CAMHRA Vision Statement
This is a document that aims to spell out the intellectual vision for CAMHRA vis-a-vis its contributions to anthropology and neighboring disciplines, the psy-sciences, service user research, mad studies, and the broader practice (action) of mental health care. It is based on discussions with the CAMHRA core academic group and Professorial Fellows who participated in an agenda-setting retreat in April 2025. CAMHRA researchers are deeply embedded in mental health research and practice in the UK and in a range of other parts of the world, including India, Iran, Japan and Portugal. As such, CAMHRA embodies a unique opportunity to create locally sensitive and globally comparative perspectives on emerging mental health
interventions, with a critical anthropological sensibility. While avoiding a single ideological stance toward CAMHRA’s conceptual framework, this statement aims to set out some of the animating questions, tensions and disciplinary legacies that will guide our community of scholars and practitioners, as we respond to the changing landscape of mental health care and shifting public perceptions of mental health.
In many parts of the world, the idea of mental health has shifted from being characterized as the unspoken, as that which is stigmatized or somatized to being cast in the language of national or global crisis. Rather than accepting the language of crisis or of silence at face value, a core commitment at CAMHRA will be to examine the ways in which mental health may allow for the expression of varying forms of collective and individual distress related to experiences of economic precarity; structural shifts, the cost-of-living crisis; forms of violence related to racial or gender inequality, eco-anxiety and climate change, as well as a range of everyday difficulties around loss, relatedness, and living, as these are experienced and expressed through the language of mental health. This is not necessarily the medicalization of social issues, but ways in which human struggles, and the political and structural tensions that shape them, may find both enabling or disabling forms of expression. Engaging with the relational aspects of mental health warrants a fresh look at the validity and value of anthropological tools – building on a long history of exchange between anthropology and the psy-disciplines, and offering new approaches, methods and concepts that are fitting with the contemporary context, in this time that seems ever more out of joint.
The dominance of evidence-based medicine in the mental health paradigm shapes a particular model of the distressed ‘mind’. At the same time, “qualitative” tools, including key anthropological innovations like illness narratives, cultural formulations, and idioms of distress have the risk of being reduced to formulaic vignettes or appendices to biomedical practice, or to “culture-bound” local examples of global trends. A core commitment at CAMHRA is to foster methodological innovation and to examine the ways in which the biosciences are not the only space that can claim rigor, precision and cross-cultural comparison. Rather than claiming rigor through certainty, precision here means being able to show the specific points at which forms of knowledge such as RCTs or rating scales may be open to uncertainty. Such methodological debates are critical to research cultures globally, and also extend further than scholarly domains, in influencing the way in which individuals and groups frame and understand their own experiences of distress, flourishing and wellbeing, and within wider fields of discourse in public cultures such as social media, clinical spaces, as well as informal spaces of care, religious formations, and political activism.
The perspectives of anthropology, when it is invited into mental health practice can help reshape research questions, offer implementation insights, critiques and longitudinal data, in ways that are essential to understanding more about the subject(s) of distress and wellbeing. Anthropology also offers perspectives at the limits of quantification – valuable in the context of the current overwhelming preference in mental healthcare research for quantitative measurement over other forms of data. This suggests an opportunity for a new and productive relationship between anthropology and the psy- sciences. To fulfil its potential, anthropology cannot simply fit into the existing research paradigm, but has to be a critical friend, arguing for fundamental changes in the way research agendas are framed and pursued. An openness to the inadequacies and shortcomings of current research can lead to new questions, innovative methodologies and research findings arising from anthropology’s commitment to grasp the context nuance, complexity and relationality of experiences of mental ill-health.
