Social Representations of Mental Health among Leaders of a Community Organization in Medellín (Colombia)

Abstract

Objective: The following article presents the views and perspectives that leaders of community organizations in the city of Medellin have on mental health. Although the issue of mental health impacts various areas of human life and development, it has traditionally been studied through an individualistic and often pathological lens, focusing mainly on internal psychological processes. In this framework, the biomedical approach—with its medicalizing, institutional and socially detached methods—     has been the predominant and hegemonic model, which consequently      tends to underestimate and distance itself from the community’s own production of knowledge and wisdom. Based on the previous discussion about different conceptions of mental health, the main purpose of the present study was to comprehend the perspectives and actions of community leaders in the city of Medellin. This was achieved through the recognition of social representations that individuals have built on the subject, going beyond the prevailing institutional      and academic discourse. Additionally, the study aims to shed light on the ways in which leading community actors organize and manage mental health within their territories, evaluating their strategies and discourses in relation to their socio-historical context.

Method: Community-     based research on the subject of mental health requires strategies and approaches that broaden the quantitative focus centered only on the biological and inner psychological aspects, and instead delve in the exploration of feelings and senses in communities, as well as in their practices or ways of dealing with situations that generate emotional and psychological distress. The phenomenological approach and ethnographic strategies of qualitative research were considered the most appropriate for this research. The previously mentioned approach was operationalized through the conducting      of focus groups and the use of interactive and participatory tools such as group discussions, the collective creation of posters and other collaborative e      knowledge-building activities. The data collection process was carried out through a focus group with 15 leaders from the Picacho Confuturo Corporation, who have experience in social participation, environmentalism, feminism, and social development. Participatory tools such as discussions, posters, and collective knowledge-building exercises were used. The information collected has been subjected to a      hermeneutic analysis of intertextual content. Through      summarization and cross-analysis, it was possible to identify codes and categories that emerged for the formulation of the results. 

Results: The gathered information allowed for the establishment of      five main social representations about mental health. First, i     dealistic and theoretical social representations, which are based in academic and scientific terminology, coming from the leaders'      own academic background and their interactions with the institutionalized world.      Second     , individualistic social representations of self-care and balance emerge, in which mental health is understood as a process of self-regulation based on emotion control and personal well-being. This perspective can lead to an excessive sense of individual responsibility, without taking into account the structural factors that also affect mental health. Subsequently,      collective or interaction-based social representations appear, in which the role of the community and relationships networks plays a major part in the construction of mental well-being. In      this perspective mental health is understood as a relational process, grounded in accompaniment and mutual support within the community. Finally, dignity-based and political rights-oriented social representations emerge, in which mental health is assumed as a fundamental right linked to human dignity and social justice. The representations emphasize the need for structural conditions that guarantee access to mental health as a collective good. Moreover     , a final category appears: critical and negotiation-based social representations. In this view, community leaders adopt a skeptical stance or one of      rejection      towards the concept of mental health itself, arguing that it has been used by the state, academia, and the private sector as a tool for social control and the categorization of individuals.

Conclusions: The research revealed various ways of understanding and managing mental health from the perspective of local leaders, taking into account their social representations. These approaches range from academic and biomedical-centered views to more collective and politically grounded      ones that emphasize social interaction, the defense of human rights and transformation of living conditions. A critical stance also emerged, questioning the validity and use of the concept of mental health itself. In this sense, the complexity and diversity of the social representation networks surrounding mental health in the social and community context becomes evident. The findings reflect the complexity of the existing social representations of mental health in community contexts. The tension between individual and collective discourse is evident, as well as the contrast between institutional and critical postures regarding the conceptualization of mental health. These social representations can be understood as coping strategies in the absence of governmental presence and resources in these areas. Moreover, these discourses are influenced by the well-being market and the self-management of community care. Additionally, it is observed that the definition of mental health is strongly shaped by historical and sociopolitical processes, highlighting the need for an integrated and contextual approach. The results suggest that academic and health institutions should broaden their approach to incorporate community knowledge in the development of public mental health policies. Furthermore, the research contributes to redefining the concept of mental health from a participatory and decolonized perspective, emphasizing the importance of bridging      academic knowledge and      community wisdom. It is suggested that intervention strategies be developed that consider the diverse social representations of mental health, promoting the recognition of self-managed practices and encouraging active community participation in shaping their own well-being. This entails a shift in the models used to address and intervene in mental health, moving forward from pathological and individualistic approaches toward community-centered, interconnected and social justice-based frameworks.