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High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country

Author

Listed:
  • Eddy Eustache
  • Margaret E Gerbasi
  • Mary C Smith Fawzi
  • J Reginald Fils-Aimé
  • Jennifer Severe
  • Giuseppe J Raviola
  • Rupinder Legha
  • Sarah Darghouth
  • David J Grelotti
  • Tatiana Thérosmé
  • Ermaze L Pierre
  • Emmeline Affricot
  • Yoldie Alcindor
  • Anne E Becker

Abstract

Background: The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth. Aims: To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting. Methods: We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth ( n  = 120, ages 18–22 years) using a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID)-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments. Results: The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector, and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year. Conclusion: Findings demonstrate a high mental health burden among Haiti’s youth and that many youth with MDE and PTSD are not accessing mental health care.

Suggested Citation

  • Eddy Eustache & Margaret E Gerbasi & Mary C Smith Fawzi & J Reginald Fils-Aimé & Jennifer Severe & Giuseppe J Raviola & Rupinder Legha & Sarah Darghouth & David J Grelotti & Tatiana Thérosmé & Erma, 2017. "High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country," International Journal of Social Psychiatry, , vol. 63(3), pages 261-274, May.
    • Handle: RePEc:sae:socpsy:v:63:y:2017:i:3:p:261-274
    DOI: 10.1177/0020764017700174
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    References listed on IDEAS

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    1. Smith Fawzi, Mary C. & Eustache, Eddy & Oswald, Catherine & Louis, Ermaze & Surkan, Pamela J. & Scanlan, Fiona & Hook, Sarah & Mancuso, Anna & Mukherjee, Joia S., 2012. "Psychosocial support intervention for HIV-affected families in Haiti: Implications for programs and policies for orphans and vulnerable children," Social Science & Medicine, Elsevier, vol. 74(10), pages 1494-1503.
    2. Patricio V. Marquez, 2016. "Mental Health Among Displaced People and Refugees," World Bank Publications - Reports 25854, The World Bank Group.
    3. Lund, Crick & Breen, Alison & Flisher, Alan J. & Kakuma, Ritsuko & Corrigall, Joanne & Joska, John A. & Swartz, Leslie & Patel, Vikram, 2010. "Poverty and common mental disorders in low and middle income countries: A systematic review," Social Science & Medicine, Elsevier, vol. 71(3), pages 517-528, August.
    4. Keys, Hunter M. & Kaiser, Bonnie N. & Kohrt, Brandon A. & Khoury, Nayla M. & Brewster, Aimée-Rika T., 2012. "Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau," Social Science & Medicine, Elsevier, vol. 75(3), pages 555-564.
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