Explanatory models and mental health treatment: is vodou an obstacle to psychiatric treatment in rural Haiti?
ABSTRACT Vodou as an explanatory framework for illness has been considered an impediment to biomedical psychiatric treatment in rural Haiti by some scholars and Haitian professionals. According to this perspective, attribution of mental illness to supernatural possession drives individuals to seek care from houngan-s (Vodou priests) and other folk practitioners, rather than physicians, psychologists, or psychiatrists. This study investigates whether explanatory models of mental illness invoking supernatural causation result in care-seeking from folk practitioners and resistance to biomedical treatment. The study comprised 31 semi-structured interviews with community leaders, traditional healers, religious leaders, and biomedical providers, 10 focus group discussions with community members, community health workers, health promoters, community leaders, and church members; and four in-depth case studies of individuals exhibiting mental illness symptoms conducted in Haiti's Central Plateau. Respondents invoked multiple explanatory models for mental illness and expressed willingness to receive treatment from both traditional and biomedical practitioners. Folk practitioners expressed a desire to collaborate with biomedical providers and often referred patients to hospitals. At the same time, respondents perceived the biomedical system as largely ineffective for treating mental health problems. Explanatory models rooted in Vodou ethnopsychology were not primary barriers to pursuing psychiatric treatment. Rather, structural factors including scarcity of treatment resources and lack of psychiatric training among health practitioners created the greatest impediments to biomedical care for mental health concerns in rural Haiti.
- SourceAvailable from: Dan Joseph SteinNature 07/2011; 475(7354):27-30. · 38.60 Impact Factor
- JAMA The Journal of the American Medical Association 05/2010; 303(19):1976-7. · 29.98 Impact Factor
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ABSTRACT: In this article, the authors summarise the origins and development of traditional medicine cultures in the Latin American and Caribbean regions, beginning with an overview of terminology and definitions related to 'medicine' and 'medical systems'. A short look is taken at original medicine cultures and at how they syncretised with colonial European medicine to give birth to a mosaic of lay and traditional medicine practices still in evidence in the New World today. A review is then made of the latest and main bibliographic sources in traditional medicine for the region, which are then analysed briefly. The main body of the paper deals with the different research approaches to traditional medicine cultures of which seven are discussed here. The authors conclude by stressing the need for closing the gap between the social and medical sciences in order to reach a better understanding of the health needs of the population. Biology and culture are at the centre of the discussion between medicine and anthropology where two trends dominate, viz. the socio-cultural and the biomedical models. The main task for ethnomedical researchers in the Latin American region is to work towards the creation of a bio-sociocultural model in an attempt to enrich systems qualitatively in the development of more humane and efficient interventions, both in the clinical field as in the field of health policies and strategies.Social Science [?] Medicine 02/1985; 21(1):5-12. · 2.73 Impact Factor