Global mental health research and practice: a decolonial approach

Rivera-Segarra, Eliut; Mascayano, Franco; Al‐Nasser, Lubna; Ven, Els van der; Martínez-Alés, Gonzalo; Durand-Arias, Sol; Moro, Maria Francesca; Karam, Elie G.; Hernández-Torres, Ruthmarie; Alarcón, Sebastián; Ramos-Pibernus, Alíxida; Alvarado, Rubén; Süsser, Ezra

doi:10.1016/s2215-0366(22)00043-8

Cited by 16 publications

(14 citation statements)

References 22 publications

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“…Such an approach would provide the foundation for revealing past hidden histories; recognizing multiple paradigms, ways of knowing, and stakeholders; and activating experiments of power-sharing with underrecognized experts and users within and outside Global North institutions. It would be consistent with growing calls for decoloniality in global health research 3 as well as with the nascent movement in the US toward integrating structural competence into health and medical training. 10…”

Section: Benefits Of Viewing the History Of Psychiatric Epidemiology ...supporting

confidence: 60%

“…After World War II, decolonialists began to illuminate and challenge hierarchical and racialist policies in international health . Yet the legacies of colonial stereotypes and policies still exert an insidious influence on global health research . Today, colonial legacies are inadvertently reinforced by asylumlike structures now rejected in much of the Global North (high-income, economically developed nations), by knowledge gaps in psychiatric epidemiology, by sparse mental health services, and by lack of attention to local contexts, including healing practices …”

Section: Historical Framework For Examining Psychiatric Epidemiologymentioning

confidence: 99%

“…2 Yet the legacies of colonial stereotypes and policies still exert an insidious influence on global health research. 1,3 Today, colonial legacies are inadvertently reinforced by asylumlike structures now rejected in much of the Global North (high-income, economically developed nations), by knowledge gaps in psychiatric epidemiology, by sparse mental health services, and by lack of attention to local contexts, including healing practices. 1,4 Within the US, historians of health and mental health are revealing many ways in which research, by omis-sion or commission, has contributed to the hierarchies of class, race, gender, and religion and their economic and political power relationships.…”

Section: Historical Framework For Examining Psychiatric Epidemiologymentioning

confidence: 99%

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Viewing Psychiatric Epidemiology Within a Global Historical Framework to Shape Future Practice

2023

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Section: Benefits Of Viewing the History Of Psychiatric Epidemiology ...supporting

confidence: 60%

Section: Historical Framework For Examining Psychiatric Epidemiologymentioning

confidence: 99%

Section: Historical Framework For Examining Psychiatric Epidemiologymentioning

confidence: 99%

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Viewing Psychiatric Epidemiology Within a Global Historical Framework to Shape Future Practice

2023

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“…Local researchers are also the ones embedded within settings and navigating the lived-through tensions inherent to conducting research, such as balancing social impact and scientific rigor, and championing local needs in international collaborations. As has been highlighted, achieving this requires attention to efforts to decolonise structural systems of research funding, ethical oversight mechanisms, publication and academic credit for research, and researcher career development 52,53 .…”

Section: Discussionmentioning

confidence: 99%

Maximising impactful and locally relevant mental health research: ethical considerations

Calia¹,

Chakrabarti²,

Sarabwe³

et al. 2022

Wellcome Open Res

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Background: Achieving ethical and meaningful mental health research in diverse global settings requires approaches to research design, conduct, and dissemination that prioritise a contextualised approach to impact and local relevance. Method: Through three case studies presented at the 2021 Global Forum on Bioethics in Research meeting on the ethical issues arising in research with people with mental health conditions, we consider the nuances to achieving ethical and meaningful mental health research in three diverse settings. The case studies include research with refugees Rwanda and Uganda; a neurodevelopmental cohort study in a low resource setting in India, and research with Syrian refugees displaced across the Middle East. Results: Key considerations highlighted across the case studies include how mental health is understood and experienced in diverse contexts to ensure respectful engagement with communities, and to inform the selection of contextually-appropriate and feasible research methods and tools to achieve meaningful data collection. Related to this is a need to consider how communities understand and engage with research to avoid therapeutic misconception, exacerbating stigma, or creating undue inducement for research participation, whilst also ensuring meaningful benefit for research participation. Central to achieving these is the meaningful integration of the views and perspectives of local stakeholders to inform research design, conduct, and legacy. The case studies foreground the potential tensions between meeting local community needs through the implementation of an intervention, and attaining standards of scientific rigor in research design and methods; and between adherence to procedural ethical requirements such as ethical review and documenting informed consent, and ethical practice through attention to the needs of the local research team. Conclusions: We conclude that engagement with how to achieve local relevance and social, practice, and academic impact offer productive ways for researchers to promote ethical research that prioritises values of solidarity, inclusion, and mutual respect.

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“…Additionally, actions toward the goal of decolonizing global health require approaches and practices that acknowledge the history of colonialism and actively resist the perpetuation of patterns of oppression, exclusion, and exploitation. 53 , 54 As more equitable strategies and practices emerge, it is also important to recognize that strategies may—and should—vary for each specific context and project given the complex power dynamics at play. The lessons learned from this demonstration case can serve to inform scale-up and sustainment of not only this specific intervention, MME, but also other interventions whose implementation relies—either explicitly or implicitly—on cultural adaptation and local collaborators.…”

Section: Discussionmentioning

confidence: 99%

Toward Meaningful Cultural Adaptation Across Implementation Stages: Lessons Learned From a Culturally Based HIV Stigma Intervention in Gaborone, Botswana

Poku

Eschliman

Wang³

et al. 2022

Glob Health Sci Pract

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We share lessons learned on how each stage of the implementation process of a culturally based stigma intervention benefited from cultural adaptationincluding incorporating interexchange of knowledge during formative work, leveraging bilingualism and the cultural familiarity of local collaborators during the intervention, and prioritizing the concerns of local collaborators to inform intervention sustainment and scale-up.nThe implementation process could have been improved by more fully formalizing and recognizing the steps taken by local collaborators to culturally adapt throughout design and implementation.n Lessons learned from this demonstration case can inform scale-up and sustainment of interventions whose implementation relies-either explicitly or implicitly-on cultural adaptation and local collaborators.n Programs can benefit from building relationships of mutual respect and reciprocity with local collaborators and formally recognizing and supporting their contributions to cultural adaptation throughout the stages of implementation.

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Global mental health research and practice: a decolonial approach

Cited by 16 publications

References 22 publications

Viewing Psychiatric Epidemiology Within a Global Historical Framework to Shape Future Practice

Viewing Psychiatric Epidemiology Within a Global Historical Framework to Shape Future Practice

Maximising impactful and locally relevant mental health research: ethical considerations

Toward Meaningful Cultural Adaptation Across Implementation Stages: Lessons Learned From a Culturally Based HIV Stigma Intervention in Gaborone, Botswana

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