Decoloniality, participation and mental health: a personal journey

My work is aimed at presenting an innovative and practical multilevel conceptual model on mental health services in contexts characterized by severe and continuous trauma, such as the ones of Gaza Strip and Niger, West Africa. The case of the ongoing crisis, social suffering, and human rights violations in the Gaza Strip, and how the socio-ecological model can be adapted to answer the specific needs of the population will be analysed and discussed. Namely, we highlight the interconnectedness of the three levels in order to prepare and empower the population through participatory and advocacy-oriented interventions. Other examples from diverse war and trauma affected populations (e.g. Refugees, IDPs and returnees in Niger) are provided. Niger is a West African country with a population of 20 million (United Nation, 2016) and the highest total fertility rate in the world (close to 7 children per woman). As a result, almost 70% of population is under the age of 25 years. International organizations have estimated that since 2000 approximately 100,000 migrants have passed through Niger each year, with a peak of 330,000 migrants in 2015. Thus, Niger has become a hub, both for West African migrants on their way to Libya, Algeria and Europe and for returning migrants travelling from Libya and Algeria to their countries of origin. Consequently, the European Union has begun to concentrate its efforts to manage Europe-bound migration in the Sahel and Sahara areas themselves. I conclude that the proposed public health approach to mental health fits with the social ecological model in locating individuals and families within the context of their community, society, religious and cultural domains, as well as socio-economic and political systems. Therefore, the emblematic case of the Gaza Community Mental Health Programme (GCMHP) work in Gaza, and COOPI Niger in Diffa and Agadez, and their attempt to flexibly address the needs of populations living in chronic political and humanitarian uncertainty is analysed in depth in my work. We stress how in the context of ongoing political and military violence, traditional and standard psychological interventions could not be effective enough in addressing the needs of the affected population. In fact, they risk underestimating community resources, pathologizing, and victimizing people living under occupation and/or chronic threat. On the other hand, participative and focused on human rights promotion programs are able to increase access to services, promote agency and community resilience as well as individual and family abilities of coping.