Effective mental health care comes in many forms, new research finds

Dr. Kaaren Mathias coordinated an international team that investigated the value of mental health care in communities in Ghana, India, occupied Palestine and South Africa.

Dr Mathias is a public health physician and senior lecturer in the School of Health Sciences at Te Whare Wānanga o Waitaha | University of Canterbury (UC). She was one of 39 academics and community-based staff from 24 countries brought together by King’s College London to explore how mental health care is defined and delivered when medical or Western resources are not accessible or available.

The work is published in the diary PLOS Global Public Health.

The group wanted to challenge the deficit model of public health, which pits low-income countries against the cultural and ideological norms of rich countries. This approach focuses on the resources a community lacks and devalues ​​or ignores its strengths, but countries like New Zealand could learn from these strengths.

Dr. Mathias points out that this deficit perspective even underlies the terms used to describe populations in the Global South: those populations found primarily (but not exclusively) in Africa, Asia, and South America.

“Low- and middle-income countries are often portrayed as ‘the developing world,’” she says. “They’re compared to countries like New Zealand that are ‘the developed world,’ and that language is already taking away from different kinds of wisdom and experience that are equally valuable, and that we can learn from here.”

Dr. Mathias led a subgroup of researchers who asked how mental health care is defined and delivered by families, community groups, and other “experts by experience” in the chosen countries. She grew up in India until she was eight and later worked there for 15 years, so she has seen firsthand how effective mental health care can be delivered in the community.

She cites the example of a psychosocial support group for women in her neighborhood in the small town of Mussoorie, northern India, that met to share mutual support and skills. This included childcare, motivating each other to exercise, and creating a support plan for a group member who had disclosed domestic violence.

According to Dr. Mathias, this initiative has had positive mental health effects for the entire group, as the women developed a strong sense of ownership and empowerment through their collaboration.

“They said, ‘Look at us, we made this possible. It was really amazing that this health care worker brought us together, but even if she goes away, we are all friends now and we will continue to support each other.’”

While she recognizes that effective mental health care must include access to medications and trained medical professionals, Dr. Mathias believes there is value in re-examining opportunities to partner with local resources that can improve mental health.

“It might be the church community offering a homework club for refugee and migrant children, or a group going for a walk together or up the Port Hills to see the stars in Matariki. These things are hugely supportive of good mental health, and if we only focus on the formalised support, we miss the other important things we can do to keep people mentally healthy.”