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26 - Involvement of People with Lived Experience of Mental Health Conditions in Decision-Making to Improve Care in Rural Ethiopia

Published online by Cambridge University Press:  20 August 2021

Michael Ashley Stein
Harvard Law School
Faraaz Mahomed
Wits University
Vikram Patel
Harvard Medical School
Charlene Sunkel
Global Mental Health Peer Network
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A human rights-based approach is required to embed the principles of participation, empowerment and accountability in mental healthcare systems. Involvement of people with lived experience in decision-making is a key element of this approach and an important ingredient of strengthening mental health systems and improving care. Ethiopia represents a case example of a low-income country where both conceptual and practical frameworks of involvement are currently being developed in the context of limited resources. Whilst experiences of involvement and autonomy in decision-making remain limited due to contextual challenges and cultural norms, approaches such as community-based rehabilitation and participatory action research offer potential platforms to promote, facilitate and enhance involvement. To ensure effective implementation, these approaches need to be supported within a pragmatic multi-stakeholder strategy that aims to create a cultural shift, empower people with lived experience, overcome structural barriers (particularly stigma and poverty), provide culturally appropriate resources (including guidance and training) and develop an implementable legislative framework for mental health care.

Publisher: Cambridge University Press
Print publication year: 2021

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