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Hong H, Yao CT. Community Inclusion Experiences While Establishing Community Mental Health Clubhouses in Taiwan: Perspectives from Mental Health Professionals. Healthcare (Basel) 2024; 12:1067. [PMID: 38891142 PMCID: PMC11171495 DOI: 10.3390/healthcare12111067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Community inclusion is a human right for all people, including people with mental illness. It is also an important part of individualized support to enable people experiencing mental illness to live in their preferred communities and to recover. In Taiwan, no study has investigated the social experiences of healthcare professionals. To fill this knowledge gap and inform ongoing mental health system strengthening, this study examined the not-in-my-backyard (NIMBY) phenomenon observed while establishing community mental health clubhouses in Taiwan and corresponding experiences of community inclusion. Data were collected through semi-structured interviews of 16 purposively sampled frontline healthcare professionals from Taiwanese mental health clubhouses. Data were analyzed using qualitative content analysis. Two themes were identified: "NIMBY phenomenon: Community residents' resistance to clubhouses" and "Measures adopted by the clubhouse for community inclusion". Two categories with eleven subcategories emerged. The findings demonstrate the following conclusions. First, the NIMBY phenomenon is related to the stigmatization and discrimination faced by individuals with mental disorders in society. Second, in Asian societies, mental disorders are associated with a particular social and cultural context. Third, the fear and rejection of individuals with mental disorders deepen their social exclusion. Forth, community mental health clubhouse models employ seven strategic approaches to community inclusion, listed as follows: capacity building for individuals, direct interaction with the public through community activities, provision of community services, life skills training, repairing and managing neighborhood relationships, assisting individuals in obtaining community employment, and conducting social education for community residents. Clearly, we need to combat social exclusion of people with mental illness and promote inclusive and accessible services and systems across sectors.
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Affiliation(s)
- Hong Hong
- Bachelor Program of Senior Health Promotion and Care Management for Indigenous People, National Changhua University of Education, Changhua 50007, Taiwan;
| | - Ching-Teng Yao
- Master Program of Long-Term Care in Aging, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Wang X, Wu Y, Chen Y, Xu J, Gao Q, Zang S. Traffic-related pollution and symptoms of depression and anxiety among Chinese adults: A population-based study. J Affect Disord 2024; 352:101-109. [PMID: 38360369 DOI: 10.1016/j.jad.2024.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Limited understanding exists regarding the associations of traffic-related pollution with depression and anxiety symptoms in individuals residing within low- and middle-income countries. METHODS Data for this study were extracted from the Psychology and Behavior Investigation of Chinese Residents (PBICR) survey, implemented between June 20 and August 31, 2023. We determined residential proximity to major roadways through self-reports and evaluated depression symptoms using the Patient Health Questionnaire-9 (PHQ-9), along with anxiety symptoms assessed through the Generalized Anxiety Disorder-7 (GAD-7). We examined the associations between residential proximity to major roadways and depression and anxiety symptoms using logistic regressions and generalized linear models, while controlling for potential confounding variables. RESULTS This study comprised a total of 22,723 participants. The adjusted odds ratios (OR) for depression symptoms were 1.34 (95 % confidence interval (CI) 1.20, 1.51), 1.29 (95 % CI 1.17, 1.43), 1.34 (95 % CI 1.20, 1.49), and 1.32 (95 % CI 1.17, 1.49) among individuals residing within <50 m, 50-100 m, 101-200 m, and 201-300 m, respectively, in comparison to those residing >300 m from a major roadway. Individuals residing <50 m, 50-100 m, 101-200 m, and 201-300 m from a major roadway exhibited adjusted OR for anxiety symptoms of 1.49 (95 % CI 1.30, 1.69), 1.21 (95 % CI 1.07, 1.37), 1.38 (95 % CI 1.21, 1.56), and 1.38 (95 % CI 1.20, 1.59), respectively, in contrast to those residing >300 m. CONCLUSIONS This study provides valuable insights into the associations between environmental factors and mental health. The findings underscore the importance of integrating environmental considerations into comprehensive mental health frameworks, especially for individuals residing near high-traffic areas.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yifei Chen
- Department of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District Area, Shenyang, Liaoning Province 110002, China
| | - Jiayi Xu
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China.
