Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T18:58:04.945Z Has data issue: false hasContentIssue false

18 - Social Neuroscience in Global Mental Health

Case Study on Stigma Reduction in Nepal

from Part II - Applications

Published online by Cambridge University Press:  18 September 2020

Laurence J. Kirmayer
Affiliation:
McGill University, Montréal
Carol M. Worthman
Affiliation:
Emory University, Atlanta
Shinobu Kitayama
Affiliation:
University of Michigan, Ann Arbor
Robert Lemelson
Affiliation:
University of California, Los Angeles
Constance A. Cummings
Affiliation:
The Foundation for Psychocultural Research
Get access

Summary

In low- and middle-income countries, the number of people with mental illness receiving minimally adequate care ranges from 1 out of 25 to 1 out of a 100. Given this major treatment gap, the World Health Organization and other institutions advocate provision of mental health care by primary care workers. However, there has been limited delivery of services after primary care workers are trained in mental health. One reason is that training programs have focused on increasing knowledge while not addressing attitudes. Social neuroscience theories can improve mental health training by addressing affect and motivation of health workers. Social neuroscience highlights the need to reduce between-group identity distinctions and threat while fostering empathy. Promoting health worker self-efficacy and therapeutic allegiance also benefits service delivery. Ultimately, social neuroscience theories can strengthen strategies to increase mental health services for persons living in low resource settings around the world.

