Institutional Corruption in the Political Economy of Global Mental Health: Challenges for Transformative Human Rights Praxis.

Through an exploration of the impacts of institutional corruption in global mental health, we argue here that deploying human rights-based approaches to health must go beyond rhetoric regarding equity in access to treatment to address power structures that systematically perpetuate harm against diverse people in specific contexts. First, applying human rights to mental health in transformative ways requires upending the biomedical paradigm that both locates mental health within people's brains and imbues psychiatric expertise as an unchallengeable authority in defining mental health conditions. Second, such change in approaches to mental health has proved challenging due in significant measure to institutional corruption, defined as a systemic, legal influence that diverts the institution from its purpose. We focus on institutional corruption driven by financial influences of the pharmaceutical industry in combination with the guild interests of the psychiatric profession. Third, we sketch the relation between institutional corruption and the spread of neoliberal policy imperatives on the financing and organization of mental health services in lower-middle and middle-income countries. Finally, we question the metrics deployed in global health that reaffirm existing presumptions in mental health systems, such as coverage, which can foster institutionalized corruption. We conclude that focusing on institutional corruption allows us to understand the need for new forms of health governance aligned with transformative human rights praxis.