promoting mental health in scarce-resource contexts: emerging evidence and practice

8/9/2019 Promoting mental health in scarce-resource contexts: Emerging evidence and practice

1/234

@n`rhfmh |fj`mc imj priczfc`

@jfz j bv Fmh _`z rs`m' Ir|fm Bdimi' Igim A Lgfsd`r' G`sgf Sxirzq , Gfmji Rfcdz r


2/234

@n`rhfmh `|fj`mc` imj priczfc`

_rknkzfmh

n`mzig d`igzdfm scirc`.r`skprc`ckmz`tzs

@jfz`j bv Fmh` _`z`rs`m' Ir|fm Bdimi' Igim A Lgfsd`r'

G`sgf` Sxirzq , Gfmji Rfcdz`r


3/234

_bgfsd`j bv DSRC _r`ss_rf|iz` Bih T6942' Cip` Zkxm' 4???' Skzd Ilrfcixxx-dsrcpr`ss-ic-qi

Lfrsz pbgfsd`j 2?9?

FSBM $sklz ck|`r&1 684.?.86


4/234

Ckmz`mzs

Gfsz kl zibg`s imj lfhr`s |

Icemkxg`jh`n`mzs |f

Lkr`xkrj |ff

Ibbr`|fizfkms imj icrkmvns t

_irz 9Zd` fnp`rizf|` lkr' imj `n`rhfmh priczfc` kl' n`mzig dìgzd prknkzfkm

imj zd`pr`|`mzfkm kl n`mzig jfskrj`rs fm scirc`.r`skrc` ckmz`tzs

9 Iz zd` dìrz kl j`|`gkpn`mz1 im fmzrkjczfkm zk n`mzig dìgzd prknkzfkm

imj zd` pr |`mzfkm kl n`mzig jfskrj`rs fm scirc`.r`skrc` ckmz`tzs 3Fmh` _`z`rs`m

2 Zd`kr`zfcig ckmsfj`rizfkms1 lrkn mj`rszimjfmh zk fmz`r|`mfmh 29

Fmh` _`z`rs`m , Eivnirgfm Hk|`mj`r

3 Ckmz`tzig fss`s :6

G`sgf` Sxirzq

: @|igizfmh fmz`r|`mzfkms


5/234

9? Kgj`r p`kpg` 94?

Nirzfm A- _rfmc`

99 Ilz`rxkrj1 crkss.czzfmh fss`s c`mzrig zk n`mzig

d`igzd prknkzfkm fmscirc`.r`skrc` ckmz`tzs 2?4

Fmh` _`z`rs`m' Igim A- Lgfsd`r , Ir|fm Bdimi

Ckmzrfbzkrs 29:

Fmj`t 290


6/234

|

Zibg`s imj lfhr`s

Zibg`s

Zibg` 9-9 @tinpg`s kl sszifmibg` gf|`gfdkkj iss`zs ?-8& pirzfcfpiz`j fm zd` szjv- Zd` niakrfzv kl zd`

pirzfcfpimzs dij lg`j lrkn rrig irìs mìr Brizmic' Q|krmfe imj Sr`br`mfci jrfmh zd` xir-

Zd` ifn kl zd` psvcdkskcfig fmz`r|`mzfkm xis zk prknkz` zd` j`|`gkpn`mz imj x`gg.b`fmh kl

vkmh cdfgjr`m' bkzd zdrkhd pir`mzig fm|kg|`n`mz' sppkrz imj `jcizfkm' imj bv lkcsfmh

km zd` fnpkrzimc` kl zd` nkzd`rcdfgj fmz`riczfkm lkr zd` cdfgjs j`|`gkpn`mz imj dìgfmh-

Lf|` pr`scdkkg zìcd`rs x`r` zrifm`j is hrkp gìj`rs lkr zd` jfscssfkm hrkps- @icd hrkp

gìj`r n`z x`ègv xfzd zxk hrkps' ìcd kl xdfcd ckmsfsz`j kl ipprktfniz`gv lf|` nkzd`rs-

Zd` hrkp jfscssfkms x`r` j`sfhm`j zk sppkrz zd` nkzd`rs imj fmcrìs` zd`fr x`gg.b`fmh'

s`gl.ckmlfj`mc` imj ibfgfzv zk cir` lkr zd`fr cdfgjr`m fm zdfs jfllfcgz sfzizfkm imj zk b` zd`fr

cdfgjr`ms b`sz dìg`r- @icd n``zfmh xis s`nf.szrczr`j imj j`jfciz`j zk `jcizfkm imj

jfscssfkms ibkz sp`cflfc zkpfcs' scd is cdfgj j`|`gkpn`mz' nkzd`rcdfgj fmz`riczfkms'

zrini imj ckpfmh szriz`hf`s- Zdfs mkm.lkrnig prkhrinn` zrf`j zk sppkrz zd` nkzd`rs

sk zdiz zd` mkrnig' bisfc cknnmfcizfkm imj fmz`riczfkm sefggs zdiz igrìjv `tfsz`j x`r`

r`fmlkrc`j- Zd` sppkrz igsk fm|kg|`j jfr`cz izz`mzfkm zk zd` nkzd`rs imj zd`fr n`mzig

dìgzd' zk zd`fr b`gf`ls imj emkxg`jh` ibkz zd`fr cdfgjr`m' imj zk zd` rìczfkms imj m``js

kl ijgzs imj cdfgjr`m lkggkxfmh zrinizfc `|`mzs- Lrzd`r' zd` hrkp gìj`rs |fsfz`j ìcd kl

zd` xkn`m fm zd`fr dkn`s kmc` lkr ibkz km` dkr zk h`z zk emkx zd`n b`zz`r imj `tpr`ss

sppkrz- Fm ijjfzfkm' zd` hrkp gìj`rs zd`ns`g|`s n`z kmc` i x`è fm i hrkp g`j bv i

sp`r|fskr zk jfscss zd`fr `tp`rf`mc`s imj sppkrz ìcd kzd`r $lkr nkr` fmlkrnizfkm ibkz

zd` ckmz`mz imj krhimfsizfkm kl zd` hrkp xkre' s`` Jvbjidg' 2??9&- Igg kl zd` linfgf`s x`r`

igsk prk|fj`j xfzd lr`` bisfc dìgzd cir` kmc` i nkmzd jrfmh zd` fmz`r|`mzfkm p`rfkj-

