Using participatory action research to reimagine community mental health services in Colombia: a mixed-method study protocol

• Published in: BMJ open 2022-12, Vol.12 (12), p.e069329-e069329
• Main Authors: Burgess, Rochelle, Dedios Sanguineti, María Cecilia, Maldonado-Carrizosa, Darío, Fonseca, Laura, Vera San Juan, Norha, Lucumí, Diego, González-Gort, Mónica, Melgar, Mónica Carreño, Gaviria, María Fanny, Tovar, Diego Ferney, Jovchelovitch, Sandra
• Format: Article
• Language: English
• Subjects: Action research; Co-design; Collaboration; Colombia; Community; Community health care; Community Mental Health Services; Coronaviruses; COVID-19; Depression & mood disorders; Economic conditions; Global Health; Health services; Health Services Research; Humans; Intervention; Medical research; Mental depression; Mental disorders; MENTAL HEALTH; Mental health care; Mixed methods research; Pandemics; Participatory research; Pilot Projects; Polyesters; Poverty; PUBLIC HEALTH; Research Design; Rural areas; Unemployment; Well being
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-069329

IntroductionMental healthcare systems are challenged by how they hear and respond to what marginalised communities experience as drivers of mental distress. In Colombia, this challenge intersects with wider challenges facing post-conflict reconstruction. Our pilot study will explore the feasibility and acceptability of a participatory approach to developing community-led participatory interventions for community mental health systems strengthening and mental health improvement, in two sites in Caquetá, Colombia.Methods and analysisThe project is divided into three distinct phases aligned with community participatory action research cycles: diagnostic, intervention and evaluation. This allows us to use a participatory approach to design a community-led, bottom-up intervention for mental health systems strengthening and the promotion of mental health and well-being.The diagnostic phase explores local understandings of mental health, mental distress and access to mental health services from community members and health providers. The intervention stage will be guided by a participatory Theory of Change process. Community priorities will inform the development of a participatory, learning and action (PLA) informed group intervention, with a community linkage forum. The pilot of the PLA intervention will be evaluated using MRC process evaluation guidelines.Ethics and disseminationThis project has received ethical approval from two sources. Universidad de Los Andes (2021–1393) and the University College London (16127/005). Dissemination of findings will include academic publications, community forums, policy briefs and visual media (cartoons, pod casts and short films).