Helen Martin

Cultural Understanding of Adversity From Multiple Stakeholder Perspective: A Study Protocol.

Background: Adversity is a complex phenomenon as such, that it differs from individuals to across nations. The term and correlating implications of adversity on mental health has previously been examined by various studies from Euro-Western nations. The WHO report on social determinants of mental health identifies that adversities can have an impact on the risk of developing common mental health problems as well as potentiate an intergenerational transfer of risk. Literature demonstrates limited studies from low and middle income countries investigating adversity from its cultural dimension. While some of the existing adversities has been proven for its universal applicability, from clinical practice we believe there exists a gap in its conceptual understanding from cultural viewpoint. This protocol describes the methodology proposed to understanding adversity among youth from the standpoint of various stakeholders i.e, mental health care providers, service users and their families. The purpose was i) to investigate mental health provider’s understanding of adversity in the clinical and cultural context, ii) to determine how persons with first episode psychosis (FEP) and their caregivers understand life experiences in relation to adversities, iii) to formulate a working definition of adversity that could be applied by clinicians in the process of identification and measuring adversity. The study was carried out at Schizophrenia Research Foundation (SCARF), a WHO collaborating center for Mental health research and training center in Chennai, India.

Methods: We adopted mixed methods into eliciting the cultural meaning, characteristics and labels were deployed, drawing various classifications as well as assessing adversity.

Implications: A study like this will help to identify the gaps thereby modifying or creating a culturally informed measure of adversity. As a result, it endows progress in clinical practice and directions for future culture-specific research in the field of psychiatry.