Accepted paper:

Opening up the 'black-box': How do community mental health workers promote positive mental health outcomes at Project Burans, Dehradun, India?

Authors:

Sumeet Jain (University of Edinburgh)
Kaaren Mathias
Pooja Pillai (Emmanuel Hospital Association)

Paper short abstract:

This research examined: 1) What are the types of skills and strategies community mental health workers (CWs for short) at Project Burans deploy with clients? 2) How do CWs conceptualize outcomes - both positive and negative? 3) How do CWs conceptualize the determinants of poor mental health?

Paper long abstract:

Community-based workers promote mental health in communities yet little attention has been given to the ways they operate and the strategies used (Chatterjee et al., 2014). For example, how do they translate biomedical concepts into frameworks that are acceptable and accessible to communities? How do micro-innovations lead to positive mental health outcomes, including social inclusion and recovery?

This research examined: 1) What are the types of skills and strategies community mental health workers (CWs for short) at Project Burans deploy with clients? 2) How do CWs conceptualize outcomes - both positive and negative? 3) How do CWs conceptualize the determinants of poor mental health?

We interviewed CWs (n=46) about clients who were randomly selected from those using a new 6-visit care-plan. Notes were typed down during the interviews and cross checked using the audio files. The notes were then coded by SJ and KM.

CWs displayed in-depth knowledge of the context of their client's lives and family dynamics and used this information to analyse possible factors that increased or decreased mental health for the client and their family members. CWs demonstrated a range of analysis and intervention skills building on contextual knowledge and personal critical reflection. The applied knowledge of the physical, social and family (ecological) contexts to undertake relevant and sometimes sophisticated analyses of the social determinants that shaped the mental health of clients. CWs used their in-depth knowledge of clients' mental health status, family dynamics and other contextual factors to adapt and implement micro-interventions in a bespoke way

panel B17
Problematising 'social interventions' in global mental health: what can ethnography offer?