Task-Shifting in Community Mental Health in Kerala: Tensions and Ruptures

Abstract

Based on an ethnography of community mental health programs run by two NGOs in Kerala which have associated themselves with preexisting, locally grown, community-based palliative clinics, this article explores how professional NGOs bring a new culture to volunteer-based programs. Professionalizing volunteers through task-shifting results in the transformation of their philosophy of community care, which constrains and narrows understandings of mental health care. The state, in alliance with psychiatric NGOs, front-stages development through aggressive task-shifting which we argue is a socio-politico-moral process, disrupting the shared consciousness between volunteers and their own communities with fatal consequences for their most vulnerable citizens.

COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health

“…121 Much can be learned from implementation research methodologies that measure local conditions and evaluate context-dependent mechanisms of change when evaluating interventions and implementation strategies for mental health care across settings. 125 A new architecture of global mental health is emerging, which challenges the view that LMICs are simply data collection sites 126,127 or test beds for interventions developed in HICs, and promotes equitable, mutually beneficial partnerships with HICs. 99 Insights from LMICs will be vital for promoting mental health during the COVID-19 pandemic.…”

Experiences of Telemental Health Providers and Support Staff Serving Indigenous Patients of Northern Canada

“…Examples include one psychiatrist meeting with Northern staff before or after the patient encounter through TMH and another psychiatrist who works with clinic nurses when no mental health nurse is available. Evidence exists that task-shifting, or strengthening the primary care health workforce, to provide mental healthcare is a promising approach in remote geographical areas (48,49) and lowresource settings (50). In case of mental health, the tasks of psychiatrists may be shifted to psychologists, social workers, mental health nurses or other professionals.…”

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

“…Thus far, social science critiques of GMH have drawn heavily on well-worn Foucauldian tropes, often adopting 'the usual frame of the battle between medicalization and its discontents, experts and patients, and the colonizing reach of disciplines and the insurgencies beating them back' (Béhague and MacLeish 2020, 10; see also Ecks 2020;Cooper 2016). In this vision, GMH catalyses the mass medicalisation of mental suffering across the Global South, undermining local cultural knowledge and deflecting attention away from social and structural determinants; the field is often described as an extension of or complicit with various wider efforts at social and economic control (e.g., Clark 2014;Das and Rao 2012;Mills 2014;Mills and Fernando 2016;Kottai and Ranganathan 2020;Watters 2010;Fernando 2011;Summerfield 2012).…”