Mental Health Inequities and the Global South: Towards an Ethical Framework of Harmony

Abstract This article establishes the foundations of an ethical framework of harmony as a policy pathway towards equitable access to mental health care and resources in the global south. It explores existing policies and strategies for mental health in Africa and points to the need to underpin the relevant approaches with an ethical framework of harmony. The insights reflect on the disproportionately low attention given to mental health care, despite its high burden tying to social, cultural and moral distress among affected persons and their communities. Against this background, a critical analysis of the dominant Western approach to mental health demonstrates how underlying epistemic assumptions are prioritised over lived experiences, resulting in mental health care approaches and policies that do not reflect local and lived realities. This paper shows that, to be effective, mental health care approaches and policies must reflect local social, cultural and moral experiences in African contexts and other similar contexts in the global south. It proposes a communitarian ethical framework of harmony, which reflects local and lived contextual realities, to guide approaches and policy processes towards effective mental health reforms.