Inclusion of people with psychosocial disability in low and middle income contexts: a practice review
DOI:
https://doi.org/10.15566/cjgh.v4i3.172Keywords:
psychosocial disability, inclusion, mental health, social determinants of health, stigma, poverty, accessAbstract
Much of the literature about mental illness in low and middle income countries (LMICs) focuses on prevalence rates, the treatment gap, and scaling up access to medical expertise and treatment. As a cause and consequence of this, global mental health programs have focused heavily on service delivery without due exploration of how programs fit into a broader picture of culture and community. There is a need for research which highlights approaches to broader inclusion, considering historical, cultural, social, and economic life contexts and recognises the community as a determinant of mental health — in prevention, recovery, resilience, and support of holistic wellness.
The purpose of this practice review is to explore the experiences of three local organisations working with people with psychosocial disability living in LMICs: Afghanistan, India, and Nepal. All three organisations have a wealth of experience in implementing mental health programs, and the review brings together evidence of this experience from interviews, reports, and evaluations. Learnings from these organisations highlight both successful approaches to strengthening inclusion and the challenges faced by people with psychosocial disability, their families, and communities.
The findings can largely be summarised in two categories, although both are very much intertwined: first, a broad advocacy, public health, and policy approach to inclusion; and second, more local, community-based initiatives. The evidence draws attention to the need to acknowledge the complexities surrounding mental health and inclusion, such as additional stigmatisation due to multidimensional poverty, gender inequality, security issues, natural disasters, and additional stressors associated with access. Organisational experiences also highlight the need to work with communities’ strengths to increase capacity around inclusion and to apply community development approaches where space is created for communities to generate holistic solutions. Most significantly, approaches at all levels require efforts to ensure that people with psychosocial disability are given a voice and are included in shaping programs, policies, and appropriate responses.
Published
How to Cite
Issue
Section
License
Christian Journal for Global Health applies the Creative Commons Attribution License to all articles that we publish. Under this license, authors retain ownership of copyright for their articles or they can transfer copyright to their institution, but authors allow anyone without permission to copy, distribute, transmit, and/or adapt articles, even for commercial purposes so long as the original authors and Christian Journal for Global Health are appropriately cited.
This work is licensed under a Creative Commons Attribution 4.0 International License.