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海地所谓的崩溃给跨国界带来的精神卫生负担:《海地幸福研究》的初步研究结果。

The transnational mental health burden of Haiti's alleged collapse: preliminary findings from The Haitian Well-Being Study.

机构信息

Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States.

Department of Psychology, University of Massachusetts, Boston, MA, United States.

出版信息

Front Public Health. 2024 Sep 27;12:1415650. doi: 10.3389/fpubh.2024.1415650. eCollection 2024.

Abstract

BACKGROUND

Transnational drug trafficking, political unrest, gang violence, and paramilitarism, which are pervasive in Haiti, have resulted in a mental health crisis for the broader Haitian community. This study explores the mental well-being of Haitians in Haiti and the United States by identifying barriers and facilitators to mental health through the lived experiences of men and women.

METHOD

Four Focus group discussions conducted in April and November 2023 engaged 28 participants (20 women and eight men) aged between 23 and 60 years from locations in Haiti (Port-au-Prince, Cite Soleil, Cayes, Cap-Haitien, Saint-Marc) and the United States. Discussions revolved around the definition of mental health, stressors, coping mechanisms, risk and protective factors, and barriers to mental health care.

RESULTS

Six principal themes emerged: 1- : continued violence, political instability, unemployment, lack of social support, adverse childhood experiences, family separation, and forced displacement were significant sources of stress. 2- : Participants reported experiencing chronic physical and psychological symptoms [i.e., hypertension, anxiety, depression, sleep issues, substance abuse, suicidal ideations, characteristics of post-traumatic stress disorder (PTSD)], which were attributed to Haiti's social, political, and infrastructure collapse. 3- : limited access to mental health services, pervasive hopelessness, scarcity of opportunities, and stigma were identified as significant risks. 4- : widespread concerns regarding the future predominated. 5- : Significant anxiety concerning the mental health and development of children, as well as the functionality of mental health practitioners, was noted. 6- : Effective coping strategies include mental stimulation, peer support, managing digital consumption, engaging in leisurely activities, such as listening to music, and faith/spirituality.

CONCLUSION

The study's findings underscore the sociopolitical and economic crisis in Haiti, which has resulted in violence and a dismantle of political, educational, financial, and health infrastructures. These factors were identified as the primary source of chronic distress, contributing to widespread mental health issues, adverse physical symptoms, and disruption in daily life. The implications for practice, healing, research & policy are discussed.

摘要

背景

跨国贩毒、政治动荡、帮派暴力和准军事组织在海地普遍存在,这导致更广泛的海地社区出现了心理健康危机。本研究通过男性和女性的生活经历,确定了海地和美国海地人心理健康的障碍和促进因素,以此探讨海地人的心理健康状况。

方法

2023 年 4 月和 11 月进行了 4 次焦点小组讨论,参与者共 28 人(20 名女性,8 名男性),年龄在 23 至 60 岁之间,来自海地(太子港、太阳城、卡伊、海地角、圣马克)和美国的不同地点。讨论围绕心理健康的定义、压力源、应对机制、风险和保护因素以及心理健康护理障碍展开。

结果

出现了 6 个主要主题:1- 持续的暴力、政治不稳定、失业、缺乏社会支持、不良的童年经历、家庭分离和被迫流离失所是重大的压力源。2- 参与者报告称经历了慢性身体和心理症状[即高血压、焦虑、抑郁、睡眠问题、药物滥用、自杀意念、创伤后应激障碍(PTSD)的特征],这些症状归因于海地社会、政治和基础设施的崩溃。3- 获得心理健康服务的机会有限、普遍感到绝望、机会稀缺和污名化被确定为重大风险。4- 对未来的普遍担忧占主导地位。5- 对儿童的心理健康和发展以及心理健康从业者的功能表示了极大的关注。6- 有效的应对策略包括刺激思维、同伴支持、管理数字消费、从事休闲活动,如听音乐和信仰/精神生活。

结论

研究结果强调了海地的社会政治和经济危机,这导致了暴力行为以及政治、教育、金融和卫生基础设施的瓦解。这些因素被确定为慢性困扰的主要来源,导致广泛的心理健康问题、不良的身体症状和日常生活中断。讨论了实践、治疗、研究和政策的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1da/11468857/91fa8f5ee81a/fpubh-12-1415650-g001.jpg

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