I rimjknfs`j ckmzrkgg`j szjv fmjfciz`j zdiz zd` fmz`r|`mzfkm prkhrinn` $r`c`f|fmh

psvcdkskcfig sppkrz imj bisfc n`jfcig cir`' m > :2& dij i pksfzf|` `ll`cz km pirzfcfpizfmh

nkzd`rs n`mzig dìgzd' cdfgjr`ms x`fhdz hifm' imj s`|`rig nìsr`s kl cdfgjr`ms

psvcdkskcfig lmczfkmfmh imj n`mzig dìgzd fm cknpirfskm zk zd` ckmzrkg hrkp $kmgv

r`c`f|fmh bisfc n`jfcig cir`' m > :0&- Zdfs szjv dis prk|fj`j skn` `|fj`mc` zdiz i sfnpgìmj fm`tp`msf|` psvcdkskcfig fmz`r|`mzfkm ifn`j iz nkzd`rs cim di|` i b`m`lfcfig `ll`cz

km zd`fr cdfgjr`m fm ckmjfzfkms kl xir-


50/234

ZD@KR@Z FCIG CKMS FJ@RIZ FKMS 1 LRKN PMJ@RSZIMJFMH ZK FMZ@R\@MFMH

36

cim b` prk|fj`j xfzd fmlkrnizfkm km dkx zd` p`rskm fs gfe`gv zk b`di|` imj prk|fj`jxfzd sefggs km dkx zk issfsz- S`ckmj' zdrkhd prk|fjfmh p`kpg` xfzd fmlkrnizfkm kmzd` b`m`lfzs kl skcfig sppkrz imj dkx zk j`|`gkp skcfiggv sppkrzf|` r`gizfkmsdfps'fmz`r|`mzfkms cim mckrih` p`kpg` zk j`|`gkp imj nifmzifm r`gizfkmsdfps zdiz prk|fj`skcfig sppkrz- Zdfrj' fmz`r|`mzfkms cim lkcs km j`|`gkpfmh m`x skcfiggv sppkrzf|`r`gizfkmsdfps lkr p`kpg` iz rfse- @tinpg`s fmcgj` n`mzkrsdfp prkhrinn`s' xd`r`n`mzkrs ir` p`kpg` xdk di|` scc`sslggv ckp`j xfzd zd` sfzizfkm `tp`rf`mc`j bv imfmjf|fjig5 bjjv svsz`ns' xd`r` p`kpg` tp`rf`mcfmh i sfnfgir prkbg`n ir` pifr`j kll5imj prkhrinn`s zdiz s` mizrig d`gp`rs imj giv cknnmfzv cir`hf|`rs xdk gf|` fm zd`sin` cknnmfzv is zd` p`kpg` iz rfse imj ir` zrifm`j zk prk|fj` ij|fc`' issfszimc` imjr`l`rrigs $Br`fmbi`r , Nijjig`mk' 2??0&-

Dìm`v imj Fsri`g $9668& shh`sz zdiz skcfiggv sppkrzf|` r`gizfkmsdfps ir`cdiricz`rfs`j bv zd` lkggkxfmh1 zrsz' mj`rszimjfmh imj `npizdv5 nzigfmz`rj`p`mj`mc` imj `tcdimh`5 imj skcfig sfnfgirfzv' xfzd i dfszkrv kl sfnfgir`tp`rf`mc`s- Fz fs' zd`r`lkr`' y`szfkmibg` xd`zd`r prkl`ssfkmig d`gp`rs' scd isdìgzd cir` prk|fj`rs' xdk niv prk|fj` sppkrz jrfmh ckmsgzizfkms' ckgj b`ckmsfj`r`j `ll`czf|` skrc`s kl skcfig sppkrz- Zd`s` r`gizfkmsdfps ir` cdiricz`rfs`jbv m`yig pkx`r r`gizfkms' xfzd sppkrz b`fmh mfjfr`czfkmiggv prk|fj`j bv zd`prkl`ssfkmig d`gp`r zk zd` cgf`mz imj mkz |fs` |`rsi $Br`fmbi`r , Nijjig`mk' 2??0&-

Fmz`r|`mfmh xfzdfm zd` hrkp svsz`n

Xdfg` fmz`r|`mzfkms xfzdfm hrkp svsz`ns cim b` dìgzd `mdimcfmh fm imj klzd`ns`g|`s lkr zd` fmjf|fjig pirzfcfpimz' zdrkhd prk|fjfmh skcfig sppkrz imjskcfig g`|`rih` is j`scrfb`j iz zd` fmz`rp`rskmig g`|`g' zd` lkcs km hrkp svsz`nsfmz`r|`mzfkms fm zdfs cdipz`r fs zk prk|fj` n`zdkjs lkr szr`mhzd`mfmh nkr` fnn`jfiz`cknnmfzv g`|`g fmlg`mc`s' is x`gg is nkr` jfszig skcf`zig g`|`g prkz`czf|` fmlg`mc`s-Szr`mhzd`mfmh hrkp prkc`ss`s' zk prknkz` fmjf|fjig imj cknnmfzv skcfig cipfzig'cim bfgj r`sfgf`mc` zdrkhd szr`mhzd`mfmh zd` r`skrc`s km xdfcd i p`rskm cimjrix fm zd`fr fnn`jfiz` skcfig `m|frkmn`mz- Fms`rzfmh crfzfcig ckmscfksm`ss zd`krvfmzk hrkp prkc`ss`s prk|fj`s i n`cdimfsn lkr licfgfzizfmh nkr` jfszig prkz`czf|`fmlg`mc`s iz i szrczrig imj cgzrig+skcfig mkrnizf|` g`|`g-

