From negotiation to accommodation: Cultural relevance in the Asha Gram Mental Health Program, Barwani district, India

"This thesis analyzes the degree of cultural relevance in the Asha Gram Mental Health Program in Barwani, India. The focus is on the role of community mental health workers as bridges between a professional culture of psychiatry and the local cultural understandings of mental health. Processes of cultural interaction are analyzed on a continuum from negotiation, defined as interaction without fundamental cultural change, to accommodation, defined as interaction with cultural change. Accommodation at the level of the vision of mental health disorders was limited while there was an active negotiation that resulted in some transformation of the social vision. Negotiation with communities at the level of relationships underpinned this transformation and contributed to a social accommodation with local forms of relationships. Although, professional and class power were important obstacles to achieving cultural relevance, the Program also demonstrates the necessity to subvert this power in order to create social change."