Thinking beyond implementation: context and culture in global mental health

Montenegro, Cristián; Ortega, Francisco

doi:10.1136/bmjgh-2020-004539

Cited by 12 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Structural transformations can ensue not only through macro-level policies but also from grassroots experiments in democratic governance, epistemic justice, critical consciousness, co-production initiatives, and in everyday modes of living and relating to others [ 62 – 65 ]. As this paper has shown, frank discussions of the emotional damages of the social and political realm played an important role in motivating young people’s desire to practice change-making and hold their therapists accountable to doing the same [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

Béhague,

Gonçalves,

da Cruz

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

View full text Add to dashboard Cite

Purpose In this paper, we explore how Brazilian socially sensitive therapy can respond to care-users’ desire to change the social and political forces shaping their lives. We use this case to demonstrate the limits of the “social determinants of health” agenda which, when operationalized, tends to leave questions of lasting structural change aside. Methods We report on mixed methods ethnographic and epidemiological results from the 1982 Pelotas (Brazil) birth cohort study, a prospective study of 5914 children. Ethnographic analysis explored the cyclical relationship between schooling, mental health care, conceptualizations of mental distress, social and political engagement, and experiences with diverse forms of discrimination. Epidemiological bivariate and multivariate analyses examined differences in socio-political participation and the reporting of discrimination at different time-points for participants who used therapy with those who did not. Effect modification analysis tested the hypothesis that the socially empowering effects of therapy were greater for marginalized and minoritized youth. Results Most young people living in situations of precarity experienced therapy, particularly when based in schools, to be a blame-inducing process. A more fulfilling and impactful therapeutic experience took shape when young people were able to shift the focus away from symptom reduction and behavioral management toward narrative life analyses, social debate, and political agency. Use of socially sensitive therapy was statistically associated with increased political participation and reporting of discrimination after controlling for confounders. The empowering effects of therapy were greater for those with less formal education and family income, but not for young people who identified as black, brown, or non-white. Conclusion The findings underscore the importance of considering agency, sociality, and politics when theorizing “the social” in clinical practice, and health and social policy.

show abstract

Section: Discussionmentioning

confidence: 99%

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

Béhague,

Gonçalves,

da Cruz

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

View full text Add to dashboard Cite

show abstract

“…In this chapter, we make use of Culver et al ( 35 ) who propose that the program of the discipline should not be limited only to the ethical aspects in psychiatry but must also include the religiosity of communities for a better understanding and perception of mental disorders, and on this matter, culture is increasingly becoming an issue for mental healthcare provider ( 36 ). Local practitioners and policymakers actively neglect cultural determinants in the mental health field ( 37 ). The imaginary of ethnic uniformity is a barrier to the implementation of culturally sensitive interventions ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

“…Local practitioners and policymakers actively neglect cultural determinants in the mental health field ( 37 ). The imaginary of ethnic uniformity is a barrier to the implementation of culturally sensitive interventions ( 37 ). In Africa, the influence of traditional concepts is great.…”

Section: Discussionmentioning

confidence: 99%

Psychiatry and mental health teaching programs of eight portuguese-speaking schools of medicine: A comparative analysis

Pedro

Palha

Ferreira

2022

Front. Public Health

View full text Add to dashboard Cite

BackgroundImprovement of teaching methods in psychiatry has been the subject of permanent adaptation and innovation. Strengthening graduate education skills in psychiatry and mental health will allow physicians to have the knowledge, skills, and attitudes to carry out early diagnosis and treatment at primary healthcare settings, taking into consideration that the population should benefit from the best interventions by general practitioners.ObjectiveThe objective of this study was to examine how the undergraduate program of psychiatry and mental health subject in the schools of medicine of the Community of Portuguese-Speaking Countries in the three continents is structured.MethodsThe methods include a narrative description of the program of psychiatry, the workload, the delivery and assessment methods, and the ethical and socio-cultural aspects in psychiatry and research made by the director of the course of psychiatry in Portugal, Brazil, and Mozambique.ResultsEight schools of medicine from Portugal, Brazil, and Mozambique participated in the study. All these schools use standards which are defined by the regulatory bodies of their countries. The teaching year varied between the third and the sixth. The workload varied between 140 and 224 h. Topics were addressed in presence or virtual methods. Combined qualitative and quantitative assessment is done to encompass competencies, skills and knowledge based on clinical histories, ongoing assessment, seminars, and final written tests. Ethical and socio-cultural aspects in various strands are taught to be linked to the local reality. Research is encouraged by using grants.ConclusionTeaching psychiatry follows global and national standards and is organized according to the reality of each country. Psychiatry departments from these three continents invest in teaching methodologies that encourage self-knowledge and the development of critical thinking, which is evaluated in a holistic context. The authors consider that the programs should have a workload according to the current burden of mental illness.

show abstract

“…On a deeper level, DMHTs have also been adapted to reflect on multilevel burdens, a potential stigmatization of mental disorders or the relevance of religion. However, cultural adaptations of DMHTs are often overlooked, poorly-reported, or not standardized [ 15 , 16 ]. Thus, although an overall influence of cultural adaptation of DMHTs on their effectiveness is suggested, it is not yet known which adaptation to which cultural differences is essential for the acceptance or effectiveness of DMHTs.…”

Section: The Role Of Technology In Mental Health From a Global Perspe...mentioning

confidence: 99%

Interdisciplinary perspectives on digital technologies for global mental health

Kuhn,

Saleem,

Klein

et al. 2024

PLOS Glob Public Health

View full text Add to dashboard Cite

Digital Mental Health Technologies (DMHTs) have the potential to close treatment gaps in settings where mental healthcare is scarce or even inaccessible. For this, DMHTs need to be affordable, evidence-based, justice-oriented, user-friendly, and embedded in a functioning digital infrastructure. This viewpoint discusses areas crucial for future developments of DMHTs. Drawing back on interdisciplinary scholarship, questions of health equity, consumer-, patient- and developer-oriented legislation, and requirements for successful implementation of technologies across the globe are discussed. Economic considerations and policy implications complement these aspects. We discuss the need for cultural adaptation specific to the context of use and point to several benefits as well as pitfalls of DMHTs for research and healthcare provision. Nonetheless, to circumvent technology-driven solutionism, the development and implementation of DMHTs require a holistic, multi-sectoral, and participatory approach.

show abstract

Thinking beyond implementation: context and culture in global mental health

Cited by 12 publications

References 14 publications

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

Psychiatry and mental health teaching programs of eight portuguese-speaking schools of medicine: A comparative analysis

Interdisciplinary perspectives on digital technologies for global mental health

Contact Info

Product

Resources

About