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Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda

Torre, Costanza (2023) Throwing therapy at the problem mental health and humanitarian intervention in Palabek refugee settlement, northern Uganda. PhD thesis, London School of Economics and Political Science.

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Identification Number: 10.21953/lse.00004557


This thesis examines the social, moral, and political lives of humanitarian mental health interventions in a refugee settlement in Uganda. It is written at the junction of two increasingly significant trends: the search for durable solutions for mass displacement, and the establishment of the field of global mental health as a key actor in the management of psychological suffering across the Global South. Through a scalar structure, it interrogates the intersections of psychological programmes with socio-economic conditions of chronic poverty and food insecurity, from policy discourses to refugees’ phenomenological experiences of suffering. In so doing, it critically examines the political significance and therapeutic potential of mental health interventions in extremely resource-poor contexts. Global mental health scholars and practitioners have developed approaches to refugee mental health based on three assumptions: that refugees’ emotional distress should be tackled by purely psychological interventions; that these programmes are clinically significant and politically neutral; and that the ‘contextual’ factors that should be considered in their implementation mostly concern ‘local’ interpretations of mental health and illness which diverge from Western biomedical frameworks. By ethnographically exploring experiences of psychological suffering among South Sudanese – and particularly Acholi – refugees in the settlement of Palabek, northern Uganda, this thesis disputes these contentions. Based on fourteen months of in-depth ethnographic fieldwork, this thesis puts forward a critique of global mental health and humanitarian interventions that takes seriously the role of poverty and power in shaping refugees’ afflictions. This thesis shows that forms of suffering experienced by refugees in Uganda are closely linked to the structural constraints of life in displacement. It shows how these interventions intersect with refugees’ phenomenological experiences of temporality and moral personhood. In so doing it argues that, when divorced from direct engagement with forms of structural injustice, current global mental health approaches actively ‘do harm’ by contributing to refugees’ psychological afflictions. Finally, this thesis proposes new directions for refugee and global mental health; it argues for a ‘temporal turn’ in refugee mental health which foregrounds refugees’ moral agency, and for the central role of livelihood interventions in generating therapeutic outcomes.

Item Type: Thesis (PhD)
Additional Information: © 2023 Costanza Torre
Library of Congress subject classification: H Social Sciences > H Social Sciences (General)
H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Departments > International Development
Supervisor: Allen, Tim and Coast, Ernestina

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