Understanding the benefits and challenges of community engagement in the development of community mental health services for common mental disorders: Lessons from a case study in a rural South African subdistrict site
Abstract
Against the backdrop of a large treatment gap for mental disorders in low- to middle-income countries (LMICs), the 2007 Lancet series on global mental health calls for a scaling up of mental health services. Community participation is largely harnessed as one strategy to facilitate this call. Using a participatory implementation framework for the development of mental health services for common mental disorders (CMDs) in a rural subdistrict in South Africa as a case study, this study sought to understand the benefits and challenges of community participation beyond that of scaling up. Qualitative process evaluation involving interviews with service providers and users was employed. The results suggest that in addition to promoting mobilization of resources and actions for scaling up mental health services, community participation can potentially contribute to more culturally competent services and personal empowerment of recipients of care. In addition, community participation holds promise for engendering community-led public health actions to ameliorate some of the social determinants of mental ill health. Challenges include that community members involved in these activities are mainly marginalized women, who have limited power to achieve structural change, including cultural practices that may be harmful to the mental health of women and children. We conclude that in addition to contributing to scaling up mental health services, community participation can potentially promote the development of culturally competent mental health services and greater community control of mental health.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Community support was sometimes reported as a facilitator, especially in small, tight-knit communities where collaboration with community members allowed implementers to safely identify and engage potential clients and ensure community acceptability.
“Community factors such as community support were sometimes reported as facilitators, especially when interventions were held in small, tight-knit communities where collaboration with community members (e.g., community leaders, traditional healers) allowed for implementers to safely identify and engage potential clients, and ensure the community acceptability of the intervention [60, 67].”
Cites
Kleinman, A. (1980) · doi:10.1525/9780520340848 · Cited by 4,945 · see citing works
No health without mental health
Prince, M. J., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61238-0 · Cited by 3,835 · see citing works
Patients and Healers in the Context of Culture
Kleinman, A. (2023) · University of California Press eBooks · doi:10.2307/jj.2711689 · Cited by 1,985 · see citing works
Resources for mental health: scarcity, inequity, and inefficiency
Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61239-2 · Cited by 1,789 · see citing works
Poverty and common mental disorders in low and middle income countries: A systematic review
Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J. A., Swartz, L., & Patel, V. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.04.027 · Cited by 1,375 · see citing works
Barriers to improvement of mental health services in low-income and middle-income countries
Saraceno, B., van Ommeren, M., Batniji, R., Cohen, A., Gureje, O., Mahoney, J., Sridhar, D., & Underhill, C. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61263-x · Cited by 1,088 · see citing works
SOCIAL NETWORKS AND SOCIAL SUPPORT
(2016) · The Gerontologist · doi:10.1093/geront/gnw162.1463 · Cited by 1,004 · see citing works
Scale up services for mental disorders: a call for action
(2007) · The Lancet · doi:10.1016/s0140-6736(07)61242-2 · Cited by 835 · see citing works
Carpiano, R. M. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.05.020 · Cited by 635 · see citing works
Campbell, C., & MacPhail, C. (2002) · Social Science & Medicine · doi:10.1016/s0277-9536(01)00289-1 · Cited by 532 · see citing works
Cohort Profile: Africa Centre Demographic Information System (ACDIS) and population-based HIV survey
Tanser, F. C., Hosegood, V., Bärnighausen, T., Herbst, K., Nyirenda, M., Muhwava, W., Newell, C., Viljoen, J., Mutevedzi, T., & Newell, M. (2007) · International Journal of Epidemiology · doi:10.1093/ije/dym211 · Cited by 403 · see citing works
Task shifting: the answer to the human resources crisis in Africa?
