This is an outdated version published on 24-05-2026. Read the most recent version.

Vol. 2 No. 1 (2026)

Conceptual Insigths and Critical Reflections

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

Published 28-04-2026 — Updated on 24-05-2026

  • Sumbal Gilani

Sumbal Gilani
University of Glasgow

Abstract

In this paper, the author argues that the pedagogical innovations called for in the global mental health (GMH) education are not waiting to be designed, in many cases they have already been built, tested against difficult realities, and quietly discarded form the international conversations simply because they weakly emerged from the Global South. Responding to the call by Karadzhov (2025) for the contextualized, collaborative, and future-oriented approaches to GMH competency development, this paper draws on the author's conceptual insights and critical reflections resulting from an extended practitioner experience in Pakistan to propose a model termed system-embedded pedagogy, an approach in which professional formation happens inside live service delivery systems rather that in preparation for them. Four interconnected MHPSS initiatives are examined through an explicit pedagogical lens: the I Support My Friends, peer-support programme for adolescents; sports-based mental health programming; the establishment of community-based protection systems, and district protection units (DCPUs) in Khyber Pakhtunkhwa and the Child Protection Van (CP Van) outreach model. Each case is mapped onto a recognized pedagogical mode, service and experiential learning, reflective supervision, peer-led and collaborative learning, problem-based learning, to demonstrate what these approaches look like when they are operationalized within a functioning, resource-constrained, community-anchored system. The paper argues that GMH academic curricula must move from treating field experience as supplementary to treating it as the spine around which theory is organized; that reflective supervision must be recognized and taught as a core pedagogical technology, not a postgraduate add-on; and that the knowledge generated in LMIC practice systems constitutes a contribution to the global GMH pedagogical evidence base, not a local exception to it.

Keywords

global mental health, pedagogy, experiential learning, MHPSS, Pakistan, competency development, community psychology, decolonial training, peer support, child protection

