care and recovery, particularly for people living with more severe and enduring mental illnesses. Above all, I am an advocate for using applied social science as a basis for dialogue with service users, clinicians, practitioners, relatives, carers, and everyone else invested in improving mental health services.

What drew you to this project?

I have been intrigued by inpatient units ever since I first started working in psychiatry. Even though things are a little different now from how they were in Goffman’s time, the ‘total institution’ was still the main conceptual apparatus I received from my professional training to think through these places. Contributing towards addressing that gap, even slightly, was part of my motivation for taking on this project. The other part was that I have always been drawn to working with people with complex psychosis. I have learned so much from them, mainly about the limits of my own frameworks and my own imagination, but also about the complex, conflicting, and sometimes unexpected roles that institutions play in their lives. This is poorly captured in a clinical evidence base that, on the whole, tends to privilege streamlined understandings and analytic closure. I thought that ethnography could be particularly useful here—to help us hold onto that complexity as we make pragmatic decisions about care.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

Music and sport are big parts of my life. Both were important for this study. I bonded with Shepherd over a shared love of sport, and when I think of Apollo Ward I mainly think of playing pool and taking requests to play music on my phone—Orbital, Ed Sheeran, the Darkness, and the Rolling Stones were the soundtrack to this study. So now I’m watching my beloved Liverpool play football again after celebrating England Lionesses win the European Championship, and I’m listening to a lot of exciting British and Irish post-punk bands—Big Special, Wet Leg, and Sprints at the moment. I also recently started reading The Brown Sahib Revisited by Tarzie Vittachi, a searing takedown of the legacies of British colonialism in South Asia that was a wonderful gift given to me by my mentor and friend Sushrut Jadhav.

If there was one takeaway or action point you hope people will get from your work, what would it be?

That we need to take people’s ambivalent feelings and contradictory dispositions towards mental health services seriously in imperfect systems, even if it makes us uncomfortable. These contradictions may be our only glimpses of the life-sustaining roles that some institutions play in people’s lives. That is not to say that we should avoid radical critique, just that we need to proceed with caution. It is easy to miss complexity in this field, and missing complexity has material consequences that tend to impact the most marginalised people disproportionately.