Evidence map›Paper›PMID 38108834›Full record

ArticleSocial psychiatry and psychiatric epidemiology2024

The politicizing clinic: insights on 'the social' for mental health policy and practice.

Dominique P Béhague, Helen Gonçalves, Suélen Henriques da Cruz, Larissa de Cruz, Bernardo L Horta, Natália P Lima

Open access · hybridAbstract read
In one paragraph

Article in Social psychiatry and psychiatric epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Dominique P BéhagueVanderbilt University, Medicine Health, and Society, Nashville, Tennessee, USA. Dominique.Behague@Vanderbilt.edu.ORCID http://orcid.org/0000-0001-8621-6942
Helen GonçalvesPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.ORCID http://orcid.org/0000-0001-6470-3352
Suélen Henriques da CruzPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Larissa de CruzPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Bernardo L HortaPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.ORCID http://orcid.org/0000-0001-9843-412X
Natália P LimaPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Universidade Federal de Pelotas · BRKing's College - North Carolina · US

Funding

Wellcome Trust
6 · The paper itself

Abstract

purposeIn this paper, we explore how Brazilian socially sensitive therapy can respond to care-users' desire to change the social and political forces shaping their lives. We use this case to demonstrate the limits of the "social determinants of health" agenda which, when operationalized, tends to leave questions of lasting structural change aside.

methodsWe report on mixed methods ethnographic and epidemiological results from the 1982 Pelotas (Brazil) birth cohort study, a prospective study of 5914 children. Ethnographic analysis explored the cyclical relationship between schooling, mental health care, conceptualizations of mental distress, social and political engagement, and experiences with diverse forms of discrimination. Epidemiological bivariate and multivariate analyses examined differences in socio-political participation and the reporting of discrimination at different time-points for participants who used therapy with those who did not. Effect modification analysis tested the hypothesis that the socially empowering effects of therapy were greater for marginalized and minoritized youth.

resultsMost young people living in situations of precarity experienced therapy, particularly when based in schools, to be a blame-inducing process. A more fulfilling and impactful therapeutic experience took shape when young people were able to shift the focus away from symptom reduction and behavioral management toward narrative life analyses, social debate, and political agency. Use of socially sensitive therapy was statistically associated with increased political participation and reporting of discrimination after controlling for confounders. The empowering effects of therapy were greater for those with less formal education and family income, but not for young people who identified as black, brown, or non-white.

conclusionThe findings underscore the importance of considering agency, sociality, and politics when theorizing "the social" in clinical practice, and health and social policy.

Indexed as

Mental DisordersAdolescentChildCohort StudiesHealth PolicyHumansProspective StudiesSchoolsAdolescenceMental health carePolitical therapeuticsPsychiatric reformSocial determinants

Identifiers

PMID38108834
PMCPMC10944422
OpenAlexW4389899767

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.