Cult Med Psychiatry (2014) 38:499–511

DOI 10.1007/s11013-014-9382-y

OPINION

Beyond Critique: Rethinking Roles

for the Anthropology of Mental Health

Rob Whitley

Published online: 3 July 2014

 Springer Science+Business Media New York 2014

Abstract The current supremacy of the ‘bio-bio-bio’ model within the discipline
of psychiatry has progressively marginalized social science approaches to mental
health. This situation begs the question, what role is there for the anthropology of
mental health? In this essay, I contend that there are three essential roles for the
anthropology of mental health in an era of biological psychiatry. These roles are to
(i) provide a meaningful critique of practices, beliefs, and movements within current
psychiatry; (ii) illuminate the socio-cultural, clinical, and familial context of suf-
fering and healing regarding emotional distress/mental illness; and (iii) act as a
catalyst for positive change regarding healing, services and provisions for people
with emotional distress/mental illness. My argument is unified by my contention
that a credible anthropology of mental health intending to make a societal contri-
bution should offer no opposition without proposition. In other words, any critique
must be counter-balanced by the detailing of solutions and proposals for change.
This will ensure that the anthropology of mental health continues to contribute
critical knowledge to the understanding of mental suffering, distress, and healing.
Such social and cultural approaches are becoming especially important given the
widespread disenchantment with an increasingly dominant biological psychiatry.

Keywords Anthropology
Psychiatry
Biopsychosocial
Qualitative

Mental health

R. Whitley (&)
Department of Psychiatry, Douglas Mental Health University Institute, McGill University,
Montreal, Canada
e-mail: [Link]@[Link]

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Introduction

In 1989, President George H. W. Bush announced that the 1990s would be an

officially recognized ‘decade of the brain.’ One aim of this endeavor was to produce
new knowledge that would address the huge burden of psychiatric and neurological
morbidities through intense research efforts (Tandon 2000). A retrospective
consideration of the ‘decade of the brain’ indicates some impressive achievements.
For example, the decade produced considerable advances in basic knowledge
regarding neuroplasticity and epigenetics; this has heavily influenced scholarly
thought across a range of disciplines including psychology, psychiatry, and
neurology (Weaver et al. 2004, Butz et al. 2009, Holtmaat and Svoboda 2009).
That said, informed consideration of the legacy of the ‘decade of the brain’ must
acknowledge that its impact went far beyond the mechanical production of new
knowledge. Future historians might see this decade as a nodal point in the
development of psychiatry, representing a momentous paradigm shift towards a
psychiatry that is now overwhelmingly dominated by neuroscience, biology, and
psychopharmacology (Insel and Quirion 2005; Insel 2010). Indeed many commen-
tators have argued that the traditional ‘bio-psycho-social’ model of mental illness
has now been replaced by a ‘bio-bio-bio’ model of genetic causation, brain disease,
and pharmacological intervention (Read 2005; Luhrmann 2012).
The current supremacy of the biological within the discipline of psychiatry has
sidelined social science approaches to mental health, which have progressively
shifted from the mainstream to the margins (Pilgrim and Rogers 2005). This begs
the question, what role is there for an anthropology of mental health given the
apparent marginalization and neglect of social science approaches in contemporary
psychiatry?
It is my contention that these wider trends within psychiatry, far from signifying
the death knell of the anthropology of mental health, should in fact be considered a
clarion call for scholars working in this field. Now, more than ever, a strong
contribution from a revitalized medical anthropology is needed to counter-balance
biological domination within psychiatry.
This may mean an expansion, or reorientation, of core activities conducted by
scholars working in the anthropology of mental health. Many commentators have
criticized medical anthropology for its perceived counter-productive oppositional
tone (e.g., Konner 1991). Hemmings (2005) argues that medical anthropology has
‘helped to articulate the problems of medicine but not provided realistic solutions,’
stating that it is largely irrelevant and ignored in clinical settings and trainings.
Good (1992) claimed that is it ‘fashionable in anthropology to criticize or even
ridicule psychiatry…,’ a sentiment still evident in the writings of many critical
anthropologists today. Others have remarked that the ability to contribute to society
is a key benchmark that applies to all academic disciplines, and that medical
anthropology sometimes falls short due to its overly critical perspectives (e.g.,
Peacock 1997, Kleinman 1985).
Mindful of the above critiques, it is my contention that an academic discipline
cannot flourish and thrive if its primary activity is to criticize another academic
discipline, however worthy such an activity maybe. Though indubitably important, I

