Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau

Keys, Hunter M.; Kaiser, Bonnie N.; Kohrt, Brandon A.; Khoury, Nayla M.; Brewster, Aimée Rika T.

doi:10.1016/j.socscimed.2012.03.040

Cited by 108 publications

(114 citation statements)

References 44 publications

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“…Based on the team’s prior qualitative research in Haiti’s Central Plateau during June-August 2010 (Kaiser et al, 2013; Kaiser et al, 2014; Keys et al, 2012; Khoury et al, 2012) and an extensive literature search, provisional training modules were developed by the study team, which included a Haitian clinical psychologist and a U.S. based cultural psychiatrist with experience in multiple LMICs. Modules drew upon mental health training manuals developed by mhGAP and Tiyatien Health 3 for CHWs in India and Liberia (Gibson et al, 2010; WHO, 2010).…”

Section: Resultsmentioning

confidence: 99%

“…The present project is part of mixed methods research examining perceptions, experiences, care seeking and supports available for persons with mental illness in Haiti’s Central Plateau (Hagaman et al, 2013; Kaiser, Kohrt, Keys, Khoury, & Brewster, 2013; Kaiser et al, 2014; Keys et al, 2012; Khoury et al, 2012; Wagenaar, Hagaman, Kaiser, McLean, & Kohrt, 2012; Wagenaar et al, 2013). …”

Section: Methodsmentioning

confidence: 99%

“…Throughout the process, the study team used the terms tris (sadness), kè pa kontan (unhappy heart) and strès (stress) to refer to mild to moderate emotional distress because these local terms were more salient than psychiatric diagnostic terminology (Kaiser et al, 2014; Keys et al, 2012). After a more specific idiom of distress that captured psychological distress was identified, maladi kalkilasyon (thinking/calculating sickness) (Kaiser et al, 2014), this term was added.…”

Section: Methodsmentioning

confidence: 99%

“…The WHO launched the mental health Gap Action Programme (mhGAP) in order to address systematic mental health needs in LMICs, including an intervention guide for general healthcare workers (WHO, 2010). In LMIC settings, such as Haiti, community based healthcare personnel may be ideal for task sharing initiatives as they are more likely to understand (lay) explanatory models and to be able to utilise local idioms of distress (Keys, Kaiser, Kohrt, Khoury, & Brewster, 2012; Kaiser et al, 2014). However, important questions remain regarding the best approach to train non specialist healthcare workers to provide mental health services.…”

Section: Introductionmentioning

confidence: 99%

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Task sharing in rural Haiti

McLean¹,

Kaiser²,

Hagaman

et al. 2015

Intervention

Self Cite

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Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees’ perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery, and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased confidence regarding utilising skills, and career advancement. Qualitative findings support the added value of apprenticeship according to trainees.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Task sharing in rural Haiti

McLean¹,

Kaiser²,

Hagaman

et al. 2015

Intervention

Self Cite

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“…60 For example, pedi bon sans li (losing one's good senses) often signifies psychosis, while ke`sere (heartbreak) suggests anxiety, and maladi tonbe`(falling sickness) can refer to possible seizure. 61 Spiritual, religious, familial, and community outlets can be protective, but stigma, discrimination, and mistreatment can result: people suffering from mental illness can be ostracized, beaten, tied up, or locked up. As a result, by the time they arrive at a mental health clinic, their situation is likely to be more urgent.…”

Section: Beliefs and Values Related To Mental And Neurologic Illnessmentioning

confidence: 99%

Child and Adolescent Mental Health in Haiti

Legha

Solages

2015

Child and Adolescent Psychiatric Clinics of North America

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Somatization

Kohrt¹

2014

The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society

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Somatization historically has referred to the physical presentation of psychological distress. Somatization has been an area of interest to anthropologists and cross‐cultural psychiatrists because of prior claims that somatization was more common in non‐Western cultural groups. However, some studies have suggested that somatic differences across cultural groups are overstated. Instead, somatic symptoms are a universal component of depression, present worldwide in both Western and non‐Western communities. One reason for differences across settings in rates of somatization may be variation in local health problems and access to biomedical diagnostic and treatment resources. Despite the number of studies that have addressed this issue when studying patient populations from Western cultures, less attention has been given to the issue of physical pathology presenting as psychiatric pathology in non‐Western samples. More recent cross‐cultural psychiatric approaches have advocated for addressing physical symptom presentation of psychiatric populations within the context of local healthy populations; understanding the influence of the local burden of physiological diseases on somatic presentation of mental illness; documenting how psychological idioms of distress may be linguistically translated as physical complaints; and placing somatic complaints within the context of cultural variation in concepts of mind–body.

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Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau

Cited by 108 publications

References 44 publications

Task sharing in rural Haiti

Task sharing in rural Haiti

Child and Adolescent Mental Health in Haiti

Somatization

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