Introducing recovery-oriented practice in Indonesia: the Sukabumi project – an innovative mental health programme

Stratford, Anthony; Kusuma, N; Goding, Margaret; Paroissien, David; Brophy, Lisa; Damayanti, Yeni; Fraser, Julia; Ng, Chee H.

doi:10.1080/02185385.2014.885210

Cited by 13 publications

(13 citation statements)

References 7 publications

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“…Where Western models of peer support were implemented, service users questioned why the trainer openly discussed their mental health, as this was rarely talked about within their culture [63]. However, there was also evidence that openly discussing and sharing experiences of poor mental health and involving local people in the development of services could reduce stigma and promote social inclusion (O3 [35,36,42,47,48]), particularly when people rejoined their community after being discharged from inpatient services [64].…”

Section: Sharing Experiencesmentioning

confidence: 99%

“…Including experiential knowledge in the development of services meant that service providers developed a greater understanding of local mental health needs, and how interventions could best be designed to meet these needs. There was evidence that this could lead to more person centered care (O5 [44,48,51,59]), increased service use (O6 [44,50,59]) and efficiency (O7 [41,42,44,59,64,65]) and improved mental health and quality of life of service users (O2 [41-43, 47, 59, 66]). Some sources also reported how this helped to reduce the stigma associated with poor mental health (O3 [48,64,67]), particularly in peer-led projects, such as a Thai psychoeducation intervention where the trainers had personal experience of caring for family members with a serious mental illness [63].…”

Section: Using Experiential Knowledgementioning

confidence: 99%

“…A lack of understanding of mental health and the benefits of involvement, awareness of patient's rights and a lack of confidence and knowledge about how to assert these rights was a barrier (C4 [39,44,46,64,69]). A further barrier was the limited infrastructure available to support involvement (C5), such as limited funds, transportation to access remote communities, understaffing, and limited organisational support for involvement from NGOs and statutory services, at both a local and national level [39,47,49,58,59,62,69].…”

Section: Using Experiential Knowledgementioning

confidence: 99%

“…The mechanism of empowerment was facilitated by contexts which understood and were supportive of recovery or civic engagement at a micro, meso or macro level (C3/C4 [39,42,46,50]). The collective culture central to some South East Asian countries was an important contextual facilitator [46,64] but such cultures were not ubiquitous within included publications [50]. Other barriers to empowerment included low mental health literacy and desire for involvement amongst service users and their carers and high levels of stigma amongst communities (C4, C8 [39,42,50,62,64,[72][73][74]).…”

Section: Empowering Individuals and Communitiesmentioning

confidence: 99%

“…The collective culture central to some South East Asian countries was an important contextual facilitator [46,64] but such cultures were not ubiquitous within included publications [50]. Other barriers to empowerment included low mental health literacy and desire for involvement amongst service users and their carers and high levels of stigma amongst communities (C4, C8 [39,42,50,62,64,[72][73][74]). Hope and accountability were identified as central features of empowerment within studies [64,67].…”

Section: Empowering Individuals and Communitiesmentioning

confidence: 99%

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Implementing civic engagement within mental health services in South East Asia: a systematic review and realist synthesis of current evidence

James¹,

Brooks

Susanti

et al. 2020

Int J Ment Health Syst

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Introduction: Civic engagement (CE) has the potential to transform mental health services and could be particularly important for low and middle-income countries (LMICs), which are rapidly developing to respond to the burden of poor mental health. Research from high income countries has found many challenges associated with the meaningful implementation of CE in practice, but this has been underexplored in LIMCS and in South East Asia (SEA) in particular. Methods:We completed a realist synthesis and systematic review of peer reviewed publications and grey literature to identify the context and actions which promote successful implementation of CE approaches in SEA. We used a theory-driven approach-realist synthesis-to analyse data and develop context-mechanism-outcome configurations that can be used to explain how civic engagement approaches operate in South East Asian contexts. We worked closely with patient and public representatives to guide the review from the outset.Results: Fifty-seven published and unpublished articles were included, 24 were evaluations of CE, including two Randomized Controlled Trials. The majority of CE interventions featured uptake or adaptation of Western models of care. We identified important cultural differences in the enactment of civic engagement in SEA contexts and four mechanisms which, alongside their contextual barriers and facilitators, can be used to explain how civic engagement produces a range of outcomes for people experiencing mental health problems, their families and communities. Our review illustrates how CE interventions can be successfully implemented in SEA, however Western models should be adapted to fit with local cultures and values to promote successful implementation. Barriers to implementation included distrust of services/outside agencies, stigma, paternalistic cultures, limited resource and infrastructure. Conclusion:Our findings provide guidance for the implementation of CE approaches within SEA contexts and identify areas for further research. Due to the collectivist nature of many SEA cultures, and the impact of shared traumas on community mental health, CE might best be implemented at community level, with a focus on relational decision making. Registration This review is registered on PROSPERO: CRD42018087841.

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