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argue in this essay that the anthropology of mental health must counter-balance any
critique with proposed solutions. My argument is unified by my contention that a
credible anthropology of mental health intending to make a societal contribution
should offer no opposition without proposition.
In this regard, it is worth noting that Shand (2005) makes a distinction between
anthropology in medicine and anthropology of medicine. This is similar to Scheper-
Hughes (1990) distinction between clinical medical anthropology and critical
medical anthropology. While the anthropology of medicine (or critical medical
anthropology) often focuses on critique and theoretical issues, anthropology in
medicine (or clinical medical anthropology) focuses on practical solutions to
pressing problems. I contend that the latter is a vitally important component of the
anthropology of mental health because of its concrete contribution to service
provision.
As such, I argue that there are three essential and complementary roles for the
anthropology of mental health in this era of biological psychiatry. These three roles
are to (i) provide a meaningful critique of practices, beliefs, and movements within
current psychiatry; (ii) illuminate the socio-cultural, clinical, and familial context of
suffering and healing regarding emotional distress/mental illness; and (iii) act as a
catalyst for positive change regarding healing, services, and provisions for people
with emotional distress/mental illness.
Each of these three roles is discussed separately below, and is illuminated
through the presentation of various examples. It is noted that these examples are
selective rather than exhaustive, and that there is overlap between the three roles.
Far from being a comprehensive overview, the aim of this paper is to stimulate
further thought regarding the roles and relevance of the anthropology of mental
health given current trends in psychiatry.

Critique

As previously stated, one of the historic roles of the anthropology of mental health is
to provide a critique of the various practices, beliefs, and movements that make up
contemporaneous psychiatry. This remains a valuable activity, and has traditionally
taken various forms, but might best be divided into critiques that focus on
psychiatric abuses, absences, or excesses.
In terms of abuses, the anthropology of mental health has revealed numerous
practices within psychiatry that have had a deleterious effect on patients, staff, or
families. Along with other social scientists, anthropologists have played a key role
in uncovering some of the contemporaneous and historic abuses that were
commonly occurring within mental hospitals (e.g., Metzl 2009, Barrett 1996,
Goffman 1961). The amassed critique derived from social science research on this
topic contributed to changing perspectives regarding the wisdom of long-term
hospitalization for people with a severe mental illness. This is an example where
critique played an influential role in changing practice on the ground.
Anthropologists have also been at the forefront of other critiques regarding
potential abuses within psychiatry, for example, the overreliance on pharmaceutical

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interventions to the detriment of psychosocial interventions (Jenkins 2012). Some

have noted that these interventions have been uncritically, aggressively, and
excessively exported overseas with little attention paid to emic models of distress or
local ecologies of healing (e.g., Applbaum 2006a, b). Indeed a key role for the
anthropology of mental health is to document and analyze some of the potential and
real abuses of psychiatry in non-western settings. In essence, this critique of abuses
brings focus upon the dangers of iatrogenesis and ‘too much’ psychiatric
intervention.
In contrast, the critique of absences within the anthropology of mental health has
uncovered the unavailability, inaccessibility, or inadequacy of treatments and
services offered to people with a mental illness living in the community. In essence,
this is a critique of ‘too little’ psychiatric intervention, especially where psychiatric
intervention is broadly defined to include factors such as vocational rehabilitation,
housing, and basic medical care. This is perhaps best exemplified in Estroff’s
(Estroff 1981, 1985) classic evaluation of an early Program for Assertive
Community Treatment (PACT). This study illuminated the scantiness of follow-
up supports and the concomitant struggles made by those attempting to survive in
the community. Likewise, the accumulated work of numerous anthropologists
indicates the grinding insufficiency of housing services for people with a severe
mental illness, simultaneously detailing the deleterious effect of homelessness on
mental and physical health (e.g., Luhrmann 2007; Desjarlais 1997). Highlighting
societal failures to provide accessible and effective services to people with a mental
illness remains an increasingly important role for the anthropology of mental health.
In terms of excesses, the anthropology of mental health, in its study of
movements or trends within psychiatry, continues to investigate some of the
potential misapplications or unintended consequences of certain paradigms within
psychiatry. It has also tempered some of the over-enthusiastic zeal of psychiatry,
occasionally applying the brakes on psychiatric fervor. For example, many
anthropologists have continuously warned about the dangers of diagnostic
proliferation and reification within psychiatry, especially in a cross-cultural context
(e.g., Good 1992, Hinton and Good 2009). This approach questions the ontological
nature of psychiatric categories (such as post-traumatic stress disorder), as well as
the processes of social construction which underpin their ‘reality’ (Young 1995).
Critical examination of such excesses remains an essential role for the anthropology
of mental health, especially considering ongoing discussions about diagnostic
proliferation in the light of the newly released DSM-5 (Frances 2013).
Recent critical thinking vis-à-vis cross-cultural psychiatry is inspired by
Kleinman’s classic work on category fallacy, cautioning against the unquestioning
application of western-based psychiatric categories elsewhere in the world. Such
work has established that symptom expression for specific disorders shifts across
cultural boundaries, even for illnesses with a supposed organic basis, with particular
cultures often having particular ‘idioms of distress’ (Kleinman 1987). An example
of this is the considerable scholarship on the cross-cultural expression of depression,
especially work on the relative role of somatization and psychologization in
different cultures (Kirmayer and Young 1998). This body of work brings into
question the ‘exportability’ of western-based diagnostic criteria, simultaneously