Szr`mhzd`mfmh skcfig cipfzig

Jrixfmh km skcfig cipfzig zd`krv' szr`mhzd`mfmh imj `tpimjfmh p`kpg`s skcfigm`zxkres cim b` dìgzd `mdimcfmh- Fmz`r|`mzfkms ifn`j iz fmcrìsfmh skcfig sppkrzxfzdfm hrkp svsz`ns fmcgj` szr`mhzd`mfmh `tfszfmh m`zxkres zdrkhd `mdimcfmhsefggs kl n`nb`rs zk prk|fj` sppkrz zk km` imkzd`r- Zd`v cim igsk fmcgj` crìzfmhm`x skcfig m`zxkres' lkr `tinpg`' s`gl.d`gp hrkps scd is Igckdkgfcs Imkmvnks'xfzd s`gl.d`gp hrkps di|fmh b``m lkmj zk b` pirzfcgirgv `ll`czf|` fm issfszfmhp`kpg` xfzd n`mzig dìgzd prkbg`ns $Dìm`v , Fsri`g' 9668&-

Cknnmfzv j`|`gkpn`mz zd`krv' xdfcd fs i cknnkm n`zdkj lkr prknkzfmhcknnmfzv g`|`g cdimh`' lkcs`s km fmcrìsfmh cknnmfzv skcfig cipfzig- N`nb`rs


51/234

_RKNKZFMH N@MZIG D@IGZD FM [email protected]@SKPRC@ CKMZ@TZS

:?

kl cknnmfzv hrkps' xdfcd ckgj b` bkmj`j bv gkcigfzv kr i cknnkm fss`'ir` d`gp`j zk fmcrìs` zd`fr ckgg`czf|` cipicfzv zk fj`mzflv cknnkm prkbg`ns' s`zhkigs' j`|`gkp szriz`hf`s imj nkbfgfs` imj nimih` r`skrc`s zk icdf`|` zd`fr hkigs$Nfmeg`r , Xigg`rsz`fm' 9668&- C`mzrig zk cknnmfzv j`|`gkpn`mz ir` j`nkcricvimj `npkx`rn`mz iz hrissrkkzs g`|`g- Zdrkhd j`nkcrizfc pirzfcfpizfkm fm nzigsppkrz hrkps' s`gl.d`gp hrkps kr iczfkm.krf`mz`j hrkps' pirzfcfpimzs niv hifmm`x sefggs' skcfig sppkrz imj i s`ms` kl ckmzrkg k|`r zd`fr gf|`s imj `m|frkmn`mz-Zd` ckmc`pz kl `npkx`rn`mz fs c`mzrig zk cknnmfzv j`|`gkpn`mz zd`krv imj fsmj`rszkkj zk b` im `mibgfmh prkc`ss xd`r`bv fmjf|fjigs imj cknnmfzf`s issn`ckmzrkg kl zd`fr gf|`s imj zd`fr `m|frkmn`mzs- Fmjf|fjig `npkx`rn`mz kccrsxd`m p`kpg` j`|`gkp i s`ms` kl ckmzrkg k|`r zd`fr gf|`s imj zd`fr `m|frkmn`mzs' imjpkgfzfcig `npkx`rn`mz fs mj`rszkkj zk `n`rh` xd`m p`kpg` b`hfm zk di|` icc`sszk imj ckmzrkg kl r`skrc`s $Rippipkrz' 9640&-

Xdfg` zd`r` fs im `npdisfs km cipicfzv j`|`gkpn`mz' xfzd zd` dkp` zdiz zd` b`m`lfzsiccrfmh zk zd` pirzfcfpimzs xkgj sprìj zdrkhdkz zd` cknnmfzv imj b`vkmj'zd` cknnmfzv j`|`gkpn`mz ipprkicd jk`s mkz ijjr`ss brkij`r szrczrig fss`szdiz nifmzifm mj`rj`|`gkpn`mz fm scirc`.r`skrc` ckmz`tzs' zd`r`bv pr`s`r|fmh zd`szizs yk- Mkzxfzdszimjfmh zdfs crfzfcfsn' zd` cknnmfzv j`|`gkpn`mz ipprkicdfs s`lg fm GNFCs' xd`r` zd`r` fs mj`rj`|`gkpn`mz' is fz ifns iz bfgjfmh zd`cipicfzv kl gkcig r`skrc`s' kl bkzd i niz`rfig imj dnim mizr`-

Zd` skcfig iczfkm nkj`g $Igfmsev' 9689&' igsk i cknnmfzv krhimfsizfkm nkj`gcknnkmgv s`j zk licfgfziz` cdimh`' s`s zd` sin` cknnmfzv krhimfsfmh prfmcfpg`s

bz ifns zk ijjr`ss zd` m``j lkr cdimh`s iz i szrczrig g`|`g- Fz dis im iczf|fsz ih`mjiimj ijkpzs pìc`lg ckmlgfcz n`zdkjs kl cdimh` scd is bkvckzzs imj j`nkmszrizfkmszk lkrc` cdimh` iz i szrczrig g`|`g-

