Explanatory Models and Mental Health Treatment: Is Vodou an Obstacle to Psychiatric Treatment in Rural Haiti?
Explanatory Models and Mental Health Treatment: Is Vodou an Obstacle to Psychiatric Treatment in Rural Haiti?
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DOI：
10.1007/s11013-012-9270-2
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发表时间：
2012-09-01
影响因子：
1.7
通讯作者：
Kohrt, Brandon A.
中科院分区：
文献类型：
--
作者：
Khoury, Nayla M.;Kaiser, Bonnie N.;Kohrt, Brandon A.
一些学者和海地专业人员认为，伏都教作为疾病的解释框架是海地农村生物医学精神病治疗的一个障碍。根据这一观点，将精神疾病归因于超自然附身驱使个人寻求houngan-s（伏都教牧师）和其他民间从业者的照顾，而不是医生，心理学家或精神病学家。本研究探讨精神疾病的解释模式，调用超自然的因果关系是否会导致寻求民间医生和抵抗生物医学治疗。该研究包括31个半结构化的采访与社区领袖，传统治疗师，宗教领袖，和生物医学提供者，10个焦点小组讨论与社区成员，社区卫生工作者，健康促进者，社区领袖，和教会成员;和四个深入的个案研究的个人表现出精神疾病症状在海地的中央高原进行。受访者援引了多种解释精神疾病的模式，并表示愿意接受传统和生物医学从业人员的治疗。民间医生表示希望与生物医学提供者合作，并经常将病人转诊到医院。与此同时，受访者认为生物医学系统在治疗心理健康问题方面基本无效。植根于伏都教民族心理学的解释模型并不是寻求精神病治疗的主要障碍。相反，结构性因素，包括治疗资源稀缺和保健从业人员缺乏精神病学培训，对海地农村地区的精神健康问题的生物医学护理造成了最大的障碍。
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.