From inclusion to justice: Rethinking inclusion as a practice of power in global mental health

The concept of inclusion has become a central and largely uncontested principle across global mental health, education, and social policy. Despite its widespread adoption, its underlying assumptions often remain insufficiently interrogated. This Perspective critically examines inclusion not as a neutral or inherently benevolent concept, but as a practice embedded within broader relations of power. Informed by sustained empirical and professional engagement across early childhood education and developmental neurorehabilitation contexts, alongside research on migration, inclusion, and inequality, the paper argues that inclusion, as commonly operationalized, may reproduce the very inequalities it seeks to address. By presupposing a normative center into which “others” must be incorporated, inclusion risks functioning less as a transformative process and more as a mechanism of adaptation, regulation, and normalization. The paper highlights how dominant approaches to inclusion tend to individualize responsibility, foregrounding competencies and access while obscuring structural and historical conditions of exclusion. It further explores how inclusion operates as a regulatory practice that defines the boundaries of belonging, often requiring partial conformity to dominant norms. Within global mental health, these dynamics are particularly salient, as efforts to expand access to care are frequently accompanied by the global circulation of standardized models that may not fully engage with local epistemologies and lived realities. In response, this Perspective proposes a shift from inclusion as incorporation toward inclusion as transformation, situating it within a broader commitment to justice understood as structural change. Rather than asking how individuals can be better included, it calls for questioning the systems, norms, and epistemologies that define belonging. Reframing inclusion in this way opens space for more relational, context-sensitive, and epistemically plural approaches to global mental health.