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Date of Award

Spring 5-15-2021

Author's School

Graduate School of Arts and Sciences

Author's Department

Social Work

Degree Name

Doctor of Philosophy (PhD)

Degree Type

Dissertation

Abstract

Mental health is a severely neglected field in low- and middle-income countries globally. Populations in countries such as Haiti demonstrate a high level of need for mental health services despite a lack of services and trained professionals. In addition to the dearth of biomedical services, local belief systems and explanatory models lead a majority of the population to rely on traditional medicine as their first option for care. The goal of this dissertation is to characterize mental health beliefs, practices, and services in northern Haiti by examining the relationship between traditional beliefs and mental illness, assessing the impact of traumatic events on mental and physical health, and identifying predictors of mental health outcomes. Using a mixed-methods approach, this dissertation utilized in-depth interviews, focus group discussions, as well as anxiety, depression, and functionality scales to assess the status of mental health care in early 21st century northern Haiti. Study findings indicate that mental illness is strongly impacted by traumatic events experienced in the context of society-scale crises, which have a significant effect on physical and mental health. Ongoing socio-political crises in particular result in high levels of violence and disorder which affect population- and individual-level mental health. Culturally-competent, evidence-based mental health services, such as those offered at Sant Sante Mantal Mòn Pele (SSMMP) represent a unique opportunity for treatment for those suffering from mental illness in this region. However, the vast majority of patients requiring mental health care first seek treatment from traditional healers such as Vodou priests, whose approach within the Vodou cosmology differs significantly from the biomedical model. Vodou priests use a variety of means to treat patients suffering from mental illness including prayer, leaves for teas and baths, as well as combinations of perfumes, rum, human remains and other powdered concoctions. Additionally, until structural factors that result in entrenched poverty, violence, and political and social chaos can be addressed, already high levels of trauma, and poor physical and mental health, will likely continue to rise. Future research could focus on how to build and expand biomedical mental health services that are culturally-adapted to local explanatory models, and find ways to sustainably collaborate with traditional healers that avoid conflict.

Language

English (en)

Chair and Committee

Lora Iannotti

Committee Members

Jean-Francois Trani, Patricia Kohl, Rebecca Lester, Carolyn Lesorogol,

Available for download on Sunday, May 15, 2022

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