Nou bezwen anpil chita (We will need many chairs):Perceptions of and attitudes towards suicide in rural Haiti Open Access

Abstract

Background Suicide is a complex, yet preventable public health problem resulting from the interaction of psychological, social, biological, and environmental factors. There are no published studies exploring suicidal behavior in the Haitian context, and few studies exploring local socio-cultural explanatory models of suicide outside of the western milieu. Purpose This study aimed to describe local cultural attitudes and models of suicide amongst healthcare professionals and community members to better inform future mental health and psychosocial services in rural Haiti. Methods Semi-structured in-depth interviews were conducted amongst 24 participants to determine norms, perceived causal pathways, and attitudes towards suicidal behavior. Participants were selected through purposive sampling of individuals who either worked as bio-medical health professionals within the community or were lay community members. Qualitative data analysis, based in grounded theory, addressed themes including suicide commonality, veracity of suicidal ideation claims, religious constructs related to suicide, and perceived causal factors and resources for suicide. Results Compared to community members, healthcare professionals were less likely to consider completed suicide a "common" and important issue. Completed suicide was commonly ascribed to a "sent spirit" from a Vodou priest. According to community respondents, completed suicides among women exclusively involved pesticide poisoning, while men chose sharp objects or hanging as their lethal method. Many suicide narratives identified common causes as strained love relationships, public shame, and extreme poverty. Respondents' accounts suggest that religious engagement is an important protective factor as well as a potential resource and target for future prevention programs. Conclusion Suicide appears to have different meanings in the clinical and lay context and this discrepancy requires further attention. There is an urgent need for additional research if the burden of suicide-related morbidity and mortality is to be appropriately addressed.

Table of Contents

Introduction

Introduction and Rationale Purpose Statement Research Questions Significance Statement List of Key Terms

Review of the Literature

Introduction Global Mental Health Epidemiology of Suicide Suicide Theory Culture and Suicide Suicide Interventions and Existing Prevention Efforts in LMICS Haitian History and Culture

Manuscript

Abstract Introduction Methods Findings Discussion Conclusion

Public Health Recommendations

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	suicide mental health Haiti
Committee Chair / Thesis Advisor	Winskell Enger, Kate, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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