Renewing the Promise: Toward a New Community Mental Health Movement

The community mental health (CMH) movement, arising in response to the shortcomings of deinstitutionalization, has been instrumental in ensuring that people live better lives. Nonetheless, there are a number of significant challenges that persist. Many people remain poor and socially isolated. For many, treatment comes late and is of unclear benefit. This paper contends that in key areas progress has been stalled due to the inherent limitations in how we conceive and practice CMH. These limitations are distinct from the fact that mental health systems are chronically under-funded and programs are not universally available. The professionally driven individual level interventions that constitute the great majority of CMH services and programs do not sufficiently engage in broader level community, policy or social change where the root causes of the marginalization of people with serious mental illness lie. Moreover, CMH thinking appears to remain rooted in the challenges that arose from deinstitutionalization, rather than those challenges faced by people with SMI who are already living in the community, and who have never experienced lengthy periods of institutionalization. In this paper, we outline ways in which CMH can be re-oriented to begin to address the profound social challenges that face people living with serious mental illness. The paper builds on ideas we first introduced in a paper on reasons why CMH systems and programs have not addressed the problem of poverty among people with serious mental illness (Sylvestre, Notten, Kerman, Polillo, & Czechowski, 2018). Specifically, we highlight how a new community mental health movement, informed by citizenship and capabilities perspectives, and oriented to systemic and policy interventions rather than only individual level ones, can hold greater promise for addressing the persistent social challenges facing people with serious mental illness.

Contribution of WHO’s Group PM+ intervention to foster solidarities in community contexts.

Building an inclusive culture for improved mental health in communities affected by transnational migration and population displacement in Niger: Contribution of WHO’s Group PM+ intervention to foster and sustain solidarities in community contexts.
Since 2018, the Italian NGO Cooperazione Internazionale (COOPI) has been delivering mental health and psychosocial support in remote communities affected by transnational migration and population displacement in various regions of Niger. This work has mainly consisted in mobilizing teams of previously trained local psychologists and psychosocial agents to improve community members’ access to psychotherapeutic and psychosocial support services. However, since this type of intervention is not sustainable over the long-term, COOPI has decided to now engage 20 community-based, lay health workers to pilot test the implementation of WHO’s Group PM+. This 15-minute Open Oral presentation will present and discuss the outcomes of this intervention in terms of its capacity to foster greater inclusiveness and solidarity among community members and stronger links between remote communities and the public health system.

Hopes and fears for the future of different local communities

To foster the wellbeing of communities is important to understand the perception residents have of the future of their community specifically their desires for the future of their community and what they fear mostly for their community (Francescato, 2017) .
Aim: the aim of this study is to investigate the perception of the future of their community of people resident in the city center of Rome, in suburban areas of Rome and small towns analyzing what they fear mostly for their community and what they desire mostly for the future of their community.
Participants:140 communities participated to the project 49% from the City Centre of Rome, 27% from the Suburban areas of Roma and 24% from small towns
Methods: our research is part of a larger project that assessed the empowerment of different communities using the Community Profiling methodology (Francescato, Tomai & Ghirelli, 2002). The community profiling has a multidisciplinary approach since it integrates tools from different disciplines. In this study we focused on the analysis of the future profile, specifically we analyzed how people feel about the future of their community, their main anxieties and hopes, comparing the different communities.
Results: our preliminary results were analyzed considering the seven profiles of the community profiling methodology (territorial, demographic, economic, service, institutional, anthropological, and psychological). The people living in the Centre of Rome focused mostly their desires on the Territorial, Psychologic, Economic and Service aspects of their community. For the Suburban areas instead the desires concentrated mostly on the Service, Territorial, Economic, Psychological and Institutional profiles. With respect to local towns people’s desire for their community were focused instead in the Economic, Services, Psychological and Institutional and Territorial aspects of the community. In all three communities fears regarded mostly territorial and psychological aspects.

The group as Liminal Space.Recognition and Reparation for Political Trauma survivors inEcuador

The traumatic political upheavals in Ecuador during the 1980s and 90s left a lasting scar on the psychosocial wellbeing of the nation and its citizens. This article questions if and what form of group processes may be helpful for survivors whose cases are investigated by the Truth Commission section of the Ecuadorian Office of the Prosecutor.
This presentation is based on empirical data from seven focus groups composed with victims of human rights violations studied by the Truth Commission of Ecuador (TCE) and a sequence of eight in-depth focus groups with torture survivors of the TCE´s Sabanilla case. The session unwraps the concepts of political trauma, recognition and reparation, and questions how victims experience group support as a reparative element from traumatic experiences within a political context.
Reparation requires a liminal time and space, set apart from a past and even a present. At the societal level, transitional justice mechanisms have been established for this purpose. Within the subjective and inter-subjective levels, a well-structured group in which individuals can find this liminal time and space to provide new shared meanings to their experience might be an important reparative process until the legal and political world might be able to respond to their demands.
This discussion addresses the intra (subjective) and inter-subjective (social and cultural) dimensions of human rights violations´ impacts. The aim of this presentation focuses on how the group may become a liminal space which, with appropriate structure and facilitation, may be helpful in the creation of a supportive and trustful environment in which new meanings to the experiences of horror might be subjectively and politically re-signified.
The session will discuss how group support for trauma survivors may become a psychotherapeutic and political space as response to traumatic political events, because the group may become a positive catalyser for recovery and a politicising element for victims to experience recognition and reparation.