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suggesting that salient and severe emotional distress common in non-western

settings could be missed through the rigid application of western-based psychiatric
models. Such work is taking on increasing importance given the recent rise of the
global mental health movement (Patel 2012).
As the pace and scope of change within psychiatry intensifies, there is an urgent
need to critically assess current trends and directions within the discipline. Current
areas of controversy where medical anthropology is encouraging reflection include
critiques regarding the aforementioned global mental health movement (Swartz
2012), recovery movement (Myers 2010), and the first episode psychosis movement
(Tranulis et al. 2009). Common across critiques of these three movements is a
sentiment that, while containing much of merit, they can be co-opted for nefarious
reasons. These include retrenchment, profiteering and psychiatric expansionism.
These movements can also lead to unintended consequences, which can be well
assessed by anthropological methods. Such consequences include unreasonable and
demanding expectations regarding recovery, increased surveillance (and consequent
stigma) of mentally healthy people deemed to be ‘at-risk’ of psychosis, and the
imposition of alien models of distress (and healing) on indigenous populations
(Watters 2010).
Another rapidly expanding area in psychiatry is the spread and utilization of
technological interventions such as Trans Cranial Stimulation (TMS), genetic
testing, and other similar interventions (Carlat 2010). These interventions hold
much promise, but as yet have shown little clinical impact. Singer and Erickson
(2011) have cautioned against ‘‘the fallacy of a biotechnological salvation that
ignores…the importance of the social and the cultural’’. Despite such admonitions,
little anthropological research has examined the impact and perceptions of such
interventions, and this remains an area ripe for future research.
Providing a coherent and carefully considered critique of psychiatric practices
remains a key role for the anthropology of mental health. This in itself indirectly
drives change by encouraging reflection and placing the spotlight on questionable
activities. However, such a critique must be complemented by more purposive
attempts to propose solutions. Thus, in the remaining sections, I detail ways in
which the anthropology of mental health can move beyond critique to positively
engage with psychiatry.

Context

A fundamental mission of the anthropology of mental health has been to illuminate

the context of suffering and healing vis-a-vis mental illness and emotional distress.
This remains an essential component of medical anthropology, and is becoming
especially important due to growing health inequalities within and between nations,
as well as increasing cultural diversity within the western world. The anthropology
of mental health is well-placed to research mental illness, emotional distress, and
social suffering among marginalized and underserved groups, at the national and
global level (Kleinman, Das and Lock 1997). In investigating the context of
suffering and healing, the anthropologist can go beyond mere description, by

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intimately analyzing the underlying cultural, social, historic, and economic issues
that produce and maintain distress and suffering (Rylko-Bauer et al. 2006).
Obviously, this is a role to which biological psychiatry is ill-fitted. In this section, I
give examples indicating how the anthropology of mental health has contributed to
the production of important knowledge regarding three specific contexts: the socio-
cultural context, the treatment context, and the family context.
Perhaps, one of the richest areas in this regard is that of indigenous mental health.
This accumulated body of research has indicated how historic discrimination,
intense economic deprivation, and social marginalization are linked to high rates of
substance abuse and suicide among some Aboriginal communities in North America
(Gone 2007; Kral 2013). This has been done through solid anthropological case
studies of single communities, often involving anthropologists working in teams
with epidemiologists, psychologists, psychiatrists, and public health scholars (e.g.,
Kral et al. 2011). Such work has propelled better and more culturally sensitive
interventions for indigenous people, though much work needs to be done.
This collaborative approach has also characterized highly successful cross-
cultural or cross-national studies that have attempted to assess the impact of social
and cultural context on mental health. Perhaps, the most famous of these is the
International Pilot Study of Schizophrenia, where a team of researchers including
anthropologists compared course and outcome of schizophrenia in nine countries,
involving over 1,000 participants (Hopper 2007). Key findings from this study, for
example, that recovery from schizophrenia appears to be better in developing
countries (Leff et al. 1992), have spawned in-depth case studies examining the role
of factors such as spirituality, family dynamics, and stigma (or lack thereof) in
influencing recovery (e.g., Corin et al. 2005; Marrow and Luhrmann 2012). Such
studies ensure that knowledge exchange between north and south is bi-directional.
This can be mutually enriching, having important implications for policy in the
developed, as much as the developing, world.
Indeed bringing anthropological sophistication to bear on the contextualization of
‘psychiatric’ distress in developing countries remains an important staple of medical
anthropology. One area of increasing focus is the examination of trauma and PTSD
in the context of war and dispossession, showing how mental illness cannot be
understood without a careful consideration of socio-political context (e.g., Kienzler
2008, Zarowsky 2000, 2004).
In addition to examining the socio-cultural context, many working in the
anthropology of mental health continue to examine the ‘treatment’ or ‘service’
context. Researchers have immersed themselves in certain treatment settings to gain
a better grasp of the impact of such treatments on people with a mental illness.
Recent examples include in-depth analysis of innovative ‘recovery centers’ that
attempt to help people with a severe mental illness (e.g., Whitley and Siantz 2012;
Lewis et al. 2012). Others have focused on the treatment team itself (e.g., Brodwin
2013; Luhrmann 2000), or examined how healers define, manage, and treat
emotional distress (e.g., Kirmayer 2004; Kleinman 1980). In this sense, anthropol-
ogists continue to be one of the few groups within psychiatry who attempt to shed
light on the lifeworlds of clinicians and healers in addition to patients. Examination
of services and treatments through an anthropological lens remains critical as these