@npkx`rn`mz xfzdfm zd` cknnmfzv j`|`gkpn`mz imj skcfig iczfkm nkj`gs fsmj`rszkkj zk `n`rh` is i r`sgz kl brfmhfmh p`kpg` zkh`zd`r fm skcfig m`zxkres'xdfcd licfgfziz`s skcfig sppkrz imj sefggs icyfsfzfkm' is x`gg is prk|fjfmh pkx`rfm mnb`rs zk `ll`cz cdimh`- Fm bkzd zd`s` nkj`gs' zd`r` fs h`m`riggv im `tz`rmiglicfgfzizkr kr iczf|fsz d`gpfmh zd` cknnmfzv- Fm zdfs s`ms`' zd`s` nkj`gs di|`b``m gib`gg`j m``js.bis`j $Nfmeg`r , Xigg`rsz`fm' 9668&- Zd` mj`rszimjfmh kl

`npkx`rn`mz xfzdfm zd`s` nkj`gs igsk jk`s mkz ij`yiz`gv zd`krfs` zd` fmjf|fjigskcf`zig fmz`rlic` fm zd` `npkx`rn`mz prkc`ss5 zk jk sk j`nimjs' rizd`r' i crfzfcigmj`rszimjfmh kl zd` ckmc`pz kl npkx`rn`mz fm xdfcd zd` j`|`gkpn`mz kl crfzfcigckmscfksm`ss fs c`mzrig-

Crfzfcig ckmscfksm`ss rifsfmh

Fm krj`r zk `msr` i zrimslkrnizf|` ih`mji' xdfcd fs licfgfzizf|` kl nkr` prkz`czf|`jfszig' dfhd`r krj`r fmlg`mc`s scd is cgzrig imj szrczrig cdimh`' dìgzdprknkzfkm fmz`r|`mzfkms m``j zk dirm`ss zd` skcfig bkmjfmh zdiz kccrs xfzdfmm`zxkres imj hrkps zk prknkz` zd` prkc`ss kl ckmscf`mzfsizfkm' is shh`sz`j bvCinpb`gg imj Nic_difg $2??2&- Zdfs fs `sp`cfiggv fnpkrzimz fm hrkps zdiz di|`b``m zrijfzfkmiggv jfsij|imzih`j fm xivs zdiz cknprknfs` zd`fr dìgzd- Zd` prkc`ss


52/234


:9

kl ckmscf`mzfsizfkm `mibg`s hrkp n`nb`rs zk `t`rcfs` ih`mcv fm r`gizfkm zk zd`fr`tfszfmh skcfig kr cgzrig ckmc`rms $_iz`g' 2??0&-

Zdfs crfzfcig ipprkicd zk `npkx`rn`mz cim b` zric`j bice zk _igk Lr`fr`s $9663&

ijgz `jcizfkm n`zdkjs' xd`r`bv snigg hrkps kl pirzfcfpimzs r`lg`cz km zd` rkkzskcfig cis`s kl prkbg`ns zdiz zd`v `tp`rf`mc`- Zxk prkc`ss`s ir` fm|kg|`j- Zd`lfrsz fs zd` j`|`gkpn`mz kl i crfzfcig ckmscfksm`ss- Zdrkhd crfzfciggv imigvsfmhzd`fr prkbg`ns' hrkp n`nb`rs ir` ibg` zk j`|`gkp i crfzfcig ckmscfksm`ss- Zdfs fsi lkrn kl psvcdkgkhfcig imj fmz`gg`czig `npkx`rn`mz' xd`r`bv n`nb`rs b`ckn`fm|`sz`j fm zd` akfmz prkjczfkm kl nìmfmh zdiz cim s`r|` is i lkrn kl fj`kgkhfcigcrfzfy` imj i cizigvsz lkr skcfig zrimslkrnizfkm- Zd` s`ckmj prkc`ss fs zdiz kl skcfigiczfkm' is ij|kciz`j bv skcfig iczfkm zd`krv- Icckrjfmh zk Lr`fr` $9663&' zdrkhd zd`j`|`gkpn`mz kl i ckgg`czf|` crfzfcig ckmscfksm`ss' hrkp n`nb`rs ir` nkr` gfe`gvzk b` ibg` zk ckgg`czf|`gv `mhih` fm iczfkms zk cdigg`mh` zd` niz`rfig bis`s kl fgg.dìgzd iz cknnmfzv imj szrczrig g`|`gs- Zdfs fs i lkrn kl pkgfzfcig `npkx`rn`mzimj fs r`giz`j zk i prkc`ss kl nkbfgfsizfkm zk cdigg`mh` i d`h`nkmfc skcfig krj`r'xdfcd p`rp`ziz`s skcfig fmaszfc`s km i pirzfcgir spd`r` xfzdfm i skcf`zv- Zd`pksfzf|` fnpicz kl zdfs ipprkicd fs `|fj`mz xd`m zd`r` fs sllfcf`mz skcfig iczfkm imjnkbfgfsizfkm bv hrkpfmhs zk `ll`cz dìgzd `mdimcfmh cdimh`s xfzdfm zd` fnn`jfiz`cknnmfzv ckmz`tz' is x`gg is cdimh`s iz i szrczrig kr pkgfcv g`|`g-

R`m`hkzfizfmh skcfig mkrns1 zd` pkpgir kpfmfkm gìj`r ipprkicd imj zd`

jfllsfkm kl fmmk|izfkm

Zd` j`|`gkpn`mz kl i crfzfcig ckmscfksm`ss zkh`zd`r xfzd crfzfcig skcfig jfigkh`fm hrkps fs igsk c`mzrig zk zd` r`m`hkzfizfkm kl ckgg`czf|` skcfig fj`mzfzf`s imjisskcfiz`j skcfig imj cgzrig r`pr`s`mzizfkms imj priczfc`s zkxirjs nkr` dìgzd`mdimcfmh igz`rmizf|`s $Cinpb`gg , Nrriv' 2??:&-

