The best known historical narrative of the international mental hygiene movement among English-speaking audiences locates its origins in the publication of A Mind That Found Itself, the autobiographical account of Clifford Beers (1876–1943), a Yale graduate and former psychiatric patient. The success of the book is thought to have prompted the creation of the first Society for Mental Hygiene in Connecticut in 1908. Beers’ biography, published as Advocate for the Insane in 1980, contends that mental hygiene abroad developed from seeds first sown in the USA and subsequently in Canada.

This article offers a critical reappraisal of that narrative and advances an alternative framework for understanding the history of the international mental hygiene movement during the first half of the twentieth century. It draws on a body of scholarship, emerging since the 1980s, that has sought to decentre the prevailing account, exposing the multiplicity of forces at work in a history that diverges from any straightforward, linear trajectory radiating from a single point of origin.

By tracing this decentred history, the article highlights the contested nature of the ‘international’ in the context of the mental hygiene movement. Case studies from the USA, France, Brazil, and Argentina reveal both the conflicts it engendered and the diverse meanings and significance it assumed within distinct national settings.