Just pluralism: thinking about concepts of mental disorder in global context

Abstract

AbstractThis paper will investigate justice requirements that a pluralist stance on concepts of mental disorder should meet for use on a global scale. This is important given that different concepts of mental disorder are connected to particular interventions which may be more or less successful in specific contexts. While taking a broadly normative view on mental disorders, I will describe relevant concepts in a more fine grained manner, referring to their connections to particular approaches to biology, the self, or community. Drawing on research on epistemic injustice, I highlight the requirement that the set of multiple concepts be sufficiently flexible to enable the participation of those possessing relevant local knowledge. Using insights from health justice, I point out that the set of concepts should be conducive to distributive and procedural justice with regard to mental health and should support interventions on social determinants of health. These requirements apply to two dimensions of pluralism: regarding what concepts to include and how to relate them to one another. I conclude by explaining how an ontology of partial overlaps connected to a concept of health as metaphysically social can help address the challenges arising particularly regarding the latter dimension.