Cross-National Diffusion of Mental Health Policy

Document Type : Original Article


School of Public Health, Yale University, New Haven, CT, USA


Following the tenets of world polity and innovation diffusion theories, I focus on the coercive and mimetic forces that influence the diffusion of mental health policy across nations. International organizations’ mandates influence government behavior. Dependency on external resources, namely foreign aid, also affects governments’ formulation of national policy. And finally, mounting adoption in a region alters the risk, benefits, and information associated with a given policy.
I use post-war, discrete time data spanning 1950 to 2011 and describing 193 nations’ mental health systems to test these diffusion mechanisms.
I find that the adoption of mental health policy is highly clustered temporally and spatially. Results provide support that membership in the World Health Organization (WHO), interdependence with neighbors and peers in regional blocs, national income status, and migrant sub-population are responsible for isomorphism. Aid, however, is an insufficient determinant of mental health policy adoption.
This study examines the extent to which mental, neurological, and substance use disorder are
addressed in national and international contexts through the lens of policy diffusion theory. It also adds to policy dialogues about non-communicable diseases as nascent items on the global health agenda.


Commentaries Published on this Paper

  • Whither Mental Health Policy-Where Does It Come from and Does It Go Anywhere Useful?; Comment on “Cross-National Diffusion of Mental Health Policy”

            Abstract | PDF

  • Diffusion of Innovation in Mental Health Policy Adoption: What Should We Ask about the Quality of Policy and the Role of Stakeholders in this Process?; Comment on “Cross-National Diffusion of Mental Health Policy”

            Abstract | PDF


Author’s Response to the Commentaries

  • Mental Health Policy Adoption as a Seminal Event: A Response to Recent Commentaries

            Abstract | PDF


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