Mental health and psychiatry level 3

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Mental health and psychiatry level 3

Olivia Tiberi School of Medicine, Imperial College London Haiti, one of the poorest countries in the world, was devastated by an earthquake in Several interventions were carried out with aims to integrate mental health into primary health care services.

The interplay between socio-cultural beliefs and health both mental and physical in Haiti has been widely commented upon by both foreign aid and local caregivers. The perception of Haitian beliefs as barriers to the availability and acceptance of mental health care has intensified the difficulty in providing effective recommendations and interventions both before and after the earthquake.

These interactions, especially relevant in mental health care and post-disaster contexts, need to be acknowledged in any healthcare setting.

In Haiti, cultural, Vodou also spelled Voodoo and social beliefs help inform explanations of illness, especially mental illness, which is frequently attributed to supernatural forces such as spells, hexes or curses.

Mental health and psychiatry level 3

This aligns with a cosmocentric perspective, in which the individual is a member of a larger universe comprised of Iwa spiritsrelationships and the natural world. This can be compared to an anthropocentric perspective, whereby an individual views oneself as central and in control of their existence, including on matters of health and disease.

This consideration for delivering mental health care in a culturally competent manner can be applied beyond Haiti in the development of interventions in post-disaster circumstances and in low-income countries globally.

Background Haiti is a country located on the island of Hispaniola in the Caribbean with a population of more than ten million people. Over the years, these extreme weather events have led to the destruction of crops and infrastructure, internal displacement and the loss of many lives.

Unfortunately, the extreme level of poverty, weak buildings and poor emergency response has made the population increasingly susceptible to and unable to cope with the devastating effects of these events. To worsen the situation, in October of the same year the worst cholera outbreak in recent history killed approximately 7, people and infected overby There are four sectors in the Haitian health system that will be mentioned and discussed throughout this paper.

In a mixed non-profit sector, the private sector manages the care; however, the staff are paid by the public sector.

Mental health and psychiatry level 3

Mental Healthcare Provision After the Earthquake With inadequate resources and many structural and cultural barriers to the provision of care for the mentally ill, the burden of mental illness is frequently unrecognized and poorly addressed in low-income countries LICs.

Much of this was evident when foreign medical aid arrived in the acute aftermath of the disaster. NGOs providing acute care to those suffering from mental distress after the earthquake provided anecdotal evidence of this rising burden.

However, due to the lack of reporting and monitoring systems, the full extent of the problem was not quantified. Secondary outcomes arose as a consequence of exposure to forces of nature and disaster, but more chronic conditions such as depressive disorders and anxiety became the more significant causes of burden on the population in Comparing the percentages of total DALYs attributed to mental and substance use disorders reveals an increase in the mental health illness burden from 1.

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The distribution of various diagnoses observed in the psychiatric hospitals has been estimated by the WHO: With the addition of the cholera outbreak, many witnessed the deaths of loved ones. A study of families found that However, to obtain a general view of the effects, a population-based survey conducted two to four months following the earthquake among 1, people affected found prevalence rates of The rates of PTSD and depressive symptoms were found to be Symptoms of grief were very common, although difficult to disentangle normal from aberrant reactions.

Case Reports In the acute aftermath of the earthquake, the lack of resources and personnel pre-empted the implementation of a screening system, which limited the collection of data on those most affected by both the earthquake and various mental illnesses.

Mental health problems were considered secondary to the basic needs of food, water, emergency medical care, shelter and security. However, the need for psychological first aid and psychiatric treatment was apparent to humanitarian assistance efforts.

Additionally, those with pre-existing or past mental illness were found to be more vulnerable to secondary mental health effects of the earthquake. She cared for a woman who was suffering from phantom limb pain and panic attacks following an emergency amputation. Such an individual narrative was not unique; several reports conveyed misunderstandings and poor communication between patient and clinician in Haiti in the aftermath of the earthquake and emphasized the need for culturally competent mental health care.

With only about fifteen psychiatrists working in the public sector in all of Haiti before the earthquake, there was little support for those with mental illness. The global median number of mental health workers is 9 per , albeit with extreme variation between low-income and high-income countries.

Globally, there were Franklin Normil, the acting director of the Mars and Kline Psychiatric Center, relays a first-hand account of this in an interview with the New York Times: We have the desire and the ability, but they do not give us the means to be professional and humane.

We had barely any staff, and these are patients who could be rehabilitated if we had the means. To compare this again to a developed nation, this same figure stood at USD in France in with the percentage spent on mental hospitals of this standing at However, this situation is not unique to Haiti: A team of mental health experts led by Mental Health Director Giuseppe Raviola from Partners in Health PIHa non-profit global health care organization, and Zanmi Lasante, its sister organization in Haiti, overviewed the earthquake response from the perspective of mental health in a landmark paper published in Psychiatric Clinics of North America in Vodou and Mental Health: Implications for Care-Seeking Behaviors Although there are great variations present within the Vodou belief system around the world and Vodou is practiced to different extents in Haiti, it plays a nearly universal role in all aspects of Haitian life including politics, ethics and health.

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Psychiatry and psychology are overlapping professions. Practitioners in both -- psychiatrists and psychologists -- are mental health professionals. Their area of expertise is the mind -- and the. Why those with mental health problems are more likely to smoke.

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