Paper short abstract:

An inclusive global mental health ‘evidence-base’ must consider how programmes adapt interventions to local context. This paper examines the processes through which the Seher community mental health programme (Pune, India) has innovated to adapt interventions to the cultural context of local communities.

Paper long abstract:

Critics argue that the emphasis within global mental health (GMH) on standardized evidence-based 'packages of care' developed in Euro-American contexts supplants local innovations and capacities. A more inclusive GMH 'evidence-base' must consider how programmes in the 'global south' adapt interventions to local context. The aim of this paper is to examine the processes through which the Seher community mental health programme (Pune, India) has innovated to adapt interventions to the cultural context of low-income communities. Between 2004 and 2014, the programme shifted orientation from mental health services to building the capacities of communities to address mental health issues. We argue that the successful cultural adaptation of Seher interventions was premised on shifts in programme design and organizational culture. Programme design encompassed cultural ways of expressing psychosocial distress and illness and enabled support for a range of differentiated roles including mental health experts, formal grassroots workers and community volunteers, thus reducing dependence on 'experts'. Organizational culture was re-oriented to allow changes in programme content based on feedback from grassroots workers and communities. The Seher experiences suggest the importance of a dialogical flow of knowledge, competencies and skills between 'communities' and 'experts' as central to building a culturally inclusive GMH evidence base.