Otake Yuko
School of Anthropology & Museum Ethnography, University of Oxford, Oxford OX2 6PE, UK.
Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
Med Sci (Basel). 2018 Oct 24;6(4):94. doi: 10.3390/medsci6040094.
Recently, discussions have considered how mental health and psychosocial support (MHPSS) can build upon local resilience in war-affected settings. To contribute to the knowledge in this field, the paper explored the gap between MHPSS and local communities in terms of perceived mental health problems and healing processes, and how the gap could be filled. Qualitative research was conducted in northern Rwanda with 43 participants between 2015 and 2016. Findings revealed how three particular gaps can isolate MHPSS recipients in their local community. First, whereas MHPSS applies bio-psychological frameworks to post-genocide mental health, community conceptualisations emphasise social aspects of suffering. Second, unlike MHPSS which encourages 'talking' about trauma, 'practicing' mutual support plays a major role in the community healing process. Third, MHPSS focuses on one part of the community (those who share the same background) and facilitates their healing in intervention groups. However, healing in natural communities continues in everyday life, through mutual support among different people. Despite these gaps, MHPSS recipients can be (re)integrated into the community through sharing suffering narratives and sharing life with other community members. The paper highlights the ways in which MHPSS could inclusively support different social groups in the overall geographical community, allowing members to preserve the existing reciprocity and recover collective life through their own initiatives.
最近,各方讨论关注了心理健康和社会心理支持(MHPSS)如何在受战争影响的地区借助当地的恢复力。为丰富该领域的知识,本文探讨了MHPSS与当地社区在感知到的心理健康问题及康复过程方面的差距,以及如何填补这一差距。2015年至2016年期间,在卢旺达北部对43名参与者开展了定性研究。研究结果揭示了三个特定差距如何在当地社区中使接受MHPSS服务的人群被孤立。其一,MHPSS将生物心理框架应用于种族灭绝后的心理健康问题,而社区观念强调痛苦的社会层面。其二,与鼓励谈论创伤的MHPSS不同,“践行”互助在社区康复过程中发挥着主要作用。其三,MHPSS关注社区中的一部分人(具有相同背景的人),并在干预小组中促进他们的康复。然而,在自然社区中,康复通过不同人群之间的互助在日常生活中持续进行。尽管存在这些差距,但接受MHPSS服务的人群可以通过分享痛苦经历和与其他社区成员共同生活(重新)融入社区。本文强调了MHPSS可以以包容的方式支持整个地理社区中不同社会群体的方式,使成员能够通过自身行动保持现有的互惠关系并恢复集体生活。