This paper examines how cultural, historical and contemporary perspectives of mental health continue to inform ways of understanding and responding to mental distress even under the biomedical gaze of the Movement for Global Mental Health (MGMH). Based on experiences in Malawi, the authors explore three prominent interventions (practical support, counselling and support groups) employed by village health workers within a mental health task-shifting initiative and reveal how the ancient philosophy of Umunthu with its values of interconnectedness, inclusion and inter-relationships informs and shapes the direction of these interventions. Practical support is marshalled through traditional village structures, counselling provides advice and an encouragement to hope, and support groups provide a place for emotional exchange and a forum for the enactment of values, reflection and reinforcement of Umunthu. What are pronounced as biomedical psychosocial interventions are in fact the delivery of culturally embedded therapeutic approaches. Historical and socio-political evidence is offered to explain the dominance of biomedical perspectives and the HSAs’ responses and a call is made for a transformation of MGMH to embrace rich philosophies such as Umunthu and enact respectful, inclusive and democratic values to enlist collaborations between equals to develop relevant and effective knowledge and local responses to mental distress.

本文探讨了心理健康的文化、历史和当代观点如何继续为理解和应对心理困扰的方式提供信息，即使在全球心理健康运动 (MGMH) 的生物医学注视下也是如此。根据马拉维的经验，作者探讨了乡村卫生工作者在心理健康任务转移倡议中采用的三种主要干预措施（实际支持、咨询和支持小组），并揭示了古老的乌蒙图哲学如何其相互联系、包容和相互关系的价值观决定了这些干预措施的方向。实际支持通过传统的村庄结构进行编组，咨询提供建议和鼓励希望，支持小组提供情感交流的场所和制定价值观、反思和强化乌蒙图的论坛。所谓的生物医学心理社会干预实际上是提供文化嵌入的治疗方法。提供历史和社会政治证据来解释生物医学观点的主导地位和 HSA 的反应，并呼吁对 MGMH 进行转型，以拥抱丰富的哲学，如Umunthu并制定尊重、包容和民主的价值观，以争取平等之间的合作，以发展相关和有效的知识和当地对精神痛苦的反应。