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Bodani N, Gohil S, Lal A. Is introduction of mental health education in dental school more important now than ever? MEDICAL TEACHER 2024; 46:722. [PMID: 38146709 DOI: 10.1080/0142159x.2023.2294217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/07/2023] [Indexed: 12/27/2023]
Affiliation(s)
- Nikita Bodani
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Shweta Gohil
- Department of Community Medicine, Sir Syed College of Medical Sciences for Girls, Karachi, Pakistan
| | - Abhishek Lal
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
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Awortwe V, Daivadanam M, Adjorlolo S, Olsson EM, Coumoundouros C, Woodford J. Prevalence and social determinants of anxiety and depression among adults in Ghana: a systematic review and meta-analysis protocol. BMJ Open 2024; 14:e081927. [PMID: 38658002 PMCID: PMC11043746 DOI: 10.1136/bmjopen-2023-081927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Anxiety and depression pose a significant global health challenge, especially affecting adults in low-income and middle-income countries. In many low-income and middle-income countries, including those in sub-Saharan Africa, social determinants such as access to affordable health services, conflict, food insecurity, and poverty may be associated with the prevalence of anxiety and depression, further contributing to health disparities. To mitigate the burden of anxiety and depression in sub-Saharan Africa, it is essential to develop country-level tailored mental health policies and strategies. For example, Ghana is working towards improving mental health via its 12 year Mental Health policy launched in 2021. However, the prevalence of anxiety and depression among adults in Ghana, along with associated social determinants remains largely unknown, posing challenges for mental health planning, resource allocation and developing targeted interventions. This systematic review seeks to (1) examine the prevalence of anxiety and depression among adults in Ghana and (2) explore social determinants potentially associated with anxiety and depression. METHODS AND ANALYSIS Electronic databases (eg, African Index Medicus, CINAHL, EMBASE, MEDLINE, and PsycINFO) will be searched with all screening steps conducted by two independent reviewers. Secondary search strategies, including grey literature searches, will be used. Studies reporting on the prevalence of anxiety, depression and/or a combined symptom measure (ie, psychological distress) among adults in Ghana, using validated instruments will be included. If data allows, random-effects-meta-analyses will be performed to estimate pooled prevalence rates of anxiety and depression. Potential clinical and methodological moderators will be examined using subgroup analyses and meta-regression. A narrative synthesis will explore social determinants potentially associated with anxiety and depression among adults in Ghana. ETHICS AND DISSEMINATION Ethical approval is not required as no primary data will be collected. Results will be disseminated via a peer-reviewed publication and presentations at academic conferences. Plain language summaries will be provided to relevant non-governmental organisations working in Ghana. PROSPERO REGISTRATION NUMBER CRD42023463078.
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Affiliation(s)
- Victoria Awortwe
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Meena Daivadanam
- Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Samuel Adjorlolo
- Department of Mental Health, School of Nursing and Midwivery, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Erik Mg Olsson
- Cardiovascular Psychology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Chelsea Coumoundouros
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Joseph AP, Babu A, Prakash LTO. The forgotten half: addressing the psychological challenges of wives of individuals with alcohol use disorder (AUD) in low- and middle-income countries. Front Psychiatry 2024; 15:1377394. [PMID: 38571999 PMCID: PMC10988612 DOI: 10.3389/fpsyt.2024.1377394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/05/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Akhil P. Joseph
- Department of Sociology & Social Work, Christ (Deemed to be University), Bangalore, Karnataka, India
- School of Social Work, Marian College Kuttikkanam Autonomous, Kuttikkanam, Kerala, India
| | - Anithamol Babu
- School of Social Work, Marian College Kuttikkanam Autonomous, Kuttikkanam, Kerala, India
- School of Social Work, Tata Institute of Social Sciences Guwahati Off-Campus Jalukbari, Assam, India
| | - LT Om Prakash
- Department of Sociology & Social Work, Christ (Deemed to be University), Bangalore, Karnataka, India
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Yao CT, Hong H, Li CH. NIMBYism and Strategies for Coping with Managing Protests during the Establishment of Community Mental Health Facilities in Taiwan: Insights from Frontline Healthcare Professionals. Healthcare (Basel) 2024; 12:484. [PMID: 38391859 PMCID: PMC10887859 DOI: 10.3390/healthcare12040484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
Taiwanese community mental health facilities encounter opposition/resistance from residents, commonly known as "Not-In-My-Backyard" (NIMBYism). This study investigated NIMBYism during the establishment of such facilities and how they respond to such resistance. A qualitative study through semi-structured interviews was used to obtain purposively sampled data. Fifteen frontline healthcare professionals from community mental health facilities in Taiwan were interviewed individually, using an organizational analysis structure. Data were analyzed using qualitative content analysis. Two themes: "Reasons for Resident Resistance" and "Institutional Response Strategies", two categories, and 11 subcategories emerged. The findings demonstrated the following: (1) Reasons behind residents' resistance toward establishing community mental health facilities are diverse. (2) Communities lack understanding regarding people with mental disorders, leading to irrational beliefs. (3) Fear and negative perceptions toward people with mental disorders exist. (4) Strategies employed by the facilities include providing community services to foster amicable relationships, organizing community outreaches, training people with mental disorders within communities, nurturing neighborhood connections, establishing and sustaining friendships within communities, inviting residents to visit community mental health facilities or introducing the facilities to communities, and leveraging governmental support. The government should adopt regulations or laws to reduce discrimination, promote human rights, and legislate to demarcate the use of community land.
