The history of mental healthcare is closely intertwined with human rights violations, incarceration, and a lack of patient-centred approaches. A ‘community-centric’ approach has often been offered as an alternative to this, but what does that really mean in the context of mental healthcare?
Community mental health is a decentralised system of mental healthcare. When envisioned, it was based on the premise that those who required psychiatric treatment would enjoy a higher quality of life and have better chances of recovery if they were treated in their own communities. Ideally, it is an accessible and responsive local framework, based in a variety of community settings that use referrals to link users to a range of social services.
Coinciding with activism from user-survivors, this community care narrative rings with notes of liberation, human rights, and ethical user-centred care. However, many lived experiences of community mental health testify to certain critical gaps.
We must be cautious not to replicate, in community spaces, the old, top-down, biomedical approaches and power hierarchies of the asylum. Here’s a few ways in which we can do so.
1. Centre the individual and their narrative
2. Look beyond physical spaces as sites for care
3. Move away from a recovery-focused approach
4. Recognise identity as a factor for mental distress
While the idea of community mental health may lead to closure of asylums—the heritage and legacy of these institutions are still often carried forward. Because public spaces, institutions, communities, and families will continue to reinforce discrimination and violence based on caste, class, gender, sexuality, ability, or religion, we need to challenge the one-dimensional idea of community and redefine care.
Read the full article about community mental health by Amalina Kohli Dave and Raj Mariwala at India Development Review.
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