This chapter contextualises how, in becoming medical hegemony, the biomedical approach has underwritten the stress paradigm as an illness model where external (life) problems are understood as individual problems that stem from internal genetic and biological pathologies that require treatment. This amplified and universalised framing of distress has become the prominent political rhetoric to relieve suffering within the global historical, political, and social relationship between the Global North and Global South. Further, this has led to the rise of ‘mental health’ as a global health priority, including through the ‘sustainable development goals’, in the face of global socio-economic and environmental threats and inequalities. Such positioning places individuals’ mental health within a marketplace of ‘demand’ and ‘supply’ elements of the treatment gap attracting powerful avocations for both mental health literacy and evidenced mental health interventions. Within this discussion, biomedicine’s medicalising of particular thoughts, emotions and behaviour is critiqued drawing epidemiological and socio-cultural evidence from labelling theory to illustrate the vast global diversity in the experience of distress and to challenge both the universality of such psychiatric classifications and the assumed unremitting worldwide rise in distress. The categorical fallacy of psychiatric diagnoses, the failure of biomedical science to illicit pathological markers or mechanisms that isolate any mental ‘diseases’, and the limitations of therapeutic effectiveness, are all highlighted as a precarious basis on which to inform mental health care and research. A contrast is offered in the way that sociology and anthropology contribute an understanding of an expansive and pluralistic relationship of culture to ‘distress’ against biomedicine’s reductionist and universally scientific understanding of mental health where peoples’ experiences diverge only through minor cultural difference. In that, this chapter presents the biomedical attributions and critiques by connecting them to coloniality and control within the discourse of distress. Towards the end, this chapter points towards the global concerns of distress. Such contrast of perspective leads many to assert the biomedical paradigm or psychiatry is itself European ‘indigenous’ knowledge and a ‘culture-bound’ practice. We argue that mental health and wellbeing must be understood within the overall health of an individual, and individual health is located within the social, political, cultural, economic, and environmental context in which they live in. The chapter ends with the proposition that it is by no means accidental that the bio-medicalised approach which originates from Europe and North America employs a medicalising agenda whereby individual self-surveillance and self-care/treatment are promoted to summon ‘mental health’– underpinned by global markets, consumerism, and big pharma.

Stress and Distress as Global Health Concerns

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发表日期：

2025年

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Janaka Jayawickrama,
Jerome Wright

摘要

This chapter contextualises how, in becoming medical hegemony, the biomedical approach has underwritten the stress paradigm as an illness model where external (life) problems are understood as individual problems that stem from internal genetic and biological pathologies that require treatment. This amplified and universalised framing of distress has become the prominent political rhetoric to relieve suffering within the global historical, political, and social relationship between the Global North and Global South. Further, this has led to the rise of ‘mental health’ as a global health priority, including through the ‘sustainable development goals’, in the face of global socio-economic and environmental threats and inequalities. Such positioning places individuals’ mental health within a marketplace of ‘demand’ and ‘supply’ elements of the treatment gap attracting powerful avocations for both mental health literacy and evidenced mental health interventions. Within this discussion, biomedicine’s medicalising of particular thoughts, emotions and behaviour is critiqued drawing epidemiological and socio-cultural evidence from labelling theory to illustrate the vast global diversity in the experience of distress and to challenge both the universality of such psychiatric classifications and the assumed unremitting worldwide rise in distress. The categorical fallacy of psychiatric diagnoses, the failure of biomedical science to illicit pathological markers or mechanisms that isolate any mental ‘diseases’, and the limitations of therapeutic effectiveness, are all highlighted as a precarious basis on which to inform mental health care and research. A contrast is offered in the way that sociology and anthropology contribute an understanding of an expansive and pluralistic relationship of culture to ‘distress’ against biomedicine’s reductionist and universally scientific understanding of mental health where peoples’ experiences diverge only through minor cultural difference. In that, this chapter presents the biomedical attributions and critiques by connecting them to coloniality and control within the discourse of distress. Towards the end, this chapter points towards the global concerns of distress. Such contrast of perspective leads many to assert the biomedical paradigm or psychiatry is itself European ‘indigenous’ knowledge and a ‘culture-bound’ practice. We argue that mental health and wellbeing must be understood within the overall health of an individual, and individual health is located within the social, political, cultural, economic, and environmental context in which they live in. The chapter ends with the proposition that it is by no means accidental that the bio-medicalised approach which originates from Europe and North America employs a medicalising agenda whereby individual self-surveillance and self-care/treatment are promoted to summon ‘mental health’– underpinned by global markets, consumerism, and big pharma.