The Interplay Between Need and Response: An ethnographic multi-stakeholder response analysis to mental distress in post-disaster urban Nepal (360G-Wellcome-203343_Z_16_Z)

‘Mental health disaster’ humanitarian efforts and resources are largely being spent on addressing post-traumatic stress disorder (PTSD) despite the lack of agreement on the public health validity and utility of the diagnosis. The usefulness of these efforts and investments is widely debated. Less amount of work has looked at the nature of the relationship between mental health care need(s) and response(s) in these settings. Focusing on post-disaster urban Nepal, this project explores how different stakeholders understand the mental health needs of the population, how they are responding to these and what is the interplay between the need(s) and response(s). The main research question is: How do mental health ‘need(s)’ and ‘response(s)’ shape and re-shape each other? The clinical/healing, humanitarian and family/community contexts will be studied ethnographically during 12 months of fieldwork in Lalitpur (Nepal). Qualitative methods of investigation will be used, including semi-structured interviews, focus groups, case studies and free-listing. The key goals are to 1) elucidate points of convergence and divergence in conceptualizations of mental distress amongst different stakeholders 2) to inform policy and provide suggestions for service delivery that could lead to more meaningful outcomes 3) help avoid inappropriate, wasteful and/or harmful ways of addressing ‘mental distress’.