Eddy Eustache1, Margaret E Gerbasi2, Mary C Smith Fawzi2, J Reginald Fils-Aimé1, Jennifer Severe2,3, Giuseppe J Raviola2,4,5, Rupinder Legha6, Sarah Darghouth7, David J Grelotti8, Tatiana Thérosmé1, Ermaze L Pierre1, Emmeline Affricot1, Yoldie Alcindor1, Anne E Becker2,7. 1. 1 Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti. 2. 2 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. 3. 3 Department of Psychiatry, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA. 4. 4 Partners In Health, Boston, MA, USA. 5. 5 Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA. 6. 6 Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA. 7. 7 Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 8. 8 Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
Abstract
BACKGROUND: The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth. AIMS: To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting. METHODS: We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth ( n = 120, ages 18-22 years) using a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID)-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments. RESULTS: The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector, and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year. CONCLUSION: Findings demonstrate a high mental health burden among Haiti's youth and that many youth with MDE and PTSD are not accessing mental health care.
BACKGROUND: The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth. AIMS: To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting. METHODS: We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth ( n = 120, ages 18-22 years) using a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID)-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments. RESULTS: The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector, and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year. CONCLUSION: Findings demonstrate a high mental health burden among Haiti's youth and that many youth with MDE and PTSD are not accessing mental health care.
Entities:
Keywords:
Haiti; Mental health treatment gap; low-income countries; mental health burden; youth
Authors: Susan P Walker; Theodore D Wachs; Julie Meeks Gardner; Betsy Lozoff; Gail A Wasserman; Ernesto Pollitt; Julie A Carter Journal: Lancet Date: 2007-01-13 Impact factor: 79.321
Authors: Fiona M Gore; Paul J N Bloem; George C Patton; Jane Ferguson; Véronique Joseph; Carolyn Coffey; Susan M Sawyer; Colin D Mathers Journal: Lancet Date: 2011-06-07 Impact factor: 79.321
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: Koen Demyttenaere; Ronny Bruffaerts; Jose Posada-Villa; Isabelle Gasquet; Viviane Kovess; Jean Pierre Lepine; Matthias C Angermeyer; Sebastian Bernert; Giovanni de Girolamo; Pierluigi Morosini; Gabriella Polidori; Takehiko Kikkawa; Norito Kawakami; Yutaka Ono; Tadashi Takeshima; Hidenori Uda; Elie G Karam; John A Fayyad; Aimee N Karam; Zeina N Mneimneh; Maria Elena Medina-Mora; Guilherme Borges; Carmen Lara; Ron de Graaf; Johan Ormel; Oye Gureje; Yucun Shen; Yueqin Huang; Mingyuan Zhang; Jordi Alonso; Josep Maria Haro; Gemma Vilagut; Evelyn J Bromet; Semyon Gluzman; Charles Webb; Ronald C Kessler; Kathleen R Merikangas; James C Anthony; Michael R Von Korff; Philip S Wang; Traolach S Brugha; Sergio Aguilar-Gaxiola; Sing Lee; Steven Heeringa; Beth-Ellen Pennell; Alan M Zaslavsky; T Bedirhan Ustun; Somnath Chatterji Journal: JAMA Date: 2004-06-02 Impact factor: 56.272
Authors: Elie G Karam; Matthew J Friedman; Eric D Hill; Ronald C Kessler; Katie A McLaughlin; Maria Petukhova; Laura Sampson; Victoria Shahly; Matthias C Angermeyer; Evelyn J Bromet; Giovanni de Girolamo; Ron de Graaf; Koen Demyttenaere; Finola Ferry; Silvia E Florescu; Josep Maria Haro; Yanling He; Aimee N Karam; Norito Kawakami; Viviane Kovess-Masfety; María Elena Medina-Mora; Mark A Oakley Browne; José A Posada-Villa; Arieh Y Shalev; Dan J Stein; Maria Carmen Viana; Zahari Zarkov; Karestan C Koenen Journal: Depress Anxiety Date: 2013-08-27 Impact factor: 6.505
Authors: Eddy Eustache; Margaret E Gerbasi; Jennifer Severe; J Reginald Fils-Aimé; Mary C Smith Fawzi; Giuseppe J Raviola; Sarah Darghouth; Kate Boyd; Tatiana Thérosmé; Rupinder Legha; Ermaze L Pierre; Emmeline Affricot; Yoldie Alcindor; David J Grelotti; Anne E Becker Journal: Int J Soc Psychiatry Date: 2017-04-03
Authors: David J Grelotti; Margaret E Gerbasi; Eddy Eustache; J Reginald Fils-Aimé; Tatiana Thérosmé; Jennifer Severe; Giuseppe J Raviola; Sarah Darghouth; Rupinder Legha; Ermaze L Pierre; Emmeline Affricot; Yoldie Alcindor; Katherine Boyd; Anne E Becker; Mary C Smith Fawzi Journal: Psychiatry Res Date: 2018-08-18 Impact factor: 3.222
Authors: Andreea Raluca Tirintica; Ivana Andjelkovic; Orela Sota; Mihail Cristian Pirlog; Maria Stoyanova; Adriana Mihai; Neal Wallace Journal: Int J Ment Health Syst Date: 2018-12-07
Authors: Rupinder K Legha; Margaret E Gerbasi; Mary C Smith Fawzi; Eddy Eustache; Tatiana Therosme; J Reginald Fils-Aime; Giuseppe J Raviola; Emmeline Affricot; Ermaze Louis Pierre; Yoldie Alcindor; Jennifer Severe; Katherine A Boyd; David J Grelotti; Sarah Darghouth; Andrew Rasmussen; Anne E Becker Journal: Confl Health Date: 2020-02-28 Impact factor: 2.723