I am a medical anthropologist with a special interest in mental health, having studied psychology for my first degree. Before starting my PhD at the London School of Hygiene and Tropical Medicicne (LSHTM) this year, I spent 4 years in Amsterdam, where I worked as a researcher for an international NGO specialising in mental health and psychosocial care, developing and evaluating interventions in post-conflict settings. I was a research consortium collaborator for PRIME (Programme for Improving Mental Health Care) focusing on issues of access and demand to mental health services in Nepal.
In 2014, I completed my master’s in Medical Anthropology and Sociology at the University of Amsterdam, conducting ethnographic research in specialised mental health services for deaf children and families. I continued to work in a research role at the University of Amsterdam’s Centre for Social Science and Global Health, until moving to London for an ESRC studentship under the Health and Wellbeing cluster at LSHTM.
My PhD research explores issues access to mental health services through an ethnography of voluntary sector care in London. It is a project located at the margins of the UK health system: the space between the clinic and the community. Of particular significance are the practices surrounding services for common mental illnesses, which may not fall easily or appropriately into diagnostic categories. In clinical settings, access to care often hinges on psychiatric diagnosis, a process that can be a gateway to care, but can also be a barrier, particularly for those who are already marginalised in systems of health and social care.
But the shape and boundaries of our health system are rapidly changing. Public health policy is shifting mental health services out of NHS, meaning that many responsibilities are being absorbed by the voluntary sector. As spaces for non-clinical mental health care are becoming increasingly widespread and prominent, it is important to attend to what this means for the practices surrounding seeking and administering care, particularly for groups who are considered hard to reach. By employing ethnographic methods within a community-based provider, I seek to explore the liminal position of such services, between community and state, and between social and institutional spaces.
The difference my research makes
Whilst the increasing scope and responsibility of voluntary sector services could well be beneficial for marginalised groups accessing care, research attention has not yet been paid to what this trend means, or will mean, for ‘on the ground’ practices within mental health care. This in-depth, ethnographic research will shed light on the issues faced by both providers and service-users in their efforts to meet mental health needs in an uncertain context. The distribution of the research through publication and conferences will contribute to discussions in the academic field of medical anthropology and sociology about the potential mainstreaming of psychiatry into community contexts, or equally, the shaping of mainstream psychiatry through more grassroots, alternative models of care.
Dr Simon Cohn, Reader in Medical Anthropology: http://www.lshtm.ac.uk/aboutus/people/cohn.simon
Brenman, N. F., Luitel, N. P., Mall, S., & Jordans, M. J. (2014). Demand and access to mental health services: A qualitative formative study in Nepal. BMC International Health and Human Rights, 14(1), 22.
Jordans, M., Kaufman, A., Brenman, N. F., Adhikari, R. P., Luitel, N., Tol, W. A., & Komproe, I. (2014). Suicide in South Asia: A scoping review. BMC Psychiatry, 14(1), 12.