Juxtaposing indigenous evidence-based models in India with concept of Ubuntu: Implications for psychiatric social work practice

Introduction

Ubuntu is an African philosophy emphasizing ‘being human through other people succinctly expressed in the phrase ‘I am because of “who we all are”’. as well as ‘ubuntu ngumuntungabantu’ in the Zulu language. This philosophy emphasizes the collective identity and positive attributes of human behavior, such as shared values of solidarity, respect, human dignity, love, compassion, and consensus (Mugumbate and Chereni, 2020). A similarity exists in the concept of ‘ubuntu’ and ‘Indian philosophy based on principles of “Oneness” and “interconnectedness of human life”’.

The core concepts of’ Indian philosophy is ‘Purushartha’ meaning ‘object of human pursuit’, which has four aims of life as ‘Dharma (righteousness)’. ‘Kama (desire)’, ‘Artha (wealth or prosperity)’ and ‘Moksha (liberations), and represents the oneness and ‘interconnectedness an individual must have with one’s society (Dalal and Misra, 2010; Shamasundar, 1991). ‘Dharma’ is regarded as the central axis around life. When someone tries to move away from Dharma, it usually results in suffering for one self and affects his life in society (Wig, 1999), ‘Karma (Action)’, helps an individual reflect within oneself to find a solution to the existing life challenges through his actions. This concept of karma is associated with ‘samskara’ (values one holds in life) and motivates a person to perform good deeds to others (society) continuously to receive the appropriate fruit of his actions. The above concept of ‘Purushartha’ and its principles of Dharma and Karma help individuals in society to maintain ‘Samskara’ (values) of solidarity, respect, human dignity, compassion, and consensus within society.

In Indian society, the concept of self is often intertwined with that of significant others, depicting belonging, dependency, empathy, and reciprocity of interconnection and oneness. Hence interpersonal relationships are given priority over personal autonomy, space, and privacy (Markus and Kitayama, 1991). Indian psyche is based on intimacy, family security, and stability, rather than the singularity, self-sufficiency, and independence of western self-hood. The lines between ‘me’ and ‘not-me’ tend to blur in these circumstances, and ‘we’ rather than ‘I’ becomes more important to Indians. Indian society mainly encourages social cohesion and interdependence (Avasthi, 2011; Thomas, 1998). Further, lack of individual confidentiality and privacy in turn leading to lack of personal responsibility in decision-making due to families active participation in mental health treatment is often observed (Varma, 1982). In its true sense, the Ubuntu concept of ‘I am because of ‘who we all are’, is a fact in Indian society for all individuals due to the presence of strong family and community connectedness.

The practices of Indigenous sociocultural models are embedded in spiritual solidarity, where individuals assist and support one another in distressful situations. From the Vedic period, such practices direct the individuals toward the enlightenment of gaining spiritual knowledge that has been important in Indian culture. These indigenous sociocultural models based on ancient literature facilitated the legacy provided by ancestors who expressed their knowledge in the form of counseling that was prevalent as a ‘guru-shishya relationship’ (student-teachers relationship) that enlightens fellow human beings (Neki, 1992).

Several western models of social work and psychotherapy have emerged for treating persons with mental disorders; however, they are considered ‘alien’ to the sociocultural milieu of India, where family is an important social agency in the treatment process (Chadda and Deb, 2013; Desai, 2012). The indigenous models based on ancient Indian texts and Epics can act as a curative factor that creates a holistic balance within the individual. The availability of traditional concepts and practices that might promote mental health and well-being may provide culturally acceptable interventions. For example, Counseling techniques consisting of selected anecdotes, concepts, and narratives from the Ramayana for persons with Common Mental Disorders (CMD’s) in India could be culture-sensitive and easily applicable as people living in India would be familiar with Indian literature (Shamasundar, 2008; Surya and Jayaram, 1996). It is thus important to understand the feasibility of developing and implementing indigenous evidence-based models of social work practice that can be acceptable and culture-sensitive. Such models could lay the path to either adapt or develop similar models of social work in other indigenous cultures around the world.

Review of ancient Indian models

The purpose of the Indigenous sociocultural models is not outward but inward practices of spiritual solidarity and interconnection between mind, body, and spirit of individuals. Atharva Veda (ancient Indian scripture) and Yoga models emphasize the interconnection between the mind (Gunas) and the body (Doshas), and the Panchkosha model of consciousness guides individuals to balance and harmony in order to prevent mental illness. These approaches promote insight, regulations of negative emotions, well-being, and coping to enhance treatment adherence in patients with mental health issues. We will first understand some of the ancient Indian models and Indian epics which have formed the basis for some of the indigenous evidence-based interventions in social work practice in India.

