Introduction

Global mental health is a field of research and intervention that aims to improve access to mental health on a global scale.1 A basic tenet in the field is the existence of a large ‘treatment gap’ for most mental disorders, especially in low-income and middle-income countries, and the need to ‘scale up’ interventions through, among other things, ‘task shifting/sharing’ to/with community health workers, traditional healers and peers.2 The rise of global mental health has unearthed old controversies in psychiatry such as the universality vs cultural specificity of mental disorders, their expressions and their relationship with forces beyond the individual.3 4

The consolidation of global mental health as a field has been accompanied by a strong call for interventions to be contextualised and adapted to cultural and social realities. Context here refers to, among other things, formal and informal health and social care systems, cultural values and norms, and social and political processes.5 6 A central argument in this call is that mental health is, maybe to a higher degree than physical health, rooted in local definitions of personhood and the good life and that these definitions are historically and socially situated. Mental health interventions need to make sense both for local practitioners and for service users and, therefore, attention to context is crucial.

Usually, these calls are addressed at a relatively specific type of intervention, involving services that start—or are designed—in one place to be then implemented in another, and whose success depends on local uptake by providers and service users. In its most simple form, this type of intervention involves a logic with three broad steps: (1) an intervention, initially conceived in the global north; (2) a set of implementers, usually trained, supervised and/or supported by representatives of global initiatives and (3) local populations, with …