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Affiliation(s)
- Ching-Teng Yao
- Master Program of Long-Term Care in Aging, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Hong Hong
- Bachelor Program of Senior Health Promotion and Care Management for Indigenous People, National Changhua University of Education, Changhua 50007, Taiwan
| | - Chien-Hsun Li
- Integrated Center of Healthy and Long-Term Care, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Yao CT, Hong H. Exploring the Operational Status and Challenges of Community-Based Mental Healthcare Centers in Taiwan: A Qualitative Analysis of Healthcare Professionals' Insights. Healthcare (Basel) 2023; 12:51. [PMID: 38200957 PMCID: PMC10779391 DOI: 10.3390/healthcare12010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Psychological disorders have become more prevalent in the presence of modernization and societal changes. Community-based mental health is important in healthcare. Taiwan has passed the Mental Health Act, and county governments have established community-based mental healthcare centers. This study aimed to fill the research gap regarding the operational status of these centers. A qualitative study design using semi-structured interviews was used to obtain data from a purposive sample. Seventeen healthcare professionals who were front-line workers of a community-based mental healthcare center in Taiwan were interviewed individually. This study uses the organizational analysis structure as the research base. The data were analyzed using qualitative content analysis. The theme-"operational status and difficulties"-and two categories with twelve subcategories emerged. The findings demonstrate (1) unclear objectives and imprecisely defined roles, (2) incomplete services provided, an overly defined area, and ineffectiveness, (3) the central government lacking clear objectives and operational strategies, (4) the public being ignorant of mental diseases and the operation of the centers, and (5) the lack of local resources for mental and social welfare. The government should immediately form clear policies to improve community-based mental healthcare, clarify the structure and models, increase resources for the centers, and provide direct services.
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Affiliation(s)
- Ching-Teng Yao
- Master Program of Long-Term Care in Aging, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Hong Hong
- Bachelor Program of Senior Health Promotion and Care Management for Indigenous People, National Changhua University of Education, Changhua 50007, Taiwan;
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Cox CM, Masiano S, Mazenga A, Stark M, Udedi M, Simon KR, Ahmed S, Nyasulu P, Kim MH. Phone-based psychosocial counseling for people living with HIV: Feasibility, acceptability and impact on uptake of psychosocial counseling services in Malawi. Glob Ment Health (Camb) 2023; 11:e3. [PMID: 38283875 PMCID: PMC10808978 DOI: 10.1017/gmh.2023.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/19/2023] [Accepted: 11/16/2023] [Indexed: 01/30/2024] Open
Abstract
People living with HIV experience psychosocial needs that often are not addressed. We designed an innovative low-resource model of phone-based psychosocial counseling (P-PSC). We describe cohort characteristics, acceptability, feasibility and utilization of P-PSC at health facilities supported by Baylor Foundation Malawi. Staff were virtually oriented at 120 sites concurrently. From facility-based phones, people with new HIV diagnosis, high viral load, treatment interruption or mental health concerns were referred without identifiable personal information to 13 psychosocial counselors via a WhatsApp group. Routine program data were retrospectively analyzed using univariate approaches and regressions with interrupted time series analyses. Clients utilizing P-PSC were 63% female, 25% youth (10-24 y) and 9% children (<10 y). They were referred from all 120 supported health facilities. Main referral reasons included new HIV diagnosis (32%), ART adherence support (32%) and treatment interruption (21%). Counseling was completed for 99% of referrals. Counseling sessions per month per psychosocial counselor increased from 77 before P-PSC to 216 in month 1 (95% CI = 82, 350, p = 0.003). Total encounters increased significantly to 31,642 in year 1 from ~6,000 during the 12 prior months, an over fivefold increase. P-PSC implementation at 120 remote facilities was acceptable and feasible with immediate, increased utilization despite few psychosocial counselors in Malawi.
