An asymmetric burden gendered experiences of caregivers of people with psycho-social disabilities... more An asymmetric burden gendered experiences of caregivers of people with psycho-social disabilities in North India
BackgroundGlobally, there is increasing emphasis on the importance of understanding the ways in w... more BackgroundGlobally, there is increasing emphasis on the importance of understanding the ways in which social inequality and injustice impact individual and community mental health. Set in the state ...
The field of Global Mental Health (GMH) aims to address the global burden of mental illness by fo... more 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 opport...
Purpose Calls for “mutuality” in global mental health (GMH) aim to produce knowledge more equitab... more Purpose Calls for “mutuality” in global mental health (GMH) aim to produce knowledge more equitably across epistemic and power differences. With funding, convening, and publishing power still concentrated in institutions in the global North, efforts to decolonize GMH emphasize the need for mutual learning instead of unidirectional knowledge transfers. This article reflects on mutuality as a concept and practice that engenders sustainable relations, conceptual innovation, and queries how epistemic power can be shared. Methods We draw on insights from an online mutual learning process over 8 months between 39 community-based and academic collaborators working in 24 countries. They came together to advance the shift towards a social paradigm in GMH. Results Our theorization of mutuality emphasizes that the processes and outcomes of knowledge production are inextricable. Mutual learning required an open-ended, iterative, and slower paced process that prioritized trust and remained respo...
An asymmetric burden gendered experiences of caregivers of people with psycho-social disabilities... more An asymmetric burden gendered experiences of caregivers of people with psycho-social disabilities in North India
BackgroundGlobally, there is increasing emphasis on the importance of understanding the ways in w... more BackgroundGlobally, there is increasing emphasis on the importance of understanding the ways in which social inequality and injustice impact individual and community mental health. Set in the state ...
The field of Global Mental Health (GMH) aims to address the global burden of mental illness by fo... more 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 opport...
Purpose Calls for “mutuality” in global mental health (GMH) aim to produce knowledge more equitab... more Purpose Calls for “mutuality” in global mental health (GMH) aim to produce knowledge more equitably across epistemic and power differences. With funding, convening, and publishing power still concentrated in institutions in the global North, efforts to decolonize GMH emphasize the need for mutual learning instead of unidirectional knowledge transfers. This article reflects on mutuality as a concept and practice that engenders sustainable relations, conceptual innovation, and queries how epistemic power can be shared. Methods We draw on insights from an online mutual learning process over 8 months between 39 community-based and academic collaborators working in 24 countries. They came together to advance the shift towards a social paradigm in GMH. Results Our theorization of mutuality emphasizes that the processes and outcomes of knowledge production are inextricable. Mutual learning required an open-ended, iterative, and slower paced process that prioritized trust and remained respo...
Purpose
Mental disorders are one of the leading causes of years lived with disability, yet fewer ... more Purpose Mental disorders are one of the leading causes of years lived with disability, yet fewer than 10% of people with common mental disorders (CMDs) in India have access to care. This emphasizes a clear priority for communities who can work collectively to facilitate more effective prevention, care, treatment and advocacy in mental health (community mental health competence). This study, set in Uttarakhand in Northern Indian, investigates processes of building knowledge, safe social spaces, and partnerships for action and health promotion taken by groups of women with CMDs in communities in rural and semi-urban Uttarakhand. Research is locally based with co-authors KM and PP long term residents in Dehradun.
Focus/Content The study was set in three communities (rural, urban and semi-urban) in Dehradun district, Uttarakhand where Burans, a partnership project of four non-governmental organisations, has been working. Burans works collaboratively with alongside communities to improve mental health by supporting community organisations and community dialogues on mental health, facilitating access to care, and supporting families with psycho-social disabilities. Eight focus group discussions were held with members of ‘self-help groups,’ comprised of women primarily with CMDs, with additional participant observation by co-investigators. Ten key informant interviews (KIIs) were also conducted with local health care providers and community members. Translated transcripts of discussions were analysed deductively using an adapted model of community mental health competence focussing on Knowledge, Safe Social Spaces and Partnerships for Action (see Appendix One).
Significance for the sub-theme area/field-building dimension of relevance and target audience This research emphasizes the importance of prioritizing the health of marginalized and vulnerable communities with a focus on gender and health equity. The innovation in this research is that it analyzes and articulates learnings and outcomes from new community-based actions for improving mental health that build on local resources. This research offers community-based solutions in low-resource contexts as a first step towards improving health system responsiveness and resilience while providing access to care.
Greater mental health competence and control may empower women to contribute to household and community decisions, and participate economically. Understanding community models for women to improve their mental health by increasing their agency and control creates communities that have the ability to advance their own health and social interests. It also provides integrated knowledge translation to the only community mental health project in Uttarakhand state, and feeds into ongoing project actions to improve the project’s self-help and support groups.
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Papers by Kaaren Mathias
Mental disorders are one of the leading causes of years lived with disability, yet fewer than 10% of people with common mental disorders (CMDs) in India have access to care. This emphasizes a clear priority for communities who can work collectively to facilitate more effective prevention, care, treatment and advocacy in mental health (community mental health competence). This study, set in Uttarakhand in Northern Indian, investigates processes of building knowledge, safe social spaces, and partnerships for action and health promotion taken by groups of women with CMDs in communities in rural and semi-urban Uttarakhand. Research is locally based with co-authors KM and PP long term residents in Dehradun.
Focus/Content
The study was set in three communities (rural, urban and semi-urban) in Dehradun district, Uttarakhand where Burans, a partnership project of four non-governmental organisations, has been working. Burans works collaboratively with alongside communities to improve mental health by supporting community organisations and community dialogues on mental health, facilitating access to care, and supporting families with psycho-social disabilities. Eight focus group discussions were held with members of ‘self-help groups,’ comprised of women primarily with CMDs, with additional participant observation by co-investigators. Ten key informant interviews (KIIs) were also conducted with local health care providers and community members. Translated transcripts of discussions were analysed deductively using an adapted model of community mental health competence focussing on Knowledge, Safe Social Spaces and Partnerships for Action (see Appendix One).
Significance for the sub-theme area/field-building dimension of relevance and target audience
This research emphasizes the importance of prioritizing the health of marginalized and vulnerable communities with a focus on gender and health equity. The innovation in this research is that it analyzes and articulates learnings and outcomes from new community-based actions for improving mental health that build on local resources. This research offers community-based solutions in low-resource contexts as a first step towards improving health system responsiveness and resilience while providing access to care.
Greater mental health competence and control may empower women to contribute to household and community decisions, and participate economically. Understanding community models for women to improve their mental health by increasing their agency and control creates communities that have the ability to advance their own health and social interests.
It also provides integrated knowledge translation to the only community mental health project in Uttarakhand state, and feeds into ongoing project actions to improve the project’s self-help and support groups.