Abstract Global Mental Health has become clearly defined as a distinct academic discipline and area of practice since the 1990s, and has gained increasing prominence. Its roots lie in international and cultural psychiatry, but it has taken a clear direction of focusing on effective real-world change through application of evidence-based health interventions in a scientific psychiatric paradigm, strongly influenced by social psychiatry. While culture is acknowledged as important, it is seen as an overlay, presuming a common scientific paradigm for mental health globally. One example of this is the use of local adaptation of international guidelines like the WHO’s mhGAP. While a growth in investment, prioritization, and application of knowledge has the potential to positively impact on lives of people affected by mental ill health, there is a risk of causing harm by inappropriate application of ideas not well-suited to local needs. Global frameworks for mental health and human rights already advocate a human rights approach with participation of people affected, but it is only by rebalancing power towards local actors that national authorities can be held to account, and potential benefits of Global Mental Health be realized.

中文翻译：

---

在全球心理健康中重新平衡力量

摘要自1990年代以来，全球精神卫生已被明确定义为一门独特的学科和实践领域，并日益受到重视。它的根源在于国际和文化精神病学，但它已采取了明确的方向，即通过在社会精神病学的强烈影响下，在科学的精神病学范式中应用基于证据的健康干预措施，将重点放在有效的现实世界变化上。尽管文化被认为是重要的，但它却被视为一种叠加，假定在全球范围内普遍存在着一种心理健康的科学范式。这方面的一个例子是对国际准则（如世界卫生组织的mhGAP）进行本地调整。尽管投资，优先次序和知识的增长有可能对受精神疾病影响的人们的生活产生积极影响，不恰当地应用不适合当地需求的想法可能会造成伤害。全球精神卫生和人权框架已经倡导了一种人权方法，要有受影响的人参与，但是只有通过平衡对地方行为者的权力，国家当局才能追究责任，并实现全球精神卫生的潜在利益。