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Affiliation(s)
- Carrie M. Cox
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Baylor College of Medicine, Texas Children’s Hospital, Houston, USA
| | - Steven Masiano
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Alick Mazenga
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Madeline Stark
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Michael Udedi
- Curative, Medical and Rehabilitation Services – Mental Health, Malawi Ministry of Health, Lilongwe, Malawi
| | - Katherine R. Simon
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Baylor College of Medicine, Texas Children’s Hospital, Houston, USA
| | - Saeed Ahmed
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Baylor College of Medicine, Texas Children’s Hospital, Houston, USA
| | - Phoebe Nyasulu
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Maria H. Kim
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
- Baylor College of Medicine, Texas Children’s Hospital, Houston, USA
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Rudan D, Marčinko D, Degmečić D, Jakšić N. Scarcity of research on psychological or psychiatric states using validated questionnaires in low- and middle-income countries: A ChatGPT-assisted bibliometric analysis and national case study on some psychometric properties. J Glob Health 2023; 13:04102. [PMID: 37781994 PMCID: PMC10543016 DOI: 10.7189/jogh.13.04102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Background It is vital to assess whether research on psychological or psychiatric states using validated questionnaires is still lagging in low- and middle-income countries and to what degree, and to continue to assess the psychometric properties of the most informative questionnaires. Methods We performed a bibliometric analysis of Web of Science Core Collection for all years to determine the number of studies performed in each country that used an inventory or a questionnaire on aggression, anxiety, depression, borderline personality, narcissism, self-harm, shame, or childhood trauma. We conducted a simple observational analysis of distributions by countries to derive the main overall conclusions, assisted by ChatGPT to test its ability to summarise and interpret this type of information. We also carried out a study in Croatia to examine some psychometric properties of five commonly used questionnaires, using Cronbach's α coefficient and zero-order correlations. Results We observed a concentration of research activity in a few high-income countries, primarily the United States and several European nations, suggesting a robust research infrastructure and a strong emphasis on studying psychological and psychiatric states within their population. In contrast, low- and middle-income countries were notably under-represented in research on psychological and psychiatric states, although the gap seems to be closing in some countries. Turkey, Iran, Brazil, South Africa, Mexico, India, Malaysia and Pakistan have been consistently contributing an increasing number of studies and catching up with the most research-intensive high-income countries. The national case study in Croatia confirmed adequate psychometric properties of the most frequently used questionnaires. Conclusions Addressing research gaps in low- and middle-income countries is crucial, because relying solely on research from high-income countries may not fully capture the nuances of psychological and psychiatric states within diverse populations. To bridge this gap, it is essential to prioritise mental health research in low-resource settings, provide training and resources to local researchers, and establish international collaborations. Such efforts can lead to the development of culturally valid questionnaires, an improved understanding of psychological and psychiatric states in diverse contexts, and the creation of effective interventions to promote mental well-being on a global scale.
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Affiliation(s)
- Duško Rudan
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Darko Marčinko
- Faculty of Medicine, University of Zagreb, Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Dunja Degmečić
- Faculty of Medicine, J. J. Strossmayer University of Osijek, Department of Psychiatry, University Hospital Centre Osijek, Osijek, Croatia
| | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
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Abstract
The field of global mental health (GMH) has undergone profound changes over the past decade. Outgrowing its earlier agenda it has performed a reflexive turn, broadened towards a social paradigm and developed new modes of knowledge production, all of which reshaped 'mental health' as a global object of knowledge and care, and the epistemic politics of the field. Drawing on long-term ethnographic fieldwork among GMH experts and recent agenda-setting publications, I discuss how GMH advocates and critical observers alike have created conceptual and practical middle-grounds between different forms of mental health knowledge - across culture, epistemic power, lived experience, policy platforms and academic disciplines - framing their dynamic encounters as dialogue, adaptation, participation, co-production or integration. Ultimately, I argue, GMH today is focusing less on establishing mental health as a universal problem than on managing its inherent multiplicity through alignment and integration across different bodies of knowledge. Global knowledge, so conceived, is fluid and malleable and produced in open-ended knowledge practices, governed by what I call 'contingent universality'. It is not new that the concepts and practices of the psy-disciplines are malleable and multiple, internally and externally contested, rapidly changing over time and not easily transferrable across space. What is new is that within the increasingly heterogenous epistemic space of GMH, these features have become assets rather than liabilities. GMH knowledge achieves both global reach and local relevance precisely because 'mental health' can be many things; it can be expressed in a wide range of idioms and concepts, and its problems and solutions align easily with others, at many scales. These fluid and integrative knowledge practices call for renewed empirical, critical and collaborative engagement.
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