Researching public action and development concepts in the context of mental health

This report summarises a project of participatory action-research combining concepts from the field of development management with practice in international mental health. The research was conducted in Estonia, Kyrgyzstan, and Romania. The policy-as-process model is central to understandings of development management but is unfamiliar to organisations working in mental health, even those working from a community level, bottom-up perspective to influence mental-health policy. At the same time practice and learning from the field of mental health and radical user-empowerment models have received little attention from development managers. The research reported here found that the policy-as-process model was useful to mental-health activists and that it provided a competing framework to more traditional, top-down and prescriptive policy concepts, and made it possible to make sense of the multiple perspectives, value-based conflicts, and power dynamics that characterise understandings and practice in mental health. Among the recommendations is a call for closer links between mental-health activism and development management, and a transfer of knowledge, understanding, and experience between the two disciplines.