Xd`m `tfszfmh skcfig imj cgzrig r`pr`s`mzizfkms ir` mk gkmh`r ijipzf|` zk zd`cdimhfmh skcfig ckmz`tz lkr tinpg`' di|fmh ngzfpg` s`tig pirzm`rs fm zd` ckmz`tzkl DF\+IFJS zd` j`|`gkpn`mz kl nkr` dìgzd `mdimcfmh skcfig r`pr`s`mzizfkmsimj priczfc`s b`ckn`s im fnpkrzimz dìgzd prknkzfkm iczf|fzv-

Xdfg` nimv b`gf`ls imj priczfc`s krfhfmiz` lrkn zd` brkij`r skcfk.cgzrig nfgf`'i cdimh` fm skcfig r`pr`s`mzizfkms imj priczfc`s fs gkciz`j fm jfigkhfcig spic`sillkrj`j bv skcfig hrkps- Fz fs fm zd`s` efmjs kl skcfig hrkpfmhs zdiz skcfig imjcgzrig r`pr`s`mzizfkms ir` r`nkgj`j imj j`|`gkp`j jrfmh zd` ckrs` kl hrkpfmz`riczfkms- Kpfmfkm.lkrnfmh fmz`rgkczkrs' xdk r`fmz`rpr`z n`jfi imj kzd`rn`ssih`s lkr zd` b`m`lfz kl sbkrjfmiz` hrkp n`nb`rs' klz`m gìj zdfs prkc`ss-

Dìgzd prknkzfkm fmz`r|`mzfkms cim dirm`ss zd`s` prkc`ss`s zk cdigg`mh` `tfszfmhskcfig mkrns imj n`jfiz` zd` r`m`hkzfizfkm kl skcfig r`pr`s`mzizfkms imj priczfc`szkxirjs dìgzd `mdimcfmh kpzfkms- Zd` pkpgir kpfmfkm gìj`r ipprkicd dis b``m

sdkxm zk b` scc`sslg fm r`m`hkzfizfmh s`tig skcfig mkrns zkxirjs nkr` dìgzd`mdimcfmh igz`rmizf|`s xfzdfm zd` ckmz`tz kl zd` DF\+IFJS `pfj`nfc xfzdfm hivcknnmfzf`s fm zd` Pmfz`j Sziz`s $E`ggv `z ig-' 9668&- Nkr` r`c`mzgv' fz fs b`fmh


53/234


:2

zfgfs`j fm i rimjknfs`j ckmzrkg zrfig icrkss lf|` GNFCs $Fmjfi' Cdfmi' _`r' Rssfiimj Qfnbibx`& $MFND Ckggibkrizf|` DF\+SZJ _r`|`mzfkm Zrfig Hrkp' 2??8&- Zd`pkpgir kpfmfkm gìj`r ipprkicd s`s `zdmkhripdfc z`cdmfy`s zk fj`mzflv kpfmfkmgìj`rs xdk ir` bkzd pkpgir imj skcfiggv fmlg`mzfig n`nb`rs kl i zirh`z hrkp$E`ggv' 2??:& imj xdk cim s`r|` is kpfmfkm.lkrnfmh fmz`rgkczkrs- Zd`s` fmjf|fjigsir` zrifm`j zk `mjkrs` imj prknkz` dìgzd `mdimcfmh b`di|fkrig mkrns jrfmh`|`rvjiv ckm|`rsizfkms' xdfcd ir` zd`m jflls`j zdrkhd zd` pkpgizfkm zdrkhd zd`prkc`ss kl jfllsfkm kl fmmk|izfkm $Rkh`rs' 9660&-

Jfllsfkm kl fmmk|izfkm zd`krv fs i x`gg emkxm cknnmfzv g`|`g zd`krv' ckmc`rm`jxfzd dkx m`x fjìs imj priczfc`s ir` kba`czflf`j imj sprìj xfzdfm imj b`zx``mcknnmfzf`s $Rkh`rs' 9660&- Kpfmfkm gìj`rs ir` zdkhdz zk pgiv i |`rv fnpkrzimzrkg` is zr`mjs`zz`rs' lfrsz fmlg`mcfmh irgv ijkpz`rs nksz kp`m zk m`x fmmk|izfkms- Icdimh` fm skcfig imj cgzrig mkrns kccrs xd`m zd`r` fs i zfppfmh' xfzd zd` niakrfzvkl zd` pkpgizfkm ijkpzfmh zd` m`x iczfkms' izzfzj`s imj |f`xs $Rkh`rs' 9660&-

`tinpg` kl i hrkp svsz`n fmz`r|`mzfkm1 xdizs fm zd` min`;

prkszfzz` kr s`t xkre`r zd` skmihicdf prka`cz' cigczzi' fmjfi

Zd` Skmihicdf _rka`cz' bis`j fm Cigczzi' Fmjfi' dis b``m isskcfiz`j xfzd gkx`r DF\ riz`s

inkmh s`t xkre`rs is cknpir`j zk kzd`r rbim c`mzr`s fm Fmjfi $Aimi `z ig- ' 2??:&- I

sfhmflfcimz isp`cz kl zd` prkhrinn` fm|kg|`j zd` r`lrinfmh kl zd` fj`mzfzv kl zd` zirh`z

hrkp lrkn prkszfzz` zk s`t xkre`r- Zdrkhd zd` r`m`hkzfizfkm kl i nkr` `npkx`rfmh

fj`mzfzv' i jfsckrs` kl cknn`rc` hrijiggv sppgimz`j i jfsckrs` kl fnnkrigfzv imjcrfn`- Zrijfzfkmiggv' zd` fj`mzfzv kl prkszfzz`s nìmz zdiz xkn`m x`r` pkx`rg`ss fm

fmz`riczfkms xfzd |irfks `ckmknfc szie`dkgj`rs $`-h- gimjkxm`rs' nijins' lft`j cgf`mzs'

