What innovative practices and processes are used to deliver psychosocial care in India? A qualitative case study of three non-profit community mental health organisations

Srinivasan, V.; Jain, Sumeet; Kwon, Winston; Bayetti, Clement; Cherian, Anish V.; Mathias, Kaaren

doi:10.1016/j.ssmmh.2023.100220

Cited by 6 publications

(4 citation statements)

References 43 publications

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“…However, NGO services in all settings are unevenly dispersed, meaning services are often inequitably distributed. For example, many metropolitan areas of India have active NGOs providing mental health care, but very few work in rural areas and there has been little coordination across NGOs regionally or nationally for advocacy although this is changing with the engagement of some larger philanthropic funders such as Mariwala Health Initiative [ 102 ]. In South Africa, while 2,000 mental health NGOs receive government subsidies, there is poor coordination between government departments and NGOs, meaning their care is fragmented.…”

Section: Responding To the Real World—community Assets For Mental Healthmentioning

confidence: 99%

“…Faith communities, professional groups, youth organisations, schools and universities, for example, bring together people to offer flexible support to vulnerable people in the community. They engage in many smaller-scale activities to respond to identified needs, such as sponsoring the renovation of mental health facilities, offering clothing, food and shelter to people with mental illness living on the streets, and providing opportunities for employment [ 102 ].…”

Section: Responding To the Real World—community Assets For Mental Healthmentioning

confidence: 99%

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Inverting the deficit model in global mental health: An examination of strengths and assets of community mental health care in Ghana, India, Occupied Palestinian territories, and South Africa

Mathias,

Bunkley,

Pillai

et al. 2024

PLOS Glob Public Health

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Global mental health [GMH] scholarship and practice has typically focused on the unmet needs and barriers to mental health in communities, developing biomedical and psychosocial interventions for integration into formal health care platforms in response. In this article, we analyse four diverse settings to disrupt the emphasises on health system weaknesses, treatment gaps and barriers which can perpetuate harmful hierarchies and colonial and medical assumptions, or a ‘deficit model’. We draw on the experiential knowledge of community mental health practitioners and researchers working in Ghana, India, the Occupied Palestinian Territory and South Africa to describe key assets existing in ‘informal’ community mental health care systems and how these are shaped by socio-political contexts. These qualitative case studies emerged from an online mutual learning process convened between 39 academic and community-based collaborators working in 24 countries who interrogated key tenets to inform a social paradigm for global mental health. Bringing together diverse expertise gained from professional practice and research, our sub-group explored the role of Community Mental Health Systems in GMH through comparative country case studies describing the features of community care beyond the health and social care system. We found that the socio-political health determinants of global economic structures in all four countries exert significant influence on local community health systems. We identified that key assets across sites included: family and community care, and support from non-profit organisations and religious and faith-based organisations. Strengthening community assets may promote reciprocal relationships between the formal and informal sectors, providing resources for support and training for communities while communities collaborate in the design and delivery of interventions rooted in localised expertise. This paper highlights the value of informal care, the unique social structures of each local context, and resources within local communities as key existing assets for mental health.

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Section: Responding To the Real World—community Assets For Mental Healthmentioning

confidence: 99%

Section: Responding To the Real World—community Assets For Mental Healthmentioning

confidence: 99%

Inverting the deficit model in global mental health: An examination of strengths and assets of community mental health care in Ghana, India, Occupied Palestinian territories, and South Africa

Mathias,

Bunkley,

Pillai

et al. 2024

PLOS Glob Public Health

Self Cite

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“…Although this view still persists, community mental healthcare now also features as a heterogeneous, de-centralized assemblage of formal and informal care, from which the ‘best practices’ and priorities of GMH ought to emerge bottom-up (Burgess & Mathias, 2017; Carrà et al, 2022; Chase, 2022; Chase et al, 2022; Florence et al, 2022). Srinivasan and colleagues (2023), for example, see psychosocial community mental health workers in India as innovators in GMH because they integrate different interpretations of the problem, draw on assets of local care systems, establish two-way flows of knowledge and facilitate recovery as social inclusion, thereby providing care that addresses the social determinants of mental health (Srinivasan et al, 2023).…”

