Finding “What Works”: Iterative Practices of Objectivity in Global Mental Health

• In Event: Making Objectivity in Data-Centric Knowledge Practices

Abstract

Complex interventions in Global Mental Health are designed to work across a great variety of differences – conceptualized as cultural, socio-economic, geographic, or temporal. In order to operationalize mental health knowledge across such diverse and changing environments, iterative knowledge practices have emerged in the name of making interventions “work.” However, producing knowledge on ‘what works’, I suggest, differs significantly from the production of ‘truth’ commonly associated with the evidence-based paradigm. This presentation attends to that difference. It draws on the use of the popular impact evaluation framework Theory of Change (ToC), which has emerged as an epistemic device that does not predominantly rely on the hardening of ‘facts’ or standardization. Instead, ToC’s practices of objectivity utilize iterative, reflexive, and adaptable knowledge practices. Drawing on 12 months of multi-sited fieldwork among Global Mental Health actors, three case studies illustrate the different uses of Theory of Change - as a design tool in a multi-country consortium, as a scale-up technique across a city, and as an accounting tool within a funding body’s global portfolio. These cases illustrate the paradoxical possibility of what I call ‘contingent universals’ - concepts that stay true until they stop “working” in the field. As such, this presentation discusses the novel stakes and questions raised by reflexive, and open-ended modes of objectivity and calls for renewed empirical and engagement.

Author

• Doerte Bemme, McGill University