scholarly journals Psychosocialization in Nepal: Notes on Translation from the Frontlines Global Mental Health

Author(s):  
Liana E Chase

As ‘psychosocial interventions’ continue to gain traction in the field of global mental health, a growing critical literature problematises their vague definition and attendant susceptibility to appropriation. In this article, I recast this ill-defined quality as interpretive flexibility and explore its role in processes of translation occurring at the frontlines of care in rural Nepal. Drawing from 14 months of ethnographic fieldwork among community-based psychosocial counsellors, I consider how the broad and flexible notion of the ‘psychosocial problem’ operates as a ‘boundary object’ in transnational mental health initiatives—that is, how it facilitates the collaboration of service users, clinicians, donors, and policymakers in shared therapeutic projects without necessarily producing agreement among these parties regarding the nature of the suffering they address. I suggest that psychosocial interventions may be gaining popularity not despite but precisely because of the lack of a unitary vision of the problems psychosocial care sets out to alleviate. In closing, I reflect on what distinguishes ‘psychosocialisation’ from medicalisation and highlight the limitations of the latter as a critical paradigm for the anthropology of global mental health.

1999 ◽  
Vol 5 (4) ◽  
pp. 288-295 ◽  
Author(s):  
Nick Temple

Psychosocial aspects of treatment have become increasingly important with the changes in psychiatric practice away from the hospital to the community. Effective psychosocial interventions and high staff morale are likely to be the key to the success of a community-based mental health service. There is a growing expectation that all psychiatrists should have a basic knowledge of therapeutic approaches in order to take a leading role in the multi-disciplinary team. They should be able to assess patients for a range of psychological and psychotherapeutic treatments. This role is vital as the matching of the patient's needs with the appropriate treatment is the key to a successful outcome.


2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 57S-62S
Author(s):  
Deepak Jayarajan ◽  
Thanapal Sivakumar ◽  
John B Torous ◽  
Jagadisha Thirthalli

The COVID-19 pandemic has interrupted the usual mechanisms of healthcare delivery and exacerbated symptoms of mental illnesses. Telemedicine has morphed from niche service to essential platform, with newly released guidelines that cover various aspects of tele-mental health delivery. Rehabilitation services, which incorporate a range of psychosocial interventions and liaison services, have been significantly impacted too. They are currently more institute-based than community-based in India. However, recent legislation has mandated that community-based rehabilitation options be available. While a large treatment gap for mental health issues has always existed, telemedicine provides an opportunity to scale services up to minimize this gap. Community-based rehabilitation can be delivered over various platforms, from text to phone to videoconferencing, and various devices. Telemedicine is cost-effective, and enables delivery of services where existing services are inadequate. The recent guidelines allow other healthcare workers to be involved in mental health service delivery. Hence, in addition to direct delivery of services, telerehabilitation can facilitate task-shifting, with mental health professionals mentoring and supervising existing human resources, such as ASHA workers, VRWs, DMHP programme staff, and others. Tele-rehabilitation also poses challenges - not all needs can be met; access and privacy can be a problem in resource-scarce settings; liaison with existing services is required; and organisations need to plan appropriately and re-allocate resources. Digital access to welfare benefits and interventions must be expanded without disadvantaging those without internet access. Yet, many rehabilitation interventions can be adapted to telemedicine platforms smoothly, and task-shifting can broaden access to care for persons with disability.


2019 ◽  
Vol 65 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Martin Agrest ◽  
PhuongThao D Le ◽  
Lawrence H Yang ◽  
Franco Mascayano ◽  
Silvia Alves-Nishioka ◽  
...  

Background: Latin America, and Chile in particular, has a rich tradition of community mental health services and programs. However, in vivo community-based psychosocial interventions, especially those with a recovery-oriented approach, remain scarce in the region. Between 2014 and 2015, a Critical Time Intervention-Task Shifting project (CTI-TS) was implemented in Santiago, Chile, as part of a larger pilot randomized control trial. CTI is a time-limited intervention delivered at a critical-time to users, is organized by phases, focuses on specific objectives and decreases in intensity over time. CTI-TS, which combines both the task-shifting strategy and the use of peers, introduces a novel approach to community mental health care that has not yet been tried in Chile. Aims: We aim to evaluate the feasibility, acceptability and applicability of such a community-based psychosocial intervention in urban settings in Latin America – specifically, in Santiago (Chile) from a user perspective. Method: We analyzed 15 in-depth interviews ( n = 15) with service users who participated in the intervention about their perceptions and experiences with CTI-TS through thematic analysis. Results: Three themes were revealed. The first was related to the structural characteristics of CTI-TS, especially regarding the timing, duration and phasic nature of the intervention. The second pertained to the acceptability of the in vivo community-based approach. The third theme dealt with the task-shifting aspect, that is, users’ perceptions of the peer support workers and the community mental health workers. Conclusions: CTI-TS was generally acceptable in this Latin American context. Users’ perspectives pointed to the need to make adjustments to some of the structural characteristics of the CTI model and to combine this type of intervention with others that can address stigma. Thus, future adaptations of CTI-TS or similar psychosocial interventions in Latin American contexts are feasible and can enhance community mental health in the region.