Section: Key Shifts In Gmhmentioning

confidence: 99%

Contingent universality: The epistemic politics of global mental health

Bemme

2023

Transcult Psychiatry

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The field of global mental health (GMH) has undergone profound changes over the past decade. Outgrowing its earlier agenda it has performed a reflexive turn, broadened towards a social paradigm and developed new modes of knowledge production, all of which reshaped ‘mental health’ as a global object of knowledge and care, and the epistemic politics of the field. Drawing on long-term ethnographic fieldwork among GMH experts and recent agenda-setting publications, I discuss how GMH advocates and critical observers alike have created conceptual and practical middle-grounds between different forms of mental health knowledge – across culture, epistemic power, lived experience, policy platforms and academic disciplines – framing their dynamic encounters as dialogue, adaptation, participation, co-production or integration. Ultimately, I argue, GMH today is focusing less on establishing mental health as a universal problem than on managing its inherent multiplicity through alignment and integration across different bodies of knowledge. Global knowledge, so conceived, is fluid and malleable and produced in open-ended knowledge practices, governed by what I call ‘contingent universality’. It is not new that the concepts and practices of the psy-disciplines are malleable and multiple, internally and externally contested, rapidly changing over time and not easily transferrable across space. What is new is that within the increasingly heterogenous epistemic space of GMH, these features have become assets rather than liabilities. GMH knowledge achieves both global reach and local relevance precisely because ‘mental health’ can be many things; it can be expressed in a wide range of idioms and concepts, and its problems and solutions align easily with others, at many scales. These fluid and integrative knowledge practices call for renewed empirical, critical and collaborative engagement.

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“…They often deliver innovative interventions that exemplify the above advocated shifts and demonstrate positive outcomes including service quality, social inclusion and high rates of remission (Kohrt et al, 2018). Authors of this paper have recently reported on a study investigating how some mental health NGOs in India balance innovation, impact, sustainability, and scale (Srinavasan et al, 2023).…”

Section: Gmh's Current Approach To Scalementioning

confidence: 99%

Critical reflections on the concept and impact of “scaling up” in Global Mental Health

Bayetti

Bakhshi

Davar³

et al. 2023

Transcult Psychiatry

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The field of Global Mental Health (GMH) aims to address the global burden of mental illness by focusing on closing the “treatment gap” faced by many low- and middle-income countries (LMICs). To increase access to services, GMH prioritizes “scaling up” mental health services, primarily advocating for the export of Western centred and developed biomedical and psychosocial “evidence-based” approaches to the Global South. While this emphasis on scalability has resulted in the increased availability of mental health services in some LMICs, there have been few critical discussions of this strategy. This commentary critically appraises the scalability of GMH by questioning the validity and sustainability of its approach. We argue that the current approach emphasizes the development of mental health services and interventions in “silos,” focusing on the treatment of mental illnesses at the exclusion of a holistic and contextualized approach to people's needs. We also question the opportunities that the current approach to GMH offers for the growth of mental health programmes of local NGOs and investigate the potential pitfalls that scalability may have on NGOs’ impact and ability to innovate. This commentary argues that any “scaling up” of mental health services must place sustainability at the core of its mission by favouring the growth and development of local solutions and wider forms of support that prioritize social inclusion and long-lasting mental health recovery.

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What innovative practices and processes are used to deliver psychosocial care in India? A qualitative case study of three non-profit community mental health organisations

Cited by 6 publications

References 43 publications

Inverting the deficit model in global mental health: An examination of strengths and assets of community mental health care in Ghana, India, Occupied Palestinian territories, and South Africa

Inverting the deficit model in global mental health: An examination of strengths and assets of community mental health care in Ghana, India, Occupied Palestinian territories, and South Africa

Contingent universality: The epistemic politics of global mental health

Critical reflections on the concept and impact of “scaling up” in Global Mental Health

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