Discussion

The development of indigenous models in social work clinical practice is imperative, given the intricate interplay of diverse cultural, normative, and value frameworks embedded in an individual’s psyche. Over recent decades, social work has adapted to dynamic socio-economic, political, religious, and cultural shifts. This evolution signifies a paradigm shift, with a growing acknowledgment of the bio-psychosocial model and the integration of perspectives from diverse backgrounds, including categories such as caste, class, gender, ethnicity, and religion. Culturally nuanced indigenous models serve as instrumental constructs for adeptly navigating adverse emotional states and comprehending the subtle contextual meanings associated with mental health challenges. The contextualization of this indigenous social work model in clinical practice holds the promise of substantially augmenting the well-being and coping mechanisms of individuals facing mental health issues. Recognizing the necessity of incorporating diverse perspectives, including caste, class, gender, ethnicity, and religion, contributes to a holistic approach to mental health support.

Global disparities persist in the prevalence of mental health conditions and access to mental health care, both internationally and nationally in different countries. These variations are deeply rooted in social and cultural determinants, encompassing factors such as socio-economic status, race/ethnicity, and cultural differences, significantly influencing mental health care delivery and outcomes. Researchers worldwide emphasize the need to develop a cultural competency framework to comprehend individuals from diverse backgrounds. Notably, studies underscore the necessity of the Cultural Adaptation Framework to ensure that interventions are culturally relevant, applicable, and feasible within clinical settings (Fendt-Newlin et al., 2020; Fennig, 2021; Rathod et al., 2020). Three pivotal elements address the gaps between mental health services and access: (i) cultural concepts of distress, (ii) treatment components, and (iii) treatment delivery. Consequently, employing a theory-driven approach and innovative experimental designs, research on cultural adaptation possesses the potential not only to enhance the accessibility of psychological treatments for culturally diverse groups but also to contribute to the advancement of empirical research on the fundamental question of the ‘methods and techniques that constituents’ of psychotherapy or counseling (Heim and Kohrt, 2019).

The elucidation of culture-related concepts is enriched through the emphasis on distinct values such as Ubuntu Ubuntu (Mayaka and Truell, 2021), ecological perspective (Coates et al., 2006), religious heritage (Graham et al., 2007), conscientisation (Goldstein, 1986), natural kinship networks (Mathebane and Sekudu, 2018; Sinclair, 2004), racism and privilege (Jones et al., 2018), self-reflection and critical consciousness frameworks (Mathebane and Sekudu, 2018), and spirituality (Mafile’o and Vakalahi, 2018). Consequently, both ‘cultural relevance’ and ‘internationalization’ emerge as imperative considerations in conceptualizing Indigenous social work, contingent upon its rootedness in local sociocultural realities. The various approaches discussed in the article collectively contribute to the conceptual framework of Indigenous social work, emphasizing cultural or local relevance. However, developing culturally based Indigenous social work confronts numerous challenges, particularly within an overarching social work discipline entrenched in Western concepts.

Implementing these interventions encounters challenges in its formative stages, necessitating the establishment of objective parameters for assessing scientific rigor. Evaluating studies purporting to be culturally beneficial requires qualitative and quantitative measures to scrutinize their effectiveness. Paramount among these parameters is the culturally appropriate response to mental health difficulties, encompassing staff training and development, as well as service evaluation methods. This necessitates consideration of social contexts, alternative explanatory models of mental health and ‘illness’, and the determination of interventions deemed beneficial for psychological distress. Henceforth, this study holds the potential to serve as a model for the development of indigenous interventions, contributing to the formulation of approaches at both the national and international levels.

Therefore, it is imperative to integrate the Indigenous development model into social work practices, contributing to both the global and local discourse on diversity in therapeutic approaches. This integration encourages professionals to embrace diverse cultural perspectives, thereby enhancing the effectiveness of counseling practices for individuals with mental health issues. The contextualization of this approach to address their specific cultural needs, utilizing culturally available and knowledgeable sources, presents an opportunity to establish an evidence base for culturally informed interventions. This, in turn, shapes both local practices and the international dialogue on integrating cultural elements into mental health care.

Hence, social workers in clinical practices must assume the role of change agents, developing indigenous, culture sensitive alternative treatments that focus on improving coping mechanisms and well-being among individuals with mental health issues in developing countries. Furthermore, these interventions need testing in larger sample sizes to establish the efficacy of the treatment, paving the way for future development, adaptation, and evaluation of sociocultural interventions for individuals experiencing mental health conditions in low- and middle-income countries.

Conclusion

Ubuntu has similar values and principles relevant to Indian philosophy. It is important to develop indigenous social work models to help reduce stress and anxiety-depression and improve the well-being and quality of life of the person with mental illness.