Review: Learning Inside the System: What Community-Based MHPSS Practice in Pakistan Teaches Us About Global Mental Health {under peer review}

 

Reviewer: Mavile Karaieva

Completed: 01-05-2026 15:14

 

Recommendation: Revisions Required

 

 

	Yes	No	N/A
Is the research question clearly defined?	+
Are the methods appropriate and sufficiently detailed?		+
Is the data analysis robust and replicable?		+
Are the conclusions supported by the results?	+
Is the manuscript well organised and clearly written?	+
Are tables, figures, and supplementary material informative and necessary?			+
Is the abstract an accurate summary of the study?	+
Does the manuscript contribute meaningfully to the field?	+
Is it relevant to the field of mental health or related disciplines that are connected to the scope of the Journal?	+
Are ethical approvals and participant consents adequately described?			+
Have competing interests, funding, and data availability been transparently declared?	+

 

Comments for the authors:

 

This manuscript addresses an important issue in global mental health training, particularly the gap between competency frameworks and the realities of practice in low-resource settings. The paper is well written, logically structured, and grounded in substantial field experience. The concept of “system-embedded pedagogy” is clearly presented and offers a useful way to think about how professional learning can develop within real service systems.

A key strength of the paper is the use of concrete programme examples. The four cases provide a clear and convincing picture of how experiential learning, peer-led approaches, and reflective supervision operate in practice. The argument remains consistent throughout, and the overall narrative is easy to follow.

At the same time, several points need clarification.

First, the paper would benefit from a clearer methodological framing. It is described as a reflective practitioner case study, but the process by which the cases were selected and analysed is not explained. A brief clarification of how the insights were developed would strengthen the credibility of the argument.

Second, the link between the individual cases and the proposed framework could be made more explicit. At the moment, the framework is introduced in the synthesis section, but it is not always clear how each case contributes to specific elements of it. Making this connection more direct would improve the practical usefulness of the paper.

Third, some of the claims in the discussion, particularly those related to implications for academic institutions, are quite broad. These points would be stronger if they were more directly tied to the examples presented or supported with additional references.

There are also several specific language and style issues that should be addressed.

For example, some sentences are overly long and contain multiple ideas, which makes them difficult to follow. The sentence “What is far less documented is what happens when the practitioner never leaves, when they are simultaneously the system builder, the supervisor, the trainer, and the learner…” could be split into two shorter sentences to improve clarity.

There are also minor grammatical errors. In the sentence “The gap in this literature, and its is a significant one…”, “its” should be corrected to “it’s”.

In several places, similar ideas are repeated within the same paragraph (for example, repeated emphasis on concepts such as “not supplementary” or “not peripheral”), which slightly reduces precision. These sections could be streamlined.

Additionally, the tone occasionally becomes more conversational than expected for an academic article. Phrases such as “This section makes no apology for being prescriptive” or “This paper is written for you” could be revised to a more neutral academic style.

Overall, this is a strong and valuable contribution, especially in bringing practitioner experience from LMIC contexts into the discussion on global mental health training. With clearer methodological positioning, a more explicit connection between the cases and the proposed framework, and careful language editing, the manuscript would be significantly strengthened.

I would be interested in reviewing a revised version once these points have been addressed.