Globalisation and mental health

Globalisation affects the way people live and work. It is hardly surprising, then, that globalisation and its related social and economic changes affect the mental health of individuals and countries. Economic and social change has left many people without incomes and has led to a breakdown in traditional family and community structures as the most able travel miles to live in crowded, polluted slums in search of work.

Waste disposal problems, traffic congestion, pollution and high crime rates make slums tough places to live and add to the chances of people suffering mental health problems. People living in the slums of Islamabad and Dhaka, for example, are prone to mental distress as well as poor physical health as they try to survive in cramped homes with inadequate access to clean water.

Social change caused by globalisation can have a detrimental effect on people in the following ways:

• As families reduce in size and fathers migrate to cities in search of work, mothers of young children can no longer rely on family support and protection against postnatal and other forms of depression. In Khayelitsha, a village near Cape Town, South Africa, 34 percent of migrant women who had recently given birth were suffering from untreated postnatal depression - approximately three times the average rate in developed countries.
• Older people may find themselves without the support of their children and grandchildren who leave the family home to find work, and are less likely to be cared for when mentally ill.
• Women in poor countries are particularly vulnerable to the effects of globalisation on their livelihoods and their roles in maintaining family cohesion. They often disproportionately bear the burden of changes associated with globalisation. The suicide rates amongst young women in China (50 percent of global suicides) and South Asia are mainly attributed to abuse, forced marriage and harsh market-orientated economic reforms.
• Suicide committed by men who have lost their livelihoods, often due to their or their employers' inability to compete in the global market is on the rise amongst factory workers in Eastern Europe and farmers in South Asia.

Globalisation and the media worldwide influence how people understand and experience mental disorder. People in developing countries adopt Western labels for mental disorders and treatment, including psychotherapy and psychotic medicines. The success of Western pharmaceutical companies in developing countries, where drug use for mental disorders is historically low, is a cause for concern. During the economic crisis of 2001 to 2002 in Argentina, for example, there was an increase in prescriptions for antidepressants, apparently as an antidote to insecurity and vulnerability; it is unlikely that pharmaceuticals would have been so widely used in such circumstances a generation ago.

Although globalisation affects those in wealthier countries as well - including through media exposure to violence and trauma - the clear priority is to understand more about how globalisation affects the mental health of people living in poorer countries, and to develop ways of supporting them. The following steps need to be taken:

• develop and disseminate research on the impact of globalisation on mental health
• include mental health assessments in impact studies of globalisation
• influence multinational companies to provide mental health support to employees and their families in developing countries
• support and develop initiatives to empower women as caregivers, focusing on literacy and skills development.

Leslie Swartz
Child, Youth and Family Development
Human Sciences Research Council
Private Bag X9182
Cape Town, 8000
South Africa
T +27 21 466 7864/6
F +27 21 466 7989
lswartz@hsrc.ac.za www.hsrc.ac.za

See also

'The future of cultural psychiatry: an international perspective', Canadian Journal of Psychiatry 45: 438-446 by L.J. Kirmayer and H. Minas, 2000

'The anxieties of globalisation: antidepressant sales and economic crisis in Argentina', Social Studies of Science 34: 247-269 by A. Lakoff, 2004

'Globalisation, cultural psychiatry and mental distress', International Journal of Social Psychiatry 49: 163-165 by A. Mastrogianni and D. Bhugra, 2003

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