Using participatory action research to reimagine community mental health services in Colombia: a mixed-method study protocol.

INTRODUCTION: Mental healthcare systems are challenged by how they hear and respond to what marginalised communities experience as drivers of mental distress. In Colombia, this challenge intersects with wider challenges facing post-conflict reconstruction. Our pilot study will explore the feasibility and acceptability of a participatory approach to developing community-led participatory interventions for community mental health systems strengthening and mental health improvement, in two sites in Caquetá, Colombia. METHODS AND ANALYSIS: The project is divided into three distinct phases aligned with community participatory action research cycles: diagnostic, intervention and evaluation. This allows us to use a participatory approach to design a community-led, bottom-up intervention for mental health systems strengthening and the promotion of mental health and well-being.The diagnostic phase explores local understandings of mental health, mental distress and access to mental health services from community members and health providers. The intervention stage will be guided by a participatory Theory of Change process. Community priorities will inform the development of a participatory, learning and action (PLA) informed group intervention, with a community linkage forum. The pilot of the PLA intervention will be evaluated using MRC process evaluation guidelines. ETHICS AND DISSEMINATION: This project has received ethical approval from two sources. Universidad de Los Andes (2021-1393) and the University College London (16127/005). Dissemination of findings will include academic publications, community forums, policy briefs and visual media (cartoons, pod casts and short films).

Grandmothers: Central scaffolding sources impacting maternal and infant feeding practices in Colombia.

A growing body of evidence highlights that maternal and child nutrition programmes need to extend beyond the mother-child dyad by adopting a family systems approach, particularly in the Global South. Guided by a sociocultural and community psychology understanding of health, the paper explores factors identifying grandmothers as central resources for nutrition programmes. The study was conducted in a Colombian urban periphery applying a qualitative longitudinal design (prenatal and postpartum). It is based on interviews with adolescent mothers and mothers in their 20s (n = 35 at T1; n = 21 at T2), grandmothers (n = 15 at T1; n = 12 at T2) and community/public stakeholders (n = 17). Many of the participants live in low-income households headed by grandmothers, who adjust feeding practices to the extent of their economic capacity. Findings reveal grandmothers play a central role in decision-making and in enabling a holistic support system for the dyad. This is defined as grandmothers' scaffolding; it covers nutrition advice, breastfeeding and infant feeding, cultural practices, caregiving and maternal mental health. The study helps build the evidence-base for the transferability of a family systems approach to Global South regions by using sociocultural and community psychology concepts to fortify the rationale for including grandmothers in maternal and child nutrition programmes. It argues for the need to continue raising the visibility of key actors like grandmothers and for nutrition programmes to align themselves more flexibly with the needs of families experiencing poverty.

Elite stigmatization of the unemployed: The association between framing and public attitudes.

This paper uses a multi-methods approach to explore the social psychological construction of stigma towards the unemployed. Study 1a uses thematic analysis to explore frames used by political elites in speeches at U.K. national party conferences between 1996 and 2016 (n = 43); in study 1b, we track the usage of these frames in six national newspapers (n = 167,723 articles) over the same period showing an increase in the use of negative frames. Study 1c shows that these are associated with national attitudes towards welfare recipients using the British Social Attitude Survey. We find the 'Othering' frame is correlated with negative attitudes towards the unemployed, even when controlling for the unemployment rate. This finding supports the claim that social attitudes are related to frames produced in the political and media spheres. We provide theoretical integration between social representations theory and framing which affords development in both domains.

Discourse and representation: A comment on Batel and Castro 'Re-opening the dialogue between the theory of social representations and discursive psychology'.

Batel and Castro propose to integrate conceptually and empirically the theory of social representations (TSR) and discursive psychology (DP). This comment emphasizes the importance of debates between different traditions of social psychology, focusing on the status of psychological entities and methodological pluralism as two areas in which fruitful tensions between DP and TSR are still evident. It critiques DP's disavowal of psychological entities and reaffirms the insights of sociocultural traditions that see intrapsychological phenomena as internalized sociality. It argues that rather than considering individual methods, the focus should be on the fit between research questions, context, and methodology. A simultaneous focus on theory, research questions, and analytical tools is best for dealing with the limitations as well as potentials of the methodological toolkit available for the study of meaning in context.

Partnerships as knowledge encounters: a psychosocial theory of partnerships for health and community development.

In this article, we present a psychosocial theory of partnership, illustrated with case studies from Cambodia and Brazil. Partnerships are conceptualised as encounters with the knowledge of self and others, entailing processes of representation and communication between all stakeholders involved, and shaped by institutional and sociocultural contexts. We argue that partnership is an evolving practice that requires critical reflection and the creation of enabling institutional contexts. As such, it must be understood not as a tool for intervention, but as part of the intervention and definition of success.

Narrative, memory and social representations: a conversation between history and social psychology.

This paper explores relations between narrative, memory and social representations by examining how social representations express the ways in which communities deal with the historical past. Drawing on a case study of social representations of the Brazilian public sphere, it shows how a specific narrative of origins re-invents history as a useful mythological resource for defending identity, building inter-group solidarity and maintaining social cohesion. Produced by a time-travelling dialogue between multiple sources, this historical narrative is functional both to transform, to stabilise and give resilience to specific social representations of public life. The Brazilian case shows that historical narratives, which tend to be considered as part of the stable core of representational fields, are neither homogenous nor consensual but open polyphasic platforms for the construction of alternative, often contradictory, representations. These representations do not go away because they are ever changing and situated, recruit multiple ways of thinking and fulfil functions of identity, inter-group solidarity and social cohesion. In the disjunction between historiography and the past as social representation are the challenges and opportunities for the dialogue between historians and social psychologists.