gkcig krhimfs`j crfn`' pkgfc` imj pkgfzfcig pirzf`s&- Zd`v x`r` szfhnizfs`j is b`fmh zd`

skrc` kl DF\ fml`czfkm fm zd` cknnmfzv imj zd` iccknpimvfmh r`spkmsfbfgfzv kl rfse

nimih`n`mz xis gkciz`j xfzd zd`n-

_kpgir kpfmfkm gìj`rs b`him iczf|`gv zk xkre zk r`sdip` zd` fj`mzfzv kl zd` s`t xkre`r

imj DF\+IFJS- Is im fnpkrzimz sz`p fm zd` prkc`ss' fmlg`mzfig kpfmfkm.lkrnfmh

fmz`rgkczkrs skhdz zk r`j`lfm` s`t xkre is `npgkvn`mz- Zdfs fm|kg|`j zd` irzfcgizfkm

kl zd` lkggkxfmh s`zs kl rfhdzs1 s`t xkre fs xkre' s`t xkre`rs di|` zd` rfhdz zk spìe kz'

s`t xkre`rs imj zd`fr cdfgjr`m j`s`r|` im `jcizfkm' s`t xkre`rs j`s`r|` hkkj dìgzd' s`txkre`rs cim di|` lr``jkn kl nk|`n`mz' imj s`t xkre`rs j`s`r|` lglfgn`mz fm i s`tig

r`gizfkmsdfp- Zd` r`lg`czf|` spic`s lkr s`t xkre`rs zk r`.pksfzfkm zd`ns`g|`s is b`fmh

nkr` fm ckmzrkg kl zd`fr gf|`s kccrr`j fm fmz`riczfkms xfzd p``rs' imj kzd`r fnpkrzimz

cknnmfzv szie`dkgj`rs-

Ihifmsz i bicejrkp kl jfs`mlrimcdfs`n`mz fm brkij`r Fmjfim skcf`zv' zd` pksfzf|`

`tp`rf`mc`s kl s`t xkre`rs xfzdfm zd` prkhrinn` iggkx`j zd`n zk lfmj zd`fr |kfc` imj

`mhih` fm iczfkm zk cdigg`mh` zrijfzfkmig cgzrig mj`rszimjfmhs kl zd` prkbg`n kl DF\ fm

zd` cknnmfzv-

Is zd` prkhrinn` `|kg|`j' zd` irzfcgizfkm kl zd` `npkx`r`j fj`mzfzf`s kl s`t xkre`rs

xis jflls`j zk zd` cknnmfzv' r`sgzfmh fm fmcrìs`j icc`pzimc` kl ckmjkn sig`s fm zd`

cknnmfzv' is x`gg is zd` zrij` mfkmfsizfkm kl s`t xkre`rs $Aimi `z ig-' 2??:&-


54/234


:3

Zd` Skmihicdf _rka`cz fm Fmjfi $s`` bkt @tinpg` kl i hrkp svsz`n fmz`r|`mzfkm&prk|fj`s i hkkj `tinpg` kl dkx zd` r`m`hkzfizfkm bv pkpgir kpfmfkm gìj`rs klskcfig fj`mzfzf`s imj mkrns kl s`t xkre`rs fm Fmjfi g`j zk nkr` dìgzd `mdimcfmhb`di|fkr lkr bkzd s`t xkre`rs imj zd`fr cgf`mzs-

Fmz`r|`mfmh xfzdfm zd` pkgfcv svsz`n

Xdfg` hrkp svsz`ns fmz`r|`mzfkms cim gzfniz`gv gìj zk pkgfcv cdimh` zdrkhdcknnmfzv krhimfsizfkm imj ij|kcicv $is jfscss`j fm zd` pr`|fks s`czfkm&'pkgfcv cdimh` cim igsk b` fmfzfiz`j lrkn xfzdfm hk|`rmn`mz szrczr`s imj hgkbigfmszfzzfkms- Zd` lkrn`r fs r`l`rr`j zk is zd` kzsfj`.fmfzfizf|` nkj`g imj zd` gizz`ris zd` fmsfj`.fmfzfizf|` nkj`g $Birzdkgkn`x `z ig-' 2??9&- Ij|kcicv xkre szfgg lkrnspirz kl zd` pkgfcv cdimh` prkc`ss' bz kccrs zdrkhd dìgzd ij|kciz`s lkrnfmh

r`gizfkmsdfps xfzd pkgfcv.nie`rs imj prk|fjfmh zfn`gv imj iccriz` fmlkrnizfkm kmdìgzd fss`s-

G`hfzfnicv' lìsfbfgfzv imj sppkrz ir` igg fnpkrzimz liczkrs fmlg`mcfmh dkx ncdizz`mzfkm fs pifj zk i pkgfcv fss` $Digg `z ig-' 9680&- G`hfzfnicv r`l`rs zk xd`zd`rzd`r` xkgj b` pbgfc icc`pzimc` kl sziz` fmz`r|`mzfkms km im fss`- Fss`s zdiz di|` ibrkij skcfig fnpicz imj gkmh.z`rn fnpgfcizfkms ir` gfe`gv zk di|` hrìz`r g`hfzfnicv$Birzdkgkn`x `z ig-' 2??9&- Lìsfbfgfzv r`l`rs zk dkx pkssfbg` fz fs zk fnpg`n`mz zd`pkgfcv xfzdfm r`skrc` imj fmlriszrczr` ckmszrifmzs- Sppkrz r`l`rs zk zd` g`|`g klpbgfc sppkrz lkr zd` pkgfcv-

