By Michael-Jane Levitan, Special Advisor, Office of Transformative Global Health
Dèyè mon gen mon
Behind the mountains, there are mountains
This popular Haitian proverb reminds us that there is more than what meets the eye. This is crucial for the work we are doing with spiritual leaders in Haiti; the main providers of mental health support. Exploring language, idioms, values, beliefs, and symbols is hugely important to better grasp cultural nuances and to appreciate the whole picture; mountains beyond mountains.
Towards peeling back these layers, we have been slowly establishing trust and building relationships with local community partners.
“Our aim is to have a collaboration, share experiences and see how do you assess, incorporate and improve the chances of people with mental illness like depression and psychosis, getting better, by working with spiritual leaders,” says Akwatu Khenti, Director of the Office of Transformative Global Health in a recent article on mental healthcare in Haiti.
In March 2015, our team returned to Port-au-Prince to ceremonially start an information sharing process on perspectives of mental health and support, mainly: cognitive behavioural therapy. Over the course of one week, we engaged with a number of groups, including: Catholic, Protestant and Vodou spiritual leaders, health professionals and community members.
“This project depends greatly on conceptions of the self; the Vodou concept of mind…It’s a different world and it has to be approached with care.” Ati Max Beauvoir, Chief Supreme of Haitian Vodou
Along these lines, we’re asking: What does emotional distress look like? What are the possible causes of distress? What types of support are offered? What does the word “depression” mean? What is the role of a spiritual leader in the community? How can we work together? What do you think about therapy?
For example, here are a few distinct attributions and symptom manifestations often seen in Haiti:
• Séizsman (seized-up-ness) is a common syndrome in Haiti that refers to paralysis brought on by rage, anger and sadness
• Reflechi twóp (thinking too much) is an idiom used to describe a condition characterized by isolation, sadness, hardship and suicidal thoughts
• Soulagement par dieu (relief through God) is considered a type of depression wherein symptoms of crying and sleeplessness are mediated by belief in God
These cultural insights will be integrated and blended with our intervention approach as part a Grand Challenges Canada seed grant.
The following set of images will introduce you to some key project partners and shed light on this important information sharing and cultural adaptation process.
As they say: “Men anpil chay pa lou”, or “Many hands make the load lighter”.
Stay tuned for more as we prepare for the next phase of this project set for this summer: training spiritual leaders in delivering culturally adapted CBT for depression.
Feel free to contact michaeljane.levitan@camh.ca for more information, or follow Akwatu Khenti on Twitter.
