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Culture, Medicine, and Psychiatry

, Volume 36, Issue 3, pp 514–534 | Cite as

Explanatory Models and Mental Health Treatment: Is Vodou an Obstacle to Psychiatric Treatment in Rural Haiti?

  • Nayla M. Khoury
  • Bonnie N. Kaiser
  • Hunter M. Keys
  • Aimee-Rika T. Brewster
  • Brandon A. KohrtEmail author
Original Paper

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.

Keywords

Vodou Spirit possession Haiti Explanatory models Treatment-seeking behavior Mental health 

Notes

Acknowledgments

The authors gratefully acknowledge the contributions of field research assistants Jerome Wilkenson, Jean Wilfrid, Lavard Anel, and Vincent Beker. The graduate researchers would like to thank our project mentors Craig Hadley, Kathy Kinlaw, Benjamin Druss, Chad Slieper, and Karen Hochman. The authors would like to thank Jean Cadet, Ralph Chery, Brian Gross, Lovia and Ralph Mondesir, and Lydia Odenat for their help with translations and data preparation. This study was supported by the Emory University’s Global Health Institute Multidisciplinary Team Field Scholars Award and the National Science Foundation Graduate Research Fellowship [grant number 0234618].

Conflict of interest

The authors have no conflicts of interest to declare.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Nayla M. Khoury
    • 1
  • Bonnie N. Kaiser
    • 2
  • Hunter M. Keys
    • 3
  • Aimee-Rika T. Brewster
    • 3
  • Brandon A. Kohrt
    • 4
    Email author
  1. 1.Emory University School of MedicineAtlantaUSA
  2. 2.Department of AnthropologyEmory UniversityAtlantaUSA
  3. 3.Rollins School of Public HealthEmory UniversityAtlantaUSA
  4. 4.Psychiatric Residency Training Program, Department of Psychiatry and Behavioral SciencesThe George Washington University Medical CenterWashingtonUSA

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