Mental Health Stigma in the Caribbean: A Review of Cultural and Spiritual Belief Systems

Innovations in clinical psychology with Caribbean peoples.

“…Along with the ubiquitous funding shortages for treatment, which exist worldwide, perhaps the greatest challenge to treatment for mental illness is the misinformation and fear that contributes to stigma and discrimination. Results of recent studies conducted on attitudes toward mental illness in the Caribbean confirm that the negative attitudes persist (Neckles, Alvarez-Jimenez, Martinez, Vernezobre, & Cortina, 2012). Other studies (Hickling, Robertson-Hickling, & Paisley, 2011;Peluso & Blay, 2004) have reported significant reductions in negative attitudes toward the mentally ill since the 1980s, which Hickling et al (2011) attributed to the movement toward deinstitutionalization, notably in Jamaica.…”

“…Other studies (Hickling, Robertson-Hickling, & Paisley, 2011;Peluso & Blay, 2004) have reported significant reductions in negative attitudes toward the mentally ill since the 1980s, which Hickling et al (2011) attributed to the movement toward deinstitutionalization, notably in Jamaica. Peluso and Blay (2004) and Neckles et al (2012) both conducted in-depth reviews of the literature on Caribbean attitudes toward mental illness, but only Neckles et al (2012) confirmed the persistence of stigma, which includes the belief that mental illness results from an external demonic source now resident within the individual (Dudley-Grant, 2006;Gopaul-McNicol, 1997); that mental illness is narrowly defined to be primarily major psychosis, most often schizophrenia (Peluso & Blay, 2004;PAHO, 2011); and the ever-present fear of not only what a mentally ill person might do but also the subsequent stigma and discrimination that would transfer to family members (Arthur et al, 2008). These attitudes have the unfortunate consequence of delaying help-seeking behavior, as well as minimizing the long-term impact on the individual.…”

“…Johnson et al (2008) encourages the clinician to be aware of the cultural differences that can arise within the therapeutic interaction when the therapist, who may come from a different culture or socioeconomic class, may not share the same traditional beliefs and practices as the client and may even hold negative attitudes toward, for example, Voodoo and other native healing practices, seeing them as evil rather than healing. Neckles et al (2012) identified Protestant, Catholic, Christianity, and Judaism as the most commonly identified major world religions. Other religious practices were identified as Voodoo, Santeria, Obeah, and Espiritismo.…”