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Home arrow Language & Literature arrow The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health

Recommendations for Future Work and Conclusions

• Create a safe and empowering training and development context

The training method focused on creating a safe space for hearing the expertise of professionals and service users across cultural and professional/ user boundaries. Potential power imbalances were identified and attended to through choice making, weight of numbers, and gender balance of participants and facilitators. This appears to have enhanced the sense of safety that staff and service users felt.

• Commit to key principles and exploration of cultural fit

There is a tension between the need to scientifically measure the benefit and activity of such peer-working initiatives and the need to maintain the dynamism and freedom of movement of such a project. Perhaps the middle path relates to the commitment to key principles and ways of working. Key principles of this project included partnership working; valuing people ‘in the room’; exploring ideas rather than imposing; nurturing culturally valid understandings and activities rather than predetermining what form an intervention will take; redressing power imbalances; explicitly and truly sharing ownership; modelling positive relationships across cultural, gender-based, vocational and social divides; and encouraging creativity.

• Engage in positive risk taking in the service of co-production

Staff and service users developed the PSW model together, and solved problems as they arose. Ugandan managers, by their willingness to accept risk within the project, championed the hope and importance of positive risk taking, an element noticeably less visible in the UK. Also, the project, having not applied a strict selection process on Ugandan participants, worked successfully with a group of Ugandan service users at different stages of wellness and recovery. These service users delivered all elements of a complex programme, which illustrated the capacity of people to rise to the challenge when opportunities are provided. Perhaps it points to a general tendency within UK services, to overprotect service users and underestimate their capability to take up new opportunities.

• Nurture long-term partnerships with supporters

It is difficult to assess the importance of UK partners’ contribution towards the project as it covered over eight years and involved many individuals and roles. The UK partners facilitated a learning space, promoted exploration, modelled mutual learning and built capacity of others by supporting and working alongside. This was enhanced by the presence of long-term volunteers who acted to reassure stakeholders’ anxieties, build confidence in the process and promote the ‘safe spaces’ of the training to stay open and accessible to all. This contribution was less focused on the training in technical expertise typical of international work and more about creating a respectful process of change.

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