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services and treatments proliferate and diversify across the world. In this sense,
Lester’s (2007) work comparing eating disorder clinics in the U.S. and in Mexico is
instructive, and maybe a model for future research.
There is a strong tradition in the anthropology of mental health examining the
influence of family context on the aetiology, course, and outcome of mental illness.
While this is often associated with the distant past, namely the now discredited
notion of the schizophregenic mother (Bateson et al. 1956), these influences persist.
Instead of speculating on family role in etiology, anthropologists in the present are
focusing on the role families who can play as facilitators (or barriers) towards
recovery, or examining the cross-cultural variation in family response to a
psychiatric diagnosis or treatment. This has involved comparing the meaning and
experiences of psychiatric diagnosis in families from different ethno-racial groups
(e.g., Carpenter-Song 2009) or examining how far families from different ethno-
racial groups encourage service utilization (Carpenter-Song et al. 2010). It has also
involved in-depth case studies of single communities to examine how changing
socio-cultural conditions impact upon family structure, and how this in turn
influences mental health (e.g., Scheper-Hughes 1982).
What is transversal across all the examples given above is the focus on the
‘social.’ In this sense, the ‘social’ can be considered an umbrella term for the
multifarious non-biological individual and supra-individual factors that impinge on
health and well-being. This is commonly elicited through in-depth ethnographic
case studies, team approaches that involve multi-disciplinary collaboration, and
comparative studies that contrast experience in different cultures. Key conclusions
resulting from the above studies are that context matters, and that documentation of
social, cultural, and historic trends is essential to understand individual-level
suffering in the here and now. Another key conclusion is that emic perspectives
must be elicited to better understand the experience of emotional distress and mental
illness. These studies suggest that one-size-fits-all solutions at both national and
global levels will unlikely work given the diversity in notions of suffering, contexts
of healing and structure of (formal and informal) health care systems. These latter
issues are dealt with in the next section, which suggests that the knowledge
produced by the anthropological studies must be marshaled to catalyze change.

Catalyst

As noted in the introduction, some have stated that medical anthropology has a
carping over-critical tone which diminishes its credibility and societal contribution.
This perspective is extended by (Rylko-Bauer et al. 2006: p. 178) who state that for
anthropologists ‘writing with passion for a largely academic audience is not nearly
enough.’ As such I contend that there is an urgent need for anthropologists to use
their work to catalyze change on the ground. Such change can be achieved through
various activities including advocacy, lobbying, engagement with policy makers,
testifying in court, writing for a broad audience (including op-eds), and other
outreach endeavors. These activities are sometimes known under the amorphous

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terms ‘public anthropology’ or ‘applied anthropology,’ with an underlying belief

