Unveiling Brazil’s Rich Tradition in Participatory Mental Health Research

An international team of researchers highlights the transformative potential of locally-driven participatory mental health research in the Global South.

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In an article recently published in Cambridge Prisms, researchers shed new light on the underappreciated wealth of knowledge on participatory mental health research methods within Brazil.

The study, titled “State of the art of participatory and user-led research in mental health in Brazil: A scoping review,” addresses a persistent imbalance in the literature on participatory research methods, which often focuses on the Global North or is conducted by researchers from the Global North within the Global South.

Participatory research methods, which engage the communities being studied in directing the research process, have seen a steady rise in popularity in the psy-disciplines since their introduction in the 1970s. These methods prioritize local epistemologies and ways of knowing in order to ensure the quality and accuracy of research within local contexts.

The authors, Ana Florence, Mateus Bocalini, Daniela Cabrini, Rita Tanzi, Melissa Funaro, Gerald Jordan, Larry Davidson, Robert Drake, Cristan Montenegro, and Silvio Yasui, hail from across the globe—Brazil, Chile, Italy, the United Kingdom, and the United States—some with lived experience of psychosocial disability.

They highlight the multiple oppressions faced by participatory research in mental health in the Global South, resulting from psychiatry’s history of exclusion and marginalization combined with the epistemic violence that arises from the geopolitics of knowledge shaping the North-South relationship.

“Psychiatry’s history of exclusion and marginalization combined with the epistemic violence that results from the geopolitics of knowledge that shape the North–South relationship places participatory research in mental health in the Global South at the intersection of multiple oppressions.. Globally, researchers remain unaware of the wealth of knowledge produced in Brazil. Thus, our study sought to review the empirical participatory literature in mental health in Brazil, identify common themes, and synthesize the results.”

By adhering to the Joanna Briggs Institute’s and the PRISMA extension guidelines for scoping reviews, the researchers were able to identify, chart, and synthesize 20 eligible studies published between 2009 and 2021. The majority of these studies were conducted at Community Mental Health centers, with 18 involving participants diagnosed with serious mental illnesses such as schizophrenia or psychosis.

The scoping review’s findings not only underscore the significance of participatory research methods in mental healthcare but also reveal how the participatory aspect of these methods varies across studies, cultures, and communities. The researchers conclude that participation in research is a crucial element of a broader democratizing process, reshaping power and knowledge relationships between expert and experiential knowledge.

The authors emphasize that the Brazilian Psychiatric Reform movement, with its focus on empowerment and autonomy, lends itself to the use of participatory research methods in support of its emancipatory project. They also stress the importance of acknowledging the intersecting and synergistic processes of social exclusion experienced by Brazilian mental health service users.

“Studies stressed the importance of participation in research as part of a broader democratizing process, reshaping power and knowledge relationships between expert and experiential knowledge. Studies noted that empowerment and autonomy are at the center of the Brazilian Psychiatric Reform movement and that participatory research lends itself to support this emancipatory project,” the authors write.
“Included studies highlighted that Brazilian mental health service users endure intersecting and synergistic processes of social exclusion that must be acknowledged. The biomedical model’s reductionist views of mental health, violence, poverty, and social exclusion were all identified as barriers to full participation in research and in shaping public policy.”

The study serves as a reminder that the Global South is often overlooked by the Global North, even though their approaches have the potential to be transformative. The decolonization of psy-disciplines and the continued development of participatory research methods are critical steps in addressing this long-standing imbalance.

 

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Florence, A. C., Bocalini, M., Cabrini, D., Tanzi, R., Funaro, M., Jordan, G., & Yasui, S. (2023). State of the art of participatory and user-led research in mental health in Brazil: A scoping review. Cambridge Prisms: Global Mental Health, 10, e21. (Link)

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