Moving the Global Mental Health Debate Forward: How a Structural Competency Framework Can Apply to Global Mental Health Training

Gajaria, Amy; Izenberg, Jacob M.; Nguyen, Viet; Rimal, Pragya; Acharya, Bibhav; Hansen, Helena

doi:10.1007/s40596-019-01073-3

Cited by 7 publications

(2 citation statements)

References 24 publications

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“…The characteristics of included articles are summarized in Table 3. Most (29/51) of the articles reviewed were editorials, commentaries, or letters to the editor 9,10,19,27‐52 . Thirteen of the articles reviewed were original research 21,53‐64 .…”

Section: Resultsmentioning

confidence: 99%

Structural competency in emergency medical education: A scoping review and operational framework

Salhi

Zeidan

Stehman

et al. 2022

AEM Education and Training

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Objectives Existing curricula and recommendations on the incorporation of structural competency and vulnerability into medical education have not provided clear guidance on how best to do so within emergency medicine (EM). The goal of this scoping review and consensus building process was to provide a comprehensive overview of structural competency, link structural competency to educational and patient care outcomes, and identify existing gaps in the literature to inform curricular implementation and future research in EM. Methods A scoping review focused on structural competency and vulnerability following Arksey and O’Malley’s six‐step framework was performed in concurrence with a multistep consensus process culminating in the 2021 SAEM Consensus Conference. Feedback was incorporated in developing a framework for a national structural competency curriculum in EM. Results A literature search identified 291 articles that underwent initial screening. Of these, 51 were determined to be relevant to EM education. The papers consistently conceptualized structural competency as an interdisciplinary framework that requires learners and educators to consider historical power and privilege to develop a professional commitment to justice. However, the papers varied in their operationalization, and no consensus existed on how to observe or measure the effects of structural competency on learners or patients. None of the studies examined the structural constraints of the learners studied. Conclusions Findings emphasize the need for training structurally competent physicians via national structural competency curricula focusing on standardized core competency proficiencies. Moreover, the findings highlight the need to assess the impact of such curricula on patient outcomes and learners’ knowledge, attitudes, and clinical care delivery. The framework aims to standardize EM education while highlighting the need for further research in how structural competency interventions would translate to an ED setting and affect patient outcomes and experiences.

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Section: Resultsmentioning

confidence: 99%

Structural competency in emergency medical education: A scoping review and operational framework

Salhi

Zeidan

Stehman

et al. 2022

AEM Education and Training

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“…What Kleinman and Jenkins are suggesting is that leaders within the MGMH need to think about risk and the social determinants of health in terms of structural and institutional terms rather than as isolated individual variables (Metzl and Hansen 2018). Typically, in psychiatry and the public health field more broadly, there is a rendering of the social as an aggregation of individual behaviors, or 'individuated risk calculators,' which overlooks the sociopolitical conditions in which behaviors/symptoms emerge and are given meaning (see, e.g., Povinelli 2011).The more recent emphasis on structural competency (Gajaria et al 2019) aligns well with community mental health approaches that politicize psychological suffering and attend to structural power (Pahwa et al 2020;Compton et al 2020;Moncrieff and Steingard 2019;Fine 2012). In contrast to the rendering of the social as an aggregation of the individual, Jenkins (2013) writes:…”

Section: Decolonizing Human Rights Discourse By Politicizing and Re-moralizing Human Sufferingmentioning

confidence: 99%

The Cultural Politics of Mental Illness: Toward a Rights-Based Approach to Global Mental Health

Cosgrove

Morrill

Karter

et al. 2020

Community Ment Health J

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The movement for global mental health (MGMH) has raised awareness about the paucity of mental health services, particularly in low-and middle-income countries. In response, policies and programs have been developed by the World Health Organization and by the Lancet Commission on global mental health, among other organizations. These policy initiatives and programs, while recognizing the importance of being responsive to local needs and culture, are based on Western biomedical conceptualizations of emotional distress. In the paper, we discuss how a rights-based approach can promote the voice and participation of people with lived experience into the MGMH. We argue that a human rights framework can be enhanced by incorporating the conceptual approaches of critical inquiry and community mental health. We also discuss how rights-based approaches and service-user activism can productively reconfigure Western psychiatric conceptualizations of distress and provide both a moral and empirical justification for a paradigm shift within the MGMH.

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A Patchwork of Good Intentions: A Critical Look at Different Perspectives Regarding Ethics-Based Mental Health Care in Under-Resourced Settings

Knizek

Mugisha

Kinyanda³

et al. 2021

Foundation of Ethics-Based Practices

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Moving the Global Mental Health Debate Forward: How a Structural Competency Framework Can Apply to Global Mental Health Training

Cited by 7 publications

References 24 publications

Structural competency in emergency medical education: A scoping review and operational framework

Structural competency in emergency medical education: A scoping review and operational framework

The Cultural Politics of Mental Illness: Toward a Rights-Based Approach to Global Mental Health

A Patchwork of Good Intentions: A Critical Look at Different Perspectives Regarding Ethics-Based Mental Health Care in Under-Resourced Settings

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