that research and action are natural bedfellows that should not be decoupled.
That said, there are challenges to such endeavors. Promoting change is a role
with which anthropologists maybe least trained and most uncomfortable in
engaging. This is partly due to the tainted legacy of colonial anthropology, where
anthropologists often worked hand-in-glove with an oppressive colonial power in
the practical management (and subjugation) of native populations (Asad 1979). This
can lead to reluctance to engage in action-oriented approaches from historically
aware anthropologists. I argue that this tainted legacy should remain instructive to
those attempting to catalyze change on the ground, but also that the anthropologist
should not stand idly by in the face of obvious injustice, suffering, and inequality.
As such, I suggest three practical ways that anthropologists can catalyze change on
the ground. These are (i) engaging with policy- makers, legislators, legislatures and
if necessary with the courts; (ii) working with community organizations and the
public to lobby for change; and (iii) improving and expanding services through
developing, evaluating, enhancing and scaling-up interventions.
In order to focus thought on this issue, I will discuss the amassed contribution of
one research group which has acted in an exemplary manner in trying to effect
change on the ground. This is the work of Kim Hopper and colleagues. They have
worked tirelessly on the issue of homelessness and mental illness for over thirty
years, conducting numerous ethnographic studies in New York City and elsewhere
(e.g., Hopper 1988; Salerno, Hopper and Baxter 1984; Baxter and Hopper 1981).
Key knowledge produced from such studies includes description of the ‘institutional
circuit’ where individuals rotate between prison, mental hospitals, homeless
shelters, and the street. It also includes description of the social problems and
structures that produce and maintain homelessness, including the role of economic
downturns, family dynamics, and government retrenchment.
However for Hopper and his team, an anthropologist’s work extends far beyond the
‘neutral’ recording and analysis of life conditions. Williams (2013) notes that Hopper
has pro-actively engaged with policy-makers at the local and national level, as well as
using his ethnographic results as expert testimony in the courts in class-action lawsuits.
Hopper has also mobilized his knowledge by working closely with community non-
profits. Most notably, he co-founded the National Coalition for the Homeless and
subsequently served as its president. This organization has been instrumental in fighting
for the human rights of homeless people, for example by winning a ‘right to shelter’
lawsuit in New York City. In summary, Hopper and colleagues have lobbied for change
at the policy level, used the courts to ensure existing laws are enforced, and partnered
with community organizations to effect further change on the ground.
Other examples could be given regarding the role of the anthropology of mental
health as a catalyst for change. Many working in this area, along with colleagues
from other disciplines, have been closely involved in the design, implementation,
evaluation, enhancement, and scale-up of psychosocial interventions that are now
delivered across many jurisdictions. This includes the qualitative evaluation of staff
success in the delivery of vocational rehabilitation interventions (Kostick et al.
2010), with the resultant knowledge being used to enhance staff training and
supervisory practices. Other studies include the qualitative evaluation of the impact

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of ‘Housing First’ interventions on people with a dual diagnosis of substance use

disorder and severe mental illness (e.g., Padgett et al. 2006). Such work has
contributed to the growing acceptance and scale-up of Housing First interventions
for people with dual diagnosis. It also includes much work on the barriers and
facilitators to the effective implementation of psychosocial interventions in
community settings (e.g., Whitley et al. 2009), which has contributed to the
successful scale-up of such interventions elsewhere (e.g., Pratt et al. 2011).
In addition to the health services research described above, many people working in
the anthropology of mental health have devoted considerable time and effort to the
creation and evaluation of specific interventions that address cultural issues. These
have had a wide distribution and impact beyond the field of anthropology. This
includes interventions that try and bring a level of ‘cultural competence’ into everyday
psychiatric encounters (e.g., Kleinman and Benson 2006). It also includes those
providing a ‘cultural consultation service’ for clinicians in routine settings who need
assistance in treating cases where cultural variables are intruding to the extent that they
make treatment planning problematic for the team (e.g., Kirmayer et al. 2003).

Conclusion

In this essay, I have delineated three complementary roles for an anthropology of

mental health. These three roles are to (i) provide a meaningful critique of practices,
beliefs, and movements within current psychiatry; (ii) illuminate the social and
clinical context of suffering and healing regarding emotional distress/mental illness;
and (iii) act as a catalyst for positive change regarding healing, services, and
provisions for people with emotional distress/mental illness. It is my contention that
a muscular and relevant anthropology of mental health must deploy all three roles
simultaneously to advance knowledge and effect change on the ground.
I argue, essentially, that there should be no opposition without proposition. Of
course any proposition must be evidence-based, founded upon detailed ethnographic
and qualitative study. Indeed, the anthropology of mental health is well-placed to
produce practical solutions grounded in social, cultural, and economic realities. By
focusing on these contexts (or cultures) of suffering and healing through the use of
in-depth ethnographic methods, the anthropology of mental health can ensure that
existing resources are harnessed and new resources diverted to support healing and
reduce suffering.
The decade of the brain promised and delivered much in terms of advancing
knowledge about mental illness and neurodevelopment. That said, there is no
evidence that the burden of psychiatric disorders has diminished in the intervening
years, and perhaps the promise of biological psychiatry has not been borne out by
subsequent realities (Angell 2011). Indeed much of the whole psychiatric enterprise
has recently come under sustained attack from various quarters outside of
anthropology. This includes a critique of the effectiveness of psychiatric medication
(Kirsch 2010; Whitaker 2010), a critique of the globalization of psychiatry
(Summerfield 2012, Watters 2010) and a critique of diagnostic proliferation as
embedded in the new DSM-V (Carlat 2010, Frances 2013). This plurality of criticism

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has opened a window of opportunity for alternative perspectives—most notably a

revitalization of the biopsychosocial model of mental health. The anthropology of
mental health remains well-poised to put the social and cultural back into psychiatry.
It is my hope that this paper stimulates reflection on how this can best be achieved.