Type
Chapter
Information
Culture, Mind, and Brain
Emerging Concepts, Models, and Applications
, pp. 438 - 449
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allport, F. H. (1954). The structuring of events: Outline of a general theory with applications to psychology. Psychological Review, 61(5), 281303. https://doi.org/10.1037/h0062678Google Scholar
Amodio, D. M. (2014). The neuroscience of prejudice and stereotyping. Nature Reviews Neuroscience, 15(10), 670–82. https://doi.org/10.1038/nrn3800Google Scholar
Berridge, K. C. (2004). Motivation concepts in behavioral neuroscience. Physiology & Behavior, 81(2), 179209. https://doi.org/10.1016/j.physbeh.2004.02.004CrossRefGoogle ScholarPubMed
Catalani, C., & Minkler, M. (2010). Photovoice: A review of the literature in health and public health. Health Education & Behavior, 37(3), 424–51. https://doi.org/10.1177/1090198109342084Google Scholar
Cikara, M., Bruneau, E., Van Bavel, J. J., & Saxe, R. (2014). Their pain gives us pleasure: How intergroup dynamics shape empathic failures and counter-empathic responses. Journal of Experimental Social Psychology, 55, 110–25. https://doi.org/10.1016/j.jesp.2014.06.007Google Scholar
Cikara, M., & Fiske, S. T. (2013). Their pain, our pleasure: Stereotype content and schadenfreude. Annals of the New York Academy of Sciences, 1299(1), 52–9. https://doi.org/10.1111/nyas.12179Google Scholar
Cikara, M., Jenkins, A. C., Dufour, N., & Saxe, R. (2014). Reduced self-referential neural response during intergroup competition predicts competitor harm. NeuroImage, 96, 3643. https://doi.org/10.1016/j.neuroimage.2014.03.080Google Scholar
Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rüsch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–73. https://doi.org/10.1176/appi.ps.201100529Google Scholar
de Figueiredo, J. M., & Griffith, J. L. (2016). Chronic pain, chronic demoralization, and the role of psychotherapy. Journal of Contemporary Psychotherapy, 46(3), 167–77. https://doi.org/10.1007/s10879-016-9331-xCrossRefGoogle Scholar
De Silva, M. J., Rathod, S. D., Hanlon, C., Breuer, E., Chisholm, D., Fekadu, A., Jordans, M., Kigozi, F., Petersen, I., Shidhaye, R., Medhin, G., Ssebunnya, J., Prince, M., Thornicroft, G., Tomlinson, M., Lund, C., & Patel, V. (2015). Evaluation of district mental healthcare plans: The PRIME consortium methodology. British Journal of Psychiatry, 208(s56), s63s70. https://doi.org/10.1192/bjp.bp.114.153858CrossRefGoogle ScholarPubMed
Decety, J. (Ed.). (2012). Empathy: From bench to bedside. MIT Press.Google Scholar
Dow, J. (1986). Universal aspects of symbolic healing – A theoretical synthesis. American Anthropologist, 88(1), 5669. https://doi.org/10.1525/aa.1986.88.1.02a00040Google Scholar
Hanlon, C., Fekadu, A., Jordans, M., Kigozi, F., Petersen, I., Shidhaye, R., Honikman, S., Lund, C., Prince, M., Raja, S., Thornicraft, G., Tomlinson, M., & Patel, V. (2015). District mental healthcare plans for five low- and middle-income countries: Commonalities, variations and evidence gaps. British Journal of Psychiatry, 208(s56), s47s54. https://doi.org/10.1192/bjp.bp.114.153767Google Scholar
Hanlon, C., Luitel, N. P., Kathree, T., Murhar, V., Shrivasta, S., Medhin, G., Ssebunnya, J., Fekadu, A., Shidhaye, R., Petersen, I., Jordans, M., Kigozi, F., Thornicroft, G., Patel, V., Tomlinson, M., Lund, C., Breuer, E., De Silva, M., & Prince, M. (2014). Challenges and opportunities for implementing integrated mental health care: A district level situation analysis from five low- and middle-income countries. PLoS ONE, 9(2), e88437. https://doi.org/10.1371/journal.pone.0088437Google Scholar
Heim, E., Kohrt, B. A., Koschorke, M., Milenova, M., & Thornicroft, G. (2018). Reducing mental health related stigma in primary health care settings in low- and middle-income countries: A systematic review. Epidemiology and Psychiatric Sciences, 4, 110. https://doi.org/10.1017/S2045796018000458Google Scholar
Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., Schulze, B., Druss, B., & Thornicroft, G. (2014). Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry, 1(6), 467–82. https://doi.org/10.1016/S2215-0366(14)00023-6Google Scholar
Jordans, M. J. D., Luitel, N. P., Pokhrel, P., & Patel, V. (2016). Development and pilot testing of a mental healthcare plan in Nepal. British Journal of Psychiatry, 208(s56), s21s28. https://doi.org/10.1192/bjp.bp.114.153718CrossRefGoogle ScholarPubMed
Kirmayer, L. J. (2004). The cultural diversity of healing: Meaning, metaphor and mechanism. British Medical Bulletin, 69, 3348. https://doi.org/10.1093/bmb/ldh006Google Scholar
Kirmayer, L. J. (2015). Empathy and alterity in psychiatry. In Kirmayer, L. J., Lemelson, R., & Cummings, C. A. (Eds.), Re-visioning psychiatry: Cultural phenomenology, critical neuroscience and global mental health (pp. 141–67). Cambridge University Press. https://doi.org/10.1017/CBO9781139424745.009CrossRefGoogle Scholar
Kohrt, B. A., Jordans, M. J. D., Turner, E. L., Sikkema, K. J., Luitel, N. P., Rai, S., Singla, D. R., Lamichhane, J., Lund, C., & Patel, V. (2018). Reducing stigma among healthcare providers to improve mental health services (RESHAPE): Protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal. Pilot and Feasibility Studies, 4(1), 36. https://doi.org/10.1186/s40814-018-0234-3CrossRefGoogle ScholarPubMed
