Cultural brokers in mental health care in Sri Lanka’s North

Abstract

This article engages in an anthropological analysis of brokerage to investigate the role of community support officers (CSOs) and mental health clinicians working on implementing post conflict reconstruction and reconciliation projects in Jaffna, in the North of Sri Lanka. I propose that CSOs and mental health clinicians become cultural brokers in health care by operating beyond the universal clinical assumptions associated with mental illness and distress, navigating the space and interrelationship between community-based local voices, national health priorities and the translocal agendas of the global mental health framework. The CSOs and mental health clinicians’ scope of authority, the complexity of their social and cultural activities along with their agentive capacity in representing marginalised voices enables them to facilitate, be responsible for and actively influence the process of intermediation and translation; in other words, they engage in brokerage. This article provides insights into the socio-cultural matrix of mental distress and suffering in post-conflict affected communities in the North of Sri Lanka and builds on brokerage theory to recognise evolving social and political landscapes in translocal mental health diagnosis and treatment.