Expert knowledge, cognitive polyphasia and health: a study on social representations of homelessness among professionals working in the voluntary sector in London.

This article develops a social representational approach to understanding expert knowledge and its relation to health. Research with homelessness professionals (HPs) working in the UK voluntary sector shows that expert definitions of homelessness can either undermine or enhance the health of the homeless. Guided by the concepts of social representations and cognitive polyphasia, the analysis reveals a contradictory field of knowledge, which reflects the struggle of professionals to sustain a humanizing approach and resist the pressures of statutory agendas. We conclude pointing to the need of recognizing the impact of professional's knowledge on the health and care policies for the homeless.

Psicologia social, saber, comunidade e cultura / Social psychology: knowledge, community and culture

Este trabalho apresenta uma reflexão sobre as relações entre saber, comunidade e cultura desde uma perspectiva psicossocial. Eu parto do conceito de representação e discuto a relação fundamental entre processo representacional e contexto, entendido como o lugar histórico, social, simbólico e cultural de uma comunidade humana. Entender o processo representacional é importante porque ele ocupa um lugar central no processo de constituição dos saberes: não há saber que não deseje representar. Ao mesmo tempo, a análise da forma representacional enquanto estrutura dialógica permite a elucidação das relações sócio-culturais que se encontram na base da formação dos saberes. A forma da representação é tanto forma do saber como forma de constituição de um contexto sócio-cultural(AU)

Psicologia social, saber, comunidade e cultura / Social psychology: knowledge, community and culture

Este trabalho apresenta uma reflexão sobre as relações entre saber, comunidade e cultura desde uma perspectiva psicossocial. Eu parto do conceito de representação e discuto a relação fundamental entre processo representacional e contexto, entendido como o lugar histórico, social, simbólico e cultural de uma comunidade humana. Entender o processo representacional é importante porque ele ocupa um lugar central no processo de constituição dos saberes: não há saber que não deseje representar. Ao mesmo tempo, a análise da forma representacional enquanto estrutura dialógica permite a elucidação das relações sócio-culturais que se encontram na base da formação dos saberes. A forma da representação é tanto forma do saber como forma de constituição de um contexto sócio-cultural.

Participation, health and the development of community resources in Southern Brazil.

This article seeks to contribute to the debate about participation and health by presenting a framework for psychosocial interventions in primary health care. It highlights the social psychological dimensions of participation and the role it plays in improving conditions of living and thus health. The Freirean concepts of dialogue, recognition and conscientization, combined with understanding of local knowledge are suggested as guiding notions for psychosocial interventions seeking to enhance community participation and develop the local level. The article discusses the challenges as well as the potential gains experienced in the process of participation presented. It concludes by reaffirming the importance of participation and empowerment in health interventions struggling against health inequalities and seeking health for all.

Espacos de mediacao e genese das representacoes sociais

O trabalho discute a relacao entre a vida publica, o desenvolvimento das representacoes e dos simbolos nas criancas e a genese das representacoes sociais. O espaco publico e discutido a partir de Habermas e Hannah Arendt e o desenvolvimento da atividade representacional e simbolica e analisada na perspectiva de Piaget e Winnicott. O mundo, o outro e a fala sao mediacoes sociais que geram as representacoes sociais. Na parte final o trabalho faz uma defesa da nocao de representacao contra ataques que recebe de autores que adotam uma perspectiva conhecida hoje como pos-moderna.

Trabalho e sofrimento psiquico

Este trabalho tem como objetivo central investigar a conexão entre o trabalho - enquanto atividade humana específica - e o sofrimento psicológico, que se expressa em larga escala nos ambulatórios públicos brasileiros através da queixa de 'doença dos nervos'. Para tanto, julgamos fundamental repor teoricamente a categoria Trabalho no âmbito da Psicologia e relacioná-la com um modelo explicativo do que seja a identidade psicológica e suas manifestações. Este modelo, fundamentado nas concepções freudianas sobre os processos identificatórios, nos permite elucidar a etiologia do sofrimento psíquico que se expressa no discurso operário e, ao mesmo tempo, indicar a lógica de sua produção. A metodologia que utilizamos é de natureza qualitativa. Optamos pelo registro da história de vida de trabalhadores que têm em comum o fato de já terem procurado algum tipo de assistência psicológico-psiquiátrica e já haverem exercido atividade produtiva. Na coleta dos depoimentos não houve qualquer preocupação factual; privilegiou-se a maneira como a vida é narrada, o fluxo das representações que emergem no discurso dos sujeitos e a prioridade que eles próprios estabelecem para o que importante ou não ser dito e lembrado. Os dados e sua análise revelaram que o trabalho constitui-se em um elemento central na constituição da identidade psicológica dos sujeitos entrevistados. É o trabalho e suas condições de exercício que estruturam a narrativa dos trabalhadores, apresentando duas associações predominantes: trabalho/vida, trabalho/sofrimento. É este duplo sentido do trabalho, que de um lado expressa-se em sua forma capitalista, conduzindo os trabalhadores à alienação e à obstaculização de sua condição de sujeitos, e, de outro, que permite a constituição de uma identidade - ser trabalhador - , que explica a lógica de produção do sofrimento. É a violência presente nas relações vivenciadas no trabalho, que se marcam pelo arbítrio e gratuidade, que provoca o sofrimento e a dor, na medida em que impede o sujeito de pensar com prazer sua própria identidade. Esse sofrimento, por sua vez, denuncia a existência de um outro trabalho no núcleo da identidade psilcológica dos trabalhadores que, ao contrário do alienado, é construtor do Mundo e do Ser Humano (AU)