Acknowledgments I presented a truncated version of this paper at the ‘Whither Public Psychiatry’
Conference held in March 2013 at the Center for Advanced Study in the Behavioral Sciences, Stanford
University. I would like to thank the participants and organizers for invaluable feedback on the ideas
expressed herein. I would also like to thank two anonymous reviewers for helpful comments on an earlier
draft of this paper.

References

Angell, M.
2011 The Epidemic of Mental Illness: Why? The New York Review of Books. New York.
Applbaum, K.
2006a Educating for Global Mental Health: The Adoption of SSRIs in Japan. In Global pharmaceu-
ticals: Ethics, Markets, Practices. A. Petryna, A. Lakoff, and A. Kleinman, eds., pp. 85–110.
Durham, NC: Duke University Press.
2006b Pharmaceutical Marketing and the Invention of the Medical Consumer. PLoS Medicine 3(4):
e189.
Asad, T.
1979 Anthropology and the Colonial Encounter. In The Politics of Anthropology: From Colonialism
and Sexism Toward a View from Below. G. Huizer and B. Mannheim, eds., pp. 85–95. The
Hague: Mouton.
Barrett, R.J.
1996 The Psychiatric Team and the Social Definition of Schizophrenia: An Anthropological Study of
Person and Illness. Cambridge: Cambridge University Press.
Bateson, G., D.D. Jackson, J. Haley, and J. Weakland
1956 Toward a Theory of Schizophrenia. Behavioral Science 1(4): 251–264.
Baxter, E., and K. Hopper
1981 Private Lives/Public Spaces: Homeless Adults on the Streets of New York City. New York:
Community Service Society of New York.
Brodwin, P.
2013 Everyday Ethics: Voices from the Front Line of Community Psychiatry. Berkeley: University of
California Press.
Butz, M., F. Wörgötter, and A. van Ooyen
2009 Activity-Dependent Structural Plasticity. Brain Research Reviews 60(2): 287.
Carlat, D.
2010 Unhinged: the Trouble with Psychiatry-a Doctor’s Revelations About a Profession in Crisis. New
York: Free Press.
Carpenter-Song, E.
2009 Caught in the Psychiatric Net: Meanings and Experiences of ADHD, Pediatric Bipolar Disorder
and Mental Health Treatment Among a Diverse Group of Families in the United States. Culture,
Medicine, and Psychiatry 33(1): 61–85.
Carpenter-Song, E., E. Chu, R.E. Drake, M. Ritsema, B. Smith, and H. Alverson
2010 Ethno-Cultural Variations in the Experience and Meaning of Mental Illness and Treatment:
Implications for Access and Utilization. Transcultural Psychiatry 47(2): 224–251.
Corin, E., R. Thara, and R. Padmavati
2005 Shadows of Culture in Psychosis in South India: A Methodological Exploration and Illustration.
International Review of Psychiatry 17(2): 75–81.
Desjarlais, R.R.
1997 Shelter Blues: Sanity and Selfhood Among the Homeless. Philadelphia: University of
Pennsylvania Press.

