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Caring for a family member with a psycho-social disability can be both rewarding and burdensome. This study analyses the experiences of caregivers of people with psychosocial disabilities (PPSDs) in rural communities in North India using relational gender theory. In-depth interviews with 18 female and male caregivers of PPSDs probed the social, emotional and health impacts of their caregiving role. Nine themes were identified that were grouped under three meta-themes: intra-personal, inter-personal and institutional impacts. Under the intra-personal meta-theme, all caregivers experienced high tension, with women describing almost overwhelming stress. Women minimised their role as caregivers, and felt negative and hopeless about their futures, while men had a more positive view of the future and themselves. Embodied experiences of psychological and social distress were consistently described by women, but not by men. Within the interpersonal meta-theme, men experienced opportunity for social connection and social support that was seldom available to women. Interpersonal violence with other household members was described by both men and women. Within the institutional meta-theme, both men and women described strength in unity, and gestures leading to the reordering of gender relations. These findings underline the significant and diffuse impacts of a gender order that values males and disadvantages females as caregivers of PPSDs, with the asymmetry of a greater burden for women. The findings point to the urgent need for global mental health policies that support and empower caregivers and that strengthen gender equality.

The World Health Organization and the Movement for Global Mental Health are advocating to ‘scale up’ mental health services, with particular emphasis on increasing access to psychiatric drugs within the global South (Lancet Global Mental Health Group 2007; Patel et al. 2011). Amid these calls, others can be heard, from local and global movements of psychiatrised peoples: people globally who have been psychiatrically diagnosed and often subjected to ‘treatments’, including institutionalisation and/or medical or surgical interventions, sometimes administered forcibly.This chapter seeks to problematise Global Mental Health by questioning how a single model can claim to account for, and ‘treat’, psychosocial distress experienced globally, and specifically in contexts of persistent poverty and entrenched inequality. The chapter documents and explores localised ways of knowing and supporting people in distress through the work of survivor-led and disabled people’s organisations in the global South (with a specific focus on India). In mobilising the local to critique ‘global’ mental health, the chapter seeks to map possibilities for transnational advocacy in formulating resistance.