2018 ◽  
Vol 40 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Jacquelyn H. Flaskerud

2021 ◽  
Author(s):  
Wissam Kheir ◽  
Edwina Zoghbi ◽  
Rachel Bteich ◽  
Alissar Rady ◽  
Rabih El Chammay

Abstract Background: Mental health services in Lebanon are weakly integrated in the health system due to a huge political unrest, cultural and societal stigma, and more importantly, due to the inappropriate planning of human resources. A shift of the mental health services in Lebanon from hospital-based care into community-based care and efficient planning of human resources became a priority given the increasing burden of mental health disorders as a consequence of socio-political and economic crises: the bordering Syrian war, the massive influx of refugees, the huge inflation rate and above all the Beirut explosion. Methods: The WHO-ATLAS was conducted in 2019 as well as the WHO-AIMS in 2015 to map mental health services in Lebanon. Data from those two reports was plugged into the service needs calculator; an economic tool including epidemiology of eight priority mental health packages and target population, outpatient service use/needs and inpatient service use/needs. Total full-time equivalents (FTE) were calculated for psychiatrists, nurses and psychosocial care providers. All formulas were extracted from the WHO “Planning and Budgeting to deliver mental health services” module of the Mental Health Policy and Service Guidance Package. Results: For an effective community-based mental health system in Lebanon, there is additional need for 182 (+16%) psychiatrists, 762 (+68%) nurses and 184 (+16%) psychosocial care providers; a total increase of 1,128 mental health workforce. Conclusions: A proper workforce skill mix for an optimal utilization of the existing staff is recommended. New models will need to account for task shifting to attempt to close the gap between what is needed and what is available.


Author(s):  
Anindya Das ◽  
Mohan Rao

We critically engage with the Movement for Global Mental Health (MGMH) through the lens of the Social Determinants of Health (SDH), suitably widened. We explore the socio-political context of Indian community mental health initiatives in order to elaborate the opportunities/impediments for a public programme. We critique the MGMH for being preoccupied with the burden of mental illness and its “treatment”, while being inattentive to the social, economic, and political contexts shaping local/global ecologies of well-being/suffering. Hence the economic arguments of the MGMH fail to examine the realities of local contexts (poor public health funding and primary health care, lax pharmaceutical regulations, asymmetric power relations and indigenous knowledge systems). Using the concepts of globalisation and global health, and taking a population perspective, we describe a neo-materialistic version of SDH.


2015 ◽  
Vol 12 (2) ◽  
pp. 33-35 ◽  
Author(s):  
Elizabeth K. MacFarlane ◽  
Renu Shakya ◽  
Helen L. Berry ◽  
Brandon A. Kohrt

‘Photovoice’, a community-based participatory research methodology, uses images as a tool to deconstruct problems by posing meaningful questions in a community to find actionable solutions. This community-enhancing technique was used to elicit experiences of climate change among women in rural Nepal. The current analysis employs mixed methods to explore the subjective mental health experience of participating in a 4- to 5-day photovoice process focused on climate change. A secondary objective of this work was to explore whether or not photovoice training, as a one-time 4-to 5-day intensive intervention, can mobilise people to be more aware of environmental changes related to climate change and to be more resilient to these changes, while providing positive mental health outcomes.


LOGOS ◽  
2017 ◽  
Vol 28 (3) ◽  
pp. 32-40 ◽  
Author(s):  
Nick Canty

This article discusses the historical development of bibliotherapy and how books can be used in the treatment of a range of minor mental health conditions. The article provides a brief historical account of how books have been used in institutions through the centuries and how the bibliotherapuetic process works through the use of texts from which the reader gains an insight into their personal situation by identifying with a character experiencing similar problems. Bibliotherapy as both clinical and community-based treatment is discussed through a number of case studies from the critical literature, in particular the Ayrshire Read Yourself Well scheme and the Reading Well/Books on Prescription scheme. The results of a medical trial on the benefits of reading a novel based on MRI (magnetic resonance imaging) scans of readers are then discussed.


Author(s):  
Liana E Chase ◽  
Dristy Gurung ◽  
Parbati Shrestha ◽  
Sunita Rumba

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