Cause for caution: culture, sensitivity and the World Mental Health Survey Initiative

Abstract

Objective: This paper examines the cultural grounding and sensitivity in the concept, implementation, instrumentation and findings of the World Health Organization World Mental Health Survey Initiative (WHO-WMS).Conclusions: The WHO-WMS Initiative is managed by agencies in Boston and Geneva and covers 28 sites in 27 nations worldwide. It uses the Composite International Diagnostic Instrument (CIDI) translated to make diagnoses in 150,000 people. A large body of potentially influential data has been produced. The Initiative assumes that psychopathology is universal and not culturally determined. This assumption cannot be safely sustained. As a result, survey findings using ethnocentrically Western instruments and diagnoses may be uninterpretable, yet may misdirect policy and treatment. There are cautions here for ethnically and linguistically diverse nations such as Australia and New Zealand.