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

 

Reviewer: Ruslan Kurmashev, MD

Completed: 2026-06-01 16:14

 

Recommendation: Accept

 

 

	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:

 

I thank the author for the careful and substantive revision of the manuscript. The revised version addresses the main concerns raised in the previous review. In particular, the addition of the «Reflective Practitioner Case Study Methodology» section significantly improves the methodological positioning of the paper. The manuscript now more clearly explains that it is a reflective practitioner case study rather than a formal qualitative study, clarifies the rationale for selecting the four cases, identifies the sources of reflection, and acknowledges the limitations arising from the author’s dual role as programme contributor and analyst.

The newly added synthesis table is also useful. It makes the relationship between the four cases and the proposed model of system-embedded pedagogy more explicit by mapping each case against its setting, target group, workforce, pedagogical mechanism, sources of reflection, competencies fostered, and key limitation. This improves the transparency and readability of the argument.

The abstract, methodology, and conclusion are now more consistent with the article’s stated conceptual and practice-informed design. The revised manuscript also states its limitations more clearly, including the absence of systematic outcome data and the need to treat the cases as practice-informed illustrations rather than empirical proof of effectiveness. Overall, the manuscript is better organised, more academically framed, and more consistent with its stated article type.

I have only minor remaining suggestions before final approval. A few formulations still slightly overstate the evidentiary status of the argument and should be softened during final copyediting. For example, phrases such as «This is an empirical one», «empirical foundation», «demonstrated», and «the approaches described here did function» may still imply a stronger empirical basis than the reflective case-study design can support. These could be replaced with more cautious wording such as «practice-derived observation», «practice-informed foundation» or «appeared to be sustained in practice».

There are also several minor editorial issues that should be corrected before final publication, including typographical or wording problems such as «principes», «pre-service ad in-service», «Norther curricula» and the reference to «DCPU and helpline cases» where the helpline is not one of the four cases discussed in the manuscript. These issues do not affect the overall scholarly value of the manuscript but should be corrected to improve final readability and accuracy.

These remaining points are minor and do not affect the overall acceptability of the revised manuscript. The author has addressed the substantive methodological and conceptual concerns raised in the previous review. I therefore recommend acceptance, subject to final copyediting and minor cautious wording adjustments.