Understanding mental distress in Arcahaie, Haiti: Heterogeneous uses of idioms of distress in communicating psychological suffering

Research on mental health in specific communities requires careful attention to cultural context and language. Studies on global mental health have increasingly analyzed idioms of distress, or culturally situated ways of conceptualizing, experiencing, and expressing distress. This study examines how idioms of distress are used and understood in Arcahaie, Haiti. The goal was to enrich current understanding of mental health conceptualization and communication by exploring the heterogeneity of common idioms of distress. Interviews with community members ( N = 47) explored meanings and perceived causations of 13 idioms of distress. Major themes included pervasiveness of poverty, ruminative thinking, effects of Vodou and Christian belief systems, embodied distress, and the behavior of “crazy” people ( moun fou). The findings suggest some specific pathways for potential community engagement projects, including training lay-leaders in cognitive behavioral therapy using existing socioreligious infrastructure and expanding access to social engagement activities. This research contributes to a small but growing body of literature on mental illness in Haiti and to methods for studying idioms of distress.

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Global Mental Health and Idioms of Distress: The Paradox of Culture-Sensitive Pathologization of Distress in Cambodia

Culture Medicine and Psychiatry ◽

10.1007/s11013-018-9612-9 ◽

2018 ◽

Vol 43 (2) ◽

pp. 211-235 ◽

Cited By ~ 9

Author(s):

Carol A. Kidron ◽

Laurence J. Kirmayer

Keyword(s):

Mental Health ◽

Global Mental Health ◽

Idioms Of Distress

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Idioms of resilience: Mental health and migration in India

International Journal of Social Psychiatry ◽

10.1177/00207640211042916 ◽

2021 ◽

pp. 002076402110429

Author(s):

Raghu Raghavan ◽

Brian Brown ◽

Jonathan Coope ◽

Mark Crossley ◽

Muthusamy Sivakami ◽

...

Keyword(s):

Lived Experience ◽

Low Income ◽

Physical Environment ◽

Cultural Context ◽

Idioms Of Distress ◽

Community Members ◽

Middle Income ◽

Middle Income Countries ◽

And Migration ◽

The City

Background: Resilience has proved to be a versatile notion to explain why people are not defeated by hardship and adversity, yet so far, we know little of how it might apply to communities and cultures in low to middle income countries. Aim: This paper aims to explore the notion of resilience in cross-cultural context through considering the lived experience of internal migration. Methods: A sample of 30 participants with experience of migration was recruited from a low-income slum dwelling neighbourhood in the city of Pune, India. These individuals participated in biographical narrative interviews in which they were encouraged to talk about their experience of migration, their adaptation to life in their new environment and making new lives for themselves. Results: Participants referred to a variety of intra-individual and external factors that sustained their resilience, including acceptance of their circumstances, the importance of memory, hope for their children’s futures as well as kindness from family friends and community members and aspects of the physical environment which were conducive to an improvement in their lives. Conclusions: By analogy with the widely used term ‘idioms of distress’, we advocate attention to the locally nuanced and culturally inflected ‘idioms of resilience’ or ‘eudaemonic idioms’ which are of crucial importance as migration and movement become ever more prominent in discussions of human problems. The nature and extent of people’s coping abilities, their aspirations and strategies for tackling adversity, their idioms of resilience and eudaemonic repertoires merit attention so that services can genuinely support their adjustment and progress in their new-found circumstances.

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