Abstract

In complex settings, women’s depression cannot be divorced from the wider structural violence of their everyday lives, which is marked by poverty and precariousness. Current debates argue for interventions supporting women’s depression that are relevant to local social welfare needs, though this is often overshadowed by efforts to scale up access to biomedical care. Such efforts often fall short of the structural change needed to tackle broader social determinants of women’s depression. Whose responsibility is it to address social determinants of mental distress in complex social settings? Can primary care settings become sites to promote collective mobilisation to tackle social determinants of mental health?

This talk will present findings from an ethnographic evaluation of brief interventions for depression among HIV -positive women delivered in primary care settings in South Africa, modified to promote collective responses to poverty. 58 individuals participated in focus groups, life history interviews and family interviews between April and August 2016. Findings highlight the long-term impact on women and families and the promotion of microcosms of ‘social change’, vis a vis supporting step-wise increases in empowerment and their ability to exercise agency in response to social determinants of mental health. Implications for future interventions will be discussed.