The modern mental health system in Nepal: Organizational persistence in the absence of legitimating myths

This paper advances an organizational explanation for the slow pace of modernization of mental health care systems in developing societies. In complement to cultural and political economic explanations of this condition, we suggest that the value of establishing modern systems in developing societies lies in the legitimation such structures provide for indigenous modernizing efforts vis-á-vis both indigenous and external audiences. The system need not meet actual levels of service demand. Its importance is in its symbolic value as an indicator of modernity. The result is a system in “permanent failure”. Implications for institutional theory and the growth of modern mental health systems in developing societies are discussed.