Zd` zfnfmh lkr pgicfmh fss`s km g`hfsgizf|` imj fmszfzzfkmig ih`mjis fs igsk crcfig-Kppkrzmfzf`s lkr pkgfcv cdimh` kccr xd`m zd`r` fs d`fhdz`m`j ixir`m`ss kl ipirzfcgir prkbg`n $Br`fmbi`r , Nijjig`mk' 2??0&- Lrzd`r' zd` ibfgfzv kl krhimfs`jij|kcicv hrkps zk crìz` fmcrìs`j ixir`m`ss kl im fss` fs pirzfcgirgv `ll`czf|ìz zfn`s kl `g`czfkms' pirzv pkgfcv lkrngizfkms imj cdimh`s fm ijnfmfszrizfkm'`sp`cfiggv xd`m mizfkmig nkkj r`hirjfmh hk|`rmn`mzs dimjgfmh kl im fss` fs pkkr-Lrzd`r' zd` inkmz kl pkx`r imj g`hfzfnicv zdiz zd` ij|kcicv hrkp kr fmjf|fjigdis xfgg fmlg`mc` dkx x`gg pkgfcv cdimh`s cim b` icdf`|`j $Birzdkgkn`x `z ig-'2??9&- @ll`czf|` s` kl cknnmfcizfkm szriz`hf`s imj n`jfi bv ij|kcicv hrkps fs

igsk c`mzrig5 lkr `tinpg`' sdkrz ij|kcicv sziz`n`mzs imj licz sd``zs ir` s`lg' is ir`lic` zk lic` imj hrkp n``zfmhs xfzd pkgfcv.nie`rs imj pkgfzfcig gìj`rs $Br`fmbi`r, Nijjig`mk' 2??0&-

Iz zd` fmz`rmizfkmig g`|`g' hgkbig pkgfcf`s fm r`gizfkm zk e`v dìgzd fss`s ill`czfmh|gm`ribg` pkpgizfkms gfe` xkn`m imj cdfgjr`m cim b` pirz kl i hgkbig pkgfcv imjij|kcicv pgim zdiz s`zs cgìr imj zfn`.bkmj zirh`zs lkr icdf`|fmh j`|`gkpn`mzkba`czf|`s' scd is fm zd` Nfgg`mmfn J`|`gkpn`mz Hkig :' xdfcd lkcs`s kmfnprk|fmh cdfgj sr|f|ig' xfzd zd` sp`cflfc zirh`z kl r`jcfmh bv zxk.zdfrjs zd`nkrzigfzv riz` inkmhsz cdfgjr`m mj`r 0 vìrs bv 2?90 $PMFC@L' 2??8& $s`` bkt @tinpg` kl hgkbig pbgfc pkgfcv fmz`r|`mzfkm&- Fm zdfs fmszimc`' zd` PM n`nb`rsziz`s zdiz ijkpz`j zd` Nfgg`mmfn J`cgirizfkm r`lg`cz`j zd`fr cknnfzn`mz zkij|imcfmh zdfs nksz pr`ssfmh j`|`gkpn`mz fss`-


55/234


::

`tinpg` kl hgkbig pbgfc pkgfcv fmz`r|`mzfkm1 |fzinfm i

sppg`n`mzizfkm i mfc`l hgkbig fmfzfizf|`

Igg cdfgjr`m di|` zd` rfhdz zk ij`yiz` mzrfzfkm lkr i dìgzdv gfl`- Pmlkrzmiz`gv' zdfslmjin`mzig rfhdz fs klz`m k|`rgkke`j b`cis` zd` ckms`y`mc`s kl pkkr mzrfzfkm niv

mkz b` fnn`jfiz`gv ippir`mz- \fzinfm I j`lfcf`mcv fs km` scd ckms`y`mc` kl pkkr

mzrfzfkm $Bìzkm `z ig-' 9663&- Ipprktfniz`gv 928 nfggfkm pr`scdkkg cdfgjr`m' `sp`cfiggv

fm Skzd Isfi imj sb.Sidirim Ilrfci' ir` ill`cz`j bv im mj`rgvfmh |fzinfm I j`lfcf`mcv'

pzzfmh zd`n iz hrìz`r rfse kl fggm`ss imj iz im `jcizfkmig jfsij|imzih` $PMFC@L'

2??8&- @ll`czf|` imj fm`tp`msf|` nìms zk lfhdz zdfs dfjj`m dmh`r di|` `tfsz`j lkr vìrs'

imj zd` fmz`rmizfkmig cknnmfzv dis nij` ngzfpg` cknnfzn`mzs zk fzs `gfnfmizfkm-

Icckrjfmh zk PMFC@L $2??8&' asz zxk dfhd.pkz`mcv sppg`n`mzs immiggv' ckszfmh g`ss

zdim PS*?-?: p`r cdfgj' cim pr`|`mz imj ckrr`cz zd` j`lfcf`mcv' imj ckmzrfbz` zk cdfgj

sr|f|ig- Icdf`|fmh imj nifmzifmfmh dfhd ck|`rih` kl |fzinfm I sppg`n`mzizfkm fscrcfig zk izzifmfmh Nfgg`mmfn J`|`gkpn`mz Hkig :1 r`jc` bv zxk.zdfrjs zd` nkrzigfzv

riz` inkmh cdfgjr`m mj`r 0 vìrs bv 2?90- PMFC@L dis pgiv`j i gìjfmh rkg` fm zd`

`llkrz zk rìcd igg cdfgjr`m b`zx``m zd` ih`s kl < nkmzds imj 06 nkmzds xfzd gfl`.si|fmh

sppg`n`mzs `|`rv :< nkmzds- Zdfs fmcgj`s z`cdmfcig issfszimc` zk ckmzrf`s' nkmfzkrfmh

fmz`r|`mzfkm ck|`rih` iz zd` mizfkmig imj hgkbig g`|`gs imj sppgvfmh mìrgv 9?? p`rc`mz

sppg`n`mzs zk ckmzrf`s zdrkhd im fm.efmj jkmizfkm lrkn zd` Hk|`rmn`mz kl Cimiji

imj Zd` Nfcrkmzrf`mz Fmfzfizf| - PMFC@L $2??8& fmjfciz`s zdiz `llkrzs zk `msr`

cdfgjr`m r`c`f|` zd` r`cknn`mj`j zxk immig sppg`n`mzs di|` fmcrìs`j jrinizfciggv-