123
Cult Med Psychiatry (2014) 38:499–511 509

Estroff, S.E.
1981 Psychiatric Deinstitutionalization: A Sociocultural Analysis. Journal of Social Issues 37(3): 116–132.
1985 Making it Crazy: An Ethnography of Psychiatric Clients in an American Community. Berkeley:
University of California Press.
Frances, A.
2013 Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big
Pharma, and the Medicalization of Ordinary Life. New York: William Morrow.
Good, B.
1992 Culture and Psychopathology: Directions for Psychiatric Anthropology. In New Directions in
Psychological Anthropology. T. Schwartz, G.M. White, and C. Lutz, eds., pp. 181–205.
Cambridge: Cambridge University Press.
Goffman, E.
1961 Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Garden City:
Anchor Books.
Gone, J.P.
2007 ‘‘We Never was Happy Living Like a Whiteman’’: Mental Health Disparities and the
Postcolonial Predicament in American Indian Communities. American Journal of Community
Psychology 40(3–4): 290–300.
Hemmings, C.P.
2005 Rethinking Medical Anthropology: How Anthropology is Failing Medicine. Anthropology and
Medicine 12(2): 91–103.
Hinton, D.E., and B. Good
2009 Culture and Panic Disorder. Stanford: Stanford University Press.
Holtmaat, A., and K. Svoboda
2009 Experience-Dependent Structural Synaptic Plasticity in the Mammalian Brain. Nature Reviews
Neuroscience 10(9): 647–658.
Hopper, K.
1988 More than Passing Strange: Homelessness and Mental Illness in New York City. American
Ethnologist 15(1): 155–167.
2007 Recovery from Schizophrenia: An International Perspective: A Report from the WHO
Collaborative Project, the International Study of Schizophrenia. Oxford: Oxford University Press.
Insel, T.R.
2010 Rethinking Schizophrenia. Nature 468(7321): 187–193.
Insel, T.R., and R. Quirion
2005 Psychiatry as a Clinical Neuroscience Discipline. Journal of the American Medical Association
294(17): 2221–2224.
Jenkins, J.H.
2012 The Anthropology of Psychopharmacology: Commentary on Contributions to the Analysis of
Pharmaceutical Self and Imaginary. Culture, Medicine and Psychiatry 36(1): 78–79.
Kienzler, H.
2008 Debating War-Trauma and Post-Traumatic Stress Disorder (PTSD) in an Interdisciplinary Arena.
Social Science and Medicine 67(2): 218–227.
Kirmayer, L.J., and A. Young
1998 Culture and Somatization: Clinical, Epidemiological and Ethnographic Perspectives. Psychoso-
matic Medicine 60: 420–430.
Kirmayer, L.J., D. Groleau, J. Guzder, C. Blake, and E. Jarvis
2003 Cultural Consultation: a Model of Mental Health Service for Multicultural Societies. Canadian
Journal of Psychiatry 48: 145–153.
Kirmayer, L.J.
2004 The Cultural Diversity of Healing: Meaning, Metaphor and Mechanism. British Medical Bulletin
69: 33–48.
Kirsch, I.
2010 The Emperor’s New Drugs: Exploding the Anti-Depressant Myth. New York: Basic Books.
Kleinman, A.
1980 Patients and Healers in the Context of Culture: An Exploration of the Borderland Between
Anthropology, Medicine, and Psychiatry. Berkeley: University of California Press.

123
510 Cult Med Psychiatry (2014) 38:499–511

1985 Interpreting Illness Experience and Clinical Meanings: How I See Clinically Applied
Anthropology. Medical Anthropology Quarterly 16(3): 69–71.
1987 Anthropology and Psychiatry: the Role of Culture in Cross-Cultural Research on Illness. British
Journal of Psychiatry 151: 447–454.
Kleinman, A., and P. Benson
2006 Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix it. PLoS
Medicine 3(10): e294.
Kleinman, A.M., V. Das, and M.M. Lock, eds.
1997 Social Suffering. Berkeley: University of California Press.
Konner, M.
1991 The Promise of Medical Anthropology: An Invited Commentary. Medical Anthropology
Quarterly 5(1): 78–82.
Kostick, K.M., R. Whitley, and P.W. Bush
2010 Client-Centeredness in Supported Employment: Specialist and Supervisor Perspectives. Journal
of Mental Health 19(6): 523–531.
Kral, M.J.
2013 The Weight on Our Shoulders is Too Much, and We are Falling. Medical Anthropology
Quarterly 27(1): 63–83.
Kral, M.J., L. Idlout, J.B. Minore, R.J. Dyck, and L.J. Kirmayer
2011 Unikkaartuit: Meanings of Well-Being, Unhappiness, Health, and Community Change Among
Inuit in Nunavut, Canada. American Journal of Community Psychology 48(3–4): 426–438.
Leff, J., N. Sartorius, A. Jablensky, A. Korten, and G. Ernberg
1992 The International Pilot Study of Schizophrenia: Five-Year Follow-Up Findings. Psychological
Medicine 22(1): 131–145.
Lester, R.J.
2007 Critical Therapeutics: Cultural Politics and Clinical Reality in Two Eating Disorder Treatment
Centers. Medical Anthropology Quarterly 21(4): 369–387.
Lewis, S.E., K. Hopper, and E. Healion
2012 Partners in Recovery: Social Support and Accountability in a Consumer-Run Mental Health
Center. Psychiatric Services 63(1): 61–65.
Luhrmann, T.M.
2000 Of Two Minds. New York: A. A. Knopf.
2007 Social Defeat and the Culture of Chronicity: Or, Why Schizophrenia Does So Well Over There
and So Badly Here. Culture, Medicine and Psychiatry 31(2): 135–172.
2012 Beyond the Brain. pp. 28–34. London: The Wilson Quarterly.
Marrow, J., and T.M. Luhrmann
2012 The Zone of Social Abandonment in Cultural Geography: on the Street in the United States,
Inside the Family in India. Culture, Medicine, and Psychiatry 36(3): 493–513.
Metzl, J.M.
2009 The Protest Psychosis. Boston: Beacon Press.
Myers, N.L.
2010 Culture, Stress and Recovery from Schizophrenia: Lessons from the Field for Global Mental
Health. Culture, Medicine, and Psychiatry 34(3): 500–528.
Padgett, D.K., L. Gulcur, and S. Tsemberis
2006 Housing First Services for People Who are Homeless with Co-Occurring Serious Mental Illness
and Substance Abuse. Research on Social Work Practice 16(1): 74–83.
Patel, V.
2012 Global Mental Health: From Science to Action. Harvard Review of Psychiatry 20(1): 6–12.
Peacock, J.L.
1997 The Future of Anthropology. American Anthropologist 99(1): 9–17.
Pilgrim, D., and A. Rogers
2005 The Troubled Relationship Between Psychiatry and Sociology. International Journal of Social
Psychiatry 51(3): 228–241.
Pratt, C.W., R.C. Smith, A. Kazmi, and S. Ahmed
2011 Introducing Psychiatric Rehabilitation at a Psychiatric Facility in Pakistan. American Journal of
Psychiatric Rehabilitation 14(4): 259–271.