Lehmann, U., Damme, W. V., Barten, F., & Sanders, D. M. (2009) · Human Resources for Health · doi:10.1186/1478-4491-7-49 · Cited by 272 · see citing works
Lund, C., Kleintjes, S., Kakuma, R., & Flisher, A. J. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-009-0078-5 · Cited by 224 · see citing works
Community Health Psychology: Promoting Analysis and Action for Social Change
Campbell, C., & Murray, M. (2004) · Journal of Health Psychology · doi:10.1177/1359105304040886 · Cited by 210 · see citing works
Campbell-Hall, V., Petersen, I., Bhana, A., Mjadu, S., Hosegood, V., & Flisher, A. J. (2010) · Transcultural Psychiatry · doi:10.1177/1363461510383459 · Cited by 205 · see citing works
Self-citationCampbell, C., Wood, R., & Kelly, M. J. (1999) · London School of Economics and Political Science Research Online (London School of Economics and Political Science) · Cited by 162 · see citing works
Mental Health Policy Development and Implementation in Four African Countries
Flisher, A. J., Lund, C., Funk, M., Banda, M., Bhana, A., Doku, V. C. K., Drew, N., Kigozi, F. N., Knapp, M. R. J., Omar, M., et al. (2007) · Journal of Health Psychology · doi:10.1177/1359105307076237 · Cited by 159 · see citing works
Self-citationEmpowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India
Kermode, M., Herrman, H., Arole, R., White, J., Premkumar, R., & Patel, V. (2007) · BMC Public Health · doi:10.1186/1471-2458-7-225 · Cited by 151 · see citing works
Social Support: An Introduction to a Complex Phenomenon
Brownell, A., & Shumaker, S. A. (1984) · Journal of Social Issues · doi:10.1111/j.1540-4560.1984.tb01104.x · Cited by 140 · see citing works
Cornish, F., & Campbell, C. (2009) · American Journal of Community Psychology · doi:10.1007/s10464-009-9254-8 · Cited by 127 · see citing works
Petersen, I., Bhana, A., Campbell-Hall, V., Mjadu, S., Lund, C., Kleintjies, S., Hosegood, V., & Flisher, A. J. (2009) · Health Policy and Planning · doi:10.1093/heapol/czn049 · Cited by 108 · see citing works
Self-citationSeedat, S., Stein, D. J., HERMAN, A. A. B., Kessler, R. C., Sonnega, J. R., Heeringa, S. G., Williams, S. L., & Williams, D. R. (2008) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-008-0399-9 · Cited by 106 · see citing works
Garrett, P. W., Dickson, H. G., Lis-Young, Whelan, A. K., & Roberto-Forero (2008) · Ethnicity and Health · doi:10.1080/13557850802035236 · Cited by 78 · see citing works
‘Sustainability’ in global health
Yang, A., Farmer, P. E., & McGahan, A. M. (2010) · Global Public Health · doi:10.1080/17441690903418977 · Cited by 68 · see citing works
Anthropology, knowledge-flows and global health
Feierman, S., Kleinman, A., Stewart, K. A., et al. (2009) · Global Public Health · doi:10.1080/17441690903401338 · Cited by 55 · see citing works
Kleintjes, S., Lund, C., Swartz, L. M., Flisher, A. J., & The MHaPP Research Programme Consor (2010) · International Review of Psychiatry · doi:10.3109/09540261.2010.536153 · Cited by 51 · see citing works
Osborne, K., Baum, F. E., & Ziersch, A. M. (2008) · Journal of Community & Applied Social Psychology · doi:10.1002/casp.988 · Cited by 43 · see citing works
A biopsychosocial approach to surgical evaluation and outcome.
Katon, W. J., & Kleinman, A. (1980) · PubMed · Cited by 23 · see citing works
The virtues of feeling culturally incompetent
Swartz, L. M. (2007) · Bioethics News · doi:10.1007/bf03351291 · Cited by 16 · see citing works
Partnership, reflection and patient focus: advancing cultural competency training relevance
Simon, M. A., Chang, E., & Dong, X. (2010) · Medical Education · doi:10.1111/j.1365-2923.2010.03714.x · Cited by 13 · see citing works
Globalization and Mental Health: Changing Views of Culture and Society
Swartz, L. M. (2008) · Global Social Policy · doi:10.1177/14680181080080030203 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Le, P. D., Eschliman, E. L., Grivel, M. M., Tang, J., Cho, Y. G., Yang, X., Tay, C., Li, T., Bass, J., & Yang, L. H. (2022) · Implementation Science · doi:10.1186/s13012-021-01179-z · Cited by 233 · see citing works
“, community leaders, traditional healers) allowed for implementers to safely identify and engage potential clients, and ensure the community acceptability of the intervention [60, 67].”
BackgroundClinical risk factors among youth at high risk for suicide in South Africa and Guyana
Thornton, V. J., Asanbe, C. B., & Denton, E. D. (2019) · Depression and Anxiety · doi:10.1002/da.22889 · Cited by 29 · see citing works
- Authors
- Petersen, I., Baillie, K., Bhana, A., & Mental Health and Poverty Research Programme Consortium
- Affiliations
- University of KwaZulu-Natal (ZA)
- Human Sciences Research Council (ZA)
- Venue
- Transcultural Psychiatry
- Publisher
- SAGE Publications
- Published
- 2012-07
- Volume
- 49
- Issue
- 3-4
- Pages
- 418-437
- ISSN
- 1363-4615 (ISSN-L)
- 1461-7471
- OpenAlex
- W2083562945
- Cited by
- 64
- References
- 31
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 7 · 2022: 11 · 2021: 5 · 2020: 5 · 2019: 8 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 5 · 2013: 2 · 2012: 2
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Transcultural Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (GR065377MA)
- Department for International Development
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Keywords
- community participation, community mental health services, common mental disorders, scaling up mental health services, culturally competent mental health services, women's empowerment, marginalized women, rural South Africa, treatment gap, participatory implementation
- MeSH terms
- Adult, Mental Disorders, Community Mental Health Services, Community Participation, Cooperative Behavior, Female, Health Personnel, Humans, Male, Patient Participation, Rural Population, South Africa, Focus Groups, Organizational Case Studies, Cultural Competency
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