Fm 9666' asz 9< p`r c`mz kl cdfgjr`m fm zd` 9?3 prfkrfzv ckmzrf`s x`r` lggv prkz`cz`j

xfzd zd` r`cknn`mj`j zxk jks`s- Bv 2??:' zdfs prkpkrzfkm dij cgfnb`j zk 04p`rc`mz'r`pr`s`mzfmh i zdr``lkgj fmcrìs`- Scc`ss`s ir` prfnirfgv zd` r`sgz kl ckmzrf`s

`szibgfsdfmh j`jfciz`j n`cdimfsns lkr |fzinfm I sppg`n`mzizfkm' klz`m xfzd kzd`r e`v

cdfgj sr|f|ig fmz`r|`mzfkms-

Ckmcgsfkm

Psfmh zd` |irfks `ckgkhfcig g`|`gs kl fmlg`mc` fj`mzflf`j fm Cdipz`r 9 kl zdfs|kgn`' x` di|` prk|fj`j im k|`r|f`x kl skn` kl zd` cknnkm dìgzd prknkzfkmzd`krf`s lkr mj`rszimjfmh rfse imj prkz`czf|` fmlg`mc`s lkr n`mzig imj b`di|fkrigdìgzd- Lrkn zdfs ckgkhfcig svsz`nfc mj`rszimjfmh kl fmlg`mc`s' x` di|` fj`mzflf`jimj jfscss`j lkr pkfmzs kl fmz`r|`mzfkm1 xfzdfm zd` fmzrip`rskmig svsz`n zkszr`mhzd`m zd` iss`zs i p`rskm brfmhs zk bìr km i sfzizfkm5 xfzdfm zd` nfcrksvsz`n$fmz`rp`rskmig g`|`g fmz`r|`mzfkms& zk szr`mhzd`m zd` prkz`czf|` fmlg`mc`s klr`gizfkmsdfps xfzd sfhmflfcimz kzd`rs5 hrkp svsz`ns fmz`r|`mzfkms xdfcd' lrkn xfzdfmi cknp`z`mcv.`mdimc`n`mz ipprkicd' di|` i zxk.prkmh`j `ll`cz kl prknkzfmhcdimh` iz i prktfnig cknnmfzv g`|`g' is x`gg is iz nkr` jfszig skcfk.cgzrig imjszrczrig g`|`gs5 imj pkgfcv g`|`g fmz`r|`mzfkms zk icdf`|` hgkbig imj mizfkmig nicrk

imj nfcrk pkgfcv cdimh` zkxirjs dìgzd `mdimcfmh igz`rmizf|`s-I lmjin`mzig prfmcfpg` kl zd` `ckgkhfcig svsz`ns ipprkicd fs zdiz zd`r` fs ir`cfprkcig r`gizfkmsdfp b`zx``m ih`mzs xfzdfm imv svsz`n imj icrkss svsz`ns- Zds'


56/234


:0

imv fmz`r|`mzfkm ifn`j iz prknkzfmh i nkr` dìgzd `mdimcfmh kzckn` sdkgjfjìggv ckmsfj`r i ngzfsvsz`ns fmz`r|`mzfkm' xdfcd nk|`s b`vkmj szr`mhzd`mfmhkmgv fmzrip`rskmig' fmz`rp`rskmig kr cknnmfzv fmlg`mc`s zk fmcgj` ipprkicd`szdiz mhih` xfzd licfgfzizfmh dìgzd `mdimcfmh fj`mzfzf`s imj skcfk.cgzrig' szrczrigimj pkgfcv fss`s ill`czfmh nirhfmigfs`j hrkps- Zdfs fs pirzfcgirgv fnpkrzimz fmGNFCs' xdfcd di|` i dfszkrv kl pk|`rzv' fm`yigfzv imj skcfig fmaszfc`s imj xd`r`zd` niz`rfigfzv kl `tfsz`mc` pgivs im fnpkrzimz rkg` fm zd` `pfj`nfkgkhv kl n`mzigdìgzd prkbg`ns-

R`l`r`mc`s

Ifrdfd`mbxi' C-K-' , Kbr`hkm' R- $2???&- I crfzfcig iss`ssn`mz kl zd`krf`s+nkj`gs s`j fm

dìgzd cknnmfcizfkm lkr DF\+IFJS-Akrmig kl Dìgzd Cknnmfcizfkm' 0' 090-

Iaq`m' F- $9669&- Zd` zd`krv kl pgimm`j b`di|fkr- Krhimfqizfkmig B`di|fkrig imj DnimJ`cfsfkm _rkc`ss s' 0?' 986299-

Igfmsev' S-J- $9689&- Rg`s lkr rijfcigs- M`x Vkre1 \fmzih` Bkkes-

Bigjxfm' I-G-' Bigjxfm' C-' , Ckg`' R-@- $966?&- Szr`ss.r`sfszimz linfgf`s imj szr`ss.r`sfszimz

cdfgjr`m- Fm A- Rkgl-' I- Nisz`m' J- Cfccd`zzf' E- M`cdz`rg`fm , S- X`fmzrib $@js&- Rfse

imj prkz`czf|` liczkrs fm zd` j`|`gkpn`mz kl psvcdkpizdkgkhv $pp- 20824?&- Cinbrfjh`1

Cinbrfjh` Pmf|`rsfzv _r`ss-

Bimjri' I- $964


57/234


:

promoting mental health in scarce-resource contexts: emerging evidence and practice

Documents