The World Health Organization came out with a new report… and once more it promotes more and more psychiatric drugging in poor and developing countries, without adequate support for advocacy, human rights, voice of mental health clients and alternatives.

Landing on my desk today was the latest book from the World Health Organization (WHO) on mental health. At 206 pages I could understand why most people will just see it as one more government report.Many may see the report is boring. Well, I can understand that.

And the title is one that at first might sound like an acceptable if murky idea to many people, “Integrating mental health into primary care.” For many people this may be common sense. Why not have mental health services in the same place as physical health services? This idea is now quite a trend all the way from here in Oregon, to the headquarters for WHO in Geneva, Switzerland.

The problem with the report is that once more it has left out the voice of mental health clients and their groups.


The people on the receiving end of mental health care deserve a voice. So what is missing from the report?

That voice is saying that there is an emergency of human rights violations in the mental health system. In fact, the director of the  mental health section Dr. Benedetto Saraceno says he agrees that there is such an emergency.

But this new WHO book does not act like there is such an emergency. There is much that is missing from the book, and the executive summary.

Where is the call for more:

  • Advocacy and human rights protections?
  • Voice for mental health clients, including support for mental health consumer/psychiatric survivor groups?
  • Promotion of more humane, non-drug alternatives?

You may download a copy of the report from the WHO web site here:

Consider a specific example in the book, from India:

The report examines the “Thiruvananthapuram District” in the Kerala State of India.

Check out this “before” and “after” summary:

On page 178:”Before the introduction of the district mental health programme, psychotropic medicines were not available in any of the primary care facilities.”

Then from the case summary on page 109: “The free and ready availability of psychotropic medications in the clinics has enabled patients to receive treatment in their communities, thus greatly reducine expenses and time spent travelling to hospitals.”

Again, to the casual reader, or to an individual deeply involved in the mental health system, this may sound like a common sense development.

But no where in that section do we hear about supporting the voice, empowerment, self-determination, and advocacy by and for mental health clients. No where do we read about addressing the over-use of psychiatric drugs.

Essentially we see the colonization in a poor and developing country. We should not be surprised about this report from India. After all, one of the foremost international leaders for the mental health user/psychiatric survivor voice in India, Bhargavi Davar, PhD, has said that WHO involvement in India is a disaster. While Dr. Saraceno in Geneva may support our rights, Dr. Davar in India sees what WHO is doing on the ground, and it is colonizing and globalizing the worst of the mental health system.

The World Health Organization should know better than be a shill for the pharmaceutical industry. WHO has done two major studies showing that long-term full recovery from a severe mental health problem is best in a poor and developing country, sometimes far higher than a rich western nation. We ought to be looking at this question, before simply exporting the western model of drug, drug, drug, drug, drug to more and more people.

Could it be India has something to teach the USA, more than the USA has to teach India, about mental and emotional well being.

Yes, over-institutionalization is certainly a crisis, especially the often filthy institutions in poor countries. But replacing those with “clean” massive psychiatric drugging of far more people than were ever institutionalized in the first place, without adequate advocacy, support, alternatives, is a profound human rights violation.

If you’d like to speak out about this, you can ask for a copy of the report, and register your opinion, by e-mailing to the World Health Organization at

It may seem useless to e-mail such a huge organization. However, MindFreedom has found out that WHO is required to catalogue every comment. When numbers of comments are received from mental health clients, this is actually a pretty big deal inside the WHO office, which I’ve visited in Geneva, Switzerland.

They say it’s rare to hear from mental health clients, and those who support their voice.

Please, help head off the boring globalization of the world with the narrow, corporate mental health system approach. The powerful pharmaceutical industry wants to colonize new markets as never before.

We support choice, including people’s choice to take prescribed psychiatric drugs. But the chemical crusade that is being directed at people in poor and developing countries, without adequate protection of rights and promotion of alternatives, threatens to harm literally tens of millions of people in the next decade or so. Speak out now!

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modified 12 Jan. 09

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