“Head take you”: Causal attributions of mental illness in Jamaica

Abstract

Causal attributions are a key factor in explanatory models of illness; however, little research on causal attributions of mental illness has been conducted in developing nations in the Caribbean, including Jamaica. Explanatory models of mental illness may be important in understanding illness experience and be a crucial factor in mental health service seeking and utilization. We explored causal attributions of mental illness in Jamaica by conducting 20 focus groups, including 16 community samples, 2 patient samples, and 2 samples of caregivers of patients, with a total of 159 participants. The 5 most commonly endorsed causal attributions of mental illness are discussed: (a) drug-related causes, including ganja (marijuana); (b) biological causes, such as chemical imbalance, familial transmission, and "blood"; (c) psychological causes, including stress and thinking too much; (d) social causes, such as relationship problems and job loss; and (e) spiritual or religious causes, including Obeah.

“It's That Route That Makes Us Sick”: Exploring Lay Beliefs About Causes of Post-traumatic Stress Disorder Among Sub-saharan African Asylum Seekers in Germany

“…Moreover, causal beliefs influence treatment-seeking and health care utilization ( 35 , 38 ). Disparities in mental health care for asylum seekers and refugees have been observed ( 38 , 42 ), and have been attributed to a large extent to clinicians' deficits in knowledge and lack of cultural competence ( 35 , 43 , 44 ). Enhancing knowledge of causal beliefs might therefore be one step toward better mental health care provision for refugees and asylum seekers.…”

Caregivers’ causal attributions of their relatives’ mental illness and the association with stigma

“…According to Ajzen and Fishbein's (1977) theory of reasoned action, understanding the attitude and beliefs that caregivers and individuals have with regard to the cause of a mental illness is important given that this will likely influence their decision to seek out specific health care services for their condition (i.e., help-seeking patterns). Furthermore, aligning patients' causal attributions of their illness with those of the service providers' is important as the level of congruence between patients' and health professionals' explanatory models of illness is likely to affect their engagement rates with mental health services (Arthur & Whitley, 2015; Elkin et al., 1999; Saravanan et al., 2007) and their compliance with treatment (Elliott, Maitoza, & Schwinger, 2011).…”

“…Qualitative and quantitative studies to identify the causal explanations of illness have been predominantly conducted among the public and patient populations and less so among caregivers (e.g., Arthur & Whitley, 2015; Polenick & Martire, 2013; Yang et al., 2015). Clarke and Couchman (2012), for instance, found caregivers of youths with psychosis frequently endorsed biological and substance use factors as well as psychological and stress-related factors, whereas Esterberg and Compton (2006) found family members of African Americans hospitalized with schizophrenia primarily endorsed biological causes (e.g., disturbance of brain chemistry, heredity, drug or alcohol abuse, brain infection).…”

“…Beliefs about the causes of mental illness have been found to be influenced by various socio-demographic characteristics including educational qualifications, age, ethnicity and culture (Adewuya & Makanjuola, 2008; Arthur & Whitley, 2015; Bignall, Jacquez, & Vaughn, 2015; Caplan et al., 2011). Higher education has generally been associated with a higher endorsement of biological and psychosocial causes (Adewuya & Makanjuola, 2008; Caplan et al., 2011; Saravanan et al., 2007), while older age has been linked to a greater tendency to endorse supernatural factors (Adewuya & Makanjuola, 2008).…”

“…Stigma associated with mental illness not only leads to discrimination and rejection but also presents a potential problem for rehabilitation and reintegration of people with mental illness back into society (Charles, Manoranjitham, & Jacob, 2007). While some studies have shown biological models to increase tolerance (i.e., less stigma) towards those with mental illness by reducing ascriptions of responsibility and blame towards the person (e.g., Phelan & Link, 2004), others have found biological causes to contribute to perceptions of unpredictability and dangerousness which in turn results in stronger rejection of those with mental illness (Angermeyer, Holzinger, Carta, & Schomerus, 2011; Arthur & Whitley, 2015; Pescosolido et al., 2010; Read & Law, 1999; Walker & Read, 2002). Whereas the aforementioned studies have mainly focused on public stigma (i.e., public opinions of individuals with mental illness), stigma experienced by family caregivers of individuals with mental illness has received less attention.…”