( pn47 )

Inequalities in (Mental) Healthcare: Critical Perspectives in Medical Anthropology


    Helmar Kurz


    University of Muenster / Germany

    Face to Face/ On Site - Presence

    Sharon Gabie

    South Africa

    Nelson Mandela University

    Face to Face/ On Site - Presence

IUAES Affiliation: Medical Anthropology and Epidemiology

IUAES Affiliation: Study of Difference, Discrimination and Marginalization

IUAES Affiliation: Religion


(Mental) Health, CAM, Healing Cooperation, Governance, Public Anthropology


(Mental) healthcare systems worldwide meet various challenges, particularly the insufficiency of resources for patients of lower economic classes and rural areas. What is more, in many places therapeutic settings remain “zones of abandonment” (Biehl 2005), particularly when affiliated with official healthcare sectors. However, some philanthropic, religious-spiritual, and private agencies provide “good examples” of (mental) healthcare (Basu et al. 2017). Changing governments and contesting policies have impacted local, translocal, and global (mental) healthcare supplies, maintaining inconsistencies in (mental) healthcare. Further, the recent COVID-19 pandemic has clearly illustrated that structural violence (Farmer 2005) and chronicity of crisis (Vigh 2008) still shape inequalities in access to health resources in both the Global North and Global South. New challenges may be requests regarding the mental healthcare provision for Indigenous and migratory communities. In South Africa, a recent case of negligence and maladministration of people with psychiatric disorders is that of Life Esidimeni. The tragedy witnessed 144 people die because of inappropriate care and the lack of equipped infrastructure and staff to cater to the needs of people in mental health care facilities and many more suffering trauma (Durojaye & Agaba 2018, Ferlito & Dhai 2018). South Africa is no exception for the fact, that countries across the globe neglect mental health care as an overall aspect of health and wellbeing. The results of a four-country study, which included South Africa, found that there is a lack of data to convince policymakers to prioritize mental health, a lack of implementation, and how to mobilize people to seek intervention to the problem at an early stage (Pillay 2019). In disadvantaged communities, black communities in particular, the stigma against mental health issues is compounded by cultural and social challenges that prevent many people from seeking early intervention (Gumede 2021). Philanthropic organizations have always been essential health resources, and not only for marginalized social groups (for the example of Brazilian Spiritism, see Kurz 2024). However, they have been widely ignored in public and academic discourse, and how political institutions contest, regulate, or integrate related approaches remains a research desideratum that this panel wants to address around the following leading questions, focusing on mental health practices but integrating all health-related aspects of human well-being: 1) Strategies between actors. What are the contemporary challenges/opportunities of diverse actors within the field of (mental) health in their particular localities? In which spaces do they intervene? Where are they excluded? What trends can be identified, e.g., in the emergence of new agencies in the field or power distributions among existing actors? 2) Content of action and intervention in the field. What is currently at stake? What are perspectives and practices? How do divergent actors respond to (mental) health challenges? 3) Political regulation. How do state and official healthcare institutions relate to contesting and complementing approaches? Do forms of cooperation exist? Do obstacles exist? What are political strategies at the intersection of political, economic, and social interests?