Context-responsive psychiatry in low-resource settings: A narrative review and evidence synthesis

Mental health systems in low-resource and transitional settings face a persistent mismatch between high clinical need, limited specialist capacity, and the complexity of psychiatric morbidity across the lifespan. This narrative review and evidence synthesis examines context-responsive psychiatry as a practical approach to strengthening care in settings where resources are constrained but psychiatric burden is substantial, including contexts across Africa, Asia, and Southeast Asia. The review integrates evidence across neurodevelopmental disorders, child and adolescent psychiatry, perinatal mental health, psychosis, mood disorders, substance-use disorders, neurocognitive impairment, psychopharmacology, quality improvement, and service delivery. It draws on locally generated clinical evidence from sub-Saharan Africa while positioning these findings alongside international literature relevant to Asian and Thai mental health systems. Across the evidence, several priorities emerge: early identification, culturally appropriate assessment, brief psychosocial interventions, pragmatic pharmacological decision-making, attention to neurocognitive and medical comorbidity, family involvement, workforce development, and system-level quality improvement. The review argues that effective psychiatric care requires clinically rigorous, culturally sensitive, ethically grounded, locally feasible, and system-aware approaches that preserve evidence-based standards while adapting delivery to real-world constraints.