The way that anthropology is often called upon in public and global mental health research is to elucidate the ‘cultural norms’ of particular communities so as to improve ‘trust’, uptake or access for ‘vulnerable’ groups or to adapt universal models or interventions to cultural specificities and norms. Similarly, anthropology is often called upon in ethno-psychiatry or ethno-psychology to highlight culturally specific models of healing and coping that ought to be used ‘on’ culturally homogenous groups. Such approaches
are based on colonial models of governance that contemporary medical anthropology turns away from, to better understand differences and antagonisms “within” cultures and households, and in understanding the role of culture as much in biomedicine, and pharmaceutical use. At the same time, anthropology retains a commitment to ontological diversity, and different ways of understanding ideas of distress beyond biomedical categories. CAMHRA sustains such a core commitment to diverse concepts of distress, illness, and health while also disaggregating overly unified ideas of culture into more specific units of analysis, such as households, neighbourhoods, and institutions and economies of care.
Anthropologists bring the organisational worlds of mental health into view, not only institutionalised care, which has long been subject to critical engagement, but also the everyday workings of healthcare systems around the world, and their impact on those who receive services and those who deliver them. We study mental health systems in interaction with societal inequalities, the wider state systems of care and control, whether criminal justice, incarceration, border control, benefits systems, housing, employment and social services, and non-state religious, rights or community institutions, centres or shrines through which people circulate.
We look for opportunities for advocacy and policy change based on alternative institutional forms for mental healthcare. We recognise that while new interventions and access to care are vital, the bureaucratic processes of care are equally consequential for recovery and justice. Anthropology’s wider-angled lens views healthcare systems in relation to the structures that enable or restrict the foundations of people’s lives such as housing, benefits and safety (including ending intimate partner violence), and in relation to countervailing policy environments that generate distress, such as in relation to migrants, asylum seekers or homeless people.
We hold that anthropology has a role in the training of mental healthcare professionals of all kinds, including the growing lived experience workforce. CAMHRA sees the discipline offering capacities for individual staff and institutional reflexivity and learning for change.
Great strides have been taken by activists and the service user movements to include lived experience in all stages of research, intervention design and delivery. There has been a move in funding and commissioning to include lived experience voice and action in the design and delivery of mental health services, and to expand the lived experience workforce including in the NHS, and through co-production and task shifting models in Global Mental Health. However, the discourse of lived experience is not self evident in these spaces, nor is it applied in the same way, equitably or justly across institutional environments. As such, lived experience is both a deeply meaningful and a contested category.
Meaningful inclusion and co-production is difficult, and currently in service design is often tokenistic, calling upon single experts in consultative ways. There is a lack of consensus or clarity on what kind of data ‘lived experience’ generates, and how it might fit with other forms of epidemiological data or social data. At the same time, it is unclear how a Euro-American model of PPI will translate into global south contexts, even as this becomes institutionally mandated for mental health research and funding.
A core commitment at CAMHRA is to foster lived experience and PPI initiatives within the UK and in other parts of the world, without having to reduce “experience” to a script, or to an institutionally mandated performance. Anthropology can help think through the epistemic and institutional preconditions for meaningful input, and the ways in which experience might be expressed in relation to other forms of knowledge. There is a further contribution of anthropology in being able to evaluate different ethical models at play in mental health research and service provision, equitable partnerships and meaningful co-production.
In such engagements, however, there is a need to reflect critically on the anthropological orientation toward speaking for others and offer new opportunities for speaking with or opening spaces for the voices of others. Amongst researchers, lived experience is not ‘out there’ or other, but researchers including anthropologists themselves may have lived experience that shapes the way they conduct ethnography, build relationships, analyse insights and produce outputs.
The orientation of being ‘in action’ means an orientation toward institutional permeability and epistemic justice, both with other disciplines, subjectivities and spaces, and within ourselves (ie. We might hold multiple roles). However, there are significant political stakes to both the problems we work on (hence we are called to be activists), and to contexts we work in (meaning our work can be coopted or used in unintended ways). It is important to understand how, historically, anthropological thinking and insights on
mental health have been instrumentalized and even weaponized for nationalist, colonial projects; and how anthropologists themselves have historically been implicated in such projects. What it means to understand the stakes of research, and how this effects methodology, is a contingent and contextual question rather than an absolute one requiring reflection on the conditions under which knowledge is produced.
