Throughout the book, we have argued that the universality of Euro-North American concepts of mental health and responses to distress are a continuation of the colonial project. In this chapter, we conclude our argument that the medicalised model of mental health in the marketplace continues this approach to maintain this division between the privileged and disadvantaged. In this coloniality, mental health concepts, services, and organisations are diverting attention from the real causes of problems to persuade the disadvantaged that the problem is in their minds. In return, the inequalities that are causing problems are maintained. Whether one lives in “developing” nations such as Malawi and Sri Lanka or a “developed” country such as the UK, suffering due to continuous poverty, deterioration of communities due to ineffective policies, and disasters are pathologised. This pathology is then promoted as something to be treated, so the disadvantaged will continue to pay for the privileged to gain and maintain power. This chapter brings together previous themes of the continuity of colonialism and Euro-North American dominance of knowledge and resources in a globalised world which is embodied within medicalised and universalist assumptions and silencing of indigenous understandings and ways of responding to distress; an approach that is indicative of an imperial approach to contemporary global health governance and to the West’s perceptions of the Global South and its own disadvantaged communities. Instead of continuing with this colonial approach, we point out that there is a need for critical thinking that would allow the ancient knowledge and contemporary knowledge, including biomedical sciences, to collaborate as equal partners. In that, we point to a number of promising examples where this dominant hegemony is being challenged from both outside and within the MGMH, where social, political, cultural, economic, and environmental determinants of mental health and wellbeing are being actively acknowledged, and people that are suffering through conflicts, disasters, and uneven development are given the responsibility and ownership to determine their own lives. This in return facilitates development.