Co-production of a pictorial recovery tool for people with psycho-social disability informed by a participatory action research approach—a qualitative study set in India

Abstract

Mental health problems are recognized as a leading cause of disability and have seen increased allocations of resources and services globally. There is a growing call for solutions supporting global mental health and recovery to be locally relevant and built on the knowledge and skills of people with mental health problems, particularly in low-income countries. Set in Dehradun district, North India, this study aimed to describe first, the process of co-production of a visual tool to support recovery for people affected by psycho-social disability; second, the key outputs developed and third, critical reflection on the process and outputs. The developmental process consisted of participatory action research and qualitative methods conducted by a team of action researchers and an experts by experience (EBE) group of community members. The team generated eight domains for recovery under three meta-domains of normalcy, belonging and contributing and the ensuing recovery tool developed pictures of activities for each domain. Challenges to using a participatory and emancipatory process were addressed by working with a mentor experienced in participatory methods, and by allocating time to concurrent critical reflection on power relationships. Findings underline the important contribution of an EBE group demonstrating their sophisticated and locally valid constructions of recovery and the need for an honest and critically reflective process in all co-productive initiatives. This study generated local conversations around recovery that helped knowledge flow from bottom-to-top and proposes that the grass-root experiences of participants in a disadvantaged environment are needed for meaningful social and health policy responses.

Social interventions: a new era for global mental health?

“…This requires shifting methods of engagement towards co-production 9 or participatory action research (PAR). Whilst, Randomised Control Trials using these approaches have shown positive impacts on improvements on other health conditions, such as diabetes 10 , more work is needed to address structural inequalities that may underpin co-production.…”

People with mental illness stigmatize mental illness less: A comparison study between a hospital-based sample of people with mental illness and a non-clinical general population sample in urban India

“…Community beliefs are largely ignored by mental health services in India and a previous study examining a “Programme for Improving Mental Health Care” (PRIME), a multiplatform multicomponent mental healthcare intervention in Madhya Pradesh for people with depression and alcohol use, suggested to increase contextually defined community-based care for better impact (Shidhaye et al, 2019). Going a step forward, psychosocial interventions could be built and implemented in partnership with the local community through an empowering approach (Mathias et al, 2020).…”

The Effectiveness of a Multi-Pronged Psycho-Social Intervention Among People With Mental Health and Epilepsy Problems - A Pre-Post Prospective Cohort Study Set in North India

“…41 Further programmes and research that examine how to build mental health literacy, engage positively with local knowledge and culture, and that seek to co-produce knowledge with people with lived experience in diverse Indian contexts is required. 43…”