Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern Colombia

Background: While there is consensus that local knowledge is important to build better mental health responses, integration of this knowledge into mental health services remains a work in progress. In this paper, we explore local understandings of mental health, mental illness, well-being and emotio...

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Main Authors: María Cecilia Dedios Sanguineti, Laura Fonseca, Rochelle A. Burgess, Natalia Concha, Mónica González, Norha Vera San Juan, Mónica Carreño, Kely Johana Palacio, María Fernanda Sotto, Sandra Jovchelovitch
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:SSM - Mental Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666560324000902
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author María Cecilia Dedios Sanguineti
Laura Fonseca
Rochelle A. Burgess
Natalia Concha
Mónica González
Norha Vera San Juan
Mónica Carreño
Kely Johana Palacio
María Fernanda Sotto
Sandra Jovchelovitch
author_facet María Cecilia Dedios Sanguineti
Laura Fonseca
Rochelle A. Burgess
Natalia Concha
Mónica González
Norha Vera San Juan
Mónica Carreño
Kely Johana Palacio
María Fernanda Sotto
Sandra Jovchelovitch
author_sort María Cecilia Dedios Sanguineti
collection DOAJ
description Background: While there is consensus that local knowledge is important to build better mental health responses, integration of this knowledge into mental health services remains a work in progress. In this paper, we explore local understandings of mental health, mental illness, well-being and emotional distress building dialogical spaces that enable community perspectives to inform academic knowledge and health systems. Methods: We identified local understandings of mental health, emotional distress, and wellbeing among two conflict-affected communities in Southern Colombia, including victims of the conflict and FARC ex-combatants. We conducted focus groups in Florencia (n = 8) and La Montañita (n = 7) (N = 99). Data was analysed using thematic analysis. Results: We found a lay theory of mind emphasising the mind-body-context relationship as central for health and wellbeing. Mental health and mental illness are explained through biomedical categories underpinned by social representations of ‘madness’ and the stigma associated with the conflict and using services in Colombia. Wellbeing and emotional distress are determined by relational, political and economic factors, and understood in relation to culture, sociability, religiosity, nature and physical health. Discussion: Accounting for local knowledge allows working with community members to identify how their experiences, values, beliefs, and the context they live in can support or hinder their emotional wellbeing. Central to this effort is to open hegemonic biomedical models to transformational dialogues that integrate the perspective and needs of the communities we work with. Our study provides actionable insights relevant for community-based mental health and primary care services, as well as those services across sectors that can contribute to the mental health of this population.
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spelling doaj-art-e4b70c0423ac411eb496c6a82c184a702025-01-04T04:57:12ZengElsevierSSM - Mental Health2666-56032025-06-017100385Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern ColombiaMaría Cecilia Dedios Sanguineti0Laura Fonseca1Rochelle A. Burgess2Natalia Concha3Mónica González4Norha Vera San Juan5Mónica Carreño6Kely Johana Palacio7María Fernanda Sotto8Sandra Jovchelovitch9School of Government, Universidad de los Andes, Bogota, ColombiaSchool of Psychology and Behavioural Sciences, Universidad de La Sabana, Chía, ColombiaUCL Institute for Global Health, London, UKQueen Mary, University of London, London, UKSchool of Government, Universidad de los Andes, Bogota, ColombiaUCL Institute for Global Health, London, UKSchool of Government, Universidad de los Andes, Bogota, ColombiaCorporación Manigua, Florencia, ColombiaCooperativa Multiactiva para el Buen Vivir y la Paz del Caquetá, La Montañita, ColombiaDepartment of Psychological and Behavioural Science, London School of Economics and Political Science, London, UK; Corresponding author.Background: While there is consensus that local knowledge is important to build better mental health responses, integration of this knowledge into mental health services remains a work in progress. In this paper, we explore local understandings of mental health, mental illness, well-being and emotional distress building dialogical spaces that enable community perspectives to inform academic knowledge and health systems. Methods: We identified local understandings of mental health, emotional distress, and wellbeing among two conflict-affected communities in Southern Colombia, including victims of the conflict and FARC ex-combatants. We conducted focus groups in Florencia (n = 8) and La Montañita (n = 7) (N = 99). Data was analysed using thematic analysis. Results: We found a lay theory of mind emphasising the mind-body-context relationship as central for health and wellbeing. Mental health and mental illness are explained through biomedical categories underpinned by social representations of ‘madness’ and the stigma associated with the conflict and using services in Colombia. Wellbeing and emotional distress are determined by relational, political and economic factors, and understood in relation to culture, sociability, religiosity, nature and physical health. Discussion: Accounting for local knowledge allows working with community members to identify how their experiences, values, beliefs, and the context they live in can support or hinder their emotional wellbeing. Central to this effort is to open hegemonic biomedical models to transformational dialogues that integrate the perspective and needs of the communities we work with. Our study provides actionable insights relevant for community-based mental health and primary care services, as well as those services across sectors that can contribute to the mental health of this population.http://www.sciencedirect.com/science/article/pii/S2666560324000902Mental healthWellbeingParticipatory action researchColombiaConflict-affected actorsSocial determinants
spellingShingle María Cecilia Dedios Sanguineti
Laura Fonseca
Rochelle A. Burgess
Natalia Concha
Mónica González
Norha Vera San Juan
Mónica Carreño
Kely Johana Palacio
María Fernanda Sotto
Sandra Jovchelovitch
Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern Colombia
SSM - Mental Health
Mental health
Wellbeing
Participatory action research
Colombia
Conflict-affected actors
Social determinants
title Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern Colombia
title_full Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern Colombia
title_fullStr Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern Colombia
title_full_unstemmed Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern Colombia
title_short Resisting epistemic violence in global mental health: Listening to local understandings of mental health and emotional distress among victims and ex-guerrilla members in Southern Colombia
title_sort resisting epistemic violence in global mental health listening to local understandings of mental health and emotional distress among victims and ex guerrilla members in southern colombia
topic Mental health
Wellbeing
Participatory action research
Colombia
Conflict-affected actors
Social determinants
url http://www.sciencedirect.com/science/article/pii/S2666560324000902
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