Title: Using collaborative visual research methods to understand experiences of mental illness, coercion and restraint in Ghana and Indonesia
Funder: Economic and Social Research Council

Abstract: There have been many concerns over the human rights of people with mental illness in developing countries, particularly the use of chains, beating, confinement in cages, and other harmful practices by traditional and faith healers. The use of restraints, confinement and other mistreatment is harmful to physical and mental health, can increase stigma and make it difficult for people with mental illness to recover and be included as productive members of society. It has been suggested that partnerships between traditional and faith healers and health workers could help to prevent human rights abuses and enable people with mental illness to get treatment and care. However, it can be challenging to establish such partnerships and bring about change. Healers and health workers use different approaches to mental illness which can conflict, and healers can feel as if their knowledge and experience is not recognised. There can be complex reasons for using chains and other restraints, which are often not well understood. There are also many different types of healers in developing countries who carry out different practices. Health systems also differ between countries and mental health workers operate with very few resources. Therefore, the best ways in which to improve the treatment of people with mental illness and create partnerships between health workers and healers is likely to vary. This project will explore the experiences of people with mental illness and their families in Indonesia and Ghana, the reasons why people with mental illness are restrained and attempts by health workers to create partnerships with healers and stop human rights abuses. We have chosen these countries because there have been similar reports on the mistreatment of people with mental illness by healers and there are attempts by governments, charities and others to prevent human rights abuses and improve treatment. These include changes in the law and training of new mental health workers. In this study we will use documentary film as our research method. This is because film is easily accessible in different languages, and can use images as well as words to gain a deep insight into people's experiences from their own perspective. Film is also more accessible to people who do not have much education and cross-culturally. With the consent of the people involved, we will film the experiences of people with mental illness in Ghana and in Indonesia who have experienced restraint, their families, healers and health workers. We will also document attempts to create partnerships between healers and mental health workers in the two countries. We will conduct interviews with the participants, which will also be filmed if they agree. We will use the footage to create documentary films that will be used to learn more about the social and cultural context that might lead to the use of restraint such as understandings of mental illness, family relationships, distance from mental health services, and the cost of getting treatment. We will also learn more about the best ways to create partnerships between healers and mental health workers to prevent human rights abuses and support people with mental illness to recover and take part in their communities, as well as the challenges they face. We will share the findings of the research between the two countries so that they can learn from each other. We will also show the film to people such as mental health workers, politicians and families so that they can understand more about the experiences of people with mental illness who have been mistreated, the circumstances around the use of chains and other forms of restraint, and the best ways to prevent human rights abuses. We hope that this will lead to improved treatment and protection of people with mental illness in the two countries, and similar developing world settings, and enable them to participate as respected and valued members of their communities.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH