{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T17:53:34Z","timestamp":1759514014790},"reference-count":78,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>People-centred mental healthcare is an influential concept for health system strengthening and sustainable development that has been developed and promoted primarily in Western contexts. It characterizes service users, families and communities as active participants in health system development. However, we have limited understanding of how well people-centred mental healthcare aligns with the multiplicity of peoples, cultures, languages and contexts in low- and middle-income countries (LMICs). Timor-Leste, a lower-middle income country in South-East Asia, is in the process of strengthening its National Mental Health Strategy 2018\u201322 to align with people-centred mental healthcare. To support the implementation of this Strategy, this study investigated the acceptability and feasibility of people-centred mental health services in Timor-Leste. In-depth semi-structured individual (n\u2009=\u200957) and group interviews (n\u2009=\u200915 groups) were conducted with 85 adults (\u226518\u2009years). Participants were service users, families, decision-makers, service providers and members of civil society and multilateral organizations across national and sub-national sites. Government and non-government mental health and social care was also observed. Framework analysis was used to analyse interview transcripts and observation notes. The study found that the ecology of mental healthcare in Timor-Leste is family-centred and that government mental health services are largely biomedically oriented. It identified the following major challenges for people-centred mental health services in Timor-Leste: different sociocultural perceptions of (in)dividual personhood, including a diminished status of people with mental illness; challenges in negotiating individual and family needs; a reliance on and demand for biomedical interventions; and barriers to health service access and availability. Opportunities for people-centred mental healthcare are better available within the social and disability sectors, which focus on social inclusion, human rights and peer support. Accounting for local cultural knowledge and understandings will strengthen design and implementation of people-centred mental healthcare in LMIC settings.<\/jats:p>","DOI":"10.1093\/heapol\/czz108","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T11:37:53Z","timestamp":1567769873000},"page":"ii93-ii103","source":"Crossref","is-referenced-by-count":15,"title":["Are people-centred mental health services acceptable and feasible in Timor-Leste? A qualitative study"],"prefix":"10.1093","volume":"34","author":[{"given":"Teresa","family":"Hall","sequence":"first","affiliation":[{"name":"Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, 333 Exhibition Street, Melbourne, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritsuko","family":"Kakuma","sequence":"additional","affiliation":[{"name":"Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK"},{"name":"Global and Cultural Mental Health Unit, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, Victoria, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Palmer","sequence":"additional","affiliation":[{"name":"School of Geography, University of Melbourne, Level 1 221 Bouverie St, Carlton, Victoria, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Martins","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Av. Cidade de Lisboa, Dili, Timor-Leste"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Minas","sequence":"additional","affiliation":[{"name":"Global and Cultural Mental Health Unit, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, Victoria, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Kermode","sequence":"additional","affiliation":[{"name":"Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, 333 Exhibition Street, Melbourne, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"2019111316295221000_czz108-B1","author":"Abimbola","year":"2019"},{"key":"2019111316295221000_czz108-B2","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/med\/9780199691319.003.0008","volume-title":"Recovery of People with Mental Illness: Philosophical and Related Perspectives","author":"Adeponle","year":"2012"},{"key":"2019111316295221000_czz108-B3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1037\/h0095655","article-title":"Recovery from mental illness: the guiding vision of the mental health system in the 1990s","volume":"16","author":"Anthony","year":"1993","journal-title":"Psychosocial Rehabilitation Journal"},{"key":"2019111316295221000_czz108-B4","doi-asserted-by":"crossref","first-page":"532.","DOI":"10.1186\/s12913-016-1740-8","article-title":"Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study","volume":"16","author":"Athie","year":"2016","journal-title":"BMC Health Services Research"},{"key":"2019111316295221000_czz108-B5","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1186\/s12913-018-3161-3","article-title":"The effects of integrated care: a systematic review of UK and international evidence","volume":"18","author":"Baxter","year":"2018","journal-title":"BMC Health Services Research"},{"key":"2019111316295221000_czz108-B6","first-page":"889","article-title":"The re-covering self: a critique of the recovery-based approach in India\u2019s mental health care","volume":"3","author":"Bayetti","year":"2016","journal-title":"Disability and the Global South"},{"key":"2019111316295221000_czz108-B7","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1192\/bjp.bp.113.128314","article-title":"Evaluating the feasibility of complex interventions in mental health services: standardised measure and reporting guidelines","volume":"204","author":"Bird","year":"2014","journal-title":"British Journal of Psychiatry"},{"key":"2019111316295221000_czz108-B8","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1017\/S0010417516000311","article-title":"Transformations of the sacred in east Timor","volume":"58","author":"Bovensiepen","year":"2016","journal-title":"Comparative Studies in Society and History"},{"key":"2019111316295221000_czz108-B9","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.amepre.2009.02.002","article-title":"How we design feasibility studies","volume":"36","author":"Bowen","year":"2009","journal-title":"American Journal of Preventive Medicine"},{"key":"2019111316295221000_czz108-B10","doi-asserted-by":"crossref","first-page":"184","DOI":"10.2471\/BLT.10.082784","article-title":"The mental health workforce gap in low- and middle-income countries: a needs-based approach","volume":"89","author":"Bruckner","year":"2011","journal-title":"Bulletin of the World Health Organization"},{"key":"2019111316295221000_czz108-B11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s10459-010-9242-7","article-title":"Doctor-patient communication in a Southeast Asian setting: the conflict between ideal and reality","volume":"16","author":"Claramita","year":"2011","journal-title":"Advances in Health Sciences Education"},{"key":"2019111316295221000_czz108-B12","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/aman.12532","article-title":"A new reflexivity: why anthropology matters in contemporary health research and practice, and how to make it matter more","volume":"118","author":"Closser","year":"2016","journal-title":"American Anthropologist"},{"key":"2019111316295221000_czz108-B13","first-page":"123","article-title":"Legal frameworks for and against people with psychosocial disability","volume":"52","author":"Davar","year":"2012","journal-title":"Economic & Political Weekly"},{"key":"2019111316295221000_czz108-B14","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s10597-010-9321-5","article-title":"Can consumer-led mental health services be equally effective? 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