Kohrt, B. A., Turner, E. L., Rai, S., Bhardwaj, A, Sikkema, K. J., Adelekun, A., Dhakal, M., Luitel, N. P., Lund, C., Patel, V., & Jordans, M. J. D. (2020). Reducing mental illness stigma in healthcare settings: Proof of concept for a social contact intervention to address what matters most for primary care providers. Social Science & Medicine, 250, 112852. https://doi.org/10.1016/j.socscimed.2020.112852CrossRefGoogle Scholar
Lund, C., Tomlinson, M., De Silva, M., Fekadu, A., Shidhaye, R., Jordans, M., Petersen, I., Bhana, A., Kigozi, F., Prince, M., Thornicroft, G., Hanlon, C., Kakuma, R., McDaid, D., Saxena, S., Chisholm, D., Raja, S., Kippen-Wood, S., Honikman, S., … Patel, V. (2012). PRIME: A programme to reduce the treatment gap for mental disorders in five low- and middle-income countries. PLoS Medicine, 9(12), e1001359. https://doi.org/10.1371/journal.pmed.1001359CrossRefGoogle Scholar
Lund, C., Tomlinson, M., & Patel, V. (2016). Integration of mental health into primary care in low- and middle-income countries: The PRIME mental healthcare plans. British Journal of Psychiatry, 208(s56), s1s3. https://doi.org/10.1192/bjp.bp.114.153668CrossRefGoogle ScholarPubMed
Makan, A., Fekadu, A., Murhar, V., Luitel, N., Kathree, T., Ssebunya, J., & Lund, C. (2015). Stakeholder analysis of the Programme for Improving Mental health carE (PRIME): Baseline findings. International Journal of Mental Health Systems, 9, 27. https://doi.org/10.1186/s13033-015-0020-zGoogle Scholar
Mattan, B. D., Wei, K. Y., Cloutier, J., & Kubota, J. T. 2018. The social neuroscience of race-based and status-based prejudice. Current Opinion in Psychology, 24, 2734. https://doi.org/10.1016/j.copsyc.2018.04.010Google Scholar
Mendenhall, E., De Silva, M. J., Hanlon, C., Petersen, I., Shidhaye, R., Jordans, M., Luitel, N., Ssebunnya, J., Fekadu, A., Patel, V., Tomlinson, M., & Lund, C. (2014). Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda. Social Science & Medicine, 118, 3342. https://doi.org/10.1016/j.socscimed.2014.07.057CrossRefGoogle ScholarPubMed
Montag, C., Dziobek, I., Richter, I. S., Neuhaus, K., Lehmann, A., Sylla, R., Heekeren, H. R., Heinz, A., & Gallinat, J. (2011). Different aspects of theory of mind in paranoid schizophrenia: Evidence from a video-based assessment. Psychiatry Research, 186(2–3), 203209. https://doi.org/10.1016/j.psychres.2010.09.006CrossRefGoogle ScholarPubMed
Pescosolido, B. A., & Manago, B. (2017). Getting underneath the power of “contact”: Revisiting the fundamental lever of stigma as a social network phenomenon. In Major, B., Dovidio, J. F., & Link, B. G. (Eds.), The Oxford handbook of stigma, discrimination, and health (pp. 397411). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780190243470.013.16Google Scholar
Pettigrew, T. F., Tropp, L. R., Wagner, U., & Christ, O. (2011). Recent advances in intergroup contact theory. International Journal of Intercultural Relations, 35(3), 271–80. https://doi.org/10.1016/j.ijintrel.2011.03.001Google Scholar
Rai, S., Gurung, D., Kaiser, B. N., Sikkema, K. J., Dhakal, M., Bhardwaj, A., Tergesen, C., & Kohrt, B. A. (2018). A service user co-facilitated intervention to reduce mental illness stigma among primary healthcare workers: Utilizing perspectives of family members and caregivers. Families, Systems, & Health, 36(2), 198209. https://doi.org/10.1037/fsh0000338Google Scholar
Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Andrade, L., Borges, G., Bruffaerts, R., Bunting, B., Caldas de Almeida, J. M., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., He, Y., Hinkov, H., … Kessler, R. C. (2017). Undertreatment of people with major depressive disorder in 21 countries. British Journal of Psychiatry, 210(2), 119–24. https://doi.org/10.1192/bjp.bp.116.188078Google Scholar
Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., Koschorke, M., Shidhaye, R., O’Reilly, C., & Henderson, C. (2015). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet, 387(10023), 1123–32. https://doi.org/10.1016/S0140-6736(15)00298-6Google Scholar
Tiihonen, J., Lönnqvist, J., Wahlbeck, K., Klaukka, T., Niskanen, L., Tanskanen, A., & Haukka, J. (2009). 11-year follow-up of mortality in patients with schizophrenia: A population-based cohort study (FIN11 study). Lancet, 374(9690), 620–7. https://doi.org/10.1016/S0140-6736(09)60742-XGoogle Scholar
Turner, V. W. (1967). The forest of symbols: Aspects of Ndembu ritual. Cornell University Press.Google Scholar
Upadhaya, N., Luitel, N. P., Koirala, S., Adhikari, R. P., Gurung, D., Shrestha, P., Tol, W. A., Kohrt, B. A., & Jordans, M. J. D. (2014). The role of mental health and psychosocial support nongovernmental organizations: Reflections from post-conflict Nepal. Intervention: International Journal of Mental Health, Psychosocial Work & Counselling in Areas of Armed Conflict, 12(Supplement 1), 113–28. https://doi.org/10.1097/WTF.0000000000000064CrossRefGoogle Scholar
Wang, C., & Burris, M. A. (1997). Photovoice: Concept, methodology, and use for participatory needs assessment. Health Education & Behavior, 24(3), 369–87. https://doi.org/10.1177/109019819702400309Google Scholar
World Health Organization. (2010). mhGAP Intervention Guide for mental, neurological and substance-use disorders in non-specialized health settings: Mental health Gap Action Programme (mhGAP). www.who.int/mental_health/publications/mhGAP_intervention_guide/en/Google Scholar
Yang, L. H., Kleinman, A., Link, B. G., Phelan, J. C., Lee, S., & Good, B. (2007). Culture and stigma: Adding moral experience to stigma theory. Social Science & Medicine, 64(7), 1524–35. https://doi.org/10.1016/j.socscimed.2006.11.013CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×