This is part of a series in which we share reports from Harvard students who have traveled to South Asia with support from a SAI grant.
By Angela Leocata, Harvard College ’18
Angela interned at Sangath in Goa, India over the summer to research community-based intervention for maternal depression
Angela, third from right, with her research team
As an SAI grant recipient, I had the opportunity to return to Goa, India to continue research I began the previous summer with Sangath, an NGO and mental health research institution. Awarded the MacArthur Foundation’s International Prize in 2008 and a pioneer of task-sharing for mental healthcare to primary care and community workers, Sangath is one of the most influential health non-profit organizations, globally. The organization is co-founded by Vikram Patel, a world-renowned research psychiatrist, Professor of International Mental Health and Trust Senior Research Fellow at the London School of Hygiene and Tropical Medicine, and 2015 recipient of Time Magazine’s “The Most Influential 100 People in the World.”
As a returning intern, I analyzed the data gathered as a product of the sub-study I helped to develop last summer. The study evaluates the impact and experience of an intervention wherein mothers are trained as peer-counselors to support other mothers with postpartum depression. While programs too frequently view women’s health as reproductive health and mental health as a Western experience, mental illness was the leading cause of global years lived with disability in both low- and high-income countries in 2004, and women share a disproportionate burden of suffering. Around the world, women predominate in rates of common mental disorders, such as depression and anxiety. This disproportion can be better understood through the social, economic, and political context in which gender and mental health disparities arise, as well as the forces that prevent access to care. The findings of this study will have powerful implications for increasing availability and access to mental healthcare for women, globally.
Unlike last summer, in which I focused mostly on the impact of the program on the mothers, this summer I began to consider its impact on the peer counselors. By supporting the counseling team, I was able to reflect on how the intervention may not only have an impact on the mothers with postpartum depression – whom the intervention is delivered to – but the delivery agents themselves. Given that the peer counselors are also mothers, and that the intervention asks them to process and share their own experiences of motherhood, I became interested in whether they, too, are affected by the intervention. This inquiry has accumulated into my thesis question, which will be integrated into the larger study. In considering the community health worker experience, I will consider a group of people central to the dissemination of mental health programs, but rarely considered in mental health literature. I view this inquiry as significant not only for this specific intervention, but for the dissemination of mental health interventions, globally.
Returning to Goa and continuing with my research from last summer shook what I thought I understood of task-sharing and global mental health. The continuation of work with the same community enabled me to consider new inquiries and ask questions I hadn’t previously imagined. By shifting now to the community health worker experience, I am able to engage with a local issue that has global implications and ask questions applicable to an ongoing practice. I intend to continue with combined coursework in Medical Anthropology, Clinical Psychology, and Global Health and Health Policy to develop my understanding of both maternal mental health and community health worker experience before continuing with fieldwork this January. I am eager to return to Goa to delve further into new questions in a context I hold a deep commitment to, and contribute to a field I consider to be both a personal passion and global need.