Full text (HTML) Revision Summary Review 1: Accept Review 2: Accept

References

  1. Alipanga, B., & Kohrt, B. A. (2022). Competency-based pre-service education for clinical psychology training in low- and middle-income countries: Case study of Makerere University in Uganda. Frontiers in Psychology, 13, Article 924683. https://doi.org/10.3389/fpsyg.2022.924683
  2. Barry, M. M., Clarke, A. M., Jenkins, R., & Patel, V. (2013). A systematic review of the effectiveness of mental health promotion interventions for young people in low- and middle-income countries. BMC Public Health, 13(1), 835. https://doi.org/10.1186/1471-2458-13-835
  3. Frank, H. E., Becker-Haimes, E. M., & Kendall, P. C. (2020). Therapist training in evidence-based interventions for mental health: A systematic review of training approaches and outcomes. Clinical Psychology: Science and Practice, 27(3), Article e12330. https://doi.org/10.1111/cpsp.12330
  4. Burgess, A., van Diggele, C., Roberts, C., & Mellis, C. (2020). Peer teacher training in health professions education. BMC Medical Education, 20(Suppl 2), 476. https://doi.org/10.1186/s12909-020-02194-y
  5. Eaton, J. (2019). Rebalancing power in global mental health. International Journal of Mental Health, 48(4), 288–298. https://doi.org/10.1080/00207411.2019.1629264
  6. Falender, C. A., & Shafranske, E. P. (2014). Clinical supervision: The state of the art. Journal of Clinical Psychology, 70(11), 1030–1041. https://doi.org/10.1002/jclp.22124
  7. Freire, P. (2000). Pedagogy of the Oppressed (30th anniversary ed.). Continuum. (Original work published 1970). Retrieved from: https://fsi-ebcao.princeton.edu/sites/g/files/toruqf1411/files/media/freire.pdf
  8. Hansoti, B., Schleiff, M., Akridge, A., & Salmanian, B. (2021). Experiential learning and mentorship in global health leadership programs: Capturing lessons from across the globe. Global Health: Science and Practice, 9(3), 645–657. https://doi.org/10.5334/aogh.3194
  9. Hards, A., Cameron, A., Sullivan, E., & Kornelsen, J. (2022). Actualizing community-academic partnerships in research: A case study on rural perinatal peer support. Research Involvement and Engagement, 8, Article 79. https://doi.org/10.1186/s40900-022-00407-0
  10. Inter-Agency Standing Committee (IASC). (2007). IASC guidelines on mental health and psychosocial support in emergency settings. IASC. https://interagencystandingcommittee.org/iasc-task-force-mental-health-and-psychosocial-support-emergency-settings/iasc-guidelines-mental-health-and-psychosocial-support-emergency-settings-2007
  11. Karadzhov, D. (2025). Advancing competency development in global mental health: A call for contextualised, collaborative and future-oriented approaches. Mental Health Open. https://doi.org/10.64257/vnybxf92
  12. Karadzhov, D., Lee, J., Hatton, G., White, R. G., Sharp, L., Jalloh, A., & Martin, J. L. (2024). Identifying core global mental health professional competencies: A multi-sectoral perspective. Cambridge Prisms: Global Mental Health, 11, e24. https://doi.org/10.1017/gmh.2024.26
  13. Davies T, Marshall J, van der Merwe N, Yarrow P, Conibear T, Lund C. Implementation outcomes of the waves for change community-based task-shared prevention intervention for adolescent mental health in South Africa. Glob Ment Health (Camb). 2025 Jun 30;12:e77. https://doi.org/10.1017/gmh.2025.10033. PMID: 40765946; PMCID: PMC12322778.
  14. Kohrt, B. A., Asher, L., Bhardwaj, A., Fazel, M., Jordans, M. J., Mutamba, B. B., Nadkarni, A., Pedersen, G. A., Singla, D. R., & Patel, V. (2018). The role of communities in mental health care in low- and middle-income countries: A meta-review of components and competencies. International Journal of Environmental Research and Public Health, 15(6), 1279. https://doi.org/10.3390/ijerph15061279
  15. Kohrt, B. A., Pedersen, G. A., Schafer, A., Carswell, K., Rupp, F., Jordans, M. J. D., West, E., Akellot, J., Collins, P. Y., Contreras, C., & EQUIP Consortium. (2025). Competency-based training and supervision: Development of the WHO-UNICEF Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) initiative. Lancet Psychiatry, 12(1), 67–80. https://doi.org/10.1016/S2215-0366(24)00183-4
  16. Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice-Hall. Retrieved from: https://www.researchgate.net/publication/235701029_Experiential_Learning_Experience_As_The_Source_Of_Learning_And_Development
  17. Eichbaum, Q. G., Adams, L. V., Evert, J., Ho, M. J., Semali, I. A., & van Schalkwyk, S. C. (2021). Decolonizing global health education: Rethinking institutional partnerships and approaches. Academic Medicine, 96(3), 329–335. https://doi.org/10.1097/ACM.0000000000003473
  18. Ruiz, A. I., Reeb, R. N., Turner, T. N., Bringle, R. G., & Clayton, P. H. (2024). Service-learning: An empirically driven and transformational pedagogy to develop psychologically literate citizens for contemporary challenges. Psychology Learning & Teaching, 23(2), 151–171. https://doi.org/10.1177/14757257241248425
  19. Schön, D. A. (1983). The reflective practitioner: How professionals think in action. Basic Books. Retrieved from: https://archive.org/details/reflectivepracti0000scho/page/n5/mode/2up
  20. Locke, J., Violante, S., Pullmann, M. D., Kerns, S. E. U., Jungbluth, N., & Dorsey, S. (2018). Agreement and discrepancy between supervisor and clinician alliance: Associations with clinicians' perceptions of psychological climate and emotional exhaustion. Administration and Policy in Mental Health and Mental Health Services Research, 45(3), 505–517. https://doi.org/10.1007/s10488-017-0841-y
  21. Poulin, J., Matis, S., & Witt, H. (2023). The social work field placement: A competency-based approach (2nd ed.). Springer Publishing. https://doi.org/10.1891/9780826137531
  22. Scala, J. J., Cha, H., Shamardani, K., Rashes, E. R., Acosta-Alvarez, L., & Mediratta, R. P. (2024). Training the next generation of community-engaged physicians: A mixed-methods evaluation of a novel course for medical service learning in the COVID-19 era. BMC Medical Education, 24, Article 426. https://doi.org/10.1186/s12909-024-05372-8
  23. Turan, J. M., Vinikoor, M. J., Su, A. Y., Rangel-Gomez, M., Sweetland, A., Verhey, R., Chibanda, D., & Paulino-Ramírez, R. (2023). Global health reciprocal innovation to address mental health and well-being: Strategies used and lessons learnt. BMJ Global Health, 8(Suppl 7), Article e013572. https://doi.org/10.1136/bmjgh-2023-013572
  24. World Health Organization. (2010). Framework for action on interprofessional education and collaborative practice. WHO. https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-education-collaborative-practice
  25. World Health Organization. (2022). World mental health report: Transforming mental health for all. WHO. https://www.who.int/publications/i/item/9789240049338
  26. World Health Organization. (2024). Mental Health Atlas. WHO. https://www.who.int/publications/i/item/9789240114487

Similar Articles

You may also start an advanced similarity search for this article.