123
Cult Med Psychiatry (2014) 38:499–511 511

Read, J.
2005 The Bio-Bio-Bio Model of Madness. The Psychologist 18(10): 596.
Rylko-Bauer, B., M. Singer, and J.V. Willigen
2006 Reclaiming Applied Anthropology: Its Past, Present, and Future. American Anthropologist
108(1): 178–190.
Salerno, D., Hopper, K., & Baxter, E.
1984. Hardship in the heartland: homelessness in eight US cities. Community Service Society of New
York, Institute for Social Welfare Research.
Scheper-Hughes, N.
1982 Saints, Scholars and Schizophrenics. Berkeley: University of California Press.
1990 Three Propositions for a Critically Applied Medical Anthropology. Social Science and Medicine
30(2): 189–197.
Shand, A.
2005 Rejoinder: In Defence of Medical Anthropology. Anthropology and Medicine 12(2): 105–113.
Singer, M., and P.I. Erickson
2011 As the Future Explodes Into the Present: Emergent Issues and the Tomorrow of Medical
Anthropology. In A Companion to Medical Anthropology. M. Singer and P.I. Erickson, eds.,
pp. 515–531. Chichester, UK: Wiley-Blackwell.
Summerfield, D.
2012 Afterword: against ‘‘Global Mental Health’’. Transcultural Psychiatry 49(3): 519–530.
Swartz, L.
2012 An Unruly Coming of Age: The Benefits of Discomfort for Global Mental Health. Transcultural
Psychiatry 49(3–4): 531–538.
Tandon, P.N.
2000 The Decade of the Brain: A Brief Review. Neurology India 48(3): 199–207.
Tranulis, C., L. Park, L. Delano, and B. Good
2009 Early Intervention in Psychosis: A Case Study on Normal and Pathological. Culture, Medicine,
and Psychiatry 33(4): 608–622.
Watters, E.
2010 Crazy Like Us: The GLobalization of the American Psyche. New York: Free Press.
Weaver, I.C., N. Cervoni, F.A. Champagne, A.C. D’Alessio, S. Sharma, J.R. Seckl, S. Dymov, M. Szyf,
and M.J. Meaney
2004 Epigenetic Programming by Maternal Behavior. Nature Neuroscience 7(8): 847–854.
Whitaker, R.
2010 Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental
Illness. New York: Random House.
Whitley, R., S. Gingerich, W. Lutz, and K. Mueser
2009 Implementing the Illness Management and Recovery Program in Community Mental Health
Settings: Facilitators and Barriers. Psychiatric Services 60(2): 202–209.
Whitley, R., and E. Siantz
2012 Best Practices: Recovery Centers for People With a Mental Illness: an Emerging Best Practice?
Psychiatric Services 63(1): 10–12.
Williams, B.
2013 Kim Hopper’s Regrets. American Anthropologist 115(1): 129–131.
Young, A.
1995 The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder. Princeton: Princeton
University Press.
Zarowsky, C.
2000 Trauma Stories: Violence, Emotion and Politics in Somali Ethiopia. Transcultural Psychiatry
37(3): 383–402.
2004 Writing Trauma: Emotion, Ethnography, and the Politics of Suffering Among Somali Returnees
in Ethiopia. Culture, Medicine and Psychiatry 28(2): 189–209.

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