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Table 9 Community achievements (mezzo level)a

From: A qualitative exploration of a family self-help mental health program in El Salvador

Subgroup Comments
User I have a relaxed life in my neighborhood. People greet me. I feel good in the street
Before, I was in the house because neighbors could not stand me. But now we talk. They even encourage me to keep making hammocks
I know now how to avoid neighbors to avoid problems when I go out
I get along with everybody, I’m proud and share it with church friends, that I can leave the house on my own to go to art therapy and go out looking for work
I have a friend now in my neighborhood. It’s easier to talk to people
Some people say I’ve changed dramatically
Family caregiver Now I’m not afraid that my son is not going to return when he goes out
We’re better understood by others in the community
I have more insight now. I can talk with whoever about mental health
I am more empathetic with other in the community, especially families with disabled persons
The program has helped improve dialogue, knowing how to listen, to respect the opinions of others
It’s helped to create a shield I can use to discern when someone wants to help or not
The program has helped us to confront the community on mental health. We’re able to overcome stigma to be able to talk with others. We don’t feel attacked but empowered to relate to others, to create greater understanding about human rights
Professional When we enter dangerous neighborhoods like “Italia,” [the gangs] don’t bother us because they respect our work
Psychiatrist: After working with this program, I would like to work at the community level and not in the psychiatric hospital
  1. Participants reflected on benefits experienced at the level of their community or neighborhood. Users feel they are treated as normal people now, not trapped inside their homes. They know how to manage situations and are able to make friends. Neighbors are sounding boards who affirm how users have changed or improved. Caregivers are not afraid when their loved ones go out, they feel understood by others in the community, are empathetic with others who have disabled family members, have improved ability to listen to others, can create a shield of protection against those who would be destructive towards them, and are able to overcome community stigma to be able to talk with others. They feel empowered to relate to others in order to create greater understanding about human rights. Professionals said they can often enter dangerous neighborhoods because their work is appreciated. One now wants to work now at the level of community services (rather than in a clinic or hospital)
  2. a Community is broadly defined here, referring to achievements in the neighborhood, but also other communities of support such as church communities