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The UC Research Repository collects, stores and makes available original research from postgraduate students, researchers and academics based at the University of Canterbury.
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Mutuality as a method: advancing a social paradigm for global mental health through mutual learning
(Springer Science and Business Media LLC, 2023) Bemme , Dörte; Roberts , Tessa; Ae-Ngibise , Kenneth A.; Gumbonzvanda , Nyaradzayi; Joag , Kaustubh; Kagee , Ashraf; Machisa , Mercilene; van der Westhuizen , Claire; van Rensburg , André; Willan , Samantha; Wuerth , Milena; Aoun , May; Jain , Sumeet; Lund , Crick; Mathias, Kaaren; Read , Ursula; Taylor Salisbury , Tatiana; Burgess, Rochelle A.
Purpose: Calls for “mutuality” in global mental health (GMH) aim to produce knowledge more equitably across epistemic and power differences. With funding, convening, and publishing power still concentrated in institutions in the global North, efforts to decolonize GMH emphasize the need for mutual learning instead of unidirectional knowledge transfers. This article reflects on mutuality as a concept and practice that engenders sustainable relations, conceptual innovation, and queries how epistemic power can be shared. Methods: We draw on insights from an online mutual learning process over 8 months between 39 community-based and academic collaborators working in 24 countries. They came together to advance the shift towards a social paradigm in GMH. Results: Our theorization of mutuality emphasizes that the processes and outcomes of knowledge production are inextricable. Mutual learning required an open-ended, iterative, and slower paced process that prioritized trust and remained responsive to all collaborators’ needs and critiques. This resulted in a social paradigm that calls for GMH to (1) move from a deficit to a strength-based view of community mental health, (2) include local and experiential knowledge in scaling processes, (3) direct funding to community organizations, and (4) challenge concepts, such as trauma and resilience, through the lens of lived experience of communities in the global South. Conclusion: Under the current institutional arrangements in GMH, mutuality can only be imperfectly achieved. We present key ingredients of our partial success at mutual learning and conclude that challenging existing structural constraints is crucial to prevent a tokenistic use of the concept.
A qualitative study to explore various meanings of mental distress and help-seeking in the Yamuna Valley, North India
(Medknow, 2021) Rawat , Meenal; Jadhav , Sushrut; Bayetti , Clement; Mathias, Kaaren
Context: In rural India, mental healthcare remains limited due to scant state services and incongruency between provider- and patient-framing distress. Help-seeking by people with mental health problems is related to how meanings of distress are understood differently by individuals, based on their interaction with various actors in the community and the available cultural explanation within their local ecologies. Methodology: This study examines the mutually constituted relationship between meanings of mental distress and help-seeking among people residing in the Upper Yamuna Valley, Uttarakhand, North India. This qualitative study builds on six in-depth interviews with people with severe mental health issues and one person with epilepsy, referred as people with psychosocial disability (PPSD) in the study. The data analysis was iterative and followed thematic approach. Results: The study found that personal belief based on one's experience, such as negative self-judgment and wider cultural explanations, such as supernatural beliefs, as well as gender roles, impacted the way people address their mental health problems, in turn shaping their help-seeking behavior. Participants lost hope for a cure after years of trying to find an effective solution. Moreover, lack of access to care and remoteness of the mountainous area made help-seeking and recovery feel impossible. Conclusions: This study underscores the need for researchers and policy professionals to explore the local context and culture to improve care and treatment quality. The study also explains that personal explanation of psychosocial problems and help seeking are not unidirectional. It is a complex phenomenon layered with the local contexts which should be addressed in clinical practice, as well as future research. Finally, clinicians' training should address the local cultural language of distress to identify the problem and suggest an effective solution.
Co-seismic disturbance of alluvial fans
(2001) Cole, Peter Roger
A series of alluvial fan models were built using a mixture of sand and water on an adjustable flume base, capable of reproducing normal faults and shallow anticlinal folding across the width of the fan. The surface of the fans was measured and photographed at regular intervals and comments recorded. Field studies gathered evidence of exposure to a risk of flooding to some occupants and to public services on the Waiho River Fan on the West Coast of New Zealand. Further field evidence found a soil age anomaly on the Fox/Cook Fan leading to a reconsideration of the fault/fan processes involved at that location.
The modelling results indicate that just as significant, if not more so, to river flow behaviour across alluvial fans is the content of bedload sediment rather than the dislocation and initial riverbed level change of the primary channels, following a seismic event. The results also suggest that there is a high likelihood of a major avulsion of the Waiho River as a result of coseismic influences on the river fan and as a consequence, an appreciable risk to life and property at Franz Josef Glacier from the Waiho River after movement of the Alpine Fault. The modelling results also support the hypothesis that rather than a surface expression as a fault scarp, the Alpine Fault is causing the ground beneath the Fox/Cook fan to fold, creating an alluvial 'island' and forcing the river to entrench into ever deepening channels.
The Political Case for a New Zealand-US Free Trade Agreement
(2023) Khoo N, Nicholas; Tan, Alex
Opening up the ‘black-box’: what strategies do community mental health workers use to address the social dimensions of mental health?
(Springer Science and Business Media LLC, 2024) Jain, Sumeet; Pillai , Pooja; Mathias, Kaaren
Purpose: Community-based workers promote mental health in communities. Recent literature has called for more attention to the ways they operate and the strategies used. 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? The aim of this study was to examine the types of skills and strategies to address social dimensions of mental health used by community health workers (CHWs) working together with people with psychosocial disability (PPSD) in urban north India. Methods: We interviewed CHWs (n = 46) about their registered PPSD who were randomly selected from 1000 people registered with a local non-profit community mental health provider. Notes taken during interviews were cross-checked with audio recordings and coded and analyzed thematically. Results: CHWs displayed social, cultural, and psychological skills in forming trusting relationships and in-depth knowledge of the context of their client's lives and family dynamics. They used this information to analyze political, social, and economic factors influencing mental health for the client and their family members. The diverse range of analysis and intervention skills of community health workers built on contextual knowledge to implement micro-innovations in a be-spoke way, applying these to the local ecology of people with psychosocial disabilities (PPSD). These approaches contributed to addressing the social and structural determinants that shaped the mental health of PPSD. Conclusion: Community health workers (CHWs) in this study addressed social aspects of mental health, individually, and by engaging with wider structural factors. The micro-innovations of CHWs are dependent on non-linear elements, including local knowledge, time, and relationships. Global mental health requires further attentive qualitative research to consider how these, and other factors shape the work of CHWs in different locales to inform locally appropriate mental health care.