Using participatory action research to reimagine community mental health services in Colombia: a mixed-method study protocol

Abstract

IntroductionMental healthcare systems are challenged by how they hear and respond to what marginalised communities experience as drivers of mental distress. In Colombia, this challenge intersects with wider challenges facing post-conflict reconstruction. Our pilot study will explore the feasibility and acceptability of a participatory approach to developing community-led participatory interventions for community mental health systems strengthening and mental health improvement, in two sites in Caquetá, Colombia.Methods and analysisThe project is divided into three distinct phases aligned with community participatory action research cycles: diagnostic, intervention and evaluation. This allows us to use a participatory approach to design a community-led, bottom-up intervention for mental health systems strengthening and the promotion of mental health and well-being.The diagnostic phase explores local understandings of mental health, mental distress and access to mental health services from community members and health providers. The intervention stage will be guided by a participatory Theory of Change process. Community priorities will inform the development of a participatory, learning and action (PLA) informed group intervention, with a community linkage forum. The pilot of the PLA intervention will be evaluated using MRC process evaluation guidelines.Ethics and disseminationThis project has received ethical approval from two sources. Universidad de Los Andes (2021–1393) and the University College London (16127/005). Dissemination of findings will include academic publications, community forums, policy briefs and visual media (cartoons, pod casts and short films).

Inverting the deficit model in global mental health: An examination of strengths and assets of community mental health care in Ghana, India, Occupied Palestinian territories, and South Africa

“…Our findings underscore that programmes and policies need to engage with local historical and socio-political contexts as well as informal care practices to ensure mental healthcare is relevant and acceptable [ 104 , 105 ]. The design and delivery of mental health care in these four countries and elsewhere should be co-designed with communities and build on and strengthen local assets and address locally-identified needs to ensure policies, services and interventions are more acceptable, relevant and equitable [ 92 , 104 , 106 ]. Co-production of policies or services with people with mental health conditions are not well represented in any of these four community mental health case studies.…”

What do we have here? A Systematic Review of Mental Health Policy in Colombia

“…Due to the scope and timeline for conducting this review, it was not possible to include individual searches for the websites of the 32 Colombian regions (Departamentos). We focused on the region of Caquetá as a case example due to (1) being the only region to be categorised in full as a PDET territory, and (2) there being a specific interest on behalf of local government in developing mental health infrastructure (12,13).…”

Reconstructing theory in mental health and psychosocial support and peacebuilding: Towards an integrated model for psychosocial peacebuilding

“…As Jeffery (2023, p. 15) Another example aligning with our approach is that of the STARS-C project, which seeks to develop mental health strengthening interventions within conflict-affected communities in Colombia using PAR cycles. It is organised around transformative co-production principles, which align with tenants of communicative action through attention to meaningful partnerships at the local organisational level, as well as devolution of key decision-making to community members (Burgess et al, 2022). Building from STARS-C, the first author is also undergoing arts-based PAR in Colombia to apply the approach outlined here in an effort to build evidence for psychosocial peacebuilding.…”